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A BILL TO BE ENTITLED
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AN ACT
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relating to the modernization of cardiovascular screening and |
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prevention under the Texas Heart Attack Prevention Bill (HB 1290). |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1369.301, Insurance Code, is amended to read as |
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follows: |
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(a) In this section, "advanced cardiovascular screening" means: |
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(1) Coronary Computed Tomography Angiography (CCTA) with Advanced |
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Plaque Analysis; |
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(2) Quantitative Disease Tracking conducted every one to four years |
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based on disease severity as determined by CCTA; |
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(3) Telecardiology Consultations for patient review and education |
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by a qualified healthcare provider. |
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(b) A health benefit plan that provides coverage for screening and |
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diagnostic evaluations of cardiovascular disease shall provide |
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coverage for advanced cardiovascular screening for eligible |
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individuals, which shall replace prior screening methodologies, |
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including but not limited to coronary artery calcium scoring and |
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carotid intima-media thickness ultrasonography. |
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(c) Coverage for advanced cardiovascular screening shall include: |
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(1) The use of CCTA with Advanced Plaque Analysis to provide a |
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comprehensive assessment of coronary artery disease by visualizing |
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luminal and plaque characteristics for improved diagnostic |
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accuracy, prognostic risk stratification, and therapeutic |
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decision-making; |
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(2) Implementation of Quantitative Disease Tracking at intervals |
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of one to four years, determined based on individual risk profiles, |
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with most individuals undergoing repeat CCTA every three to four |
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years; |
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(3) Telecardiology Consultations to provide expert cardiovascular |
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evaluations remotely, ensuring accessibility to specialized care |
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statewide; |
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(4) An increase in the mandatory reimbursement cap to $2,000 to |
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reflect the advanced nature of diagnostic procedures and |
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associated consultations, in alignment with national reimbursement |
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trends set by the Centers for Medicare & Medicaid Services (CMS). |
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SECTION 2. The following amendments are made to reflect advances in |
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cardiovascular imaging and risk assessment: |
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(a) Coronary Computed Tomography Angiography (CCTA) with Advanced |
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Plaque Analysis is recognized as the most comprehensive screening |
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modality, identifying all plaque types including non-calcified, |
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lipid-rich plaques, which have been demonstrated in landmark |
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clinical trials to be the strongest predictors of future |
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cardiovascular events. |
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(b) The inclusion of AI-enabled software for whole-heart |
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quantification and characterization of coronary atherosclerotic |
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plaque is mandated, ensuring a precise assessment of disease |
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progression or regression. |
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(c) The implementation of serial CCTA and plaque analysis at |
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tailored intervals (every one to four years) ensures effective |
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riskstratificationandidentificationof individualswith |
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residual risk of major adverse cardiovascular events following |
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initial medical treatment, addressing an estimated 80% of such |
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cases. |
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SECTION 3. The changes in law made by this Act apply only to |
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screenings performed on or after the effective date of this Act. Any |
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screening performed before the effective date of this Act is |
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governed by the law in effect at the time the screening was |
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conducted, and the former law is continued in effect for that |
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purpose. |
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SECTION 4. This Act takes effect immediately if it receives a vote |
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of two-thirds of all the members elected to each house, as provided |
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by Section 39, Article III, Texas Constitution. If this Act does not |
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receive the vote necessary for immediate effect, this Act takes |
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effect September 1, 2025. |