S 1799119th CongressIntroduced

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 preventative physical examination.

Introduced: May 19, 2025

Healthcare

Standard Summary

Comprehensive overview in 1-2 paragraphs

This bill would add a mandatory cognitive impairment detection component to two Medicare preventive services: the annual wellness visit (AWV) and the initial preventive physical examination (IPPE). Beginning January 1, 2026, providers conducting these visits must use a cognitive impairment detection tool identified by the National Institute on Aging (NIA) that meets its criteria for primary care instruments, and they must document the tool used and the results in the patient’s medical record. The change is designed to promote early identification of cognitive impairment or dementia, enabling earlier care planning, access to treatments, and involvement of caregivers and care teams. The Findings section emphasizes the growing impact of Alzheimer's disease, disparities in risk, and the potential to prevent or delay dementia through addressing modifiable risk factors.

Key Points

1The AWV requirement: During the Medicare annual wellness visit, the administrator must replace the current text with a mandate to detect cognitive impairment using an NIA-identified tool that meets primary-care criteria, with results and the tool documented in the medical record. Effective for AWVs on or after January 1, 2026.
2The IPPE requirement: The IPPE (initial preventive physical examination) must include detection of cognitive impairment as described in the AWV provision, with the same NIA-identified tool and documentation requirements. Effective for IPPEs on or after January 1, 2026.
3Tool identification: The detection must be performed using one of the cognitive impairment detection tools identified by the NIA that meet its criteria for detecting cognitive impairment in the primary care setting.
4Documentation: The results of the cognitive impairment assessment and the name of the tool used must be documented in the patient’s medical record.
5Purpose and scope: The bill seeks to enable earlier diagnosis and care planning for individuals with cognitive impairment or Alzheimer's disease and to support timely access to medical and nonmedical services, trials, and supports for patients and caregivers.

Impact Areas

Primary group/area affected: Medicare beneficiaries, particularly adults aged 65 and older, who receive AWV and/or IPPE; individuals at higher risk for Alzheimer’s disease (e.g., Black and Latino populations) may benefit from more systematic screening.Secondary group/area affected: Primary care providers and clinics performing AWV/IPPE; will need to implement the NIA-identified cognitive impairment tools, adjust workflows, and ensure documentation in electronic medical records.Additional impacts: Medicare program administration and potential effects on billing, coding, and quality measures related to preventive services; possible training needs for clinicians and staff; potential impact on caregiver planning and support services due to earlier detection and communication of diagnoses.The Findings section of the bill highlights rising prevalence and costs of Alzheimer’s disease and argues that early, documented diagnoses improve access to care planning and treatments, while noting disparities in risk among different racial/ethnic groups.The bill does not specify funding or reimbursement changes beyond the requirement to use approved screening tools and document results.

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