{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/32.1-320.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/32.1-320.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/32.1-320.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/32.1-320.html"}],"law_id":73899,"edition_id":1,"section_id":73899,"structure_id":13438,"section_number":"32.1-320","catch_line":"Duties of Attorney General; medical services providers audit and investigation unit","history":"1981, c. 255; 1982, c. 41; 1984, c. 781; 1986, c. 551; 2011, cc. 110, 175; 2012, c. 479; 2013, c. 538.","full_text":"A\n\nThere shall be established within the Office of the Attorney General a unit to audit and investigate providers of services furnished under the State Medical Assistance Plan. The Department of Medical Assistance Services shall cooperate with the Office of the Attorney General in conducting such audits and investigations and shall provide such information for these purposes as may be requested by the Attorney General or his authorized representative.B\n\nThe Attorney General or his authorized representative shall have the authority to:1\n\nConduct audits and investigations of providers of medical and other services furnished under medical assistance. Such investigations shall include investigation of complaints alleging abuse or neglect of persons in the care or custody of others who receive payments for providing health care services under the state plan for medical assistance, regardless of whether the patient who is the subject of the complaint is a recipient of medical assistance. The relevant board within the Department of Health Professions shall serve in an advisory capacity to the Attorney General in the conduct of audits or investigations of health care providers licensed by the respective regulatory boards. In the conduct of such audits or investigations, the Attorney General may examine (i) those records or portions thereof, including patient records, for which services were rendered by a health care provider and reimbursed by the Department of Medical Assistance Services under the Plan for Medical Assistance, and (ii) in cases involving a complaint alleging abuse or neglect of a person in the care or custody of others who receive payments for medical assistance, those records or portions thereof, including patient records, that are relevant to the investigation of the complaint, notwithstanding the provisions of Chapter 38 (&#xA7; 2.2-3800 et seq.) of Title 2.2 or of any other statute which may make or purport to make such records privileged or confidential. No original patient records shall be removed from the premises of the health care provider, except in accordance with Rule 4:9 of the Rules of the Supreme Court of Virginia. The disclosure of any records or information by the Attorney General is prohibited, unless such disclosure is directly connected to the official purpose for which the records or information was obtained. The disclosure of patient information as required under this section shall not subject any physician or other health services provider to any liability for breach of any confidential relationship between the provider and the patient, but no evidence resulting from such disclosure may be used in any civil, administrative or criminal proceeding against the patient unless a waiver of the applicable evidentiary privilege is obtained. The Attorney General shall cause all copies of patient medical records in his possession or that of his designee to be destroyed upon completion of the audit, investigation or proceedings, including appeals;2\n\nIssue subpoenas, propound interrogatories, compel the attendance of witnesses, administer oaths, certify to official acts, take depositions within and without the Commonwealth as now provided by law, and compel the production of pertinent books, payrolls, accounts, papers, records, documents and testimony relevant to such investigation. If a person in attendance before the Attorney General or his authorized representative refuses, without reasonable cause, to be examined or to answer a legal and pertinent question, or to produce a book or paper or other evidence when ordered to do so by the Attorney General or his authorized representative, the Attorney General or his authorized representative may apply to the judge of the circuit court of the jurisdiction where such person is in attendance, upon affidavit, for an order returnable in not less than two nor more than five days, directing such person to show cause why he should not produce such records. Upon the hearing of such order, if the court shall determine that such person, without reasonable cause, has refused to be examined or to answer a legal or pertinent question, or to produce a book or paper which he was ordered to bring or produce, he may forthwith assess all costs and reasonable attorney fees against such person. If the motion for an order is granted and the person thereafter fails to comply with the order, the court may make such orders as are provided for in the Rules of the Supreme Court of Virginia. Subpoenas shall be served and witness fees and mileage paid as allowed in civil cases in the circuit courts of this Commonwealth. Subpoenas issued under this section are expressly excluded and excepted from the provisions of subsection H of &#xA7; 32.1-127.1:03. All records, information, reports, documents, memoranda, and communications created or developed during the course of a civil investigation under this section or pursuant to &#xA7; 32.1-312 shall be considered sensitive and confidential and may be considered attorney work product or privileged investigative files.","order_by":null,"text":{"0":{"id":265749,"text":"There shall be established within the Office of the Attorney General a unit to audit and investigate providers of services furnished under the State Medical Assistance Plan. The Department of Medical Assistance Services shall cooperate with the Office of the Attorney General in conducting such audits and investigations and shall provide such information for these purposes as may be requested by the Attorney General or his authorized representative.