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 Sept. 11, 2026
1,051
Unimplemented
recommendations
3,529
Implemented and Closed
recommendations since FY 2017
Views
OIG Recommendations Grouped by Report
Showing 101–120 of 1,427 reports, containing 4,580 recommendations
Sorted by latest release date
-
West Virginia Did Not Comply With Intake, Screening, Assessment, and Investigation Requirements for Responding to Reports of Child Abuse and Neglect
25-A-01-124.01We recommend that the West Virginia Department of Human Services, Bureau for Social Services take appropriate steps to ensure child welfare workers perform all required procedures within the intake assessment and the initial assessment processes as required.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 03/25/2026
- Legislative Related
- No
25-A-01-124.02We recommend that the West Virginia Department of Human Services, Bureau for Social Services provide training to supervisors on the requirement to notify mandated reporters of whether the referral was accepted for assessment or screened out.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 03/25/2026
- Legislative Related
- No
25-A-01-124.03We recommend that the West Virginia Department of Human Services, Bureau for Social Services develop a new system edit to prevent an incorrect safety assessment decision based on the impending safety threats selected.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 03/25/2026
- Legislative Related
- No
25-A-01-124.04We recommend that the West Virginia Department of Human Services, Bureau for Social Services develop written policies and procedures that include a requirement for supervisors to monitor child welfare worker progress to ensure interviews with children and adults are conducted as required; and aging reports on a weekly basis to promptly identify delays in closing out the initial assessment within 30 days as required.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 03/25/2026
- Legislative Related
- No
-
Hospitals Charged CMS for Trauma Team Activations That Did Not Comply With Federal Requirements
25-A-01-123.01We recommend that the Centers for Medicare & Medicaid Services take the necessary steps to address the estimated $2.4 billion in unallowable trauma team activation charges reported on hospitals' cost reports and the resulting incorrect outlier payments to improve the accuracy of data used to establish future PPS payment rates.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 03/31/2026
- Next Update Expected
- 10/01/2026
- Legislative Related
- No
25-A-01-123.02We recommend that the Centers for Medicare & Medicaid Services work with the MACs to identify similar instances of noncompliance that occurred after our audit period to determine and address the impact to the Federal Government related to claims for trauma team activation that did not comply with Federal requirements.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 03/31/2026
- Next Update Expected
- 10/01/2026
- Legislative Related
- No
25-A-01-123.03We recommend that the Centers for Medicare & Medicaid Services revise CMS guidance to explain when trauma team activation is reasonable and necessary (e.g., by incorporating ACS trauma center requirements and, if necessary, providing specific examples).- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 03/22/2026
- Legislative Related
- No
25-A-01-123.04We recommend that the Centers for Medicare & Medicaid Services provide more frequent education to hospitals on CMS requirements for submitting claims with trauma team activation.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/10/2026
- Legislative Related
- No
-
Deficiencies With Incorporating Required Cybersecurity Language in HHS Contracts and Timeliness of Contractor Incident Reporting
25-A-18-122.01We recommend that the Department of Health and Human Services Office of the Chief Information Officer require OpDivs to modify any ICT service contracts that lack required security language, including the required language as stated in the HHS Policy for Information Technology Procurements – Security and Privacy Language.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/21/2026
- Legislative Related
- No
25-A-18-122.02We recommend that the Department of Health and Human Services Office of the Chief Information Officer implement a verification step in the procurement process to confirm that all ICT service contracts include the required security language pertaining to incident reporting before awarding the contracts.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 08/21/2026
- Next Update Expected
- 02/21/2027
- Legislative Related
- No
-
Seventeen of Twenty-Five Selected Hospitals Did Not Comply or May Not Have Complied With the Provider Relief Fund Balance Billing Requirement
25-A-02-121.01We recommend that the Health Resources and Services Administration determine whether the selected hospitals made refunds to the patients identified in this audit for billings that did not or may not have complied with the PRF balance billing requirement.- Status
- Closed Implemented
- Responsible Agency
- HRSA
- Response
- Concur
- Potential Savings
- $637,035
- Last Update Received
- -
- Closed Date
- 07/30/2026
