,,ii #aagth ,,congress #ast ,session ,s4 #afib ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #ai1 #bjba,mrs4 ,capito 7for herself1 ,ms4 ,stabenow1 ,mr4 ,wicker1 and ,mr4 ,menendez7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to provide better care and outcomes for ,americans living with ,alzheimer's disease and related dementias and their caregivers1 while accelerating progress toward prevention strategies1 disease modifying treatments1 and1 ultimately1 a cure4 #a4 ,short title2 table of contents2 findings 7a7 ,short title ,this ,act may be cited as the ,concentrating on ,high-,value ,alzheimer's ,needs to ,get to an ,end 7,,change7 ,act of #bjba4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents2 findings4,sec4 #b4 ,cognitive impairment detection benefit in the ,medicare annual wellness visit and initial preventive physical examination4,sec4 #c4 ,medicare quality payment program4,sec4 #d4 ,report to congress on implementation4 7c7 ,findings ,congress finds the following3 7#a7 ,it is estimated that #f1bjj1jjj ,americans age #fe and older are living with ,alzheimer's disease in #bjba4 ,more than #a in #i people age #fe and older has ,alzheimer's4 ,by #bjej1 the number of ,americans age #fe and older with ,alzheimer's dementia is projected to reach #ab1gjj1jjj4 7#b7 ,alzheimer's disease disproportionately impacts women and people of color4 7#c7 ,almost two-thirds of ,americans with ,alzheimer's disease are women4 7#d7 ,according to the ,centers for ,disease ,control and ,prevention1 among people ages #fe and older1 ,african ,americans have the highest prevalence of ,alzheimer's disease and related dementias 7#ac4h percent71 followed by ,hispanics 7#ab4b percent71 and non-,hispanic ,whites 7#aj4c percent71 ,american ,indian and ,alaska ,natives 7#i4a percent71 and ,asian and ,pacific ,islanders 7#h4d percent74 ,this higher prevalence translates into a higher death rate--,alzheimer's deaths increased #ee percent among all ,americans between #aiii and #bjad1 while the number was #ajg percent for ,latinos and #ii percent for ,african ,americans4 7#e7 ,currently available data shows that about half of individuals age #fe and older with mild cognitive impairment 7,,mci7--roughly #e1jjj1jjj ,americans--have ,,mci due to ,alzheimer's disease4 ,approximately #ae percent of individuals with ,,mci develop dementia after #b years and #cb percent develop ,alzheimer's dementia within #e years' follow-up4 7#f7 ,addressing modifiable risk factors such as physical activity1 smoking1 education1 staying socially and mentally active1 blood pressure1 and diet might prevent or delay up to #dj percent of dementia cases4 7#g7 ,an early1 documented diagnosis1 communicated to the patient and caregiver1 enables early access to care planning services and available medical and nonmedical treatments1 and optimizes patients' ability to build a care team1 participate in support services1 and enroll in clinical trials4 7#h7 ,alzheimer's exacts an emotional and physical toll on caregivers1 resulting in higher incidence of heart disease1 cancer1 depression1 and other health consequences4 7#i7 ,more than #aa1jjj1jjj ,americans provide unpaid care for people with ,alzheimer's or other dementia and provided nearly #beg1jjj1jjj1jjj in unpaid care to people living with ,alzheimer's and other dementias in #bjbj4 7#aj7 ,in #bjba1 it is estimated that ,alzheimer's and related dementias will have cost ,medicare and ,medicaid programs #bci1jjj1jjj1jjj4 ,by #bjej1 it is estimated that these direct costs will increase to as much as #a1ajj1jjj1jjj1jjj4 #b4 ,cognitive impairment detection benefit in the ,medicare annual wellness visit and initial preventive physical examination 7a7 ,annual wellness visit 7#a7 ,in general ,section #ahfa7;hhh77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7hhh77#b77 is amended-- 7,a7 by striking subparagraph 7,d7 and inserting the following3 7,d7 ,detection of any cognitive impairment or progression of cognitive impairment that shall-- 7i7 be performed using a cognitive impairment detection tool identified by the ,national ,institute on ,aging as meeting its criteria for selecting instruments to detect cognitive impairment in the primary care setting1 and other validated cognitive detection tools as the ,secretary determines2 7ii7 include documentation of the tool used for detecting cognitive impairment and results of the assessment in the medical record of the patient2 and 7iii7 take into consideration the tool used1 and results of1 any previously performed cognitive impairment detection assessment4 2 7,b7 by moving subparagraphs 7,g7 and 7,h7 two ems to the left2 7,c7 by redesignating subparagraph 7,i7 as subparagraph 7,j72 and 7,d7 by inserting after subparagraph 7,h7 the following new subparagraph3 7,i7 ,referral of patients with detected cognitive impairment or potential cognitive decline to-- 7i7 appropriate ,alzheimer's disease and dementia diagnostic services1 including amyloid positron emission tomography1 and other medically accepted diagnostic tests that the ,secretary determines are safe and effective2 7ii7 specialists and other clinicians with expertise in diagnosing or treating ,alzheimer's disease and related dementias2 7iii7 available community-based services1 including patient and caregiver counseling and social support services2 and 7iv7 appropriate clinical trials4 4 7#b7 ,effective date ,the amendments made by paragraph 7#a7 shall apply to annual wellness visits furnished on or after ,january #a1 #bjbb4 7b7 ,initial preventive physical examination 7#a7 ,in general ,section #ahfa7ww77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7ww77#a77 is amended by inserting detection of any cognitive impairment or progression of cognitive impairment as described in subparagraph 7,d7 of subsection 7hhh77#b7 and referrals as described in subparagraph 7,i7 of such subsection1 after upon the agreement with the individual14 7#b7 ,effective date ,the amendments made by paragraph 7#a7 shall apply to initial preventive physical examinations furnished on or after ,january #a1 #bjbb4 #c4 ,medicare quality payment program ,not later than ,january #a1 #bjbb1 the ,secretary of ,health and ,human ,services shall implement ,medicare policies under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 including quality measures and ,medicare ,advantage plan rating and risk adjustment mechanisms1 that reflect the public health imperative of-- 7#a7 promoting healthy brain lifestyle choices2 7#b7 identifying and responding to patient risk factors for ,alzheimer's disease and related dementias2 and 7#c7 incentivizing providers for-- 7,a7 adequate and reliable cognitive impairment detection in the primary care setting1 that is documented in the electronic health record of the patient and communicated to the patient2 7,b7 timely ,alzheimer's disease diagnosis2 and 7,c7 appropriate care planning services1 including identification of1 and communication with patients and caregivers regarding1 the potential for clinical trial participation4 #d4 ,report to congress on implementation ,not later than #c years after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall submit to ,congress a report on the implementation of the provisions of1 and amendments made by1 this ,act1 including-- 7#a7 the increased use of validated tools for detection of cognitive impairment and ,alzheimer's disease2 7#b7 utilization of ,alzheimer's disease diagnostic and care planning services2 and 7#c7 outreach efforts in the primary care and patient communities4