(1) IN GENERAL.—Section 1861(hhh)(2) of the 
Social Security Act (42 U.S.C. 1395x(hhh)(2)) is 
amended— 
(A) by striking subparagraph (D) and in-
serting the following: 
‘‘(D) Detection of any cognitive impair-
ment or progression of cognitive impairment 
that shall— 
‘‘(i) be performed using a cognitive 
impairment detection tool identified by the 
National Institute on Aging as meeting its 
criteria for selecting instruments to detect 
cognitive impairment in the primary care 
setting, and other validated cognitive de-
tection tools as the Secretary determines; 
‘‘(ii) include documentation of the tool 
used for detecting cognitive impairment 
and results of the assessment in the pa-
tient’s medical record; and 
‘‘(iii) take into consideration the tool 
used, and results of, any previously per-
formed cognitive impairment detection as-
sessment.’’; 
(B) by redesignating subparagraph (I) as 
subparagraph (J); and 
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(C) by inserting after subparagraph (H) 
the following new subparagraph: 
‘‘(I) Referral of patients with detected cog-
nitive impairment or potential cognitive decline 
to— 
‘‘(i) appropriate Alzheimer’s disease 
and dementia diagnostic services, including 
amyloid positron emission tomography, and 
other medically accepted diagnostic tests 
that the Secretary determines are safe and 
effective; 
‘‘(ii) specialists and other clinicians 
with expertise in diagnosing or treating 
Alzheimer’s disease and related dementias; 
‘‘(iii) available community-based serv-
ices, including patient and caregiver coun-
seling and social support services; and 
‘‘(iv) appropriate clinical trials.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply to annual wellness vis-
its furnished on or after January 1, 2020. 
(b) INITIAL
PREVENTIVE
PHYSICAL
EXAMINA-
TION.— 
(1) IN GENERAL.—Section 1861(ww)(1) of the 
Social Security Act (42 U.S.C. 1395x(ww)(1)) is 
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amended by striking ‘‘agreement with the individual, 
and’’ and inserting ‘‘agreement with the individual, 
detection of any cognitive impairment or progression 
of cognitive impairment as described in subpara-
graph (D) of subsection (hhh)(2) and referrals as 
described in subparagraph (I) of such subsection, 
and’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply to initial preventive 
physical examinations furnished on or after January 
1, 2020. 
SEC. 3. MEDICARE QUALITY PAYMENT PROGRAM. 
Not later than January 1, 2020, the Secretary of 
Health and Human Services shall implement Medicare 
policies under title XVIII of the Social Security Act, in-
cluding quality measures and Medicare Advantage plan 
rating and risk adjustment mechanisms, that reflect the 
public health imperative of— 
(1) promoting healthy brain lifestyle choices; 
(2) identifying and responding to patient risk 
factors for Alzheimer’s disease and related demen-
tias; and 
(3) incentivizing providers for— 
(A) adequate and reliable cognitive impair-
ment detection in the primary care setting, that 
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is documented in the patient’s electronic health 
record and communicated to the patient; 
(B) timely Alzheimer’s disease diagnosis; 
and 
(C) appropriate care planning services, in-
cluding identification of, and communication 
with patients and caregivers about, the poten-
tial for clinical trial participation. 
SEC. 4. REPORT TO CONGRESS ON IMPLEMENTATION OF 
THIS ACT. 
Not later than 3 years after the date of the enact-
ment of this Act, the Secretary of Health and Human 
Services shall submit a report to Congress on the imple-
mentation of the provisions of, and amendments made by, 
this Act, including— 
(1) the increased use of validated tools for de-
tection of cognitive impairment and Alzheimer’s dis-
ease; 
(2) utilization of Alzheimer’s disease diagnostic 
and care planning services; and 
(3) outreach efforts in the primary care and pa-
tient communities. 
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SEC. 5. STUDY AND REPORT ON REGULATORY AND LEGIS-
LATIVE CHANGES OR REFINEMENTS THAT 
WOULD ACCELERATE ALZHEIMER’S DISEASE 
RESEARCH PROGRESS. 
(a) IN GENERAL.—The Comptroller General of the 
United States (in this section referred to as the ‘‘Comp-
troller General’’) shall conduct a study on regulatory and 
legislative changes or refinements that would accelerate 
Alzheimer’s disease research progress. In conducting such 
study, the Comptroller General shall consult with inter-
ested stakeholders, including industry leaders, researchers, 
clinical experts, patient advocacy groups, caregivers, pa-
tients, providers, and State leaders. Such study shall in-
clude an analysis of innovative public-private partnerships, 
innovative financing tools, incentives, and other mecha-
nisms to enhance the quality of care for individuals diag-
nosed with Alzheimer’s disease, reduce the emotional, fi-
nancial, and physical burden on familial care partners, 
and accelerate development of preventative, curative, and 
disease-modifying therapies. 
(b) REPORT.—Not later than 1 year after the date 
of the enactment of this Act, the Comptroller General shall 
submit to Congress a report containing the results of the 
study conducted under subsection (a), together with rec-
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ommendations for such legislation and administrative ac-
tion as the Comptroller General determines appropriate. 
Æ 
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