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Get all documents related to guidelines in an easily downloadable format here.

Clinical Practice Guidelines

Find up-to-date clinical guidelines for cardiology, diabetes, physical/behavioral health, respiratory, and women’s health as well as preventive and immunization guidelines for adult and pediatric care.

Learn About Our Clinical Practice Guidelines

Quality Assurance Guidelines

Find UPMC Health Plan’s guidelines related to quality assurance including complaints & grievances, HIPAA, member rights & responsibilities, and more.

Learn About Quality Assurance Guidelines

EPSDT Clinical & Operational Guidelines

Find UPMC Health Plan’s guidelines for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) requirements here.

Learn About EPSDT Clinical & Operational Guidelines