I 
114TH CONGRESS 
2D SESSION 
H. R. 5681 
To require the Center for Medicare and Medicaid Innovation to test the 
efficacy of providing Alzheimer’s Disease caregiver support services in 
delaying or reducing the use of institutionalized care for Medicare bene-
ficiaries with Alzheimer’s Disease or a related dementia. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 7, 2016 
Ms. LINDA T. SA´NCHEZ of California (for herself and Mr. ROSKAM) intro-
duced the following bill; which was referred to the Committee on Ways 
and Means, and in addition to the Committee on Energy and Commerce, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of the 
committee concerned 
A BILL 
To require the Center for Medicare and Medicaid Innovation 
to test the efficacy of providing Alzheimer’s Disease care-
giver support services in delaying or reducing the use 
of institutionalized care for Medicare beneficiaries with 
Alzheimer’s Disease or a related dementia. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Alzheimer’s Bene-
ficiary and Caregiver Support Act’’. 
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SEC. 2. TESTING OF MEDICARE AND MEDICAID COVERAGE 
OF ALZHEIMER’S DISEASE CAREGIVER SUP-
PORT SERVICES. 
Section 1115A of the Social Security Act (42 U.S.C. 
1315a) is amended— 
(1) in subsection (b)(2)— 
(A) in subparagraph (A), by adding at the 
end the following new sentence: ‘‘The models 
selected under this subparagraph shall include 
the model described in subparagraph (D), which 
shall be implemented by not later than the date 
that is 1 year after the date of enactment of 
such subparagraph.’’; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(D) ALZHEIMER’S
DISEASE
CAREGIVER 
SUPPORT
SERVICES
MODEL.—The model de-
scribed in this subparagraph is a model that 
meets the requirements of subsection (h) with 
respect to coverage of, and payment for, Alz-
heimer’s Disease caregiver support services (as 
defined in such subsection).’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(h) COVERAGE OF ALZHEIMER’S DISEASE CARE-
GIVER SUPPORT SERVICES.— 
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‘‘(1) IN GENERAL.—Subject to the succeeding 
provisions of this subsection, for the 3-year period 
that begins on January 1, 2018, the Secretary shall 
test the efficacy of coverage of, and payment for, 
Alzheimer’s Disease caregiver support services (as 
defined in paragraph (2)) under the applicable title, 
in delaying or reducing the use of institutionalized 
care for applicable Medicare beneficiaries (as defined 
in paragraph (3)). 
‘‘(2) DEFINITION
OF
ALZHEIMER’S
DISEASE 
CAREGIVER SUPPORT SERVICES.—In this subsection, 
the term ‘Alzheimer’s Disease caregiver support 
services’ means the following services furnished by 
an eligible professional (as defined in paragraph (3)) 
to a family caregiver (as defined in such paragraph) 
of an applicable Medicare beneficiary (as defined in 
such paragraph): 
‘‘(A) A defined set of counseling sessions 
over a fixed period of time (as determined ap-
propriate by the Secretary), including a com-
prehensive baseline interview, two individual 
counseling sessions, and four family counseling 
sessions. 
‘‘(B) Following such defined set of coun-
seling sessions, a subsequent period (as deter-
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mined appropriate by the Secretary) of follow- 
up assessments, support group participation, 
and ad hoc counseling or consultations to sup-
port the family caregiver as needs arise and the 
health of the applicable Medicare beneficiary 
changes. 
‘‘(3) ADDITIONAL DEFINITIONS.—In this sub-
section: 
‘‘(A) 
APPLICABLE
MEDICARE
BENE-
FICIARY.—The term ‘applicable Medicare bene-
ficiary’ means an individual— 
‘‘(i) who is entitled to benefits under 
part A and enrolled under part B of title 
XVIII who is not enrolled in a Medicare 
Advantage plan under part C of such title, 
an eligible organization under section 
1876, or a PACE program under section 
1894; and 
‘‘(ii) who has been diagnosed with 
Alzheimer’s Disease or a related dementia. 
‘‘(B) ELIGIBLE PROFESSIONAL.—The term 
‘eligible professional’ means an individual 
who— 
‘‘(i) is a clinical social worker (as de-
fined in section 1861(hh)(1)) or a nurse 
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practitioner 
(as 
defined 
in 
section 
1861(aa)(5)(A)); and 
‘‘(ii) has undergone extensive online 
training in the best practices for caregiver 
intervention for patients who have been di-
agnosed with Alzheimer’s Disease or a re-
lated dementia. 
‘‘(C) FAMILY CAREGIVER.—The term ‘fam-
ily caregiver’ means, with respect to an applica-
ble Medicare beneficiary, a spouse, adult child, 
or other family member of the applicable Medi-
care beneficiary who is part of the care team of 
the applicable Medicare beneficiary and receives 
no monetary compensation for their service as 
part of the team. 
‘‘(4) PAYMENT.—The Secretary shall establish 
payment amounts under this subsection for Alz-
heimer’s Disease caregiver support services. 
‘‘(5) NUMBER
OF
FAMILY
CAREGIVERS
FUR-
NISHED ALZHEIMER’S DISEASE CAREGIVER SUPPORT 
SERVICES.—The Secretary shall select a sufficient 
number of eligible professionals to participate in the 
model under this subsection to ensure that the pri-
mary family caregiver and at least one other, infor-
mal family caregiver of applicable Medicare bene-
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ficiaries receive Alzheimer’s Disease caregiver sup-
port services under this subsection.’’. 
Æ 
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