DEFENDING DOCTORS

DEFENDING DOCTORS 

The image is a chess board with the two queens off to the left but no other moves made. It is centered on the page and illustrates the point that Medical Doctor defense is a chess game. This is anImage of chessboard to illustrate point of article 3d chess board image

Tactics – Strategic Thinking – Planning

Lawyers in Lafayette is a team of criminal defense specialists, former prosecutors, a licensed chiropractor and an MBA .  We are dedicated to defending doctors, medical groups, and medical service professionals.  We are physician advocates, or to paraphrase poet Michael McClure, we are “Physician Patriots”.  We remember when a physician was a respected community leader and resource rather than a target of politicians and cost cutting corporations.

Our defense focuses on medical board defense and criminal defense of physicians.  We do not defend medical malpractice cases but we are often consulted as medical malpractice allegations sometimes expand into criminal charges against doctors.  We work with transactional lawyers, medical practice attorneys  and lawyers who develop medical practices, acquisitions and compliance.  However, our aspect of that work is confined to referrals and to consulting on criminal law, medical fraud and similar issues that develop.  We are also retained by physicians and medical practice attorneys to handle the actual trial of cases.

When lawyers are hired for medical board or criminal defense matters, beware of claims by firms that they are “specialists”.  Criminal defense whether it is of accused murder clients or in the defense of doctors is a specialty defined by the California Rules of Court.  The use of the phrase, criminal defense specialist in legal advertising is not just a word or phrase.  It is intended to be used for people who qualify under the California Rules of Court as certified specialists.  See: California Rule of Court – Rule 9.35. Certified legal  official seal of the state bar of california board of legal specialization showing a california state bear with state bar of california certification as criminal defense specialist and link to news article on horowitz if you click the picture

(a) Definition

A “certified specialist” is a California attorney who holds a current certificate as a specialist issued by the State Bar of California Board of Legal Specialization or any other entity approved by the State Bar to designate specialists

We are genuine specialists, with three people in our a group of associated lawyers  certified as criminal defense specialists by the State Bar of California, Board of Legal Specialization.  Beware of any “specialist” claims that lack a State Bar certification.

What is health care fraud and abuse?
Johns Hopkins Healthcare LLC describes Fraud as “any deliberate and dishonest act committed with the knowledge that it could result in an unauthorized benefit to the person committing the act or someone else who is similarly not entitled to the benefit.”   The website is instructive because it openly describes the process by which Johns Hopkins looks for fraud.  They say “the JHHC Corporate Compliance Department investigates all detected outliers and other deviations from standard practice as well as all allegations of health care fraud and abuse that it receives from recipients and others.”  So computer programs track “outliers” based upon expected frequencies of diagnosis, severity, comorbidity and other objective factors.  Deviations from standard practice are usually computer tracked as the types of treatments and frequency of utilization of higher cost treatments are computer assessed.  The other factor are complaints – usually patient or disgruntled employee complaints.
From these sources, come the claims of fraud and abuse.  In other words, differences in diagnosis, causation assessments and treatment protocols can be deemed fraud if there is a potential financial benefit in deviating from what JHHC (or insurance companies in general), deem to be usual and normal.
Once potential fraud is identified, it is put into buckets, these are essentially categories of alleged wrongdoing that they fit the more general definition of fraud.  The website (which can be found here) lists the following types of frauds.
  • Misrepresentation of the type or level of service provided;
  • Misrepresentation of the individual rendering service;
  • Billing for items and services that have not been rendered;
  • Billing for services that have not been properly documented;
  • Billing for items and services that are not medically necessary;
  • Seeking payment or reimbursement for services rendered for procedures that are integral to other procedures performed on the same date of service (unbundling);
  • Seeking increased payment or reimbursement for services that are correctly billed at a lower rate (up-coding).

Abuse is defined as practices that are inconsistent with accepted sound fiscal, business, or medical practices, and result in an unnecessary cost or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for health care.

  • Misusing codes on a claim;
  • Charging excessively for services or supplies; and
  • Billing for services that were not medically necessary.

Now why did we list Johns Hopkins in such detail?  Because Johns Hopkins promotes certain types of “alternative medicine” that is either proven to be fraudulent or unproven.  Their site promotes appointments in

All of the above are widely considered fraudulent, not helpful and potential dangerous to patients.

