RICO is a conspiracy law. Congress’s intent in passing it is unclear. Many businesspersons assert that it was intended only to apply to gangsters, but one of the drafters of RICO counters that it was intended to be a sort of national deceptive business practices act. Irrespective of congressional intent, the U.S. Supreme Court has ruled that RICO is not restricted to organized crime enforcement. This is consistent with the plain language of RICO. It is also more reasonable to assume that a plaintiff would be inclined to sue a business person rather than a gangster.

A person violates RICO by engaging in a conspiracy—a joint effort with at least one or more individuals or organizations—to break any of a lengthy list of specific state and federal laws. Violating one of the listed laws is called a predicate act. Physicians are at risk because breaching their fiduciary duty to patients, or violating other technical laws such as the Medicare fraud and abuse provisions, can support fraud allegations that are predicate acts under RICO.