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Committee hears bill to expand insurance coverage for advanced CT heart screening; insurers raise evidence and cost concerns
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Summary
Senate Bill 2744 would expand mandated insurance coverage to include coronary CT angiography with advanced plaque analysis to find non‑calcified plaque; physicians and a patient testified for the bill, while insurer representatives warned the preventive evidence review and price mandates are not yet in place.
Senate Bill 2744, offered by Senator Paxton, would expand insurance coverage for newer CT‑based heart screening that visualizes non‑calcified (“soft”) plaque and uses advanced analysis, including artificial intelligence, to assess coronary artery disease. Paxton and invited medical witnesses argued the technology identifies vulnerable plaque earlier than older calcium scoring methods and could permit preventive treatment to reduce heart‑attack deaths.
Paxton said the update would modernize the 2009 Heart Attack Prevention Act (House Bill 1290) to reflect current imaging capability. Cardiologist Dr. James Minh described the technology as a noninvasive CT method that visualizes soft plaque and argued the disease is far more prevalent than some cancers: “If you rewind back to 02/2020, there were 2 times as many cardiovascular deaths as there were deaths from COVID‑19,” he said, noting many people who suffer fatal heart attacks have no preceding symptoms.
A patient witness, John David Enright, said advanced CT angiography identified significant soft plaque despite a zero coronary calcium score and that medical therapy and lifestyle changes reduced his plaque by approximately 50% over a year. Proponents described the per‑person screening cost (CCTA plus analysis and consultation) as “a little south of $2,000” and compared that to average colonoscopy costs.
Jamie Dudensing, CEO of the Texas Association of Health Plans, testified in opposition. He said similar plaque analyses can be covered today for symptomatic patients following medical‑necessity reviews, but the technology has not received an A or B preventive‑service grade from the U.S. Preventive Services Task Force (USPSTF). Dudensing warned that a statutory mandate would set a specific payment level that could exceed Medicare averages and increase employer plan costs without the USPSTF evidence review.
Other witnesses testified in support, describing local direct‑to‑consumer scanning options at lower prices; advocate Sheila Hemphill described consumer availability of calcium scoring options. Committee members asked about prevalence and cost‑effectiveness; proponents said heart‑disease prevalence is far higher than colon cancer and that the number needed to screen compares favorably. The committee closed public testimony and left the bill pending.
