Practice Guidelines

Preventive and clinical practice guidelines are based on the health needs and opportunities for improvement identified as part of the Quality Assurance Program Improvement (QAPI) program. Whenever possible, PA Health & Wellness adopts preventive and clinical practice guidelines that are published by nationally recognized organizations or government institutions as well as state-wide collaborative and/or a consensus of healthcare professionals in the applicable field.

These guidelines are intended to clarify standards and expectations for providers. They should not:

  • Come before the providers’ responsibility to provide treatment based on the participant’s individual needs.
  • Substitute as orders for treatment of a participant.
  • Guarantee coverage or payment for the type or level of care proposed or provided.

Pennsylvania Health and Wellness has adopted the evidence based guidelines published by the National Guideline Clearinghouse.