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 461–480 of 1,376 reports, containing 4,429 recommendations
Sorted by latest release date
-
In Five States, There Was No Evidence That Many Children in Foster Care Had a Screening for Sex Trafficking When They Returned After Going Missing
22-E-07-025.01ACF should work with States to improve compliance with requirements to screen children who return to foster care after going missing to identify whether they are victims of sex trafficking.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/20/2022
- Legislative Related
- No
22-E-07-025.02ACF should encourage all States to evaluate the value of adding an assessment of risk for sex trafficking when children return to foster care after going missing.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 11/14/2023
- Next Update Expected
- 11/20/2024
- Legislative Related
- No
22-E-07-025.03ACF should conduct oversight activities to identify States that may not screen all children for sex trafficking when they return to foster care after going missing.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 11/14/2023
- Next Update Expected
- 11/20/2024
- Legislative Related
- No
-
The Centers for Medicare & Medicaid Services Had Policies and Procedures in Place To Mitigate Vulnerabilities in a Timely Manner, but Improvements Are Needed
22-A-18-071.01Remediate the vulnerabilities identified on internet-facing systems and implement procedures to ensure compliance with BOD 19-02 requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/18/2023
- Legislative Related
- No
22-A-18-071.02Implement procedures to ensure that unsupported software that no longer receives security updates, repairs, bug fixes, and threat mitigation is replaced prior to the known EOS or implement compensating controls (if possible) and accept risk in accordance with existing CMS policies and procedures.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/18/2023
- Legislative Related
- No
22-A-18-071.03Implement oversight to ensure corrective actions are performed in accordance with Federal requirements and in the timeframe set forth in CMS policy.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/18/2023
- Legislative Related
- No
22-A-18-071.04Implement a process to centralize the monitoring and reporting of vulnerabilities identified in all CMS systems across all CMS data centers.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/18/2023
- Legislative Related
- No
-
The Food and Drug Administration's Foreign For-Cause Drug Inspection Program Can Be Improved To Protect the Nation's Drug Supply
22-A-01-069.01We recommend that the Food and Drug Administration identify and implement additional ways to improve the timeliness of its foreign for-cause drug inspection process.- Status
- Open Unimplemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2025
- Next Update Expected
- 09/06/2025
- Legislative Related
- No
22-A-01-069.02We recommend that the Food and Drug Administration consider streamlining the process for writing and reviewing EIRs to minimize potential delays due to unexpected events.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/12/2024
- Legislative Related
- No
22-A-01-069.03We recommend that the Food and Drug Administration conduct an analysis of the workloads of individuals responsible for: (1) determining final classification, (2) issuing warning letters, and (3) holding regulatory meetings, and address any potential issues identified by this analysis.- Status
- Open Unimplemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2025
- Next Update Expected
- 09/06/2025
- Legislative Related
- No
22-A-01-069.04We recommend that the Food and Drug Administration implement policies and procedures to ensure that lead investigators assigned to inspections have completed the Level 1 Investigator Certification Process.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/13/2025
- Legislative Related
- No
22-A-01-069.05We recommend that the Food and Drug Administration ensure that supervisors review investigators' qualifications and document that they meet applicable training requirements when the investigator training records do not exist.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/20/2024
- Legislative Related
- No
22-A-01-069.06We recommend that the Food and Drug Administration review the training records of the lead investigators that were outside the scope of the audit to verify that documentation supports either that the investigators completed the required training courses, Level 1 Performance Audit, and Level 1 Investigator Certification; or that investigators are recommended as "experienced investigators" by supervisors and have completed training courses equivalent to the current required training courses.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/20/2024
- Legislative Related
- No
-
More Than 90 Percent of the New Hampshire Managed Care Organization and Fee-for-Service Claims for Opioid Treatment Program Services Did Not Comply With Medicaid Requirements
22-A-01-070.01We recommend that the New Hampshire Department of Health and Human Services refund $7,943,271 to the Federal Government.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $7,943,271
- Last Update Received
- -
- Closed Date
- 07/03/2023
- Legislative Related
- No
22-A-01-070.02We recommend that the New Hampshire Department of Health and Human Services ensure that providers comply with Federal and State requirements for providing and claiming Medicaid reimbursement for OTP services by considering whether BDAS needs additional resources to oversee providers, and working with providers to recruit, retain, and train personnel on skills to adequately track and document OTP services rendered to patients.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/03/2023
