42 CFR §441.360
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
FFP for home and community-based services listed in § 440.181 of this subchapter is not available in expenditures for the following:
- (a)Services furnished in a facility subject to the health and welfare requirements described in § 441.352(a) during any period in which the facility is found not to be in compliance with the applicable State requirements described in that section.
- (b)The cost of room and board except when furnished as part of respite care services in a facility, approved by the State, that is not a private residence. For purposes of this subpart, “board” means three meals a day or any other full nutritional regimen. “Board” does not include meals, which do not comprise a full nutritional regimen, furnished as part of adult day health services.
- (c)The portion of the cost of room and board attributed to unrelated, live-in personal caregivers when the waiver beneficiary lives in the caregiver's home or a residence owned or leased by the provider of the Medicaid services (the caregiver).
- (d)Services that are not included in the approved State plan and not approved as waiver services by CMS.
- (e)Services furnished to beneficiaries who are ineligible under the terms of the approved waiver.
- (f)Services furnished by a provider when either the services or the provider do not meet the standards that are set by the State and included in the approved waiver.
- (g)Services furnished to a beneficiary by his or her spouse.