2026 Quality Assurance Reporting Requirements (QARR)

May 20, 2026

RE: Clarification #1 for Measurement Year (MY) 2026 Updates

Dear Colleague,

This letter contains information about the MY2026 Quality Assurance Reporting Requirements (QARR) Technical Specifications Manual, the MY2026 PLD File Specifications files, The MY2026 NYS QARR Value Set, and the MY2026 NYS QARR Medication List. The files are posted on our Managed Care Information for Health Plans page. The revised specifications should be used in the plans’ processing for MY2026 QARR.

This clarification includes the following changes made to the MY2026 QARR reporting requirements.

Change Version Version Date Section(s) Changed Change Summary
1 5/26/2026 QARR MY2026 Technical Specifications QARR Submission Required File date
  • Removed “Plan-lock” audited HEDIS data date to align with HEDIS specifications
2026 NYS Patient-Level Detail (PLD) File Specifications
  • Updated National Provider Identifier (NPI) invalid reporting threshold requirement.
Patient-Level Detail File (PLD) MY2026 Commercial Line of Business:
  1. Race
    • Stratification verbiage update: removed "Some" from "Some Other Race" to align with NCQA/HEDIS updates.
  2. Asian American Subgroups:
    • Added Middle Eastern or North African as a disqualifier to align with NCQA/HEDIS updates.
    • Removed "Some " from "Some Other Race" in element description to align with NCQA/HEDIS updates.
  3. Native Hawaiian/Pacific Islander Subgroups
    • Added Middle Eastern or North African as a disqualifier to align with NCQA/HEDIS updates.
    • Native Hawaiian/Pacific Islander Subgroups: Removed "Some " from "Some Other Race" in element description to align with NCQA/HEDIS updates.
  4. Middle Eastern or North African Subgroups
    • Added Middle Eastern or North African Subgroups field to align with NYS mandates.
Medicaid Line of Business:
  1. Race
    • Stratification verbiage update: removed "Some" from "Some Other Race" to align with NCQA/HEDIS updates.
  2. Asian American Subgroups:
    • Added Middle Eastern or North African as a disqualifier to align with NCQA/HEDIS updates.
    • Removed "Some " from "Some Other Race" in element description to align with NCQA/HEDIS updates.
  3. Native Hawaiian/Pacific Islander Subgroups
    • Added Middle Eastern or North African as a disqualifier to align with NCQA/HEDIS
    • Native Hawaiian/Pacific Islander Subgroups: Removed "Some " from "Some Other Race" in element description to align with NCQA/HEDIS updates.
  4. Middle Eastern or North African Subgroups
    • Added Middle Eastern or North African Subgroups field to align with NYS mandates.
Qualified Health Plans (QHP) Line of Business:
  1. Race
    • Stratification verbiage update: removed "Some" from "Some Other Race" to align with NCQA/HEDIS updates.
  2. Asian American Subgroups:
    • Added Middle Eastern or North African as a disqualifier to align with NCQA/HEDIS
    • Removed "Some" from "Some Other Race" in element description to align with NCQA/HEDIS updates.
  3. Native Hawaiian/Pacific Islander Subgroups
    • Added Middle Eastern or North African as a disqualifier to align with NCQA/HEDIS
    • Native Hawaiian/Pacific Islander Subgroups: Removed "Some " from "Some Other Race" in element description to align with NCQA/HEDIS updates.
  4. Middle Eastern or North African Subgroups
    • Added Middle Eastern or North African Subgroups field to align with NYS mandates.
MY2026 NYS QARR Value Set Updated Value Set codes to align with HEDIS/NYS updates
  • NYS POS Group 1 – added 1 code
  • NYS Stand Alone Visits – Added 3 codes, removed 1
  • NYS Stimulant – removed 32 codes
MY2026 NYS QARR Medication List NYS QARR Medication List has been added to the QARR Reporting guidelines webpage referenced above.

If there are any questions about the above edits, or if you find issues or have concerns with the MY2026 Technical Specifications manual or other documents, please email nysqarr@health.ny.gov.

Sincerely,

Paloma Luisi, MPH
Director, Bureau of Quality Measurement & Evaluation
Center for Applied Research and Evaluation
Office of Health Services Quality and Analytics

CC: R. Josberger
E. Nichols
C. Fan