Paxton’s Heart Screening Rewrite Mandates One Scan And AI Software

The text as introduced · 510 words

By: Paxton
S.B. No. 2744

A BILL TO BE ENTITLED

AN ACT

relating to the modernization of cardiovascular screening and

prevention under the Texas Heart Attack Prevention Bill (HB 1290).

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 1369.301, Insurance Code, is amended to read as

follows:

(a) In this section, "advanced cardiovascular screening" means:

(1) Coronary Computed Tomography Angiography (CCTA) with Advanced

Plaque Analysis;

(2) Quantitative Disease Tracking conducted every one to four years

based on disease severity as determined by CCTA;

(3) Telecardiology Consultations for patient review and education

by a qualified healthcare provider.

(b) A health benefit plan that provides coverage for screening and

diagnostic evaluations of cardiovascular disease shall provide

coverage for advanced cardiovascular screening for eligible

individuals, which shall replace prior screening methodologies,

including but not limited to coronary artery calcium scoring and

carotid intima-media thickness ultrasonography.

(c) Coverage for advanced cardiovascular screening shall include:

(1) The use of CCTA with Advanced Plaque Analysis to provide a

comprehensive assessment of coronary artery disease by visualizing

luminal and plaque characteristics for improved diagnostic

accuracy, prognostic risk stratification, and therapeutic

decision-making;

(2) Implementation of Quantitative Disease Tracking at intervals

of one to four years, determined based on individual risk profiles,

with most individuals undergoing repeat CCTA every three to four

years;

(3) Telecardiology Consultations to provide expert cardiovascular

evaluations remotely, ensuring accessibility to specialized care

statewide;

(4) An increase in the mandatory reimbursement cap to $2,000 to

reflect the advanced nature of diagnostic procedures and

associated consultations, in alignment with national reimbursement

trends set by the Centers for Medicare & Medicaid Services (CMS).

SECTION 2. The following amendments are made to reflect advances in

cardiovascular imaging and risk assessment:

(a) Coronary Computed Tomography Angiography (CCTA) with Advanced

Plaque Analysis is recognized as the most comprehensive screening

modality, identifying all plaque types including non-calcified,

lipid-rich plaques, which have been demonstrated in landmark

clinical trials to be the strongest predictors of future

cardiovascular events.

(b) The inclusion of AI-enabled software for whole-heart

quantification and characterization of coronary atherosclerotic

plaque is mandated, ensuring a precise assessment of disease

progression or regression.

(c) The implementation of serial CCTA and plaque analysis at

tailored intervals (every one to four years) ensures effective

risk stratification and identification of individuals with

residual risk of major adverse cardiovascular events following

initial medical treatment, addressing an estimated 80% of such

cases.

SECTION 3. The changes in law made by this Act apply only to

screenings performed on or after the effective date of this Act. Any

screening performed before the effective date of this Act is

governed by the law in effect at the time the screening was

conducted, and the former law is continued in effect for that

purpose.

SECTION 4. This Act takes effect immediately if it receives a vote

of two-thirds of all the members elected to each house, as provided

by Section 39, Article III, Texas Constitution. If this Act does not

receive the vote necessary for immediate effect, this Act takes

effect September 1, 2025.