{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/32.1-314.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/32.1-314.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/32.1-314.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/32.1-314.html"}],"law_id":63947,"edition_id":1,"section_id":63947,"structure_id":13438,"section_number":"32.1-314","catch_line":"False statement or representation in applications for payment or for use in determining rights to payment; concealment of facts; penalty","history":"1981, c. 255; 1986, c. 551; 1995, c. 491; 2010, c. 305; 2011, cc. 444, 479; 2015, c. 537.","full_text":"A\n\nAny person who engages in the following activities shall be guilty of a felony punishable by a term of imprisonment of not less than one nor more than 20 years, or in the discretion of the jury or the court trying the case without a jury, confinement in jail for not more than 12 months and, in addition to such imprisonment or confinement, may be fined an amount not to exceed $25,000:1\n\nKnowingly and willfully making or causing to be made any false statement or representation of a material fact in any application for any payment under medical assistance;2\n\nAt any time knowingly and willfully making or causing to be made any false statement or representation of a material fact for use in determining rights to such payment, or knowingly and willfully falsifying, concealing or covering up by any trick, scheme or device a material fact, causing a material fact to be falsified, concealed, or covered up in such a manner in connection with such application or payment; or3\n\nWhen having knowledge of the occurrence of any event affecting (i) the initial or continued right to any payment or (ii) the initial or continued right to any such payment of any other individual in whose behalf he has applied for or is receiving such payments, willfully concealing or failing to disclose such event, causing such concealment or failure to disclose such an event with an intent fraudulently to secure such payment either in a greater amount or quantity than is due or when no such payment is authorized.B\n\nUpon conviction for any violation of subsection A, the court shall order restitution to be made to the Department of Medical Assistance Services for any loss caused by the violation.C\n\nThe Director of the Department of Medical Assistance Services may terminate or deny a contract to a provider for any violation of this section pursuant to § 32.1-325.D\n\nVenue for the trial of any person charged with an offense under this section shall be the county or city in which (i) any act was performed in furtherance of the offense or (ii) the person charged with the offense resided at the time of the offense.","order_by":null,"text":{"0":{"id":232883,"text":"Any person who engages in the following activities shall be guilty of a felony punishable by a term of imprisonment of not less than one nor more than 20 years, or in the discretion of the jury or the court trying the case without a jury, confinement in jail for not more than 12 months and, in addition to such imprisonment or confinement, may be fined an amount not to exceed $25,000:","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"A1"},"1":{"id":232884,"text":"Knowingly and willfully making or causing to be made any false statement or representation of a material fact in any application for any payment under medical assistance;","type":"section","prefixes":["A","1"],"prefix":"1","entire_prefix":"A1","prefix_anchor":"A1","level":2,"prior_prefix":"A","next_prefix":"A2"},"2":{"id":232885,"text":"At any time knowingly and willfully making or causing to be made any false statement or representation of a material fact for use in determining rights to such payment, or knowingly and willfully falsifying, concealing or covering up by any trick, scheme or device a material fact, causing a material fact to be falsified, concealed, or covered up in such a manner in connection with such application or payment; or","type":"section","prefixes":["A","2"],"prefix":"2","entire_prefix":"A2","prefix_anchor":"A2","level":2,"prior_prefix":"A1","next_prefix":"A3"},"3":{"id":232886,"text":"When having knowledge of the occurrence of any event affecting (i) the initial or continued right to any payment or (ii) the initial or continued right to any such payment of any other individual in whose behalf he has applied for or is receiving such payments, willfully concealing or failing to disclose such event, causing such concealment or failure to disclose such an event with an intent fraudulently to secure such payment either in a greater amount or quantity than is due or when no such payment is authorized.","type":"section","prefixes":["A","3"],"prefix":"3","entire_prefix":"A3","prefix_anchor":"A3","level":2,"prior_prefix":"A2","next_prefix":"B"},"4":{"id":232887,"text":"Upon conviction for any violation of subsection A, the court shall order restitution to be made to the Department of Medical Assistance Services for any loss caused by the violation.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A3","next_prefix":"C"},"5":{"id":232888,"text":"The Director of the Department of Medical Assistance Services may terminate or deny a contract to a provider for any violation of this section pursuant to § 32.1-325.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"6":{"id":232889,"text":"Venue for the trial of any person charged with an offense under this section shall be the county or city in which (i) any act was performed in furtherance of the offense or (ii) the person charged with the offense resided at the time of the offense.