Pinal/Gila LTC has developed and/or adopted clinical performance measures that are based on practice guidelines relevant to the members served. Steps taken to ensure that decision-making in the areas of utilization management are consistent with the adopted practice guidelines will be described for each measure, as well as the process used to consider the health needs of the members in adopting and/or developing performance measures.

P/GLTC reviews and evaluates practice guidelines through Peer Review Committee, MM/UM Committee, Quality Management Committee, and Pharmacy Benefit Manager Meetings as appropriate to the subject matter.