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 December 17, 2025
1,189
Unimplemented
recommendations
3,163
Implemented and Closed
recommendations since FY 2017
Views
OIG Recommendations Grouped by Report
Showing 921–940 of 1,352 reports, containing 4,352 recommendations
Sorted by latest release date
-
Massachusetts Did Not Ensure Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions
19-A-01-085.01We recommend that the State agency work with the MCOs to determine the portion of the $9,971,471 that was unallowable for claims containing PPCs and its impact on current and future year capitation payment rates.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/23/2020
- Legislative Related
- No
19-A-01-085.02We recommend that the State agency enforce the requirement in its managed-care contracts that makes MCO compliance with the PPC provisions a condition of their payment and includes the specific means to recoup funds from the MCOs when such contract provisions and Federal and State requirements are not met—a measure that, if incorporated, could result in cost savings for the Medicaid program.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/23/2020
- Legislative Related
- No
19-A-01-085.03We recommend that the State agency enforce the requirement in its managed-care contracts that allows intermediate sanctions to be imposed upon the MCO for failure to comply with applicable Federal or State statutory or regulatory requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/23/2020
- Legislative Related
- No
19-A-01-085.04We recommend that the State agency require the MCOs to implement internal controls to prohibit payments for inpatient hospital services related to treating PPCs and ensure edits implemented after our audit period are effective.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/23/2020
- Legislative Related
- No
19-A-01-085.05We recommend that the State agency require its MCOs to review all claims for inpatient hospital services that were paid after our audit period to determine whether any payments for services related to treating PPCs were unallowable and adjust future capitation payment rates for any unallowable payments identified.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/23/2020
- Legislative Related
- No
19-A-01-085.06We recommend that the State agency strengthen its monitoring of MCOs to ensure that they comply with Federal and State requirements and the State's managed-care contracts relating to the nonpayment of PPCs.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/23/2020
- Legislative Related
- No
19-A-01-085.07We recommend that the State agency ensure that claims identified by the MMIS edit are referred back to the MCOs for appropriate correction and inclusion of missing POA codes.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/23/2020
- Legislative Related
- No
-
California Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries' Deaths
19-A-04-083.01We recommend that the State Agency refund $53,425,143 to the Federal Government.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $53,425,143
- Last Update Received
- -
- Closed Date
- 07/15/2021
- Legislative Related
- No
19-A-04-083.02We recommend that the State Agency identify capitation payments made on behalf of deceased beneficiaries before and after our audit period and repay the Federal share of amounts recovered.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/29/2019
- Legislative Related
- No
19-A-04-083.03We recommend that the State Agency identify and recover unallowable payments made to MCOs during our audit period on behalf of deceased beneficiaries, which we estimated to be at least $70,989,604.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/15/2021
- Legislative Related
- No
19-A-04-083.04We recommend that the State Agency perform quarterly reviews of eligibility system records to ensure that beneficiaries with dates of death are removed from Medi-Cal.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/16/2021
- Legislative Related
- No
19-A-04-083.05We recommend that the State Agency use additional sources of date of death consistently to help reduce unallowable payments.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/29/2019
- Legislative Related
- No
-
One Percent of Drugs With Medicaid Reimbursement Were Not FDA-Approved
19-E-03-013.01CMS should work with States to recoup any potentially inappropriate Federal reimbursement for drugs that CMS determines were not FDA-approved and did not meet the criteria for an exception.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/02/2024
- Legislative Related
- No
19-E-03-013.02CMS should continue to improve its reporting system to prevent inappropriate reimbursement for drugs that are not FDA approved.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/21/2020
- Legislative Related
- No
19-E-03-013.03CMS should work with States to ensure that they prevent inappropriate reimbursement for drugs that are not FDA-approved and do not meet the criteria for an exception.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/04/2021
- Legislative Related
- No
-
Some Diagnosis Codes That Essence Healthcare, Inc., Submitted to CMS Did Not Comply With Federal Requirements
19-A-07-082.01We recommend that Essence refund to the Federal Government the $158,904 in overpayments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $158,904
