Recommendations Tracker
HHS-OIG provides independent and objective oversight that promotes economy, efficiency, and effectiveness in HHS programs and operations. To drive this positive change, we produce reports and identify recommendations for improvement. We have developed this public-facing page for tracking all of our open recommendations.
Use the Top Unimplemented View below to read OIG's Top Unimplemented Recommendations. In OIG’s view, these top recommendations for HHS programs, if implemented, would have the greatest impact in terms of cost savings, program effectiveness and efficiency, and public health and safety. Learn more
Summary of All Recommendations
Updated Monthly · Last updated on April 15, 2026
1,094
Unimplemented
recommendations
3,367
Implemented and Closed
recommendations since FY 2017
Views
OIG Recommendations Grouped by Report
Showing 1–20 of 1,385 reports, containing 4,461 recommendations
Sorted by latest release date
-
Vibrent Health Claimed Unallowable Costs Under a National Institutes of Health Other Transaction Award
26-A-04-060.01We recommend that Vibrent Health work with NIH to refund the $1.9 million of unapproved fringe benefits and indirect costs.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- $1,900,000
- Last Update Received
- -
- Next Update Expected
- 10/01/2026
- Legislative Related
- No
26-A-04-060.02We recommend that Vibrent Health work with NIH to determine the allowability of costs associated with the at least $14.6 million of unreasonable costs that Vibrent paid to related-party subcontractors, and refund any costs that NIH deems to be unallowable.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- $14,600,000
- Last Update Received
- -
- Next Update Expected
- 10/01/2026
- Legislative Related
- No
26-A-04-060.03We recommend that Vibrent Health create an oversight function to independently ensure it complies with applicable terms and conditions of future Federal awards.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/01/2026
- Legislative Related
- No
-
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Priority Health (Contract H2320) Submitted to CMS
26-A-07-059.01We recommend that Priority Health refund to the Federal Government the $4,479,698 of estimated net overpayments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $4,479,698
- Last Update Received
- -
- Next Update Expected
- 09/29/2026
- Legislative Related
- No
26-A-07-059.02We recommend that Priority Health identify, for the high-risk diagnoses included in this report, similar instances of noncompliance that occurred after our audit period and refund any resulting overpayments to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/29/2026
- Legislative Related
- No
26-A-07-059.03We recommend that Priority Health continue its examination of its existing compliance procedures to identify areas where improvements can be made to ensure that diagnosis codes that are at high risk for being miscoded comply with Federal requirements (when submitted to CMS for use in CMS's risk adjustment program) and take the necessary steps to enhance those procedures.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/29/2026
- Legislative Related
- No
-
Medicare Home Health Agency Provider Compliance Audit: VNS Health
26-A-02-057.01We recommend that VNS Health refund the $2,965,484 in estimated overpayments to the Medicare program, excluding amounts presumed to be unrecoverable under the Section 1870 waiver of liability provision.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $2,965,484
- Last Update Received
- -
- Next Update Expected
- 09/25/2026
- Legislative Related
- No
26-A-02-057.02We recommend that VNS Health consider conducting one or more internal audits or investigations for claims after our audit period based on the risks identified by this audit to identify any similar overpayments the provider might have received and return any identified overpayments to the Medicare program.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/25/2026
- Legislative Related
- No
26-A-02-057.03We recommend that VNS Health strengthen its review of medical record documentation to ensure compliance with Medicare billing requirements.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/25/2026
- Legislative Related
- No
-
Review of the Department of Health and Human Services’ Compliance With the Federal Information Security Modernization Act of 2014 for Fiscal Year 2025
26-A-18-055.01We recommend that HHS develop a formal process for creating and maintaining cybersecurity profiles (current and target), including developing policies and procedures and implementing these policies and procedures at the Department level and at the Division level.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/23/2026
- Legislative Related
- No
26-A-18-055.02We recommend that HHS implement the Cybersecurity Risk Management Strategy at the Department level and confirm implementation of the CRMS at the Division level. All Divisions should inherit the HHS Department enterprise-wide risk management strategy or develop and implement their own. Additionally, HHS should confirm that all risks, including those incurred during organizational restructuring, are documented, evaluated, and accounted for according to the CRMS.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/23/2026
- Legislative Related
- No
26-A-18-055.03We recommend that HHS require and ensure Divisions implement SCRM policy and procedures.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/23/2026
- Legislative Related
- No
26-A-18-055.04We recommend that HHS update the departmental policy to accurately define cybersecurity roles and responsibilities and define the processes to evaluate the performance of cybersecurity roles and responsibilities.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/23/2026