- Legislative Related
- No
22-A-01-070.03We recommend that the New Hampshire Department of Health and Human Services improve communication with providers regarding the State requirements for OUD treatment and provide written confirmation to providers about whether offsite counseling may be included as a required counseling service.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/03/2023
- Legislative Related
- No
-
Office of Refugee Resettlement's Influx Care Facility and Emergency Intake Sites Did Not Adequately Safeguard Unaccompanied Children From COVID-19
22-A-06-068.01We recommend that the Office of Refugee Resettlement develop a process to clearly communicate COVID-19 guidance and updates to the appropriate staff at the EISs so that staff have a full understanding of what is required of them to help protect against the spread of COVID-19.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/16/2023
- Legislative Related
- No
22-A-06-068.02We recommend that the Office of Refugee Resettlement reiterate to facilities that they must comply with ORR's COVID-19 testing and reporting requirements and with State reporting requirements.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/16/2023
- Legislative Related
- No
22-A-06-068.03We recommend that the Office of Refugee Resettlement improve and increase training provided to facilities regarding COVID-19 mitigation strategies.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/07/2023
- Legislative Related
- No
22-A-06-068.04We recommend that the Office of Refugee Resettlement perform routine oversight of facilities to reinforce implementation and compliance with all requirements related to COVID-19.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/16/2023
- Legislative Related
- No
-
Iowa Medicaid Fraud Control Unit: 2021 Inspection
22-E-12-028.01Assess the adequacy of existing staffing levels, and if warranted, develop a plan to expand the size of the Unit.- Status
- Closed Implemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/03/2022
- Legislative Related
- No
-
Medicare and Beneficiaries Paid Substantially More to Provider-Based Facilities in Eight Selected States in Calendar Years 2010 Through 2017 Than They Paid to Freestanding Facilities in the Same States for the Same Type of Services
22-A-07-067.01We recommend that CMS pursue legislative or regulatory changes to lower costs for both the Medicare program and beneficiaries, by equalizing payments as appropriate between provider based facilities and freestanding facilities for E&M services.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 12/11/2023
- Next Update Expected
- 06/11/2024
- Legislative Related
- No
-
Maine Implemented Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Critical Incidents
22-A-01-066.01We recommend that the Maine Department of Health and Human Services continue to work with CMS to fully implement the prior recommendation to ensure that followup reports are submitted by community-based providers appropriately.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/11/2023
- Legislative Related
- No
22-A-01-066.02We recommend that the Maine Department of Health and Human Services ensure that the Mortality Review Committee reviews Mortality Review Form aggregate data to identify patterns and trends and to make recommendations to improve care.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/11/2023
- Legislative Related
- No
-
Inaccuracies in Medicare's Race and Ethnicity Data Hinder the Ability To Assess Health Disparities
22-E-02-022.01CMS should develop its own source of race and ethnicity data.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/11/2025
- Legislative Related
- No
22-E-02-022.02CMS should use self-reported race and ethnicity information to improve data for current beneficiaries.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/11/2025
- Legislative Related
- No
22-E-02-022.03CMS should develop a process to ensure that the data are as standardized as possible.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 07/20/2023
- Next Update Expected
- 12/11/2026
- Legislative Related
- No
22-E-02-022.04CMS should educate beneficiaries about CMS's efforts to improve the race and ethnicity information.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/11/2025
- Legislative Related
- No
-
Opportunities Exist To Strengthen NIH Grantees' Oversight of Investigators' Foreign Significant Financial Interests and Other Support
22-E-03-021.01NIH should ensure that grantees comply with Federal requirements to train investigators regarding disclosure of significant financial interests.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/20/2022
- Legislative Related
- No
22-E-03-021.02NIH should ensure that grantees conduct the required review of investigators' significant financial interests to determine whether conflicts exist.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/20/2022
- Legislative Related
- No
22-E-03-021.03NIH should specifically require grantees to provide trainings and maintain a written policy regarding investigators' disclosure of other support.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 08/20/2025
- Next Update Expected
- 09/15/2026
- Legislative Related
- No
22-E-03-021.04NIH should modify reporting mechanisms to require grantees to report whether investigators' significant financial interests and other support involve foreign entities.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 08/20/2025
- Next Update Expected
- 09/15/2026
- Legislative Related
- No
