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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 1,121–1,140 of 1,159 reports, containing 3,741 recommendations
Sorted by latest release date
-
Review of New Mexico Medicaid Personal Care Services Provided by Ambercare Home Health
12-A-06-167.01We recommend that the State agency refund to the Federal Government the $888,683 paid to Ambercare for unallowable personal care services.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $888,683
- Last Update Received
- 03/19/2024
- Next Update Expected
- 09/27/2024
- Legislative Related
- No
-
Limited Oversight of Home Health Agency OASIS Data
12-E-01-024.02CMS should establish and implement enforcement actions for HHAs that submit OASIS data after the 30-day deadline.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 03/18/2024
- Next Update Expected
- 08/26/2012
- Legislative Related
- No
12-E-01-024.03CMS should develop clear guidelines that delineate expectations for States regarding timely and accurate OASIS data.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 03/18/2024
- Next Update Expected
- 08/26/2012
- Legislative Related
- No
-
Medicare Advantage Organizations' Identification of Potential Fraud and Abuse
12-E-03-022.02CMS should review MA organizations to determine why certain organizations reported especially high or low volumes of potential Part C and Part D fraud and abuse incidents and inquiries.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/10/2024
- Legislative Related
- No
-
Hospital Incident Reporting Systems Do Not Capture Most Patient Harm
12-E-06-015.03CMS should provide guidance to accreditors regarding survey or assessment of hospital efforts to track and analyze events and should scrutinize survey processes when approving accreditation programs.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 08/07/2019
- Next Update Expected
- 11/22/2022
- Legislative Related
- No
-
Review of Medicaid Personal Care Claims Submitted by Providers in New Jersey
12-A-02-089.01We recommend that the State agency refund $145,405,192 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $145,405,192
- Last Update Received
- 03/20/2024
- Next Update Expected
- 09/20/2024
- Legislative Related
- No
-
Addressing Vulnerabilities Reported by Medicare Benefit Integrity Contractors
12-E-03-009.02CMS should require all benefit integrity contractors to report monetary impact, when calculable, in a consistent format.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/28/2022
- Legislative Related
- No
-
Review of Medicaid Payments for Nonemergency Medical Transportation Services Claims Submitted by Providers in New York City
12-A-02-065.01We recommend that DOH refund $16,951,335 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $16,951,335
- Last Update Received
- 08/11/2023
- Next Update Expected
- 02/24/2024
- Legislative Related
- No
-
Conflict-of-Interest Waivers Granted to HHS Employees in 2009
11-E-04-045.01OGC should require OPDIVs and STAFFDIVs to document conflict-of interest waivers as recommended in Governmentwide Federal ethics regulations and the Secretary's instructions.- Status
- Open Unimplemented
- Responsible Agency
- OGC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 09/28/2016
- Next Update Expected
- 09/28/2017
- Legislative Related
- No
11-E-04-045.03OGC should take action to revise the conflict-of-interest waivers in our review that were not documented as recommended in Governmentwide Federal ethics regulations and the Secretary's instructions, if the waivers are still in effect.- Status
- Open Unimplemented
- Responsible Agency
- OGC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 09/28/2016
- Next Update Expected
- 09/28/2017
- Legislative Related
- No
11-E-04-045.05OGC should require all employees to sign and date, or similarly document, their conflict of interest waivers.- Status
- Open Unimplemented
- Responsible Agency
- OGC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 09/28/2016
- Next Update Expected
- 09/28/2017
- Legislative Related
- No
-
Questionable Billing by Suppliers of Lower Limb Prostheses
11-E-02-043.04CMS should revise the requirements in the local coverage determination.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/29/2021
- Legislative Related
- No
11-E-02-043.05CMS should enhance screening for currently enrolled suppliers of lower limb prostheses.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 02/22/2012
- Next Update Expected
- 02/16/2012
- Legislative Related
- No
-
Review of Select Medicaid Inpatient Psychiatric Hospital Service Requirements for One Illinois State-Owned Psychiatric Hospital During the Period January 1, 2000, Through December 31, 2009
11-A-05-353.01We recommended that the State agency refund $82,929,010 to the Federal Government for its share of inpatient psychiatric service and disproportionate share hospital (DSH) payments made to hospital A for claims with dates of service outside the regulatory gap period.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $82,929,010
- Last Update Received
- 04/09/2024
- Next Update Expected
- 10/09/2024
- Legislative Related
- No
