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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 July 17, 2024
1,285
Unimplemented
recommendations
$277.4B
Potential savingsfrom unimplemented recommendations
2,552
Implemented and Closed
recommendations since FY 2017
OIG Recommendations Grouped by Report
Views
Showing 1,021–1,040 of 1,181 reports, containing 3,837 recommendations
Sorted by latest release date
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Washington State Claimed Federal Medicaid Reimbursement for Inpatient Hospital Services Related to Treating Provider-Preventable Conditions
16-A-09-198.01We recommend that the State agency work with CMS to determine what portion of the $10,842,919 Federal share claimed was unallowable for Federal Medicaid reimbursement and refund to the Federal Government the unallowable amount.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $199,898
- Last Update Received
- -
- Closed Date
- 10/15/2021
- Legislative Related
- No
16-A-09-198.02We recommend that the State agency review all paid claims before our audit period for inpatient hospital services with dates of admission from January 1, 2010, through June 30, 2012, to determine whether payments should be adjusted for any claims that contained PPCs and a POA code indicating that the condition was not present on admission; a POA code indicating that the documentation in the patient’s medical record was insufficient to determine whether the condition was present on admission; or no POA code.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/15/2021
- Legislative Related
- No
16-A-09-198.03We recommend that the State agency refund to the Federal Government its share of any unallowable amounts for those paid claims reviewed.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/15/2021
- Legislative Related
- No
-
Medicare Compliance Review of North Carolina Baptist Hospital for Claims Paid From January 1, 2013, Through August 31, 2014
16-A-04-197.02We recommended that the hospital strengthen controls to ensure full compliance with Medicare requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/08/2022
- Legislative Related
- No
16-A-04-197.03We recommended that the hospital exercise reasonable diligence to identify and return any additional overpayments received outside of our audit period, in accordance with the 60-day repayment rule.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/08/2022
- Legislative Related
- No
-
New Jersey Made Incorrect Medicaid Electronic Health Record Incentive Payments
16-A-02-190.01We recommend that the State agency refund to the Federal government $2,270,213 in net overpayments made to 15 hospitals.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $2,270,213
- Last Update Received
- -
- Closed Date
- 10/25/2021
- Legislative Related
- No
-
Medicare Compliance Review of Home Health VNA for 2011 and 2012
16-A-01-187.01We recommend that the Agency refund to the Medicare contractor $6,348,971 in estimated overpayments for claims incorrectly billed that are within the 3-year recovery period.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $6,348,971
- Last Update Received
- -
- Closed Date
- 11/16/2021
- Legislative Related
- No
-
MACs Continue to Use Different Methods to Determine Drug Coverage
16-E-03-037.01CMS should assign a single entity to assist MACs with making coverage determinations.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/22/2024
- Legislative Related
- No
-
Texas Did Not Always Comply With Federal Requirements and Its Cost Allocation Plan When It Claimed Medicaid Administrative Costs
16-A-06-173.02We recommend that the State Agency ensure that the method the State agency uses to allocate the indirect costs is consistent with the approved PACAP.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/08/2022
- Legislative Related
- No
-
FDA is Issuing More Postmarketing Requirements, but Challenges with Oversight Persist
16-E-01-035.01FDA should provide a standardized form for Annual Status Reports (ASRs), ensure that they are complete, and require sponsors to submit them electronically.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/28/2024
- Legislative Related
- No
16-E-01-035.02FDA should build capacity in the Document Archiving, Reporting, and Regulatory Tracking System (DARRTS) to support postmarketing requirements (PMR) oversight.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/28/2024
- Legislative Related
- No
-
Adverse Events in Rehabilitation Hospitals: National Incidence Among Medicare Beneficiaries
16-E-06-034.03CMS should include information about potential events and patient harm in its quality guidance to rehab hospitals.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 07/16/2021
- Next Update Expected
- 08/11/2022
- Legislative Related
- No
-
Medicare Compliance Review of Excellent Home Care Services, LLC
16-A-02-169.01We recommend that the Agency refund to the Medicare contractor $6,382,323 in estimated net overpayments for claims incorrectly billed that are within the 3-year claims recovery period.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $1,531,015
- Last Update Received
- -
- Closed Date
- 11/01/2021
- Legislative Related
- No
-
Medicare Compliance Review of Houston Methodist Hospital for 2012 and 2013
16-A-06-165.01We recommend that the Hospital refund to the Medicare contractor $579,799 in estimated net overpayments for claims that were incorrectly billed during the 3-year recovery period.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $579,799
- Last Update Received
- -
- Closed Date
- 04/07/2023
- Legislative Related
- No
