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Recommendations Tracker
HHS-OIG provides independent and objective oversight that promotes economy, efficiency, and effectiveness in HHS programs and operations. To drive positive change, we produce reports and identify recommendations for improvement. We have developed this public-facing page for tracking all of our open recommendations. Learn More
Summary of Recommendations Data
Updated Monthly · Last updated on April 15, 2024
1,298
Unimplemented
recommendations
$280.1B
Potential savingsfrom unimplemented recommendations
2,443
Implemented and Closed
recommendations since FY 2017
OIG Recommendations Grouped by Report
Views
Showing 481–500 of 1,159 reports, containing 3,741 recommendations
Sorted by latest release date
-
Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Incurred Cost Proposals
20-A-07-166.01We recommend that Noridian Healthcare Solutions LLC work with CMS to ensure that its final settlement of contract costs reflects a decrease in Medicare nonqualified cost of $1,348,960 for CYs 2014 through 2016.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,348,960
- Last Update Received
- -
- Closed Date
- 03/05/2021
- Legislative Related
- No
-
Maine Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs
20-A-07-162.01We recommend that the Maine Department of Health and Human Services refund to the Federal Government $4,004,984 (Federal share) for claims for single-source physician-administered drugs that were ineligible for Federal reimbursement.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $4,004,984
- Last Update Received
- -
- Closed Date
- 03/10/2023
- Legislative Related
- No
20-A-07-162.02We recommend that the Maine Department of Health and Human Services refund to the Federal Government $276,229 (Federal share) for claims for top-20 multiple-source physician-administered drugs that were ineligible for Federal reimbursement.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $276,229
- Last Update Received
- -
- Closed Date
- 03/10/2023
- Legislative Related
- No
20-A-07-162.03We recommend that the Maine Department of Health and Human Services work with CMS to determine the unallowable portion of $605,768 (Federal share) for other claims for multiple-source physician-administered drugs that may have been ineligible for Federal reimbursement, refund that amount, and consider invoicing drug manufacturers for rebates for these drugs if CMS determines that the drug claims are allowable.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/16/2020
- Legislative Related
- No
20-A-07-162.04We recommend that the Maine Department of Health and Human Services consider invoicing drug manufacturers for rebates totaling $10.8 million (Federal share) for claims for physician-administered drugs dispensed at non-Critical Access Hospitals.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $10,801,067
- Last Update Received
- -
- Closed Date
- 03/10/2023
- Legislative Related
- No
20-A-07-162.05We recommend that the Maine Department of Health and Human Services strengthen its internal controls to ensure that all physician-administered drugs eligible for rebates are invoiced.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/16/2020
- Legislative Related
- No
-
Some Manufacturers Reported Inaccurate Drug Product Data to CMS
20-E-03-040.01CMS should work with the manufacturers associated with errors to correct and resubmit accurate product data.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/01/2024
- Next Update Expected
- 06/10/2023
- Legislative Related
- No
-
Medicare Home Health Agency Provider Compliance Audit: Mercy Health Visiting Nurse Services
20-A-05-156.01We recommend that Mercy Health Visiting Nurse Services refund to the Medicare program the portion of the estimated $1,074,136 in overpayments for claims incorrectly billed that are within the 4-year reopening period.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,074,136
- Last Update Received
- -
- Closed Date
- 12/21/2022
- Legislative Related
- No
20-A-05-156.02We recommend that Mercy Health Visiting Nurse Services based on the results of this audit, exercise reasonable diligence to identify, report and return any overpayments in accordance with the 60-day rule and identify any of those returned overpayments as having been made in accordance with this recommendation.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $4,919
- Last Update Received
- -
- Closed Date
- 05/18/2021
- Legislative Related
- No
20-A-05-156.03We recommend Mercy Health Visiting Nurse Services strengthen its procedures to ensure that the homebound statuses of Medicare beneficiaries are verified and continually monitored and the specific factors qualifying beneficiaries as homebound are documented and beneficiaries are receiving only reasonable and necessary skilled services.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/03/2021
- Legislative Related
- No
-
