2025 SESSION

INTRODUCED

25104137D

HOUSE JOINT RESOLUTION NO. 464

Offered January 13, 2025

Prefiled January 8, 2025

Directing the Health Insurance Reform Commission to study requiring insurance carriers to provide coverage for certain tests for the early detection of cardiovascular disease in at-risk populations. Report.

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Patron—Earley

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Referred to Committee on Rules

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WHEREAS, cardiovascular disease is the leading cause of death for men and women in the United States; and

WHEREAS, early detection of cardiovascular disease can lead to better health outcomes and reduced health care costs; and

WHEREAS, the buildup of coronary calcium and plaque in the carotid arteries can cause the inner layers of the walls of the carotid arteries to grow thicker over time, which may signal an elevated risk for cardiovascular disease; computed tomography scans measuring coronary artery calcification or ultrasonography scans measuring carotid intima-media thickness and plaque can help determine the risk of cardiovascular disease; now, therefore, be it

RESOLVED by the House of Delegates, the Senate concurring, That the Health Insurance Reform Commission be directed to study requiring insurance carriers to provide coverage for certain tests for the early detection of cardiovascular disease in at-risk populations. Such coverage would include coverage for computed tomography scans measuring coronary artery calcification or ultrasonography scans measuring carotid intima-media thickness and plaque for an enrollee who is a male between the ages of 45 and 75 or a female between the ages of 55 and 75 and who is diabetic or has a risk of developing coronary heart disease based on an intermediate or higher score using the Framingham Heart Study coronary prediction algorithm.

In conducting its study, the Health Insurance Reform Commission (the Commission) shall assess the social and financial impact and the medical efficacy of such coverage, which assessment shall include an estimate of the effects of the enactment of the proposed mandate on the costs of health coverage in the Commonwealth, including any estimated additional costs that the Commonwealth may be responsible for pursuant to § 1311(d)(3)(B) of the federal Patient Protection and Affordable Care Act. The Commission shall determine whether such coverage should be considered as part of an essential health benefits benchmark plan review in accordance with the provisions of § 30-343.1 of the Code of Virginia.

The Office of the Clerk of the House of Delegates shall provide administrative staff support to the Commission for this study. The Division of Legislative Services shall provide legal, research, policy analysis, and other services as requested by the Commission. Technical assistance shall be provided to the Commission by the Bureau of Insurance. All agencies of the Commonwealth shall provide assistance to the Commission for this study, upon request.

The Commission shall complete its meetings by November 30, 2025, and the chairman shall submit to the Division of Legislative Automated Systems an executive summary of its findings and recommendations no later than the first day of the 2026 Regular Session of the General Assembly. The executive summary shall state whether the Commission intends to submit to the General Assembly and the Governor a report of its findings and recommendations for publication as a House or Senate document. The executive summary and report shall be submitted as provided in the procedures of the Division of Legislative Automated Systems for the processing of legislative documents and reports and shall be posted on the General Assembly's website.