Horizon Medical Center, based in North Texas, has settled with the U.S. Department of Justice for $14.2 million over potential violations of Medicare billing rules and the Stark Law.
The medical center, which operates outpatient surgery facilities in Dallas County, self-reported the issues to the DOJ, acknowledging errors in billing for services provided at off-campus facilities without the required “PN” modifier.
The DOJ also raised concerns about Horizon’s financial arrangements with management companies and equipment leases connected to physicians at these facilities, suggesting possible conflicts under the Stark Law, which restricts certain financial relationships to prevent improper referrals.
“This office will continue to make sure that companies follow the rules of the road when submitting claims to federal healthcare programs,” said U.S. Attorney Leigha Simonton, while emphasizing the DOJ’s commitment to crediting self-disclosures.
This settlement aligns with recent DOJ efforts to encourage companies to voluntarily report misconduct. Other cases under the same policy include settlements with Oliver Street Dermatology Management and Consolidated Nuclear Security.
The claims remain allegations, with no liability determination.
