,,ii #aag? ,,congress #a/ ,session ,s4 #afib ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,may #ai1 #bjba,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$s to ,get to an ,end 7,,*ange7 ,act ( #bjba4 7b7 ,table ( cont5ts ,! table ( cont5ts = ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title2 table ( cont5ts2 f9d+s4,sec4 #b4 ,cognitive impairm5t detection b5efit 9 ! ,m$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 #f1bjj1jjj ,am]icans age #fe & old] are liv+ ) ,alzheim]'s disease 9 #bjba4 ,m ?an #a 9 #i p age #fe & old] has ,alzheim]'s4 ,by #bjej1 ! numb] ( ,am]icans age #fe & old] ) ,alzheim]'s dem5tia is project$ to rea* #ab1gjj1jjj4 7#b7 ,alzheim]'s disease disproportionately impacts wom5 & p ( color4 7#c7 ,almo/ two-?irds ( ,am]icans ) ,alzheim]'s disease are wom54 7#d7 ,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? rate--,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#e7 ,curr5tly available data %[s t ab\t half ( individuals age #fe & old] ) mild cognitive impairm5t 7,,mci7--r\ghly #e1jjj1jjj ,am]icans--h ,,mci due to ,alzheim]'s disease4 ,approximately #ae p]c5t ( individuals ) ,,mci develop dem5tia aft] #b ye>s & #cb p]c5t develop ,alzheim]'s dem5tia )9 #e ye>s' foll[-up4 7#f7 ,address+ modifiable risk factors su* z physical activity1 smok+1 education1 /ay+ socially & m5tally active1 blood pressure1 & diet might prev5t or delay up to #dj p]c5t ( dem5tia cases4 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 ,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#i7 ,m ?an #aa1jjj1jjj ,am]icans provide unpaid c>e = p ) ,alzheim]'s or o!r dem5tia & provid$ ne>ly #beg1jjj1jjj1jjj 9 unpaid c>e to p liv+ ) ,alzheim]'s & o!r dem5tias 9 #bjbj4 7#aj7 ,9 #bjba1 x is e/imat$ t ,alzheim]'s & relat$ dem5tias w h co/ ,m$ic>e & ,m$icaid programs #bci1jjj1jjj1jjj4 ,by #bjej1 x is e/imat$ t ^! direct co/s w increase to z mu* z #a1ajj1jjj1jjj1jjj4 #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 #bjbb4 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 #bjbb4 #c4 ,m$ic>e quality paym5t program ,n lat] ?an ,janu>y #a1 #bjbb1 ! ,secret>y ( ,heal? & ,human ,s]vices %all implem5t ,m$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