I 
119TH CONGRESS 
1ST SESSION H. R. 3501 
To amend title XVIII of the Social Security Act to provide for certain 
cognitive impairment detection in the Medicare annual wellness visit 
and initial preventive physical examination. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 19, 2025 
Ms. SA´NCHEZ (for herself, Mr. LAHOOD, Ms. MATSUI, and Mr. BILIRAKIS) 
introduced the following bill; which was referred to the Committee on En-
ergy and Commerce, and in addition to the Committee on Ways and 
Means, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for certain cognitive impairment detection in the Medi-
care annual wellness visit and initial preventive physical 
examination. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. FINDINGS. 
Congress finds the following: 
(1) It is estimated that 6.9 million Americans 
are living with Alzheimer’s disease, a number that is 
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estimated to rise to nearly 13.8 million by 2060. 
About one in eleven people age 65 and older has Alz-
heimer’s. 
(2) Older Black Americans are twice as likely, 
and Latino Americans are one and one-half times as 
likely, to have Alzheimer’s disease than older White 
Americans. Nearly two-thirds of Americans with Alz-
heimer’s disease are women. 
(3) Alzheimer’s disease is the fifth-leading 
cause of death in America among Americans aged 
65 and older. 
(4) Between 2000 and 2021, deaths from 
stroke, heart disease and HIV decreased, whereas 
reported deaths from AD increased more than 140 
percent. 
(5) Addressing modifiable risk factors for Alz-
heimer’s and other dementias such as hypertension, 
physical inactivity, smoking, depression, diabetes, 
obesity, and poor nutrition might prevent or delay 
up to 40 percent of dementia cases. In 2021 the Na-
tional Plan to Addresses Alzheimer’s disease was up-
dated to include a new goal to focus on reducing risk 
of developing dementia. 
(6) An early, documented diagnosis, commu-
nicated to the patient and caregiver, enables early 
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access to care planning services and available med-
ical and nonmedical treatments, and optimizes pa-
tients’ ability to build a care team, participate in 
support services, and enroll in clinical trials. 
(7) Alzheimer’s exacts an emotional and phys-
ical toll on caregivers, resulting in higher incidence 
of heart disease, cancer, depression, and other health 
consequences. 
(8) More than 11.5 million Americans provide 
unpaid care for people with Alzheimer’s or other de-
mentia and provided nearly $347 billion in unpaid 
care to people living with Alzheimer’s and other de-
mentias in 2023. 
(9) In 2024, it is estimated that Alzheimer’s 
and related dementias will cost our nation $360 bil-
lion, not including the value of unpaid caregiving. 
By 2050, it is estimated that these direct costs will 
increase to nearly $1.1 trillion. 
(10) Medicare and Medicaid are expected to 
cover nearly $231 billion, only about 64 percent of 
the total healthcare and long-term payments for peo-
ple with Alzheimer’s or dementia. Out-of-pocket 
spending is expected to be about $91 billion, or 
about 25 percent of total payments. 
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SEC. 2. COGNITIVE IMPAIRMENT DETECTION BENEFIT IN 
THE MEDICARE ANNUAL WELLNESS VISIT 
AND INITIAL PREVENTIVE PHYSICAL EXAM-
INATION. 
(a) ANNUAL WELLNESS VISIT.— 
(1) IN GENERAL.—Section 1861(hhh)(2) of the 
Social Security Act (42 U.S.C. 1395x(hhh)(2)) is 
amended by striking subparagraph (D) and inserting 
the following: 
‘‘(D) Detection of any cognitive impair-
ment that shall— 
‘‘(i) be performed using one of the 
cognitive impairment detection tools identi-
fied by the National Institute on Aging as 
meeting its criteria for selecting instru-
ments to detect cognitive impairment in 
the primary care setting; and 
‘‘(ii) include documentation of the tool 
used for detecting cognitive impairment 
and results of the assessment in the pa-
tient’s medical record.’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply to annual wellness vis-
its furnished on or after January 1, 2026. 
(b) INITIAL
PREVENTIVE
PHYSICAL
EXAMINA-
TION.— 
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(1) IN GENERAL.—Section 1861(ww)(1) of the 
Social Security Act (42 U.S.C. 1395x(ww)(1)) is 
amended by striking ‘‘agreement with the individual, 
and’’ and inserting ‘‘agreement with the individual, 
detection of any cognitive impairment as described 
in subsection (hhh)(2)(D), and’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply to initial preventive 
physical examinations furnished on or after January 
1, 2026. 
Æ 
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