{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/32.1-325.1_1.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/32.1-325.1_1.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/32.1-325.1_1.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/32.1-325.1_1.html"}],"law_id":87103,"edition_id":1,"section_id":87103,"structure_id":13276,"section_number":"32.1-325.1:1","catch_line":"Definitions; recovery of overpayment for medical assistance services","history":"1990, c. 389; 1994, c. 669; 1999, c. 1024; 2005, c. 839.","full_text":"A\n\nFor the purposes of this section, the following definitions shall apply:\n\t\t\t&#8220;Agreement&#8221; means any contract executed for the delivery of services to recipients of medical assistance pursuant to subdivision D 2 of &#xA7; 32.1-325.\n\t\t\t&#8220;Successor in interest&#8221; means any person as defined in &#xA7; 1-230 having stockholders, directors, officers, or partners in common with a health care provider for which an agreement has been terminated.\n\t\t\t&#8220;Termination&#8221; means (i) the cessation of operations by a provider, (ii) the sale or transfer of the provider, (iii) the reorganization or restructuring of the health care provider, or (iv) the termination of an agreement by either party.B\n\nThe Director of Medical Assistance Services shall collect by any means available to him at law any amount owed to the Commonwealth because of overpayment for medical assistance services. Upon making an initial determination that an overpayment has been made to the provider pursuant to &#xA7; 32.1-325.1, the Director shall notify the provider of the amount of the overpayment. Such initial determination shall be made within the earlier of (i) four years, or (ii) 15 months after filing of the final cost report by the provider subsequent to sale of the facility or termination of the provider. The provider shall make arrangements satisfactory to the Director to repay the amount due. If the provider fails or refuses to make arrangements satisfactory to the Director for such repayment or fails or refuses to repay the Commonwealth for the amount due for overpayment in a timely manner, the Director may devise a schedule for reducing the Medicaid reimbursement due to any successor in interest.C\n\nIn any case in which the Director is unable to recover the amount due for overpayment pursuant to subsection B, he shall not enter into another agreement with the responsible provider or any person who is the transferee, assignee, or successor in interest to such provider unless (i) he receives satisfactory assurances of repayment of all amounts due or (ii) the agreement with the provider is necessary in order to ensure that Medicaid recipients have access to the covered services rendered by the provider.\n\t\t\tFurther, to the extent consistent with federal and state law, the Director shall not enter into any agreement with a provider having any stockholder possessing a material financial interest, partner, director, officer, or owner in common with a provider which has terminated a previous agreement for participation in the medical assistance services program without making satisfactory arrangements to repay all outstanding Medicaid overpayment.D\n\nThe provisions of this section shall not apply to successors in interest with respect to transfer of a medical care facility pursuant to contracts entered into before February 1, 1990.","order_by":null,"text":{"0":{"id":311901,"text":"For the purposes of this section, the following definitions shall apply:\n\t\t\t&#8220;Agreement&#8221; means any contract executed for the delivery of services to recipients of medical assistance pursuant to subdivision D 2 of &#xA7; 32.1-325.\n\t\t\t&#8220;Successor in interest&#8221; means any person as defined in &#xA7; 1-230 having stockholders, directors, officers, or partners in common with a health care provider for which an agreement has been terminated.\n\t\t\t&#8220;Termination&#8221; means (i) the cessation of operations by a provider, (ii) the sale or transfer of the provider, (iii) the reorganization or restructuring of the health care provider, or (iv) the termination of an agreement by either party.