Look here for provider education including webinars, videos and other resources. Click a button below to find what you need!
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Claims Education
Clinical Practice Guidelines
Shared Decision Making Aids
Policies & Protocol
Training & Resources
iCare Family Care & Family Care Partnership Provider Resource
New Wisconsin Medicaid In Lieu of Service: Medically Tailored Meals
Dental Benefit Exception Guidelines (Medicare)
Durable Medical Equipment/Supplies (DME/DMS) Claims
Electronic Visit Verification Guide
EXL Provider Portal User Manual
*How to file LTC Claims Electronically
Mental/Behavioral Health & AODA Claims
Personal Care Worker (PCW) Claims
PCW Claims via iCare Provider Portal
Clinical Practice Guidelines Policy
Combating Fraud Waste and Abuse
Fraud Waste and Abuse - iCare Policy
HCBS Provider Rate Increase Updates
Links Regarding Adult Long Term Care Functional Screen
Member Rights - Family Care Partnership
Provider Portal Registration Guide
Provider Reference Manual - FCP
Home & Community-Based Services (HCBS) Settings Rule, Department of Health Services
*The HCBS settings rule free training code for Inclusa/iCare’s residential providers will be changing as of August 1, 2026 to INIC-SETTINGS-2. This promo code will be valid until December 31, 2026 or until all of the codes have been used. The use of funding for free training will be reevaluated by DHS later this year to determine if it will continue in 2027.
DHS has been thrilled with the number of providers that have completed this very useful training. We encourage residential providers to continue to register, include staff at each setting and complete the training so they are fully informed about the HCBS settings rule requirements.
DHS FAQ HCBS Settings Rule: FAQs, Wisconsin Department of Health Services
YouTube Videos:
HCBC Benchmarks
*In addition DHS has added the HCBS Settings Rule Modification Tool to assist providers in looking at HCBS questions.
If a residential provider has questions about the HCBS settings rule, please reach out to netdev@icarehealthplan.org.
Cultural Competency Training 1
Wisconsin Department of Health Services Trainings: https://www.dhs.wisconsin.gov/wppnt/index.htm
2025 - Jan. 9: Working with Identity: Cultural Humility to Cultural Relevance
Presenter: Shawn Smith
Materials: January 9, 2025 Presentation (PDF)
Recording: Working with Identity: Cultural Humility to Cultural Reverence January 9 2025 on Vimeo
2021 - April 8: Addiction, Culture, and Implicit Biases
Presenter: Yee Xiong, MD
Materials: Presentation (PDF)
Recording: View the recording
April 22: Cultural Humility and Implicit Bias in Mental Health Care
Presenter: Erri Hewitt, Ph.D.
Recording: View the recording
2022 - February 10: Suicide within the LGBTQ+ Community: Implications for Providers
Presenter: Will Hutter, PsyD, LMFT
April 14: Providing Care for Limited English Proficient Individuals: Working Effectively with Interpreters
Presenter: Shiva Bidar-Sielaff
November 10: I Don't See Color -- Real Tools for Becoming a More Culturally Responsive SUD Clinician
Presenter: Venesha Harden, CSAC, ICS
2023 - January 12: Culturally-Sensitive Approaches to Attachment Work with Families and Individuals
Presenter: Daniela Guerrero, MA, LPC
Visit X-Plain Health Encyclopedia for a library of health information and resources.
MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations. Materials linked below are produced by the federal government and therefore not copyrighted.
Printable versions in English & Spanish are available on Medline Plus for the following topics (click on hyperlinks):
Health Topics - symptoms, causes, treatment and prevention for over 1000 diseases, illnesses, health conditions and wellness issues
Medical Tests – what the test is, why it is ordered, how it will feel and what results mean
Healthy Recipes – recipes for healthy meals
Videos – animated videos to explain health and medicine topics
All Clinical Practice Guidelines recommended by iCare are based on national medical association and health organization
recommendations. While not inclusive for all possible clinical guidelines, they are aligned with national STAR inititative metrics
for MCO's.
American Society of Addiction Medicine. (2020) The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management . American Society of Addiction Medicine
Jophlin LL, et al., ACG Clinical Guideline: Alcohol-Associated Liver Disease. Am J Gastroenterol. 2024 Jan 1;119(1):30-54. doi: 10.14309/ajg.0000000000002572. Epub 2023 Sep 1. PMID: 38174913; PMCID: PMC11040545.
