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Welcome Aspirus Medicare Advantage Providers

Aspirus Health Plan’s clinical practice guidelines includes the primary source with a direct link to online content, modifications (if needed) for our unique populations, rationale for modifications and additional references if available.

Medical

Aspirus Health Plan, through the Quality Improvement Advisory and Credentialing Committee (QIACC), adopts medical clinical practice guidelines from nationally or locally recognized sources. Sources may include medical specialty societies and other professional organizations. The guidelines are based on reasonable medical evidence or a consensus on clinical treatment patterns by physicians in the selected field of practice.

Asthma, Diagnosis and Management (PDF) (Approval: September 27, 2022)
Primary Source: Global Initiative for Asthma

Diabetes in Adults, Type 2 Diagnosis and Management (PDF) (Approval: September 27, 2022)
Primary Source: American Diabetes Association

Management of Heart Failure in Adults (PDF) (Approval: September 27, 2022)
Primary Source: Journal of the American College of Cardiology (JACC)

Obesity in Adults Prevention and Management (PDF) (Approval: September 27, 2022)
Primary Source: American Academy of Family Physicians

Preventive Services Adults (PDF) (Approval: September 27, 2022)
Primary Source: American Academy of Family Physicians

Mental Health and Substance Use Disorder

Aspirus Health Plan adopted the following mental health clinical practice guidelines to support good decision-making by patients and clinicians, improve member health outcomes and meet NCQA accreditation standards. Adult guidelines are adopted from American Psychiatric Association (APA).

Management of Posttraumatic Stress Disorder and Acute Stress Disorder (PDF) (Approval: September 27, 2022)
Primary Source: Department of Veterans Affairs and Department of Defense

Treatment of Opioid Use Disorder (PDF) (Approval: September 27, 2022)
Primary Source: American Society of Addiction Medicine

Treatment of Patients with Major Depressive Disorder (PDF) (Approval: September 27, 2022)
Primary Source: American Psychiatric Association

Treatment of Patients with Schizophrenia (PDF) (Approval: September 27, 2022)
Primary Source: American Psychiatric Association

Treatment of Patients with Substance Use Disorders (SUD) (PDF) (Approval: September 27, 2022)
Primary Source: American Psychiatric Association