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 March 26, 2026
1,162
Unimplemented
recommendations
3,267
Implemented and Closed
recommendations since FY 2017
Views
OIG Recommendations Grouped by Report
Showing 201–220 of 1,376 reports, containing 4,429 recommendations
Sorted by latest release date
-
Many States Lack Information To Monitor Maltreatment in Residential Facilities for Children in Foster Care
24-E-07-018.01ACF should provide guidance and technical assistance to States to build data collection and monitoring capabilities that are foundational to effective oversight of maltreatment in residential facilities.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/02/2026
- Legislative Related
- No
24-E-07-018.02ACF should help States to improve their abilities to monitor patterns of maltreatment and performance across chains of residential facilities operating in multiple States.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/02/2026
- Legislative Related
- No
24-E-07-018.03ACF should take steps to improve inter-State communication when children are placed in out-of-State residential facilities.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/02/2026
- Legislative Related
- No
24-E-07-018.04ACF should work with States to improve reporting of placement data in NCANDS.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/20/2025
- Legislative Related
- No
-
North Carolina Did Not Report and Return All Medicaid Overpayments for the State’s Medicaid Fraud Control Unit Cases
24-A-06-083.01We recommend that the North Carolina Department of Health and Human Services report and return the Federal share for the seven unreported cases, totaling $30,352,630 ($20,134,402 Federal share).- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $20,134,402
- Last Update Received
- -
- Closed Date
- 03/04/2026
- Legislative Related
- No
24-A-06-083.02We recommend that the North Carolina Department of Health and Human Services strengthen internal controls by expanding written policies and procedures to include procedures for requesting, recording, and reporting all MFCU-determined Medicaid overpayments within prescribed regulatory timeframes, and ensuring they received all case files.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/27/2026
- Legislative Related
- No
24-A-06-083.03We recommend that the North Carolina Department of Health and Human Services work with the MFCU to determine the Medicaid overpayments for cases after our audit period and ensure that all overpayments are reported on the Form CMS-64.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/27/2026
- Legislative Related
- No
-
NIH Did Not Close Contracts in Accordance With Federal Requirements, Resulting in the Increased Risk of Fraud, Waste, and Abuse
24-A-04-082.01We recommend that the National Institutes of Health complete the administrative closeout requirements for the 29 contracts totaling more than $1.9 billion identified in our audit.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/10/2025
- Legislative Related
- No
24-A-04-082.02We recommend that the National Institutes of Health incorporate, by reference, the administrative closeout requirements from the FAR and HHSCCD into the NIH Policy Manual.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/13/2026
- Legislative Related
- No
24-A-04-082.03We recommend that the National Institutes of Health update the NIH Policy Manual to address migration of contract file records to new contract management systems; preservation of all contract file records when employees depart the agency; and prevention of contract records from being destroyed before contract closeout has occurred.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/13/2026
- Legislative Related
- No
24-A-04-082.04We recommend that the National Institutes of Health establish control activities for monitoring the performance of contract personnel's compliance with administrative closeout requirements.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 12/01/2025
- Next Update Expected
- 06/01/2026
- Legislative Related
- No
-
CMS Could Strengthen Program Safeguards To Prevent and Detect Improper Medicare Payments for Short Inpatient Stays
24-A-09-081.01To strengthen program safeguards for preventing and detecting improper payments for short inpatient stays and recovering overpayments for claims that do not comply with Medicare requirements, we recommend that the Centers for Medicare & Medicaid Services work with its contractors to add information to inpatient claims indicating any stay that did not span two or more midnights because of an unforeseen circumstance (e.g., a condition code).- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/25/2025
- Legislative Related
- No
24-A-09-081.02To strengthen program safeguards for preventing and detecting improper payments for short inpatient stays and recovering overpayments for claims that do not comply with Medicare requirements, we recommend that the Centers for Medicare & Medicaid Services work with its contractors to develop a list of ICD-10 procedure codes associated with the HCPCS codes on the inpatient only procedures list.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Partial Concur
- Potential Savings
- -
- Last Update Received
- 12/02/2025
- Next Update Expected
- 06/02/2026
- Legislative Related
- No
