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

Back to Directed Payments​ | Fee-For-Service Supplemental Payment​​​

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 State Fiscal Year (SFY) 2017-18 rating period, the state has directed Managed Care Plans (MCPs) to make enhanced supplemental payments to eligible provider types for the applicable Current Procedural Technology (CPT) codes upon approval from Centers for Medicare & Medicaid Services (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 each CMS approved rating period.

For any managed care questions regarding this program, please reach out to the Proposition 56 Directed Payment team at Prop56DP@dhcs.ca.gov.

​ SFY 2017/2018 (July 1, 2017 - June 30, 2018)

• ​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​/2019 (July 1, 2018 - June 30, 2019)

• 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)

• ​​Bridge Period P56 Physician Services Directed Payment Preprint
• Bridge Period P56 Physician Services Directed Payment Approval Letter
  
• Bridge Period P56 Directed Payment Evaluation​
  

CY 20​21​ (January 1, 2021 - December 31, 2021)

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

CY 2022 (January 1, 2022 - December 31, 2022)

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

CY 2023 (January 1, 2023 - December 31, 2023)

• ​​​CY 2023 P56 Physician Services Directed Payment Combined Package​

​​​​​​​​​​Resources ​​​​​​

• Proposition 56 Directed Payments Expenditures File Technical Guidance​​ ​​
• Proposition 56 Managed Care Contact List​
• APL 18-010
  
• APL 19-006
  
• ​APL 19-015​
• ​APL 23-019​