42 CFR § 438.816 - Expenditures for the beneficiary support system for enrollees using LTSS.

---
identifier: "/us/cfr/t42/s438.816"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 438.816 - Expenditures for the beneficiary support system for enrollees using LTSS."
title_number: 42
title_name: "Public Health"
section_number: "438.816"
section_name: "Expenditures for the beneficiary support system for enrollees using LTSS."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "C"
subchapter_name: "MEDICAL ASSISTANCE PROGRAMS"
part_number: "438"
part_name: "MANAGED CARE"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302."
regulatory_source: "67 FR 41095, June 14, 2002, unless otherwise noted."
cfr_part: "438"
---


# 438.816 Expenditures for the beneficiary support system for enrollees using LTSS.

State expenditures for the person or entity providing the services outlined in § 438.71(d) are considered necessary for the proper and efficient operation of the State plan and thus eligible for FFP only if all of the following conditions are met:

(a) Costs must be supported by an allocation methodology that appears in the State's approved Public Assistance Cost Allocation Plan in § 433.34 of this chapter.

(b) The costs do not duplicate payment for activities that are already being offered or should be provided by other entities or paid by other programs.

(c) The person or entity providing the services must meet the requirements in § 438.810(b)(1) and (2).

(d) The initial contract or MOA for services performed has been reviewed and approved by CMS.