,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #bbhc  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,april #aj1 #bjai,ms4 
,sn*ez 7= h]self1 ,mr4 ,la,hood1 ,ms4   
,matsui1 & ,mrs4 ,rodg]s ( ,wa%+ton7    
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to provide bett] c>e &        
outcomes = ,am]icans liv+ ) ,alzheim]'s 
disease & relat$ dem5tias & _! c>egiv]s 
:ile accel]at+ progress t[>d prev5tion  
/rategies1 disease modify+ treatm5ts1 &1
 ultimately1 a cure4  #a4 ,%ort title2  
table ( cont5ts2 f9d+s  7a7 ,%ort title 
,?is ,act may be cit$ z ! ,conc5trat+ on
 ,high-value ,alzheim]'s ,ne$s to ,get  
to an ,end ,act ( #bjai or ! ,,*ange    
,act ( #bjai4  7b7 ,table ( cont5ts ,!  
table ( cont5ts ( ?is ,act is z foll[s3 
,sec4 #a4 ,%ort title2 table ( cont5ts2 

f9d+s4 ,sec4 #b4 ,cognitive impairm5t   
detection b5efit 9 ! ,m$ic>e annual     
wellness visit & initial prev5tive      
physical exam9ation4 ,sec4 #c4 ,m$ic>e  
quality paym5t program4 ,sec4 #d4       
,report to ,congress on implem5tation ( 
?is ,act4 ,sec4 #e4 ,/udy & report on   
regulatory & legislative *anges or      
ref9em5ts t w\ld accel]ate ,alzheim]'s  
disease rese>* progress4  7c7 ,f9d+s    
,congress f9ds z foll[s3 7#a7 ,x is     
e/imat$ t #e4h million ,am]icans are    
liv+ ) ,alzheim]'s disease 9 #bjai4 ,?is
 includes an e/imat$ #e4f million p age 
#fe & old] & approximately #bjj1jjj     
individuals "u age #fe :o h y\ng]-onset 
,alzheim]'s4 ,by #bjej1 ! numb] ( p age 
#fe & old] ) ,alzheim]'s dem5tia is     
project$ to increase to #ac4h million   
,am]icans4  7#b7 ,z _m z half ( !       
e/imat$ #e1ajj1jjj ,am]ican s5iors )    
,alzheim]'s disease & o!r dem5tias h    
nev] receiv$ a diagnosis4  7#c7 ,9      
#bjai1 x is e/imat$ t ,alzheim]'s &     
relat$ dem5tias w h co/ ! ,m$ic>e &     

,m$icaid programs #aie billion4 ,by     
#bjej1 x is e/imat$ t ^! direct co/s w  
increase to z mu* z #a4a trillion4  7#d7
 ,alzheim]'s exacts an emotional &      
physical toll on c>egiv]s1 result+ 9    
high] incid5ce ( he>t disease1 canc]1   
depression1 & o!r heal? consequ5ces4    
7#e7 ,alzheim]'s disease                
disproportionately impacts wom5 & p (   
color4 ,wom5 are twice z likely to      
develop ,alzheim]'s z !y are brea/      
canc]4 ,african ,am]icans are ab\t two  
times m likely ?an ,:ite ,am]icans to h 
,alzheim]'s disease & o!r dem5tias4     
,lat9os are ab\t "o & "o-half times m   
likely ?an ,:ite ,am]icans to h         
,alzheim]'s disease & o!r dem5tias4     
,accord+ to ! ,c5t]s = ,disease ,control
 & ,prev5tion1 among p ages #fe & old]1 
,african ,am]icans h ! highe/ preval5ce 
( ,alzheim]'s disease & relat$ dem5tias 
7#ac4h p]c5t71 foll[$ by ,hispanics     
7#ab4b p]c5t71 & non-,hispanic ,:ites   
7#aj4c p]c5t71 ,am]ican ,indian &       
,alaska ,natives 7#i4a p]c5t71 & ,asian 

& ,pacific ,isl&]s 7#h4d p]c5t74 ,?is   
high] preval5ce translates into a high] 
dea? rate3 ,alzheim]'s dea?s increas$   
#ee p]c5t among all ,am]icans betwe5    
#aiii & #bjad1 :ile ! numb] 0 #ajg p]c5t
 = ,lat9os & #ii p]c5t = ,african       
,am]icans4  7#f7 ,!re are evid5ce-bas$1 
reliable1 & ,,nih-id5tifi$ cognitive    
impairm5t detection tools available at !
 ,national ,in/itute on ,ag+'s          
,alzheim]'s & ,dem5tia ,res\rces =      
,pr(essionals website t mu/ replace     
detection by direct obs]vation 9 !      
,m$ic>e ,annual visits & ,welcome to    
,m$ic>e visits4 ,! ,,nih-id5tifi$ tools 
w all[ = appropriate foll[-up in/ead (  
delay+ diagnosis or imp$+ opportunities 
= pati5ts to access timely treatm5t     
options1 includ+ cl9ical trial          
p>ticipation4  7#g7 ,an e>ly1 docum5t$  
diagnosis1 communicat$ to ! pati5t &    
c>egiv]1 enables e>ly access to c>e     
plann+ s]vices & available m$ical &     
nonm$ical treatm5ts1 & optimizes        
pati5ts' ability to build a c>e team1   