22-E-03-021.05NIH should conduct outreach to grantees with R13 conference grants to clarify requirements regarding the disclosure and review of investigators' significant financial interests and other support.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/02/2024
- Legislative Related
- No
22-E-03-021.06NIH should clarify whether and how grantees should verify investigators' significant financial interests and other support prior to submitting information to NIH.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/08/2023
- Legislative Related
- No
22-E-03-021.07NIH should establish a method for grantees to share their best practices for identifying and reviewing investigators' foreign significant financial interests and other support.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/08/2023
- Legislative Related
- No
-
Cost Allocation Services Needs To Update Its Indirect Cost Rate-Setting Guidance
22-A-06-065.01We recommend that CAS update its Review Guide to conform with applicable Federal regulations and CAS internal policies and procedures.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/30/2022
- Legislative Related
- No
22-A-06-065.02We recommend that CAS take steps to ensure that branch chiefs and negotiators follow all Federal and internal CAS requirements.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/30/2022
- Legislative Related
- No
22-A-06-065.03We recommend that CAS include all federally required documents on checklists provided to the nonprofit organizations and on checklists used by CAS officials.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/30/2022
- Legislative Related
- No
22-A-06-065.04We recommend that CAS review its staffing levels and determine whether resources are aligned efficiently, and adjust as needed, to ensure that the indirect cost rate-setting process is conducted in a timely manner.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/30/2022
- Legislative Related
- No
22-A-06-065.05We recommend that CAS seek clarification on whether the policy of including executive compensation higher than the Level II statutory cap in its indirect cost pool calculation complies with Federal law and governmentwide policy.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/30/2022
- Legislative Related
- No
22-A-06-065.06We recommend that CAS ensure that negotiated final indirect cost rates are calculated based on actual costs.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 11/30/2022
- Legislative Related
- No
-
Medicare Improperly Paid Durable Medical Equipment Suppliers an Estimated $8 Million of the $40 Million Paid for Power Mobility Device Repairs
22-A-09-063.01We recommend that the Centers for Medicare & Medicaid Services instruct the DME MACs to recover $41,137 in overpayments for PMD repairs made to PMDs that belonged to 76 sampled beneficiaries.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $41,137
- Last Update Received
- -
- Closed Date
- 11/30/2023
- Legislative Related
- No
22-A-09-063.02We recommend that the Centers for Medicare & Medicaid Services instruct the DME MACs to notify the suppliers to refund $10,494 in coinsurance that was collected from the 76 sampled beneficiaries.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/19/2023
- Legislative Related
- No
22-A-09-063.03We recommend that the Centers for Medicare & Medicaid Services instruct the DME MACs to based upon the results of this audit, notify appropriate suppliers (i.e., those for whom CMS determines this audit constitutes credible information of potential overpayments) so that the suppliers 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
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/27/2023
- Legislative Related
- No
22-A-09-063.04We recommend that the Centers for Medicare & Medicaid Services instruct the DME MACs to improve the education of suppliers on Medicare requirements for PMD repairs and for documenting labor time spent on repairs.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/30/2023
- Legislative Related
- No
22-A-09-063.05We recommend that the Centers for Medicare & Medicaid Services work with the DME MACs to do the following, which could have saved Medicare an estimated $7,948,182 during our audit period: implement a system edit that applies to all PMD repairs and identifies PMD repairs for review of supplier documentation to help ensure that PMD repairs are adequately documented and that the PMD repair charges are reasonable and necessary.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $7,948,182
- Last Update Received
- -
- Closed Date
- 08/15/2024
- Legislative Related
- No
22-A-09-063.06We also recommend that the Centers for Medicare & Medicaid Services work with the DME MACs to do the following, which could have saved Medicare an estimated $7,948,182 during our audit period; Implement a system edit to determine whether PMD repair charges exceed the estimated cost to replace the PMDs being repaired.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 02/03/2025
- Next Update Expected
- 08/04/2025
- Legislative Related
- No
22-A-09-063.07We recommend that the Centers for Medicare & Medicaid Services establish Medicare requirements that: (1) include the documentation standards established by guidance for PMD repairs; (2) specify that accumulated costs of repairs made to power wheelchairs during their 5 year RUL must not exceed a certain threshold; and (3) specify that suppliers must provide warranties for repairs made to PMDs, which could have saved Medicare an estimated $3,739,346 during our audit period.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $3,739,346
- Last Update Received
- 04/04/2025
- Next Update Expected
- 10/04/2025
