HB0427 • 2026

Employees, Employers

AN ACT to amend Tennessee Code Annotated, Title 4; Title 8; Title 50; Title 56 and Title 68, relative to living organ donation.

Labor

Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor: Love, Akbari
Last action: 2026-04-08
Official status: Sponsor(s) Added.
Effective date: Not listed

Plain English Breakdown

The bill summary text does not specify whether the leave is paid or unpaid for employers.

Living Organ Donation Leave and Insurance Protection

This bill requires eligible state employees to receive up to four weeks of leave for recovery after donating an organ and prohibits insurers from discriminating against living organ donors in insurance policies unless there are actual actuarial risks involved.

What This Bill Does

Gives eligible state employees up to four weeks of paid leave for recovery after a living organ donation surgery.
Requires employers to provide eligible employees with up to twelve weeks of unpaid leave for the same reason.
Prohibits insurers from denying or changing coverage based on an individual's status as a living organ donor, unless there are actual actuarial risks involved.

Who It Names or Affects

Eligible state employees who have worked full-time for at least one year in specific government positions.
Employers with one or more employees, including the state and its political subdivisions.
Insurance companies that provide life insurance, disability insurance, or long-term care insurance.

Terms To Know

Eligible employee: An employee who has worked full-time for at least one year in specific state government positions.
Living organ donor: A person who donates all or part of an organ while still alive.

Limits and Unknowns

The bill does not specify the exact number of weeks for paid leave granted by employers, which is left to be determined.
It is unclear how insurers will interpret and apply the actuarial risk exception in practice.
The effective date of this legislation has not been set.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

HA0607

Amendment 1-0 to HB0427

Plain English: This amendment adds new sections to Tennessee laws that allow eligible employees up to twelve weeks of leave for recovery after donating an organ and prevent insurance companies from discriminating against living organ donors.

Adds a section in Title 8 allowing eligible employees up to twelve weeks of leave for recovery after donating an organ.
Adds a section in Title 50 requiring employers to grant eligible employees up to twelve weeks of leave for the same reason.
Adds a section in Title 56 prohibiting insurance companies from denying or changing coverage based solely on someone being a living organ donor.
Adds a section in Title 68 requiring the Department of Health to create and publish educational materials about living organ donation.

The exact impact of these changes is not fully explained in the amendment text.

HA0608

Amendment 2-0 to HB0427

Plain English: This amendment adds new sections to Tennessee laws that give state employees and private sector workers up to twelve weeks of leave for recovery after donating an organ.

Adds a section in Title 8 allowing eligible state employees to take up to twelve weeks off work for recovery from living organ donation surgery.
Adds a section in Title 50 requiring employers to provide eligible employees with up to twelve weeks of leave for recovery from living organ donation surgery.
Adds a section in Title 68 directing the Department of Health and the Department of Commerce and Insurance to create educational materials about living organ donation, including information on benefits, risks, and insurance impacts.

The amendment does not specify what happens if an employee needs more than twelve weeks for recovery.
It is unclear how this will affect employees who are not covered under the definition of 'eligible employee'.

SA0241

Amendment 1-0 to SB0579

Plain English: The amendment adds new sections to Tennessee laws that allow eligible employees up to twelve weeks of leave for recovery after donating an organ and prevent insurance companies from discriminating against living organ donors.

Adds a section in Title 8 allowing eligible employees up to twelve weeks of leave for recovering from surgery related to a living organ donation.
Adds a section in Title 50 requiring employers to grant eligible employees up to twelve weeks of leave for recovery after donating an organ.
Adds a section in Title 56 prohibiting insurance companies from denying or changing coverage based solely on the status of being a living organ donor.
Adds a section in Title 68 requiring the Department of Health to create and publish educational materials about living organ donation.

The exact impact of these changes on employees and insurance companies is not fully explained in the amendment text.

SA0655

Amendment 2-0 to SB0579

Plain English: This amendment adds new sections to Tennessee laws that require employers to give eligible employees up to four weeks of leave for recovery after donating an organ.