Our point – Health Care Fraud is often decided by the powerful and inflicted on the treating doctors.

To see more about Johns Hopkins alternative medicine promotion –

 

CLICK HERE

Other fraud and abuse websites include:

Total Health Care Fraud Site

Revcycle Healthcare Management

PHYSICIAN ADVOCATES

As Physician Advocates and lawyers for the medical profession, we support the tradition of a medical degree signifying a sacred place in our society.  We are “Juris Doctors” but we do not call ourselves, “Dr. Horowitz” or “Dr. Kensok”.  To our firm, the title “Dr.” (doctor) signifies a special set of achievements, years of sacrifice and the title Dr. is entitled to a special dignity and respect.

As advocates for physicians, we pride ourselves on maintaining the highest level of training and expertise.  Lawyers for doctors must be aware that even a simple DUI (Driving Under the Influence) conviction can impact job prospects, hospital privileges and destroy a career.red circle with av rating meaning the highest ethical rating for attorneys Martindale Hubbell highest rating a for excellence and v for highest ethics.https://www.tmz.com/videos/0_tgm8r7op/

As associated lawyers we have separate practices but form teams of lawyers best suited to meet the needs of your case.  Some cases need a former top prosecutor (Tom Kensok) who has filed medical fraud charges and has a very detailed knowledge of the inner workings of the charging process.  Other cases utilize our trial lawyers, who have the experience of taking hundreds of cases to trial.  For business issues, our paralegal with an MBA will be part of the team.  Each case is unique and each doctor gets a custom team of qualified professionals.

When you get a “specialist” on your medical case, that person is always a State Bar certified criminal defense specialist.  That person has met strict experience standards, undergo rigorous peer review, judicial review and then pass a complex written examination.  There are also enhanced continuing education requirements to maintain “specialist” certification.

Having a specialist is critical in meeting charges against doctors at the prefiling stage. Our former prosecutors know how to resolve cases against doctors before charges are filed. Our experience in the courtroom allows us to see in advance the way a case against a doctor may develop. We create strategies to stop the investigation and to protect the doctor’s reputation and practice.

Call       925-283-1863

Photo of medical doctor lawyer, Daniel Russo (Dan Russo) in front of law books at his Vallejo officePhysician Defense lawyer Daniel Horowitz shown on television with host "Nancy Grace" on the "Nancy Grace Show" . the caption is "Jackson Molestation Case" where horowitz and grace debate opening statementsTom Kensok is a physican defense lawyer and this shows him with a smiling face, blue shirt, blue and silver time

Criminal Defense Specialist

 CRIMINAL DEFENSE SPECIALIST

 

 

bear with state bar of california certification as criminal defense specialist and link to news article on horowitz if you click the picture

 To legally advertise as a criminal defense specialist, the attorney must pass a written test and undergo extensive peer review by other criminal defense attorneys, judges and prosecutors.  If you had a serious medical condition wouldn’t you seek the services of a specialist?  The same is true in criminal defense.  A criminal defense attorney who is a general practitioner will rarely have the expertise to provide you with the best defense against criminal charges.

 

WHY CHOOSE A CRIMINAL DEFENSE SPECIALIST ?

If you have a heart problem would you go to a foot doctor?  Of course not.  But many attorneys advertise as “CRIMINAL DEFENSE LAWYER” and some (without State Bar approval), call themselves “CRIMINAL DEFENSE SPECIALISTS”.  But are they ?   The specialist certification requires academic achievement, trial skills and certification from other attorneys.  Unlike flashy advertising claims, the State Bar of California Board of Legal Specialization certification is an objective, earned achievement.  Only a few hundred attorneys in the entire State of California are certified criminal defense specialists.

Both Daniel Horowitz and  Carmela Caramagno are criminal defense specialists certified by the State of California Board of Legal Specialization.   Tom Kensok is a former Assistant District Attorney who was lead counsel in over 100 serious felony trials.  Oksana Tsykova is a National Trial Lawyer “Top 40 Under 40” award recipient.

 

TRIAL EXPERIENCE

Criminal law is Trial law.  Personal injury cases usually settle.  High stakes federal criminal cases often settle.  But high stakes state court cases often go to trial.    Daniel Horowitz is one of the nation’s most experienced jury trial lawyers.

