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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 positive change, we produce reports and identify recommendations for improvement. We have developed this public-facing page for tracking all of our open recommendations. Learn More
Summary of Recommendations Data
Updated Monthly · Last updated on September 16, 2024
1,350
Unimplemented
recommendations
$281.0B
Potential savingsfrom unimplemented recommendations
2,589
Implemented and Closed
recommendations since FY 2017
OIG Recommendations Grouped by Report
Views
Showing 21–40 of 1,200 reports, containing 3,939 recommendations
Sorted by latest release date
-
The National Institutes of Health Has Made Progress But Could Further Improve Its Closeout Process for Grants and Similar Awards
24-A-04-084.01We recommend that the National Institutes of Health formalize the recently implemented FRPPR monitoring control into NIH policy.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/24/2024
- Legislative Related
- No
24-A-04-084.02We recommend that the National Institutes of Health facilitate timely unilateral closeout within 1 year of the PPE date by implementing a policy that requires the unilateral closeout process be completed early enough to allow for final closeout within 1 year of the PPE date; and providing additional training to staff involved in the closeout process to increase staff awareness (i.e., sending monitoring reports to ICs for awards eligible for unilateral closeout).- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/24/2024
- Legislative Related
- No
24-A-04-084.03We recommend that the National Institutes of Health create policies and procedures for reporting award recipients in SAM.gov that do not submit the required final reports within 1 year of the award PPE date.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/24/2024
- Legislative Related
- No
24-A-04-084.04We recommend that the National Institutes of Health retroactively report all recipients with unilateral closeout actions in calendar year 2023 in SAM.gov.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/24/2024
- Legislative Related
- No
-
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
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/20/2024
- 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
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/20/2024
- 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
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/20/2024
- Legislative Related
- No
24-E-07-018.04ACF should work with States to improve reporting of placement data in NCANDS.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/20/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $20,134,402
- Last Update Received
- -
- Next Update Expected
- 12/19/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/19/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/19/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/16/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/16/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/16/2024
- 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
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/16/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/10/2024
- 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
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/10/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/10/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/10/2024
- 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
- Open Unimplemented
- Responsible Agency
- FDA
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- FDA
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- FDA
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- FDA
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- FDA
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/09/2024
- 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
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/09/2024
- 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
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- FDA
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- FDA
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- MFCU
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 12/04/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/23/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/23/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/23/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/23/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/23/2024
- 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
- Not Yet Due
- Potential Savings
- $236,587
- Last Update Received
- -
- Next Update Expected
- 11/19/2024
- 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
- Not Yet Due
- Potential Savings
- $1,377,025
- Last Update Received
- -
- Next Update Expected
- 11/19/2024
- 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
- Open Unimplemented
- Responsible Agency
- CDC
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/19/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 08/23/2024
- Next Update Expected
- 02/25/2025
- Legislative Related
- No
-
Department of Health and Human Services Met Many Requirements, but It Did Not Fully Comply With the Payment Integrity Information Act of 2019 and Applicable Improper Payment Guidance for the Fiscal Year 2023
24-A-17-077.01We recommend that HHS continue to develop and implement the enhanced policies and procedures in place to fulfill the requirement of assessing all programs with annual outlays greater than $10 million at least once every three years. Additionally, we recommend that HHS continue to work with OMB to develop an approach and obtain concurrence to perform risk assessments at a level that meets the intent of PIIA.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/15/2024
- Legislative Related
- No
24-A-17-077.02We recommend that HHS continue advocating for legislative changes and work with OMB and other stakeholders to develop and implement an approach to calculating and reporting on TANF IPs going forward. This process will aid in identifying root causes of TANF IPs and allow HHS to report CAPs in the AFR.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/15/2024
- Legislative Related
- No
24-A-17-077.03We recommend that HHS to continue to train HHS regional staff, IV-E agencies and other stakeholders on the updated Title IV-E review guide and monitor the implementation to report on Foster Care in FY 2024.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/15/2024
- Legislative Related
- No
24-A-17-077.04We recommend that HHS focus on the root causes of the IP percentage and evaluate critical and feasible action steps to assist states with their compliance efforts for these requirements. This would include working with the states to bring their respective systems into full compliance with the requirements to decrease the IP rate percentage below 10 percent. HHS should work with the states to follow up on repeat root causes of errors and enhance the CAPs for implementation. In addition, as HHS reviews only 17 states each year for the CHIP IP rate, HHS should continue to follow up with states during the interim period to verify that corrective actions identified after the Payment Error Rate Measurement (PERM) review are being implemented. HHS should also consider sharing corrective action best practices across states to help address these issues. Additionally, HHS should continue to focus on corrective actions around eligibility as there is an increased risk that the rates for Medicaid- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/15/2024
- Legislative Related
- No
24-A-17-077.05We recommend that HHS improve its recovery audit efforts as required under PIIA (that part codified at 31 U.S.C. § 3352(i)(1)(A)) to identify and recoup overpayments for Medicare Part C. HHS should also continue to explore alternative vehicles to conduct recovery audits that will fit into the larger Medicare Part C program in FY 2024 in the event that the RADV program cannot effectively serve as HHS' sole recovery audit strategy. If using a recovery audit contractor approach is determined not to be cost-effective, HHS should document how existing programs are cost-effective when compared to the use of a recovery audit contractor.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/15/2024
- Legislative Related
- No
24-A-17-077.06We recommend that HHS continue to work with OMB and other relevant stakeholders to complete the IP measurement program for the State-based Exchanges to report a full and accurate IP estimate.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/15/2024
- Legislative Related
- No
24-A-17-077.07We recommend that HHS enhance its corrective action plans that focus on the root causes of the IP percentage, such as medical record discrepancies, which make up nearly 88 percent of Medicare Part C IP. Evaluate and document critical and feasible action steps to improve reduction targets and demonstrate improvements to payment integrity.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/15/2024
- Legislative Related
- No
24-A-17-077.08We recommend that HHS should include in its UIP estimation methodology an evaluation of patient eligibility and consider alternative methods to perform this evaluation if data limitations exist.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/15/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/14/2024
- 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
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/14/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/14/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/14/2024
- Legislative Related
- No
24-E-01-016.02NIH should develop additional ways of supporting researchers in meeting inclusion enrollment targets.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/14/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/14/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $673,686
- Last Update Received
- -
- Next Update Expected
- 11/13/2024
- 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
- -
- Next Update Expected
- 11/13/2024
- 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
- -
- Next Update Expected
- 11/13/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/13/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/13/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- $7,469,306
- Last Update Received
- -
- Next Update Expected
- 11/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- $73,515
- Last Update Received
- -
- Next Update Expected
- 11/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/09/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/08/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/08/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/08/2024
- 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
- -
- Next Update Expected
- 11/07/2024
- 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
- -
- Next Update Expected
- 11/07/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/07/2024
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 07/29/2024
- Next Update Expected
- 01/30/2025
- 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
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 07/29/2024
- Next Update Expected
- 01/30/2025
- 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
- 07/29/2024
- Next Update Expected
- 01/30/2025
- 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
- 07/29/2024
- Next Update Expected
- 01/30/2025
- 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
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/25/2024
- 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
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/25/2024
- 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
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/25/2024
- 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
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/25/2024
- 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
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/25/2024
- 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
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/25/2024
- 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
- Open Unimplemented
- Responsible Agency
- SAMHSA
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/21/2024
- 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
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/21/2024
- 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
- Open Unimplemented
- Responsible Agency
- SAMHSA
- Response
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/21/2024
- 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
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/21/2024
- 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
- Not Yet Due
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/21/2024
- Legislative Related
- No