- Legislative Related
- No
25-A-02-121.02We recommend that the Health Resources and Services Administration as part of its established and ongoing program integrity procedures, perform postpayment reviews of hospitals for compliance with the balance billing requirement, including the hospitals we identified that may not have complied, to ensure that patients were not billed more than their in-network amount and were refunded any improper billed amounts.- Status
- Closed Implemented
- Responsible Agency
- HRSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/08/2025
- Legislative Related
- No
-
New Jersey Did Not Ensure That Some Medicaid Personal Care Assistant Services Provided Under the Personal Preference Program Met Federal and State Requirements
25-A-02-119.01We recommend that the New Jersey Department of Human Services improve its oversight and monitoring of its New Jersey Medicaid PPP by requiring MCOs to revise their procedures to include: (1) maintaining PCA assessments, (2) completing PCA reassessments annually, (3) maintaining monthly budget amounts, and (4) updating monthly budget amounts in accordance with applicable PCA assessments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/14/2026
- Next Update Expected
- 10/14/2026
- Legislative Related
- No
25-A-02-119.02We recommend that the New Jersey Department of Human Services improve its oversight and monitoring of its New Jersey Medicaid PPP by requiring the fiscal intermediary to revise its procedures to include: (1) documenting participants' cash plans, (2) populating accurate information on cash plans, (3) documenting all services to be provided in participants' cash plans, and (4) completing and documenting OIG LEIE verifications for caregivers.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/14/2026
- Next Update Expected
- 10/14/2026
- Legislative Related
- No
-
Texas Did Not Calculate or Collect Hospice Cap Overpayments Totaling $10.5 Million
25-A-06-120.01We recommend that the Texas Health and Human Services Commission collect the hospice cap overpayments totaling $10,498,423 and refund the Federal share of $6,916,454 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $6,916,454
- Last Update Received
- 04/16/2026
- Next Update Expected
- 10/16/2026
- Legislative Related
- No
25-A-06-120.02We recommend that the Texas Health and Human Services Commission develop and implement policies and procedures related to calculating and collecting hospice cap overpayments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/16/2026
- Next Update Expected
- 10/16/2026
- Legislative Related
- No
-
Puerto Rico Medicaid Fraud Control Unit: 2024 Onsite Review
25-E-06-039.01Build upon its efforts to increase referrals from managed care organizations.- Status
- Closed Implemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/03/2026
- Legislative Related
- No
25-E-06-039.02Update its electronic case management system to address the system's limitations and provide further training on the system to Unit staff.- Status
- Open Unimplemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/10/2026
- Next Update Expected
- 03/10/2026
- Legislative Related
- No
25-E-06-039.03Implement a process to ensure that periodic supervisory case file reviews are conducted and documented on a consistent basis.- Status
- Closed Implemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/03/2026
- Legislative Related
- No
25-E-06-039.04Take steps to ensure that it reports all convictions and adverse actions to Federal partners within the appropriate timeframes.- Status
- Closed Implemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/03/2026
- Legislative Related
- No
-
Nursing Homes Failed To Report 43 Percent of Falls With Major Injury and Hospitalization Among Their Medicare-Enrolled Residents
25-E-05-040.01CMS should take steps to ensure the completeness and accuracy of the nursing home-reported Minimum Data Set data used to calculate the quality measures for falls with major injury.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 01/05/2026
- Next Update Expected
- 01/29/2027
- Legislative Related
- No
25-E-05-040.02CMS should explore whether approaches to improve the quality measures related to falls could similarly be used to improve the accuracy of other nursing home quality measures.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 01/05/2026
- Next Update Expected
- 01/29/2027
- Legislative Related
- No
-
The Patient Safety Organization Program: Key Barriers Impeding Nationwide Progress Toward Reducing Patient Harm in Hospitals
25-E-01-051.01AHRQ should increase alignment of the PSO program with other HHS patient safety efforts.- Status
- Open Unimplemented
- Responsible Agency
- AHRQ
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/09/2026
- Next Update Expected
- 03/11/2027
- Legislative Related
- No
25-E-01-051.02AHRQ should promote opportunities to involve patients and families in PSO activities.- Status
- Closed Implemented
- Responsible Agency
- AHRQ
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/11/2026
- Legislative Related
- No
25-E-01-051.03AHRQ should clarify cybersecurity protections and data use limitations for PSWP submitted to the NPSD.- Status
- Closed Implemented
- Responsible Agency
