,i  #aaith ,,congress  #ast ,session    
,h4 ,r4 #ceja  ,,in ,,the ,,house ,,of  
,,representatives  ,may #ai1 #bjbe,ms4  
,snchez 7for herself1 ,mr4 ,la,hood1    
,ms4 ,matsui1 and ,mr4 ,bilirakis7      
introduced the following bill2 which was
 referred to the ,committee on ,energy  
and ,commerce1 and in addition to the   
,committee on ,ways and ,means1 for a   
period to be subsequently determined by 
the ,speaker1 in each case for          
consideration of such provisions as fall
 within the jurisdiction of the         
committee concerned  ,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 ,findings ,congress finds the     
following3 7#a7 ,it is estimated that   
#f4i million ,americans are living with 
,alzheimer's disease1 a number that is  
estimated to rise to nearly #ac4h       
million by #bjfj4 ,about one in eleven  

people age #fe and older has            
,alzheimer's4  7#b7 ,older ,black       
,americans are twice as likely1 and     
,latino ,americans are one and one-half 
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   
,alzheimer's disease is the             
fifth-leading cause of death in ,america
 among ,americans aged #fe and older4   
7#d7 ,between #bjjj and #bjba1 deaths   
from stroke1 heart disease and ,,hiv    
decreased1 whereas reported deaths from 
,,ad increased more than #adj percent4  
7#e7 ,addressing modifiable risk factors
 for ,alzheimer's and other dementias   
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 ,addresses           
,alzheimer's disease was updated to     
include a new goal to focus on reducing 

risk of developing dementia4  7#f7 ,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#g7        
,alzheimer's exacts an emotional and    
physical toll on caregivers1 resulting  
in higher incidence of heart disease1   
cancer1 depression1 and other health    
consequences4  7#h7 ,more than #aa4e    
million ,americans provide unpaid care  
for people with ,alzheimer's or other   
dementia and provided nearly #cdg       
billion in unpaid care to people living 
with ,alzheimer's and other dementias in
 #bjbc4  7#i7 ,in #bjbd1 it is estimated
 that ,alzheimer's and related dementias
 will cost our nation #cfj billion1 not 
including the value of unpaid           
caregiving4 ,by #bjej1 it is estimated  
that these direct costs will increase to

 nearly #a4a trillion4  7#aj7 ,medicare 
and ,medicaid are expected to cover     
nearly #bca billion1 only about #fd     
percent of the total healthcare and     
long-term payments for people with      
,alzheimer's or dementia4 ,out-of-pocket
 spending is expected to be about #ia   
billion1 or about #be percent of total  
payments4  #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 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 #bjbf4  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 #bjbf4