Adds a requirement for state employers to provide up to four weeks of paid leave for full-time employees who have been with the employer for at least one year and are recovering from living organ donation surgery.
Defines 'eligible employee' as someone working full-time for the state for at least twelve consecutive months in specific entities, excluding certain administrative boards or commissions.
Requires private employers to provide up to four weeks of leave for eligible employees who have been with their employer for at least one year and are recovering from living organ donation surgery.

The amendment does not specify the exact process for requesting this leave beyond requiring notice as soon as reasonably possible if the surgery date is known less than thirty days in advance.
It's unclear how this new requirement will be enforced or what penalties might apply to employers who do not comply.

Bill History

2026-04-09 Tennessee General Assembly
Signed by Senate Speaker
2026-04-08 Tennessee General Assembly
Sponsor(s) Added.
2026-04-08 Tennessee General Assembly
Comp. SB subst.
2026-04-08 Tennessee General Assembly
Enrolled and ready for signatures
2026-04-08 Tennessee General Assembly
Passed H., Ayes 90, Nays 0, PNV 5
2026-04-08 Tennessee General Assembly
Am. withdrawn. (Amendment 2 - HA0608)
2026-04-08 Tennessee General Assembly
Am. withdrawn. (Amendment 1 - HA0607)
2026-04-08 Tennessee General Assembly
Subst. for comp. HB.
2026-04-02 Tennessee General Assembly
H. Placed on Regular Calendar for 4/8/2026
2026-04-01 Tennessee General Assembly
Placed on cal. Calendar & Rules Committee for 4/2/2026
2026-04-01 Tennessee General Assembly
Rec. for pass; ref to Calendar & Rules Committee
2026-03-25 Tennessee General Assembly
Placed on cal. State & Local Government Committee for 3/31/2026
2026-03-25 Tennessee General Assembly
Action def. in State & Local Government Committee to 3/31/2026
2026-03-23 Tennessee General Assembly
Rcvd. from S., held on H. desk.
2026-03-19 Tennessee General Assembly
Engrossed; ready for transmission to House
2026-03-19 Tennessee General Assembly
Sponsor(s) Added.
2026-03-19 Tennessee General Assembly
Passed Senate as amended, Ayes 32, Nays 0
2026-03-19 Tennessee General Assembly
Amendment withdrawn. (Amendment 1 - SA0241)
2026-03-19 Tennessee General Assembly
Senate adopted Amendment (Amendment 2 - SA0655)
2026-03-18 Tennessee General Assembly
Placed on cal. State & Local Government Committee for 3/24/2026
2026-03-18 Tennessee General Assembly
Action def. in State & Local Government Committee to 3/24/2026
2026-03-17 Tennessee General Assembly
Placed on Senate Regular Calendar for 3/19/2026
2026-03-11 Tennessee General Assembly
Placed on cal. State & Local Government Committee for 3/18/2026
2026-03-10 Tennessee General Assembly
Recommended for passage with amendment/s, refer to Senate Calendar Committee Ayes 9, Nays 0 PNV 0
2026-03-09 Tennessee General Assembly
Sponsor(s) Added.
2026-03-05 Tennessee General Assembly
Re-ref. State & Local Government Committee
2026-03-04 Tennessee General Assembly
Placed on cal. Calendar & Rules Committee for 3/5/2026
2026-03-04 Tennessee General Assembly
Rec. for pass. if am., ref. to Calendar & Rules Committee
2026-03-04 Tennessee General Assembly
Placed on Senate Commerce and Labor Committee calendar for 3/10/2026
2026-03-03 Tennessee General Assembly
Action deferred in Senate Commerce and Labor Committee to 3/10/2026
2026-03-02 Tennessee General Assembly
Sponsor(s) Added.
2026-02-25 Tennessee General Assembly
Placed on cal. State & Local Government Committee for 3/4/2026
2026-02-24 Tennessee General Assembly
Placed on Senate Commerce and Labor Committee calendar for 3/3/2026
2025-04-08 Tennessee General Assembly
Taken off notice for cal. in State & Local Government Committee
2025-04-02 Tennessee General Assembly
Placed on cal. State & Local Government Committee for 4/9/2025
2025-04-02 Tennessee General Assembly
Action def. in State & Local Government Committee to 4/9/2025
2025-03-26 Tennessee General Assembly
Placed on cal. State & Local Government Committee for 4/2/2025
2025-03-26 Tennessee General Assembly
Action def. in State & Local Government Committee to 4/2/2025
2025-03-25 Tennessee General Assembly
Failed in Senate Commerce and Labor Committee
2025-03-19 Tennessee General Assembly
Placed on cal. State & Local Government Committee for 3/26/2025
2025-03-19 Tennessee General Assembly
Action def. in State & Local Government Committee to 3/26/2025
2025-03-19 Tennessee General Assembly
Placed on Senate Commerce and Labor Committee calendar for 3/25/2025
2025-03-18 Tennessee General Assembly
Action deferred in Senate Commerce and Labor Committee to 3/25/2025
2025-03-18 Tennessee General Assembly
Sponsor(s) Added.
2025-03-13 Tennessee General Assembly
Placed on Senate Commerce and Labor Committee calendar for 3/18/2025
2025-03-12 Tennessee General Assembly
Placed on cal. State & Local Government Committee for 3/19/2025
2025-03-12 Tennessee General Assembly
Rec. for pass by s/c ref. to State & Local Government Committee
2025-03-11 Tennessee General Assembly
Placed on Senate Commerce and Labor Committee calendar for 3/18/2025
2025-03-05 Tennessee General Assembly
Placed on s/c cal Public Service Subcommittee for 3/12/2025
2025-02-12 Tennessee General Assembly
Passed on Second Consideration, refer to Senate Commerce and Labor Committee
2025-02-10 Tennessee General Assembly
Introduced, Passed on First Consideration
2025-02-05 Tennessee General Assembly
Assigned to s/c Public Service Subcommittee
2025-02-05 Tennessee General Assembly
P2C, ref. to State & Local Government Committee
2025-02-03 Tennessee General Assembly
Intro., P1C.
2025-01-30 Tennessee General Assembly
Filed for introduction
2025-01-28 Tennessee General Assembly
Filed for introduction

