Concerns Rise Over AI in Medicare Monitoring
27 Apr 2026
In a submission to the Australian National Audit Office (ANAO), the RACGP urged the Department of Health, Disability and Ageing (DoHDA) to limit the use of AI where possible due to potential risks.
The college said relying only on AI systems could be dangerous, as medical practices vary widely. It warned that strict or unclear rules set by automated systems may not reflect real clinical situations.
The RACGP also noted a lack of clarity about how AI is currently being used and what data it relies on. This, it says, could reduce trust in decisions made about doctors and their billing practices.
Dr Tony Bayliss from the RACGP said there are already concerns about how compliance cases are identified. He warned that adding AI could make the process even less transparent.
The college stressed that human oversight is essential to avoid serious errors, pointing to past issues like the Robodebt scheme as a caution.
Another concern is that AI may wrongly flag doctors whose work patterns differ for valid reasons. For example, longer consultations for older patients could appear unusual to an algorithm, even when clinically appropriate.
The RACGP also warned that GPs with specialised interests could be seen as outliers and unfairly targeted.
Instead of relying heavily on enforcement, the college supports using education to manage minor compliance issues. It also highlighted how stressful compliance investigations can be for doctors.
The submission emphasised that patient safety must come first. It warned that inaccurate or poorly designed AI systems in healthcare could lead to serious harm.
The RACGP is calling for stronger safeguards, better guidance, and ongoing consultation with medical groups as AI use grows in the health system.
The ANAO is expected to release its findings on the use of AI in Medicare compliance later this year.
https://www1.racgp.org.au/
Source: RACGP / newsGP report on AI use in Medicare compliance
Categories
- MBS
- PBS
- The Department Of Health And Aged Care
- RACGP
- NIP
- AHPRA
- NSW Health
- Queensland Health
- Victoria Health
- Tasmania News
- Western Australia
- SA Health
- NT HEALTH
- Pharmacy Board Of Ahpra
- National Asthma Council
- NT
- AMA
- NACCHO
- BCNA
- Australian College Of Nurse Practitioners
- Asthma Australia
- LFA
- Palliative Care
- Primary Health Network
- AIHW
- Children's Health Queenland
- Kidney Health
- CHF
- MHC
- Gold Coast
- Tsa
- TGA
Popular Posts
Recent Posts
Tags
- Environmental health National Health and Climate Strategy environmental-health-national-health-and-climate-strategy