304
Opinion of the Court
Humana Insurance paid significantly less than 80% of the hospital's actual charges for the care that policy beneficiaries received, and the beneficiaries paid significantly more than 20% of those charges.2
The employee beneficiaries brought suit in the United States District Court for the District of Nevada,3 alleging that Humana Insurance and Humana Inc. violated RICO through a pattern of racketeering activity consisting of mail, wire, radio, and television fraud.4 Defendants Humana Insurance and Humana Inc. moved for summary judgment, citing § 2(b) of the McCarran-Ferguson Act, which provides:
"No Act of Congress shall be construed to invalidate, impair, or supersede any law enacted by any State for the purpose of regulating the business of insurance, or which imposes a fee or tax upon such business, unless such Act specifically relates to the business of insurance." 15 U. S. C. § 1012(b).
The District Court granted the motion. In that court's view, RICO's private remedies, including the federal statute's treble damages provision, 18 U. S. C. § 1964(c), so exceeded Nevada's administrative penalties for insurance fraud, see infra, at 311-312, that applying RICO to the alleged conduct would have been "tantamount to allowing Congress to intercede in an area expressly left to the states under
2 State investigation of the scheme, launched by Nevada's Attorney General, terminated when Humana Insurance and Nevada's Insurance Commissioner entered into a consent decree under which the insurer paid a fine of $50,000.
3 The complaint separated plaintiffs into two classes, a "Co-Payor Class" comprising employee beneficiaries, and a "Premium Payor Class" comprising employers who purchased the policies. See 114 F. 3d 1467, 1472 (CA9 1997). Only the employees' claims have been placed at issue here.
4 The complaint also presented claims under the Employee Retirement Income Security Act of 1974 (ERISA), 88 Stat. 829, as amended, 29 U. S. C. § 1001 et seq., and § 2 of the Sherman Act, 26 Stat. 209, as amended, 15 U. S. C. § 2. The disposition of those claims is not germane to the issue on which this Court's review was sought and granted.
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