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":265750,"text":"The Attorney General or his authorized representative shall have the authority to:","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"B1"},"2":{"id":265751,"text":"Conduct audits and investigations of providers of medical and other services furnished under medical assistance. Such investigations shall include investigation of complaints alleging abuse or neglect of persons in the care or custody of others who receive payments for providing health care services under the state plan for medical assistance, regardless of whether the patient who is the subject of the complaint is a recipient of medical assistance. The relevant board within the Department of Health Professions shall serve in an advisory capacity to the Attorney General in the conduct of audits or investigations of health care providers licensed by the respective regulatory boards. In the conduct of such audits or investigations, the Attorney General may examine (i) those records or portions thereof, including patient records, for which services were rendered by a health care provider and reimbursed by the Department of Medical Assistance Services under the Plan for Medical Assistance, and (ii) in cases involving a complaint alleging abuse or neglect of a person in the care or custody of others who receive payments for medical assistance, those records or portions thereof, including patient records, that are relevant to the investigation of the complaint, notwithstanding the provisions of Chapter 38 (&#xA7; 2.2-3800 et seq.) of Title 2.2 or of any other statute which may make or purport to make such records privileged or confidential. No original patient records shall be removed from the premises of the health care provider, except in accordance with Rule 4:9 of the Rules of the Supreme Court of Virginia. The disclosure of any records or information by the Attorney General is prohibited, unless such disclosure is directly connected to the official purpose for which the records or information was obtained. The disclosure of patient information as required under this section shall not subject any physician or other health services provider to any liability for breach of any confidential relationship between the provider and the patient, but no evidence resulting from such disclosure may be used in any civil, administrative or criminal proceeding against the patient unless a waiver of the applicable evidentiary privilege is obtained. The Attorney General shall cause all copies of patient medical records in his possession or that of his designee to be destroyed upon completion of the audit, investigation or proceedings, including appeals;","type":"section","prefixes":["B","1"],"prefix":"1","entire_prefix":"B1","prefix_anchor":"B1","level":2,"prior_prefix":"B","next_prefix":"B2"},"3":{"id":265752,"text":"Issue subpoenas, propound interrogatories, compel the attendance of witnesses, administer oaths, certify to official acts, take depositions within and without the Commonwealth as now provided by law, and compel the production of pertinent books, payrolls, accounts, papers, records, documents and testimony relevant to such investigation. If a person in attendance before the Attorney General or his authorized representative refuses, without reasonable cause, to be examined or to answer a legal and pertinent question, or to produce a book or paper or other evidence when ordered to do so by the Attorney General or his authorized representative, the Attorney General or his authorized representative may apply to the judge of the circuit court of the jurisdiction where such person is in attendance, upon affidavit, for an order returnable in not less than two nor more than five days, directing such person to show cause why he should not produce such records. Upon the hearing of such order, if the court shall determine that such person, without reasonable cause, has refused to be examined or to answer a legal or pertinent question, or to produce a book or paper which he was ordered to bring or produce, he may forthwith assess all costs and reasonable attorney fees against such person. If the motion for an order is granted and the person thereafter fails to comply with the order, the court may make such orders as are provided for in the Rules of the Supreme Court of Virginia. Subpoenas shall be served and witness fees and mileage paid as allowed in civil cases in the circuit courts of this Commonwealth. Subpoenas issued under this section are expressly excluded and excepted from the provisions of subsection H of &#xA7; 32.1-127.1:03. All records, information, reports, documents, memoranda, and communications created or developed during the course of a civil investigation under this