,,ii  #aahth ,,congress  #ast ,session  
,s4 #bcgi  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,july #ai1     
#bjbc,mrs4 ,capito 7for herself1 ,ms4   
,stabenow1 ,mr4 ,menendez1 and ,mr4     
,wicker7 introduced the following bill2 
which was read twice and referred to the
 ,committee on ,finance  ,a ,,bill  ,to 
amend title ,,xviii of the ,social      
,security ,act to provide for certain   
cognitive impairment detection in the   
,medicare annual wellness visit and     
initial preventive physical examination4
  #a4 ,short title ,this ,act may be    
cited as the ,concentrating on          
,high-value ,alzheimer's ,needs to ,get 
to an ,end ,act of #bjbc or the ,,change
 ,act of #bjbc4  #b4 ,findings ,congress
 finds the following3 7#a7 ,it is       
estimated that #f4g million ,americans  
are living with ,alzheimer's disease1 a 
number that is estimated to rise to     
nearly #ac4h million by #bjfj4 ,about #a
 in #i people age #fe and older have    
,alzheimer's4  7#b7 ,older ,black       

,americans are twice as likely1 and     
,latino ,americans are #a4e times as    
likely1 to have ,alzheimer's disease    
than older ,white ,americans4 ,nearly   
two-thirds of ,americans with           
,alzheimer's disease are women4  7#c7   
,in #bjba1 ,alzheimer's disease was the 
seventh-leading cause of death in the   
,united ,states4  7#d7 ,addressing      
modifiable risk factors for ,alzheimer's
 and other types of dementia such as    
hypertension1 physical inactivity1      
smoking1 depression1 diabetes1 obesity1 
and poor nutrition might prevent or     
delay up to #dj percent of dementia     
cases4 ,in #bjba the ,national ,plan to 
,address ,alzheimer's disease was       
updated to include a new goal to focus  
on reducing risk of developing dementia4
  7#e7 ,an early documented diagnosis   
communicated to the patient and         
caregiver enables early access to care  
planning services and available medical 
and non-medical treatments and optimizes
 patients' ability to build a care team1

 participate in support services1 and   
enroll in clinical trials4  7#f7        
,alzheimer's exacts an emotional and    
physical toll on caregivers1 resulting  
in higher incidence of heart disease1   
cancer1 depression1 and other health    
consequences4  7#g7 ,more than #aa      
million ,americans provide unpaid care  
for people with ,alzheimer's or other   
dementia and provided nearly #cdj       
billion in unpaid care to people living 
with ,alzheimer's and other dementia in 
#bjbb4  7#h7 ,in #bjbc1 it is estimated 
that ,alzheimer's and related dementia  
will cost our nation #cde billion1 not  
including the value of unpaid           
caregiving4 ,by #bjej1 it is estimated  
that these direct costs will increase to
 nearly #a trillion4  #c4 ,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 by striking 
subparagraph 7,d7 and inserting the     
following3  7,d7 ,detection of any      
cognitive impairment that shall-- 7i7 be
 performed using one of the cognitive   
impairment detection tools identified by
 the ,national ,institute on ,aging as  
meeting its criteria for selecting      
instruments to detect cognitive         
impairment in the primary care setting2 
and  7ii7 include documentation of the  
tool used for detecting cognitive       
impairment and results of the assessment
 in the patient's medical record4  4    
7#b7 ,effective date ,the amendment made
 by paragraph 7#a7 shall apply to annual
 wellness visits furnished on or after  
,january #a1 #bjbd4  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 
striking agreement with the individual1 
and and inserting agreement with the    
individual1 detection of any cognitive  

impairment as described in subsection   
7hhh77#b77;,d71 and4  7#b7 ,effective   
date ,the amendment made by paragraph   
7#a7 shall apply to initial preventive  
physical examinations furnished on or   
after ,january #a1 #bjbd4