Group Health Incorporated Overstated Its EmblemHealth Services Company, LLC, Employees' Retirement Plan Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of December 31, 2015
20-A-07-157.01We recommend that GHI decrease the EHS Retirement Plan Medicare segment pension assets by $351,803 and recognize $5,399,565as the EHS Retirement Plan Medicare segment assets as of December 31, 2015.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/05/2021
- Legislative Related
- No
20-A-07-157.02We recommend that GHI increase Medicare's share of EHS Retirement Plan Medicare segment excess pension assets as of December 31, 2015 by $1,83,427 and recognize $404,616 as Medicare's share of the pension assets as a result of the benefit curtailment.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,183,427
- Last Update Received
- -
- Closed Date
- 03/05/2021
- Legislative Related
- No
-
Group Health Incorporated Overstated Its Local 153 Pension Plan Medicare Segment Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of August 31, 2016
20-A-07-158.01We recommend that GHI decrease the Local 153 Plan Medicare segment pension assets by $4,898,757 and recognize $36,888,234 as the Local 153 Plan Medicare segment pension assets as of August 31, 2016.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/05/2021
- Legislative Related
- No
20-A-07-158.02We recommend that GHI increase Medicare's share of the local 153 Plan Medicare segment excess pension assets as of August 31, 2016 by $6,987,526 and recognize $855,827 as Medicare's share of the pension assets as a result of the benefit curtailment.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $6,987,526
- Last Update Received
- -
- Closed Date
- 03/05/2021
- Legislative Related
- No
-
Group Health Incorporated Did Not Claim Some Allowable Medicare Pension Costs for Calendar Years 2009 Through 2016
20-A-07-159.01We recommend that GHI work with CMS to ensure that its final settlement of contract costs reflects an increase in Medicare pension costs of $1,101,642 for CYs 2009 through 2016.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/03/2022
- Legislative Related
- No
-
Group Health Incorporated Overstated Its Allowable Medicare Supplemental Executive Retirement Plan Costs for Calendar Years 2009 Through 2016
20-A-07-160.01We recommend that GHI work with CMS to revise its ICPs for CYs 2009 through 2016 to reduce its claimed SERP costs by $586,734.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $586,734
- Last Update Received
- -
- Closed Date
- 03/05/2021
- Legislative Related
- No
-
Group Health Incorporated Claimed Some Unallowable Medicare Postretirement Benefit Costs for Calendar Years 2009 Through 2016
20-A-07-161.01We recommend that GHI work with CMS to ensure that its final settlement of contract costs reflects a decrease in Medicare PRB costs of $1,622,214 for CYs 2009 through 2016.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,622,214
- Last Update Received
- -
- Closed Date
- 03/05/2021
- Legislative Related
- No
-
The National Institutes of Health Should Improve Its Stewardship and Accountability Over Hardware and Software Assets
20-A-18-155.01We recommend that the National Institutes of Health establish an oversight body that ensures property accountability management responsibilities and control activities for Government property are performed.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2021
- Next Update Expected
- 09/10/2022
- Legislative Related
- No
20-A-18-155.02We recommend that the National Institutes of Health appoint a Board of Survey and Survey officers at each IC and complete investigations and reviews on incidents to accountable property, and conduct them going forward according to property management policy and procedures.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2021
- Next Update Expected
- 09/10/2022
- Legislative Related
- No
20-A-18-155.03We recommend that the National Institutes of Health formalize and implement a performance indicator for the completion of investigations for lost, damaged, stolen, or destroyed accountable property and risk indicators to use together with other performance indicators in its accountable personal property management program.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2021
- Next Update Expected
- 09/10/2022
- Legislative Related
- No
20-A-18-155.04We recommend that the National Institutes of Health implement routine mandatory training for ICs' procurement personnel and Property Custodial and Accountability officers on its Personal Property Management policies and procedures.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2021
- Next Update Expected
- 09/10/2022
- Legislative Related
- No
20-A-18-155.05We recommend that the National Institutes of Health complete corrective actions for FYs 2017 and 2018 FMFIA audits’ control deficiency record.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2021
- Next Update Expected
- 09/10/2022
- Legislative Related
- No