- AHRQ
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/11/2026
- Legislative Related
- No
25-E-01-051.04AHRQ should take steps to harness technologies and new data sources that could help address barriers facing the NPSD.- Status
- Open Unimplemented
- Responsible Agency
- AHRQ
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/09/2026
- Next Update Expected
- 03/11/2027
- Legislative Related
- No
-
Mississippi Did Not Report and Return All Medicaid Overpayments for the State’s Medicaid Fraud Control Unit Cases
25-A-06-118.01We recommend that the Mississippi Division of Medicaid work with CMS to determine whether any Federal share is owed for the six unreported cases that related to paid claims, totaling $4,163,439 ($3,495,018 Federal share).- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $3,495,018
- Last Update Received
- 03/31/2026
- Next Update Expected
- 09/30/2026
- Legislative Related
- No
25-A-06-118.02We recommend that the Mississippi Division of Medicaid work with any necessary State authorities to report and return the Federal share of the unreported MFCU-determined Medicaid overpayments that related to court-ordered awards that were collected, totaling $7,217 ($6,077 Federal share).- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $6,077
- Last Update Received
- 03/31/2026
- Next Update Expected
- 09/30/2026
- Legislative Related
- No
25-A-06-118.03We recommend that the Mississippi Division of Medicaid work with any necessary State authorities to identify MFCU collections of the remaining $138,588 ($114,483 Federal share) in court-ordered awards and report and return the Federal share if and when they are collected.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $114,483
- Last Update Received
- 03/31/2026
- Next Update Expected
- 09/30/2026
- Legislative Related
- No
25-A-06-118.04We recommend that the Mississippi Division of Medicaid strengthen internal controls by expanding written policies and procedures to include procedures for reviewing all checks and MFCU-determined Medicaid overpayment court documents received from the MFCU, recording them in the State agency's accounting system, reporting them on the Form CMS-64 within prescribed regulatory timeframes, and adding instructions on how to report court-ordered awards.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/31/2026
- Next Update Expected
- 09/30/2026
- Legislative Related
- No
25-A-06-118.05We recommend that the Mississippi Division of Medicaid work with any necessary State authorities to determine the Medicaid overpayments and court-ordered awards for cases after our audit period and include any unreported items on the Form CMS-64 according to Federal requirements.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/31/2026
- Next Update Expected
- 09/30/2026
- Legislative Related
- No
-
Hawaii Did Not Ensure That Selected Nursing Facilities Complied With Federal and State Background Check Requirements
25-A-09-117.01We recommend that the Hawaii Department of Human Services and the Department of Health conduct periodic reviews of nursing facilities' compliance with background check requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/21/2025
- Legislative Related
- No
-
By Requiring Emergency Preparedness Plans for Independent Labs, CMS Could Better Ensure That Medicare Enrollees Have Access to Infectious-Disease Diagnostic Testing During a Public Health Emergency
25-A-09-116.01We recommend that the Centers for Medicare & Medicaid Services consider requiring independent labs that participate in Medicare to have emergency preparedness plans to better ensure that Medicare enrollees have access to diagnostic testing related to an emerging infectious disease or a biological toxin in the event of a future PHE.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/11/2026
- Legislative Related
- No
-
ACF Did Not Award, Monitor, and Close Selected Contracts for the Unaccompanied Alien Children Program in Accordance With Federal Requirements
25-A-06-115.01We recommend that the Administration for Children and Families develop action plans to consider the use of advance contracts so that contracting officers can provide for full and open competition; adequately evaluate proposed prices; and confirm that contracts contain a detailed statement of work, all of the required clauses, and a quality assurance surveillance plan.- Status
- Closed Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/25/2026
- Legislative Related
- No
25-A-06-115.02We recommend that the Administration for Children and Families develop action plans to verify that contracts contain measurable performance standards.- Status
- Closed Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/25/2026
- Legislative Related
- No
25-A-06-115.03We recommend that the Administration for Children and Families develop action plans to implement policies and procedures for COR file management.- Status
- Closed Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/25/2026
- Legislative Related
- No
25-A-06-115.04We recommend that the Administration for Children and Families develop action plans to train contracting officers to improve the contract closeout process by deobligating excess funds within 30 days after completion of the contract and obtaining a release of all liabilities, obligations, and claims arising from the contract before issuing the final payment.- Status
