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Bill would require insurers to cover coronary calcium score testing for higher‑risk patients
Summary
Delegate Jamila Woods reintroduced a bill (HB 6-66) to require Medicaid and commercial insurers to cover coronary artery calcium (CAC) testing for people with three or more specified risk factors; the sponsor framed the test as an evidence‑based predictor that can guide preventive care and reduce future cardiovascular events.
Delegate Jamila Woods presented House Bill 6-66, which would require Maryland Medical Assistance and private insurers to cover coronary artery calcium (CAC) testing for people with at least three of the following risk factors: high blood pressure, diabetes, high cholesterol or a family history of premature coronary artery disease. The sponsor said CAC testing is an evidence‑based, cost‑effective tool for identifying elevated cardiovascular risk among asymptomatic patients and can guide preventive care.
Several patient witnesses and advocates, including heart‑attack survivors and representatives of the Open My Heart Foundation, supported the bill and gave personal testimony about late or missed diagnoses. Delegate Woods said CAC testing is already covered by Medicaid in some circumstances but that commercial coverage varies and that the bill would make coverage uniform for those meeting the specified risk profile.
The Department of Health submitted written support with suggested amendments to add certain risk‑group clarifications (such as autoimmune disease and smoking). The Maryland Health Care Commission had prepared analysis and the sponsor indicated she would accept technical changes the Department suggested. Insurers raised concerns in written testimony and cautioned about premium impact and the need to calibrate clinical criteria. Sponsor and supporters noted a Texas law (HB 1290) as precedent and cited clinical and programmatic arguments that targeted CAC screening can reduce downstream costs by focusing preventive care on those at highest risk.
Committee discussion focused on whether additional risk groups should be included and on the change’s likely fiscal impact; the Department of Health told the committee the fiscal effect would be minimal for a narrowly defined population and expressed support for agreed clarifying amendments.
No formal vote was taken at the hearing; the sponsor asked to work with stakeholders on technical amendments.