- Last Update Received
- -
- Closed Date
- 12/07/2020
- Legislative Related
- No
19-A-07-082.02We recommend that Essence identify, for the diagnoses included in this report, instances of noncompliance in the enrollee-years that occurred during our audit period, but were not included in our judgmental sample, and before and after our audit period, and refund any resulting overpayments to the Federal Government.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/22/2021
- Legislative Related
- No
19-A-07-082.03We recommend that Essence enhance its policies and procedures to detect and correct noncompliance with Federal requirements for all diagnosis codes used to calculate risk-adjusted payments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/31/2020
- Next Update Expected
- 10/30/2022
- Legislative Related
- No
-
Medicaid Could Save Hundreds of Millions by Excluding Authorized Generic Drug Transactions to Secondary Manufacturers from Brand Name Drugs' Average Manufacturer Price Calculations
19-A-06-081.01We recommend that CMS seek legislative change to exclude authorized generic drug transactions to secondary manufacturers from the AMP calculation of the brand name drug.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/13/2023
- Legislative Related
- Yes
-
The Children's Village, Inc., an Administration for Children and Families Grantee, Did Not Always Comply with Applicable Federal and State Policies and Requirements
19-A-02-079.01We recommend that Children's Village take corrective action to ensure that its facility is free from potentially harmful conditions.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/23/2025
- Legislative Related
- No
19-A-02-079.02We recommend that Children's Village determine whether resources are aligned as needed to ensure that all required documentation is maintained in UAC case files and that ORR policies and procedures are followed when releasing UAC to sponsors.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/23/2025
- Legislative Related
- No
19-A-02-079.03We recommend that Children's Village ensure that all medical exams and educational assessments are documented and performed as required by ORR.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/23/2025
- Legislative Related
- No
19-A-02-079.04We recommend that Children's Village ensure that all employee requirements pertaining to background investigations and experience are met and documented.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/14/2025
- Next Update Expected
- 09/17/2025
- Legislative Related
- No
19-A-02-079.05We recommend that Children's Village refund to the Federal Government $2,623,785 in unallowable grant expenditures.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Partial Concur
- Potential Savings
- $2,623,785
- Last Update Received
- -
- Closed Date
- 07/23/2025
- Legislative Related
- No
19-A-02-079.06We recommend that Children's Village review its claimed expenditures for FYs 2016 and 2017 (the second and third years of the grant awards) to determine whether they were claimed in accordance with Federal requirements and refund to the Federal Government any unallowable amount.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/14/2025
- Next Update Expected
- 09/17/2025
- Legislative Related
- No
19-A-02-079.07We recommend that Children's Village ensure that costs are properly approved, allocated, and adequately supported.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/14/2025
- Next Update Expected
- 09/17/2025
- Legislative Related
- No
19-A-02-079.08We recommend that Children's Village implement financial management system procedures to ensure Federal funds are drawn down only when needed, all related obligations are paid timely, and grant funds are separately identified and segregated.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/23/2025
- Legislative Related
- No
-
The Centers for Disease Control and Prevention's South Africa Office Generally Implemented Our Prior Audit Recommendation
19-A-04-078.01We recommend that CDC-SA continue to strengthen its CoAg tracking process, by consistently completing a grant file checklist at the end of the CoAg's budget period, to ensure that reviews of the CoAgs are completed by the appropriate staff; completed in a timely manner; and maintained in the recipient CoAg file.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/25/2019
- Legislative Related
- No
19-A-04-078.02We recommend that CDC-SA continue to update and review its SOPs annually to include specific and clear procedures when changes in control activities occur for monitoring recipient CoAgs, such as, but not limited to, review of the expenditures and the time limit of the audit report review.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/25/2019
- Legislative Related
- No
-
National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded Between 2013 and 2016
19-E-07-012.01CMS should take appropriate action to encourage participating States to obtain necessary authorities to fully implement Program requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/30/2024
- 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 2018