section or pursuant to &#xA7; 32.1-312 shall be considered sensitive and confidential and may be considered attorney work product or privileged investigative files.","type":"section","prefixes":["B","2"],"prefix":"2","entire_prefix":"B2","prefix_anchor":"B2","level":2,"prior_prefix":"B1"}},"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":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},"next_section":{"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},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/32.1-320\/","history_text":"<p>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 6 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 1982, chapter 41; in 1984, chapter 781; in 1986, chapter 551; in 2011, chapters <a href=\"https:\/\/legacylis.virginia.gov\/cgi-bin\/legp604.exe?111+ful+CHAP0110\">110<\/a> and <a href=\"https:\/\/legacylis.virginia.gov\/cgi-bin\/legp604.exe?111+ful+CHAP0175\">175<\/a>; in 2012, chapter <a href=\"https:\/\/legacylis.virginia.gov\/cgi-bin\/legp604.exe?121+ful+CHAP0479\">479<\/a>; in 2013, chapter <a href=\"https:\/\/legacylis.virginia.gov\/cgi-bin\/legp604.exe?131+ful+CHAP0538\">538<\/a>.<\/p>","references":[{"id":58930,"section_number":"32.1-127.1:03","catch_line":"Health records privacy","order_by":null,"url":"\/32.1-127.1_03\/"},{"id":60362,"section_number":"32.1-320.1","catch_line":"Powers and duties of sworn unit investigators","order_by":null,"url":"\/32.1-320.1\/"}],"refers_to":[{"id":69409,"section_number":"2.2-3800","catch_line":"Short title; findings; principles of information practice","order_by":null,"url":"\/2.2-3800\/"},{"id":58930,"section_number":"32.1-127.1:03","catch_line":"Health records privacy","order_by":null,"url":"\/32.1-127.1_03\/"},{"id":54506,"section_number":"32.1-312","catch_line":"Fraudulently obtaining excess or attempting to obtain excess benefits or payments; penalty","order_by":null,"url":"\/32.1-312\/"}],"permalink":{"id":204747,"object_type":"law","relational_id":73899,"identifier":"32.1-320","token":"32.1\/9\/1\/32.1-320","url":"\/32.1-320\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/32.1-320\/","token":"32.1\/9\/1\/32.1-320","dublin_core":{"Title":"Duties of Attorney General; medical services providers audit and investigation unit","Type":"Text","Format":"text\/html","Identifier":"\u00a7 32.1-320","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t<section id=\"A\"><p><span class=\"prefix-number\">A.<\/span> There shall be established within the Office of the <span class=\"dictionary\">Attorney General<\/span> a unit to audit and investigate providers of services furnished under the State Medical Assistance Plan. The <span class=\"dictionary\">Department<\/span> of Medical Assistance Services shall cooperate with the Office of the <span class=\"dictionary\">Attorney General<\/span> in conducting such audits and investigations and shall provide such information for these purposes as may be requested by the <span class=\"dictionary\">Attorney General<\/span> or his authorized representative. <a id=\"paragraph-265749\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-320\/#A\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"B\"><p><span class=\"prefix-number\">B.<\/span> The <span class=\"dictionary\">Attorney General<\/span> or his authorized representative shall have the authority to: <a id=\"paragraph-265750\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-320\/#B\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"B1\" class=\"indent-1\"><p><span class=\"prefix-number\">1.<\/span> Conduct audits and investigations of providers of medical and other services furnished under medical assistance. Such investigations shall include investigation of complaints alleging abuse or neglect of <span class=\"dictionary\">persons<\/span> in the care or <span class=\"dictionary\">custody<\/span> of others who receive payments for providing health care services under the state plan for medical assistance, regardless of whether the patient who is the subject of the complaint is a recipient of medical assistance. The relevant <span class=\"dictionary\">board<\/span> within the <span class=\"dictionary\">Department<\/span> of Health Professions shall serve in an advisory capacity to the <span class=\"dictionary\">Attorney General<\/span> in the conduct of audits or investigations of health care providers licensed by the respective regulatory <span class=\"dictionary\">boards<\/span>. In the conduct of such audits or investigations, the <span class=\"dictionary\">Attorney General<\/span> may examine (i) those records or portions thereof, including patient records, for which services were rendered by a health care provider and reimbursed by the <span class=\"dictionary\">Department<\/span> of Medical Assistance Services under the Plan for Medical Assistance, and (ii) in cases involving a complaint alleging abuse or neglect of a <span class=\"dictionary\">person<\/span> in the care or <span class=\"dictionary\">custody<\/span> of others who receive payments for medical assistance, those records or portions thereof, including patient records, that are relevant to the investigation of the complaint, notwithstanding the provisions of Chapter 38 (&#xA7; <a class=\"law\" title=\"Short title; findings; principles of information practice\" href=\"\/2.2-3800\/\">2.2-3800<\/a> et seq.) of Title 2.2 or of any other <span class=\"dictionary\">statute<\/span> which may make or purport to make such