Senate committee hears testimony for coverage of coronary calcium scans to boost preventive cardiac care

Senators considered testimony Jan. 28 on Senate Bill 56, which would direct the Oregon Health Authority and certain health plans to cover coronary artery calcium CT scans ordered by clinicians to assess heart-disease risk in selected patients.

Supporters, including Sen. Cedric Hayden, Sen. Chris Gorsek and Clackamas County Commissioner and OHSU cardiac nurse Phil West, said the scan is a noninvasive, 10–15 minute test that can identify coronary plaque and help clinicians and patients target preventive therapy, including lipid-lowering treatment, before costly and invasive cardiac events occur.

Why it matters: Proponents framed SB 56 as a prevention measure that could reduce downstream costs from heart attacks and hospitalizations by giving clinicians better risk information for patients with intermediate risk. Witnesses said the test is not intended for the general healthy population but for patients whose risk profile leaves clinicians uncertain about starting or intensifying preventive therapy.

Sen. Hayden said the test has been used in medicine for about 15 years and costs roughly $150 in some settings; he and others argued that preventing even one major cardiac event would offset screening costs. Sen. Gorsek described his own experience with preventive cardiac care and urged wider access to screening that he said could save lives and costs.

Phil West, a Clackamas County commissioner who also practices as a cardiac nurse at Oregon Health & Science University (OHSU), told the committee that OHSU has historically subsidized some of these scans but that rising costs and reduced subsidization mean many patients now face threefold higher prices. “The data received allows providers to effectively intervene and to prevent a more invasive, more expensive treatments,” West said, adding that the test helps tailor risk assessment and can reduce polypharmacy.

Committee members pressed witnesses on evidence and scale. Sen. Elizabeth Reynolds noted the U.S. Preventive Services Task Force has not issued a blanket recommendation for this screening and asked why Oregon should mandate coverage now. West and other proponents said the scan is targeted—typically for adults 40–70 with multiple risk factors—and used when clinicians are uncertain about treatment decisions; they offered to provide additional evidence and noted existing clinical guidelines in preventive cardiology.

Questions also focused on fiscal impact and population size. Committee staff noted the bill’s prior fiscal estimates (from a 2023 introduction) showed biennial costs in the low hundreds of thousands (about $805,000 for 2023–25 in prior analysis). Witnesses said actual costs depend heavily on how many tests clinicians order and whether private plans already cover some scans; members acknowledged the bill would primarily affect publicly funded plans and not necessarily self-insured employer plans.

The hearing closed without a recorded committee vote. Sponsors asked the committee to move the bill forward so preventive CT calcium scoring could be part of clinicians’ toolkits for selected patients.