19-A-18-075.01In order to move HHS toward an effective risk management domain, we recommend that the HHS OCIO continue to work with OPDIVs to enhance its enterprise risk management strategy and program to integrate governance functions for information security, strategic planning and strategic reviews, internal control activities, and applicable mission/business areas. These enhancements should include the integration of threat modeling for dynamic risk assessments and appropriate reporting tools to timely respond to new threats as they arise.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.02In order to move HHS toward an effective risk management domain, we recommend that the HHS OCIO continue to develop an approach for the Department to ensure that CDM tools, Security Governance, Risk management, and Compliance (sGRC) tools, and associated processes are implemented at all OPDIVs for the integration of risk management programs at the enterprise, business process, and information system levels to ensure consistency with OMB, NIST, and Department guidelines and requirements.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.03In order to move HHS toward an effective configuration management domain, we recommend that the HHS OCIO continue to work with OPDIVs to leverage qualitative and quantitative performance measures to determine the effectiveness of OPDIVs' configuration management plans. These measures should be based on results from automated toolsets to determine security misconfigurations, unsupported information system components, and effectiveness of flaw remediation processes. Define the timeframe for OPDIV communication of the performance measures to the OCIO.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.04In order to move HHS toward an effective configuration management domain, we recommend that the HHS OCIO continue to Implement the approach for the Department to fully implement CDM tools, sGRC tools, and process tools to consistently record, implement, and maintain configuration controls, baseline configurations of its information systems, and an inventory of related components.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.05In order to move HHS toward an effective identity and access management domain, we recommend that the HHS OCIO continue to work with OPDIVs to determine the effectiveness of identity and access management processes. These measures should monitor OPDIVs' implementation of strong authentication techniques for all privileged and non-privileged users.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.06In order to move HHS toward an effective identity and access management domain, we recommend that the HHS OCIO continue to Assist OPDIV implementation of "to-be" Identity, Credential, and Access Management (ICAM) architecture and integration of their ICAM strategy and activities within its enterprise and Federal ICAM segment architecture.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.07In order to move HHS toward an effective data protection and privacy domain, we recommend that the HHS OCIO continue to HHS OCIO update relevant Department policies, procedures, and guidance.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.08In order to move HHS toward an effective data protection and privacy domain, we recommend that the HHS OCIO continue to Work with the OPDIVs to measure the effectiveness of privacy specific controls and trainings through tracked breaches and maintain current privacy related documentation.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.09We recommend that HHS OCIO continue to work with the OPDIV to assign the necessary personnel to monitor compliance with the security awareness and training program.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.10In order to move HHS toward an effective ISCM domain, we recommend that the HHS OCIO continue to provide department-wide guidance and DHS-supplied CDM tools to each OPDIV for the implementation of their ISCM programs. This should include periodic reporting requirements and metrics to monitor real time threats identified by the Computer Security Incident Response Center (CSIRC) across the HHS enterprise.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.11In order to move HHS toward an effective ISCM domain, we recommend that the HHS OCIO continue to enhance OPDIVs security continuous monitoring efforts to maintain visibility into IT assets, be aware of all vulnerabilities, be informed about security threats, and verify that all software assets are scanned on the network on a regular basis, as required.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.12In order to move HHS toward an effective ISCM domain, we recommend that the HHS OCIO continue to assist OPDIVS in maintaining and managing system ATOs and security control assessments per the HHS policy and guidelines.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.13We recommend that the HHS OCIO work with the OPDIV to improve enforcement and communication of the incident response program organization wide. Improvements should focus on measuring consistent profiling techniques and improve communication between the CSIRC, OPDIVs, and components.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
