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Proposition 56

Voters approved Proposition 56 — the California Healthcare, Research and Prevention Tobacco Tax Act — in November 2016. Proposition 56 increased the excise tax rate on cigarettes, electronic cigarettes and other tobacco products. In 2017, Assembly Bill 120 was passed to appropriate these Proposition 56 funds for directed Department of Health Care Services (DHCS) health care expenditures. Learn more about Proposition 56 and how to send any concerns, issues or questions to Aetna Better Health® of California. 

All Plan Letters (APLs)

All Plan Letters (APLs) from DHCS govern the distribution of Proposition 56 funds and date back to 2017. Primary distribution includes supplemental payments to providers and facilities. Each APL includes details about:

  • Covered services

  • Funding amounts

  • Effective dates for programs  

  • Guidelines for payments 

  • Requirements for qualification

APL 19-013 (PDF): Proposition 56 Hyde reimbursement requirements for specified services

APL 19-015 (PDF): Proposition 56 directed payments for physician services (supersedes APL 19-006)

APL 19-016 (PDF): Proposition 56 directed Payments for developmental screening services

APL 19-018 (PDF): Proposition 56 directed payments for adverse childhood experiences screening services

APL 20-014 (PDF): Proposition 56 value-based payment program directed payments

APL 22-011 (PDF): Proposition 56 directed payments for family planning services (supersedes APL 20-013)

APL 22-021 (PDF): Proposition 56 Behavioral Health Integration Incentive Program

Who is eligible for Proposition 56 supplemental payments?

Any professional provider eligible to bill for the applicable services included in any of the APLs governing Proposition 56 funds.

Is anyone excluded from Proposition 56 supplemental payments?

In general, services rendered in these settings are excluded from Proposition 56 supplemental payments:

  • Federally Qualified Health Centers (FQHCs)

  • Rural Health Centers (RHCs)

  • Cost Based Reimbursement Clinics (CBRCs)

  • Indian Heath Setting (IHS)

When are Proposition 56 supplemental payments effective?

The effective dates and periods for Proposition 56 payments vary, depending on the APL governing their distribution.

What is the payment amount for Proposition 56 and how will I know which codes to bill for a Proposition 56 supplemental payment?

The eligible (qualified) procedure codes and corresponding supplemental payment amounts vary based on the specific guidelines for each APL.

Who do I contact if I have not received my payment?

We’re waiting to hear from you. You can email us.

More information

Learn more about Proposition 56 supplemental payments (PDF).

Contact us

Email us anytime with questions.

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