- Closed Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/25/2026
- Legislative Related
- No
-
Most Children Enrolled in Medicaid Did Not Receive Timely Suicide-Related Followup Care
25-E-07-037.01CMS should assist low-performing States to better ensure that children at risk of suicide receive timely followup care.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/06/2026
- Next Update Expected
- 03/11/2027
- Legislative Related
- No
-
National Government Services, Inc., Reopened and Corrected Cost Report Final Settlements for Desk Reviews Only With Obvious Errors To Correct Payments Made to Medicare Providers
25-A-06-112.01We recommend that National Government Services, Inc. develop and provide additional education to desk reviewers and supervisors regarding applicable criteria and review requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/11/2026
- Legislative Related
- No
25-A-06-112.02We recommend that National Government Services, Inc. develop and implement enhanced procedures, which expand upon the current procedures and which are not limited to the additional training for which NGS has already identified a need, so that supervisors are better qualified to detect incorrect adjustments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/11/2026
- Legislative Related
- No
-
Novitas Solutions, Inc., Reopened and Corrected Cost Report Final Settlements for Desk Reviews Only With Obvious Errors To Correct Payments Made to Medicare Providers
25-A-06-111.01We recommend that Novitas Solutions, Inc. develop and provide additional education to desk reviewers and supervisors regarding applicable criteria and review requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/02/2025
- Legislative Related
- No
25-A-06-111.02We recommend that Novitas Solutions, Inc. develop and implement enhanced procedures, which expand upon the current procedures and which are not limited to the additional training for which Novitas has already identified a need, so that supervisors are better qualified to detect incorrect adjustments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/06/2026
- Legislative Related
- No
-
ACF Did Not Monitor States’ Compliance With All American Rescue Plan Child Care Stabilization Grant Provisions
25-A-02-110.01We recommend that the Administration for Children and Families develop a written plan that can be quickly tailored to fit the circumstances, in the event of future funding of new, emergency, or temporary CCDF programs that includes procedures to identify the key compliance provisions of the authorizing and appropriating legislation, effectively monitor compliance with key provisions, and assess and update the plan as program risk areas are identified.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 02/26/2026
- Legislative Related
- No
25-A-02-110.02We recommend that the Administration for Children and Families strengthen its procedures to assess the reliability of State-reported program data, collected for emergency, or temporary CCDF programs, prior to publishing such data.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 02/26/2026
- Legislative Related
- No
25-A-02-110.03We recommend that the Administration for Children and Families establish requirements that States develop internal controls and identify areas of risk for future emergency, or temporary CCDF programs.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 02/26/2026
- Legislative Related
- No
-
Some Medicaid Managed Care Plans Made Few or No Referrals of Potential Provider Fraud
25-E-03-036.01CMS should follow up with States that had Medicaid managed care plans with no referrals of potential provider fraud, waste, or abuse in 2022.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 02/23/2026
- Next Update Expected
- 02/10/2027
- Legislative Related
- No
25-E-03-036.02CMS should encourage States to increase the number of Medicaid managed care plans that have received State-led training on the fraud referral process.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/18/2026
- Legislative Related
- No
-
CMS Should Confirm It Is Receiving Medicare Postoperative Visit Data on Global Surgeries When Reporting Is Required
25-A-05-109.01We recommend that the Centers for Medicare & Medicaid Services confirm it is receiving CPT code 99024 data from practitioners that it expected would be reporting postoperative visits and notify any practitioners if no postoperative visits are reported.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/16/2026
- Next Update Expected
- 10/16/2026
- Legislative Related
- No
-
Most Health Centers Provide Some Behavioral Health Services to Patients With Substance Use Disorder, Despite Facing Challenges That Limit Comprehensive Treatment
25-E-BL-035.01HRSA should take additional steps to help health centers overcome barriers that impede provision of both drug counseling and medication for opioid use disorder (MOUD).- Status
- Closed Implemented
- Responsible Agency
- HRSA
- Response
- Partial Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/25/2026
- Legislative Related
- No