19-A-18-075.14In order to move HHS toward an effective contingency planning domain, we recommend that the HHS OCIO continue to Assist OPDIVs in the implementation of a monitoring program that identifies metrics based on defined mission and business risk. The program should validate OPDIVs implementation of contingency planning policies, procedures, and strategies in the following areas: conducting business impact analysis, conducting contingency plan testing, implementing information system backup and storage requirements, incorporating supply chain risks and the selection of alternative processing sites.- Status
- Closed Unimplemented
- Responsible Agency
- OCR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/01/2020
- Legislative Related
- No
-
Indiana Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs
19-A-05-074.01We recommend that the State agency refund to the Federal Government $695,070 (Federal share) for claims for single-source physician-administered drugs that were ineligible for Federal reimbursement.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $695,070
- Last Update Received
- -
- Closed Date
- 09/27/2022
- Legislative Related
- No
19-A-05-074.02We recommend that the State agency refund to the Federal Government $15,350 (Federal share) for claims for top-20 multiple-source physician-administered drugs that were ineligible for Federal reimbursement.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $15,350
- Last Update Received
- -
- Closed Date
- 02/24/2020
- Legislative Related
- No
19-A-05-074.03We recommend that the State agency work with CMS to determine and refund the unallowable portion of Federal reimbursement for physician-administered drugs that were not invoiced for rebates after September 30, 2017.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/24/2020
- Legislative Related
- No
19-A-05-074.04We recommend that the State agency strengthen its internal controls to ensure that all physician-administered drugs eligible for rebates are invoiced.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/24/2020
- Legislative Related
- No
19-A-05-074.05We recommend that the State agency work with CMS to determine the unallowable portion of $135,661 (Federal share) for other claims for covered outpatient physician-administered drugs that were submitted without NDCs and that may have been ineligible for Federal reimbursement and refund that amount.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $135,661
- Last Update Received
- -
- Closed Date
- 09/27/2022
- Legislative Related
- No
19-A-05-074.06We recommend that the State agency work with CMS to determine whether the remaining $6,678 (Federal share) of other physician-administered drug claims could have been invoiced to the manufacturers to receive rebates and, if so, upon receipt of the rebates, refund the Federal share of the manufacturers' rebates for those claims.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $6,678
- Last Update Received
- -
- Closed Date
- 02/24/2020
- Legislative Related
- No
-
Although the Administration for Community Living Resolved Nearly All Audit Recommendations, It Did Not Always Do So in Accordance With Federal Timeframe Requirements
19-A-07-073.01We recommend that ACL follow its policies and procedures related to the audit resolution process to ensure that all management decisions are issued within the required 6-month resolution period.- Status
- Closed Implemented
- Responsible Agency
- ACL
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/17/2020
- Legislative Related
- No
19-A-07-073.02We recommend that ACL promptly resolve the six outstanding audit recommendations that were past due as of September 30, 2016.- Status
- Closed Implemented
- Responsible Agency
- ACL
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/17/2020
- Legislative Related
- No
-
The Passamaquoddy Tribe's Pleasant Point Health Center Needs To Improve Its Medical-Referral Process
19-A-01-072.01We recommend that the Passamaquoddy Tribe at Pleasant Point reestablish the practice of conducting MCC meetings that are comprised of the required medical and administrative staff to review referrals on a weekly basis in accordance with Federal requirements.- Status
- Closed Implemented
- Responsible Agency
- IHS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/01/2021
- Legislative Related
- No
19-A-01-072.02We recommend that the Passamaquoddy Tribe at Pleasant Point develop and implement policies and procedures to ensure accurate documentation of medical referrals, including eliminate the system default settings for referral medical priority level codes; ensure provider training and proper use of the correct medical priority level code definitions; ensure supervision of PRC administrative staff so that referrals are properly closed, accurately documented, and closed individually; and identify process requirements for closing referrals and documenting the reasons that referrals were not completed.- Status
- Closed Implemented
- Responsible Agency
- IHS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/06/2020
- Legislative Related
- No
19-A-01-072.03We recommend that the Passamaquoddy Tribe at Pleasant Point institute safeguards to prevent the loss of medical referrals from RCIS, including the implementation of a tracking, reporting, and review process that ensures that the RCIS accounts for all medical referrals created.- Status
- Closed Implemented
- Responsible Agency
- IHS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/06/2020
- Legislative Related
- No
-
New Jersey Did Not Provide Adequate Oversight of Its Medicaid Delivery System Reform Incentive Payment Program
