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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>63947</law_id><section_number>32.1-314</section_number><catch_line>False statement or representation in applications for payment or for use in determining rights to payment; concealment of facts; penalty</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>18.2-513</reference><reference>32.1-325</reference></referred_to_by><structure><unit label="title" level="1" order_by="1" identifier="32.1">Health</unit><unit label="chapter" level="2" order_by="1" identifier="9">Regulation of Medical Assistance</unit><unit label="article" level="3" order_by="1" identifier="1">In General</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> Any <span class="dictionary">person</span> who engages in the following activities shall be guilty of a <span class="dictionary">felony</span> punishable by a term of imprisonment of not less than one nor more than 20 years, or in the discretion of the <span class="dictionary">jury</span> or the <span class="dictionary">court</span> trying the case without a <span class="dictionary">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: <a id="paragraph-232883" class="section-permalink" href="https://vacode.org/32.1-314/#A"><i class="fa fa-link"/></a></p></section>
						<section id="A1" class="indent-1"><p><span class="prefix-number">1.</span> Knowingly and willfully making or causing to be made any false statement or representation of a <span class="dictionary">material</span> <span class="dictionary">fact</span> in any application for any payment under medical assistance; <a id="paragraph-232884" class="section-permalink" href="https://vacode.org/32.1-314/#A1"><i class="fa fa-link"/></a></p></section>
						<section id="A2" class="indent-1"><p><span class="prefix-number">2.</span> At any time knowingly and willfully making or causing to be made any false statement or representation of a <span class="dictionary">material</span> <span class="dictionary">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 <span class="dictionary">material</span> <span class="dictionary">fact</span>, causing a <span class="dictionary">material</span> <span class="dictionary">fact</span> to be falsified, concealed, or covered up in such a manner in connection with such application or payment; or <a id="paragraph-232885" class="section-permalink" href="https://vacode.org/32.1-314/#A2"><i class="fa fa-link"/></a></p></section>
						<section id="A3" class="indent-1"><p><span class="prefix-number">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 <span class="dictionary">intent</span> fraudulently to secure such payment either in a greater amount or quantity than is due or when no such payment is authorized. <a id="paragraph-232886" class="section-permalink" href="https://vacode.org/32.1-314/#A3"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> Upon <span class="dictionary">conviction</span> for any violation of subsection A, the <span class="dictionary">court</span> shall <span class="dictionary">order</span> <span class="dictionary">restitution</span> to be made to the <span class="dictionary">Department</span> of Medical Assistance Services for any loss caused by the violation. <a id="paragraph-232887" class="section-permalink" href="https://vacode.org/32.1-314/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> The Director of the <span class="dictionary">Department</span> of Medical Assistance Services may terminate or deny a <span class="dictionary">contract</span> to a provider for any violation of this section pursuant to &#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>. <a id="paragraph-232888" class="section-permalink" href="https://vacode.org/32.1-314/#C"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> <span class="dictionary">Venue</span> for the <span class="dictionary">trial</span> of any <span class="dictionary">person</span> charged with an <span class="dictionary">offense</span> under this section shall be the county or city in which (i) any act was performed in furtherance of the <span class="dictionary">offense</span> or (ii) the <span class="dictionary">person</span> charged with the <span class="dictionary">offense</span> resided at the time of the <span class="dictionary">offense</span>. <a id="paragraph-232889" class="section-permalink" href="https://vacode.org/32.1-314/#D"><i class="fa fa-link"/></a></p></section></text><history>1981, c. 255; 1986, c. 551; 1995, c. 491; 2010, c. 305; 2011, cc. 444, 479; 2015, c. 537.</history><metadata></metadata></law>
