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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 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 November 14, 2025

1,188

Unimplemented
recommendations

3,135

Implemented and Closed
recommendations since FY 2017

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OIG's Top Unimplemented Recommendations

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Comprising monetary, programmatic, legislative, and procedural recommendations related to HHS Operating Divisions, full implementation of these recommendations could produce substantial savings for the Federal Government and taxpayers and improve the operation of HHS programs.
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Showing 1–4 of 4 recommendations Sorted by oldest release date
  • Centers for Medicare and Medicaid Services
    PROGRAM
    CHANGE

    CMS's Encounter Data Lack Essential Information That Medicare Advantage Organizations Have the Ability to Collect
    20-E-03-037.01
    CMS should require MAOs to submit the ordering provider NPI on encounter records for DMEPOS and for laboratory, imaging, and home health services.
    PROGRAM
    CHANGE
    Implementation requires the responsible agency to change a program’s policies, activities, requirements, etc.

    Status
    Open Unimplemented
    Issued to CMS
    08/24/2020
    Evaluation Report
    OEI-03-19-00430
  • Centers for Medicare and Medicaid Services
    PROGRAM
    CHANGE

    High Rates of Prior Authorization Denials by Some Plans and Limited State Oversight Raise Concerns About Access to Care in Medicaid Managed Care
    23-E-09-029.04
    CMS should require States to implement automatic external medical reviews of upheld MCO prior authorization denials.
    PROGRAM
    CHANGE
    Implementation requires the responsible agency to change a program’s policies, activities, requirements, etc.

    Status
    Open Unimplemented
    Issued to CMS
    07/17/2023
    Evaluation Report
    OEI-09-19-00350
  • Centers for Medicare and Medicaid Services
    PROCESS
    CHANGE

    CMS Did Not Ensure That Selected States Complied With Medicaid Managed Care Mental Health and Substance Use Disorder Parity Requirements
    24-A-02-050.03
    We recommend that the Centers for Medicare & Medicaid Services improve its oversight of States' compliance with MH/SUD parity requirements, including following up with any States that have identified any noncompliance with parity requirements to verify that the States have taken actions to address the noncompliance.
    PROCESS
    CHANGE
    Implementation requires the responsible agency to change a program’s system or procedure.

    This recommendation was implemented on September 16, 2025 after the OIG's list of Top Unimplemented Recommendations was published.
    Status
    Closed Implemented
    Issued to CMS
    03/25/2024
    Audit Report
    A-02-22-01016
  • Centers for Medicare and Medicaid Services
    $4.2B
    Potential Savings

    Medicare Advantage: Questionable Use of Health Risk Assessments Continues To Drive Up Payments to Plans by Billions
    25-E-03-003.01
    CMS should impose additional restrictions on the use of diagnoses reported only on in-home HRAs or chart reviews that are linked to in-home HRAs for risk-adjusted payments.
    $4.2B
    Potential Savings

    Status
    Open Unimplemented
    Issued to CMS
    10/21/2024
    Evaluation Report
    OEI-03-23-00380