19-A-02-070.01We recommend that the State agency work with DOH, the DSRIP program contractor, and the five selected hospitals to determine whether the $50,920,788 ($25,460,394 Federal share) in pay-for performance incentive payments to the five hospitals was appropriate.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/03/2021
- Legislative Related
- No
19-A-02-070.02We recommend that the State agency work with DOH, the DSRIP program contractor, and the 44 hospitals not covered by this review to determine whether the $131,511,277 ($65,755,639 Federal share) in pay-for-performance incentive payments to those hospitals was appropriate.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/03/2021
- Legislative Related
- No
19-A-02-070.03We recommend that the State agency improve its oversight of the DSRIP program to ensure that its contractor maintains the Medicaid claims data necessary to support its determinations for whether hospitals qualify for pay-for-performance incentive payments and hospitals report information consistent with the performance measure criteria to the DSRIP program contractor.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/03/2021
- Legislative Related
- No
-
New York Did Not Provide Adequate Stewardship of Substance Abuse Prevention and Treatment Block Grant Funds
19-A-02-069.01We recommend that SAMHSA provide formal guidance to the State agency on accounting for SABG expenditures.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/22/2021
- Legislative Related
- No
19-A-02-069.02We recommend that SAMHSA provide formal guidance to the State agency on alerting SAMHSA about any unexpended funds.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/22/2021
- Legislative Related
- No
19-A-02-069.03We recommend that SAMHSA provide formal guidance to the State agency on amending the FFR to reflect actual SABG expenditures.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/22/2021
- Legislative Related
- No
19-A-02-069.04We recommend that SAMHSA recover $1,800,212 from the State agency.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- $1,800,212
- Last Update Received
- -
- Closed Date
- 05/26/2022
- Legislative Related
- No
19-A-02-069.05We recommend that the State agency review the revenues reported on the fiscal reports of providers not reviewed in this audit and recover any excess unexpended funds.- Status
- Open Unimplemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 07/22/2025
- Next Update Expected
- 01/23/2026
- Legislative Related
- No
19-A-02-069.06We recommend that the State agency develop and implement procedures to ensure that the necessary staff have access to Medicaid revenue data and reconcile the data with the revenue reported on providers' fiscal reports.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/04/2021
- Legislative Related
- No
-
Missouri Claimed Some Unallowable Medicaid Payments for Targeted Case Management Services
19-A-07-067.01We recommend that the State agency refund $3,781,709 to the Federal Government for unallowable TCM claims.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $3,781,709
- Last Update Received
- 10/06/2025
- Next Update Expected
- 04/06/2026
- Legislative Related
- No
19-A-07-067.02We recommend that the State agency strengthen its policies and procedures to ensure that TCM providers maintain documentation to document that case managers are qualified to perform TCM services, TCM providers maintain documentation to support the TCM services provided, it does not pay TCM providers or claim Federal reimbursement for services that are not TCM services, and it correctly reports recoupment of TCM claims from TCM providers on its CMS-64 reports.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 10/06/2025
- Next Update Expected
- 04/06/2026
- Legislative Related
- No
-
Michigan Disbursed Only Part of Its Civil Money Penalty Collections, Limiting Resources To Protect or Improve Care for Nursing Facility Residents
19-A-05-065.01We recommend that the State agency work with organizations to fully utilize CMP collections to fund activities that protect or improve the quality of care for nursing facility resident and continue to review its process to make them more effective and efficient.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/06/2019
- Legislative Related
- No
-
Although the Centers for Disease Control and Prevention Resolved Nearly All Audit Recommendations, It Did Not Always Do So in Accordance With Federal Timeframe Requirements
19-A-07-064.01We recommend that CDC follow its policies and procedures related to the audit resolution process to ensure that all management decisions are issued within the required 6-month resolution period.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/26/2019
- Legislative Related
- No
19-A-07-064.02We recommend that CDC promptly resolve the 27 outstanding audit recommendations (33 that were past due as of September 30, 2016, less 6 resolved after the end of our audit period).- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/26/2019
- Legislative Related
- No
-
CMS Improperly Paid Millions of Dollars for Skilled Nursing Facility Services When the Medicare 3-Day Inpatient Hospital Stay Requirement Was Not Met
