Proposition 56 – Family Planning Services
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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 Bridge Period (July 1, 2019 through December 31, 2020) 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 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 2019-20 through each CMS approved rating period.
These supplemental payments for Medi-Cal family planning services are intended to help support the larger Medi-Cal population in accessing and using family planning services as well as the providers delivering such services in the Medi-Cal program.
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)
- Bridge Period P56 Family Planning Services Directed Payment Preprint
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Bridge Period P56 Family Planning Services Directed Payment Approval Letter
- Bridge Period P56 Family Planning Services Program Evaluation
CY 2021 (January 1, 2021 – December 31, 2021)
- CY 2021 P56 Family Planning Services Directed Payment Preprint
- CY 2021 P56 Family Planning Services Directed Payment Approval Letter
- CY 2021 P56 Family Planning Services Directed Payment Evaluation Report
CY 2022 (January 1, 2022 – December 31, 2022)
- CY 2022 P56 Family Planning Services Approval Package
- CY 2022 P56 Family Planning Services – Attachment 1 – Prop 56 State Directed Fee Schedules
- CY 2022 P56 Family Planning Services – PY3 – CY 2022 – Attachment 2 – Prop 56 Family Planning Evaluation Plan
- CY 2022 P56 Family Planning Services – PY3 – CY 2022 – Attachment 3 – Prop 56 Family Planning Risk Corridor
- CY 2022 P56 Family Planning Services – CY 2022 – Medi-Cal 438.6(c) Prop 56 Table 2
- CY 2022 P56 Family Planning Services Evaluation Report
CY 2023 (January 1, 2023 – December 31, 2023)
- CY 2023 P56 Family Planning Services Combined Package
- CY 2023 P56 Family Planning Services Approval Letter
- CY 2023 P56 Family Planning Services Evaluation Report