11-A-05-353.02We recommended that the State agency work with CMS to determine whether the State agency should refund an additional $12,590,126 to the Federal Government for its share of payments made to hospital A for claims with dates of service during the regulatory gap period.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $12,590,126
- Last Update Received
- 04/09/2024
- Next Update Expected
- 10/09/2024
- Legislative Related
- No
11-A-05-353.03We recommended that the State agency identify and refund the Federal share of any additional payments made to hospital A for claims with dates of service after the audit period if neither the State agency nor hospital A can demonstrate the hospital’s compliance with Federal inpatient psychiatric hospital service requirements.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/09/2024
- Next Update Expected
- 10/09/2024
- Legislative Related
- No
-
Review of Administrative Costs Claimed by Pennsylvania's Home and Community-Based Waiver for Individuals Aged 60 and Over
11-A-03-320.03We recommended that the State agency amend its cost allocation plan to identify all Aging Waiver administrative costs and include detailed allocation methodologies to enable CMS to determine if the costs are being allocated in proportion to benefits received.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/08/2022
- Legislative Related
- No
-
States' Collection of Medicaid Rebates for Physician-Administered Drugs
11-E-03-029.01CMS should take action against States that do not meet the DRA's requirement to collect rebates on physician-administered drugs.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/08/2024
- Legislative Related
- No
11-E-03-029.02CMS should ensure that all State agencies are accurately identifying and collecting physician-administered drug rebates owed by manufacturers.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/08/2024
- Legislative Related
- No
-
State Medicaid Policies and Oversight Activities Related to 340B-Purchased Drugs
11-E-05-028.03HRSA should share 340B ceiling prices with States.- Status
- Open Unimplemented
- Responsible Agency
- HRSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/02/2024
- Next Update Expected
- 07/01/2024
- Legislative Related
- Yes
-
Review of Medicaid Payments for Services Provided Under New York's Section 1915(c) Traumatic Brain Injury Waiver at Belvedere of Albany, LLC, From January 1, 2005, Through December 31, 2007
11-A-02-293.01We recommended that the State agency refund $1,555,291 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Partial Concur
- Potential Savings
- $1,555,291
- Last Update Received
- 03/11/2024
- Next Update Expected
- 09/11/2024
- Legislative Related
- No
11-A-02-293.02We recommended that the State agency work with CMS to resolve the claims, totaling $2,087,622, for which Medicaid reimbursement may have been unallowable.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/31/2021
- Legislative Related
- No
-
Review of Medicaid Payments for Services Provided Under New York's Section 1915(c) Traumatic Brain Injury Waiver at Venture Forthe, Inc., From January 1, 2005, Through December 31, 2007
11-A-02-284.01We recommended that the State agency refund $3,156,501 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Partial Concur
- Potential Savings
- $3,156,501
- Last Update Received
- 03/11/2024
- Next Update Expected
- 09/11/2024
- Legislative Related
- No
11-A-02-284.02We recommended that the State agency work with CMS to resolve the claims, totaling $352,968, for which Medicaid reimbursement may have been unallowable.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/31/2021
- Legislative Related
- No
-
Medicare Atypical Antipsychotic Drug Claims for Elderly Nursing Home Residents
11-E-07-023.01CMS should facilitate access to information necessary to ensure accurate coverage and reimbursement determination.- Status
- Closed Superseded
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/20/2024
- Legislative Related
- No
-
Institutional Conflicts of Interest at NIH Grantees
11-E-03-014.01NIH should promulgate regulations that address institutional financial conflicts of interest.- Status
- Closed Unimplemented
- Responsible Agency
- NIH
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/03/2024
- Legislative Related
- Yes
-
Medicare Payments for Newly Available Generic Drugs
11-E-03-015.01CMS should work with Congress to require manufacturers of first generics to submit monthly ASP data during the period of initial generic availability.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/20/2023
- Legislative Related
- Yes
-
Review of New York's Medicaid Rehabilitative Services Claims Submitted by Community Residence Providers
11-A-02-098.02We recommended that the State agency refund $207,569,115 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Partial Concur
- Potential Savings
- $207,569,115
- Last Update Received
- 04/01/2024
- Next Update Expected
- 10/03/2024
- Legislative Related
- No
-
Review of Indiana's Reporting Fund Recoveries for Federal and State Medicaid Programs on the Form CMS-64 for Federal Fiscal Years 2000 Through 2008
11-A-05-023.01We recommended that the State agency include unreported Medicaid overpayments of $61,644,098 on the CMS-64 and refund $38,858,614 to the Federal Government.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $38,858,614
- Last Update Received
- -
- Closed Date
- 10/25/2021
- Legislative Related
- No