19-A-05-063.01We recommend that CMS ensure that when SNF claims are being processed for payment, the CWF qualifying inpatient hospital stay edit for SNF claims is enabled and operating properly to identify SNF claims ineligible for Medicare reimbursement.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/12/2021
- Legislative Related
- No
19-A-05-063.02We recommend that CMS require hospitals to provide a written notification to beneficiaries whose discharge plans include posthospital SNF care, clearly stating how many inpatient days of care the hospital provided and whether the 3-day rule for Medicare coverage of SNF stays has been met. If necessary, CMS should seek statutory authority to do so.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/13/2025
- Legislative Related
- No
19-A-05-063.03We recommend that CMS require SNFs to obtain from the hospital or beneficiary, at the time of admission, a copy of the hospital's written notification to the beneficiary and retain it in the beneficiary's medical record. If necessary, CMS should seek statutory authority to do so.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/13/2025
- Legislative Related
- No
19-A-05-063.04We recommend that CMS require SNFs to provide written notice to beneficiaries if Medicare is expected to deny payment for the SNF stay when the 3-day rule is not met. If necessary, CMS should seek statutory authority to do so.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/10/2021
- Legislative Related
- No
19-A-05-063.05We recommend that CMS educate hospitals about the importance of explicitly communicating the correct number of inpatient days to beneficiaries and whether the inpatient days qualify subsequent SNF care for Medicare reimbursement so that beneficiaries understand their potential financial liability related to SNF care.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/24/2021
- Legislative Related
- No
19-A-05-063.06We recommend that CMS educate SNFs about their responsibility to submit accurate and valid claims for payment that are supported with documentation that clearly shows that the SNF services qualify for reimbursement.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/24/2021
- Legislative Related
- No
-
New Mexico Did Not Always Appropriately Refund the Federal Share of Recoveries from Managed Care Organizations
19-A-06-062.01We recommend that the State agency refund to the Federal Government the additional $4,421,572 Federal share related to ACA expansion recoveries and recoveries originally claimed at higher FMAPs, such as those for Family Planning and Breast and Cervical Cancer.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $4,421,572
- Last Update Received
- -
- Closed Date
- 06/18/2019
- Legislative Related
- No
19-A-06-062.02We recommend that the State agency consider conducting its reconciliations of MCO payments in a more timely manner.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/18/2019
- Legislative Related
- No
19-A-06-062.03We recommend that the State agency establish policies and procedures to identify MCO recoveries that were originally claimed at higher FMAPs.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/31/2019
- Legislative Related
- No
19-A-06-062.04We recommend that the State agency establish policies and procedures to ensure that it performs reconciliations of capitation payments for Community Benefit services as required under its contracts with MCOs, perform those reconciliations, and refund the Federal share of any MCO recoveries made to the Federal Government.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/07/2023
- Legislative Related
- No
-
Lincoln Hall Boys' Haven, an Administration for Children and Families Grantee, Did Not Always Comply With Applicable Federal and State Policies and Requirements
19-A-02-061.01We recommended that Lincoln Hall adhere to ORR and State requirements for monthly fire drills, video monitoring systems in common areas, and employee training, background investigations, health screenings, and employment qualification.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/17/2020
- Legislative Related
- No
19-A-02-061.02We recommend that Lincoln Hall implement a financial management system that identifies the source and application of Federal funds.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- $29,807,160
- Last Update Received
- -
- Closed Date
- 11/16/2020
- Legislative Related
- No
19-A-02-061.03We recommended that Lincoln Hall provide documentation to support the $29,807,160 of program costs or refund the Federal Government.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/16/2020
- Legislative Related
- No
19-A-02-061.04We recommended that Lincoln Hall update policies to meet applicable safety requirements for the care and release of children in its custody and maintain supporting documentation.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/16/2020
- Legislative Related
- No
19-A-02-061.05We recommend that Lincoln Hall increase oversight of its reviewing process for UAC case files to ensure that all required documentation is maintained in the file.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/16/2020
- Legislative Related
- No
19-A-02-061.06We recommended that Lincoln Hall develop policies and procedures that adhere to requirements for monitoring subrecipients and contractors.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/16/2020
- Legislative Related
- No