NCQA updates PCMH standards for 2027: What practices need to know
NCQA has updated its PCMH standards for 2027, focusing on care management changes. Practices should prepare now to align with new requirements.
1 min read
Mandi Diamond
:
Published
Updated
An important deadline is approaching for New York State Patient-Centered Medical Home-recognized practices. The Department of Health is requesting that all PCMH-recognized sites that submitted a Social Care Network (SCN) referral workflow attestation complete a practice type survey by Aug. 14.
Starting in 2026, NYS PCMH incentive enhancement payments are tied to quality reporting. Practices that wish to continue receiving enhanced payments, an additional $2 or $4 per member per month for assigned Medicaid managed care and Child Health Plus members, must meet reporting requirements and complete the necessary attestations.
To support quality measure evaluation, DOH is asking practices to confirm whether each site serves primarily adult, pediatric or adult and pediatric populations. The survey must be completed for each NYS PCMH-recognized site.
Sites that do not complete the survey may be classified as adult and pediatric, requiring reporting on all four required quality measures. You can email DOH if you have survey questions here.
Leaders should review the survey instructions carefully, especially when submitting information for multiple sites, to ensure all responses are completed before the deadline.
Need help understanding the requirements or maintaining your PCMH recognition and incentive payments? Refer to DOH's PCHM attestation FAQs.
NCQA has updated its PCMH standards for 2027, focusing on care management changes. Practices should prepare now to align with new requirements.
Prepare for the 2027 PCMH annual reporting cycle by reviewing key practices and leveraging shared opportunities for efficient documentation and...
Discover the key updates in NCQA PCMH Standards Version 11.1 and how they impact 2026 annual reporting for medical practices.