Provider Support Helping Members

Prenatal Program

Maternity Management Prenatal Program

When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. That is why we encourage all of our moms-to-be to take part in our New Baby, New LifeSM program — a comprehensive case management and care coordination program that offers:

  • Individualized, one-on-one case management support for women at highest risk
  • Please see our flier on managing pregnant women with high-risk conditions.
  • Care coordination for moms who may need a little extra support
  • Educational materials and information on community resources
  • Incentives to keep up with prenatal and postpartum checkups and well-child visits after the baby is born

An important component of the prenatal program is the early identification of pregnant women. When you know a patient is pregnant, complete the Pregnancy Notification Report Form (PNR) immediately after the patient’s visit and return it to us by fax at 1-855-410-4451.

All identified pregnant women are automatically included in the New Baby, New LifeSM program. An OB high risk assessment to determine the level of case management support mom may need during her pregnancy is completed. A prenatal packet is sent that includes information on planning a healthy pregnancy, resources related to pregnancy, information on the importance of prenatal visits, and other related topics and incentive offerings for attending prenatal visits.

Once your patient delivers, she will also receive a postpartum packet with information on postpartum care, well-child care, postpartum depression, and other related topics and incentive offers for attending their postpartum visit within 21-56 days and for well-child visits in the first 15 months. In addition, our program offers your patient prenatal, breastfeeding, and parenting classes through referrals to local community classes. We will also remind her to get a postpartum exam and give her a gift card incentive when she gets the exam within 21 to 56 days after childbirth.

Prenatal Toolkit
Steps to take for primary care physicians and obstetricians
  1. Confirm a diagnosis of pregnancy for the Medi-Cal Managed Care (Medi-Cal) member.
  2. Introduce the member to the Comprehensive Perinatal Services Program (CPSP). Advise what services are available and document acceptance or refusal.
  3. If the patient accepts CPSP, you can provide the services or refer the patient to a provider who offers CPSP. Keep copies of CPSP assessments in the patient’s medical record.
  4. Health and Safety Code Section 125107 requires prenatal care providers to offer HIV counseling and testing to pregnant women. Per the law, documentation that patients were offered HIV counseling, testing and information is required. Therefore, document counseling, testing and results in patient medical records. See Assembly Bill (AB) 682 (Berg) for more information.1
  5. Providers should refer all pregnant and breastfeeding members enrolled in Medi-Cal to the Women, Infants, and Children (WIC) Special Supplemental Nutrition Program in their area.
  6. Refer the patient to our Health Education department by email at to learn about prenatal, breastfeeding or childbirth classes in your area.
  7. You may complete a Pregnancy Notification Form and fax to 1-855-410-4451.
  8. If you are an OB/GYN, you may use the Availity Portal to report prenatal and postpartum care to Anthem Blue Cross (Anthem).
  9. Offer influenza and tetanus, diphtheria and pertussis (Tdap) vaccines to pregnant members to protect the mother and baby.2
  10. If the patient’s pregnancy becomes high-risk at any time during her prenatal care, please notify Anthem by fax using the Case Management Referral Form.
  11. If patients have general questions about lactation or breastfeeding, please refer them to the 24/7 NurseLine at 1-800-224-0336. A registered nurse is available 24/7 to answer questions.

1 Office of AIDS, California Department of Public Health.
2 Public Health Service, Centers for Disease Control and Prevention (CDC).


Breastfeeding Promotion

Anthem Blue Cross (Anthem) supports the Department of Health Care Services policy (MMCD Policy Letter 98-10) regarding the promotion, education, counseling and provision of medically necessary breastfeeding services.*

  1. Breastfeeding is recognized as the preferred method of infant feeding by the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists, and the American Public Health Association.
  2. Breastfeeding should be encouraged for all pregnant women unless it is not medically appropriate.
  3. Providers should refer all pregnant and breastfeeding Medicaid-eligible women to the Women, Infants, and Children (WIC) Special Supplemental Nutrition Program in their area.
  4. Pregnant members should be referred to Anthem’s Health Education department prior to delivery for assistance connecting to breastfeeding resources. Please contact
  5. Providers should not provide formula samples, coupons or materials from infant formula companies to members who are pregnant or breastfeeding.
  6. All materials given to patients should be screened for negative or contradictory messages about breastfeeding.
  7. Lactation management aids are covered by Anthem for Medi-Cal Managed Care members. The process to obtain a lactation management aid may vary by the member enrollment type (for example, Fee-for-Service or Capitated group). Three lactation aid devices are available: the hand-held manual breast pump, standard electric nonhospital-grade (single user) pump in alternating current and/or direct current (AC and/or DC) and hospital-grade pump rentals (AC and/or DC).
    • Hand-held breast pumps (nonelectric) can be obtained via prescription without prior authorization.
    • Both nonhospital-grade (single user) pumps (AC and/or DC) and hospital-grade pump rentals (AC and/or DC) are only provided if medically necessary. Review Clinical UM Guideline CG-DME-35 for more information.
    • Find more information about lactation management aids here.
  8. If the mother is unable to breastfeed due to medical reasons and the infant cannot tolerate or has medical contraindications to the use of any formula (including elemental formula), you must arrange for the provision of human milk for the newborn. The Mothers’ Milk Bank of Santa Clara Valley may be contacted at 1-877-375-6645.
  9. If a patient has general questions about lactation or breastfeeding, please refer the patient to the 24/7 NurseLine at 1-800-224-0336. A registered nurse is available 24/7 to answer questions.