records privileged or confidential. No original patient records shall be removed from the premises of the health care provider, except in accordance with Rule 4:9 of the Rules of the Supreme <span class=\"dictionary\">Court<\/span> of Virginia. The disclosure of any records or information by the <span class=\"dictionary\">Attorney General<\/span> is prohibited, unless such disclosure is directly connected to the official purpose for which the records or information was obtained. The disclosure of patient information as required under this section shall not subject any physician or other health services provider to any liability for breach of any confidential relationship between the provider and the patient, but no <span class=\"dictionary\">evidence<\/span> resulting from such disclosure may be used in any civil, administrative or criminal proceeding against the patient unless a <span class=\"dictionary\">waiver<\/span> of the applicable evidentiary <span class=\"dictionary\">privilege<\/span> is obtained. The <span class=\"dictionary\">Attorney General<\/span> shall cause all copies of patient medical records in his <span class=\"dictionary\">possession<\/span> or that of his designee to be destroyed upon completion of the audit, investigation or proceedings, including <span class=\"dictionary\">appeals<\/span>; <a id=\"paragraph-265751\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-320\/#B1\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"B2\" class=\"indent-1\"><p><span class=\"prefix-number\">2.<\/span> <span class=\"dictionary\">Issue<\/span> <span class=\"dictionary\">subpoenas<\/span>, propound <span class=\"dictionary\">interrogatories<\/span>, compel the attendance of witnesses, administer <span class=\"dictionary\">oaths<\/span>, certify to official acts, take <span class=\"dictionary\">depositions<\/span> within and without the Commonwealth as now provided by <span class=\"dictionary\">law<\/span>, and compel the production of pertinent books, payrolls, accounts, papers, records, documents and <span class=\"dictionary\">testimony<\/span> relevant to such investigation. If a <span class=\"dictionary\">person<\/span> in attendance before the <span class=\"dictionary\">Attorney General<\/span> or his authorized representative refuses, without reasonable cause, to be examined or to answer a legal and pertinent question, or to produce a book or paper or other <span class=\"dictionary\">evidence<\/span> when ordered to do so by the <span class=\"dictionary\">Attorney General<\/span> or his authorized representative, the <span class=\"dictionary\">Attorney General<\/span> or his authorized representative may apply to the <span class=\"dictionary\">judge<\/span> of the <span class=\"dictionary\">circuit<\/span> <span class=\"dictionary\">court<\/span> of the <span class=\"dictionary\">jurisdiction<\/span> where such <span class=\"dictionary\">person<\/span> is in attendance, upon <span class=\"dictionary\">affidavit<\/span>, for an <span class=\"dictionary\">order<\/span> returnable in not less than two nor more than five days, directing such <span class=\"dictionary\">person<\/span> to show cause why he should not produce such records. Upon the <span class=\"dictionary\">hearing<\/span> of such <span class=\"dictionary\">order<\/span>, if the <span class=\"dictionary\">court<\/span> shall determine that such <span class=\"dictionary\">person<\/span>, without reasonable cause, has refused to be examined or to answer a legal or pertinent question, or to produce a book or paper which he was ordered to bring or produce, he may forthwith assess all costs and reasonable attorney fees against such <span class=\"dictionary\">person<\/span>. If the <span class=\"dictionary\">motion<\/span> for an <span class=\"dictionary\">order<\/span> is granted and the <span class=\"dictionary\">person<\/span> thereafter fails to comply with the <span class=\"dictionary\">order<\/span>, the <span class=\"dictionary\">court<\/span> may make such <span class=\"dictionary\">orders<\/span> as are provided for in the Rules of the Supreme <span class=\"dictionary\">Court<\/span> of Virginia. <span class=\"dictionary\">Subpoenas<\/span> shall be served and <span class=\"dictionary\">witness<\/span> fees and mileage paid as allowed in civil cases in the <span class=\"dictionary\">circuit<\/span> <span class=\"dictionary\">courts<\/span> of this Commonwealth. <span class=\"dictionary\">Subpoenas<\/span> issued under this section are expressly excluded and excepted from the provisions of subsection H of &#xA7; <a class=\"law\" title=\"Health records privacy\" href=\"\/32.1-127.1_03\/\">32.1-127.1:03<\/a>. All records, information, reports, documents, memoranda, and communications created or developed during the course of a civil investigation under this section or pursuant to &#xA7; <a class=\"law\" title=\"Fraudulently obtaining excess or attempting to obtain excess benefits or payments; penalty\" href=\"\/32.1-312\/\">32.1-312<\/a> shall be considered sensitive and confidential and may be considered attorney work product or privileged investigative files. <a id=\"paragraph-265752\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-320\/#B2\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>","plain_text":"                                 CODE OF VIRGINIA\n\nDUTIES OF ATTORNEY GENERAL; MEDICAL SERVICES PROVIDERS AUDIT AND INVESTIGATION\nUNIT (\u00a7 32.1-320)\n\nA. There shall be established within the Office of the Attorney General a unit\nto audit and investigate providers of services furnished under the State Medical\nAssistance Plan. The Department of Medical Assistance Services shall cooperate\nwith the Office of the Attorney General in conducting such audits and\ninvestigations and shall provide such information for these purposes as may be\nrequested by the Attorney General or his authorized representative.