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OFFICE OF HEALTH POLICY

Informational Bulletin

Revised

February 29, 2012

The Office of Health Policy (OHP) is issuing this informational bulletin to clarify the use of secondary sources to be used when Massachusetts Treatment Guidelines are not in existence or do not apply for a particular diagnosis. The following secondary sources are acceptable treatment guidelines to be consulted when conducting utilization review on Massachusetts claims:

Treatment Guidelines developed by other states, American College of Occupational and Environmental Medicine (ACOEM), McKesson’s InterQual, Genex Clinical Guidelines Tool, Milliman Care Guidelines, and Official Disability Guidelines (ODG).

Treatment Guidelines developed by other states should be considered before other listed secondary sources.

Internal Guidelines should be developed in accordance with the OHP requirements on an as needed basis.

Diane M. Neelon

Diane M. Neelon, RN, BSN, JD

Director, Office of Health Policy

Director’s Designee

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PHILIP L. HILLMAN

Director

1 Congress Street, Suite 100

Boston, Massachusetts 02114-2017

TIMOTHY P. MURRAY

Lieutenant Governor

DEVAL L. PATRICK

Governor

THE COMMONWEALTH OF MASSACHUSETTS

Department of Industrial Accidents

DIA/OHP

IB 104

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