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

The Medical staff counselor Pub Date : 1993-01-01
P W Shaw, R A Griffith
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引用次数: 0

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.

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美国诉莱文案:禁止反悔原则在医疗保险报销中的应用。
莱文案的裁决重申,医疗服务提供者有权真诚地依赖官方解释和授权政府官员的陈述,以确定他们在医疗保险计划下的行为是否恰当。虽然禁止反悔的诱捕原则是作为刑事诉讼的正当程序辩护而发展起来的,但作为该原则基础的公平的基本概念也应适用于民事诉讼。因此,在民事保健报销报销审计的情况下,如提供者的行为依赖于负责执行的适当行政机构对法规或条例的解释,应可利用禁止反悔来为陷阱辩护。
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