SB 461: Department of Human Services; the single state agency responsible for the administration of the state Medicaid program; provide

Right now the Department of Community Health administers Georgia's Medicaid program, the joint state-federal health coverage system for low-income residents, children, and people with disabilities. This bill rewrites large parts of Titles 31 and 49 of Georgia law to shift that responsibility to the Department of Human Services instead. The bill changes definitions of 'board,' 'commissioner,' and 'department' throughout Chapter 4 of Title 49 so they refer to the Department of Human Services rather than the Department of Community Health. It sets July 1, 2027 as the date the Department of Human Services takes over adopting and administering the state Medicaid plan, paying or denying claims, certifying provider eligibility, and succeeding to existing rules and administrative orders tied to Medicaid. Until that date, the Department of Community Health keeps running the program. The Department of Human Services must also submit any needed Medicaid state plan amendment or waiver request to the federal Centers for Medicare and Medicaid Services. The bill would take effect as soon as the Governor signs it or it becomes law without his signature.

• Transfers the powers, functions, and duties of administering Georgia's Medicaid program from the Department of Community Health to the Department of Human Services, effective July 1, 2027.
• Redefines 'board,' 'commissioner,' and 'department' in Georgia's medical assistance law (O.C.G.A. Chapter 4 of Title 49) to mean the Department of Human Services and its board and commissioner instead of Community Health's.
• Requires the Department of Human Services to succeed to all existing Medicaid-related rules, regulations, policies, procedures, and administrative orders in effect on June 30, 2027.
• Requires the two departments to cooperate on a transition plan to move Medicaid administration between them.
• Directs the Department of Human Services to submit any necessary Medicaid state plan amendment or waiver request to the federal Centers for Medicare and Medicaid Services.
• Removes references to the medical assistance program from certain Department of Community Health code sections, such as the definition of 'state medical plan' used for credentialing and billing rules.

The Department of Community Health and the Department of Human Services, both of which must reorganize staff, rules, and responsibilities; Medicaid recipients, applicants, and providers whose claims and eligibility determinations will eventually be handled by a different state agency; and county-level offices that interact with either department.

For Georgians who rely on Medicaid, day-to-day interactions such as filing claims, proving eligibility, or dealing with provider disputes would eventually run through the Department of Human Services instead of the Department of Community Health, changing which state agency answers questions, issues rules, and processes paperwork.

• Section 2 adds a new subsection to O.C.G.A. § 31-2-4 stating that, starting July 1, 2027, the Department of Human Services will perform the Community Health duties tied to Medicaid administration.
• Section 5 amends O.C.G.A. § 49-2-1 to state that on and after July 1, 2027, the Department of Human Services will exercise Community Health's powers over the Medicaid program.
• Section 7 redefines 'board,' 'commissioner,' and 'department' in O.C.G.A. § 49-4-141 to point to the Department of Human Services rather than Community Health.
• Section 8 amends O.C.G.A. § 49-4-142 so Community Health keeps administering the state Medicaid plan only until June 30, 2027, after which Human Services takes over, and requires the two agencies to cooperate on the transition.
• Section 13 has the Department of Human Services assume, after July 1, 2027, the functions of certifying provider standards and determining recipient eligibility that Community Health previously held.
• Section 14 has the Department of Human Services succeed to all Medicaid-related rules, policies, and administrative orders of Community Health that are in effect on June 30, 2027.
• Sections 15 through 17 replace references to 'Department of Community Health,' 'commissioner of community health,' and 'Board of Community Health' with generic 'department,' 'commissioner,' and 'board' throughout several Medicaid-related Code sections.
• Section 18 requires the Department of Human Services to submit a Medicaid state plan amendment or waiver request to the federal Centers for Medicare and Medicaid Services if needed to carry out the law.

1. 2026-02-05Senate Read and Referred (Senado)
2. 2026-02-04Senate Hopper (Senado)

• Blake Tillery (R, SD-019)Patrocinador principal
• Randy Robertson (R, SD-029)
• Larry Walker (R, SD-020)
• Ben Watson (R, SD-001)

• Medicaid administration
• Department of Human Services
• Department of Community Health
• state government reorganization
• health care policy