Proposition 56 - Developmental Screening Services
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Directed Payments
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 Bridge Period (July 1, 2019 through December 31, 2020) rating period and January 1, 2020 dates of service, the state has directed Managed Care Plans (MCPs) to make enhanced supplemental payments to eligible provider types for the applicable Current Procedural Technology (CPT) code upon approval from Centers for Medicare & Medicaid Services (CMS) and receipt of funding. The Budget Act of 2021 authorized continued funding for developmental screening services payments past the December 31, 2021, sunset date. In addition, beginning July 1, 2022, the Budget Act of 2021 changed the source of the nonfederal share of the directed payments for developmental screenings to the state General Fund. Pursuant to State Plan Amendment (SPA) 21-0045, the developmental screening services program will become a benefit and will no longer by funded by Proposition 56 one the SPA receives CMS approval. The enhanced directed payment is contingent upon the MCPs' receipt of the providers' actual utilization for these codes reported through encounter data. for Bridge Period 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.
Bridge Period (July 1, 2019 – December 31, 2020)*
CY 2021 (January 1, 2021 - December 31, 2021)
CY 2022 (January 1, 2022 - December 31, 2022)
CY 2023 (January 1, 2023 - December 31, 2023)
CY 2024 (January 1, 2024 - December 31, 2024)
CY 2025 (January 1, 2025 - December 31, 2025)
Resources
*The effective data of the Developmental Screenings program was January 1, 2020, during the Bridge Period.