\n\nB. The Attorney General or his authorized representative shall have the\nauthority to:\n\n   1. Conduct audits and investigations of providers of medical and other\n   services furnished under medical assistance. Such investigations shall include\n   investigation of complaints alleging abuse or neglect of persons in the care\n   or custody of others who receive payments for providing health care services\n   under the state plan for medical assistance, regardless of whether the patient\n   who is the subject of the complaint is a recipient of medical assistance. The\n   relevant board within the Department of Health Professions shall serve in an\n   advisory capacity to the Attorney General in the conduct of audits or\n   investigations of health care providers licensed by the respective regulatory\n   boards. In the conduct of such audits or investigations, the Attorney General\n   may examine (i) those records or portions thereof, including patient records,\n   for which services were rendered by a health care provider and reimbursed by\n   the Department of Medical Assistance Services under the Plan for Medical\n   Assistance, and (ii) in cases involving a complaint alleging abuse or neglect\n   of a person in the care or custody of others who receive payments for medical\n   assistance, those records or portions thereof, including patient records, that\n   are relevant to the investigation of the complaint, notwithstanding the\n   provisions of Chapter 38 (&#xA7; 2.2-3800 et seq.) of Title 2.2 or of any\n   other statute which may make or purport to make such records privileged or\n   confidential. No original patient records shall be removed from the premises\n   of the health care provider, except in accordance with Rule 4:9 of the Rules\n   of the Supreme Court of Virginia. The disclosure of any records or information\n   by the Attorney General is prohibited, unless such disclosure is directly\n   connected to the official purpose for which the records or information was\n   obtained. The disclosure of patient information as required under this section\n   shall not subject any physician or other health services provider to any\n   liability for breach of any confidential relationship between the provider and\n   the patient, but no evidence resulting from such disclosure may be used in any\n   civil, administrative or criminal proceeding against the patient unless a\n   waiver of the applicable evidentiary privilege is obtained. The Attorney\n   General shall cause all copies of patient medical records in his possession or\n   that of his designee to be destroyed upon completion of the audit,\n   investigation or proceedings, including appeals;\n\n   2. Issue subpoenas, propound interrogatories, compel the attendance of\n   witnesses, administer oaths, certify to official acts, take depositions within\n   and without the Commonwealth as now provided by law, and compel the production\n   of pertinent books, payrolls, accounts, papers, records, documents and\n   testimony relevant to such investigation. If a person in attendance before the\n   Attorney General or his authorized representative refuses, without reasonable\n   cause, to be examined or to answer a legal and pertinent question, or to\n   produce a book or paper or other evidence when ordered to do so by the\n   Attorney General or his authorized representative, the Attorney General or his\n   authorized representative may apply to the judge of the circuit court of the\n   jurisdiction where such person is in attendance, upon affidavit, for an order\n   returnable in not less than two nor more than five days, directing such person\n   to show cause why he should not produce such records. Upon the hearing of such\n   order, if the court shall determine that such person, without reasonable\n   cause, has refused to be examined or to answer a legal or pertinent question,\n   or to produce a book or paper which he was ordered to bring or produce, he may\n   forthwith assess all costs and reasonable attorney fees against such person.\n   If the motion for an order is granted and the person thereafter fails to\n   comply with the order, the court may make such orders as are provided for in\n   the Rules of the Supreme Court of Virginia. Subpoenas shall be served and\n   witness fees and mileage paid as allowed in civil cases in the circuit courts\n   of this Commonwealth. Subpoenas issued under this section are expressly\n   excluded and excepted from the provisions of subsection H of &#xA7;\n   32.1-127.1:03. All records, information, reports, documents, memoranda, and\n   communications created or developed during the course of a civil investigation\n   under this section or pursuant to &#xA7; 32.1-312 shall be considered\n   sensitive and confidential and may be considered attorney work product or\n   privileged investigative files.\n\nHISTORY: 1981, c. 255; 1982, c. 41; 1984, c. 781; 1986, c. 551; 2011, cc. 110,\n175; 2012, c. 479; 2013, c. 538.","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}}