Senate · Introduced · 2025-2026 Regular Session

SB 481: Medical Assistance; Medicaid coverage for heart and lung transplants when medically necessary; require

Last action February 10, 2026 · Senate Read and Referred

A Georgia Senate bill would require the state's Medicaid program to cover heart and lung transplants, along with related care and anti-rejection drugs, whenever a licensed physician says the procedure is medically necessary.

Read the full bill text

These buttons carry the bill's own text, not the summaries below. Copy for LLM, View as markdown, and Send to AI use the Markdown version: the text as filed, then the summaries under a heading that names them as ours. View raw is the text alone.

The summaries below were written by an AI model (claude-sonnet-5) from the text of the bill and are not part of it. Quote the text, not the summary. The stored text is the Introduced version, the latest LegiScan holds.

In plain language

Georgia's Medicaid program is run by the Department of Community Health under Title 49 of state law. This bill adds a new section requiring the department to cover heart and lung transplants for Medicaid patients whenever a physician licensed in Georgia determines the transplant is medically necessary. Coverage would also extend to related healthcare services provided before and after the transplant, as well as immunosuppressant drugs, which patients need long-term to keep their bodies from rejecting a transplanted organ. Because Medicaid is a joint state-federal program, the bill directs the Department of Community Health to submit any state plan amendment or waiver request needed to the federal Department of Health and Human Services to actually put this coverage into effect. The bill repeals any conflicting laws but does not state a specific effective date beyond the Act's general terms.

What the bill does

Adds a new Code section (O.C.G.A. § 49-4-159.5) requiring Georgia Medicaid to cover heart and lung transplants when a Georgia-licensed physician deems them medically necessary.
Extends that coverage to healthcare services provided before and after the transplant, not just the surgery itself.
Requires Medicaid to cover immunosuppressant drugs, the medications transplant patients need to prevent organ rejection.
Directs the Department of Community Health to file any Medicaid state plan amendment or federal waiver request needed to carry out the new coverage requirement.

Who it affects

Georgians enrolled in Medicaid who need heart or lung transplants, the physicians who determine medical necessity, and the Department of Community Health, which administers Medicaid and would need federal approval to implement the change.

Why it matters

Transplant surgery, follow-up care, and lifelong immunosuppressant drugs are expensive. If enacted, Medicaid patients needing a heart or lung transplant would have a clearer guarantee of coverage for the surgery and the ongoing medications required to keep the transplant successful.

Key provisions

Section 1 creates O.C.G.A. § 49-4-159.5(a), requiring Medicaid coverage for heart and lung transplants determined medically necessary by a licensed Georgia physician, plus related pre- and post-transplant care and immunosuppressant drugs.
Section 1 creates subsection (b), requiring the Department of Community Health to submit any Medicaid state plan amendment or waiver request needed to implement the coverage to the federal Department of Health and Human Services.
Section 2 repeals any state laws that conflict with the new requirement.

From the bill

“The department shall provide Medicaid coverage for heart and lung transplants when such procedures are determined by a duly licensed physician in this state to be medically necessary.”
This is the bill's core requirement mandating Medicaid coverage for these transplants.

“Such coverage shall include related healthcare services before and after such transplants and immunosuppressant drugs.”
This extends the required coverage to follow-up care and anti-rejection medication.

Status timeline

2026-02-10Senate Read and Referred (Senate)
2026-02-09Senate Hopper (Senate)

Topics

Medicaid coverage
organ transplants
healthcare access
immunosuppressant drugs
health policy

Ask about this bill

Machine-readable https://georgiacommons.org/bills/2025-2026/sb481.md · https://georgiacommons.org/bills/index.md · MCP https://mcp.georgiacommons.org/mcp