Section 1181.1. Policy

Section 1181.2. Definitions

Section 1181.21. Scope of benefits for the categorically needy

Section 1181.22. Scope of benefits for the medically needy

Section 1181.23. Scope of benefits for State Blind Pension recipients

Section 1181.24. Scope of benefits for qualified Medicare beneficiaries

Section 1181.25. Scope of benefits for General Assistance recipients

Section 1181.41. Provider participation requirements

Section 1181.41a. Dual participation requirements for Medicare and MA Programs—statement of policy

Section 1181.42. Additional participation requirements for hospital-based nursing units

Section 1181.43. Additional participation requirements for intermediate care facilities for the mentally retarded

Section 1181.44. Additional participation requirements for State-operated nursing facilities other than intermediate care facilities for the mentally retarded

Section 1181.45. Ongoing responsibilities of providers

Section 1181.51. General payment policy

Section 1181.52. Payment conditions

Section 1181.53. Payment conditions related to the recipient’s initial need for care

Section 1181.54. Payment conditions related to the recipient’s continued need for care

Section 1181.55. General limitations on payment

Section 1181.56. Limitations on payment for reserved beds

Section 1181.56a. Limitations on payment for reserved beds—statement of policy

Section 1181.56b. Charges for bed hold days—statement of policy

Section 1181.56c. Reimbursement for hospital reserved bed days during a Medicare benefit period—statement of policy

Section 1181.57. Limitations on payment for prescription drugs

Section 1181.58. Limitations on payment during strike or disaster situations requiring patient evacuation

Section 1181.58a. [Reserved]

Section 1181.59. Payment to a nursing facility for heavy care/intermediate services or intermediate care provided in a dually certified skilled bed

Section 1181.60. Utilizing Medicare as a resource

Section 1181.61. Services included in the interim per diem rate

Section 1181.61a. Nurse-aide programs—statement of policy

Section 1181.62. Noncompensable services

Section 1181.63. Method of payment

Section 1181.64. Cost reporting

Section 1181.65. Cost-finding

Section 1181.66. Setting ceilings on allowable net operating costs

Appendix A. CEILINGS ON NET OPERATING COST REIMBURSEMENT FOR GENERAL AND COUNTY NURSING FACILITIES

Section 1181.67. Setting interim per diem rates

Section 1181.68. Upper limits of payment

Section 1181.69. Annual adjustment

Section 1181.71. Annual reporting

Section 1181.72. Interim reporting

Section 1181.73. Final reporting

Section 1181.74. Auditing requirements related to cost reports

Section 1181.75. Auditing requirements related to patient fund management

Section 1181.81. Scope of claims review procedures

Section 1181.82. Review of need for admission

Section 1181.83. Inspections of care

Section 1181.84. Facility course of action

Section 1181.85. Facility utilization review requirements

Section 1181.86. Provider misutilization

Section 1181.91. Failure to file a cost report

Section 1181.92. Failure to maintain adequate records

Section 1181.93. Failure to correct deficiencies

Section 1181.94. Failure to adhere to certification requirements

Section 1181.95. Failure to adhere to medical evaluation requirements

Section 1181.96. Failure to comply with requirements of maintaining patient’s funds

Section 1181.101. Facility’s right to a hearing