20-A-18-155.06We recommend that the National Institutes of Health develop relevant milestones with estimated milestone completion dates that support the implementation of a standardized agencywide operating model that centralizes and integrates software asset management and software license management.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/08/2023
- Legislative Related
- No
20-A-18-155.07We recommend that the National Institutes of Health employ a primary software asset management tool that centralizes and automates the capture of software inventory and entitlement data into each IC operating environment.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2021
- Next Update Expected
- 09/10/2022
- Legislative Related
- No
-
Billions in Estimated Medicare Advantage Payments From Diagnoses Reported Only on Health Risk Assessments Raise Concerns
20-E-03-039.01CMS should require MAOs to implement best practices to ensure care coordination for HRAs.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 11/30/2022
- Next Update Expected
- 12/14/2023
- Legislative Related
- No
20-E-03-039.02CMS should provide targeted oversight of the 10 parent organizations that drove most of the risk-adjusted payments resulting from in-home HRAs.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 12/21/2021
- Next Update Expected
- 03/08/2023
- Legislative Related
- No
20-E-03-039.03CMS should provide targeted oversight of the 20 MAOs that drove risk-adjusted payments resulting from in-home HRAs for beneficiaries who had no other service records in the 2016 encounter data.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 12/21/2021
- Next Update Expected
- 03/08/2023
- Legislative Related
- No
20-E-03-039.04CMS should reassess the risks and benefits of allowing in-home HRAs to be used as sources of diagnoses for risk adjustment and reconsider excluding such diagnoses from risk adjustment.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 11/30/2022
- Next Update Expected
- 12/14/2023
- Legislative Related
- No
20-E-03-039.05CMS should require MAOs to flag any MAO-initiated HRAs in their MA encounter data.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 11/30/2022
- Next Update Expected
- 12/14/2023
- Legislative Related
- No
-
Indiana Did Not Ensure That Medicaid Payments Were Made Properly for Some Claims Identified as Having Third-Party Coverage
20-A-05-154.01We recommended that the Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning refund $36,573 to the Federal Government.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $36,573
- Last Update Received
- -
- Closed Date
- 02/08/2022
- Legislative Related
- No
20-A-05-154.02We recommended that the Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning work with DXC to ensure that providers submit billed amounts and third-party payment amounts that match the claims billed to the third-party carrier.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/21/2022
- Legislative Related
- No
20-A-05-154.03We recommended that the Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning work with DXC to ensure that Medicaid claims are priced correctly.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/08/2022
- Legislative Related
- No
20-A-05-154.04We recommended that the Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning work with DXC to ensure that CoreMMIS contains accurate and complete information to avoid paying claims when a third party is liable, including all active third-party carriers and policies, and all third-party coverage benefits (and the system is allowed to generate provider inquiry letters for Medicaid claims with benefits not included in CoreMMIS).- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/09/2023
- Legislative Related
- No
20-A-05-154.05We recommended that the Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning work with DXC to ensure that CoreMMIS contains accurate and complete information to avoid paying claims when a third party is liable, including accurate third-party coverage dates.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/09/2023
- Legislative Related
- No
20-A-05-154.06We recommended that the Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning work with DXC to ensure that HMS has accurate and complete Medicaid claim information to bill third-party carriers.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/09/2023
- Legislative Related
- No
20-A-05-154.07We recommended that the Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning work with DXC to ensure that HMS has accurate and complete third-party policy information, and addresses system edits preventing billing to third-party carriers.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/10/2022
- Legislative Related
- No
20-A-05-154.08We recommended that the Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning work with DXC to ensure that when HMS recovers Medicaid excess payments from third-party carriers that exceed the total Medicaid payment on a claim, HMS determines whether the member has other Medicaid expenditures to which the excess payments recovered could be applied.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/21/2022
