HHS to use AI to detect healthcare audit backlogs

The Department of Health and Human Services has announced the launch of an AI-powered program to scan years of audit reports from federal healthcare funding recipients across all 50 states, targeting fraud and wasteful spending

What happened

HHS launched a new initiative called Audit Enforcement and Risk Oversight (AERO) in late May 2026. AERO uses AI analytical tools to scan at least five years of audit history for recipients of federal healthcare funds in every state. Gustav Chiarello, Assistant Secretary for Financial Resources, is leading the program. HHS sent letters to all 50 states notifying them of the initiative, though the letters did not include a deadline for corrective action or indicate when HHS would begin withholding funds. Early findings indicate a large number of audit deficiencies have gone unaddressed, and hundreds of federal grantees have not submitted required audits. States that fail to address deficiencies risk losing federal funding.

Going deeper

For recipients unwilling to address audit findings, HHS has outlined the following enforcement actions it may pursue:

• Temporarily withholding payments until corrective action is taken
• Disallowing costs for activities associated with noncompliance
• Suspending or terminating awards in part or entirely
• Initiating suspension or debarment proceedings
• Withholding future federal funds for the project or program
• Pursuing any other legally available remedies

AERO is part of broader HHS enforcement that also includes Medicaid funding deferrals to Minnesota and California, Medicare enrollment freezes, and a requirement that all 50 states audit Medicaid providers.

What was said

In its May 21, 2026 press release, HHS described AERO as holding "states and grantees accountable for persistent audit failures across HHS-funded programs."

Gustav Chiarello noted that AI allows the government to dig into lengthy and exhaustive audit reports that would normally go unreviewed. HHS stated that early findings show a large number of audit deficiencies have gone unaddressed, and that hundreds of federal grantees have not submitted their required audits.

Why it matters

The volume of audit reports made review difficult, creating a gap that allowed deficiencies to go unaddressed, sometimes for years. By using AI to close that gap, non-compliant recipients can no longer hide behind the volume of paperwork

For hospitals, clinics, Medicaid-dependent programs, and state agencies that rely on federal funding to operate, this is a compliance risk. The threat of funding loss is not hypothetical, as the HHS has already decided to defer Medicaid funding to Minnesota and California as part of this broader enforcement.

The bottom line

HHS is no longer limited by the volume of paperwork standing between auditors and accountability. Recipients of federal healthcare funding should conduct an internal review of their audit history, address outstanding deficiencies, and ensure all required audits are submitted.

FAQs

Who qualifies as a federal healthcare funding recipient?

Any state, local government, nonprofit, or institution of higher education that receives federal funding.

What is AI's role in AERO?

AI allows HHS to scan and analyze large volumes of audit reports.

What AI tools is HHS using?

HHS has confirmed it is using ChatGPT among its AI tools, but has not publicly disclosed the full list of tools.