                                 CODE OF VIRGINIA

FRAUDULENTLY OBTAINING EXCESS OR ATTEMPTING TO OBTAIN EXCESS BENEFITS OR
PAYMENTS; PENALTY (§ 32.1-312)

A. No person, agency or institution, but not including an individual medical
assistance recipient of health care, on behalf of himself or others, whether
under a contract or otherwise, shall obtain or attempt to obtain benefits or
payments where the Commonwealth directly or indirectly provides any portion of
the benefits or payments pursuant to the Plan for Medical Assistance and any
amendments thereto as provided for in § 32.1-325, hereafter referred to as
&#8220;medical assistance&#8221; in a greater amount than that to which entitled
by:

   1. Knowingly and willfully making or causing to be made any false statement or
   false representation of material fact;

   2. Knowingly and willfully concealing or causing to be concealed any material
   facts; or

   3. Knowingly and willfully engaging in any fraudulent scheme or device,
   including, but not limited to, submitting a claim for services, drugs,
   supplies or equipment that were unfurnished or were of a lower quality, or a
   substitution or misrepresentation of items billed.

B. Any person, agency or institution knowingly and willfully violating any of
the provisions of subsection A shall be (i) liable for repayment of any excess
benefits or payments received, plus interest on the amount of the excess
benefits or payments at the rate of 1.5 percent each month for the period from
the date upon which payment was made to the date upon which repayment is made to
the Commonwealth and (ii) in addition to any other penalties provided by law,
subject to civil penalties. The state Attorney General may petition the circuit
court in the jurisdiction of the alleged offense, to seek an order assessing
civil penalties in an amount not to exceed three times the amount of such excess
benefits or payments. Such civil penalties shall not apply to any acts or
omissions occurring prior to the effective date of this law.

C. A criminal action need not be brought against a person for that person to be
civilly liable under this section.

D. Civil penalties shall be deposited in the general fund of the state treasury
upon their receipt.

E. A civil action under this section shall be brought (i) within six years of
the date on which the violation was committed, or (ii) within three years of the
date when an official of the Commonwealth charged with the responsibility to act
in the circumstances discovered or reasonably should have discovered the facts
material to the cause of action. However, in no event shall the limitations
period extend more than 10 years from the date on which the violation was
committed.

HISTORY: 1981, c. 255; 1984, c. 781; 2007, c. 569; 2010, c. 305.