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C"}},"ancestry":[{"id":13438,"edition_id":1,"name":"In General","identifier":"1","label":"article","depth":3,"order_by":1,"parent_id":13437,"metadata":{},"date_created":"2026-06-26 03:44:53","date_modified":"2026-06-26 03:44:53","permalink":{"id":204701,"object_type":"structure","relational_id":13438,"identifier":"1","token":"32.1\/9\/1","url":"\/32.1\/9\/1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13437,"edition_id":1,"name":"Regulation of Medical Assistance","identifier":"9","label":"chapter","depth":2,"order_by":1,"parent_id":12727,"metadata":{},"date_created":"2026-06-26 03:44:53","date_modified":"2026-06-26 03:44:53","permalink":{"id":204699,"object_type":"structure","relational_id":13437,"identifier":"9","token":"32.1\/9","url":"\/32.1\/9\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12727,"edition_id":1,"name":"Health","identifier":"32.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:50","date_modified":"2026-06-26 03:43:50","permalink":{"id":201099,"object_type":"structure","relational_id":12727,"identifier":"32.1","token":"32.1","url":"\/32.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":85954,"structure_id":13438,"section_number":"32.1-310","catch_line":"Declaration of purpose; authority to audit records; authority to review complaints of abuse or neglect","url":"\/32.1-310\/","token":"32.1\/9\/1\/32.1-310","metadata":false},{"id":70907,"structure_id":13438,"section_number":"32.1-311","catch_line":"Repealed","url":"\/32.1-311\/","token":"32.1\/9\/1\/32.1-311","metadata":false},{"id":54506,"structure_id":13438,"section_number":"32.1-312","catch_line":"Fraudulently obtaining excess or attempting to obtain excess benefits or payments; penalty","url":"\/32.1-312\/","token":"32.1\/9\/1\/32.1-312","metadata":false},{"id":78625,"structure_id":13438,"section_number":"32.1-313","catch_line":"Liability for excess benefits or payments obtained without intent to violate chapter","url":"\/32.1-313\/","token":"32.1\/9\/1\/32.1-313","metadata":false},{"id":63947,"structure_id":13438,"section_number":"32.1-314","catch_line":"False statement or representation in applications for payment or for use in determining rights to payment; concealment of facts; penalty","url":"\/32.1-314\/","token":"32.1\/9\/1\/32.1-314","metadata":false},{"id":70472,"structure_id":13438,"section_number":"32.1-315","catch_line":"Solicitation or receipt of remuneration for certain services; offer or payment of remuneration for inducement of such services; penalty","url":"\/32.1-315\/","token":"32.1\/9\/1\/32.1-315","metadata":false},{"id":65811,"structure_id":13438,"section_number":"32.1-316","catch_line":"False statement or representation as to conditions or operations of institution or facility; penalty","url":"\/32.1-316\/","token":"32.1\/9\/1\/32.1-316","metadata":false},{"id":63268,"structure_id":13438,"section_number":"32.1-317","catch_line":"Collecting excess payment for services; charging, soliciting, accepting or receiving certain consideration as precondition for admittance to facility or requirement for continued stay; penalty","url":"\/32.1-317\/","token":"32.1\/9\/1\/32.1-317","metadata":false},{"id":69423,"structure_id":13438,"section_number":"32.1-318","catch_line":"Knowing failure to deposit, transfer or maintain patient trust funds in separate account; penalty","url":"\/32.1-318\/","token":"32.1\/9\/1\/32.1-318","metadata":false},{"id":71136,"structure_id":13438,"section_number":"32.1-319","catch_line":"Written verification of application, statement or form; penalty for false or misleading information","url":"\/32.1-319\/","token":"32.1\/9\/1\/32.1-319","metadata":false},{"id":54400,"structure_id":13438,"section_number":"32.1-319.1","catch_line":"Department to establish pilot program to use data analytics to mitigate risk of improper payments","url":"\/32.1-319.1\/","token":"32.1\/9\/1\/32.1-319.1","metadata":false},{"id":73899,"structure_id":13438,"section_number":"32.1-320","catch_line":"Duties of Attorney General; medical services providers audit and investigation unit","url":"\/32.1-320\/","token":"32.1\/9\/1\/32.1-320","metadata":false},{"id":60362,"structure_id":13438,"section_number":"32.1-320.1","catch_line":"Powers and duties of sworn unit investigators","url":"\/32.1-320.1\/","token":"32.1\/9\/1\/32.1-320.1","metadata":false},{"id":81672,"structure_id":13438,"section_number":"32.1-321","catch_line":"Prosecution of cases","url":"\/32.1-321\/","token":"32.1\/9\/1\/32.1-321","metadata":false},{"id":72394,"structure_id":13438,"section_number":"32.1-321.01","catch_line":"Exemptions from disclosure","url":"\/32.1-321.01\/","token":"32.1\/9\/1\/32.1-321.01","metadata":false}],"previous_section":{"id":78625,"structure_id":13438,"section_number":"32.1-313","catch_line":"Liability for excess benefits or payments obtained without intent to violate chapter","url":"\/32.1-313\/","token":"32.1\/9\/1\/32.1-313","metadata":false},"next_section":{"id":70472,"structure_id":13438,"section_number":"32.1-315","catch_line":"Solicitation or receipt of remuneration for certain services; offer or payment of remuneration for inducement of such services; penalty","url":"\/32.1-315\/","token":"32.1\/9\/1\/32.1-315","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/32.1-314\/","history_text":"

