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
Views
OIG Recommendations Grouped by Report
Showing 261–280 of 1,340 reports, containing 4,323 recommendations
Sorted by latest release date
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The Substance Abuse and Mental Health Services Administration Did Not Ensure That Clinics Fully Complied With Federal Requirements When Awarding and Monitoring Certified Community Behavioral Health Clinic Expansion Grants
23-A-02-111.01We recommend that the Substance Abuse and Mental Health Services Administration improve its policies and procedures for awarding CCBHC-E grants to ensure that clinics comply with Federal requirements by establishing required time frames to verify that clinics met certification eligibility requirements, and processes to verify whether clinics entered into agreements with DCOs to provide certain services.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/25/2024
- Legislative Related
- No
23-A-02-111.02We recommend that the Substance Abuse and Mental Health Services Administration improve its policies and procedures for monitoring CCBHC-E grants to ensure that clinics comply with Federal requirements by establishing processes to verify that clinics filled key personnel positions, ensured key personnel met level-of-effort requirements, timely submitted FFRs, and properly reported cash on hand.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/25/2024
- Legislative Related
- No
-
Texas Made Capitation Payments for Enrollees Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Another State
23-A-05-113.01We recommend that the Texas Health and Human Services Commission resume and enhance procedures that are in accordance with Federal requirements and the State's unwinding process to identify and disenroll enrollees who are residing and enrolled in Medicaid managed care in another State.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/03/2023
- Legislative Related
- No
23-A-05-113.02We recommend that the Texas Health and Human Services Commission work with CMS to consider the potential use of T-MSIS data to identify potential cases of concurrent enrollment.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/03/2023
- Legislative Related
- No
-
Puerto Rico Claimed More Than $500 Thousand in Unallowable Medicaid Managed Care Payments for Enrollees Assigned More Than One Identification Number
23-A-02-109.01We recommend that the Puerto Rico Department of Health refund $516,762 to the Federal Government.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $516,762
- Last Update Received
- -
- Closed Date
- 10/17/2024
- Legislative Related
- No
23-A-02-109.02We recommend that the Puerto Rico Department of Health strengthen its process for ensuring that no person is issued more than one identification number.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/07/2024
- Legislative Related
- No
23-A-02-109.03We recommend that the Puerto Rico Department of Health establish policies and procedures with the Puerto Rico Health Insurance Administration (referred to in Spanish with acronym ASES) to ensure ASES recovers unallowable payments made on behalf of enrollees assigned more than one identification number.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/07/2024
- Legislative Related
- No
-
Risk Assessment of the Administration for Children and Families' Purchase Card Program for Fiscal Year 2021
23-A-04-107.01We recommend that ACF develop mitigating controls and strategies to lower the high and moderate risks we identified.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/14/2024
- Legislative Related
- No
-
CDC's Vaccines for Children Program Recipients Did Not Conduct Site Visits at Some Providers as Required
23-A-09-110.01We recommend that the Centers for Disease Control and Prevention work with program recipients to implement a plan and timeline to: (1) conduct the required site visits that are overdue and (2) verify the completion of followup actions that had not been completed by the deadlines.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/13/2024
- Legislative Related
- No
23-A-09-110.02We recommend that the Centers for Disease Control and Prevention develop an action plan to enforce site visit requirements by CDC's planned date of July 1, 2023.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/13/2024
- Legislative Related
- No
23-A-09-110.03We recommend that the Centers for Disease Control and Prevention complete the development and implementation of internal written policies and procedures for VFC program oversight activities, including oversight of program recipients' site visits to ensure that requirements are met.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/05/2024
- Legislative Related
- No
23-A-09-110.04We recommend that the Centers for Disease Control and Prevention update its Provider Education, Assessment, and Reporting online system to include interactive reminders or alerts related to overdue site visits and followup actions.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/05/2024
- Legislative Related
- No
-
