<?xml version="1.0"?>
<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>73899</law_id><section_number>32.1-320</section_number><catch_line>Duties of Attorney General; medical services providers audit and investigation unit</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>32.1-127.1:03</reference><reference>32.1-320.1</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> 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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section>
						<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"/></a></p></section></text><history>1981, c. 255; 1982, c. 41; 1984, c. 781; 1986, c. 551; 2011, cc. 110, 175; 2012, c. 479; 2013, c. 538.</history><metadata></metadata></law>
