Ep. 678 Medicare Audits Explained: Impact on Physicians & Practices with Jason Greis

What do you actually do when a Medicare audit letter lands in your inbox? On this episode of BackTable Podcast, Dr. Ally Baheti interviews healthcare attorney Jason Greis, partner at Benesch, to demystify the audit process and the rising scrutiny on interventional practices. They discuss why audits are accelerating, which procedures are under the microscope, and how enforcement economics and AI-driven review are reshaping the landscape for OBLs and ASCs. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by RADPAD® Radiation Protection https://www.radpad.com/ --- Timestamps 00:00 - Introduction 02:32 - Audit Hotspots in Endovascular Work 05:00 - AI Oversight and Proactive Compliance 13:35 - The Alphabet Soup of Audit Types 19:16 - Responding to an Audit and the Appeals Ladder 24:48 - Employment Status, Liability and AI Downcoding 30:29 - Final Advice and Wrap Up --- More about this episode The conversation covers the “alphabet soup” of audit types, the five-step appeals process, and strategies for proactive compliance and documentation. The discussion walks through personal liability, employment status, the risks of algorithmic downcoding by commercial payers, and why practices must balance when to fight and when to let an audit go. The episode closes with actionable advice on protecting your practice, the dangers of putting patient data into AI tools, and why trade organizations are the first line of defense. --- Resources OIG: Utilization Trends and Medicare Part B Billing for Office-Based Peripheral Vascular Procedures Raise Questions About Program Integrity (OEI-01-24-00250) https://oig.hhs.gov/reports/all/2026/utilization-trends-and-medicare-part-b-billing-for-office-based-peripheral-vascular-procedures-raise-questions-about-program-integrity/ CMS Wasteful and Inappropriate Service Reduction (WISeR) Model https://www.cms.gov/priorities/innovation/innovation-models/wiser CMS Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) https://www.cms.gov/fraud CMS Medicare Fee-for-Service Appeals: The Five Levels https://www.cms.gov/medicare/appeals-grievances/fee-for-service CMS Medicare Fee-for-Service Compliance Programs (TPE, RAC, SMRC, CERT) https://www.cms.gov/data-research/monitoring-programs/medicare-fee-service-compliance-programs BackTable VI Ep. 478: ASC vs. OBL: Legal Insights Explained https://www.backtable.com/shows/vi/podcasts/478/asc-vs-obl-legal-insights-explained --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app