Medicare Improperly Paid Acute-Care Hospitals for Inpatient Claims Subject to the Post-Acute-Care Transfer Policy Over a 4-Year Period, but CMS's System Edits Were Effective in Reducing Improper Payments by the End of the Period
23-A-09-108.01We recommend that the Centers for Medicare & Medicaid Services direct the MACs to recover from acute-care hospitals the portion of the $41,401,244 in identified overpayments for our audit period that are within the 4-year reopening period in accordance with CMS's policies and procedures.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $41,401,244
- Last Update Received
- 03/05/2025
- Next Update Expected
- 09/05/2025
- Legislative Related
- No
23-A-09-108.02We recommend that the Centers for Medicare & Medicaid Services instruct the MACs to, based on the results of this audit, notify appropriate providers (i.e., those for whom CMS determines this audit constitutes credible information of potential overpayments) so that the providers can exercise reasonable diligence to identify, report, and return any overpayments in accordance with the 60-day rule and identify any of those returned overpayments as having been made in accordance with this recommendation.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/05/2025
- Next Update Expected
- 09/05/2025
- Legislative Related
- No
-
Georgia Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control
23-A-04-106.01We recommend that the Georgia Department of Community Health follow up with the 19 nursing homes in this audit that demonstrated life safety, emergency preparedness, and infection control deficiencies to ensure that they have taken corrective actions.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/27/2023
- Legislative Related
- No
23-A-04-106.02We recommend that the Georgia Department of Community Health work with CMS to develop a risk-based approach to identify nursing homes where surveys should be conducted more frequently than once every 15 months, such as those with a history of multiple high-risk deficiencies or frequent management turnover.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Partial Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/27/2023
- Legislative Related
- No
23-A-04-106.03We recommend that the Georgia Department of Community Health develop a plan with CMS to address the foundational issues preventing more frequent surveys at nursing homes with a history of multiple high-risk deficiencies.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Partial Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/27/2023
- Legislative Related
- No
23-A-04-106.04We recommend that the Georgia Department of Community Health work with CMS to develop standardized life safety training for nursing home staff.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/27/2023
- Legislative Related
- No
-
Home Health Agencies Failed To Report Over Half of Falls With Major Injury and Hospitalization Among Their Medicare Patients
23-E-05-039.01CMS should take steps to ensure the completeness and accuracy of the HHA-reported OASIS data used to calculate the falls with major injury quality measure.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 05/10/2024
- Next Update Expected
- 06/10/2025
- Legislative Related
- No
23-E-05-039.02CMS should use data sources, in addition to OASIS assessments, to improve the accuracy of the quality measure related to falls with major injury.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 05/10/2024
- Next Update Expected
- 06/10/2025
- Legislative Related
- No
23-E-05-039.03CMS should ensure that HHAs submit required OASIS assessments when their patients are hospitalized.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 05/10/2024
- Next Update Expected
- 06/10/2025
- Legislative Related
- No
23-E-05-039.04CMS should explore whether improvements to the quality measure related to falls can also be used to improve the accuracy of other home health measures.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 05/10/2024
- Next Update Expected
- 06/10/2025
- Legislative Related
- No
-
Minnesota Medicaid Fraud Control Unit: 2022 Inspection
22-E-06-042.01Continue efforts to hire a second-line supervisor and assess whether additional supervisors are warranted to meet the Unit's oversight needs.- Status
- Closed Implemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/16/2024
- Legislative Related
- No
22-E-06-042.02Build upon its efforts to increase referrals of patient abuse or neglect.- Status
- Closed Implemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/16/2024
- Legislative Related
- No
22-E-06-042.03Implement a comprehensive case management system that allows for efficient access to case documents and information.- Status
- Open Unimplemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 05/10/2024
- Next Update Expected
- Legislative Related
- No
22-E-06-042.04Take steps to ensure that periodic supervisory reviews are conducted on a consistent basis and that case files include documentation of supervisory approvals.- Status
- Closed Implemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/16/2024
- Legislative Related
- No
