In New York, the rate of opioid overdose deaths for women aged 18-44 tripled between 2010 and 2016. In response, the New York State Perinatal Quality Collaborative (NYSPQC) implemented the New York State (NYS) Opioid Use Disorder (OUD) in Pregnancy & Neonatal Abstinence Syndrome (NAS) Project based on the AIM Obstetric Care for Women with OUD patient safety bundle. The project began as a pilot in September 2018 with 14 birthing facilities participating and submitting data. The project has since expanded to include a total of 39 birthing facilities. The percentage of facilities that implemented a universal screening protocol for OUD increased from 21% in January 2019 to 73% in December 2021 among the 14 facilities participating in the pilot phase and from 33% in December 2020 to 86% in December 2021 among the 25 facilities participating in the expansion phase. The percentage of birthing people with OUD who received medication for opioid use disorder or behavioral health treatment during pregnancy increased from 72% to 93%, as reported by pilot phase facilities, and increased from 85% to 94%, as reported by expansion phase facilities. The NYSPQC continues to lead the NYS OUD in Pregnancy & NAS Project with webinars, educational opportunities, data collection and analysis, resource distribution, and clinical and quality improvement support.