SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘HOPE for Alzheimer’s: 
Health Outcomes, Planning, and Education Act’’. 
SEC. 2. MEDICARE COVERAGE OF COMPREHENSIVE ALZ-
HEIMER’S DISEASE AND OTHER DEMENTIA 
DIAGNOSIS AND SERVICES. 
(a) IN GENERAL.—Section 1861 of the Social Secu-
rity Act is amended— 
(1) in subsection (s)(2)— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (EE); 
(B) by adding ‘‘and’’ at the end of sub-
paragraph (FF); and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(GG) comprehensive Alzheimer’s disease and 
other dementia diagnosis and services (as defined in 
subsection (iii));’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘Comprehensive Alzheimer’s Disease and Other 
Dementia Diagnosis and Services 
‘‘(iii)(1) The term ‘comprehensive Alzheimer’s disease 
and other dementia diagnosis and services’ means the 
services described in paragraph (2) furnished to an indi-
vidual— 
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‘‘(A) who does not already have a diagnosis of 
Alzheimer’s disease or other dementia; and 
‘‘(B) for whom there has been a determination 
by a physician or practitioner (as defined in section 
1842(b)(18)(C)), in a medical setting such as a phy-
sician’s office, a skilled nursing facility, a community 
health center, or another similar setting, that the in-
dividual— 
‘‘(i) may have a cognitive impairment or 
dementia; and 
‘‘(ii) has a need for a diagnostic evaluation 
for Alzheimer’s disease or another dementia. 
‘‘(2) The services described in this paragraph are the 
following: 
‘‘(A) A diagnostic evaluation, including referral 
to a specialist if recommended, in accordance with 
guidelines specified by the Secretary. 
‘‘(B) If the individual is diagnosed with Alz-
heimer’s disease or another dementia under the eval-
uation under subparagraph (A), care planning serv-
ices (with the individual or with one or more family 
caregivers of the individual without the presence of 
the individual), including assistance understanding 
the diagnosis as well as the medical and non-medical 
options for ongoing treatment, services, and sup-
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ports, and information about how to obtain such 
treatments, services, and supports. 
‘‘(C) Medical record documentation, with re-
spect to an individual, of the diagnostic evaluation 
under subparagraph (A) and any care planning serv-
ices under subparagraph (B). 
‘‘(3) The Secretary shall establish standards to carry 
out this subsection in consultation with Alzheimer’s dis-
ease and other dementia stakeholders, including patients 
and their advocates, and medical experts in the areas of 
detection, diagnostics, and care planning.’’. 
(b) PAYMENT.—Section 1833(a)(1) of the Social Se-
curity Act (42 U.S.C. 1395l(a)(1)) is amended by striking 
‘‘and’’ before ‘‘(X)’’ and inserting before the semicolon at 
the end the following: ‘‘, and (Y) with respect to com-
prehensive Alzheimer’s disease and other dementia diag-
nosis and services (as defined in section 1861(iii)), the 
amount paid shall be an amount equal to 80 percent of 
the amount determined under a fee schedule established 
by the Secretary’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2011. 
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SEC. 3. FEDERAL COORDINATED HEALTH CARE OFFICE 
STUDY AND REPORT. 
(a) STUDY.—The Federal Coordinated Health Care 
Office (as established under section 2602 of the Patient 
Protection and Affordable Care Act (42 U.S.C. 1315b)) 
shall conduct a study to identify— 
(1) barriers to the detection of Alzheimer’s dis-
ease and other dementias for dual eligible individuals 
(as defined in subsection (f) of such section 2602); 
(2) barriers to the furnishing of comprehensive 
Alzheimer’s disease and other dementia diagnosis 
and services (as defined in section 1866(iii) of the 
Social Security Act, as added by section 2) to such 
individuals; and 
(3) ways to eliminate the barriers described in 
paragraphs (1) and (2). 
(b) REPORT.—Not later than 2 years after the date 
of the enactment of this Act, the Federal Coordinated 
Health Care Office shall submit to Congress a report on 
the study conducted under subsection (a) together with 
recommendations for such legislation and administrative 
actions as the Office determines appropriate. 
Æ 
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