-
Florida Did Not Refund $106 Million Federal Share of Medicaid Managed Care Rebates It Received for Calendar Years 2015 Through 2020
23-A-04-104.01We recommend that the Florida Agency for Health Care Administration refund $106,153,061 to the Federal Government, representing the Federal share of rebates for calendar years 2015 through 2019 that the State agency did not refund.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $106,153,061
- Last Update Received
- 11/04/2025
- Next Update Expected
- 05/04/2026
- Legislative Related
- No
-
Risk Assessment of the Administration for Children and Families' Travel Card Program for Fiscal Year 2021
23-A-04-105.01We recommend that ACF develop mitigating controls and strategies to lower the high and moderate risks we identified.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/19/2023
- Legislative Related
- No
-
Widespread Pandemic Disruption Spurred Innovation to State Paternity Establishment Practices
23-E-06-038.01OCSS should create forums for identifying and sharing State agency best practices in providing paternity establishment services.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2024
- Next Update Expected
- 03/07/2025
- Legislative Related
- No
23-E-06-038.02OCSS should bolster State agency resilience during emergencies.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2024
- Next Update Expected
- 03/07/2025
- Legislative Related
- No
-
Medicare Made $17.8 Million in Potentially Improper Payments for Opioid-Use-Disorder Treatment Services Furnished by Opioid Treatment Programs
23-A-09-103.01We recommend that the Centers for Medicare & Medicaid Services work with MACs to determine whether claims billed by OTPs for OUD treatment services complied with Medicare requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/30/2024
- Legislative Related
- No
23-A-09-103.02We recommend that the Centers for Medicare & Medicaid Services instruct MACs, based upon the results of this audit, to notify appropriate providers (i.e., those for whom CMS determines this audit constitutes credible information of potential overpayments) so that the providers can exercise reasonable diligence to identify, report, and return any overpayments, up to $17,817,121, in accordance with the 60-day rule and identify any of those returned overpayments as having been made in accordance with this recommendation.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $17,817,121
- Last Update Received
- -
- Closed Date
- 08/28/2024
- Legislative Related
- No
23-A-09-103.03We recommend that the Centers for Medicare & Medicaid Services instruct MACs to implement edits in their claims processing systems to prevent an OTP from being paid for: (1) a weekly bundle with a service date that was within a contiguous 7-day period of another weekly bundle's service date for the same enrollee at the same OTP or (2) two weekly bundles with the same service date for the same enrollee at the same OTP.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/06/2025
- Legislative Related
- No
23-A-09-103.04We recommend that the Centers for Medicare & Medicaid Services revise its billing guidance to specify that OTPs should not bill add-on HCPCS codes for take-home supplies of medication for the same episode of care that was already covered by a weekly bundle that included medication, and instruct MACs to implement edits in their claims processing systems to identify improperly billed claims for take?home medication.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/05/2025
- Next Update Expected
- 09/06/2025
- Legislative Related
- No
23-A-09-103.05We recommend that the Centers for Medicare & Medicaid Services develop billing requirements for OTPs to include OUD diagnosis codes on claims for OUD treatment services to indicate that enrollees have OUD diagnoses, and consider working with MACs to implement a system edit to ensure that OTP payments are made for enrollees only when OUD diagnosis codes are included on claims.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/05/2025
- Next Update Expected
- 09/06/2025
- Legislative Related
- No
23-A-09-103.06We recommend that the Centers for Medicare & Medicaid Services work with MACs to provide education on proper billing of intake activities to the 8 OTPs that billed 14 or more intake activity claims per enrollee during our audit period.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/22/2024
- Legislative Related
- No
-
Medicare Paid Independent Organ Procurement Organizations Over Half a Million Dollars for Professional and Public Education Overhead Costs That Did Not Meet Medicare Requirements
23-A-09-102.01We recommend that the Centers for Medicare & Medicaid Services instruct Palmetto GBA to recover $72,208 in unallowable Medicare payments by adjusting the applicable OPOs' cost reports to correct the $148,750 of unallowable professional and public education overhead costs reported, consistent with relevant laws and the agency's policies and procedures.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $72,208
- Last Update Received
- -
- Closed Date
- 02/02/2024
- Legislative Related
- No
