                                 CODE OF VIRGINIA

DUTIES OF ATTORNEY GENERAL; MEDICAL SERVICES PROVIDERS AUDIT AND INVESTIGATION
UNIT (§ 32.1-320)

A. 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.

B. The Attorney General or his authorized representative shall have the
authority to:

   1. 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;

   2. 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.

HISTORY: 1981, c. 255; 1982, c. 41; 1984, c. 781; 1986, c. 551; 2011, cc. 110,
175; 2012, c. 479; 2013, c. 538.