- Legislative Related
- No
20-A-05-154.09We recommended that the Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning work with DXC to ensure that HMS pursues recovery of Medicaid payments in a timely manner for claims with TPL.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/10/2022
- Legislative Related
- No
-
Baylor Scott & White—College Station: Audit of Outpatient Outlier Payments
20-A-06-151.01We recommend that Baylor Scott & White - College Station refund to the Medicare contractor the portion of the $189,27637 in estimated overpayments for incorrectly billed claims that are within the 4-year reopening period.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $189,276
- Last Update Received
- -
- Closed Date
- 12/31/2021
- Legislative Related
- No
20-A-06-151.02We recommend that Baylor Scott & White-College Station based upon the results of this audit, exercise reasonable diligence to identify, report, and return any overpayments in accordance with the 60-day rule and identify any of those returned overpayments as having been made in accordance with this recommendation.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $93,957
- Last Update Received
- -
- Closed Date
- 03/14/2022
- Legislative Related
- No
20-A-06-151.03We recommend that Baylor Scott & White-College Station improve procedures and provide education to ensure claims billed to Medicare are accurate.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/17/2020
- Legislative Related
- No
20-A-06-151.04We recommend that Baylor Scott & White-College Station implement changes to billing system to ensure claims billed to Medicare are accurate.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/17/2020
- Legislative Related
- No
-
Hawaii's Monitoring Generally Ensured Child Care Provider Compliance With State Criminal Background Check Requirements
20-A-09-152.01We recommend that the Hawaii Department of Human Services confirm that the licensing unit responsible for the child-care-center provider that did not complete a required criminal background check has implemented a corrective action plan to ensure that background checks are completed for all staff who have been fingerprinted.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/20/2020
- Legislative Related
- No
-
National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded in 2019
20-E-07-038.01CMS should assist participating States in addressing the challenge of coordination between State-level departments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/14/2022
- Legislative Related
- No
20-E-07-038.02CMS should require that participating States consistently submit data that allow for CMS and each State to calculate determinations of ineligibility.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/30/2022
- Next Update Expected
- 04/14/2023
- Legislative Related
- No
-
Medicare Hospital Provider Compliance Audit: Flagstaff Medical Center
20-A-07-149.01We recommend that Flagstaff Medical Center refund to the Medicare contractor $79,216 in estimated overpayments for the audit period for claims that it incorrectly billed.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $79,216
- Last Update Received
- -
- Closed Date
- 01/05/2021
- Legislative Related
- No
20-A-07-149.02We recommend that Flagstaff Medical Center based on the results of this audit, exercise reasonable diligence to identify, report, and return any overpayments in accordance with the 60-day rule,8 and identify any of those returned overpayments as having been made in accordance with this recommendation.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/05/2021
- Legislative Related
- No
20-A-07-149.03We recommend that CMS strengthen controls to ensure full compliance with Medicare requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/05/2021
- Legislative Related
- No
-
Colorado Claimed Unsupported and Incorrect Federal Medicaid Reimbursement for Beneficiaries Enrolled in the New Adult Group
20-A-07-150.01We recommend that the Colorado Department of Health Care Policy and Financing update the CBMS by implementing an automatically accessible eligibility history that retains all beneficiary histories when retroactive changes occur, thereby eliminating the need for manual interventions to identify changes in eligibility status.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 11/14/2023
- Next Update Expected
- 09/20/2024
- Legislative Related
- No
20-A-07-150.02We recommend that the Colorado Department of Health Care Policy and Financing ensure that the MMIS retains all beneficiary eligibility changes and reconcile the beneficiaries’ data contained in the MMIS to the data in the CBMS to determine whether discrepancies in Medicaid eligibility groups are occurring.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/20/2024
- Legislative Related
- No