23-A-09-102.02We recommend that the Centers for Medicare & Medicaid Services update applicable Medicare requirements to clarify which types of professional and public education overhead costs are unallowable (e.g., clarify whether the costs of meals provided to non-OPO employees for professional education and the costs of tickets to entertainment events purchased for the purpose of public education are unallowable), which could have saved Medicare an estimated $664,295 for professional and public education overhead costs during our audit period.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $592,087
- Last Update Received
- 04/07/2025
- Next Update Expected
- 10/07/2025
- Legislative Related
- No
-
Texas Inappropriately Claimed Nearly $1.8 Million in Federal Medicaid Funds for Private Medicaid Management Information System Contractor Costs
23-A-06-100.01We recommend that the Texas Department of Health and Human Services Commission refund the $1,776,003 Federal share to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,776,003
- Last Update Received
- 09/25/2025
- Next Update Expected
- 03/25/2026
- Legislative Related
- No
23-A-06-100.02We recommend that the Texas Department of Health and Human Services Commission ensure DIR costs are allocated to Medicaid based on an approved methodology in the CAP.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/14/2023
- Legislative Related
- No
23-A-06-100.03We recommend that the Texas Department of Health and Human Services Commission establish policies and procedures to ensure that its contractors' employees complete timesheets with sufficient detail of actual effort by project to support costs allocated to Medicaid.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/14/2023
- Legislative Related
- No
23-A-06-100.04We recommend that the Texas Department of Health and Human Services Commission strengthen policies and procedures to track its private MMIS contractor costs to APDs and ensure that the Federal match is claimed at the approved rate and ensure that it doesn't claim costs when it is reimbursed for those costs by other agencies.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/14/2023
- Legislative Related
- No
-
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Presbyterian Health Plan, Inc. (Contract H3204) Submitted to CMS
23-A-07-099.01We recommend that Presbyterian Health Plan, Inc., refund to the Federal Government the $1,302,682 of estimated net overpayments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,302,682
- Last Update Received
- 09/15/2025
- Next Update Expected
- 03/15/2026
- Legislative Related
- No
23-A-07-099.02We recommend that Presbyterian Health Plan, Inc., identify, for the high-risk diagnoses included in this report, similar instances of noncompliance that occurred before or after our audit period and refund any resulting overpayments to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 09/15/2025
- Next Update Expected
- 03/15/2026
- Legislative Related
- No
23-A-07-099.03We recommend that Presbyterian Health Plan, Inc., continue its examination of its existing compliance procedures to identify areas where improvements can be made to ensure that diagnosis codes that are at high risk for being miscoded comply with Federal requirements (when submitted to CMS for use in CMS's risk adjustment program) and take the necessary steps to enhance those procedures.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 09/15/2025
- Next Update Expected
- 03/15/2026
- Legislative Related
- No
-
First Coast Service Options, Inc., Did Not Claim Some Allowable Medicare Supplemental Executive Retirement Plan Costs
23-A-07-095.01We recommend that First Coast work with CMS to ensure that its final settlement of contract costs reflects an increase in Medicare SERP costs of $266,886 for CYs 2015 through 2018.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/28/2024
- Legislative Related
- No
-
First Coast Service Options, Inc., Overstated Its Medicare Segment Postretirement Benefit Assets as of January 1, 2019
23-A-07-096.01We recommend that First Coast Service Options, Inc., decrease the Medicare segment PRB assets by $211,471 as of January 1, 2019.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/30/2024
- Legislative Related
- No
-
First Coast Service Options, Inc., Did Not Claim Some Allowable Medicare Postretirement Benefit Costs
23-A-07-097.01We recommend that First Coast work with CMS to ensure that its final settlement of contract costs reflects an increase in Medicare PRB costs of $762,388 for CYs 2015 through 2018.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/06/2025
- Legislative Related
- No
-
First Coast Service Options, Inc., Claimed Some Unallowable Medicare Nonqualified Plan Costs Through Its Incurred Cost Proposals
23-A-07-098.01We recommend that First Coast work with CMS to ensure that its final settlement of contract costs reflects a decrease in Medicare nonqualified costs of $73,194 for CYs 2015 through 2018.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $73,194
- Last Update Received
- -
- Closed Date
- 10/28/2024
- Legislative Related
- No