- Legislative Related
- No
26-A-18-055.05We recommend that HHS conduct the workforce skills assessment/gap analysis timely and periodically update the assessment/gap analysis to account for changes in the risk environment across HHS and the Divisions.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/23/2026
- Legislative Related
- No
26-A-18-055.06We recommend that HHS confirm that Divisions maintain comprehensive and accurate software and hardware asset and license inventories and employ the use of information system security continuous monitoring (ISCM) tools to monitor the security posture of assets in accordance with the defined standards across HHS. HHS should confirm that implementation of these inventories is consistent with established standards.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/23/2026
- Legislative Related
- No
26-A-18-055.07We recommend that HHS develop policies, procedures, and guidance for the creation and maintenance of data and metadata inventories. These policies, procedures, and guidance should be implemented throughout HHS. HHS should establish a process to monitor Divisions' adherence to department-level policies, procedures, and guidance.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/23/2026
- Legislative Related
- No
26-A-18-055.08We recommend that HHS require Divisions to implement common secure configurations and effective flaw remediation processes for all their systems according to Divisions standards or standards approved by HHS for the Division. Divisions should ensure that scanning for compliance and vulnerabilities is performed according to HHS policies and procedures and that all deviations and vulnerabilities are remediated within the defined timelines set by HHS. HHS should confirm that Divisions are meeting the established standards.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/23/2026
- Legislative Related
- No
26-A-18-055.09We recommend that HHS enforce HHS policies and procedures for provisioning and monitoring access of all privileged users and confirm implementation aligns with the policies and procedures. Privileged user access requests with the required approval should be documented and retained.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/23/2026
- Legislative Related
- No
26-A-18-055.10We recommend that HHS enforce policies and develop procedures for conducting and updating Business Impact Analyses (BIAs) and require implementation at the Department level and Division level. Divisions should implement as necessary and reference HHS policy as part of their contingency planning efforts to standardize the prioritization of business operations and functions.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/23/2026
- Legislative Related
- No
-
Nursing Homes Inappropriately Diagnosed Residents with Schizophrenia to Mask the Misuse of Antipsychotic Drugs
26-E-02-015.01CMS should build on its efforts to reduce inappropriate schizophrenia diagnoses in nursing homes.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/13/2026
- Next Update Expected
- 09/15/2026
- Legislative Related
- No
26-E-02-015.02CMS should expand its use of data to monitor nursing homes' use of schizophrenia diagnoses and target oversight.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/13/2026
- Next Update Expected
- 09/15/2026
- Legislative Related
- No
26-E-02-015.03CMS should increase efforts to ensure that nursing home residents and their families are fully informed when antipsychotic drugs are given.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/13/2026
- Next Update Expected
- 09/15/2026
- Legislative Related
- No
-
Nursing Homes’ Inappropriate Use of Antipsychotic Drugs Poses a Risk to Residents
26-E-02-016.01CMS should further develop resources for nursing homes and increase transparency in order to reduce inappropriate use of antipsychotic drugs and improve dementia care in nursing homes.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/13/2026
- Next Update Expected
- 09/15/2026
- Legislative Related
- No
26-E-02-016.02CMS should take steps to ensure that nursing home medical directors fulfill their role in reducing the inappropriate use of antipsychotic drugs.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 04/13/2026
- Next Update Expected
- 09/15/2026
- Legislative Related
- No
26-E-02-016.03CMS should take steps to ensure that nursing home pharmacists fulfill their role in reducing the inappropriate use of antipsychotic drugs.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 04/13/2026
- Next Update Expected
- 09/15/2026
- Legislative Related
- No
26-E-02-016.04CMS should assist nursing homes to improve their policies and procedures pertaining to antipsychotic drug use.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/13/2026
- Next Update Expected
- 09/15/2026
- Legislative Related
- No
-
Indiana Generally Ensured That Selected Nursing Homes Complied With Federal Background Check Requirements
26-A-05-054.01We recommend that the Indiana Family and Social Services Administration and the Indiana Department of Health advise nursing homes to verify that employees' background checks are completed and maintain documentation of the completed background checks.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/15/2026
- Legislative Related
- No
-
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Gateway Health Plan, Inc., (Contract H5932) Submitted to CMS
26-A-03-053.01We recommend that Gateway Health Plan, Inc. refund to the Federal Government the $4,314,513 of estimated net overpayments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $4,314,513
- Last Update Received
- -
- Next Update Expected
- 09/11/2026
