,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #aabf  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,april #aj1 #bjai ,mrs4
 ,capito 7= h]self1 ,ms4 ,/ab5[1 ,mr4   
,wick]1 & ,mr4 ,m55dez7 introduc$ !     
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to provide bett] c>e & outcomes =      
,am]icans liv+ ) ,alzheim]'s disease &  
relat$ dem5tias & _! c>egiv]s1 :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$s to ,get  
to an ,end 7,,*ange7 ,act ( #bjai4  7b7 
,table ( cont5ts ,! table ( cont5ts =   
?is ,act is z foll[s3 ,sec4 #a4 ,%ort   
title2 table ( cont5ts2 f9d+s4 ,sec4 #b4
 ,cognitive impairm5t detection b5efit 9
 ! ,m$ic>e annual wellness visit &      
initial prev5tive physical exam9ation4  
,sec4 #c4 ,m$ic>e quality paym5t        
program4 ,sec4 #d4 ,report to ,congress 

on implem5tation4  7c7 ,f9d+s ,congress 
f9ds ! foll[+3  7#a7 ,x is e/imat$ t    
#e1hjj1jjj million ,am]icans are liv+ ) 
,alzheim]'s disease 9 #bjai4 ,?is       
includes an e/imat$ #e1fjj1jjj 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 #ac1hjj1jjj     
,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 expect$ t ,alzheim]'s &     
relat$ dem5tias w co/ ,m$ic>e & ,m$icaid
 #aie1jjj1jjj1jjj4 ,by #bjej1 x is      
e/imat$ t ov]all ,alzheim]'s co/s w     
increase to m ?an #a1ajj1jjj1jjj1jjj4   
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 #b   
times m likely ?an ,:ite ,am]icans to h 
,alzheim]'s disease & o!r dem5tias4     
,lat9os are ab\t #aa_/b times m likely  
?an ,:ite ,am]icans to h ,alzheim]'s    
disease & o!r dem5tias4 ,accord+ to !   
,c5t]s = ,disease ,control1 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 ,! late/ sci5ce reveals
 !re are actions t c be tak5 bo? n[ &   
across ! lifespan ( an individual to    

help optimize bra9 heal?1 r$uce ! risk (
 cognitive decl9e1 & help mitigate      
symptoms4 ,!re are also important       
behavioral & social dim5sions t c\ld    
delay cognitive decl9e & build a        
resili5t bra94 ,= example1 a #bjaf /udy 
support$ by ! ,national ,in/itutes (    
,heal? f\nd t a diet high 9 natural     
plant-bas$ foods & limit$ 9 saturat$    
fats 0 associat$ ) r$uc$ cognitive      
decl9e4 ,a #bjag /udy publi%$ by !      
,lancet ,commission f\nd t physical     
activity _h a significant protective    
effect aga9/ cognitive decl9e4 ,a /udy  
support$ by ! ,national ,in/itutes (    
,heal? :i* 0 publi%$ 9 #bjah f\nd a     
connection betwe5 l[] blood pressure &  
decreas$ cognitive impairm5t4 ,an       
,am]ican ,academy ( ,neurology /udy     
rec5tly publi%$ f\nd t physical activity
 & cognitive activity 7 bo? associat$ ) 
r$uc$ risk ( total dem5tia4  7#g7 ,!re  
are evid5ce-bas$1 reliable1 & ,national 
,in/itutes ( ,heal?-id5tifi$ cognitive  
impairm5t detection tools t are         

available on ! ,alzheim]'s & ,dem5tia   
,res\rces website ( ! ,national         
,in/itute on ,ag+ t mu/ replace         
detection by direct obs]vation 9 !      
,m$ic>e ,annual visits & ,welcome to    
,m$ic>e visits4 ,! ,national ,in/itutes 
( ,heal?-id5tifi$ tools w all[ =        
appropriate foll[-up in/ead ( delay+    
diagnosis or imp$+ opportunities =      
pati5ts to access timely treatm5t       
options1 includ+ cl9ical trial          
p>ticipation4  7#h7 ,an e>ly1 docum5t$  
diagnosis1 communicat$ to ! pati5t &    
c>egiv]1 enables e>ly access to c>e     
plann+ s]vices & available m$ical &     
nonm$ical treatm5ts1 & optimizes !      
ability ( pati5ts to build a c>e team1  
p>ticipate 9 support s]vices1 & enroll 9
 cl9ical trials4  7#i7 ,african         
,am]icans repres5t #ac p]c5t ( ! ,unit$ 
,/ates population1 b only #e p]c5t (    
cl9ical trial p>ticipants1 & ,lat9os    
repres5t #ag p]c5t ( ! ,unit$ ,/ates    
population1 b less ?an #a 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#aj7 ,inability  
to id5tify eligible pati5ts at ! e>lie/ 
/ages ( disease is a sub/antial imp$im5t
 to effici5t rese>* t[>d ,alzheim]'s    
disease prev5tion1 treatm5t1 & cure4    
7#aa7 ,advanc+ treatm5t options to      
prev5t1 treat1 or cure ,alzheim]'s is an
 urg5t national priority4  7#ab7 ,a     
p>adigm %ift to drive syn]gies betwe5   
high-value pati5t c>e1 c>egiv] support1 
bra9 heal? promotion1 & rese>*          
initiatives is our be/ hope = prev5t+1  
treat+1 & cur+ ,alzheim]'s disease4  #b4
 ,cognitive impairm5t detection b5efit 9
 ! ,m$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 ! m$ical      
record ( ! pati5t2 &  7iii7 take into   
consid]ation ! tool us$1 & results (1   
any previ\sly p]=m$ cognitive impairm5t 
detection assessm5t4  2  7,b7 by mov+   
subp>agraphs 7,g7 & 7,h7 two ems to !   
left2  7,c7 by r$esignat+ subp>agraph   
7,i7 z subp>agraph 7,j72 &  7,d7 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 ins]t+      
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 aft] 
^u ! agreem5t ) ! individual14  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 ,act 7#db ,u4,s4,c4   
#acie et seq471 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 ! electronic heal? record ( !
 pati5t & 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 reg>d+1 ! pot5tial
 = cl9ical trial p>ticipation4  #d4     
,report to ,congress on implem5tation ,n
 lat] ?an #c ye>s aft] ! date ( !       
enactm5t ( ?is ,act1 ! ,secret>y (      
,heal? & ,human ,s]vices %all submit to 
,congress a report 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