[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 2379 Introduced in Senate (IS)]

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118th CONGRESS
  1st Session
                                S. 2379

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

                             July 19, 2023

 Mrs. Capito (for herself, Ms. Stabenow, Mr. Menendez, and Mr. Wicker) 
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. SHORT TITLE.

    This Act may be cited as the ``Concentrating on High-value 
Alzheimer's Needs to Get to an End Act of 2023'' or the ``CHANGE Act of 
2023''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) It is estimated that 6.7 million Americans are living 
        with Alzheimer's disease, a number that is estimated to rise to 
        nearly 13.8 million by 2060. About 1 in 9 people age 65 and 
        older have Alzheimer's.
            (2) Older Black Americans are twice as likely, and Latino 
        Americans are 1.5 times as likely, to have Alzheimer's disease 
        than older White Americans. Nearly two-thirds of Americans with 
        Alzheimer's disease are women.
            (3) In 2021, Alzheimer's disease was the seventh-leading 
        cause of death in the United States.
            (4) Addressing modifiable risk factors for Alzheimer's and 
        other types of dementia 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 Address Alzheimer's disease 
        was updated to include a new goal to focus on reducing risk of 
        developing dementia.
            (5) An early documented diagnosis communicated to the 
        patient and caregiver enables early access to care planning 
        services and available medical and non-medical treatments and 
        optimizes patients' ability to build a care team, participate 
        in support services, and enroll in clinical trials.
            (6) Alzheimer's exacts an emotional and physical toll on 
        caregivers, resulting in higher incidence of heart disease, 
        cancer, depression, and other health consequences.
            (7) More than 11 million Americans provide unpaid care for 
        people with Alzheimer's or other dementia and provided nearly 
        $340 billion in unpaid care to people living with Alzheimer's 
        and other dementia in 2022.
            (8) In 2023, it is estimated that Alzheimer's and related 
        dementia will cost our nation $345 billion, not including the 
        value of unpaid caregiving. By 2050, it is estimated that these 
        direct costs will increase to nearly $1 trillion.

SEC. 3. 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, 2024.
    (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, 2024.
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