- Legislative Related
- No
26-A-03-053.02We recommend that Gateway Health Plan, Inc. identify, for the high-risk diagnoses included in this report, similar instances of noncompliance that occurred after our audit period and refund any resulting overpayments to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/11/2026
- Legislative Related
- No
26-A-03-053.03We recommend that Gateway Health Plan, Inc. continue its examination of its existing compliance procedures to identify areas where improvements can be made to ensure that diagnosis codes that are at high risk for being miscoded comply with Federal requirements (when submitted to CMS for use in CMS's risk adjustment program) and take the necessary steps to enhance those procedures.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/11/2026
- Legislative Related
- No
-
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Blue Cross and Blue Shield of Alabama (Contract H0104) Submitted to CMS
26-A-07-052.01We recommend that Blue Cross and Blue Shield of Alabama refund to the Federal Government the $7,058,246 of estimated overpayments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $7,058,246
- Last Update Received
- 04/07/2026
- Next Update Expected
- 10/07/2026
- Legislative Related
- No
26-A-07-052.02We recommend that Blue Cross and Blue Shield of Alabama identify, for the high-risk diagnoses included in this report, similar instances of noncompliance that occurred after our audit period and refund any resulting overpayments to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/07/2026
- Next Update Expected
- 10/07/2026
- Legislative Related
- No
26-A-07-052.03We recommend that Blue Cross and Blue Shield of Alabama enhance its examination of its existing compliance procedures to identify areas where improvements can be made to ensure that diagnoses that are at high risk for being miscoded comply with Federal requirements (when submitted to CMS for use in CMS's risk adjustment program) and take the necessary steps to enhance those procedures.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/07/2026
- Next Update Expected
- 10/07/2026
- Legislative Related
- No
-
Emergency Department Procedure Codes Used on Medicare Claims for Services Billed With Nonemergency Department Sites of Service Resulted in Over $15 Million in Improper and Potentially Improper Payments
26-A-07-051.01We recommend that CMS direct the Medicare contractors to recover the $922,524 in improper payments made to physicians for claims in which emergency department procedure codes were billed with nonemergency place of service codes.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $922,524
- Last Update Received
- -
- Next Update Expected
- 09/08/2026
- Legislative Related
- No
26-A-07-051.02We recommend that CMS direct the Medicare contractors to assess the potentially improper payments made to hospitals identified in this report for: non-CAHs totaling $9,553,078, to determine the allowability of those payments and recoup any improper payments, CAHs totaling $4,656,827, to determine the allowability of those payments and adjust any Medicare reimbursement, and deductibles that the Medicare contractors determine to have been improperly collected from enrollees, and direct the relevant hospitals to reimburse enrollees for the deductibles that the hospitals should not have charged.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $14,209,905
- Last Update Received
- -
- Next Update Expected
- 09/08/2026
- Legislative Related
- No
26-A-07-051.03We recommend that CMS direct the Medicare contractors to implement or refine claims processing controls, such as system edits, to identify and prevent improper payments of claims for emergency department services billed with nonemergency place of service codes.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/08/2026
- Legislative Related
- No
26-A-07-051.04We recommend that CMS specify in the Manual that hospitals are required to use emergency revenue center codes when billing Medicare claims containing emergency department procedure codes.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/08/2026
- Legislative Related
- No
26-A-07-051.05We recommend that CMS direct the Medicare contractors to review claims submitted by providers after our audit period to identify instances when Medicare paid providers for claims in which emergency department procedure codes were billed with nonemergency place of service or revenue center codes, and recover any improper payments identified.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/08/2026
- Legislative Related
- No
-
Sarasota Memorial Hospital Received At Least $12.1 Million in Medicare Overpayments
26-A-04-049.01We recommend that the Hospital refund to the Federal government the estimated $12,199,717 in net overpayments for incorrectly billed claims, excluding amounts presumed to be unrecoverable under the Section 1870 waiver of liability provision.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $12,199,717
- Last Update Received
- -
- Next Update Expected
- 08/24/2026
- Legislative Related
- No
26-A-04-049.02We recommend that the Hospital consider conducting one or more internal audits or investigations for claims beyond our audit period, based on the risks identified by this audit, to identify any similar overpayments and return any identified overpayments to the Medicare program.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/24/2026
- Legislative Related
- No
26-A-04-049.03We recommend that the Hospital provide additional training to clinical and billing personnel on its policies and procedures related to the following: The Two-Midnight Rule; The medical necessity of inpatient and outpatient services; IRF admissions; The billing of services provided; Inpatient and outpatient coding.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/24/2026