Children
American Academy Family Physicians
Anxiety Disorders in Children and Adolescents 2022 | AFP
Adults
American Academy of Family Physicians
Generalized Anxiety Disorders and Panic Disorder in Adults 2022
American Academy of Family Physicians
Attention Deficit/Hyperactivity Disorder: AAP Updates for Diagnosis and Management, 2020
American Academy of Pediatrics
Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents, 2019
American Academy of Pediatrics
Identification, Evaluation, and Management of Children With Autism Spectrum Disorder, 2020
Department of Veterans Affairs Department of Defense (VA/DoD)
VA/DoD Clinical Practice Guideline for the Diagnosis and Treatment of Low Back Pain, 2022
Behavior or conduct problems in children (oppositional defiant disorder)
Centers for Disease Control and Prevention: (CDC):
Behavior or Conduct Problems in Children, 2023
Department of Veterans Affairs/Department of Defense
Management of Bipolar disorder in Adults, 2023
Cardiovascular Disease Risk Predictor (Updated June 2026)
The American Heart Association PREVENT™ Online Calculator - Professional Heart Daily | American Heart Association
https://professional.heart.org/en/guidelines-and-sttements/prevent-calculator
Atrial fibrillation (new June 2025)
American College of Cardiology (ACC)/American Heart Association (AHA)/American College of Clinical Pharmacy (ACCP)/Heart Rhythm Society (HRSA)
ACC/AHA/ACCP/HRSA Joint Committee on Clinical Practice Guidelines: Guideline for the diagnosis and management of atrial fibrillation, 2023(opens in new window)
Heart failure
American Heart Association/American College of Cardiology/Heart Failure Society of America
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines(opens in new window)
Cardiovascular disease and stroke
American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Clinical Practice Guidelines
ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, 2019(opens in new window)
Valvular heart disease
American College of Cardiology (ACC)/American Heart Association (AHA) Joint Committee on Clinical Practice Guidelines Task Force
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
Lipids Management for Cardiovascular Disease Risk Reduction (2025) - VA/DOD Clinical Practice Guidelines
https://www.healthquality.va.gov/guidelines/CD/lipids/index.asp
Department of Veterans Affairs/Department of Defense (VA/DoD)
Clinical Practice Guideline for the Management of Chronic Multisymptom Illness, 2021
Infectious Diseases Society of America (IDSA) (New July 2024)
IDSA Guidelines on the Treatment and Management of Patients with COVID-19, 2025
Adolescents
American Academy of Pediatrics (AAP)
American Academy of Pediatrics Part 1 Guideline for Adolescent Depression in Primary Care (GLAD-PC), 2018(opens in new window)
American Academy of Pediatrics Part 2 Guideline for Adolescent Depression in Primary Care (GLAD-PC), 2018(opens in new window)
Adults
Department of Veterans Affairs Department of Defense (VA/DoD)
Managing Depression in Primary Care, 2020(opens in new window)
Depression across three age cohorts
American Psychological Association
APA Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts, 2019
American Diabetes Association (ADA)
Introduction and Methodology: Standards of Care in Diabetes—2026 | Diabetes Care | American Diabetes Association
Lifestyle Interventions for treatment and remission of type 2 diabetes and prediabetes in adults 2025
https://journals.sagepub.com/doi/full/10.1177/15598276251325488]
The Task Force on Global Guidelines for Falls in Older Adults
World Guidelines for Falls Prevention and Management for Older Adults: A Global Initiative, 2022
| Centers for Disease Control and Prevention (CDC) Stopping Elderly Accidents, Deaths, and Injuries (STEADI) 2025 |
| https://www.cdc.gov/steadi/hcp/clinical-resources/index.html] |
Department of Veterans Affairs/Department of Defense (VA/DoD)
VA/DoD Clinical Practice Guideline: Management of Headache, 2023
| Human Immunodeficiency Virus Medical Association (HIVMA) Infectious Disease Society of America (IDSA) |
| HIVMA/IDSA Primary Care Guidance for Providers Who Care for Persons With Human Immunodeficiency Virus: 2024 [url: https://www.idsociety.org/practice-guideline/primary-care-management-of-people-with-hiv/] |
