CA SB186

Renames the "Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program" to the "Medi-Cal Physicians and Dentists Loan Repayment Program" and extends its operation indefinitely by removing the January 1, 2026 sunset date.

Establishes the Medi-Cal Loan Repayment Program Special Fund in the State Treasury to receive funds from the California Electronic Cigarette Excise Tax Fund and managed care plan remittances for noncompliance with the 85% medical loss ratio requirement.

Creates the Workforce and Quality Incentive Program for skilled nursing facilities contracting with Medi-Cal managed care plans, targeting $280,000,000 in performance-based directed payments for 2023 with annual increases through 2026.

Extends the Medi-Cal Long-Term Care Reimbursement Act operative period from December 31, 2022 to December 31, 2026, establishing maximum annual rate increases for 2023-2026 and creating penalties up to $150,000 per facility for noncompliance with specified quality measures.

Requires skilled nursing facilities that received increased Medicaid payments during the COVID-19 Public Health Emergency to spend at least 85% of those revenues on additional labor costs, with recoupment of amounts not meeting this threshold through facility payment withholding.