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Civil RICO Claims Against Pharmaceutical Companies

Civil RICO claims can be filed against both healthcare practitioners and pharmaceutical companies. Claims against healthcare practitioners often involve individual misconduct, such as fraudulent billing or unnecessary medical procedures that directly affect patient care and financial stability.

On the other hand, claims against pharmaceutical companies usually involve large-scale deceptive practices that can mislead millions of patients and healthcare providers, potentially causing widespread health risks and significant financial losses for patients and third-party payers.

If you or your practice is involved in a RICO civil suit, a RICO and False Claims Act attorney can guide you through the legal process.

What Is a Civil RICO Claim?

Patients and third-party payers can bring legal claims against pharmaceutical companies under the Racketeer Influenced and Corrupt Organizations Act (RICO). These civil RICO claims argue that the companies caused financial harm through deceptive drug promotion practices.

Elements of Civil RICO Claims

To claim a violation of RICO, the plaintiff must prove the following: (1) the defendant (2) committed at least two acts (3) forming a pattern (4) of illegal activities (5) and either invested in, maintained interest in, or participated in (6) an enterprise (7) that impact interstate or international commerce.

Civil RICO lawsuits against pharmaceutical companies often involve accusations of mail and wire fraud, using mail, phone, email, or another form of communication to deceive others. The claims focus on pharmaceutical companies promoting drugs fraudulently through these means, such as making false or misleading statements about a drug’s benefits, risks, or off-label uses.

Examples of Civil RICO Claims in Healthcare

Rico civil suits typically tackle fraudulent or misleading practices. The following are some of the most common disputes we see in the healthcare sector:

  • Fraudulent practices. This includes engaging in prescription fraud or employing deceitful billing practices, such as overcharging patients or insurance companies. Monetary fraud is a prevalent issue in the healthcare industry.
  • Kickbacks and referrals. A medical professional might be accused of receiving money for sending patients to specific medical facilities, or labs when it is unnecessary. Putting financial gain over patient care is illegal and unethical.

Preventing RICO Civil Lawsuits

As a healthcare professional, you are expected to abide by the highest standards of patient care. This means following legal and ethical regulations that put the patient above all else. Unfortunately, this is not always the case. Unethical medical professionals may take advantage of patients, prioritizing monetary gain over the patient’s health and well-being.

Here are tips on how to avoid potential RICO civil lawsuits:

  • Adhere to ethical standards. Always prioritize patient well-being over financial gain. Avoid any practices that could be viewed as prioritizing profit over care.
  • Avoid kickbacks and referrals. Do not accept financial incentives for referring patients to specific facilities, labs, or practices. Ensure all referrals are based solely on the patient’s best interests.
  • Be transparent with billing. Make sure all billing practices are transparent and accurate. Avoid overcharging or engaging in fraudulent billing.
  • Stay up to date on legal regulations. Stay informed on federal and state laws regarding pharmacy regulations. Regularly attend trainings and seek legal advice when necessary.
  • Conduct regular financial audits. Regularly audit your pharmacy’ss financial activities to identify and change potential issues before they turn into legal issues.

Speak to a Healthcare Practice Attorney

Fenton Jurkowitz Law Group has a team of seasoned healthcare law lawyers who can provide one-on-one assistance if you become involved in a civil RICO claim. We don’t just give legal advice — we help you arrive at solutions quickly and effectively while ensuring the claim is filed within the civil RICO statute of limitations. Fill out our contact form on our website to connect with a RICO and False Claims Act attorney today.