SB278 expands and standardizes insurance coverage for coronary artery calcium (CAC) screening across several New Mexico health coverage laws. The bill renames the covered service from “heart scan” to “coronary artery calcium screening” and requires group health coverage, health maintenance organization contracts, and medical assistance coverage to pay for the screening when ordered at a health care provider’s discretion as a clinical management tool. It also removes cost sharing for the screening, meaning eligible patients would not pay deductibles, copayments, or coinsurance for the test.
The bill broadens eligibility by deleting the prior age-and-risk definition of “eligible insured/enrollee/subscriber,” which had limited coverage to people ages 45 to 65 with an intermediate risk of coronary heart disease. It also changes the repeat-testing interval from every five years to every four years for people whose prior CAC score was zero, while continuing to state that future screenings are not required if the score is greater than zero. The bill keeps existing exclusions for short-term travel, accident-only, and limited or specified-disease policies, and it applies to policies and plans delivered, issued, or renewed on or after January 1, 2026.
Impact
SB278 amends multiple sections of the New Mexico Insurance Code, the Health Care Purchasing Act, and the Public Assistance Act to require coverage of CAC screening without cost sharing in group health plans, HMO contracts, and Medicaid-related medical assistance coverage. By removing the prior statutory eligibility limits, the bill appears to make access to the screening broader and more dependent on provider judgment than on age or calculated cardiovascular risk. The practical effect is to mandate insurer and managed-care coverage for a preventive cardiovascular diagnostic test under the specified conditions, beginning with policies renewed or issued on or after January 1, 2026.
Sentiment
The available voting history suggests the bill had meaningful but not unanimous support in the Senate, passing final passage 24-15. No committee transcripts are provided, so there is no recorded discussion to indicate detailed arguments for or against the measure. The vote pattern indicates a generally favorable sentiment toward expanding preventive cardiac screening coverage, but with a substantial minority opposed or unconvinced.
Contention
The main points of contention likely center on cost and scope. Supporters would favor eliminating out-of-pocket costs and broadening access to CAC screening as a preventive tool, while opponents may be concerned about requiring insurers and public programs to cover a test more broadly, especially after the bill removes the prior age and intermediate-risk eligibility limits. Another possible issue is the shift from a more defined eligibility standard to provider discretion, which may raise concerns about utilization, medical necessity, and insurance premium or program cost impacts.
Exempting elective percutaneous coronary intervention performed in certain hospitals owned or operated by a state entity from certificate of need requirements.