Guidelines for Care Decisions

The Alliance uses care guidelines from the company MCG Health to help review medical necessity for health service requests. MCG care guidelines are the protected intellectual property of MCG. The Alliance cannot share them without MCG’s permission.

MCG provides a tool that current and prospective Alliance members can use to view care guidelines that might affect them. The guidelines apply to Medi-Cal, TotalCare (HMO D-SNP) and IHSS members. Please note: you will not be able to print them.

Follow the steps below to view the guidelines.

Access Instructions

Step 1: Visit the MCG care guidelines webpage. Read the disclaimer and accept the terms and conditions.

Step 2: Fill out the User Information form.

Step 3: Complete the verification process to continue.

Step 4: Click on the arrow icon to expand the list of guidelines in the content group.

Step 5: Click on the guideline you want to view.