Official Summary Text

In addition to leave granted under present law, this bill requires an eligible state employee to be granted absence from work for a period of time equal to 12 weeks for recovery from surgery related to a living organ donation. If the eligible state empl
oyee learns of the surgery date less than 30 days in advance, then the employee must give notice as soon as reasonably possible. For the purpose of calculating service anniversary dates, this absence from work is considered full-time employment.

As used in the provisions above, an "eligible state employee" means either:



An employee who has been employed full-time with the state for at least 12 consecutive months with (i) the executive branch and all boards, commissions and agencies of state government, unless excluded by state law; (ii) the judicial branch of state government, including the administrative office of the courts; (iii) the office of the attorney general; (iv) the offices of the district attorneys general and the district public defenders; (v) the Tennessee higher education commission; (vi) the Tennessee advisory commission on intergovernmental relations;(vii) the Tennessee housing development agency; and (viii) the Tennessee rehabilitative initiative in correction board.



An employee who has been employed full-time with the state for at least 12 consecutive months with any administrative board and commissions, except for an employee of any administrative board or commission that is attached to the legislative branch, the office of the secretary of state, the office of the state treasurer, or the office of the comptroller of the treasury.

OTHER EMPLOYERS

This bill requires an employer to grant an eligible employee an absence from work for a period of time equal to 12 weeks for recovery from surgery related to a living organ donation. If the eligible employee learns of the surgery date less than 30 days
in advance, then the employee must give notice as soon as reasonably possible. As used in these provisions, "employer" means a person or entity that employs one or more employees and includes the state and its political subdivisions.

INSURANCE COVERAGE

This bill prohibits an insurer from denying coverage, canceling coverage, refusing to issue, determining the price or premium for, or otherwise varying any term or condition of a life insurance policy, disability insurance policy, or long-term care insur
ance policy for a person based solely, and without any actual, unique, and material actuarial risks, on the status of the person as a living organ donor.

INFORMATIONAL MATERIAL

This bill requires the department of health, in consultation with the department of commerce and insurance, to produce informational material on living organ donation to educate the public on the (i) benefits and risks of living organ donation and (ii) i
mpact of living organ donation on the access of a living organ donor to insurance. By July 1, 2025, the department of health must make available on the department's website the informational material on living organ donation.

