New York State Medicaid Perinatal Care Standards 2026 Update
IMPACTED LOBS: Medicaid, HARP, HIV-SNP
Effective as of February 1st, 2026
Dear MetroPlusHealth Provider,
New York State Medicaid has recently updated Perinatal Care Standards to establish comprehensive, statewide requirements for the delivery of care to pregnant and postpartum individuals, replacing prior 2022 standards and applying to all Medicaid providers and managed care plans involved in prenatal, labor/delivery, and postpartum services. These standards emphasize that care must be high-quality, person-centered, and evidence-based, aligning with national clinical guidelines (such as American College of Obstetricians and Gynecologists (ACOG) and American Academy of Pediatrics (AAP)) and promoting a cohesive, coordinated care experience across all provider types.
Medicaid Perinatal Care Standards
- Provider Practice Guiding Principles
- Principal Maternal Care Provider
- Access to Care
- Presumptive Eligibility / Medicaid Coverage
- Comprehensive Prenatal Care Risk Assessment and Approach
- Care Plan
- Coordination of Care
- Home Visits
- Initial and Comprehensive Postpartum Visits Provided by the Principal Maternal Care Provider
- Breastfeeding/Chestfeeding
The updated standards create a goal of delivering equitable, comprehensive, and coordinated perinatal care that improves maternal and infant health outcomes. Please visit the website for Medicaid Perinatal Care Standards for further guidance.
We appreciate your continued cooperation and commitment to our members. If you have any questions regarding this notice, please contact MetroPlusHealth at: 800.303.9626 or [email protected].