119-s1799

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1799 Introduced in Senate

    (IS) ]

<DOC>

119th CONGRESS
 1st Session
 S. 1799

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.

_______________________________________________________________________

 IN THE SENATE OF THE UNITED STATES

 May 19, 2025

Mrs. Capito (for herself and Mr. Warner) introduced the following bill; 
 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 examination.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. FINDINGS.

 Congress finds the following:

    (1) It is estimated that 6,900,000 Americans are living 
 with Alzheimer's disease, a number that is estimated to rise to 
 nearly 13,800,000 by 2060. About 1 in 11 people age 65 and 
 older has Alzheimer's disease.

    (2) Older Black Americans are 2 times as likely, and Latino 
 Americans are 1.5 times as likely, to have Alzheimer's disease 
 than older White Americans. Nearly \2/3\ 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 
 Alzheimer's disease increased more than 140 percent.

    (5) Addressing modifiable risk factors for Alzheimer's 
 disease 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 issued by the Secretary of Health and Human Services 
 under the National Alzheimer's Project Act (Public Law 111-375) 
 was updated to include a new goal to focus on reducing the 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 an individual's ability to build a care team, 
 participate in support services, and enroll in clinical trials.

    (7) Alzheimer's disease exacts an emotional and physical 
 toll on caregivers, resulting in higher incidence of heart 
 disease, cancer, depression, and other health consequences.

    (8) In 2023, more than 11,500,000 Americans provided nearly 
 $347,000,000,000 in unpaid care for individuals with 
 Alzheimer's disease or other dementias.

    (9) In 2024, it is estimated that Alzheimer's and related 
 dementias will cost the United States $360,000,000,000, not 
 including the value of unpaid caregiving. By 2050, it is 
 estimated that these direct costs will increase to nearly 
 $1,100,000,000,000.

    (10) Medicare and Medicaid are expected to cover nearly 
 $231,000,000,000 of care for individuals with Alzheimer's 
 disease and related dementias, only about 64 percent of the 
 total healthcare and long-term care payments for individuals 
 with Alzheimer's disease and related dementias. Out-of-pocket 
 spending for such care is expected to be about $91,000,000,000, 
 or about 25 percent of total healthcare and long-term care 
 payments for such individuals.

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 1 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 individual'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.
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