United States v. Levin: entrapment by estoppel doctrine applied in Medicare reimbursement context

Med Staff Couns. 1993 Fall;7(4):55-8.

Abstract

The decision in Levin reaffirms that health care providers should be entitled to rely in good faith on official interpretations and representations by authorized government officials as to the propriety of their conduct under the Medicare program. Although the doctrine of entrapment by estoppel was developed as a due process defense to a criminal prosecution, the fundamental notions of fairness underlying the doctrine should be applicable as well as in a civil action. Thus, the defense of entrapment by estoppel should be available, for example, in the context of civil health care reimbursement recoupment audits, where a provider has acted in reliance on the interpretation of a statute or regulation by the appropriate administrative agency charged with its enforcement.

Publication types

  • Legal Case

MeSH terms

  • Centers for Medicare and Medicaid Services, U.S.
  • Commerce / legislation & jurisprudence
  • Criminal Law
  • Fraud / legislation & jurisprudence*
  • Humans
  • Insurance, Health, Reimbursement / legislation & jurisprudence*
  • Kentucky
  • Lenses, Intraocular / economics
  • Liability, Legal
  • Medicare / legislation & jurisprudence*
  • Surgical Equipment / economics
  • United States