The National Institutes of Health states, “Having a healthy pregnancy is one of the best ways to promote a healthy birth. Getting early and regular prenatal care improves the chances of a healthy pregnancy.” A healthy mom and baby is the top priority of our Mom’s GEMS Prenatal Program. Mom’s GEMS (Getting Early Maternity Services) Prenatal Program helps to ensure that expecting members get proper prenatal care and education on how to promote a healthy pregnancy and healthy baby. Mom’s GEMS’ will give your patients guidance by helping them with:

• Education on importance of keeping all Ob/Gyn routine visits
• Help coordinating access to specialists, or other doctors
• Case/Care management services – Nurses and Social Workers
• Transportation through LogistiCare
• Nutrition advice
• Breastfeeding guidance

What providers need to do

As part of this program, Horizon NJ Health requires obstetricians or other approved licensed health care providers, including nurse midwives, to complete the Division of Medical Assistance and Health Services’ (DMAHS) uniform Perinatal Risk Assessment (PRA) forms.

Providers will not be reimbursed for prenatal services without a submitted PRA form. Please follow the steps below to submit the PRA forms.

• Complete and submit the Initial Visit PRA form for all patients at the first prenatal visit. Forms should be entered and submitted within three business days. The responses on the Initial Visit PRA forms are used to risk-stratify our members into our GEMS Care Management Program.
• Complete and submit a Follow-up PRA form to update information provided in the Initial Visit PRA form. The Follow-up PRA form should be submitted anytime there is an insurance change, and when any risk factors or other patient information changes.
• New: Complete and submit a Third Trimester PRA form when the patient is 30 to 36 weeks gestation.

All prenatal care providers must be registered with Family Health Initiatives (FHI) in order to access PRA|SPECT. Register online at praspect.org or call 1-856-665-6000. New users must register by calling FHI at 1-856-665-6000 or emailing PRA@FHIWorks.org. PRA forms are submitted by logging into praspect.org.

Personalized pregnancy information with the BabyGEMS app