The Commonwealth of Virginia is actively defending against a lawsuit filed by the Nansemond Indian Nation and its healthcare provider, Fishing Point Healthcare, amid growing concerns of potential Virginia Tribe Medicaid Billing Fraud. The state has suspended Medicaid payments to the provider and referred the case to its Medicaid Fraud Control Unit for investigation.

According to filings in federal court, Fishing Point Healthcare—operating under the Nansemond Indian Tribe—has billed the Commonwealth hundreds of millions of dollars over two years for services provided to approximately 2,000 Medicaid recipients. The state alleges these charges dramatically exceed those of major hospitals serving significantly larger populations.

The Commonwealth asserts that Fishing Point engaged in questionable billing practices, including:

• Charging the federal all-inclusive rate of $801 for basic services such as over-the-counter medications and personal care without physician oversight;

• Billing for multiple services during a single outpatient visit—sometimes exceeding the five-visit daily limit;

• Submitting reimbursement claims for unauthorized services lacking proper documentation.

Between 2023 and 2024, Fishing Point’s Medicaid claims reportedly surged by more than 3,500%, prompting state officials to act swiftly in order to protect taxpayer funds and uphold the integrity of Virginia’s Medicaid program.

“In short, there appears to be potential fraud or abuse happening at Fishing Point,” the state wrote in a legal filing, noting that the suspension of payments is in full compliance with federal law while allegations are under investigation.

The Nansemond Tribe, however, argues that the state violated multiple federal statutes by altering Medicaid policies without required tribal consultation or federal approval. In its April 1 lawsuit, the tribe claims the state’s actions infringe upon tribal sovereignty and undermine operations guaranteed under the Indian Self-Determination and Education Assistance Act (ISDEAA).

The tribe further asserts that a federal audit found Fishing Point in compliance with Medicaid rules and accuses the Commonwealth of launching an “inflammatory” and politically motivated attack.

“This is not about fraud—it’s about retaliation,” said Jessie Barrington, counsel for the tribe. “Virginia’s last-minute fraud claim is not supported by any verified findings. Growth is not fraud. Compliance is not fraud.”

Despite ongoing litigation and suspended reimbursements, Fishing Point has opened a second clinic and plans a third location soon. The state notes that the clinics continue to serve over 1,100 Medicaid beneficiaries monthly—far exceeding the size of the Nansemond tribal population—raising further questions about service eligibility.

The Commonwealth is represented by McGuireWoods LLP. The Nansemond Indian Nation is represented by Cultural Heritage Partners PLLC. The case is being heard in the U.S. District Court for the Eastern District of Virginia under case number 2:25-cv-00195.