- Legislative Related
- No
-
Colorado Made at Least $77.8 Million in Improper Fee-for-Service Medicaid Payments for Applied Behavior Analysis Provided to Children
26-A-09-050.01We recommend that the Colorado Department of Health Care Policy and Financing refund $42,649,438 (Federal share) to the Federal Government for FFS Medicaid ABA payments that did not comply with Federal and State requirements.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $42,649,438
- Last Update Received
- -
- Next Update Expected
- 08/24/2026
- Legislative Related
- No
26-A-09-050.02We recommend that the Colorado Department of Health Care Policy and Financing provide additional guidance to ABA facilities on: (1) documenting ABA, including services that must be provided to support the use of CPT code 97155, signature requirements, and the information needed in session notes to support ABA provided. (2) billing ABA, including what the State agency considers billable ABA time; and (3) credentialing requirements for ABA providers.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/24/2026
- Legislative Related
- No
26-A-09-050.03We recommend that the Colorado Department of Health Care Policy and Financing periodically perform a statewide postpayment review of Medicaid ABA payments, including reviewing medical records, to educate providers on Federal and State requirements related to documentation and provider credentialing and to recover payments that did not comply with Federal and State requirements.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/24/2026
- Legislative Related
- No
26-A-09-050.04We recommend that the Colorado Department of Health Care Policy and Financing periodically review its prior authorization contractor's procedures for verifying ABA facilities' compliance with requirements for State diagnostic evaluations and treatment referrals for ABA.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/24/2026
- Legislative Related
- No
26-A-09-050.05We recommend that the Colorado Department of Health Care Policy and Financing exercise reasonable diligence to review and determine whether any of the estimated $112,542,978 (Federal share) in potentially improper ABA payments complied with Federal and State requirements and refund the Federal share of any improper payment amount to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/24/2026
- Legislative Related
- No
-
Alaska Missed Opportunities to Protect American Indian and Alaska Native Children Missing from Foster Care
26-E-07-013.01ACF should support Alaska in improving compliance with Federal and State requirements related to children who go missing or run away from foster care.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/22/2026
- Legislative Related
- No
26-E-07-013.02ACF should develop resources for Alaska, and other States as appropriate, on working with Tribes to support children in foster care.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/22/2026
- Legislative Related
- No
26-E-07-013.03ACF should support Alaska, and other States as appropriate, to improve States' abilities to accurately track children's whereabouts.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/22/2026
- Legislative Related
- No
-
Fourteen of Thirty Selected Indian Health Service and Rural Providers Did Not Comply or May Not Have Complied With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments
26-A-09-042.01We recommend that HRSA require the 12 providers that we determined as having used PRF payments for unallowable expenditures totaling $70,590,911 to return the unallowable amounts to the Federal Government or ensure that the providers properly replace the unallowable expenditures with allowable unreimbursed lost revenues or eligible expenses, if any.- Status
- Open Unimplemented
- Responsible Agency
- HRSA
- Response
- Not Yet Due
- Potential Savings
- $70,590,911
- Last Update Received
- -
- Next Update Expected
- 08/19/2026
- Legislative Related
- No
26-A-09-042.02We recommend that HRSA require the two providers that we determined as having inaccurately calculated and reported lost revenues totaling $19,709,036 to identify and return to the Federal Government any PRF payments inappropriately used to offset lost revenues or replace the amounts with allowable unreimbursed lost revenues or eligible expenses, if any.- Status
- Open Unimplemented
- Responsible Agency
- HRSA
- Response
- Not Yet Due
- Potential Savings
- $19,709,036
- Last Update Received
- -
- Next Update Expected
- 08/19/2026
- Legislative Related
- No
26-A-09-042.03We recommend that HRSA work with the two providers that we identified as having used PRF payments totaling $382,656 for expenditures that may have been unallowable to determine which amounts should have been allocated and require the providers to return unallowable amounts to the Federal Government or ensure that the providers properly replace these unallowable expenditures with unreimbursed lost revenues or eligible expenses, if any.- Status
- Open Unimplemented
- Responsible Agency
- HRSA
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/19/2026
- Legislative Related
- No
-
Medicare Home Health Agency Provider Compliance Audit: Alternate Solutions Homecare of Dayton
26-A-05-041.01We recommend that Alternate Solutions refund the $940 overpayment to the Medicare program.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $940
- Last Update Received
- -
- Next Update Expected
- 08/18/2026
- Legislative Related
- No
26-A-05-041.02We recommend that Alternate Solutions consider conducting one or more internal audits or investigations for claims after our audit period, based on the risks identified by this audit, to identify any similar overpayments the provider might have received and return any identified overpayments to the Medicare program.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/18/2026
