PRECEDENTIAL

        UNITED STATES COURT OF APPEALS
             FOR THE THIRD CIRCUIT
                  _____________

                       No. 19-3340
                      _____________

ST. LUKE’S HEALTH NETWORK, INC., DBA St. Luke’s
University Health Network; SAINT LUKE’S HOSPITAL OF
    BETHLEHEM, PENNSYLVANIA, DBA St. Luke’s
   University Hospital, Bethlehem Campus; ST. LUKE’S
 QUAKERTOWN HOSPITAL; CARBON-SCHUYLKILL
   COMMUNITY HOSPITAL, DBA St. Luke’s Miners
          Memorial Hospital; BLUE MOUNTAIN
HOSPITAL, individually and on behalf of all others similarly
  situated, DBA St. Luke’s Hospital, Palmerton Campus,
                                                Appellants

                             v.

  LANCASTER GENERAL HOSPITAL; LANCASTER
        GENERAL HEALTH; UNIVERSITY OF
  PENNSYLVANIA HEALTH SYSTEM; UNIVERSITY
    OF PENNSYLVANIA TRUSTEES; JOHN DOE 1;
                 JOHN DOE 2
                ______________

       Appeal from the United States District Court
          for the Eastern District of Pennsylvania
             (Civ. Action No. 5-18-cv-02157)
       District Judge: Honorable Jeffrey L. Schmehl
                     ______________

                  Argued March 31, 2020
                     ______________

Before: GREENAWAY, JR., PORTER, and MATEY, Circuit
                     Judges.

               (Opinion filed: July 22, 2020)


Brian W. Barnes [ARGUED]
David H. Thompson
Cooper & Kirk
1523 New Hampshire Avenue, N.W.
Washington, DC 20036

Douglas J. McGill
Webber McGill
760 Route 10
Suite 104
Whippany, NJ 07981
       Counsel for Appellants

Kevin W. Fay [ARGUED]
Peter J. Hoffman
Jeffrey P. Lewis
Eckert Seamans Cherin & Mellott
50 South 16th Street
Two Liberty Place, 22nd Floor
Philadelphia, PA 19102
       Counsel for Appellees




                                2
                       ______________

                          OPINION
                       _______________

GREENAWAY, JR., Circuit Judge.

        This case involves a state-run program to reimburse
Pennsylvania hospitals for treating indigent patients.
Plaintiffs-Appellants are a group of hospitals and their related
health care networks that seek civil remedies from Defendants-
Appellees, another hospital and hospital system, for violations
of the Racketeer Influenced & Corrupt Organizations Act
(“RICO”), 18 U.S.C. § 1964(c)–(d). Plaintiffs allege that
Defendants submitted fraudulent claims for reimbursement, in
violation of the wire fraud statute, 18 U.S.C. § 1343, and
received an unduly inflated proportion of the available funding.
As a result, Plaintiffs claim they were reimbursed an artificially
smaller share of funds. The District Court dismissed Plaintiffs’
claims for lack of RICO standing, an additional requirement to
Article III standing. It found that Plaintiffs failed to plead
sufficient facts to demonstrate that their injury was caused by
Defendants’ alleged fraud.

       Because we find Plaintiffs’ theory of liability
adequately alleges proximate causation, we will reverse the
District Court and remand for further proceedings consistent
with this opinion.




                                3
                   I.     BACKGROUND

    A.     Tobacco Settlement Act and Extraordinary
                   Expense Program

        In 1998, Pennsylvania and forty-five other states
entered into a master settlement agreement with certain
cigarette manufacturers. As part of the settlement, the cigarette
manufacturers disbursed funding to the states to cover tobacco-
related health care costs. To allocate the funds to hospitals
providing care to indigent patients, the Pennsylvania General
Assembly enacted the Tobacco Settlement Act in 2001 (the
“Act”). P.L. 755, No. 77 (codified at 35 Pa. Stat. § 5701.101
et seq. (2001)).

        This case concerns the Hospital Extraordinary Expense
Program (“EE Program”) established under the Act. The EE
Program reimburses participating ho