H.R. 9823: Alzheimer’s Early Detection Act of 2026

This bill would require most health coverage to pay for Alzheimer’s biomarker testing, which is testing of blood, tissue, or other biospecimens for signs associated with Alzheimer’s disease.

What coverage would be required

• Private health plans: Group health plans and individual and group health insurers would have to cover Alzheimer’s biomarker testing as a benefit.
• Medicaid: State Medicaid programs would also have to cover this testing.

How the testing would be covered

The bill says coverage for this testing would have to be provided in a way similar to other covered medical services. In practice, that means:

• Plans could not make the cost-sharing rules for this testing more restrictive than they are for most other medical and surgical benefits.
• Plans could not apply special treatment limits only to this testing.
• If prior authorization is required, the plan would have to decide within 72 hours, or within 24 hours if the provider says delay could seriously harm the patient’s life or health.
• If the plan does not respond on time, the request would be treated as approved.
• Plans could not require step therapy before covering the test.
• Coverage would need to be structured to support equitable access, including for rural and underserved populations, and to use minimally invasive testing when appropriate.

What counts as Alzheimer’s biomarker testing

The bill defines this broadly as analysis of tissue, blood, or other biospecimens for biomarkers, including single tests, multi-test panels, protein expression tests, and certain genomic sequencing tests, when used for:

• early detection, risk stratification, diagnosis, treatment, management, or ongoing monitoring of Alzheimer’s disease;
• use consistent with FDA labeling;
• determining eligibility for or managing treatment with an FDA-approved Alzheimer’s drug;
• use consistent with Medicare coverage determinations; or
• use consistent with clinical practice guidelines or expert consensus statements.

Timing

• The private insurance changes would take effect for plan years starting one year after enactment.
• The Medicaid changes would take effect for calendar quarters starting one year after enactment.

Reporting requirement

The bill would also require the NIH Director to arrange, through the National Academies of Sciences, Engineering, and Medicine, a study and report to Congress on the value of biomarker testing for detecting and treating Alzheimer’s disease. The first report would be due within one year after enactment, with annual reports for the next two years.

Relevant Companies

• UNH — UnitedHealth Group; as a major health insurer and operator of employer-sponsored coverage, it could face expanded coverage obligations for Alzheimer’s biomarker testing.
• HUM — Humana; as a large insurer with Medicare-related business, it could be affected by broader coverage requirements and utilization of Alzheimer’s testing.
• CVS — CVS Health; through its health insurance operations, it could be affected by new mandated coverage requirements.
• CNC — Centene; as a major Medicaid managed care and insurance company, it could be affected by required Medicaid coverage and private-plan coverage rules.
• CI — The Cigna Group; as a large health insurer, it could be affected by the mandated coverage and prior authorization rules.
• ELV — Elevance Health; as a major insurer, it could be affected by the requirement to cover this testing in group and individual plans.