- Legislative Related
- No
-
New York Should Improve Its Monitoring of Low-Income Home Energy Assistance Program Subrecipients
26-A-02-040.01We recommend that New York State Office of Temporary and Disability Assistance work with subrecipients to determine the allowability of the $197 million in lump-sum payments for LIHEAP expenses and return funds for unsupported expenses to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Not Yet Due
- Potential Savings
- $197,394,162
- Last Update Received
- -
- Next Update Expected
- 08/17/2026
- Legislative Related
- No
26-A-02-040.02We recommend that the New York State Office of Temporary and Disability Assistance implement procedures to monitor subrecipient expenses, including lump-sum reimbursements.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/17/2026
- Legislative Related
- No
-
Missouri Did Not Obtain Millions of Dollars in Rebates for Medicaid Physician-Administered and Pharmacy Drugs
26-A-07-039.01We recommend that the Missouri Department of Social Services refund to the Federal Government $9,510,305 (Federal share) for claims for singlesource physician-administered drugs that were ineligible for Federal reimbursement.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $9,510,305
- Last Update Received
- -
- Next Update Expected
- 08/10/2026
- Legislative Related
- No
26-A-07-039.02We recommend that the Missouri Department of Social Services refund to the Federal Government $204,564 (Federal share) for claims for top-20 multiple-source physician-administered drugs that were ineligible for Federal reimbursement.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $204,564
- Last Update Received
- -
- Next Update Expected
- 08/10/2026
- Legislative Related
- No
26-A-07-039.03We recommend that the Missouri Department of Social Services work with CMS to determine the unallowable portion of $165,783 (Federal share) for claims for other physician-administered drugs that may have been required to be invoiced, and invoice drug manufacturers for rebates for those drugs.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $165,783
- Last Update Received
- -
- Next Update Expected
- 08/10/2026
- Legislative Related
- No
26-A-07-039.04We recommend that the Missouri Department of Social Services obtain rebates for the pharmacy drugs totaling $2,478,099 (Federal share), which had not previously been invoiced for rebate, and refund the Federal share.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $2,478,099
- Last Update Received
- -
- Next Update Expected
- 08/10/2026
- Legislative Related
- No
26-A-07-039.05We recommend that the Missouri Department of Social Services work with CMS to resolve all of the recommendations made in our previous audit report.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/10/2026
- Legislative Related
- No
26-A-07-039.06We recommend that the Missouri Department of Social Services strengthen internal controls to ensure that all pharmacy and physician-administered drugs eligible for rebates are invoiced.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/10/2026
- Legislative Related
- No
-
ACF’s $529 Million Sole Source Contract Award for Unaccompanied Alien Children Services Was Based on an Unsolicited Proposal, Double the Cost Estimate, and Noncompliant With Pre-Award Requirements
26-A-03-037.01We recommend that the Administration for Children and Families use the information in this report to promote better contract planning and efficient use of resources to ensure sufficient capacity to serve the UAC population during periods of increased need.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/09/2026
- Legislative Related
- No
-
West Virginia Did Not Obtain Rebates Associated With Millions of Dollars in Medicaid Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations
26-A-07-038.01We recommend that the West Virginia Bureau for Medical Services refund to the Federal Government $6,055,786 (Federal share) for claims for single-source physician-administered drugs that were ineligible for Federal reimbursement.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $6,055,786
- Last Update Received
- -
- Next Update Expected
- 08/09/2026
- Legislative Related
- No
26-A-07-038.02We recommend that the West Virginia Bureau for Medical Services refund to the Federal Government $22,718 (Federal share) for claims for top-20 multiple-source physician-administered drugs that were ineligible for Federal reimbursement.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- $22,718
- Last Update Received
- -
- Next Update Expected
- 08/09/2026
- Legislative Related
- No
-
Philadelphia Did Not Meet All of the Requirements for the COVID-19 Screening Testing Program at K-12 Schools
26-A-05-036.01We recommend that the Philadelphia Department of Public Health develop or update ELC procedures for compliance with Federal, subrecipient, and contract requirements, including: oversight of subrecipients to ensure background check requirements are followed and monitoring of subrecipients' contract terms and conditions.- Status
- Open Unimplemented
- Responsible Agency
- CDC
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 08/03/2026
- Legislative Related
- No
26-A-05-036.02We recommend that the Philadelphia Department of Public Health refund CDC $257,620 for costs reimbursed to the subrecipient that were unallowable or were overpayments.- Status
- Open Unimplemented
- Responsible Agency
- CDC
- Response
- Not Yet Due
- Potential Savings
- $257,620
- Last Update Received
- -
- Next Update Expected
- 08/03/2026
- Legislative Related
- No