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.
- Bill Number
- H.R. 3501
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-05-19: Referred to the Committee on Energy 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 jurisdiction of the committee concerned.
- Last Updated
- 2026-05-20T08:08:26Z
AI-Generated Summary
Purpose
The legislation, H.R. 3501, aims to improve early detection of cognitive impairments, such as those associated with Alzheimer's disease and other dementias, by requiring their screening during Medicare's routine preventive services. This supports timely diagnosis, care planning, and access to treatments, addressing the growing public health burden of dementia.
Key Provisions
- Findings Section: Outlines congressional recognition of Alzheimer's prevalence (affecting 6.9 million Americans, projected to double by 2060), racial and gender disparities, its status as a leading cause of death among seniors, rising mortality rates, preventable risk factors (e.g., hypertension, inactivity), benefits of early diagnosis, caregiver strain, and escalating costs (estimated at $360 billion in 2024, rising to $1.1 trillion by 2050).
- Annual Wellness Visit Amendment: Mandates detection of cognitive impairment using tools approved by the National Institute on Aging (NIA) for primary care settings. Requires documentation of the tool used and assessment results in the patient's medical record.
- Initial Preventive Physical Examination Amendment: Adds a requirement for cognitive impairment detection, mirroring the annual wellness visit standards, as part of the personalized prevention plan.
- Effective Date: Changes apply to services provided on or after January 1, 2026.
Significant Changes to Existing Law
- Amends Section 1861(hhh)(2) of the Social Security Act by replacing subparagraph (D) in the annual wellness visit definition to explicitly include cognitive impairment detection, shifting from optional to mandatory screening with standardized tools.
- Modifies Section 1861(ww)(1) of the Social Security Act to insert cognitive impairment detection into the "Welcome to Medicare" initial exam, which previously focused on other preventive elements like cardiovascular and cancer screenings without this specific requirement.
These updates integrate dementia screening into core Medicare preventive benefits without altering payment structures or eligibility.
Potential Impacts
- On Citizens: Medicare beneficiaries, particularly those aged 65 and older, may benefit from earlier identification of cognitive issues, leading to better access to care, support services, and clinical trials. This could reduce out-of-pocket costs (currently 25% of dementia-related expenses) and ease the emotional and health burdens on family caregivers, who provide $347 billion in unpaid care annually.
- On Government Agencies: The Centers for Medicare & Medicaid Services (CMS) will need to update guidelines, train providers, and ensure compliance, potentially increasing short-term administrative costs but yielding long-term savings by preventing advanced dementia stages. Medicare and Medicaid, covering 64% of dementia care costs, could see moderated growth in expenditures.
- On International Relations: No direct impacts, as the bill focuses on domestic U.S. healthcare policy.
Main Stakeholders Affected
- Medicare Enrollees: Primarily seniors, including disproportionately affected groups like Black Americans (twice as likely), Latino Americans (1.5 times as likely), and women (two-thirds of cases).
- Healthcare Providers: Physicians and primary care teams must incorporate NIA-approved screening tools (brief assessments like memory tests) into visits, with added documentation responsibilities.
- Caregivers and Families: Over 11.5 million unpaid caregivers may experience reduced strain through earlier interventions.
- Government and Advocacy Groups: CMS for implementation; organizations like the Alzheimer's Association for alignment with national plans; NIA for tool validation.
- Insurers and Payers: Medicare program bears primary costs, with potential ripple effects on private insurers via shared risk factors.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens preventive care under Medicare (title XVIII of the Social Security Act) without expanding benefits or entitlements, ensuring compliance with existing reimbursement rules. Relies on NIA's evidence-based criteria to avoid arbitrary standards.
- Constitutional: No apparent challenges; aligns with Congress's authority to regulate interstate commerce and social welfare programs, promoting public health without infringing on individual rights.
- Political: Supports bipartisan efforts (introduced by a diverse group of representatives) to address aging demographics and health equity, potentially influencing future dementia research funding or risk-reduction initiatives in the National Plan to Address Alzheimer's Disease. May face debate over implementation costs versus preventive benefits.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Sánchez, Linda T. [D-CA-38]
Cosponsors (30)
Rep. LaHood, Darin [R-IL-16], Rep. Matsui, Doris O. [D-CA-7], Rep. Bilirakis, Gus M. [R-FL-12], Rep. Sewell, Terri A. [D-AL-7], Rep. Schakowsky, Janice D. [D-IL-9], Rep. Chu, Judy [D-CA-28], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Cohen, Steve [D-TN-9], Rep. Raskin, Jamie [D-MD-8], Rep. Vargas, Juan [D-CA-52], Rep. Tlaib, Rashida [D-MI-12], Rep. Gottheimer, Josh [D-NJ-5], Rep. Sherrill, Mikie [D-NJ-11], Rep. Titus, Dina [D-NV-1], Rep. Khanna, Ro [D-CA-17], Rep. Barragán, Nanette Diaz [D-CA-44], Rep. Waters, Maxine [D-CA-43], Rep. Pocan, Mark [D-WI-2], Rep. Trahan, Lori [D-MA-3], Rep. Magaziner, Seth [D-RI-2], Rep. Fitzpatrick, Brian K. [R-PA-1], Rep. Davis, Donald G. [D-NC-1], Rep. Bacon, Don [R-NE-2], Rep. Landsman, Greg [D-OH-1], Rep. Stanton, Greg [D-AZ-4], Rep. Pingree, Chellie [D-ME-1], Rep. Salazar, Maria Elvira [R-FL-27], Rep. Miller, Carol D. [R-WV-1], Rep. Kiggans, Jennifer A. [R-VA-2], Rep. Auchincloss, Jake [D-MA-4]
Recent Actions
- 2025-05-19: Referred to the Committee on Energy 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 jurisdiction of the committee concerned.
- 2025-05-19: Referred to the Committee on Energy 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 jurisdiction of the committee concerned.
- 2025-05-19: Introduced in House
- 2025-05-19: Introduced in House
Bill Versions
- 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. — issued 2025-05-19 — PDF (5 pages)