Healthcare Fraud Defense Attorney
Daniel Horowitz: Premier Healthcare Fraud Defense Lawyer
Healthcare fraud defense lawyer Daniel Horowitz specializes in criminal defense in courts from New York to Oakland, San Diego and San Francisco. Few healthcare fraud defense groups have even a single attorney certified as a “Criminal Defense Specialist” by the State Bar of California (Board of Legal Specialization). Lawyers in Lafayette has three attorneys (with separate practices) who team to work together on complex medical fraud cases. These criminal defense specialists are Daniel Horowitz, Dan Russo, and Carmela Caramagno. As the practices are separate we can represent three defendants in a single case without conflicts of interest.
Do You Need a Healthcare Fraud Lawyer “Near Me”?
Lawyers in Lafayette is located in Lafayette, California (Contra Costa County) Our expert defense lawyers work with healthcare expert witnesses, top investigators and medical experts to systematically dismantle medical fraud charges. This is not geographically dependent, it is experience based. We understand that if you do an internet search for a healthcare lawyer “near me” our firm may not show at the top of your area's listing. However, healthcare cases are paperwork intensive and years of experience and expertise are generally more important than a direct local presence.
In many instances, our attorneys work with local attorneys. On complex criminal cases and for State of California fraud cases or federal healthcare fraud cases the legal issues are not geographically dependent and expertise and experience are the key to success.
Board specialization makes a significant difference in both medicine and criminal defense law. The best attorneys are recognized as “Criminal Defense Specialists” after meeting strict experience qualifications, undergoing peer review and judicial review, rigorous testing and advanced continuing education requirements. Our lead counsel Daniel Horowitz has been a certified criminal defense specialist for over 25 years. (State Bar of California Board of Legal Specialization certification) We work with independent attorneys Dan Russo and Carmela Caramagno on many healthcare fraud cases and they are both certified criminal defense specialists.
Why Choose Daniel Horowitz for Healthcare Fraud Defense?
Extensive Experience: Over 200 jury trials and a deep understanding of healthcare and medical fraud.
Certified Specialists: Three criminal defense specialists certified by the State Bar of California.
Comprehensive Expertise: In-depth knowledge of both criminal and healthcare law, ensuring a robust defense against healthcare fraud charges.
If you are facing healthcare fraud charges, trust the expertise of Daniel Horowitz and his team to provide you with the best defense possible.
Healthcare Fraud is Different from Financial Fraud
Medical Fraud is Different From Standard Criminal fraud. For example, healthcare fraud has specialized tracking systems (DHCS TRACS) which is a specialized system designed only for health care investigations. Terms such as “Medically Necessary” has a special meaning when billing certain government medical programs. A healthcare law expert knows these things and uses them to provide you with the best possible representation.
Are Kickbacks Legal?
Think of this “Are kickbacks legal?” Of course not. The minute you put the label “kickback” on the conduct the answer is obvious. The real question is what is a medical kickback? Can a PCP refer to a surgeon? Yes. Can that same surgeon refer to the PCP? Yes as well. And yet, depending upon their motivations this may be an improper referral. On a larger scale if a surgery center provides assistance to surgeons providing transportation for the surgeon's patients, high scale housing and restaurants when the surgeon commutes over 50 miles and stays for a week to do scheduled surgeries and the center handles the surgeon's paperwork, coding and provides supplies - is this good medical practice or kickbacks? What if the surgery center provides payments for marketing services and other contractual payments? See the Dr. David Payne case for some answers.
The Stark Law, Stark Law ancillary exceptions, the AKS (anti kickback law), the Federal Exclusion Statute, even worker's compensation fraud are often creatures of statute and are not inherently evil acts. This means that doctors facing criminal fraud charges are often shocked to learn that their innocent conduct may involve criminal consequences.
COMMON MEDICAL FRAUD STATUTES
What is the Stark Law?
The Stark Law prohibits physicians from referring Medicare patients for certain designated health services (DHS) to entities with which they or their immediate family members have a financial relationship, unless an exception applies and is met. Financial relationships include ownership, investment interests, and compensation arrangements.
Read Daniel's Blog Post on Why We Track Large Hospital Stark Cases
PHYSICIANS BEWARE - DON'T LEND YOUR NAME
They Follow Your Money – We Can Follow Their Money
Insurance companies provide funding to prosecutors. Special taxes on employers also support fraud investigations. This means there is a financial and emotional incentive for fraud prosecutors to file charges. The insurance companies become “crime fighting” partners to the district attorney white collar crime units. Medical practice management has many grey areas. Few white collar prosecutors have sufficient medical/medical billing/delegation of medical duty background to accurately assess the legitimacy of your conduct.
Many seminars are funded by insurance companies and some local prosecutors are “honored” with the opportunity to speak at those seminars to promote their careers. Prosecutorial objectivity is often compromised.
BIG PROFITS – False Claims Act, 31 U.S.C. 3729 (FCA)
The False Claims Act, 31 U.S.C. 3729 (FCA), is a federal civil fraud statute. The FCA allows healthcare fraud, medicare fraud, and false claim lawsuits to be filed by professional litigators, disgruntled former employees and others. They are called “relators” and they sue on behalf of a “defrauded” governmental entity. The incentive is a percentage of the final recovery.
The government can also file its own civil fraud claim.
Many times, a criminal case will follow shortly after the filing of one of these cases. Sometimes the False Claims Act filing with be parasitic and follow the filing of criminal charges. This is yet another expense that burdens a defendant. Fortunately, some insurance policies will defend against these claims.
Client Testimonials
-
Very caring individual. Daniel handled my divorce back in 1991 and is a very understanding and caring person who took care of my needs with patience and understanding. He is one of a very few of that special breed. Wish to God there were more like him. Thanks, Daniel.Jean M.
-
There are lawyers and then there are real lawyers. Dan Horowitz is a real lawyer in every since of the word. Dan is a Certified Specialist in Criminal Law. You will not find very many attorneys having such recognition especially one that hits on all cylinders as Dan. In addition to his knowledge of the law and his experience, which I found to be unmatched, i appreciated the fact that he at all times is genuine, which for me says it all. Thank you Dan.Cory N.
-
I can not say enough about Mr. Horowitz and his staff. Brook was amazing to myself and my family. My case was very unique. He believed in me and listened to what I had to say. I highly recommend him and his staff. Yvett BlineYvett Bline
-
We have used Mr. Horowitz for over 10 years as our business lawyer. We have never had any problems. He guides us with great wisdom and caring.Albert J.