Proposition 56 - Adverse Childhood Experiences
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Directed PaymentsThe 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) codes upon approval from Centers for Medicare & Medicaid Services (CMS) and receipt of funding. The Budget Act of 2021 authorized continued funding for the ACE Screening (ACEs) 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 trauma screenings to the state General Fund. Pursuant to State Plan Amendment (SPA) 21-0045, the ACEs program will become a benefit, and it will no longer be funded by Proposition 56. The enhanced directed payment is contingent upon the MCPs' receipt of providers' actual utilization for these codes reported through encounter data for SFY 2019-20 through each CMS approved rating period.
For any managed care questions regarding this program, please reach out to DHCS Prop56DP team at Prop56DP@dhcs.ca.gov.
Bridge Period (July 1, 2019 - December 31, 2020)*
Please note: Per 42 CFR 438.6, minimum fee schedules approved by the State Plan Amendment (SPA) no longer require preprint approval; therefore, DHCS will no longer be requesting directed payment authority from CMS on an annual basis outside of the SPA process.
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* The effective date of the ACEs program was January 1, 2020, during the Bridge Period.