24-A-09-081.03To strengthen program safeguards for preventing and detecting improper payments for short inpatient stays and recovering overpayments for claims that do not comply with Medicare requirements, we recommend that the Centers for Medicare & Medicaid Services work with its contractors to implement prepayment edits for claims for short inpatient stays at risk for noncompliance with the two-midnight rule (i.e., short inpatient stays with risk factors such as canceled procedures or certain MS-DRGs).- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/17/2025
- Legislative Related
- No
24-A-09-081.04To strengthen program safeguards for preventing and detecting improper payments for short inpatient stays and recovering overpayments for claims that do not comply with Medicare requirements, we recommend that the Centers for Medicare & Medicaid Services work with its contractors to update policies and procedures for postpayment reviews to focus on claims for short inpatient stays identified as at risk for noncompliance with the two-midnight rule and recovery of overpayments (e.g., through additional reviews by RACs or other contractors).- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/23/2024
- Legislative Related
- No
-
The Food and Drug Administration’s Inspection and Recall Process Should Be Improved To Ensure the Safety of the Infant Formula Supply
24-A-01-080.01We recommend that the Food and Drug Administration prioritize maintaining the NCCC's continuity of operations by cross-training staff on whistleblower policies and procedures and NCCC duties, including monitoring the Occupational Safety and Health Administration whistleblower email inbox.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/28/2025
- Legislative Related
- No
24-A-01-080.02We recommend that the Food and Drug Administration develop and implement policies and procedures requiring periodic reporting (e.g.,monthly reporting) to senior leadership on the status of open whistleblower complaints.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/30/2025
- Legislative Related
- No
24-A-01-080.03We recommend that the Food and Drug Administration implement policies and procedures that facilitate reporting consumer complaints in real time to investigators onsite when an active inspection is occurring at the facility identified in the complaint.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/16/2025
- Legislative Related
- No
24-A-01-080.04We recommend that the Food and Drug Administration strengthen the QFC process to identify data entry inaccuracies.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/30/2025
- Legislative Related
- No
24-A-01-080.05We recommend that the Food and Drug Administration formalize written policies and procedures that either require that the CAERS coordinator forward all reports that originate in CAERS to the NCCC or identify specific factors that the CAERS coordinator must consider when determining if adverse event reports should be forwarded to the NCCC, and include specific examples of types of adverse event reports that do not need to be forwarded to the NCCC.- Status
- Closed Acceptable Alternative
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/19/2024
- Legislative Related
- No
24-A-01-080.06We recommend that the Food and Drug Administration develop policies and procedures that FDA can use during future public health emergencies to identify how and when it is necessary to conduct mission-critical inspections and ensure that mission-critical inspections are conducted in a timely manner.- Status
- Open Unimplemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 12/10/2024
- Next Update Expected
- 06/19/2025
- Legislative Related
- No
24-A-01-080.07We recommend that the Food and Drug Administration design and implement policies and procedures specific to the use of its FDA-required infant formula recall authority.- Status
- Open Unimplemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 12/10/2024
- Next Update Expected
- 06/19/2025
- Legislative Related
- No
24-A-01-080.08We recommend that the Food and Drug Administration amend the language on the CAERS adverse event report form to emphasize the importance of including the lot number to encourage the public to report this information.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/19/2024
- Legislative Related
- No
24-A-01-080.09We recommend that the Food and Drug Administration continue to seek legislative authority to require infant formula manufacturers to notify and provide the bacterial isolate to FDA every time a product sample is found to be positive for Cronobacter or Salmonella, even if the affected lots have not been distributed, and update its existing databases with the information received.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/30/2025
- Legislative Related
- Yes
-
Washington Medicaid Fraud Control Unit: 2023 Inspection
24-E-09-017.01Implement new policies and procedures to ensure required reporting of convictions and adverse actions to Federal partners.- Status
- Closed Implemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/02/2025
- Legislative Related
- No
-
Medicare Remains Vulnerable to Fraud, Waste, and Abuse Related to Off-the-Shelf Orthotic Braces, Which May Result in Improper Payments and Impact the Health of Enrollees
24-A-09-079.01We recommend that the Centers for Medicare & Medicaid Services determine why claims that did not have the required modifiers were paid for replacement OTS braces, and take steps to prevent payments for such claims.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/28/2024
- Legislative Related
- No
24-A-09-079.02We recommend that the Centers for Medicare & Medicaid Services identify providers who ordered OTS braces for enrollees with whom they had no treating relationships and use that information to determine whether to provide additional education to�or take administrative or legal action against�the ordering providers or associated suppliers.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/03/2024