- Legislative Related
- No
-
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Peoples Health Network (Contract H1961) Submitted to CMS
22-A-06-060.01We recommend that Peoples Health Network refund to the Federal Government the $3,312,219 in estimated overpayments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Partial Concur
- Potential Savings
- $3,312,219
- Last Update Received
- 10/01/2025
- Next Update Expected
- 04/01/2026
- Legislative Related
- No
22-A-06-060.02We recommend that Peoples Health Network 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
- 10/01/2025
- Next Update Expected
- 04/01/2026
- Legislative Related
- No
22-A-06-060.03We recommend that Peoples Health Network enhance 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
- 10/01/2025
- Next Update Expected
- 04/01/2026
- Legislative Related
- No
-
Vanderbilt University Medical Center: Audit of Outpatient Outlier Payments
22-A-06-061.01We recommend that Vanderbilt University Medical Center refund to the Medicare contractor the portion of the $686,500 in estimated outpatient outlier net overpayments for incorrectly billed claims that are within the 4-year reopening period.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $686,500
- Last Update Received
- -
- Closed Date
- 12/22/2022
- Legislative Related
- No
22-A-06-061.02We recommend that Vanderbilt University Medical Center based on the results of this audit, 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
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/22/2022
- Legislative Related
- No
22-A-06-061.03We recommend that Vanderbilt University Medical Center improve procedures and provide education to staff to ensure that claims billed to Medicare are accurate.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/27/2024
- Legislative Related
- No
22-A-06-061.04We recommend that Vanderbilt University Medical Center implement changes to its billing system to ensure that claims billed to Medicare are accurate.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/27/2024
- Legislative Related
- No
-
Texas Did Not Report and Return All Medicaid Overpayments for the State's Medicaid Fraud Control Unit's Cases
22-A-06-059.01We recommend that the Texas Health and Human Services Commission report and return the Federal share for the 26 cases, totaling $19 million ($11.1 million Federal share).- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $11,122,401
- Last Update Received
- -
- Closed Date
- 08/24/2022
- Legislative Related
- No
22-A-06-059.02We recommend that the Texas Health and Human Services Commission strengthen internal controls by developing written policies and procedures, including procedures for recording MFCU-determined Medicaid overpayments, and reconciling case files received from the MFCU with the overpayments recorded in the State agency's accounting system.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/24/2022
- Legislative Related
- No
22-A-06-059.03We recommend that the Texas Health and Human Services Commission ensure that it reports all MFCU-determined Medicaid overpayments in accordance with Federal regulations and within regulatory timeframes.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/24/2022
- Legislative Related
- No
22-A-06-059.04We recommend that the Texas Health and Human Services Commission review the MFCU-determined Medicaid overpayments for cases after our audit period to ensure that all overpayments were reported on the Form CMS-64.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/08/2023
- Legislative Related
- No
-
Washington State Did Not Comply With Federal and State Requirements for Claiming Enhanced Federal Reimbursement for Medicaid Managed-Care Health Home Service Expenditures
22-A-09-055.01We recommend that the Washington State Health Care Authority refund to the Federal Government $374,579 for managed-care health home service encounters that were no longer supported.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $374,579
- Last Update Received
- -
- Closed Date
- 06/30/2023
- Legislative Related
- No
22-A-09-055.02We recommend that the Washington State Health Care Authority refund to the Federal Government $29,161 for the 195 encounters that exceeded the number of reportable health home service encounters that were allowed for a beneficiary.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $29,161
- Last Update Received
- -
- Closed Date
- 06/30/2023
- Legislative Related
- No
22-A-09-055.03We recommend that the Washington State Health Care Authority determine the portion of the remaining $1,367,120 that should have been claimed for managed-care health home service expenditures based on the portion of the MCOs' capitation payment rate that was specifically attributable to health home services, and refund any unallowable amounts.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/24/2025
- Legislative Related
- No
22-A-09-055.04We recommend that the Washington State Health Care Authority review all managed-care health home encounters from July 1, 2013, through March 31, 2017, to determine the enhanced Federal reimbursement that should have been claimed for Medicaid managed-care health home service expenditures based on the portion of the MCOs' capitation payment rate that was specifically attributable to health home services and refund to the Federal Government any unallowable amounts.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/24/2025
- Legislative Related
- No
22-A-09-055.05We recommend that the Washington State Health Care Authority review all managed-care health home encounters from July 1, 2013, through March 31, 2017, to identify whether the encounters used to support claims for enhanced Federal reimbursement have since been removed from the encounter data and refund to the Federal Government any amounts that are no longer supported.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/24/2025
