Code of Virginia
Chapter 9 - Regulation of Medical Assistance
§ 32.1-313. Liability for excess benefits or payments obtained without intent to violate chapter

A. Any person, agency or institution, but not including an individual medical assistance recipient of health care, that, without intent to violate this chapter, whether under contract or otherwise, obtains benefits or payments where the Commonwealth directly or indirectly provides any portion of the benefits or payments under medical assistance to which such person, agency or institution is not entitled, or in a greater amount than that to which entitled, shall be liable for (i) any excess benefits or payments received, and (ii) interest on the amount of the excess benefits or payments at the judgment rate as defined in § 6.2-302 from the date upon which such person, agency, or institution knew or reasonably should have known that it had received excess benefits or payments to the date upon which repayment is made to the Commonwealth. No person, agency or institution shall be liable for payment of interest, however, when excess benefits or payments were obtained as a result of errors made solely by the Department of Medical Assistance Services. Whenever a penalty or interest is due under this section or § 32.1-312, such penalty or interest shall not be reimbursable by the Commonwealth as an allowable cost under any of the provisions of this chapter.
B. 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.
1981, c. 255; 1986, c. 551; 2007, c. 569.

Structure Code of Virginia

Code of Virginia

Title 32.1 - Health

Chapter 9 - Regulation of Medical Assistance

§ 32.1-310. Declaration of purpose; authority to audit records; authority to review complaints of abuse or neglect

§ 32.1-311. Repealed

§ 32.1-312. Fraudulently obtaining excess or attempting to obtain excess benefits or payments; penalty

§ 32.1-313. Liability for excess benefits or payments obtained without intent to violate chapter

§ 32.1-314. False statement or representation in applications for payment or for use in determining rights to payment; concealment of facts; penalty

§ 32.1-315. Solicitation or receipt of remuneration for certain services; offer or payment of remuneration for inducement of such services; penalty

§ 32.1-316. False statement or representation as to conditions or operations of institution or facility; penalty

§ 32.1-317. Collecting excess payment for services; charging, soliciting, accepting or receiving certain consideration as precondition for admittance to facility or requirement for continued stay; penalty

§ 32.1-318. Knowing failure to deposit, transfer or maintain patient trust funds in separate account; penalty

§ 32.1-319. Written verification of application, statement or form; penalty for false or misleading information

§ 32.1-319.1. Department to establish pilot program to use data analytics to mitigate risk of improper payments

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

§ 32.1-321. Prosecution of cases

§ 32.1-321.01. Exemptions from disclosure

§ 32.1-321.1. Powers and duties of Department

§ 32.1-321.2. Liability for excess benefits or payments obtained without intent to violate this article; recovery of Medical Assistance erroneously paid

§ 32.1-321.3. Fraudulently obtaining benefits; liability for fraudulently issued benefits; civil action to recover; penalty

§ 32.1-321.4. False statement or representation in applications for eligibility or for use in determining rights to benefits; concealment of facts; criminal penalty

§ 32.1-322. Repealed