​​​​​​​​​​​​​​Proposition 56 - Supplemental Payment for Physician Services

Back to Directed Payments - Proposition 56

The California Healthcare, Research and Prevention Tobacco Tax​ Act of 2016 (Proposition 56), passed by the voters in November 2016, increased the excise tax rate on cigarettes and electronic cigarettes, effective April 1, 2017, and other tobacco products effective July 1, 2017. The excise tax increased to $2.87 per pack of 20 cigarettes on distributors selling cigarettes in California with an equivalent excise tax rate increase on other tobacco products.

Beginning with the July 1, 2017 rating period, the state has directed Managed Care Plans (MCPs) to make enhanced supplemental payments to eligible provider types for the applicable CPT codes upon approval from CMS and receipt of funding. The enhanced supplemental payment is contingent upon the MCPs’ receipt of providers’ actual utilization for these codes reported through encounter data for SFY 2017-18 through CY 2023.

Please see the links to the supporting documentation for this program for each rating period:

SFY 2017-​18

• APL 18-010​
  
• SFY 2017-18 P56 Physician Services Directed Payment Preprint​
  
• SFY 2017-18 P56 Physician Services Directed Payment Approval Letter
  
• SFY 2017-2018 Directed Payment Evaluation
  

SFY 2018​-19

• APL 19-006
• SFY 2018-19 P56 Physician Services Directed Payment Preprint
• SFY 2018-19 P56 Physician Services Directed Payment Approval Letter
  
• SFY 2018-2019 Directed Payment Evaluation​ 
  

Bridge Period (July 1, 2019 – December 3​​1, 2020)

• ​APL 19-015​​
• Bridge Period P56 Physician Services Directed Payment Preprint
  
• Bridge Period P56 Physician Services Directed Payment Approval Letter
  

CY 20​21​

• ​CY 2021 P56 ​Physician Services Directed Payment Preprint​
• CY 2021 P56 Physician Services Directed Payment Approval Lette​r​​

CY 2022 

• ​CY 2022 P56 Physician Services Directed Payment Approval Letter
  
• CY 2022 P56 Physician Services Directed Payment Preprint​​

​​​​​​​​​​Resources ​​​​​​

• ​Proposition 56 Directed Payments Expenditures File Technical Guidance​ ​​
  
• Propostion 56 Managed Care Contact List​