Physician Defense in California

A California Physician Defense Firm with a National Reputation

Daniel Horowitz is nationally recognized as a trial lawyer, physician advocate, law professor, television legal commentator, published journal author and lecturer. You have seen Daniel in the press successfully defending doctors who refused to dump extra COVID vaccines and defending physician whistleblowers who faced retaliation for upholding medical values against corporate interests. His work for CNN and MSNBC as a legal commentator, published articles and work as a law professor and lecturer make Daniel Horowitz a well known and powerful force for physician rights.  

Pro-Active Healthcare License Defense

Healthcare license defense is a highly specialized area of law.   Daniel Horowitz, Mark Ravis (MD & JD) and Michael Yates, D.C. focus on proactive medical license defense.    We do pre-peer review intervention and negotiation.  We look to defuse and cooperate when possible.  We document and advance your interests in a chess like fashion.  

We are never reactive.  We are forward looking and confront challenges to your licence using a sophisticated analysis of internal communications, trends in healthcare license prosecutions and years of experience so that our defense anticipates the attacks. 

We have years of experience intervening in peer review investigations and challenging sham peer review.   We know the dangers of a non-standard FPPE, OPPE, PIPs and other pre-charging, pre-peer review actions.   

Our approach is strong and proactive but always balanced and tactical.  We focus on quashing and resolving investigations so that you never reach the point of license suspension, privilege suspension or Accusation.  

Physician Defense Attorneys:

We defend California Physicians in licensing hearings, criminal investigations and against criminal charges, summary suspensions and NPDB filings.  

Our Lawyers Let Doctors Be Doctors

 “I never signed up for this!"   We hear words to that effect almost everytime a doctor faces unfair challenges to his/her medical license.  On the other hand, as attorneys, this is exactly what we signed up for when we took our oath.  

Daniel's work providing physician defense in California is driven by the fundamental belief that medical doctors and the medical profession need protection from excessive governmental and insurance company intrusion.  When Daniel was a child Dr. Bernie Rosenberg came to his apartment when Dan had measles.  He had his black leather bag and long coat just like in a movie.  Dr. Rosenberg practiced until he died in his 80's.  He had a fulfilling life and wonderful career.  While those days are gone, the medical profession is still the most noble profession.  You are entitled to support, appreciation and protection.  This is how Dan Horowitz and lawyer / Dr. Mark Ravis approach their physician representation.

Experience

Daniel is a member of the American College of Healthcare Executives, American Health Law Association, American Bar Association Health Law division and the Contra Costa County Trial Lawyers Association (among others).   He is a veteran of hundreds of jury trials, administrative hearings and physician based legal proceedings.  

In Contra Costa County his trial victory for Dr. Judson Brandeis led to a $ 1.7 million dollar award and control of his intellectual property.  

A physician facing criminal charges for insurance fraud in Los Angeles hired Horowitz and they turned the tables and successfully prosecuted a civil lawsuit against the insurance company.  

His defense in the Stockton MUA trials was successful and cut short the planned prosecution of over a hundred chiropractors and anesthesiologists.   In a recent case, Horowitz settled a physician peer review case in just months taking it over from an attorney who had litigated it for over four years.   

Physician Representation Nationwide

Daniel Horowitz works nationwide with the best medical lawyers in the country.  We have established relationships with medical attorneys with offices in New York, New Jersey, Pennsylvania, Washington State, Washington D.C., Rhode Island and Texas. 

Fair hearings, peer review, NPDB and other license protection cases can be handled quickly and effectively with Daniel Horowitz and Dr. Mark Ravis representing you.  In California we work regularly with specific attorneys in Orange County, Los Angeles County, Alameda County, Contra Costa County, San Joaquin County, and Stanislaus County.  Daniel Horowitz and Dr. Mark Ravis are directly licensed to appear in all courts in California.

The Best Medical Defense is at Times Invisible

Sometimes the best physician legal work goes unnoticed.  Peer review inquires evaporate, Medical Board investigations are closed.  In those instances, Daniel's work successfully protecting doctors undergoing peer review, MEC investigations and licensing matters is both successful and unnoticed.  In the public domain, Daniel's powerful work as a dedicated physician advocate includes high profile trial victories and the San Francisco Chronicle front page cases involving Dr. Alicia Kalamas and the AIlee Jong vs. John Muir Health  case.  Other public successes are the COVID medical board cases (one public, the rest private).

