Nursing Facilities

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Chapter 1: General Information
Chapter 2: Provider Participation Requirements
Chapter 3: Member Eligibility
Chapter 4: Covered Services and Limitations
Chapter 5: Billing Instructions
Chapter 6: Utilization Review and Control
Chapter 7: Residents' Rights and Responsibilities
Chapter 8: Method for Establishing Payment Rates
Chapter 9: Nursing Facility Sanctions
Chapter 10: Appendix D: Instructions for Completing the Patient Intensity Rating System Review
Chapter 11: Appendix F: Nursing Facility Price-Based Payment Billing Guide
Chapter 12: Appendix H: Value Based Purchasing Program
Chapter 13: Brain Injury Services Case Management

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