- Legislative Related
- No
24-A-09-079.03We recommend that the Centers for Medicare & Medicaid Services analyze supplier billing patterns and use that information to determine whether to conduct additional prepayment or postpayment reviews of suppliers or impose a temporary moratorium on enrolling new suppliers of OTS braces if CMS determines that there is significant potential for fraud, waste, or abuse.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/03/2024
- Legislative Related
- No
24-A-09-079.04We recommend that the Centers for Medicare and Medicaid Services review Medicare allowable amounts for OTS braces that are not currently in the DMEPOS Competitive Bidding Program to ensure that Medicare payments for OTS braces are reasonably comparable with payments made by non-Medicare payers, and determine whether to include any of those procedure codes for braces in future rounds of competitive bidding.- Status
- Closed Superseded
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/02/2024
- Legislative Related
- No
24-A-09-079.05We recommend that the Centers for Medicare & Medicaid Services educate suppliers and enrollees on telemarketing practices for OTS braces, specifically on not using direct solicitation of enrollees, and consider revoking billing privileges of suppliers that engage in prohibited solicitation practices.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/21/2025
- Legislative Related
- No
24-A-09-079.06We recommend that the Centers for Medicare & Medicaid Services use predictive data analysis and information from other Federal agencies and from State agencies to identify emerging fraud schemes related to OTS braces, and use CMS's authority to prevent further losses to the Medicare program.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/03/2024
- Legislative Related
- No
-
Selected CDC Racial and Ethnic Approaches to Community Health Program Recipients Generally Complied With Federal Requirements But Did Not Meet All Targets and Charged Some Unallowable Costs
24-A-02-078.01We recommend that the Centers for Disease Control and Prevention require the five recipients in our sample identified as having charged unallowable REACH program costs to refund $236,587 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CDC
- Response
- Partial Concur
- Potential Savings
- $236,587
- Last Update Received
- 12/17/2025
- Next Update Expected
- 06/17/2026
- Legislative Related
- No
24-A-02-078.02We recommend that the Centers for Disease Control and Prevention require the six recipients in our sample that may have improperly charged salary, related fringe benefit, and overhead costs to the REACH program award to refund $1,377,025 to the Federal Government or work with the recipients to determine what portion of these costs is allocable to their REACH program award and refund any unallocable portion of these costs to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CDC
- Response
- Partial Concur
- Potential Savings
- $1,377,025
- Last Update Received
- 12/17/2025
- Next Update Expected
- 06/17/2026
- Legislative Related
- No
24-A-02-078.03We recommend that the Centers for Disease Control and Prevention provide additional technical assistance to recipients to ensure that only allowable, allocable, and documented costs are charged to their REACH program awards.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/07/2024
- Legislative Related
- No
-
California Improperly Claimed $52.7 Million in Federal Medicaid Reimbursement for Capitation Payments Made on Behalf of Noncitizens With Unsatisfactory Immigration Status
24-A-09-076.01We recommend that the California Department of Health Care Services refund to the Federal Government the improperly claimed Federal reimbursement of $52,652,689 for capitation payments made on behalf of noncitizens with UIS.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $52,652,689
- Last Update Received
- -
- Closed Date
- 08/25/2024
- Legislative Related
- No
24-A-09-076.02We recommend that the California Department of Health Care Services work with CMS to determine the amount of any improperly claimed Federal reimbursement for capitation payments made on behalf of noncitizens with UIS for an agreed-upon period not covered by our audit.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2025
- Legislative Related
- No
-
Medicaid Managed Care: States Do Not Consistently Define or Validate Paid Amount Data for Drug Claims
24-E-03-015.01CMS should revise the T-MSIS Data Dictionary to instruct States to report the paid amount as the amount paid to the pharmacy for all Medicaid managed care drug claims.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/13/2024
- Legislative Related
- No
24-E-03-015.02CMS should provide additional technical assistance to States to clarify what to include or exclude from the reported paid amounts to providers for Medicaid managed care drug claims.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 08/19/2025
- Next Update Expected
- 09/11/2026
- Legislative Related
- No
24-E-03-015.03CMS should follow up with States that did not verify that paid amounts for managed care drug claims were complete.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/11/2025
- Legislative Related
- No
-
Plans and Enrollment Often Fell Short for Underrepresented Groups in a Sample of NIH-Funded Clinical Trials