Trial Attorney Oksana TyskovaTrial Attorney Carmela Caramagno horowitz in t shirt outside martinez california courthouse with security signs on metal and glass doors

         RECENT CRIMINAL JURY TRIALS

The types of cases that Daniel Horowitz has recently taken to trial may help you in deciding whether his office is a good fit for your case.

  • Felony Vehicular Manslaughter
  • Major Drug Conspiracy
  • Attempted Murder
  • Murder
  • Dissuading a Witness
  • Felony DUI with Great Bodily Injury
  • MS-13 Gang Conspiracy
  • Family Affiliated Mafia Gang Conspiracy
  • Medical Fraud
  • Insurance Fraud

 

AREAS OF CRIMINAL PRACTICE

The combined areas of excellence for Daniel Horowitz, Carmela Caramagno & Oksana Tsykova include:

A Team of Specialists

When you hire criminal defense specialist Daniel Horowitz, you also have the ability to form a custom team of top lawyers specializing in criminal defense. Carmela Caramagno is also a State Bar of California certified specialist and Tom Kensok was a top level prosecutor for almost 3 decades.  Even the firms youngest member has been lead counsel in over a dozen jury trials.   Why hire a “big firm” which has most of your critical work done by an inexperienced associate ?  With “Lawyers in Lafayette”, you can custom assemble a team of the most experienced trial lawyers.  Our support team includes paralegals who have been approved and appointed on capital murder cases, a licensed chiropractor, investigators with significant military, corporate and police experience.   You deserve the best and we provide the best custom defense team ideally suited to your needs.

Criminal Defense Specialists

outlined image of a state of california type bear with state bar of california certification as criminal defense specialist and link to news article on horowitz if you click the picture CRIMINAL DEFENSE SPECIALISTS

Our practice group has 4 Criminal Defense Specialists who are certified as specialists in criminal defense by the State Bar of California Board of Legal Specialization.

What is a Certified Criminal Defense Specialist ?  Read: CALIFORNIA RULE of COURT 9.35

Daniel Horowitz – Certified Criminal Defense Specialist

Daniel Russo – Certified Criminal Defense Specialist

Carmela Caramagno – Certified Criminal Defense

Douglass MacMaster – Certified Criminal Defense Specialist

WHY YOU NEED A CRIMINAL DEFENSE SPECIALIST

Your Primary Care medical doctor refers you to a specialist when you have a specific type of injury.

If you are charged with a crime you should go to a board certified (type) criminal defense lawyer.

Within the world of criminal defense lawyers there is a group that like doctors is “Board Certified”.  Our board, as lawyers, is the State Bar of California operated Board of Legal Specialization.  The title of Criminal Defense Specialist is controlled by the State Bar and it is a title that cannot be used by any attorney who has not met the strict standards of qualification set by the State Bar.

We have four attorneys in our group of associated lawyers who are certified as specialists by the State Bar of California.

The Specialist designation is earned by years of experience.  Once you apply there is rigorous peer review, reviews from the judiciary and a very detailed written examination.  Daniel Horowitz and Tom Kensok have both taught training courses for potential criminal defense specialists and prior to joining Lawyers in Lafayette, Tom Kensok was a senior District Attorney in Contra Costa County responsible for hiring and training new prosecutors.

Daniel Horowitz is a criminal defense specialist, a “Top 100 Trial Lawyer” and a member of the National Association of Distinguished Counsel – Nation’s Top One Percent.

image is a circle with an eagle and a reference to Membership as Nations top 1 percent lawyers awarded by the national association of distinguished counsel.

Our offices are in Contra Costa County and in Vallejo but our cases take us around the world.   Our attorneys have appeared in courts in Israel, Cyprus, The Netherlands and throughout the United States.

We represent attorneys charged with criminal fraud, chiropractors fighting billing fraud and scope of practice allegations and many medical doctors.

The recent legalization of marijuana on a state level and the federal hemp growing laws, have led to many criminal cases being filed in the federal courts.  We represent hemp growers, CBD processors and marijuana distributors against federal charges.  Our trial team defends gang cases, general criminal cases, homicides, vehicular manslaughter, federal drug crimes, DUI’s,  conspiracy and most other serious state and federal felonies.

