I 

118TH CONGRESS 

2D SESSION H. R. 7267 

To amend title XIX of the Social Security Act to provide a temporary 

higher Federal medical assistance percentage for Federal expenditures 

under the Medicaid program that are associated with the cost of compliance with certain Federal regulations with respect to services furnished 

in certain intermediate care facilities or home and community-based 

services furnished to individuals with intellectual and developmental disabilities. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 7, 2024 

Mr. TONKO (for himself and Mr. FITZPATRICK) introduced the following bill; 

which was referred to the Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to provide 

a temporary higher Federal medical assistance percentage for Federal expenditures under the Medicaid program that are associated with the cost of compliance 

with certain Federal regulations with respect to services 

furnished in certain intermediate care facilities or home 

and community-based services furnished to individuals 

with intellectual and developmental disabilities. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Disability Community 

3 Act of 2023’’. 

4 SEC. 2. HIGHER FMAP FOR CERTAIN MEDICAID EXPENDI5 TURES ASSOCIATED WITH CERTAIN REGULA6 TION COMPLIANCE. 

7 (a) IN GENERAL.—Section 1903(a)(5) of the Social 

8 Security Act (42 U.S.C. 1396b(a)(5)) is amended— 

9 (1) by striking ‘‘an amount equal to’’ and in10 serting ‘‘(A) an amount equal to’’; 

11 (2) by striking ‘‘supplies;’’ and inserting ‘‘sup12 plies; and’’; and 

13 (3) by adding at the end the following: 

14 ‘‘(B) an amount equal to 90 percent of the sum 

15 of the amounts expended during a quarter in 2024, 

16 2025, or 2026, for items and services furnished in 

17 an intermediate care facility for the mentally re18 tarded or for home and community-based services 

19 furnished to individuals with intellectual and devel20 opmental disabilities, as the Secretary determines 

21 are attributable to compliance with any of the regu22 lations specified in— 

23 ‘‘(i) part 541.600 of title 29, Code of Fed24 eral Regulations; or 

25 ‘‘(ii) part 430, 431, 435, 436, 440, 441, or 

26 447 of title 42, Code of Federal Regulations;’’. 


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1 (b) CONFORMING TERMINOLOGY FOR INTERMEDIATE

2 CARE FACILITIES.—Title XIX of the Social Security Act 

3 (42 U.S.C. 1396 et seq.) is amended— 

4 (1) by striking ‘‘intermediate care facility for 

5 the mentally retarded’’ each time such term appears 

6 (including in headings) and inserting ‘‘intermediate 

7 care facility for individuals with intellectual and de8 velopmental disabilities’’; 

9 (2) by striking ‘‘intermediate care facilities for 

10 the mentally retarded’’ each time such term appears 

11 (including in headings) and inserting ‘‘intermediate 

12 care facilities for individuals with intellectual and 

13 developmental disabilities’’; 

14 (3) by striking ‘‘State mental retardation or de15 velopmental disability authority’’ each time such 

16 term appears and inserting ‘‘State intellectual or de17 velopmental disability authority’’; 

18 (4) in section 1905(d)— 

19 (A) in the matter before paragraph (1), by 

20 striking ‘‘thereof) for the mentally retarded or 

21 persons’’ and inserting ‘‘thereof) for individuals 

22 with intellectual or developmental disabilities 

23 or’’; 

24 (B) in paragraph (1), by striking ‘‘men25 tally retarded individuals’’ and inserting ‘‘indiVerDate Sep 11 2014 18:56 Feb 08, 2024 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H7267.IH H7267

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1 viduals with intellectual or developmental dis2 abilities’’; and 

3 (C) in paragraph (2), by striking ‘‘the 

4 mentally retarded individual’’ and inserting 

5 ‘‘the individual with an intellectual or develop6 mental disability’’; 

7 (5) in section 1915(c)(7)(C), by striking ‘‘men8 tal retardation’’ and inserting ‘‘intellectual or devel9 opmental disabilities’’; 

10 (6) in section 1919(b)— 

11 (A) in paragraph (3)— 

12 (i) in subparagraph (E), by striking 

13 ‘‘mentally retarded’’ and inserting ‘‘has in14 tellectual or developmental disabilities’’; 

15 and 

16 (ii) in subparagraph (F)— 

17 (I) in the heading, by striking 

18 ‘‘AND MENTALLY RETARDED INDIVID19 UALS’’ and inserting ‘‘INDIVIDUALS

20 AND INDIVIDUALS WITH INTELLEC21 TUAL OR DEVELOPMENTAL DISABIL22 ITIES’’; and 

23 (II) in clause (ii)— 

24 (aa) by striking ‘‘is mentally 

25 retarded’’ and inserting ‘‘has an 


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1 intellectual or developmental dis2 ability’’; and 

3 (bb) by striking ‘‘for mental 

4 retardation’’ and inserting ‘‘for 

5 intellectual or developmental dis6 abilities’’; 

7 (B) in paragraph (4)— 

8 (i) in subparagraph (A)(vii), by strik9 ing ‘‘mentally ill and mentally retarded 

10 residents’’ and inserting ‘‘residents who 

11 are mentally ill or who have intellectual or 

12 developmental disabilities’’; and 

13 (ii) in subparagraph (C)(ii)(IV), by 

14 striking ‘‘the mentally retarded’’ and in15 serting ‘‘individuals with intellectual or de16 velopmental disabilities’’; and 

17 (7) in section 1919(e)— 

18 (A) in paragraph (7)— 

19 (i) in subparagraph (A)(i), by striking 

20 ‘‘mentally ill and mentally retarded individ21 uals’’ and inserting ‘‘individuals who are 

22 mentally ill or who have intellectual or de23 velopmental disabilities’’; 

24 (ii) in subparagraph (B)— 


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1 (I) by striking ‘‘mental retarda2 tion’’ each place such term appears 

3 and inserting ‘‘intellectual or develop4 mental disability’’; 

5 (II) in clause (ii)— 

6 (aa) in the heading, by 

7 striking ‘‘MENTALLY RETARDED

8 RESIDENTS’’ and inserting ‘‘RESI9 DENTS WITH INTELLECTUAL OR

10 DEVELOPMENTAL DISABILITIES’’; 

11 and 

12 (bb) in the matter preceding 

13 subclause (I), by striking ‘‘is 

14 mentally retarded’’ and inserting 

15 ‘‘has an intellectual or develop16 mental disability’’; and 

17 (III) in clause (iii), by striking 

18 ‘‘mentally ill or mentally retarded 

19 resident’’ and inserting ‘‘resident who 

20 is mentally ill or who has an intellec21 tual or developmental disability’’; 

22 (iii) in subparagraph (C), by striking 

23 ‘‘mental retardation’’ each place such term 

24 appears and inserting ‘‘intellectual or de25 velopmental disability’’; 


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1 (iv) in subparagraph (E)— 

2 (I) by striking ‘‘are mentally re3 tarded or’’ and inserting ‘‘have intel4 lectual or developmental disabilities or 

5 are’’; and 

6 (II) by striking ‘‘mental retarda7 tion’’ and inserting ‘‘intellectual or de8 velopmental disability’’; and 

9 (v) in subparagraph (G)(ii)— 

10 (I) by striking ‘‘be ‘mentally re11 tarded’ ’’ and inserting ‘‘have ‘an in12 tellectual or developmental dis13 ability’ ’’; and 

14 (II) by striking ‘‘is mentally re15 tarded or a person with’’ and insert16 ing ‘‘has an intellectual or develop17 mental disability or’’. 

Æ 


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