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":311902,"text":"The Director of Medical Assistance Services shall collect by any means available to him at law any amount owed to the Commonwealth because of overpayment for medical assistance services. Upon making an initial determination that an overpayment has been made to the provider pursuant to &#xA7; 32.1-325.1, the Director shall notify the provider of the amount of the overpayment. Such initial determination shall be made within the earlier of (i) four years, or (ii) 15 months after filing of the final cost report by the provider subsequent to sale of the facility or termination of the provider. The provider shall make arrangements satisfactory to the Director to repay the amount due. If the provider fails or refuses to make arrangements satisfactory to the Director for such repayment or fails or refuses to repay the Commonwealth for the amount due for overpayment in a timely manner, the Director may devise a schedule for reducing the Medicaid reimbursement due to any successor in interest.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":311903,"text":"In any case in which the Director is unable to recover the amount due for overpayment pursuant to subsection B, he shall not enter into another agreement with the responsible provider or any person who is the transferee, assignee, or successor in interest to such provider unless (i) he receives satisfactory assurances of repayment of all amounts due or (ii) the agreement with the provider is necessary in order to ensure that Medicaid recipients have access to the covered services rendered by the provider.\n\t\t\tFurther, to the extent consistent with federal and state law, the Director shall not enter into any agreement with a provider having any stockholder possessing a material financial interest, partner, director, officer, or owner in common with a provider which has terminated a previous agreement for participation in the medical assistance services program without making satisfactory arrangements to repay all outstanding Medicaid overpayment.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":311904,"text":"The provisions of this section shall not apply to successors in interest with respect to transfer of a medical care facility pursuant to contracts entered into before February 1, 1990.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C"}},"ancestry":[{"id":13276,"edition_id":1,"name":"General Provisions","identifier":"1","label":"article","depth":3,"order_by":1,"parent_id":13275,"metadata":{},"date_created":"2026-06-26 03:44:33","date_modified":"2026-06-26 03:44:33","permalink":{"id":201355,"object_type":"structure","relational_id":13276,"identifier":"1","token":"32.1\/10\/1","url":"\/32.1\/10\/1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13275,"edition_id":1,"name":"Department of Medical Assistance Services","identifier":"10","label":"chapter","depth":2,"order_by":1,"parent_id":12727,"metadata":{},"date_created":"2026-06-26 03:44:33","date_modified":"2026-06-26 03:44:33","permalink":{"id":201353,"object_type":"structure","relational_id":13275,"identifier":"10","token":"32.1\/10","url":"\/32.1\/10\/","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":75748,"structure_id":13276,"section_number":"32.1-323","catch_line":"Department of Medical Assistance Services","url":"\/32.1-323\/","token":"32.1\/10\/1\/32.1-323","metadata":false},{"id":73079,"structure_id":13276,"section_number":"32.1-323.1","catch_line":"Department to submit forecast of expenditures","url":"\/32.1-323.1\/","token":"32.1\/10\/1\/32.1-323.1","metadata":false},{"id":78209,"structure_id":13276,"section_number":"32.1-323.2","catch_line":"Elimination of waiting lists for certain waivers","url":"\/32.1-323.2\/","token":"32.1\/10\/1\/32.1-323.2","metadata":false},{"id":65434,"structure_id":13276,"section_number":"32.1-323.3","catch_line":"Dependents of foreign service members; waiting lists for certain waivers","url":"\/32.1-323.3\/","token":"32.1\/10\/1\/32.1-323.3","metadata":false},{"id":74370,"structure_id":13276,"section_number":"32.1-323.4","catch_line":"Department to facilitate transition of persons between certain waiver programs","url":"\/32.1-323.4\/","token":"32.1\/10\/1\/32.1-323.4","metadata":false},{"id":56444,"structure_id":13276,"section_number":"32.1-324","catch_line":"Board of Medical Assistance Services","url":"\/32.1-324\/","token":"32.1\/10\/1\/32.1-324","metadata":false},{"id":82951,"structure_id":13276,"section_number":"32.1-324.1","catch_line":"Authority