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