Horizon Medical Center, which operates a long-term acute care hospital with several ASCs, self-reported that it failed to include a modifier and location to identify services performed at non-excepted, off-campus outpatient facilities when submitting claims to Medicare, according to a Nov. 4 news release from the Justice Department.
Horizon disclosed that it had entered into management agreements with third-party companies affiliated with physicians performing surgery at its outpatient facilities. It also leased equipment through operating agreements with companies affiliated with those same physicians.
As part of its disclosure, Horizon Medical Center included an analysis conducted by an independent third-party expert to assess the financial impact of omitting the required modifier.
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