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 May 15, 2026
1,085
Unimplemented
recommendations
3,387
Implemented and Closed
recommendations since FY 2017
Views
OIG Recommendations Grouped by Report
Showing 1,181–1,200 of 1,390 reports, containing 4,472 recommendations
Sorted by latest release date
-
Enhancements Needed in the Tracking and Collection of Medicare Overpayments Identified by ZPICs and PSCs
17-E-03-043.02CMS should identify strategies to increase MACs' collection of ZPIC- and UPIC-referred overpayments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 10/18/2023
- Next Update Expected
- 11/14/2024
- Legislative Related
- No
17-E-03-043.05CMS should implement the surety bond requirement for home health providers and consider the feasibility of implementing surety bonds for other providers based on their level of risk.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 09/27/2022
- Next Update Expected
- 12/05/2023
- Legislative Related
- No
-
The Turtle Mountain Band of Chippewa Indians Improperly Administered Some Low-Income Home Energy Assistance Program Funds for Fiscal Years 2010 Through 2013
17-A-07-189.01We recommend that TMT refund to the Federal Government $587,248 in unsupported and unallowable LIHEAP funds.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- $587,248
- Last Update Received
- -
- Closed Date
- 12/01/2023
- Legislative Related
- No
17-A-07-189.02We recommend that TMT determine how much of the $96,932 that energy suppliers returned to the tribe was returned after the 2-year grant period and repay the Federal Government that amount.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- $96,932
- Last Update Received
- -
- Closed Date
- 12/01/2023
- Legislative Related
- No
-
Hawaii Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations
17-A-09-188.01We recommend that the State agency bill for and collect from manufacturers rebates for pharmacy drugs and refund to the Federal Government $8,045,840 (Federal share).- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $8,045,840
- Last Update Received
- -
- Closed Date
- 05/16/2023
- Legislative Related
- No
17-A-09-188.02We recommend that the State agency bill for and collect from manufacturers rebates for single-source and top-20 multiple-source physician-administered drugs and refund to the Federal Government $1,632,332 (Federal share).- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,632,332
- Last Update Received
- -
- Closed Date
- 05/02/2023
- Legislative Related
- No
17-A-09-188.03We recommend that the State agency work with CMS to determine whether the non-top-20 multiple-source physician-administered drugs were eligible for rebates and, if so, upon receipt of the rebates, refund up to $57,783 (Federal share) of rebates collected.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/02/2023
- Legislative Related
- No
17-A-09-188.04We recommend that the State agency work with CMS to determine whether the other physician-administered drugs, associated with 122,436 claim lines, were eligible for rebates and, if so, determine the rebates due and upon receipt of the rebates refund the Federal share of the rebates collected.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/23/2022
- Legislative Related
- No
17-A-09-188.05We recommend that the State agency determine which physician-administered drugs were not billed for rebates after our audit period, determine the rebates due, and upon receipt of the rebates refund the Federal share of the rebates collected.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/22/2022
- Legislative Related
- No
-
Challenges Remain in FDA's Inspections of Domestic Food Facilities
17-E-02-042.03FDA should improve the timeliness of FDA's actions, including warning letters, so that facilities do not continue to operate under harmful conditions.- Status
- Open Unimplemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/09/2026
- Next Update Expected
- 03/24/2027
- Legislative Related
- No
-
Some Oklahoma Group Homes Did Not Always Comply With State Requirements
17-A-06-186.03We recommend that the State agency revise the State licensing requirement for the monitoring of vehicles used to transport children to ensure that the State agency monitors all vehicles at least annually.- Status
- Closed Acceptable Alternative
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/23/2023
- Legislative Related
- No
-
CMS Did Not Provide Effective Oversight To Ensure That State Marketplaces Always Properly Determined Individuals' Eligibility for Qualified Health Plans and Insurance Affordability Programs
17-A-09-185.01We recommend that CMS set firm deadlines for marketplaces to fully develop system functionality for verifying applicants' eligibility and resolving inconsistencies, assess potential enforcement mechanisms that would ensure that marketplaces meet those deadlines, and, if such mechanisms are identified, seek legislative authority to establish them.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/30/2026
- Legislative Related
- Yes
17-A-09-185.05We recommend that CMS continue to work with marketplaces to develop the reporting capability to ensure that all required data elements in the Quarterly Metrics Reports are submitted.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/06/2023
- Legislative Related
- No
17-A-09-185.06We recommend that CMS require marketplaces to submit additional data elements related to average length of time to resolve inconsistencies, number of unresolved inconsistencies, and number of applicants for whom the marketplace received an FTR response code from the IRS and who were determined eligible for insurance affordability programs.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/06/2023
- Legislative Related
- No
-
OHRP Should Inform Potential Complainants of How They Can Seek Whistleblower Protections
17-E-01-040.02OHRP should request that HHS consider the adequacy of whistleblower protections for complainants who make disclosures to OHRP about human subjects protections.- Status
- Closed Implemented
- Responsible Agency
- OASH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/02/2022
- Legislative Related
- No
-
Vulnerabilities Remain in Medicare Hospital Outlier Payments
17-A-07-175.02We recommend that CMS determine whether the cost reports that had exceeded the 3-year reopening limit may be reopened due to similar fault and, if so, work with the Medicare contractors to reopen them.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/05/2022
- Legislative Related
- No
17-A-07-175.03We recommend that CMS ensure that the Medicare contractors review all cost reports submitted since the end of the audit periods in our previous reviews and ensure that those whose outlier payments qualified for reconciliation are correctly identified, referred, and reconciled in accordance with Federal guidelines.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/05/2022
