Care Management for High-Risk Pregnancies (CMHRP)

The Care Management for High-Risk Pregnancies (CMHRP) program is the primary vehicle for delivering care management to pregnant women who may be at risk for adverse birth outcomes.

This program builds on the legacy model of care management for pregnant women administered in the local health departments since 1988. Through the years, the program name has changed, but the focus of care management services for pregnant recipients has remained the same.  

CMHRP will continue to be provided by Local Health Departments (LHDs). Medicaid will continue to support the partnership between LHD care managers and maternity care providers, delivering coordination of care and ensuring social drivers of health are addressed. 

A key feature of the program is the standardized Pregnancy Risk Screening tool used by obstetric provider to help identify Medicaid recipients at risk for an adverse birth outcomes and refer them to the CMHRP program. All pregnant Medicaid recipients will continue to receive a coordinated set of high-quality, clinical maternity services through the Pregnancy Management Program (Pregnancy Medical Home). 

Programmatic Guidance

The Program Guidance is used to assist Health Plans with providing additional resources that may be beneficial in managing CMHRP programs.

• Healthy Opportunities Pilot Program Guide for LHDs - Dec 8, 2022
  • Local Health Department Manual Healthy Opportunities Pilot Standard Terms and Conditions
• Program Guide: Management of High-Risk Pregnancies in Tailored Plan - Sept. 30, 2022
• Data Sharing Specification Requirements for CMARC-CMHRP - March 10, 2023 
• Companion Guide for Care Management Service Termination and Transfer of Service Process - Aug. 30, 2022
• Program Guide for Care Management of High- Risk Pregnancies and At-Risk Children in Managed Care - May 12, 2021

Forms

• CMHRP Request to Transfer Services - Aug. 26, 2022
• CMHRP Pregnancy Risk Screening Form English - Dec. 1, 2020 
• CMHRP Pregnancy Risk Screening Form Spanish - Dec. 1, 2020  
• CMHRP Community Referral Form Word (23 KB); PDF (176 KB) -  Sept. 1, 2019

Frequently Asked Questions

• NC Medicaid Managed Care Transformation: A Fact Sheet for CMARC and CMHRP Providers - Mar. 21, 2023

Additional Information

• NC Medicaid Pregnancy Management Program Clinical Policy
• North Carolina’s Care Management Strategy Under Managed Care
• CMHRP Contact Lists (The Primary and Secondary CMHRP Referral contact lists are updated monthly and can be found at: Under the manual section – Care Management for High Risk Pregnancies (CMHRP) Manual – 10. Contacts)