24-E-01-016.01NIH should hold researchers accountable for clearly describing the rationale for planned study population, as required by NIH policy.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/31/2025
- Legislative Related
- No
24-E-01-016.02NIH should develop additional ways of supporting researchers in meeting inclusion enrollment targets.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/03/2024
- Legislative Related
- No
24-E-01-016.03NIH should promptly take steps to align NIH's demographic data collection and reporting with the revised OMB requirements and obtain more precise clinical trial inclusion enrollment data.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/06/2026
- Legislative Related
- No
-
Colorado Did Not Report and Refund the Correct Federal Share of Medicaid-Related Overpayments for Some Cases Identified by the State’s Program Integrity Section
24-A-07-075.01We recommend that the Colorado Department of Health Care Policy and Financing report and refund $385,180 ($673,686 Federal share) (footnote 10) in unreported Medicaid overpayments that were related to paid claims that have been recovered and collected.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $673,686
- Last Update Received
- -
- Closed Date
- 11/17/2025
- Legislative Related
- No
24-A-07-075.02We recommend that the Colorado Department of Health Care Policy and Financing determine the value of overpayments identified after our audit period that have been recovered and collected but not reported, report them on the Form CMS-64, and refund the Federal share of the recovered overpayments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 09/24/2025
- Next Update Expected
- 05/17/2026
- Legislative Related
- No
24-A-07-075.03We recommend that the Colorado Department of Health Care Policy and Financing work with CMS to determine the amount of interest, if any, on the Federal share owed by the State agency and report that amount to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 09/24/2025
- Next Update Expected
- 05/17/2026
- Legislative Related
- No
24-A-07-075.04We recommend that the Colorado Department of Health Care Policy and Financing strengthen policies and procedures to ensure that overpayments are reported correctly and in a timely manner on the Form CMS-64 in accordance with Federal requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/16/2024
- Legislative Related
- No
24-A-07-075.05We recommend that the Colorado Department of Health Care Policy and Financing update policies and procedures to ensure that Medicaid overpayments are reported on the Form CMS-64.9C1 if recovered or on the Form CMS-64.9OFWA if not recovered within timeframes specified by Federal requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/16/2024
- Legislative Related
- No
-
New York Medical College Claimed Unallowable Grant Costs and Did Not Meet Certain Financial Conflict of Interest Requirements
24-A-04-074.01We recommend that New York Medical College work with NIH to determine the allowability of $7,469,306 in salary and wages, fringe benefits, and related indirect costs that the College charged to its NIH awards during our audit period and refund any identified overpayments.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Partial Concur
- Potential Savings
- $7,469,306
- Last Update Received
- -
- Closed Date
- 11/13/2024
- Legislative Related
- No
24-A-04-074.02We recommend that New York Medical College refund $73,515 in unallowable salary costs, cost transfers, and travel costs.- Status
- Closed Acceptable Alternative
- Responsible Agency
- NIH
- Response
- Partial Concur
- Potential Savings
- $73,515
- Last Update Received
- -
- Closed Date
- 11/13/2024
- Legislative Related
- No
24-A-04-074.03We recommend that New York Medical College strengthen its internal controls by developing a policy or procedure for monitoring salaries so that they are at or under the NIH salary cap.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/13/2024
- Legislative Related
- No
24-A-04-074.04We recommend that New York Medical College strengthen its internal controls by developing a policy or procedure that requires compensation costs to be reasonable, conform to established College policy, and be consistently applied regardless of the source of the funds and that reasonably reflects the percentage of time actually devoted to its NIH-funded projects.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/13/2024
- Legislative Related
- No
24-A-04-074.05We recommend that New York Medical College strengthen its internal controls by working with NIH to quantify and refund any additional salary increases charged to NIH awards that were not reasonable, did not conform to established College policy, and were not consistently applied regardless of the source of funds.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/13/2024
- Legislative Related
- No
24-A-04-074.06We recommend that New York Medical College strengthen its internal controls completing the timely certification of employee time and effort reports to provide reasonable assurance that the charges are accurate, allowable, and properly allocated.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/13/2024
- Legislative Related
- No
24-A-04-074.07We recommend that New York Medical College strengthen its internal controls by establishing time requirements for employees to sign and supervisors to review effort certification forms.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/13/2024
- Legislative Related
- No
24-A-04-074.08We recommend that New York Medical College strengthen its internal controls by developing a cost transfer policy that includes the documentation requirements contained in NIH GPS 7.5.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/13/2024