to administer oaths, conduct hearings; obtaining relevant documents and other information","url":"\/32.1-324.1\/","token":"32.1\/10\/1\/32.1-324.1","metadata":false},{"id":68172,"structure_id":13276,"section_number":"32.1-324.2","catch_line":"Director to facilitate communication","url":"\/32.1-324.2\/","token":"32.1\/10\/1\/32.1-324.2","metadata":false},{"id":75151,"structure_id":13276,"section_number":"32.1-324.3","catch_line":"Uninsured Medical Catastrophe Fund established","url":"\/32.1-324.3\/","token":"32.1\/10\/1\/32.1-324.3","metadata":false},{"id":77747,"structure_id":13276,"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","url":"\/32.1-325\/","token":"32.1\/10\/1\/32.1-325","metadata":false},{"id":76231,"structure_id":13276,"section_number":"32.1-325.001","catch_line":"Repealed","url":"\/32.1-325.001\/","token":"32.1\/10\/1\/32.1-325.001","metadata":false},{"id":83706,"structure_id":13276,"section_number":"32.1-325.01","catch_line":"Certain term life insurance considered resources","url":"\/32.1-325.01\/","token":"32.1\/10\/1\/32.1-325.01","metadata":false},{"id":54270,"structure_id":13276,"section_number":"32.1-325.02","catch_line":"Determinations of assets; disclaimers of interests to be considered uncompensated transfers of assets for Medicaid eligibility purposes under certain circumstances","url":"\/32.1-325.02\/","token":"32.1\/10\/1\/32.1-325.02","metadata":false},{"id":73332,"structure_id":13276,"section_number":"32.1-325.03","catch_line":"Legal presence required for certain state and local public benefits; exceptions; definitions; proof of legal presence","url":"\/32.1-325.03\/","token":"32.1\/10\/1\/32.1-325.03","metadata":false},{"id":83713,"structure_id":13276,"section_number":"32.1-325.04","catch_line":"Eligibility for medical assistance; individuals confined in state correctional facilities","url":"\/32.1-325.04\/","token":"32.1\/10\/1\/32.1-325.04","metadata":false},{"id":75066,"structure_id":13276,"section_number":"32.1-325.1","catch_line":"Appeals of agency determinations","url":"\/32.1-325.1\/","token":"32.1\/10\/1\/32.1-325.1","metadata":false},{"id":87103,"structure_id":13276,"section_number":"32.1-325.1:1","catch_line":"Definitions; recovery of overpayment for medical assistance services","url":"\/32.1-325.1_1\/","token":"32.1\/10\/1\/32.1-325.1_1","metadata":false},{"id":56047,"structure_id":13276,"section_number":"32.1-325.2","catch_line":"Department is payor of last resort","url":"\/32.1-325.2\/","token":"32.1\/10\/1\/32.1-325.2","metadata":false},{"id":60758,"structure_id":13276,"section_number":"32.1-325.3","catch_line":"Disclosure or use of information for purpose not connected with medical assistance program; Department not subject to certain disclosure","url":"\/32.1-325.3\/","token":"32.1\/10\/1\/32.1-325.3","metadata":false},{"id":55595,"structure_id":13276,"section_number":"32.1-325.4","catch_line":"Penalty for violation","url":"\/32.1-325.4\/","token":"32.1\/10\/1\/32.1-325.4","metadata":false},{"id":60835,"structure_id":13276,"section_number":"32.1-325.5","catch_line":"State pharmacy benefits manager","url":"\/32.1-325.5\/","token":"32.1\/10\/1\/32.1-325.5","metadata":false},{"id":62094,"structure_id":13276,"section_number":"32.1-326","catch_line":"Director may make payments to or for eligible persons in state-owned medical facilities","url":"\/32.1-326\/","token":"32.1\/10\/1\/32.1-326","metadata":false},{"id":75399,"structure_id":13276,"section_number":"32.1-326.1","catch_line":"Department to operate program of estate recovery","url":"\/32.1-326.1\/","token":"32.1\/10\/1\/32.1-326.1","metadata":false},{"id":86309,"structure_id":13276,"section_number":"32.1-326.2","catch_line":"Pilot school\/community health centers","url":"\/32.1-326.2\/","token":"32.1\/10\/1\/32.1-326.2","metadata":false},{"id":69227,"structure_id":13276,"section_number":"32.1-326.3","catch_line":"Special education health services; memorandum of agreement between the Department of Education and the Department of Medical Assistance Services","url":"\/32.1-326.3\/","token":"32.1\/10\/1\/32.1-326.3","metadata":false},{"id":81598,"structure_id":13276,"section_number":"32.1-327","catch_line":"Claim against indigent's estate for payments