| American Heart Association (AHA)/American College of Cardiology (ACC) /American Association Nurse Practitioners (AANP)/American Academy of Physician Associates (AAPA) /Association of Black Cardiologists (ABC)/American College of Clinical Pharmacy ACCP/ American College of Preventive Medicine (ACPM) /American Geriatrics Society (AGS0 /American Medical Association (AMA)/American Society of Preventive Cardiology (ASPC)/ National Medical Association (NMA) /Preventive Cardiovascular Nurses Association (PCNA)/Society of General Internal Medicine (SGIM) |
| Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines, 2025 |
| [url:https://www.ahajournals.org/doi/10.1161/CIR.0000000000001356] |
| American Academy of Family Physicians Adults 19 and Older Immunization Schedule 2025 |
| https://www.aafp.org/family-physician/patient-care/prevention-wellness/immunizations-vaccines/immunization-schedules/adult-immunization-schedule.html?] |
Adult
Adult Immunization Schedule by Age, Centers for Disease Control, 2025
Child
Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger
American Academy of Pediatrics (AAP), 2026
Women
| Journal of Women’s Health |
| Female Urinary Incontinence Evidence-Based Treatment Pathway: An Infographic for shared decision-making, 2022 |
Men
| National Institute for Health and Care Excellence (NICE) |
| Lower Urinary Tract Symptoms in Men, 2015 |
| National Kidney Foundation (NKF) (2026) |
| KDOQI Guidelines/Commentaries: American Journal of Kidney Diseases |
| Integration of Lifestyle Medicine into Primary Care: A comprehensive Review, 2026 |
| https://pmc.ncbi.nlm.nih.gov/articles/PMC12812067/ |
Forward Health Topic #7837. Anti-Obesity Drugs. Wisconsin Medicaid coverage of anti-obesity drugs
Children and Adolescents
| American Academy of Pediatrics |
| Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity, 2023 |
Adults
| Department of Veterans Affairs/Department of Defense |
| https://www.healthquality.va.gov/HEALTHQUALITY/guidelines/CD/obesity/index.asp |
American Psychiatric Association: (APA)
Treating Obsessive-Compulsive Disorder a Quick Reference Guide, 2007
Dosage reduction
Health and Human Services (HHS)
HSS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics, 2019
Prescribing
Centers for Disease Control and Prevention (CDC)
CDC Clinical Practice Guideline for Prescribing Opioids for Pain (CDC), 2022
Use in pregnancy
| American College of Obstetricians and Gynecologists (ACOG) |
| https://www.acog.org/clinical/guidance/committee-opinion/2017/08/opioid-use-and-opioid-use-disorder-in-pregnancy |
Adults
American Thoracic Society (ATS)
Home Oxygen Therapy for Adults with Chronic Lung Disease. An Official American Thoracic Society Clinical Practice Guideline, 2020(opens in new window)
Reprinted with permission of the American Thoracic Society.
Copyright ®2024 American Thoracic Society. All rights reserved.
Cite: Susan S. Jacobs, Jerry A Krishnan, David J Lederer, Marya Ghazipura, Tanzib Hossain, Ai-Yui M. Tan, Brain Carlin, M. Bradley Drummond, Magnus Ekstrőm, Chris, Garvey, Bridget A. Graney, Beverly Jackson, Thomas Kallstrom, Shandra L. Knight, Kathleen Lindell, Valentin Prieto-Centurion, Elissabetta A. Renzoni, Christopher J. Ryerson, Ann Schneidman, Jeffrey Swigris, Dona Upson, Anne E Holland,/2020/American Journal of Respiratory and Critical Care Medicine/Volume 202/Issue 10/e121-e141
The American Journal of Respiratory and Critical Care Medicine is an official journal of the American Thoracic Society.
Children
American Thoracic Society (ATS)
Home Oxygen Therapy for Children. An Official American Thoracic Society Clinical Practice Guideline, 2018(opens in new window)
Reprinted with permission of the American Thoracic Society.
Copyright ®2024 American Thoracic Society. All rights reserved.
Cite: Don Hayes Jr., Kevin C. Wilson, Katelyn Kirvchenia, Stephen M.M. Hawkins, Ian M. Balfour-Lynn, David Gozal, Howard B. Panitch, Mark L. Splaingard, Lawrence M. Rhein, Geoffrey Kurland, Steven H. Abman, Timothy M. Hoffman, Christopher L. Carrol, Mary E. Cataletto, Dmitry Tumin, Eyal Oren, Richard J. Martin, Joyce Baker, Gregory R. Porta, Deborah Kaley, Ann Gettys, Robin R. Deterding, /2018/American Journal of Respiratory and Critical Care Medicine/Volume 199/Issue 3/e5-e23
The American Journal of Respiratory and Critical Care Medicine is an official journal of the American Thoracic Society.
