Evidence-Based Clinical Practice Guidelines Sample Clauses

Evidence-Based Clinical Practice Guidelines. Contractor shall adopt practice guidelines, specified in 42 CFR 438.236 (b), (c) and (d), that are based on valid and reliable clinical evidence or a consensus of healthcare professionals and that consider the needs of Members. Contractor shall adopt these practice guidelines in consultation with Contractor’s Participating Providers and shall review and update them periodically as appropriate. Contractor shall disseminate the practice guidelines to all affected Providers and, upon request, to Members, Potential Members or Member Representatives. Contractor’s decisions for utilization management, Member education, coverage of services, or other areas, to which the guidelines apply, must be consistent with the adopted practice guidelines.
Sample 1
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Related to Evidence-Based Clinical Practice Guidelines

  • Practice Guidelines 37.1. CONTRACTOR shall adopt practice guidelines (or adopt COUNTY’S practice guidelines) that meet the following requirements:

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