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HB 666

Maryland Medical Assistance Program and Health Insurance - Required Coverage for Calcium Score Testing

2025 Regular Session Introduced by Gabriel Acevero and 55 co-sponsors

Maryland mandates Medicaid and insurers cover coronary artery calcium scoring tests without prior authorization or patient cost-sharing to increase cardiovascular disease screening access.

Approved by the Governor - Chapter 684
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Bill Summary · HB 666

Legislative bill overview

HB 666 requires Maryland's Medical Assistance Program (Medicaid) and health insurance plans to cover coronary artery calcium (CAC) scoring tests without prior authorization or cost-sharing requirements. Calcium score testing is a non-invasive imaging procedure that measures calcium buildup in coronary arteries to assess cardiovascular disease risk. The bill became law in May 2025 after passing both chambers and receiving gubernatorial approval.

Why is this important

Cardiovascular disease remains a leading cause of death, and early risk identification can enable preventive interventions. By removing financial and administrative barriers to calcium scoring, the legislation aims to increase access to this screening tool for Medicaid beneficiaries and insured individuals who may otherwise delay or forgo testing due to cost or approval delays. However, the expansion of coverage mandates increases insurance costs, which may be passed to consumers or employers.

Potential points of contention

  • Cost implications: Mandatory coverage without cost-sharing expands insurer liability, potentially raising premiums for all policyholders to subsidize screening for some
  • Clinical utility debate: Medical societies hold varying positions on calcium scoring's effectiveness as a primary screening tool versus its use for specific risk groups, raising questions about whether universal coverage is evidence-based
  • Prior authorization removal: Eliminating prior authorization increases utilization and costs but may reduce inappropriate denials of medically necessary tests

Compiled from official sources — confirm details with the bill’s official record.

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