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*hb1364*
HOUSE BILL 1364
J3, J1 6lr0639
By: Delegate Pena –Melnyk Delegates Pena –Melnyk, Alston, Bagnall, Cullison,
Guzzone, Hill, Hutchinson, S. Johnson, Kaufman, Kipke, Lopez, Martinez,
Reilly, Rosenberg, Ross, Taveras, White Holland, and Woorman
Introduced and read first time: February 13, 2026
Assigned to: Health
Committee Report: Favorable with amendments
House action: Adopted
Read second time: February 26, 2026
CHAPTER ______
AN ACT concerning 1
Public Health – Mammograms – Arterial Calcification Notice 2
FOR the purpose of requiring certain centers where mammography testing is performed to 3
include in the screening results letter that is sent to a patient, as required by federal 4
law, a notice of the presence of arterial calcification as observed during the patient’s 5
mammogram; and generally relating to mammography testing. 6
BY repealing and reenacting, with amendments, 7
Article – Health – General 8
Section 20–115 9
Annotated Code of Maryland 10
(2023 Replacement Volume and 2025 Supplement) 11
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 12
That the Laws of Maryland read as follows: 13
Article – Health – General 14
20–115. 15
(a) (1) In this section the following words have the meanings indicated. 16
2 HOUSE BILL 1364
(2) (i) “Center” means any facility that produces, develops, or 1
interprets: 2
1. Screening mammograms; or 3
2. Diagnostic mammograms. 4
(ii) “Center” includes a hospital, outpatient depart ment, medical 5
laboratory, clinic, radiology practice, office of a health care provider, or other testing facility 6
conducting mammography testing. 7
(iii) “Center” does not include a facility of the federal Department of 8
Veterans Affairs. 9
(3) “Dense breast tissue” means heterogeneously dense or extremely dense 10
tissue as defined in nationally recognized guidelines or systems for breast imaging 11
reporting of mammography screening, including the breast imaging reporting and data 12
system of the American College of Radiology. 13
(4) “Mammogram” means a radiographic image produced through 14
mammography. 15
(5) “Mammography testing” means the imaging of the breast with ionizing 16
radiation. 17
(b) On or after July 1, 1992, a person may not perform mammography testing 18
unless: 19
(1) The individual performing mammography testing is qualified under 20
Title 14 of the Health Occupations Article; and 21
(2) The center where the mammography testing is performed: 22
(i) Is accredited or has applied for accreditation under the American 23
College of Radiology Screening Mammography Accreditation Program; and 24
(ii) Has obtained a certificate of approval from the federal Food and 25
Drug Administration as specified in the federal Mammography Quality Standards Act of 26
1992. 27
(c) (1) (i) This section SUBSECTION does not apply if the federal 28
Mammography Quality Standards Act of 1992, or regulations adopted under the Act, 29
requires a notice regarding breast density to be included in the screening results letter that 30
is sent to a patient. 31
(ii) This section SUBSECTION may not be construed to: 32
HOUSE BILL 1364 3
1. Require a notice regarding breast density to be sent to a 1
patient that is inconsistent with the provisions of the federal Mammography Quality 2
Standards Act of 1992, or regulations adopted under the Act; or 3
2. Create a standard of care, obligation, or duty that provides 4
a basis for a cause of action. 5
(2) Subject to paragraph (3) of this subsection, a center where 6
mammography testing is performed shall include in a screening results letter that is sent 7