- Legislative Related
- No
22-A-09-055.06We recommend that the Washington State Health Care Authority review all managed-care health home encounters from July 1, 2013, through March 31, 2017, to identify whether the encounters exceeded the number of reportable encounters that were allowed for an enrolled beneficiary and refund to the Federal Government any amounts related to unallowable encounters.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/24/2025
- Legislative Related
- No
22-A-09-055.07We recommend that the Washington State Health Care Authority implement a procedure to identify whether encounters used to support journal vouchers have been removed from the encounter data and refund to the Federal Government any Federal reimbursement that was claimed and is no longer supported.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/15/2024
- Legislative Related
- No
22-A-09-055.08We recommend that the Washington State Health Care Authority strengthen its MMIS edits to limit the reporting of an encounter for a tier-1 health home service to only once in a beneficiary's lifetime and ensure that only one encounter per beneficiary is reported each month.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/24/2025
- Legislative Related
- No
-
National Background Check Program for Long-Term-Care Providers: An Interim Assessment
22-E-07-018.01CMS should ensure that participating States submit accurate quarterly reports.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/29/2024
- Legislative Related
- No
-
Adverse Events in Hospitals: A Quarter of Medicare Patients Experienced Harm in October 2018
22-E-06-017.01CMS should update and broaden its lists of hospital-acquired conditions to capture common, preventable, and high-cost harm events.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/29/2025
- Next Update Expected
- 05/12/2026
- Legislative Related
- No
22-E-06-017.02CMS should explore expanding the use of patient safety metrics in pilots and demonstrations for health care payment and service delivery, as appropriate.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/05/2024
- Legislative Related
- No
22-E-06-017.03CMS should develop and release interpretive guidance to surveyors for assessing hospital compliance with requirements to track and monitor patient harm events.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/12/2023
- Legislative Related
- No
22-E-06-017.04AHRQ should, with support from HHS leadership, coordinate agency efforts to update agency-specific Quality Strategic Plans.- Status
- Closed Acceptable Alternative
- Responsible Agency
- AHRQ
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/10/2025
- Legislative Related
- No
22-E-06-017.05AHRQ should optimize use of the Quality and Safety Review System (QSRS), including assessing the feasibility of automating data capture for national measurement and to facilitate local use.- Status
- Closed Implemented
- Responsible Agency
- AHRQ
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/10/2025
- Legislative Related
- No
22-E-06-017.06AHRQ should develop an effective model to disseminate information on national clinical practice guidelines or best practices to improve patient safety.- Status
- Closed Implemented
- Responsible Agency
- AHRQ
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/13/2023
- Legislative Related
- No
22-E-06-017.07AHRQ should continue efforts to identify and develop new strategies to prevent common patient harm events in hospitals.- Status
- Closed Implemented
- Responsible Agency
- AHRQ
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/13/2023
- Legislative Related
- No
-
HHS Should Improve Internal Coordination Regarding Unaccompanied Children
22-E-BL-016.01ACF should take steps to improve internal coordination and communication about unaccompanied children.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/13/2023
- Legislative Related
- No
22-E-BL-016.02ACF and CDC should ensure that CDC coordinates with ORR when making future decisions that could affect the number of unaccompanied children placed in ORR's care, including any Title 42 order.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/13/2023
- Legislative Related
- No
22-E-BL-016.03ACF and CDC should ensure that CDC coordinates with ORR when making future decisions that could affect the number of unaccompanied children placed in ORR's care, including any Title 42 order.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/12/2022
- Legislative Related
- No
22-E-BL-016.04CDC should take steps to improve internal coordination and communication about unaccompanied children.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/12/2022
- Legislative Related
- No
-
Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care
22-E-09-015.01CMS should issue new guidance on the appropriate use of MAO clinical criteria in medical necessity reviews.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/19/2023
- Legislative Related
- No
22-E-09-015.02CMS should update its audit protocols to address the issues identified in this report, such as MAO use of clinical criteria, and/or examine particular service types.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/09/2025
- Legislative Related
- No
22-E-09-015.03CMS should direct MAOs to take additional steps to identify and address vulnerabilities that can lead to manual review errors and system errors.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/02/2024
- Legislative Related
- No