ON MARCH 19, 2026, THE SENATE ADOPTED AMENDMENT #2 AND PASSED SENATE BILL 579, AS AMENDED.

AMENDMENT #2 makes the following changes:



Requires an eligible employee to be granted absence from work for a period of time equal to four weeks, rather than 12 weeks, for recovery from surgery related to a living organ donation.


Clarifies that an "employer," as used in the bill, means the employer of any eligible employee.


Removes the provision that prohibits an insurer from denying coverage, canceling coverage, refusing to issue, determining the price or premium for, or otherwise varying any term or condition of a life insurance policy, disability insurance policy, or long term care insurance policy for a person based solely on the status of the person as a living organ donor.


Requires the department of health to make available on the department's website informational material on living organ donation by July 1, 2026, rather than July 1, 2025.

Current Bill Text

Read the full stored bill text

SENATE BILL 579
By Akbari

HOUSE BILL 427
By Love

HB0427
001429
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 4;
Title 8; Title 50; Title 56 and Title 68, relative to
living organ donation.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 8, Chapter 50, Part 8, is amended by
adding the following as a new section:
(a) In addition to leave granted under §§ 8-50-801, 8-50-802, 8-50-806, and 8-
50-813, an eligible employee must be granted absence from work for a period of time
equal to twelve (12) weeks for recovery from surgery related to a living organ donation.
If the eligible employee learns of the surgery date for the living organ donation less than
thirty (30) days in advance, then the employee shall give notice as soon as reasonably
possible. For the purpose of calculating service anniversary dates, this absence from
work is considered full-time employment.
(b) As used in this section:
(1) "Eligible employee" means:
(1) An employee who has been employed full-time with the state
for at least twelve (12) consecutive months with an entity described in §§
8-30-102(a), 8-30-102(b)(2), 8-30-102(b)(6)-(7), and 8-30-102(b)(10)-(13);
or
(2) An employee who has been employed full-time with the state
for at least twelve (12) consecutive months with an entity described in §
8-30-102(b)(9), except for an employee of any administrative board or

- 2 - 001429

commission that is attached to an entity described in § 8-30-102(b)(1) or
§ 8-30-102(b)(3)-(5); and
(2) "Living organ donor" means an individual who has donated all or part
of an organ and is not deceased.
SECTION 2. Tennessee Code Annotated, Title 50, Chapter 1, Part 3, is amended by
adding the following as a new section:
(a) An employer shall grant an eligible employee an absence from work for a
period of time equal to twelve (12) weeks for recovery from surgery related to a living
organ donation. If the eligible employee learns of the surgery date for the living organ
donation less than thirty (30) days in advance, then the employee shall give notice as
soon as reasonably possible.
(b) As used in this section:
(1) "Eligible employee" has the same meaning as in the Family and
Medical Leave Act (29 U.S.C. § 2601 et seq.);
(2) "Employer" means a person or entity that employs one (1) or more
employees and includes the state and its political subdivisions; and
(3) "Living organ donation" means a medical procedure by which an
individual donates all or part of an organ and is not deceased.
SECTION 3. Tennessee Code Annotated, Title 56, Chapter 7, Part 23, is amended by
adding the following as a new section:
(a) An insurer shall not deny coverage, cancel coverage, refuse to issue,
determine the price or premium for, or otherwise vary any term or condition of a life
insurance policy, disability insurance policy, or long-term care insurance policy for a
person based solely, and without any actual, unique, and material actuarial risks, on the
status of the person as a living organ donor.

- 3 - 001429

(b) As used in this section, "living organ donor" means an individual who has
donated all or part of an organ and is not deceased.
SECTION 4. Tennessee Code Annotated, Title 68, Chapter 1, Part 1, is amended by
adding the following as a new section:
(a) The department of health in consultation with the department of commerce
and insurance shall produce informational material on living organ donation to educate
the public on the:
(1) Benefits and risks of living organ donation; and
(2) Impact of living organ donation on the access of a living organ donor
to insurance.
(b) By July 1, 2025, the department of health shall make available on the
department's website the informational material on living organ donation described in
subsection (a).
SECTION 5. This act takes effect upon becoming a law, the public welfare requiring it.