May 19, 2025
Ms. Sánchez (for herself, Mr. LaHood, Ms. Matsui, and Mr. Bilirakis) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
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 examination.
Section 1. Findings
Congress finds the following:
(1)
It is estimated that 6.9 million Americans are living with Alzheimer’s disease, a number that is estimated to rise to nearly 13.8 million by 2060. About one in eleven people age 65 and older has Alzheimer’s.
(2)
Older Black Americans are twice as likely, and Latino Americans are one and one-half times as likely, to have Alzheimer’s disease than older White Americans. Nearly two-thirds of Americans with Alzheimer’s disease are women.
(3)
Alzheimer’s disease is the fifth-leading cause of death in America among Americans aged 65 and older.
(4)
Between 2000 and 2021, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 140 percent.
(5)
Addressing modifiable risk factors for Alzheimer’s and other dementias such as hypertension, physical inactivity, smoking, depression, diabetes, obesity, and poor nutrition might prevent or delay up to 40 percent of dementia cases. In 2021 the National Plan to Addresses Alzheimer’s disease was updated to include a new goal to focus on reducing risk of developing dementia.
(6)
An early, documented diagnosis, communicated to the patient and caregiver, enables early access to care planning services and available medical and nonmedical treatments, and optimizes patients’ ability to build a care team, participate in support services, and enroll in clinical trials.
(7)
Alzheimer’s exacts an emotional and physical toll on caregivers, resulting in higher incidence of heart disease, cancer, depression, and other health consequences.
(8)
More than 11.5 million Americans provide unpaid care for people with Alzheimer’s or other dementia and provided nearly $347 billion in unpaid care to people living with Alzheimer’s and other dementias in 2023.
(9)
In 2024, it is estimated that Alzheimer’s and related dementias will cost our nation $360 billion, not including the value of unpaid caregiving. By 2050, it is estimated that these direct costs will increase to nearly $1.1 trillion.
(10)
Medicare and Medicaid are expected to cover nearly $231 billion, only about 64 percent of the total healthcare and long-term payments for people with Alzheimer’s or dementia. Out-of-pocket spending is expected to be about $91 billion, or about 25 percent of total payments.
Sec. 2. Cognitive impairment detection benefit in the medicare annual wellness visit and initial preventive physical examination
(a) Annual wellness visit
(1) In general
Section 1861(hhh)(2) of the Social Security Act (42 U.S.C. 1395x(hhh)(2)) is amended by striking subparagraph (D) and inserting the following:
(D)
Detection of any cognitive impairment that shall—
(i)
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 setting; and
(ii)
include documentation of the tool used for detecting cognitive impairment and results of the assessment in the patient’s medical record.
(2) Effective date
The amendment made by paragraph (1) shall apply to annual wellness visits furnished on or after January 1, 2026.
(b) Initial preventive physical examination
(1) In general
Section 1861(ww)(1) of the Social Security Act (42 U.S.C. 1395x(ww)(1)) is amended by striking agreement with the individual, and
and inserting agreement with the individual, detection of any cognitive impairment as described in subsection (hhh)(2)(D), and
.
(2) Effective date
The amendment made by paragraph (1) shall apply to initial preventive physical examinations furnished on or after January 1, 2026.