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2013 SESSION
Be it enacted by the General Assembly of Virginia:
1. That § 32.1-320 of the Code of Virginia is amended and reenacted as follows:
§ 32.1-320. Duties of Attorney General; medical services providers audit and investigation unit.
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 (§ 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's 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 § 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 §
32.1-312 shall be considered sensitive and confidential and may be considered
attorney work product or privileged investigative files.