; (ii) specialists and other clinicians with expertise in diagnosing or treating Alzheimer’s disease and related dementias; (iii) available community-based services, including patient and caregiver counseling and social support services; and (iv) appropriate clinical trials. . (2) Effective date The amendments made by paragraph (1) shall apply to annual wellness visits furnished on or after January 1, 2020. (b) Initial preventive physical examination (1) In general Section 1861(ww)(1) of the Social Security Act ( 42 U.S.C. 1395x(ww)(1) ) is amended by inserting detection of any cognitive impairment or progression of cognitive impairment as described in subparagraph (D) of subsection (hhh)(2) and referrals as described in subparagraph (I) of such subsection, after upon the agreement with the individual, . (2) Effective date The amendments made by paragraph (1) shall apply to initial preventive physical examinations furnished on or after January 1, 2020. 3. Medicare quality payment program Not later than January 1, 2020, the Secretary of Health and Human Services shall implement Medicare policies under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq.), including quality measures and Medicare Advantage plan rating and risk adjustment mechanisms, that reflect the public health imperative of— (1) promoting healthy brain lifestyle choices; (2) identifying and responding to patient risk factors for Alzheimer’s disease and related dementias; and (3) incentivizing providers for— (A) adequate and reliable cognitive impairment detection in the primary care setting, that is documented in the electronic health record of the patient and communicated to the patient; (B) timely Alzheimer’s disease diagnosis