,,ii  #aaith ,,congress  #ast ,session  
,s4 #agii  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,may #ai1 #bjbe
 ,mrs4 ,capito 7for herself and ,mr4    
,warner7 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  ,findings  ,congress finds the   
following3 7#a7 ,it is estimated that   
#f1ijj1jjj ,americans are living with   
,alzheimer's disease1 a number that is  
estimated to rise to nearly #ac1hjj1jjj 
by #bjfj4 ,about #a in #aa people age   
#fe and older has ,alzheimer's disease4 
7#b7 ,older ,black ,americans are #b    
times as likely1 and ,latino ,americans 
are #a4e times as likely1 to have       
,alzheimer's disease than older ,white  
,americans4 ,nearly #b_/c 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 disease1 and ,,hiv   
decreased1 whereas reported deaths from 
,alzheimer's disease increased more than
 #adj percent4  7#e7 ,addressing        
modifiable risk factors for ,alzheimer's
 disease and other dementias1 such as   
hypertension1 physical inactivity1      
smoking1 depression1 diabetes1 obesity1 
and poor nutrition1 might prevent or    
delay up to #dj percent of dementia     
cases4 ,in #bjba1 the ,national ,plan to
 ,addresses ,alzheimer's ,disease issued
 by the ,secretary of ,health and ,human
 ,services under the ,national          
,alzheimer's ,project ,act 7,public ,law
 #aaa-cge7 was updated to include a new 
goal to focus on reducing the 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 an            
individual's ability to build a care    
team1 participate in support services1  
and enroll in clinical trials4  7#g7    
,alzheimer's disease exacts an emotional
 and physical toll on caregivers1       
resulting in higher incidence of heart  
disease1 cancer1 depression1 and other  
health consequences4  7#h7 ,in #bjbc1   
more than #aa1ejj1jjj ,americans        
provided nearly #cdg1jjj1jjj1jjj in     
unpaid care for individuals with        
,alzheimer's disease or other dementias4
  7#i7 ,in #bjbd1 it is estimated that  
,alzheimer's and related dementias will 
cost the ,united ,states                
#cfj1jjj1jjj1jjj1 not including the     
value of unpaid caregiving4 ,by #bjej1  
it is estimated that these direct costs 
will increase to nearly                 
#a1ajj1jjj1jjj1jjj4  7#aj7 ,medicare and
 ,medicaid are expected to cover nearly 
#bca1jjj1jjj1jjj of care for individuals
 with ,alzheimer's disease and related  

dementias1 only about #fd percent of the
 total healthcare and long-term care    
payments for individuals with           
,alzheimer's disease and related        
dementias4 ,out-of-pocket spending for  
such care is expected to be about       
#ia1jjj1jjj1jjj1 or about #be percent of
 total healthcare and long-term care    
payments for such individuals4  #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 #a 
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        
individual'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