---
title: SB 428. Medical Assistance; Department of Community Health to submit a waiver request to the federal Centers for Medicare and Medicaid Services; direct
collection: bills
id: 2025-2026/sb428
cite_as: SB 428, 2025-2026 Regular Session (Ga.)
canonical_url: https://georgiacommons.org/bills/2025-2026/sb428
md_url: https://georgiacommons.org/bills/2025-2026/sb428.md
text_url: https://georgiacommons.org/bills/2025-2026/sb428/text
source_url: https://www.legis.ga.gov/legislation/72468
date: 2026-05-11
status: passed
corpus_version: bills-2026-09-13
license: Public record of the Georgia General Assembly, via LegiScan; see about.md
publisher: Georgia Commons, an independent project of Georgia Civic Data. Not the State of Georgia. Not legal advice.
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omitted: votes and history
omitted_chars: 995
omitted_url: https://georgiacommons.org/bills/2025-2026/sb428.md?full=1
bill_number: SB 428
session: 2025-2026 Regular Session
session_slug: 2025-2026
chamber: Senate
bill_type: bill
status_date: 2026-05-11
last_action: Effective Date 2026-07-01
sponsors:
- Kay Kirkpatrick
- Bo Hatchett
- Ben Watson
- Drew Echols
- Kim Jackson
- Chuck Efstration
text_version: Enrolled
has_text: true
legiscan_url: https://legiscan.com/GA/bill/SB428/2025
upstream_id: 2095196
summaries_model: claude-sonnet-5
topic_tags:
- Medicaid
- mental health services
- healthcare policy
- home and community based care
---
# SB 428. Medical Assistance; Department of Community Health to submit a waiver request to the federal Centers for Medicare and Medicaid Services; direct
## Text
Senate Bill 428
By: Senators Kirkpatrick of the 32nd, Hatchett of the 50th, Watson of the 1st, Echols of the
49th and Jackson of the 41st
AS PASSED
A BILL TO BE ENTITLED
AN ACT
To amend Article 7 of Chapter 4 of Title 49 of the Official Code of Georgia Annotated,
relating to medical assistance generally, so as to direct the Department of Community Health
to submit a waiver request to the federal Centers for Medicare and Medicaid Services to
authorize the qualification for Medicaid reimbursement of certain home and community
based services; to provide for implementation upon approval; to provide for related matters;
to repeal conflicting laws; and for other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
Article 7 of Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to
medical assistance generally, is amended by adding a new Code section to read as follows:
"49-4-142.6.
(a) Not later than December 31, 2026, the department may submit a waiver request to the
federal Centers for Medicare and Medicaid Services to authorize the qualification for
Medicaid reimbursement of home and community based services for recipients of medical
assistance who are over the age of 21 and in need of mental health services but do not
require an institutional level of care, as determined by consideration of associated risk
factors, including, but not limited to, a history of hospitalization stays, psychiatric crises,
emergency department visits, prior incarceration, homelessness, or any combination
thereof.
(b) Upon approval of the waiver provided for in subsection (a) of this Code section, the
department shall take all necessary steps to provide for payment of such care and services
with Medicaid funds."
SECTION 2.
All laws and parts of laws in conflict with this Act are repealed.
## Summaries written by Georgia Commons
The following was written by claude-sonnet-5 from the text above and is not part of the bill. Quote the text, not the summary.
A Georgia Senate bill directs the Department of Community Health to seek federal approval to let Medicaid pay for home and community based mental health services for certain adults, rather than only institutional care.
### Plain-language summary
Currently, Georgia's Medicaid program largely reimburses mental health treatment provided in institutional settings. This bill adds a new section to Georgia's Medicaid law directing the Department of Community Health to submit a waiver request to the federal Centers for Medicare and Medicaid Services (the federal agency that oversees Medicaid) by December 31, 2026.
The waiver would seek permission for Medicaid to pay for home and community based services for adults over 21 who need mental health treatment but do not need an institutional level of care. Eligibility would be based on risk factors such as past hospital stays, psychiatric crises, emergency room visits, incarceration, or homelessness. If the federal government approves the waiver, the department must then take the steps needed to actually pay for that care using Medicaid funds.
### What it does
- Adds a new Code section (O.C.G.A. ยง 49-4-142.6) directing the Department of Community Health to submit a Medicaid waiver request by December 31, 2026.
- Targets Medicaid recipients over age 21 who need mental health services but do not require institutional level care.
- Defines qualifying risk factors including hospitalization history, psychiatric crises, ER visits, prior incarceration, and homelessness.
- Requires the department, once the waiver is approved, to take necessary steps to pay for these home and community based services with Medicaid funds.
- Repeals any conflicting Georgia laws.
### Who it affects
Adults over 21 on Medicaid who need mental health treatment but not institutional care, the Department of Community Health, which must apply for the waiver, and providers of home and community based mental health services who could become newly eligible for Medicaid reimbursement.
### Why it matters
If the federal waiver is approved, more Georgians with mental health needs could receive treatment at home or in their communities instead of institutions, potentially reaching people with histories of hospitalization, crisis episodes, incarceration, or homelessness who currently fall outside Medicaid's coverage of community-based mental health care.
### Key provisions
- Section 1 creates new Code section 49-4-142.6, giving the department authority (not a strict mandate, using 'may') to submit the waiver by December 31, 2026.
- The waiver targets adults over 21 needing mental health services who do not require institutional level care.
- Eligibility is tied to risk factors such as hospitalization stays, psychiatric crises, emergency department visits, prior incarceration, or homelessness.
- Once the federal waiver is approved, the department must take all necessary steps to arrange Medicaid payment for the covered services.
- Section 2 repeals any conflicting existing laws.
## Status
- Status: Passed (2026-05-11)
- Last action: Effective Date 2026-07-01 (2026-05-11)
- Sponsors: Kay Kirkpatrick, Bo Hatchett, Ben Watson, Drew Echols, Kim Jackson, Chuck Efstration
- Official page: https://www.legis.ga.gov/legislation/72468
> The history, votes, and amendments (995 characters) are at https://georgiacommons.org/bills/2025-2026/sb428.md?full=1