Stuart Gerson Quoted in “Health-Care Fraud’s Hammer: An Organized Crime Law”Bloomberg BNA Health Care Daily Report June 28, 2018
Stuart M. Gerson, Member of the Firm in the Litigation and Health Care & Life Sciences practices, in the firm’s Washington, DC, and New York offices, was quoted in the Bloomberg BNA Health Care Daily Report, in “Health-Care Fraud’s Hammer: An Organized Crime Law,” by Matt Phifer.
Following is an excerpt:
Racketeering immediately conjures images of the Mafia, John Gotti, and Al Capone, but a law intended to fight organized crime is also being used as a tool in health-care fraud cases.
While many health-care fraud cases revolve around the False Claims Act, the Stark law, and the anti-kickback statute, there is another option for plaintiffs accusing providers of health-care fraud: the Racketeer Influenced and Corrupt Organizations Act (RICO). And it is being used as an alternative to those traditional health-care fraud actions.
The wide interpretation of RICO by courts and the willingness of plaintiffs to use it to accuse health-care providers of fraud mean that providers need to be ready for the very damaging consequences of facing a civil RICO action. …
RICO carries heavy criminal consequences, including penalties up to $25,000 and prison sentences that can last two decades. But RICO also provides an opportunity for people whose business or property was harmed by a RICO violation to file a civil suit under the law and receive treble damages and attorneys’ fees.
Its stigma can be devastating for a health-care provider, such as a hospital.
“Charging somebody with RICO really carries a stigma,” Stuart Gerson, a member of Epstein Becker Green’s health-care and life sciences practice in Washington who is a former acting U.S. attorney general. “It puts them under the shade of ‘The Sopranos,’ the Mafia type.” …
The lawyers who spoke to Bloomberg Law were split on whether civil RICO is a growing trend in health-care cases, but it’s undoubtedly being used. …
But Gerson hesitated to call it a trend. “I think what we’ve seen is a couple cases and it shows no more than some creative attorneys view this as an alternative way to bring a treble damages case,” Gerson said, pointing out that there are still far more FCA cases.