Legislation to educate clinicians on care planning services available through Medicare
WASHINGTON, D.C., March 27, 2019
— The Alzheimer's Association and its advocacy arm, the Alzheimer’s Impact Movement (AIM), are proud to support the bipartisan Improving HOPE for Alzheimer’s Act (S. 880/H.R. 1873). The bill was introduced today by Sens. Debbie Stabenow (D-Mich.), Susan Collins (R-Maine), Ed Markey (D-Mass.), Shelley Moore Capito (R-W.Va.), and Bob Menendez (D-N.J.), and by Reps. Paul Tonko (D-N.Y.), Jackie Walorski (R-Ind.), Earl Blumenauer (D-Ore.), Brett Guthrie (R-Ky.), Maxine Waters (D-Calif.) and Chris Smith (R-N.J.). The bipartisan bill would support provider education and outreach to improve awareness and utilization of comprehensive Alzheimer’s and dementia care planning services covered under Medicare.
“For the more than 5 million Americans currently living with Alzheimer’s, and the 14 million expected to develop the disease by 2050, early detection, documented diagnosis and access to care-planning services are increasingly critical,” said Robert Egge, Alzheimer's Association chief public policy officer and AIM executive director
. “The Alzheimer’s Association and AIM thank our bipartisan Congressional champions for addressing this need with the introduction of the Improving HOPE for Alzheimer’s Act.”
Care planning allows diagnosed individuals and their caregivers to learn about medical and non-medical treatments, clinical trials, and support services available in the community — resulting in a higher quality of life for those with the disease. Studies have shown that individuals receiving dementia-specific care planning have fewer hospitalizations, fewer emergency room visits, and better medication management. And, for individuals with dementia and another chronic conditions, care coordination is also critical for disease management.
Since January 2017, Medicare has covered care planning for individuals with cognitive impairment, providing clinicians the time and resources to provide a comprehensive set of care planning services to people with cognitive impairment and their caregivers. However, patients and medical providers are often not aware of this resource. In the first year the care planning reimbursement was available (2017), fewer than 1% of seniors living with Alzheimer’s received the care planning benefit.
The Improving HOPE for Alzheimer’s Act requires the Centers for Medicare & Medicaid Services (CMS) to conduct education and outreach about care planning services available for individuals with Alzheimer’s disease and related dementias to physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse midwives. Additionally, it requires a report to Congress on provider outreach and utilization rates, including information on any barriers Medicare beneficiaries face in accessing these services and recommendations to address those barriers.
“Thanks to our HOPE for Alzheimer’s Act, patients and caregivers can now get the information and support they need to cope with this heartbreaking disease,” said Sen. Stabenow
. “We need to take the next step to make sure patients and their families can take advantage of the resources that are now available to them.”
"When patients receive a devastating diagnosis of dementia, it is imperative that they and their families receive the resources they need, including information about treatment options and what medical and community services are available,” said Sen. Collins
. “Fortunately, following my advocacy with Senator Stabenow, CMS implemented a new rule last year that allows Medicare beneficiaries to receive a care planning session. Our legislation would help expand access to this service by increasing awareness of this policy change among physicians. As the Co-Chair of the Senate Alzheimer’s Task Force, I will continue to support patients and their caregivers.”
"This legislation encourages doctors to talk to their patients about an Alzheimer's diagnosis and ensures that the necessary steps are taken to provide them with access to available care planning services," said Egge
The Improving HOPE for Alzheimer’s Act builds upon the success of the bipartisan HOPE for Alzheimer’s Act, which was first introduced in 2009 and designed to provide comprehensive care planning services following a dementia diagnosis with the services available to both the diagnosed individual and a caregiver. The Alzheimer’s Association, AIM and its nationwide network of advocates grew bipartisan support for the bill, culminating in more than two-thirds of Congress — 310 House and 57 Senate — signing on as cosponsors. In October 2016 CMS announced a new care planning billing code, 99483, which was officially implemented on January 1, 2017.
With the code, clinicians can have the time and resources to provide a comprehensive set of care planning services to people with cognitive impairment and their caregivers. Through education and outreach to providers about the comprehensive Alzheimer’s disease and related dementia care planning services now available under Medicare, the now-introduced Improving HOPE for Alzheimer’s Act seeks to give clinicians the knowledge and the tools to better help their patients and families living with dementia.
“Receiving an Alzheimer’s diagnosis is one of the scariest and most disorienting moments a family can face. Having your health care provider take the time to walk you through your diagnosis and care planning options can make all the difference during this trying time. I’m proud to introduce the Improving HOPE for Alzheimer’s Act, which will ensure that more families are able to take advantage of this benefit, so that they can better prepare for the challenges that an Alzheimer’s diagnosis brings, resulting in better treatment, better outcomes and more peace of mind,” said Rep. Tonko
“For Alzheimer’s patients, as well as their families and caregivers, care planning can make a real difference in their quality of life and help them get the best care possible,” Rep. Walorski said
. “Medicare coverage now includes comprehensive care planning so individuals with Alzheimer’s disease and other forms of dementia can learn about the treatments, services, and other supports available to them. The Improving HOPE for Alzheimer’s Act will improve access to care planning by ensuring doctors and other medical providers are fully informed of the services they can provide under Medicare.”
The Alzheimer’s Association is the leading voluntary health organization in Alzheimer's care, support and research. Our mission is to eliminate Alzheimer’s disease through the advancement of research, to provide and enhance care and support for all affected, and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer’s. For more information, visit alz.org.
Alzheimer's Impact Movement
The Alzheimer's Impact Movement (AIM) is the advocacy arm of the Alzheimer's Association. AIM works to develop and advance policies to overcome Alzheimer's disease through increased investment in research, enhanced care and improved support. For more information, visit alzimpact.org.