- Legislative Related
- No
24-A-04-074.09We recommend that New York Medical College strengthen its internal controls by providing employees training on the specific types of travel expenses that the College considers non-reimbursable, such as alcohol and airline seat selection fees and training on the documentation needed to support travel costs.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/13/2024
- Legislative Related
- No
24-A-04-074.10We recommend that New York Medical College strengthen its internal controls by monitoring key individuals' completion of annual FCOI disclosure forms and completion of required FCOI training.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/13/2024
- Legislative Related
- No
-
State Agencies Could Be Obtaining Hundreds of Millions in Additional Medicaid Rebates Associated With Physician-Administered Drugs
24-A-07-073.01We recommend that the Centers for Medicare & Medicaid Services work with the State agencies to implement internal controls, including policies and procedures, to collect NDCs, in order to facilitate the collection of all rebates for eligible physician-administered drugs.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/13/2024
- Legislative Related
- No
24-A-07-073.02We recommend that the Centers for Medicare & Medicaid Services issue finalized guidance regarding multiple-source physician-administered drugs, to clarify and reinforce the requirement that rebates should be collected for all required physician-administered drugs.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/17/2024
- Legislative Related
- No
24-A-07-073.03We recommend that the Centers for Medicare & Medicaid Services work with and encourage the State agencies to maximize the amount of physician administered drug rebates that can be obtained when feasible, including invoicing for and obtaining rebates in cases when the rebates may not be required.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/13/2024
- Legislative Related
- No
-
New Mexico Should Refund Almost $120 Million to the Federal Government for Medicaid Nursing Facility Level-of-Care Managed Care Capitated Payments
24-A-06-072.01We recommend that the New Mexico Human Services Department recoup $139,232,902 in Community Benefit services capitated payments from its MCOs and refund the $98,582,176 in Federal share to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $98,582,176
- Last Update Received
- 10/15/2025
- Next Update Expected
- 04/16/2026
- Legislative Related
- No
24-A-06-072.02We recommend that the New Mexico Human Services Department recoup the $29,442,388 in NFLOC capitated payments from its MCOs and refund the $20,536,132 Federal share to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $20,536,132
- Last Update Received
- 10/15/2025
- Next Update Expected
- 04/16/2026
- Legislative Related
- No
24-A-06-072.03We recommend that the New Mexico Human Services Department establish policies and procedures to recoup NFLOC capitated payments made to its MCOs based on settings-of-care that are removed after payment and no longer valid.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/16/2025
- Legislative Related
- No
-
California Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements
24-A-09-070.01We recommend that the California Department of Health Care Services redetermine eligibility for the nine sampled enrollees whose eligibility was incorrectly determined and the five sampled enrollees whose eligibility may have been incorrectly determined.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/22/2025
- Legislative Related
- No
24-A-09-070.02We recommend that the California Department of Health Care Services provide caseworkers additional training to reduce errors related to: (1) calculating and verifying income, (2) entering income information into the county case management system, and (3) using electronic data sources when verifying enrollees' reported income.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/07/2025
- Legislative Related
- No
24-A-09-070.03We recommend that the California Department of Health Care Services revise its guidance to instruct counties to document in case files essential information to support enrollees' continuing eligibility, including: (1) attempts to review enrollees' eligibility on a manual ex parte basis and (2) income and household information provided by the enrollee in person.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 05/17/16
- Next Update Expected
- 03/30/2026
- Legislative Related
- No
24-A-09-070.04We recommend that the California Department of Health Care Services identify and correct the system issues that prevented the State agency from renewing enrollees' eligibility on an ex parte basis when those enrollees should have been determined eligible and from sending a notice of termination to enrollees.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 05/17/16
- Next Update Expected
- 03/30/2026
- Legislative Related
- No
-
The Office of Intergovernmental and External Affairs’ Purchase Card Program Did Not Comply With Federal and HHS Requirements
24-A-03-069.01We recommend that the Office of Intergovernmental and External Affairs create and maintain a centralized database to store supporting documentation for all purchase card transactions to align with Program Guide requirements.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/18/2025
- Legislative Related
- No