    Areas of Physician Defense Practice

1. Medical Board, Medical License Defense & Hospital & Medical Group Discipline

              A. Sometimes a Doctor Needs a Doctor (who is a lawyer)

Our medical license defense group includes Dr. Mark Ravis who is a currently licensed physician and active lawyer.  Whether the challenge to your medical license is in credentialing, privilege restrictions, MEC investigation or active discipline - our physician lawyers will fight for you.

              B. Physician Advocates with Extensive Courtroom Expertise

Peer review, medical board cases are trial cases.  We are hearing saavy with experience far beyond that of most physician lawyers.  We combine vast technical experience with seasoned trial lawyers to provide you with the very best medical license defense.  Our hearing and litigation experience is unmatched when you need a lawyer for peer review, MEC investigations, direct involvement by the medical board and National Practitioner Data Bank (NPDB) reports/prevention.   If a Medical Board Accusation goes to trial, we believe no physician advocate in California can match the 200 jury trials and thousands of evidentiary hearings conducted by Daniel Horowitz.

2. Medical Board Accusations

A Medical Board Accusation is a public event.  Unless it is withdrawn it stays with you for years.  The Accusation process starts with the investigation.  We are expert in preventing filings, negotiating resolutions and anticipating the weaknesses in the medical board's case.  If a hearing is necessary to protect your license we have exceptional trial lawyers with skills forged by thousands of hours in a courtroom.  

            A. What Does a Physician Lawyer Seek in a Medical Board Case?

 Of course, total victory and vindication.  But realistically “a fair trial is no trial at all” and we focus on preventing a filing in the 1st place.  If an Accusation is filed we look to have it withdrawn.  If the Accusation stays we look to have it modified, negotiated and resolved with the least amount of damage.   

            B. What Happens if the Accusation is Not Resolved?

Daniel Horowitz is one of California's most experienced trial lawyers.  He is legendary for his blistering cross examinations of opposing medical experts.  His medical expert and lawyer, Dr. Mark Ravis is a currently licensed physician and trial lawyer in his own right.  If your case has to be fought in the courtroom, the Horowitz trial team is your 1st and best choice.

What is the Statute of Limitations for a Medical Board Accusation?

Medical Board Accusation Defense

3. National Practitioner Data Bank

National Practitioner Data Bank (NPDB) reporting tags a physician for life.   We can challenge initial reports, seek modifications, appeal adverse judgments and document your file.

Learn About the NPDB Reporting Rules

NPDB “Secretarial Review”

Who Has Access to the NPDB?

We Practice Medical Board Preventive Medicine 

There is no vaccination to protect you from the Medical Board but we can discuss danger areas with you and act to preempt any board action.  Our medical lawyers and paralegals regularly review filed board cases.  We track the hot button discipline areas for the medical board.  We can evaluate your practice and help push you out of harms' way.   

If you are involved in a medical malpractice case beware!  Even a completely innocent physician can be subject to mandatory reporting when a malpractice case settles.

Medical Board Reporting of a Medical Malpractice Settlement or Malpractice Award

4.  Judicial Review of Hospital, Medical Staff/MEC Decisions

California has a judicial review statute that allows a physician to obtain judicial review of many types of adverse licensing, credentialing and disciplinary decisions.  We can review your situation and make a determination as to whether CCP 1094.5 or other statute will protect your rights.  

CCP 1094.5  & Judicial Review

5. FPPE & OPPE - Advice & Oversight

OPPE/FPPE's can be a strong warning signal that you need a physician lawyer's advice.

A standard OPPE is non threatening but a certain number involve criticisms of a physicians' work and can constitute a low level of peer review.  In California Evidence Code section 1157 may protect some OPPE activities and may trigger the need for self protective action on the part of the physician.  An FPPE (sometimes termed an FPR, Focused Practitioner Review) is a process whereby the medical staff evaluates the privilege-specific competence of the practitioner that lacks documented evidence of competently performing the requested privilege(s) at the organization. This process may also be used when a question arises of a currently-privileged practitioner's ability to provide safe, high quality patient care.  This is an event that requires caution and can easily lead to license related issues.  (This is particularly true when the FPPE (FPR) is tied to a PIP (Performance Improvement Plan) which even when completed is (or can be) used as direct evidence of below standard performance prior to the PIP.  Any future issues will be related back to the FPPE and PIP.

Finally, remember that the Joint Commission requires a standardized FPPE process for all newly requested privileges.  The FPPE is privilege specific, has defined criteria for success or failure, a time frame that is defined and outside review (available) if there is an issue.

