Health dept used AI to identify MBS rorts without detailed ethical risk assessment, says audit report
The department failed to properly assess the ethical and legal risks before using the AI-enabled model.
Federal health officials have revealed they used AI to identify hundreds of cases of suspected Medicare fraud and non-compliance last year.
According to a new audit report, the technology analysed MBS claims data between July 2024 and December 2025 to detect “signals” requiring human review.
The report did not provide full details of how it was done, but it said the AI-enabled model identified 597 potential matters for human review in an analysis carried out by the department last year.
Of these, 82 were reviewed and 18 were classed as “true positives”, the Artificial Intelligence and Medicare Benefits Integrity report says.