16-A-06-165.03We recommend that the Hospital work with the Medicare contractor to return overpayments that were made outside of the 3-year recovery period, which we estimate to be as much as $619,350 for our audit period, in accordance with the 60-day repayment rule.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/07/2023
- Legislative Related
- No
-
New York Overpaid Certain Medicaid Mental Health Services Providers
16-A-02-152.01We recommend that the State agency refund $8,106,746 to the Federal Government for COPS and CSP overpayments for the period 2009 through 2012.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $8,106,746
- Last Update Received
- -
- Closed Date
- 11/09/2023
- Legislative Related
- No
-
CMS Is Taking Steps To Improve Oversight of Provider-Based Facilities, But Vulnerabilities Remain
16-E-04-026.02CMS should require hospitals to submit attestations for all their provider-based facilities.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 05/24/2024
- Next Update Expected
- 07/15/2025
- Legislative Related
- No
16-E-04-026.04CMS should take appropriate action against hospitals and their off-campus provider-based facilities that we identified as not meeting requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/20/2023
- Legislative Related
- No
-
State Efforts to Exclude 340B Drugs from Medicaid Managed Care Rebates
16-E-05-025.01CMS should require the use of claim level methods to identify 340B claims.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 05/23/2024
- Next Update Expected
- 07/01/2024
- Legislative Related
- Yes
-
Medicaid: Vulnerabilities Related to Provider Enrollment and Ownership Disclosure
16-E-04-020.03CMS should require State Medicaid programs to verify the completeness and accuracy of provider ownership information.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 07/18/2018
- Next Update Expected
- 11/19/2016
- Legislative Related
- No
-
Medicaid Enhanced Provider Enrollment Screenings Have Not Been Fully Implemented
16-E-05-022.01CMS should assist States in implementing fingerprint-based criminal background checks for all high-risk providers.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/01/2022
- Legislative Related
- No
16-E-05-022.04CMS should develop a central system where States can submit and access screening results from other States.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/06/2023
- Legislative Related
- No
16-E-05-022.05CMS should strengthen minimum standards for fingerprint-based criminal background checks and site visits.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/06/2023
- Legislative Related
- No
16-E-05-022.06CMS should work with States to develop a plan to complete their revalidation screening in a timely way.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 02/21/2024
- Next Update Expected
- 02/26/2025
- Legislative Related
- No
-
Enhanced Enrollment Screening of Medicare Providers: Early Implementation Results
16-E-03-017.03CMS should revise and clarify site visit forms so that they can be more easily used by inspectors to determine whether a facility is operational.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/25/2021
- Legislative Related
- No
-
Medicare Compliance Review of Lafayette General Medical Center for Claims Paid During 2013 and 2014
16-A-06-124.01We recommend that the Hospital refund to the Medicare program $4,126,732 in estimated overpayments for claims that it incorrectly billed.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $4,126,732
- Last Update Received
- -
- Closed Date
- 10/29/2021
- Legislative Related
- No
-
Medicare Contractor Payments to Providers for Hospital Outpatient Dental Services in Jurisdiction H Generally Did Not Comply With Medicare Requirements
16-A-06-114.01We recommend that Novitas recover the $1,767,106 in unallowable payments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,767,106
- Last Update Received
- -
- Closed Date
- 02/08/2023
- Legislative Related
- No
-
Opportunities for Program Improvements Related to States' Withdrawals of Federal Medicaid Funds
16-A-06-104.01We recommend that CMS issue guidance that clarifies existing requirements and provides further interpretation of the "as needed" language in 42 CFR § 430.30(d)(3) as it relates to the withdrawal of Medicaid funds.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2024
- Legislative Related
- No
16-A-06-104.02We recommend that CMS publish regulations that are consistent with the Treasury provisions in 31 CFR part 205 and educate States.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/20/2024
- Legislative Related
- No
16-A-06-104.03We recommend that CMS publish and enforce formal guidance based on the November 8, 2011, email, so that States are aware of the appropriate PMS account from which to withdraw or return fund.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2024
- Legislative Related
- No
16-A-06-104.04We recommend that CMS require States to reconcile total Federal Medicaid funds withdrawn with the Federal share of net expenditures and issue appropriate reconciliation guidelines.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2024
- Legislative Related
- No
-
California Improperly Claimed Enhanced Federal Reimbursement for Selected Claim Lines for Medicaid Family Planning Drugs and Supplies in Los Angeles and Orange Counties
16-A-09-098.04We recommend that the State agency ensure that providers comply with State agency policies and procedures requiring them to verify the accuracy of submitted claims for family planning drugs and supplies.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/31/2021
- Legislative Related
- No