to a patient, as required by federal law, the following notice: “This notice contains the 8
results of your recent mammogram, including information about breast density. 9
If your mammogram shows that your breast tissue is dense, you should kno w that 10
dense breast tissue is a common finding and is not abnormal, with about half of women 11
having dense or highly dense breasts. However, dense breast tissue can make it harder to 12
find cancer on a mammogram and may also be associated with an increased risk of cancer. 13
IF YOUR MAMMOGRAM SHO WS BREAST ARTERIAL C ALCIFICATION, YOU 14
SHOULD KNOW THAT BRE AST ARTERIAL CALCIFI CATION IS A COMMON F INDING. 15
HOWEVER, BREAST ARTERIAL CALC IFICATION MAY BE AN INDICATOR OF AN 16
INCREASED RISK OF CA RDIOVASCULAR DISEASE. IF YOU HAVE BREAST ARTERIAL 17
CALCIFICATIONS, PLEASE DISCUSS THIS WITH YOUR PHYSICIAN TO ASSESS YOUR 18
CARDIOVASCULAR RISKS AND DETERMINE IF ADD ITIONAL TESTING MAY BE 19
APPROPRIATE FOR YOU. 20
This information about the result of your mammogram is given to you to raise your 21
awareness and to inform your conversations with your physician. Together, you can decide 22
whether additional screening options are right for you based on your mammogram results, 23
individual risk factors, or physical examination. A report of your result s was sent to your 24
physician.”. 25
(3) If the Department finds significant differences between the content of 26
the notice that is required to be provided under paragraph (2) of this subsection and current 27
medical evidence on breast density, the Department may adopt regulations that change the 28
content of the notice. 29
(d) (1) THIS SUBSECTION MAY N OT BE CONSTRUED TO C REATE A 30
STANDARD OF CARE, OBLIGATION, OR DUTY THAT PROVIDES A BASIS FOR A CAUS E 31
OF ACTION. 32
(2) SUBJECT TO PARAGRAPH (3) OF THIS SUBSECTION , A CENTER 33
WHERE MAMMOGRAPHY TESTING IS PERFORMED SHALL INCLUDE IN A SC REENING 34
RESULTS LETTER THAT IS SENT TO A PATIENT, AS REQUIRED BY FEDERAL LAW, THE 35
FOLLOWING NOTICE: 36
4 HOUSE BILL 1364
“THIS NOTICE CONTAINS THE RESULTS OF YOUR RECENT MAMMOGRAM , 1
INCLUDING INFORMATION ABOUT BREAST ARTERIAL CALCIFICATION. 2
IF YOUR MAMMOGRAM SHO WS BREAST ARTERIAL C ALCIFICATION, YOU 3
SHOULD KNOW THAT BRE AST ARTERIAL CALCIFI CATION IS A COMMON F INDING. 4
HOWEVER, BREAST ARTERIAL CALC IFICATION MAY BE AN INDICATOR OF AN 5
INCREASED RISK OF CARDIOVASCULAR DISEASE. IF YOU HAVE BREAST AR TERIAL 6
CALCIFICATIONS, PLEASE DISCUSS THIS WITH YOUR PHYSICIAN TO ASSESS YOUR 7
CARDIOVASCULAR RISKS AND DETERMINE IF ADD ITIONAL TESTING MAY BE 8
APPROPRIATE FOR YOU. 9
THIS INFORMATION ABOUT THE RESULT OF YOUR MAMMOGRAM IS GIVEN TO 10
YOU TO RAISE YOUR AW ARENESS AND TO INFOR M YOUR CONVERSATIONS WITH 11
YOUR PHYSICIAN. TOGETHER YOU CAN DECIDE WHETHER ADDITIONAL SCREENING 12
OPTIONS ARE RIGHT FOR YOU BASED ON YOUR MAMMOGRAM RESULTS, INDIVIDUAL 13
RISK FACTORS, OR PHYSICAL EXAMINATION. A REPORT OF YOUR RESULTS WAS SENT 14
TO YOUR PHYSICIAN.”. 15
(3) IF THE DEPARTMENT FINDS SIGN IFICANT DIFFERENCES 16
BETWEEN THE CONTENT OF THE NOTICE THAT I S REQUIRED TO BE PRO VIDED 17
UNDER PARAGRAPH (2) OF THIS SUBSECTION AND CURRENT MEDICAL EVIDENCE ON 18
BREAST ARTERIAL CALC IFICATION, THE DEPARTMENT MAY ADOPT REGULATIONS 19
THAT CHANGE THE CONTENT OF THE NOTICE. 20
(E) Notwithstanding any other provision of this title, the penalty for a violation of 21
subsection (b) of this section may not exceed $1,000. 22
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 23
October 1, 2026. 24
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.