F. Reasonableness of, and necessity for, skilled nursing care

Program payment may be made for skilled nursing services required by an individual only if they are found to be reasonable and necessary for the treatment of the individual's illness of injury. To be considered reasonable and necessary for the treatment of an illness or injury, the services furnished must be consistent with the nature and severity of the individual's illness or injury, their particular medical needs and accepted standards of medical practice.

Services directed to the prevention of illness or injury are not covered under the program.