If an OPPE appears to have a specific criticism attached or if an FPPE is initiated, you should contact the Horowitz medical group for expert legal advice to ensure that the OPPE/FPPE does not lead to reportable restrictions or loss of privileges.  

                                       Beware of a “Friendly” FPPE

Never consider an FPPE friendly.  Consider the recent federal court case Klivington v. Voss (M.D. Ala., Aug. 25, 2023, No. 1:22-CV-574-CWB) 2023 WL 5512253.  In that case an FPPE triggered an NPDB report. The hospital filed with the National Practitioner Data Bank.  The doctor strongly disagreed with the report and sued claiming she was targeted unfairly.    The point is the ability of entity to file these reports and put its spin on matters in the public eye, puts the doctor at a great disadvantage.  An FPPE can end well but it is also a potential fast track to a bridge to nowhere.  (See Dr. Klivington's recent successful ruling on a motion in this case.)

 In a Northern California federal case a negative FPPE finding led to reporting.  The doctor challenged this and lost.  ["California Business & Professions Code § 805 would require the filing of a report with the Medical Board of California, and a report also would be filed with the National Practitioner Data Bank (“NPDB”) pursuant to 42 U.S.C. § 11101 et seq.” (Ryan v. Putnam (C.D. Cal., Mar. 22, 2022)

6. MEC Investigations, Credentialing, DEA Investigation

Decades of sacrifice to earn your license can be damaged or destroyed in days by aggressive peer review, summary suspensions and reports to the medical board and NPDB.

7.  Informal MEC Inquires to Disciplinary Hearings

Have you been offered a “PIP”?   Is “anger management” or other social skills training being offered or required?   Our lawyers are expert in Medical Executive Committee (MEC) inquiries, informal discipline and investigations. 

8. Peer Review, Credentialing, DEA & Criminal

Our lawyers are expert in high conflict areas of medical law.   This includes Peer Review proceedings, credentialing, privilege limitation matters, DEA inquiries and criminal matters concerning your license.  Medical Staff rules, by-laws and the Medical Executive Committee role at a hospital affect the rights and duties of physicians within a hospital.  The basic outline of the medical staff and MEC responsibilities are outlined in our blog titled What is Medical Staff, Organized Medical Staff & the MEC.   

9. Contracts, Medical Group Formation, Compliance, Physician Assistant Practice Agreements, Partnership and Existing Practice Expansion

Our medical lawyers will carefully review the paperwork that governs your professional life.  The actual rules that govern a doctor's life are often learned “on the job” or “informally” but can be critical when a dispute arises between a physician and the hospital.   We can assess your situation based not only on the “facts” but on the rules that you signed onto.   If you are an employed physician and non-disclosure agreement are being used as a tacit “non-compete”, we can help.  We can review your agreements to see if non-solicitation clauses prevent outreach to your patients.

Our medical contract lawyers have written and reviewed hundreds of contracts.  If you are establishing a medical group, hospital or expanding an existing practice, our lawyers can assist in formation, regulation, registration and compliance.   (Read Our Article on DMEPOS Bond Requirements & How a bond requirement may indicate the need for a deeper, lawyer guided analysis.)

If you are employing or supervising one or more Physician Assistant's, our medical contract lawyers should review your agreements to ensure that you are protected.  

Dangers of Physician Assistant Contracts from a California Medical Lawyer Perspective

10. Criminal Charges Against Doctors 

(Board Certified Criminal Defense Specialists)

There are no routine criminal convictions for physicians.  DUI's, Domestic Violence and other misdemeanors can impact your career and even your license.  A large number of medical board suspensions arose out of physicians who failed to comply with DUI related alcohol treatment ordered by the medical board.  Another trap are the self reporting rules under Business & Professions Code section 802.1, that apply to physicians upon Indictment and conviction.  We are tracking telemedicine fraud cases and other HFPP (Healthcare Fraud Prevention Partnership) 

What Happens to Your License if You Are Convicted of a Crime?

                                     John Muir Health Physicians

As a Contra Costa County based physician law practice many of our physician clients have significant professional involvements with John Muir Health.  We are well aware of the pressures and entanglements that affect Walnut Creek or Concord medical groups that depend heavily on their relationship with JMH.   We understand the benefits and necessities of those relationships and can help you navigate any difficulties or rough spots.   

Walnut Creek - Concord JMH By-Law Article