* Department of Health Care Services, State of California Health and Welfare Agency. MMCD Policy Letter 98-10.

Importance of Breastfeeding

  • Human milk is uniquely suited for human infants.
  • Human milk is easy to digest and contains all the nutrients that babies need in the early months of life.
  • Breast milk contains factors that help infants grow and mature.
  • Factors in breast milk protect infants from a wide variety of illnesses.
  • Breast milk contains antibodies specific to illnesses encountered by each mother and baby.
  • Fatty acids, unique to human milk, may play a role in infant brain and visual development.
  • In several large studies, children who have been breastfed had a small advantage over those who have been artificially fed when given a variety of cognitive and neurological tests, including measures of IQ.

Breastfeeding saves lives.

  • Lack of breastfeeding is a risk factor for sudden infant death syndrome (SIDS).
  • Human milk may protect premature infants from life-threatening gastrointestinal disease.

Breastfeeding infants are healthier.

  • Infants who are exclusively breastfed for at least 4 months are half as likely as artificially (milk or milk substitute other than mothers’ milk) fed infants to have ear infections in the first year of life.
  • Breastfeeding reduces the incidence and lessens the severity of bacterial infections such as meningitis, lower respiratory infections, and bacteremia in infants.
  • Breastfeeding is protective against infant botulism.
  • Evidence suggests that exclusive breastfeeding for at least two months protects susceptible children from Type I insulin dependent diabetes mellitus (IDDM).
  • Breastfeeding may reduce the risk for subsequent inflammatory bowel disease and childhood lymphoma.
  • Breastfed infants are less likely to have diarrhea.
  • Women who were breastfed as a child are less likely to develop multiple sclerosis.

Breastfeeding helps mothers recover from childbirth.

  • Breastfeeding helps the uterus shrink to its pre-pregnancy state and reduces blood loss after delivery.
  • Mothers who breastfeed for at least three months may lose more weight than bottle-feeding mothers.
  • Breastfeeding mothers usually resume their menstrual cycles 20 to 30 weeks later than bottle-feeding moms.

Breastfeeding keeps women healthier throughout their lives.

  • Breastfeeding reduces the risk of breast and ovarian cancer.
  • Breastfeeding may reduce the risk of osteoporosis.
  • During lactation, total cholesterol, LDL cholesterol, and triglyceride levels decline while the beneficial HDL cholesterol level remains high.

Breastfeeding is economical.

  • The cost of artificial milk has increased 150 percent since the 1980s.
  • If no California infants were breastfed, the cost of artificial baby milk would exceed $400 million per year.
  • Breastfeeding reduces health care costs.

Breastfeeding is environmentally sound.*

  • Unlike artificial baby milk, breastfeeding requires no fossil fuels for its manufacture or preparation.
  • Breastfeeding reduces pollutants created as by-products during the manufacture of plastics and artificial baby milk.
  • Breastfeeding reduces the burden on our landfills.

*Breastfeeding Promotion Committee Report to the California Department of Health Services Primary Care and Family Health

Women, Infants, and Children (WIC) Program

The California Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a supplemental food and nutrition education program. It serves low-income pregnant, breastfeeding, and postpartum women, and infants and young children who are at nutritional risk.

The purpose of the WIC program is to prevent health problems and to improve the health of program participants during critical times of growth and development. It is unique among federally administered food assistance programs because it provides specific supplemental nutritious food and nutrition education to a specific target population as an adjunct to ongoing health care.

The WIC prescreening tool link below can be used to determine if a member may be eligible for WIC benefits. This prescreening tool is not an application for WIC. To apply for WIC benefits, you must make an appointment at your WIC local agency.

Referral forms can be requested from local WIC agencies or by calling the State WIC Branch at 1-888-942-9675.

If you would like more information about breastfeeding, our Prenatal Program or prenatal education

please contact Anthem Blue Cross Provider Services at
1-888-285-7801 in Los Angeles County, or 1-800-407-4627 in all other California counties
, and ask for the Prenatal Project Coordinator.