Justice Department accuses radiologist of amassing $6.5M in improper Medicare payments

The Department of Justice has filed suit against a Pennsylvania interventional radiologist and his affiliated practices, accusing the physician of billing Medicare for medically unnecessary procedures.

James McGuckin, MD, allegedly submitted more than 500 false claims to the Medicare program totaling “at least” $6.5 million between 2016 to 2019, the DOJ said Tuesday. Unnecessary vascular procedures included angioplasty, atherectomy, placement of stents and “indiscriminate use” of intravenous ultrasound.

“Performing medically unnecessary procedures puts patients at risk and contributes to the soaring costs of healthcare, especially the invasive vascular procedures alleged in this case,” U.S. Attorney Jacqueline C. Romero said in a May 2 announcement of the lawsuit. “As this litigation demonstrates, we are committed to safeguarding federal healthcare program beneficiaries and protecting public funds.”

McGuckin did not immediately respond to a Radiology Business request for comment left with a receptionist at one of his practice locations. All claims are allegations only, the DOJ noted, with no determination of civil liability.

The performed procedures required puncturing skin and inserting devices into the arteries in patients’ legs, authorities noted. Unnecessary vascular interventions can cause potential harm they added, increasing the likelihood of additional services, with a greater risk of leg amputations.

McGuckin was first sanctioned by the Washington Medical Quality Insurance Commission in 2015. Several other state medical boards and Medicaid programs later did the same, including in Pennsylvania, the DOJ said. The radiologist reportedly performed services such as angioplasty and stenting on “hundreds” of individuals for purported treatment of multiple sclerosis, “a nonvascular disease,” authorities said.

Then in 2018, the radiologist signed a False Claims Act settlement as owner of Vascular Access Centers and any related entities, agreeing to pay “at least” $3.825 million. Under the agreement, McGuckin admitted his businesses performed and billed for vascular procedures “even though the patients presented without any documented evidence that they exhibited a need for therapies.” The following year, Vascular Access Centers filed for bankruptcy, a move Judge Ashely M. Chan believed was “orchestrated in bad faith,” including making false statements to the Pennsylvania court.

Interventional radiologist and whistleblower Aaron Shiloh, MD, surfaced the latest allegations after working at one of McGuckin’s businesses. The False Claims Act permits parties such as Shiloh to sue on behalf of the government when they discover evidence that someone is submitting false claims to Medicare. He stands to collect a share of the recovery, if the DOJ prevails in its case. A federal victory also would entitle authorities to three times the damages that resulted and penalties as high as $27,018 per claim. Attorney Romero and colleagues first filed notice of their intent to intervene in the case in February, according to the announcement.

“Without people like Dr. Shiloh being willing to shed light on allegations of fraud, preserving government program funds would be far more challenging,” Romero added.

Pennsylvania practice locations named in the lawsuit include the Peripheral Vascular Institute of Philadelphia, the Main Line Vascular Institute of King of Prussia, the Lehigh Valley Vascular Institute of Bethlehem, and the PA Vascular Institute of East Stroudsburg.