20-A-07-150.03We recommend that the Colorado Department of Health Care Policy and Financing ensure that the CBMS has automated edits to enroll Transitional Medicaid beneficiaries in the correct eligibility group.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 11/09/2020
- Next Update Expected
- 09/01/2022
- Legislative Related
- No
-
Indiana's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 17 of 30 Providers Reviewed
20-A-05-148.01We recommend that the Indiana Family and Social Services Administration conduct all required criminal background checks for the 56 individuals we reviewed who did not have all required background checks at the time of our data requests and site visits.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Partial Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/06/2023
- Legislative Related
- No
20-A-05-148.02We recommend that the Indiana Family and Social Services Administration verify that the disqualified employee was terminated and not allowed onsite.- Status
- Closed Acceptable Alternative
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/06/2023
- Legislative Related
- No
20-A-05-148.03We recommend that the Indiana Family and Social Services Administration conduct the required criminal background checks on all new employees and new household members.- Status
- Closed Acceptable Alternative
- Responsible Agency
- ACF
- Response
- Partial Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/06/2023
- Legislative Related
- No
20-A-05-148.04We recommend that the Indiana Family and Social Services Administration develop a system that regularly notifies providers to initiate required background check procedures for all new employees and notifies providers when background check applications have not been received or fully processed.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Partial Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/06/2023
- Legislative Related
- No
-
Texas Relied on Impermissible Provider-Related Donations To Fund the State Share of the Medicaid Delivery System Reform Incentive Payment Program
20-A-06-147.01We recommend that the Texas Health and Human Services Commission refund $83,833,972 in Federal funds it inappropriately received because it used IGTs derived from impermissible provider-related donations to fund the State share of DSRIP Program payments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $83,833,972
- Last Update Received
- 03/08/2024
- Next Update Expected
- 09/28/2024
- Legislative Related
- No
20-A-06-147.02We recommend that the Texas Health and Human Services Commission provide its IGT entities with guidance about arrangements that may result in impermissible provider-related donations, such as those outlined in CMS’s clarifying letter.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/08/2024
- Next Update Expected
- 09/28/2024
- Legislative Related
- No
20-A-06-147.03We recommend that the Texas Health and Human Services Commission request that its IGT entities disclose if similar arrangements exist and provide the State agency with action plans on ending the arrangements.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/08/2024
- Next Update Expected
- 09/28/2024
- Legislative Related
- No
-
Michigan Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations
20-A-05-143.01We recommend that the Michigan Department of Health and Human Services bill for and collect manufacturers’ rebates for pharmacy drugs and for single-source and top-20 multiple-source physician-administered drugs that we calculated to be at least $30,031,147 (Federal share) and refund the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $30,031,147
- Last Update Received
- 10/27/2022
- Next Update Expected
- 04/27/2023
- Legislative Related
- No
20-A-05-143.02We recommend that the Michigan Department of Health and Human Services work with CMS to determine whether the non-top-20 multiple-source physician-administered drugs and other physician-administered drugs without NDCs were eligible for rebates that we calculated to be at least $1,460,089 (Federal share) and, if so, upon receipt of the rebates, refund the Federal share of the rebates collected.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 10/27/2022
- Next Update Expected
- 04/27/2023
- Legislative Related
- No
20-A-05-143.03We recommend that the Michigan Department of Health and Human Services work with CMS to ensure that all pharmacy and physician-administered drugs eligible for rebates after our audit period are processed for rebates.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/09/2021
- Legislative Related
- No
20-A-05-143.04We recommend that the Michigan Department of Health and Human Services improve the processes for determining drug rebate eligibility to ensure that all rebate-eligible pharmacy and physician-administered drugs contained in the drug utilization data submitted by the MCOs are identified and billed for rebates.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/09/2021
- Legislative Related
- No