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Bill

SB 60

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

2025 Regular Session Introduced by Malcolm Augustine

Maryland mandates Medicaid and health insurers cover coronary calcium scoring tests without prior authorization or patient cost-sharing to improve early heart disease detection.

Approved by the Governor - Chapter 685
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Bill Summary · SB 60

Legislative bill overview

SB 60 requires Maryland's Medical Assistance Program (Medicaid) and health insurance plans to cover coronary artery calcium scoring tests—non-invasive imaging that measures plaque buildup in heart arteries. The bill mandates coverage without prior authorization requirements and without cost-sharing for eligible patients, making this preventive cardiac screening more accessible.

Why is this important

Coronary artery calcium scoring helps identify cardiovascular disease risk before symptoms appear, enabling early intervention that can prevent heart attacks and strokes. This mandate removes financial and administrative barriers to a screening tool that major medical organizations recommend for intermediate-risk patients, potentially improving early detection rates and health outcomes for Maryland residents.

Potential points of contention

  • Cost implications: Expanded coverage increases expenses for Medicaid and insurers, which may be passed to consumers through higher premiums or reduced state budgets for other programs
  • Medical necessity debates: Not all cardiologists agree calcium scoring is necessary for all patient populations; coverage without prior authorization could lead to overutilization or screening of lower-risk individuals
  • Insurance market impact: Private insurers may face compliance costs and utilization management challenges, potentially affecting plan design or pricing in Maryland's insurance market

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

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