made","url":"\/32.1-327\/","token":"32.1\/10\/1\/32.1-327","metadata":false},{"id":59946,"structure_id":13276,"section_number":"32.1-328","catch_line":"Repealed","url":"\/32.1-328\/","token":"32.1\/10\/1\/32.1-328","metadata":false},{"id":74371,"structure_id":13276,"section_number":"32.1-329","catch_line":"Repealed","url":"\/32.1-329\/","token":"32.1\/10\/1\/32.1-329","metadata":false},{"id":85726,"structure_id":13276,"section_number":"32.1-330","catch_line":"Long-term services and supports screening required","url":"\/32.1-330\/","token":"32.1\/10\/1\/32.1-330","metadata":false},{"id":80319,"structure_id":13276,"section_number":"32.1-330.01","catch_line":"Reports related to long-term services and supports","url":"\/32.1-330.01\/","token":"32.1\/10\/1\/32.1-330.01","metadata":false},{"id":56351,"structure_id":13276,"section_number":"32.1-330.02","catch_line":"Average hourly payment rates; publication","url":"\/32.1-330.02\/","token":"32.1\/10\/1\/32.1-330.02","metadata":false},{"id":75895,"structure_id":13276,"section_number":"32.1-330.1","catch_line":"Department to implement premium assistance program for HIV-positive individuals","url":"\/32.1-330.1\/","token":"32.1\/10\/1\/32.1-330.1","metadata":false},{"id":67982,"structure_id":13276,"section_number":"32.1-330.2","catch_line":"Medicaid managed care programs; program information documents; plain language required","url":"\/32.1-330.2\/","token":"32.1\/10\/1\/32.1-330.2","metadata":false},{"id":67859,"structure_id":13276,"section_number":"32.1-330.3","catch_line":"Operation of a PACE plan; oversight by Department of Medical Assistance Services","url":"\/32.1-330.3\/","token":"32.1\/10\/1\/32.1-330.3","metadata":false},{"id":85218,"structure_id":13276,"section_number":"32.1-330.4","catch_line":"Uniform assessment instrument for PACE plans","url":"\/32.1-330.4\/","token":"32.1\/10\/1\/32.1-330.4","metadata":false},{"id":56407,"structure_id":13276,"section_number":"32.1-330.5","catch_line":"Reports related to eligibility renewal","url":"\/32.1-330.5\/","token":"32.1\/10\/1\/32.1-330.5","metadata":false},{"id":59199,"structure_id":13276,"section_number":"32.1-331","catch_line":"Repealed","url":"\/32.1-331\/","token":"32.1\/10\/1\/32.1-331","metadata":false},{"id":60720,"structure_id":13276,"section_number":"32.1-331.01","catch_line":"Health Care Coverage Assessment Fund","url":"\/32.1-331.01\/","token":"32.1\/10\/1\/32.1-331.01","metadata":false},{"id":76953,"structure_id":13276,"section_number":"32.1-331.02","catch_line":"Health Care Provider Payment Rate Assessment Fund","url":"\/32.1-331.02\/","token":"32.1\/10\/1\/32.1-331.02","metadata":false},{"id":79240,"structure_id":13276,"section_number":"32.1-331.03","catch_line":"Process for payment directly to nursing facility or ICF\/MR","url":"\/32.1-331.03\/","token":"32.1\/10\/1\/32.1-331.03","metadata":false},{"id":80605,"structure_id":13276,"section_number":"32.1-331.04","catch_line":"Personal care aides; orientation program","url":"\/32.1-331.04\/","token":"32.1\/10\/1\/32.1-331.04","metadata":false},{"id":84036,"structure_id":13276,"section_number":"32.1-331.05","catch_line":"Coordinated specialty care; work group","url":"\/32.1-331.05\/","token":"32.1\/10\/1\/32.1-331.05","metadata":false},{"id":77511,"structure_id":13276,"section_number":"32.1-331.06","catch_line":"Annual review of medications and treatment for sickle cell disease; report","url":"\/32.1-331.06\/","token":"32.1\/10\/1\/32.1-331.06","metadata":false}],"previous_section":{"id":75066,"structure_id":13276,"section_number":"32.1-325.1","catch_line":"Appeals of agency determinations","url":"\/32.1-325.1\/","token":"32.1\/10\/1\/32.1-325.1","metadata":false},"next_section":{"id":56047,"structure_id":13276,"section_number":"32.1-325.2","catch_line":"Department is payor of last resort","url":"\/32.1-325.2\/","token":"32.1\/10\/1\/32.1-325.2","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/32.1-325.1:1\/","history_text":"<p>This law was first created in 1990. The record of its establishment is cataloged in chapter 389 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 1990 \u201cActs\u201d aren\u2019t available online. It has been modified 3 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 1994, chapter <a href=\"https:\/\/legacylis.virginia.gov\/cgi-bin\/legp604.exe?941+ful+CHAP0669\">669<\/a>; in 1999, chapter <a href=\"https:\/\/legacylis.virginia.gov\/cgi-bin\/legp604.exe?991+ful+CHAP1024\">1024<\/a>; in 2005, chapter <a href=\"https:\/\/legacylis.virginia.gov\/cgi-bin\/legp604.exe?051+ful+CHAP0839\">839<\/a>.