Medicare AdvantageAdministrativeMedium impact
[Ohio] Updated Clinical Practice Guidelines Released
CareSource·GA, OH, NV, NC, WV, WI · Cardiology, Internal Medicine, Infectious Disease +2 more·Provider Bulletin
We identified it
Sep 11, 2026
Summary
CareSource has updated and approved five new Clinical Practice Guidelines (CPGs) effective immediately covering hypertension, blood cholesterol, coronary artery disease, hepatitis C, and maternal/postpartum care. These evidence-based guidelines will be used to measure member health outcomes and inform clinical care delivery across multiple CareSource plans in Georgia, Ohio, Nevada, North Carolina, West Virginia, and Wisconsin.
Action Required
Immediately: Providers should review the updated Clinical Practice Guidelines published on the CareSource Health Links page, particularly in the following clinical areas: hypertension management, dyslipidemia/blood cholesterol management, coronary artery disease, hepatitis C testing and management, and maternal/postpartum care. Update clinical protocols and documentation practices to align with these nationally accepted ACC/AHA and AASLD-IDSA standards. Billing teams should ensure that claims submitted for services in these areas reflect adherence to the newly approved guidelines, as CareSource will use guideline compliance to measure outcomes and quality metrics. Contact CareSource Provider Services if clarification is needed on guideline implementation for your specific state/plan.