24-A-03-069.02We recommend that the Office of Intergovernmental and External Affairs remind cardholders and AOs of the documentation and reconciliation requirements outlined in Federal and HHS requirements and provide them with a copy of the Program Guide as part of the annual refresher training process.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/18/2025
- Legislative Related
- No
24-A-03-069.03We recommend that the Office of Intergovernmental and External Affairs remind AOs to notify the Property Management Office when purchases of accountable property are made by IEA cardholders to ensure accountability and timely updating of the property records in the PMIS.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/18/2025
- Legislative Related
- No
24-A-03-069.04We recommend that the Office of Intergovernmental and External Affairs provide to all cardholders and AOs training that encompasses the requirements related to the purchase of sensitive items, including properly completing the HHS-755 and tracking purchases in the PMIS.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/18/2025
- Legislative Related
- No
24-A-03-069.05We recommend that the Office of Intergovernmental and External Affairs remind AOs to provide timely notice of separated cardholders to the A/OPC and remind cardholders to contact their AO timely before separating so that all outstanding purchase card transactions can be processed and reconciled before separation from employment as part of the annual refresher training process.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/18/2025
- Legislative Related
- No
24-A-03-069.06We recommend that the Office of Intergovernmental and External Affairs work with the HHS A/OPC to create and maintain a centralized database as required by the Program Guide that captures the training certificates of all cardholders and AOs, including certificates for the annual refresher training.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/18/2025
- Legislative Related
- No
-
West Virginia Lacked Effective Oversight of Its Opioid Response Grants
24-A-06-067.01We recommend that West Virginia's Bureau of Behavioral Health include requirements in its procedures to maintain documentation used to prepare the annual progress report.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/29/2025
- Legislative Related
- No
24-A-06-067.02We recommend that West Virginia's Bureau of Behavioral Health conduct a periodic review of supporting documentation (e.g., invoices, payroll registers, and time-and-effort reports) for any subrecipient expenditures submitted to BBH.- Status
- Open Unimplemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 02/06/2026
- Next Update Expected
- 08/06/2026
- Legislative Related
- No
24-A-06-067.03We recommend that West Virginia's Bureau of Behavioral Health revise pre-designed progress reports to capture the necessary data to determine whether program goals are being met.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/29/2025
- Legislative Related
- No
24-A-06-067.04We recommend that West Virginia's Bureau of Behavioral Health provide training to program managers to ensure that advanced payments are being approved as close as administratively feasible to actual disbursements by the subrecipient.- Status
- Open Unimplemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 02/06/2026
- Next Update Expected
- 08/06/2026
- Legislative Related
- No
24-A-06-067.05We recommend that West Virginia's Bureau of Behavioral Health revise procedures to ensure that subrecipient agreements are finalized and closed out with returned funds recorded in the general ledger prior to filing the Federal financial report.- Status
- Open Unimplemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 02/06/2026
- Next Update Expected
- 08/06/2026
- Legislative Related
- No
-
Ohio Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements
24-A-05-066.01We recommend that the Ohio Department of Medicaid take appropriate action with respect to the incorrect Medicaid eligibility determinations identified in our sample.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/30/2024
- Legislative Related
- No
24-A-05-066.02We recommend that the Ohio Department of Medicaid provide periodic training to caseworkers about verifying and documenting enrollees' income during the renewal process.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/21/2025
- Legislative Related
- No
24-A-05-066.03We recommend that the Ohio Department of Medicaid provide additional training to caseworkers about using current information when conducting enrollee eligibility determinations.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/21/2025
- Legislative Related
- No
-
CMS Could Improve Its Procedures for Setting Medicare Clinical Diagnostic Laboratory Test Rates Under the Clinical Laboratory Fee Schedule for Future Public Health Emergencies
24-A-01-065.01We recommend that the Centers for Medicare & Medicaid Services establish procedures to improve communication among all stakeholders involved in setting new CDLT rates during a PHE.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2025
- Next Update Expected
- 10/09/2025
- Legislative Related
- No
24-A-01-065.02We recommend that the Centers for Medicare & Medicaid Services improve its procedures, which may require seeking legislative authority, for setting and adjusting rates for new CDLTs during a PHE by providing the MACs with the flexibility needed to set and adjust payment rates that would cover the laboratory costs of providing services when responding to a PHE.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 03/28/2025
- Next Update Expected
- 10/09/2025
- Legislative Related
- No