<\/p>","references":false,"refers_to":[{"id":56662,"section_number":"1-230","catch_line":"Person","order_by":null,"url":"\/1-230\/"},{"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\/"},{"id":75066,"section_number":"32.1-325.1","catch_line":"Appeals of agency determinations","order_by":null,"url":"\/32.1-325.1\/"}],"permalink":{"id":201421,"object_type":"law","relational_id":87103,"identifier":"32.1-325.1:1","token":"32.1\/10\/1\/32.1-325.1_1","url":"\/32.1-325.1_1\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/32.1-325.1_1\/","token":"32.1\/10\/1\/32.1-325.1_1","dublin_core":{"Title":"Definitions; recovery of overpayment for medical assistance services","Type":"Text","Format":"text\/html","Identifier":"\u00a7 32.1-325.1:1","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t<section id=\"A\"><p><span class=\"prefix-number\">A.<\/span> For the purposes of this section, the following definitions shall apply:\n\t\t\t&#8220;<span class=\"dictionary\">Agreement<\/span>&#8221; means any <span class=\"dictionary\">contract<\/span> executed for the delivery of services to recipients of medical assistance pursuant to subdivision D 2 of &#xA7; <a class=\"law\" title=\"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\" href=\"\/32.1-325\/\">32.1-325<\/a>.\n\t\t\t&#8220;<span class=\"dictionary\">Successor in interest<\/span>&#8221; means any <span class=\"dictionary\">person<\/span> as defined in &#xA7; <a class=\"law\" title=\"Person\" href=\"\/1-230\/\">1-230<\/a> having stockholders, directors, officers, or partners in common with a health care provider for which an <span class=\"dictionary\">agreement<\/span> has been terminated.\n\t\t\t&#8220;<span class=\"dictionary\">Termination<\/span>&#8221; means (i) the cessation of operations by a provider, (ii) the sale or transfer of the provider, (iii) the reorganization or restructuring of the health care provider, or (iv) the <span class=\"dictionary\">termination<\/span> of an <span class=\"dictionary\">agreement<\/span> by either <span class=\"dictionary\">party<\/span>. <a id=\"paragraph-311901\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-325.1_1\/#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 Director of Medical Assistance Services shall collect by any means available to him at <span class=\"dictionary\">law<\/span> any amount owed to the Commonwealth because of overpayment for medical assistance services. Upon making an initial determination that an overpayment has been made to the provider pursuant to &#xA7; <a class=\"law\" title=\"Appeals of agency determinations\" href=\"\/32.1-325.1\/\">32.1-325.1<\/a>, the Director shall notify the provider of the amount of the overpayment. Such initial determination shall be made within the earlier of (i) four years, or (ii) 15 months after filing of the final cost report by the provider subsequent to sale of the facility or <span class=\"dictionary\">termination<\/span> of the provider. The provider shall make arrangements satisfactory to the Director to repay the amount due. If the provider fails or refuses to make arrangements satisfactory to the Director for such repayment or fails or refuses to repay the Commonwealth for the amount due for overpayment in a timely manner, the Director may devise a schedule for reducing the Medicaid reimbursement due to any <span class=\"dictionary\">successor in interest<\/span>. <a id=\"paragraph-311902\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-325.1_1\/#B\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"C\"><p><span class=\"prefix-number\">C.<\/span> In any case in which the Director is unable to recover the amount due for overpayment pursuant to subsection B, he shall not enter into another <span class=\"dictionary\">agreement<\/span> with the responsible provider or any <span class=\"dictionary\">person<\/span> who is the transferee, assignee, or <span class=\"dictionary\">successor in interest<\/span> to such provider unless (i) he receives satisfactory assurances of repayment of all amounts due or (ii) the <span class=\"dictionary\">agreement<\/span> with the provider is necessary in <span class=\"dictionary\">order<\/span> to ensure that Medicaid recipients have access to the covered services rendered by the provider.