p>ticipate 9 support s]vices1 & enroll 9
 cl9ical trials4  7#h7 ,african         
,am]icans repres5t #ac p]c5t ( !        
population ( ! ,unit$ ,/ates b only #e  
p]c5t ( cl9ical trial p>ticipants1 &    
,lat9os repres5t #ag p]c5t ( !          
population ( ! ,unit$ ,/ates b less ?an 
"o p]c5t ( cl9ical trial p>ticipants4   
,fur!r1 ,lat9os & ,african ,am]icans    
acc\nt = only #c4e p]c5t & #a4b p]c5t1  
respectively1 ( pr9cipal inve/igators   
support$ by ! ,national ,in/itutes (    
,heal? fund+1 limit+ ?is p]spective 9   
rese>*4 ,bett] recruitm5t & trial       
designs are critical to address+        
innovation 9 ,alzheim]'s g5]ally1       
includ+ ! und]repres5tation ( ,african  
,am]icans & ,lat9os4  7#i7 ,inability to
 id5tify eligible pati5ts at ! e>lie/   
/ages ( disease is a sub/antial imp$im5t
 to effici5t rese>* t[>d ,alzheim]'s    
disease prev5tion1 treatm5t1 & cure4    
7#aj7 ,advanc+ treatm5t options to      
prev5t1 treat1 or cure ,alzheim]'s is an
 urg5t national priority4  7#aa7 ,a     

p>adigm %ift to drive syn]gies betwe5   
high-value pati5t c>e1 c>egiv] support1 
bra9 heal? promotion1 & rese>*          
initiatives is our be/ hope = prev5t+1  
treat+1 & cur+ ,alzheim]'s disease4  #b4
 ,cognitive impairm5t detection b5efit 9
 ! ,m$ic>e annual wellness visit &      
initial prev5tive physical exam9ation   
7a7 ,annual wellness visit  7#a7 ,9     
g5]al ,section #ahfa7;hhh77#b7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7hhh77#b77 is am5d$-- 7,a7 by     
/rik+ subp>agraph 7,d7 & ins]t+ !       
foll[+3  7,d7 ,detection ( any cognitive
 impairm5t or progression ( cognitive   
impairm5t t %all-- 7i7 be p]=m$ us+ a   
cognitive impairm5t detection tool      
id5tifi$ by ! ,national ,in/itute on    
,ag+ z meet+ its crit]ia = select+      
in/rum5ts to detect cognitive impairm5t 
9 ! prim>y c>e sett+1 & o!r validat$    
cognitive detection tools z ! ,secret>y 
det]m9es2  7ii7 include docum5tation ( !
 tool us$ = detect+ cognitive impairm5t 
& results ( ! assessm5t 9 ! pati5t's    

m$ical record2 &  7iii7 take into       
consid]ation ! tool us$1 & results (1   
any previ\sly p]=m$ cognitive impairm5t 
detection assessm5t4  2  7,b7 by        
r$esignat+ subp>agraph 7,i7 z           
subp>agraph 7,j72 &  7,c7 by ins]t+ aft]
 subp>agraph 7,h7 ! foll[+ new          
subp>agraph3  7,i7 ,ref]ral ( pati5ts ) 
detect$ cognitive impairm5t or pot5tial 
cognitive decl9e to-- 7i7 appropriate   
,alzheim]'s disease & dem5tia diagno/ic 
s]vices1 includ+ amyloid positron       
emission tomography1 & o!r m$ically     
accept$ diagno/ic te/s t ! ,secret>y    
det]m9es are safe & effective2  7ii7    
speciali/s & o!r cl9icians ) exp]tise 9 
diagnos+ or treat+ ,alzheim]'s disease &
 relat$ dem5tias2  7iii7 available      
community-bas$ s]vices1 includ+ pati5t &
 c>egiv] c\nsel+ & social support       
s]vices2 &  7iv7 appropriate cl9ical    
trials4  4  7#b7 ,effective date ,!     
am5dm5ts made by p>agraph 7#a7 %all     
apply to annual wellness visits furni%$ 
on or aft] ,janu>y #a1 #bjbj4  7b7      