This law was first created in 1981. The record of its establishment is cataloged in chapter 255 of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. Unfortunately, the 1981 \u201cActs\u201d aren\u2019t available online. It has been modified 5 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 1986, chapter 551; in 1995, chapter 491<\/a>; in 2010, chapter 305<\/a>; in 2011, chapters 444<\/a> and 479<\/a>; in 2015, chapter 537<\/a>.<\/p>","references":[{"id":68291,"section_number":"18.2-513","catch_line":"Definitions","order_by":null,"url":"\/18.2-513\/"},{"id":77747,"section_number":"32.1-325","catch_line":"Board to submit plan for medical assistance services to U.S. Secretary of Health and Human Services pursuant to federal law; administration of plan; contracts with health care providers","order_by":null,"url":"\/32.1-325\/"}],"refers_to":false,"permalink":{"id":204719,"object_type":"law","relational_id":63947,"identifier":"32.1-314","token":"32.1\/9\/1\/32.1-314","url":"\/32.1-314\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/32.1-314\/","token":"32.1\/9\/1\/32.1-314","dublin_core":{"Title":"False statement or representation in applications for payment or for use in determining rights to payment; concealment of facts; penalty","Type":"Text","Format":"text\/html","Identifier":"\u00a7 32.1-314","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> Any person<\/span> who engages in the following activities shall be guilty of a felony<\/span> punishable by a term of imprisonment of not less than one nor more than 20 years, or in the discretion of the jury<\/span> or the court<\/span> trying the case without a jury<\/span>, confinement in jail for not more than 12 months and, in addition to such imprisonment or confinement, may be fined an amount not to exceed $25,000: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Knowingly and willfully making or causing to be made any false statement or representation of a material<\/span> fact<\/span> in any application for any payment under medical assistance; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> At any time knowingly and willfully making or causing to be made any false statement or representation of a material<\/span> fact<\/span> for use in determining rights to such payment, or knowingly and willfully falsifying, concealing or covering up by any trick, scheme or device a material<\/span> fact<\/span>, causing a material<\/span> fact<\/span> to be falsified, concealed, or covered up in such a manner in connection with such application or payment; or <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> When having knowledge of the occurrence of any event affecting (i) the initial or continued right to any payment or (ii) the initial or continued right to any such payment of any other individual in whose behalf he has applied for or is receiving such payments, willfully concealing or failing to disclose such event, causing such concealment or failure to disclose such an event with an intent<\/span> fraudulently to secure such payment either in a greater amount or quantity than is due or when no such payment is authorized. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> Upon conviction<\/span> for any violation of subsection A, the court<\/span> shall order<\/span> restitution<\/span> to be made to the Department<\/span> of Medical Assistance Services for any loss caused by the violation. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> The Director of the Department<\/span> of Medical Assistance Services may terminate or deny a contract<\/span> to a provider for any violation of this section pursuant to § 32.1-325<\/a>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> Venue<\/span> for the trial<\/span> of any person<\/span> charged with an offense<\/span> under this section shall be the county or city in which (i) any act was performed in furtherance of the offense<\/span> or (ii) the person<\/span> charged with the offense<\/span> resided at the time of the offense<\/span>. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nFALSE STATEMENT OR REPRESENTATION IN APPLICATIONS FOR PAYMENT OR FOR USE IN\nDETERMINING RIGHTS TO PAYMENT; CONCEALMENT OF FACTS; PENALTY (\u00a7 32.1-314)\n\nA. Any person who engages in the following activities shall be guilty of a\nfelony punishable by a term of imprisonment of not less than one nor more than\n20 years, or in the discretion of the jury or the court trying the case without\na jury, confinement in jail for not more than 12 months and, in addition to such\nimprisonment or confinement, may be fined an amount not to exceed $25,000:\n\n 1. Knowingly and willfully making or causing to be made any false statement or\n representation of a material fact in any application for any payment under\n medical assistance;\n\n 2. At any time knowingly and willfully making or causing to be made any false\n statement or representation of a material fact for use in determining rights\n to such payment, or knowingly and willfully falsifying, concealing or covering\n up by any trick, scheme or device a material fact, causing a material fact to\n be falsified, concealed, or covered up in such a manner in connection with\n such application or payment; or\n\n 3. When having knowledge of the occurrence of any event affecting (i) the\n initial or continued right to any payment or (ii) the initial or continued\n right to any such payment of any other individual in whose behalf he has\n applied for or is receiving such payments, willfully concealing or failing to\n disclose such event, causing such concealment or failure to disclose such an\n event with an intent fraudulently to secure such payment either in a greater\n amount or quantity than is due or when no such payment is authorized.\n\nB. Upon conviction for any violation of subsection A, the court shall order\nrestitution to be made to the Department of Medical Assistance Services for any\nloss caused by the violation.\n\nC. The Director of the Department of Medical Assistance Services may terminate\nor deny a contract to a provider for any violation of this section pursuant to\n§ 32.1-325.\n\nD. Venue for the trial of any person charged with an offense under this section\nshall be the county or city in which (i) any act was performed in furtherance of\nthe offense or (ii) the person charged with the offense resided at the time of\nthe offense.\n\nHISTORY: 1981, c. 255; 1986, c. 551; 1995, c. 491; 2010, c. 305; 2011, cc. 444,\n479; 2015, c. 537.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}