II 

113TH CONGRESS 

1ST SESSION S. 709 

To amend title XVIII of the Social Security Act to increase diagnosis of 

Alzheimer’s disease and related dementias, leading to better care and 

outcomes for Americans living with Alzheimer’s disease and related dementias. 

IN THE SENATE OF THE UNITED STATES 

APRIL 11, 2013 

Ms. STABENOW (for herself, Ms. COLLINS, Mr. BEGICH, Mr. BROWN, Mr. 

FRANKEN, Ms. KLOBUCHAR, Mrs. GILLIBRAND, and Mr. MENENDEZ) 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 increase 

diagnosis of Alzheimer’s disease and related dementias, 

leading to better care and outcomes for Americans living 

with Alzheimer’s disease and related dementias. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Health Outcomes, 

5 Planning, and Education for Alzheimer’s Act’’. 


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1 SEC. 2. FINDINGS AND PURPOSE. 

2 (a) FINDINGS.—Congress makes the following find3 ings: 

4 (1) As many as half of the estimated 5.2 mil5 lion Americans with Alzheimer’s disease have never 

6 received a diagnosis. 

7 (2) An early and documented diagnosis and ac8 cess to care planning services leads to better out9 comes for individuals with Alzheimer’s disease and 

10 other dementias and their caregivers. 

11 (3) Combining the existing Medicare benefits of 

12 a diagnostic evaluation and care planning into a sin13 gle package of services would help ensure that indi14 viduals receive an appropriate diagnosis as well as 

15 critical information about the disease and available 

16 care options, which leads to better outcomes. 

17 (4) An accurate diagnosis allows for better 

18 management of other known chronic conditions and 

19 more efficient utilization of medical resources, in20 cluding reducing complications and the number of 

21 costly emergency room visits and hospitalizations. 

22 (5) A formal diagnosis allows individuals and 

23 their caregivers to have access to available medical 

24 and non-medical treatments, build a care team, par25 ticipate in support services, and enroll in clinical 

26 trials. 


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1 (6) Undertaking the diagnostic process poten2 tially allows cognitive impairment to be reversed, as 

3 the cognitive impairment of nine percent of individ4 uals experiencing dementia-like symptoms is due to 

5 a potentially reversible cause, such as depression or 

6 vitamin deficiency. 

7 (b) PURPOSE.—The purpose of this Act is to increase 

8 diagnosis of Alzheimer’s disease and related dementias, 

9 leading to better care and outcomes for Americans living 

10 with Alzheimer’s disease and related dementias. 

11 SEC. 3. MEDICARE COVERAGE OF COMPREHENSIVE ALZ12 HEIMER’S DISEASE DIAGNOSIS AND SERV13 ICES. 

14 (a) IN GENERAL.—Section 1861 of the Social Secu15 rity Act (42 U.S.C. 1395x) is amended— 

16 (1) in subsection (s)(2)— 

17 (A) by striking ‘‘and’’ at the end of sub18 paragraph (EE); 

19 (B) by adding ‘‘and’’ at the end of sub20 paragraph (FF); and 

21 (C) by adding at the end the following new 

22 subparagraph: 

23 ‘‘(GG) comprehensive Alzheimer’s disease diag24 nosis and services (as defined in subsection (iii));’’; 

25 and 


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1 (2) by adding at the end the following new sub2 section: 

3 ‘‘Comprehensive Alzheimer’s Disease Diagnosis and 

4 Services 

5 ‘‘(iii)(1) The term ‘comprehensive Alzheimer’s disease 

6 diagnosis and services’ means the services described in 

7 paragraph (2) furnished to an individual— 

8 ‘‘(A) who does not already have a diagnosis of 

9 Alzheimer’s disease; and 

10 ‘‘(B) for whom a physician or a practitioner de11 scribed in clause (i), (iv), or (v) of section 

12 1842(b)(18)(C), in a medical setting such as a phy13 sician’s office, a hospital, a skilled nursing facility, 

14 a community health center, or another similar med15 ical setting— 

16 ‘‘(i) has detected the individual may have 

17 a cognitive impairment or dementia; and 

18 ‘‘(ii) pursuant to such detection, has deter19 mined a diagnostic evaluation for Alzheimer’s 

20 disease is needed. 

21 ‘‘(2) The services described in this paragraph are the 

22 following: 

23 ‘‘(A) A diagnostic evaluation, including referral 

24 to a specialist if recommended. 


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1 ‘‘(B) If the individual is diagnosed with Alz2 heimer’s disease under the diagnostic evaluation 

3 under subparagraph (A), care planning services 

4 (with the individual, with the personal representative 

5 of the individual, or with one or more family care6 givers of the individual with or without the presence 

7 of the individual), including assistance under8 standing the diagnosis as well as the medical and 

9 non-medical options for ongoing treatment, services, 

10 and supports, and information about how to obtain 

11 such treatments, services, and supports. Such care 

12 planning services for individuals diagnosed with Alz13 heimer’s disease should take into consideration and 

14 address other co-morbid chronic conditions. 

15 ‘‘(C) Medical record documentation, with re16 spect to an individual, of the diagnostic evaluation 

17 under subparagraph (A), the diagnosis, and any care 

18 planning services under subparagraph (B). 

19 ‘‘(3) In this subsection— 

20 ‘‘(A) the term ‘Alzheimer’s disease’ means Alz21 heimer’s disease and related dementias; and 

22 ‘‘(B) the term ‘personal representative’ means, 

23 with respect to an individual, a person legally au24 thorized to make health care decisions on such indi25 vidual’s behalf.’’. 


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1 (b) PAYMENT.—Section 1833(a)(1) of the Social Se2 curity Act (42 U.S.C. 1395l(a)(1)) is amended by striking 

3 ‘‘and’’ before ‘‘(Z)’’ and inserting before the semicolon at 

4 the end the following: ‘‘, and (AA) with respect to com5 prehensive Alzheimer’s disease diagnosis and services (as 

6 defined in section 1861(iii)), the amount paid shall be an 

7 amount equal to 80 percent of the amount determined 

8 under a fee schedule designated by the Secretary’’. 

9 (c) EFFECTIVE DATE.—The amendments made by 

10 this section shall apply to services furnished on or after 

11 January 1 of the year following the year which includes 

12 the date of the enactment of this Act. 

Æ 


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