,initial prev5tive physical exam9ation  
7#a7 ,9 g5]al ,section #ahfa7ww77#a7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciex7ww77#a77 is am5d$ by /rik+       
agreem5t ) ! individual1 & & ins]t+     
agreem5t ) ! individual1 detection ( any
 cognitive impairm5t or progression (   
cognitive impairm5t z describ$ 9        
subp>agraph 7,d7 ( subsection 7hhh77#b7 
& ref]rals z describ$ 9 subp>agraph 7,i7
 ( su* subsection1 &4  7#b7 ,effective  
date ,! am5dm5ts made by p>agraph 7#a7  
%all apply to initial prev5tive physical
 exam9ations furni%$ on or aft] ,janu>y 
#a1 #bjbj4  #c4 ,m$ic>e quality paym5t  
program ,n lat] ?an ,janu>y #a1 #bjbj1 !
 ,secret>y ( ,heal? & ,human ,s]vices   
%all implem5t ,m$ic>e policies "u title 
,,xviii ( ! ,social ,security ,act1     
includ+ quality measures & ,m$ic>e      
,advantage plan rat+ & risk adju/m5t    
me*anisms1 t reflect ! public heal?     
imp]ative (--  7#a7 promot+ heal?y bra9 
life/yle *oices2  7#b7 id5tify+ &       
respond+ to pati5t risk factors =       

,alzheim]'s disease & relat$ dem5tias2 &
  7#c7 inc5tiviz+ provid]s =-- 7,a7     
adequate & reliable cognitive impairm5t 
detection 9 ! prim>y c>e sett+1 t is    
docum5t$ 9 ! pati5t's electronic heal?  
record & communicat$ to ! pati5t2  7,b7 
timely ,alzheim]'s disease diagnosis2 & 
7,c7 appropriate c>e plann+ s]vices1    
includ+ id5tification (1 & communication
 ) pati5ts & c>egiv]s ab\t1 ! pot5tial =
 cl9ical trial p>ticipation4  #d4       
,report to ,congress on implem5tation ( 
?is ,act ,n lat] ?an #c ye>s aft] ! date
 ( ! enactm5t ( ?is ,act1 ! ,secret>y ( 
,heal? & ,human ,s]vices %all submit a  
report to ,congress on ! implem5tation (
 ! provisions (1 & am5dm5ts made by1 ?is
 ,act1 includ+--  7#a7 ! increas$ use ( 
validat$ tools = detection ( cognitive  
impairm5t & ,alzheim]'s disease2  7#b7  
utilization ( ,alzheim]'s disease       
diagno/ic & c>e plann+ s]vices2 &  7#c7 
outrea* ef=ts 9 ! prim>y c>e & pati5t   
communities4  #e4 ,/udy & report on     
regulatory & legislative *anges or      

ref9em5ts t w\ld accel]ate ,alzheim]'s  
disease rese>* progress  7a7 ,9 g5]al ,!
 ,comptroll] ,g5]al ( ! ,unit$ ,/ates 79
 ?is section ref]r$ to z ! ,comptroll]  
,g5]al7 %all conduct a /udy on          
regulatory & legislative *anges or      
ref9em5ts t w\ld accel]ate ,alzheim]'s  
disease rese>* progress4 ,9 conduct+ su*
 /udy1 ! ,comptroll] ,g5]al %all consult
 ) int]e/$ /akehold]s1 includ+ indu/ry  
lead]s1 rese>*]s1 cl9ical exp]ts1 pati5t
 advocacy gr\ps1 c>egiv]s1 pati5ts1     
provid]s1 & ,/ate lead]s4 ,su* /udy %all
 include an analysis ( innovative       
public-private p>tn]%ips1 innovative    
f9anc+ tools1 inc5tives1 & o!r me*anisms
 to enhance ! quality ( c>e =           
individuals diagnos$ ) ,alzheim]'s      
disease1 r$uce ! emotional1 f9ancial1 & 
physical burd5 on familial c>e p>tn]s1 &
 accel]ate developm5t ( prev5tative1    
curative1 & disease-modify+ !rapies4    
7b7 ,report ,n lat] ?an #a ye> aft] !   
date ( ! enactm5t ( ?is ,act1 !         
,comptroll] ,g5]al %all submit to       

,congress a report conta9+ ! results ( !
 /udy conduct$ "u subsection 7a71 toge!r
 ) recomm5dations = su* legislation &   
adm9i/rative action z ! ,comptroll]     
,g5]al det]m9es appropriate4