Medicare to cover early Alzheimer's blood tests starting 2028

What it does

This bill amends Medicare law to cover blood-based screening tests for early-stage Alzheimer's disease and related dementias, effective January 1, 2028. The tests must be FDA-cleared, classified, or approved, and include genomic sequencing, protein analysis, or other biomarker tests the Secretary deems equivalent. Medicare will pay for these tests as a covered service.

Why we flagged it

The bill's operative mechanism is straightforward: it adds a new category of preventive screening tests to Medicare's covered services. This is a standard coverage amendment, not a carve-out or restriction.

What the text implies

• The Secretary has broad discretion to define 'equivalent' tests beyond the listed categories (genomic sequencing, protein expression, imaging), potentially expanding coverage scope without further legislative action.
• Effective date of January 1, 2028 creates a 3-year lag before coverage begins, during which test developers and manufacturers may accelerate FDA submissions and market positioning.
• No explicit payment rate or reimbursement cap is stated in the bill; payment methodology will be determined under existing Medicare payment rules, which may result in variable reimbursement across test types.
• Coverage of pre-symptomatic screening (asymptomatic individuals with no cognitive symptoms) is broader than typical Medicare preventive services and may drive high utilization among the 65+ population.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

Medicare beneficiaries gain access to early dementia screening tests at no cost-sharing, enabling earlier detection and potential intervention. The bill does not restrict existing coverage or impose new limitations on beneficiaries; it expands a preventive service.

Who stands to gain

• in vitro diagnostic (IVD) manufacturers producing blood biomarker tests
• genomic sequencing companies
• clinical laboratory service providers
• diagnostic imaging providers (if imaging-based tests are deemed equivalent)

Named in the bill

Medicare, Social Security Act, FDA (Food and Drug Administration), Section 510(k), Section 513(f)(2), Section 515, Federal Food, Drug, and Cosmetic Act, Secretary of Health and Human Services

Where it stands

57 cosponsors: 32 Democrats, 25 Republicans.

• Nov 20, 2025 — Introduced · Congress.gov: “Introduced in Senate”
• Nov 20, 2025 — Referred to Senate Committee on Finance · Congress.gov: “Read twice and referred to the Committee on Finance. (Sponsor introductory remarks on measure: CR S8278-8279)”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

10 lobbying clients named this bill on 13 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $3,950,000 in lobbying spend. A filing names 9 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 91% of bills with at least one filing.

Susan Collins, the sponsor, reported $2,459,513 in PAC receipts in the 2026 cycle. $2,000 of that came from 1 PAC tied to these lobbying clients.

• Eisai Inc. — $1,500,000 on 2 filings
• Biogen — $1,060,000 on 1 filing
• Acadia Pharmaceuticals — $700,000 on 1 filing
• Usagainstalzheimers Action — $220,000 on 2 filings
• The Michael J. Fox Foundation for Parkinson's Research — $150,000 on 1 filing

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.