National Coalition for Hospice and Palliative Care
Clinical Practice Guidelines for Quality Palliative Care, 4th edition, 2018
Dent E, Morley JE, et.al. (2019). Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management. J Nutr Health Aging, 3(9):771-787. doi: 10.1007/s12603-019-1273-z.
Department of Veterans Affairs/Department of Defense (VA/DoD)
VA/DoD Clinical Practice Guidelines for the Management of Pregnancy, 2023
Children
American Academy of Pediatrics (AAP)
Recommendations for Preventive Pediatric Health Care – Bright Futures Periodicity Table, 2025(opens in new window)
All ages (USPSTF)
United States Preventive Services Task Force (USPSTF)
Prevention TaskForce Search
Women
The American College of Obstetricians and Gynecologists (ACOG)
Well-Woman Chart | WPSI
Asthma
| GINA © 2026 Global Initiative for Asthma.reprinted with permission. Available from www.ginasthma.org |
| Reports - Global Initiative for Asthma - GINA |
Chronic Obstructive Pulmonary Disease (COPD)
| Global Initiative for Chronic Obstructive Lung Disease (GOLD) |
| Global Strategy for the Prevention, Diagnosis and Management of COPD, 2026 Report |
Children and Adolescents (New July 2025)
American Academy of Child and Adolescent Psychiatry (AACAP)
Practice parameter for the assessment and treatment of children and adolescents with schizophrenia, 2019
Department of Veterans Affairs/Department of Defense (VA/DoD)
Management of First-Episode Psychosis and Schizophrenia, 2023
American Society of Hematology
Clinical Practice Guidelines on Sickle Cell Disease, 2024
|
||
| VA/DoD Clinical Practice Guidelines for the Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea (Insomnia/OSA), 2025 | ||
Children and adolescents
Substance Abuse and Mental Health Services Administration (SAMHSA) Advisory: Screening and Treatment of Substance Use Disorders among Adolescents (based on TIP 31-32) 2021(opens in new window)
Adults
Department of Veterans Affairs/ Department of Defense
Substance use Disorders in Adults, 2021
Children
American Academy of Pediatrics
Suicide and Suicide Risk in Adolescents, 2023/2024
Adults
Department of Veterans Affairs/Department of Defense
Assessment and Management of Patients at Risk for Suicide 2024
Centers for Disease Control and Prevention (CDC)
Sexually Transmitted Infections Treatment Guidelines: Syphilis, 2021
Digital health implementation playbook series, American Medical Association (AMA), 2024
ACOG statement
American College of Obstetricians and Gynecologists (ACOG) Statement
ACOG Committee Opinion Health Care for Transgender and Gender Diverse Individuals, 2024
Standard of care
World Professional Association for Transgender Health (WPATH)
Standards of Care for the Health of Transgender and Gender Diverse People, Version 8, 2023
Psychological care
American Psychological Association
APA Guidelines for Psychological Practice with Sexual Minority Persons, 2021
Women
Female Urinary Incontinence Evidence-Based Treatment Pathways: An Infographic for shared decision-making,
Journal of Women’s Health, 2022
Men
Lower Urinary Tract Symptoms in Men, National Institute for Health and Care Excellence (NICE), 2015
To be compliant with state and federal requirements, iCare, a Humana subsidiary, provides access to medical/behavioral health guidelines from well-respected sources. Inclusion of recommendations for specific testing and/or therapeutic interventions in the guidelines does not guarantee coverage. These guidelines are not coverage criteria. Additional information about coverage criteria may be found at Humana.com/coveragepolicies and in the member’s plan benefit documents. These guidelines are not a substitute for a physician’s or other healthcare professional's clinical judgment and are not always applicable to every individual. The physician or healthcare professional and patient should work in partnership in the decision-making process regarding the patient's treatment.
Information from the guidelines will not guarantee a specific outcome for each patient. None of the information in the guidelines is intended to interfere with or prohibit clinical decisions made by a treating physician or other healthcare professional regarding medically available treatment options for patients.
Links to other websites are provided for your convenience only and do not constitute or imply endorsement by iCare, a Humana subsidiary, of these sites, products or services described on these sites, or of any other material contained therein. iCare, a Humana subsidiary, disclaims responsibility for their content and accuracy.
Shared Decision Making Aids are tools for patients and clinicians to use that provide detailed, balanced, evidence-based information about competing treatment options - National Academy of Medicine
We'd love to hear from you! At iCare, we celebrate the successes of shared responsibility, and we're always looking to build partnerships that achieve health outcomes. That starts with open communication, and we make it easy for you to connect with the right people.
H2237_IC2203_M
Last Update Date 2/9/24
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