- Legislative Related
- No
17-A-07-175.04We recommend that CMS maintain a system that identifies and tracks all cost reports that Medicare contractors have referred for reconciliation and that recalculates outlier payments on the basis of claim submissions made by hospitals.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/27/2023
- Legislative Related
- No
-
Drug Supply Chain Security: Wholesalers Exchange Most Tracing Information
17-E-05-038.02FDA should provide technical assistance regarding exempt products.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/24/2022
- Legislative Related
- No
-
New York State Improperly Claimed Medicaid Reimbursement for Some Managed Long-Term Care Payments
17-A-02-170.02We recommend that DOH ensure that future contracts with MLTC plans include provisions that allow the State agency to recover payments when plans do not comply with contract requirements. This measure could have saved the Medicaid program approximately $1.4 billion ($717 million Federal share) during SFY 2014.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $717,473,637
- Last Update Received
- 01/22/2018
- Next Update Expected
- 09/11/2022
- Legislative Related
- No
-
Companion Data Services, LLC, Overstated Its Medicare Segment Pension Assets
17-A-07-165.01We recommend that CDS decrease its Medicare segment pension assets as of January 1, 2013 by $117,880 and recognize $10,430,248 as the CDS Medicare segment pension assets.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/03/2022
- Legislative Related
- No
-
Texas Improperly Received Medicaid Reimbursement for School-Based Health Services
17-A-06-152.01We recommended that the State agency refund to the Federal Government the $18,925,853 Federal share of unallowable reimbursement that was claimed for the Medicaid SHARS program because the random moments were coded incorrectly.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $18,925,853
- Last Update Received
- -
- Closed Date
- 02/27/2025
- Legislative Related
- No
-
Maine Did Not Comply With Federal and State Requirements for Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities
17-A-01-149.02We recommend that the State agency fully implement its own regulations regarding the reporting and monitoring of critical incidents involving Medicaid beneficiaries with developmental disabilities residing in community residences. Specifically, we recommend that the State agency work with community-based providers to ensure that administrative reviews are conducted and reported appropriately.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/11/2023
- Legislative Related
- No
-
Oklahoma Did Not Adequately Oversee Its Medicaid Nonemergency Medical Transportation Program
17-A-06-144.01We recommend that the State agency improve its oversight and monitoring of its Medicaid NEMT brokerage program by requiring that LogistiCare strengthen its procedures to ensure that (1) transport personnel are licensed and qualified, (2) NEMT services are adequately documented, (3) vehicles used to transport Medicaid beneficiaries meet State requirements (4) beneficiaries receive Medicaid-eligible medical services on the date of transportation, and (5) NEMT services are provided.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/08/2022
- Legislative Related
- No
17-A-06-144.02We recommend the State agency ensure that managed care contracts with the transportation broker contain provisions that (1) consider improper claims to the transportation broker when developing future capitated rates paid by the State agency and (2) provide a means for the State agency to recoup funds from the transportation broker when contract provisions 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
- 02/08/2022
- Legislative Related
- No
-
OHRP Generally Conducted Its Compliance Activities Independently, But Changes Would Strengthen Its Independence
17-E-01-028.01HHS should address factors that may limit OHRP's ability to operate independently.- Status
- Open Unimplemented
- Responsible Agency
- OASH
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 01/25/2019
- Legislative Related
- No
17-E-01-028.02OHRP should post the following on its website: (a) a description of its approach to oversight and (b) data (in aggregate) on the full array of its compliance activities.- Status
- Closed Implemented
- Responsible Agency
- OASH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/12/2024
- Legislative Related
- No
-
Some Hospitals in Medicare Jurisdiction E Claimed Residents as More Than One Full-Time Equivalent
17-A-02-141.01We recommend that Noridian recover $434,531 in excess Medicare GME reimbursement paid to 36 hospitals in MAC Jurisdiction E.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $434,531
- Last Update Received
- 04/02/2026
- Next Update Expected
- 10/03/2026
- Legislative Related
- No
-
Some Hospitals in Medicare Jurisdiction F Claimed Residents as More Than One Full-Time Equivalent
17-A-02-142.01We recommend that Noridian recover $365,387 in excess Medicare GME reimbursement paid to 21 hospitals in MAC Jurisdiction F.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $365,387
- Last Update Received
- -
- Closed Date
- 12/29/2022
- Legislative Related
- No
-
First Coast Service Options, Inc., Understated Its Medicare Segment and Overstated Its Other Segment Allocable Postretirement Benefit Costs
17-A-07-135.01We recommend that FCSO increase the Medicare segment PRB costs used to calculate its indirect cost rates by $50,387 for CYs 2008 through 2012.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/03/2022
- Legislative Related
- No
17-A-07-135.02We recommend that FCSO decrease the Other segment PRB costs used to calculate its indirect cost rates by $3,357,884 for CYs 2008 through 2012.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/03/2022
- Legislative Related
- No
-
First Coast Service Options, Inc., Overstated Its Medicare Segment Postretirement Benefit Assets
17-A-07-133.01We recommend that FCSO decrease its Medicare segment PRB assets by $4,997,091 as of January 1, 2013.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/03/2022
- Legislative Related
- No
-
Medicare Could Save Millions by Eliminating the Lump-Sum Purchase Option for All Power Mobility Devices
17-A-05-119.01We recommend that CMS seek legislation to eliminate the lump-sum payment option for all PMDs. If such legislation had been in place during CYs 2011 through 2014, Medicare could have saved at least an additional $10,245,539.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/04/2026
- Legislative Related
- Yes