A LEGAL TEAM CUSTOM DESIGNED TO MEET YOUR NEEDS
Our nationally recognized lawyers are experienced trial attorneys with separate practices.  We maintain separate practices and form custom legal teams based upon your needs.  We match your case to the experience and expertise of the individual attorneys.    The trial lawyers have personally been lead counsel hundreds of complex, high stakes jury trials.  Our class action section is led by Michael Hassen, the leading class action attorney in the United States.
TECHNOLOGY
We utilize the most advanced case management and trial technology with cloud based file sharing, custom client “sandboxes” to exchange data and ideas, advanced electronic search techniques and sophisticated case presentation technology.  Daniel Horowitz was one of the leaders of the computer revolution in the law profession, consulting with DTSearch, CaseMap and other (now) well established technology solution providers at their early stages of development.

Higher Productivity

Our more modern (and lower overhead structure) provides a higher level of representation without additional cost.  Separate practices / Custom teams means that you pay only for the attorneys and staff who fit the needs of your case.  In large firms you buy a partner and her/his subordinate attorneys and staff.  You pay for group meetings and training of attorneys who are not immediately suited for your type of case.  At Lawyers in Lafayette each case is assessed by the lead attorney and staffed from our group of highly experienced attorneys, investigators and paralegals.

Our paralegals are diverse and have exceptional qualifications.  One is has an M.B.A., another is a licensed chiropractor, yet another has been qualified and appointed to work on a capital murder case.  Our investigators range from former Naval Intelligence officers to retired police detectives and former journalists.

 Trial Credibility

There is no substitute for experience.   All of our lawyers are experienced trial attorneys.

Daniel Horowitz has a portfolio of multi million dollar judgments in employment and car accident cases in addition to his many criminal defense victories.  Former Contra Costa County Prosecutors Tom Kensok and Doug MacMaster, have hundreds of convictions for serious felonies.  Carmela Caramagno and Oksana Tyskova have more jury trial experience than most senior partners in “big” firms.  Carmela is a certified criminal defense specialist and Oksana is completely fluent in both Russian and Ukrainian.

Appellate Credibility

Our appellate attorneys are admitted to practice before the United States Supreme Court and the California Supreme Court.

Media & High Profile Cases

Daniel Horowitz is a television legal commentator and frequent legal analyst in the press and on national news programs.  He is frequently found in articles published by the Associated Press, CNN, the Drudge Report and on the television networks commenting on high profile cases.  Horowitz has recently been featured in the L.A. Times (a police corruption expose which led to the reversal of 12 convictions).  Other profile cases include the Los Angeles area “Bling Ring” case and the lawsuit filed against actor Mel Gibson. 

We have  successfully defended Fortune 500 corporations in large class actions as well as individuals such as author Terry McMillan, Radio Show Superstar Michael Savage, Al Pacino and Oksana Grigorieva (the pianist and singer assaulted by actor Mel Gibson).

Our criminal cases include the “Bling Ring” case which was the subject of a movie by Sophia Coppola, the Susan Polk murder case, the “FAIM” (Family Affiliated Irish Mafia) trials in Contra Costa County, and many cases involving medical fraud, chiropractic fraud and healthcare fraud.

International & Nationwide Law Practice

Our offices are located in Lafayette, California and Walnut Creek, California .  This is in Contra Costa County outside of San Francisco.  Our attorneys are admitted in New York, Washington D.C. and have appeared in courts from Wyoming to The Netherlands, Ukraine, Israel, Cyprus and numerous other jurisdictions.   Attorney Oksana Tyskova is fluent in both Russian and Ukrainian.

image is a formal seal of the united states court of appeals ninth circuit with a women holding some hard to see object. This is the official seal. Daniel Horowitz is admitted to practice and has won cases in the ninth circuit court of appeals An eagle with a square flag in or over his mid section (or her midsection) and the words sealof the supreme court of the united statesDaniel Horowitz admitted to practice before the supreme court of the united states this shows a supreme court emblem with eagle on it.

 

Ratings and Reviews

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Top 1 percent logo horowitz is a member of the national association of distinguished counsel
National Trial lawyers logo horowitz has been named a top 100 trial lawyer