\n\t\t\tFurther, to the extent consistent with federal and state <span class=\"dictionary\">law<\/span>, the Director shall not enter into any <span class=\"dictionary\">agreement<\/span> with a provider having any stockholder possessing a <span class=\"dictionary\">material<\/span> financial interest, partner, director, officer, or owner in common with a provider which has terminated a previous <span class=\"dictionary\">agreement<\/span> for participation in the medical assistance services program without making satisfactory arrangements to repay all outstanding Medicaid overpayment. <a id=\"paragraph-311903\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-325.1_1\/#C\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"D\"><p><span class=\"prefix-number\">D.<\/span> The provisions of this section shall not apply to successors in interest with respect to transfer of a <span class=\"dictionary\">medical care facility<\/span> pursuant to <span class=\"dictionary\">contracts<\/span> entered into before February 1, 1990. <a id=\"paragraph-311904\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/32.1-325.1_1\/#D\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>","plain_text":"                                 CODE OF VIRGINIA\n\nDEFINITIONS; RECOVERY OF OVERPAYMENT FOR MEDICAL ASSISTANCE SERVICES (\u00a7\n32.1-325.1:1)\n\nA. For the purposes of this section, the following definitions shall apply:\n\t\t\t&#8220;Agreement&#8221; means any contract executed for the delivery of\nservices to recipients of medical assistance pursuant to subdivision D 2 of\n&#xA7; 32.1-325.\n\t\t\t&#8220;Successor in interest&#8221; means any person as defined in &#xA7;\n1-230 having stockholders, directors, officers, or partners in common with a\nhealth care provider for which an agreement has been terminated.\n\t\t\t&#8220;Termination&#8221; means (i) the cessation of operations by a\nprovider, (ii) the sale or transfer of the provider, (iii) the reorganization or\nrestructuring of the health care provider, or (iv) the termination of an\nagreement by either party.\n\nB. The Director of Medical Assistance Services shall collect by any means\navailable to him at law any amount owed to the Commonwealth because of\noverpayment for medical assistance services. Upon making an initial\ndetermination that an overpayment has been made to the provider pursuant to\n&#xA7; 32.1-325.1, the Director shall notify the provider of the amount of the\noverpayment. Such initial determination shall be made within the earlier of (i)\nfour years, or (ii) 15 months after filing of the final cost report by the\nprovider subsequent to sale of the facility or termination of the provider. The\nprovider shall make arrangements satisfactory to the Director to repay the\namount due. If the provider fails or refuses to make arrangements satisfactory\nto the Director for such repayment or fails or refuses to repay the Commonwealth\nfor the amount due for overpayment in a timely manner, the Director may devise a\nschedule for reducing the Medicaid reimbursement due to any successor in\ninterest.\n\nC. In any case in which the Director is unable to recover the amount due for\noverpayment pursuant to subsection B, he shall not enter into another agreement\nwith the responsible provider or any person who is the transferee, assignee, or\nsuccessor in interest to such provider unless (i) he receives satisfactory\nassurances of repayment of all amounts due or (ii) the agreement with the\nprovider is necessary in order to ensure that Medicaid recipients have access to\nthe covered services rendered by the provider.\n\t\t\tFurther, to the extent consistent with federal and state law, the Director\nshall not enter into any agreement with a provider having any stockholder\npossessing a material financial interest, partner, director, officer, or owner\nin common with a provider which has terminated a previous agreement for\nparticipation in the medical assistance services program without making\nsatisfactory arrangements to repay all outstanding Medicaid overpayment.\n\nD. The provisions of this section shall not apply to successors in interest with\nrespect to transfer of a medical care facility pursuant to contracts entered\ninto before February 1, 1990.\n\nHISTORY: 1990, c. 389; 1994, c. 669; 1999, c. 1024; 2005, c. 839.","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}}