32.1-320 - Duties of Attorney General; medical services providers audit and investigation unit. - Virginia Statutes

§ 32.1-320. Duties of Attorney General; medical services providers audit andinvestigation unit.

A. There shall be established within the Office of the Attorney General aunit to audit and investigate providers of services furnished under the StateMedical Assistance Plan. The Department of Medical Assistance Services shallcooperate with the Office of the Attorney General in conducting such auditsand investigations and shall provide such information for these purposes asmay be requested by the Attorney General or his authorized representative.

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

1. Conduct audits and investigations of providers of medical and otherservices furnished under medical assistance. The relevant board within theDepartment of Health Professions shall serve in an advisory capacity to theAttorney General in the conduct of audits or investigations of health careproviders licensed by the respective regulatory boards. In the conduct ofsuch audits or investigations, the Attorney General may examine only thoserecords or portions thereof, including patient records, for which serviceswere rendered by a health care provider and reimbursed by the Department ofMedical Assistance Services under the Plan for Medical Assistance,notwithstanding the provisions of Chapter 38 (§ 2.2-3800 et seq.) of Title2.2 or of any other statute which may make or purport to make such recordsprivileged or confidential. No original patient records shall be removed fromthe premises of the health care provider, except in accordance with Rule 4:9of the Rules of the Supreme Court of Virginia. The disclosure of any recordsor information by the Attorney General is prohibited, unless such disclosureis directly connected to the official purpose for which the records orinformation was obtained. The disclosure of patient information as requiredunder this section shall not subject any physician or other health servicesprovider to any liability for breach of any confidential relationship betweenthe provider and the patient, but no evidence resulting from such disclosuremay be used in any civil, administrative or criminal proceeding against thepatient unless a waiver of the applicable evidentiary privilege is obtained.The Attorney General shall cause all copies of patient medical records in hispossession or that of his designee to be destroyed upon completion of theaudit, investigation or proceedings, including appeals;

2. Issue subpoenas, compel the attendance of witnesses, administer oaths,certify to official acts, take depositions within and without theCommonwealth as now provided by law, and compel the production of pertinentbooks, payrolls, accounts, papers, records, documents and testimony relevantto such investigation. If a person in attendance before the Attorney Generalor his authorized representative refuses, without reasonable cause, to beexamined or to answer a legal and pertinent question, or to produce a book orpaper or other evidence when ordered to do so by the Attorney General or hisauthorized representative, the Attorney General or his authorizedrepresentative may apply to the judge of the circuit court of thejurisdiction where such person is in attendance, upon affidavit, for an orderreturnable in not less than two nor more than five days, directing suchperson to show cause why he should not produce such records. Upon the hearingof such order, if the court shall determine that such person, withoutreasonable cause, has refused to be examined or to answer a legal orpertinent question, or to produce a book or paper which he was ordered tobring or produce, he may forthwith assess all costs and reasonable attorney'sfees against such person. If the motion for an order is granted and theperson thereafter fails to comply with the order, the court may make suchorders 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 incivil cases in the circuit courts of this Commonwealth.

(1981, c. 255; 1982, c. 41; 1984, c. 781; 1986, c. 551.)