(1) The department uses the criteria listed in this rule to specify the chronic conditions included in the disease management program and the age groups eligible to participate. Conditions and age groups are subject to change as clinical practices and evidenced-based health care practice guidelines change. The following criteria are used:

(a) disease management program services improve client self-management, decrease medical service utilization and costs, or improve clinical measures and health outcomes;

(b) the existing clinical practice for the condition varies from evidence-based health care best practice guidelines;

(c) the prevalence of the condition in the Medicaid population is sufficient to warrant management;

(d) a client with the condition is able to understand and apply condition specific management techniques; and

(e) management of the condition does not clinically conflict with other co-morbidities.