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 Sept. 11, 2026
1,051
Unimplemented
recommendations
3,529
Implemented and Closed
recommendations since FY 2017
Views
OIG Recommendations Grouped by Report
Showing 521–540 of 1,427 reports, containing 4,580 recommendations
Sorted by latest release date
-
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
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/09/2026
- 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
- 06/08/2026
- Next Update Expected
- 07/06/2027
- 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
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/28/2026
- 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
- 08/24/2026
- Next Update Expected
- 02/26/2027
- 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
- 06/05/2026
- Next Update Expected
- 12/24/2026
- 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
- 06/05/2026
- Next Update Expected
- 12/24/2026
- 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
- 06/05/2026
- Next Update Expected
- 12/24/2026
- 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
-
Massachusetts Implemented Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Critical Incidents
22-A-01-052.01We recommend that the Massachusetts Executive Office of Health and Human Services, Office of Medicaid continue to coordinate with DDS and DPPC to ensure that all reasonable suspicions of abuse and neglect are properly identified, reported, and investigated as needed.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/30/2025
- Legislative Related
- No
22-A-01-052.02We recommend that the Massachusetts Executive Office of Health and Human Services, Office of Medicaid require periodic training for DDS and group home staff on reporting reasonable suspicions of abuse and neglect.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/01/2025
- Legislative Related
- No
-
Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2021
22-A-18-053.01Continue implementation of an automated CDM solution that provides a centralized, enterprise-wide view of risks across all of HHS.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2023
- Legislative Related
- No
22-A-18-053.02Update the ISCM strategy to include a more specific roadmap; including target dates, for ISCM deployment across the HHS enterprise.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/28/2025
- Legislative Related
- No
22-A-18-053.03HHS should perform an enterprise risk assessment over known control weaknesses (e.g., Authority to Operate, incomplete OpDiv provided system inventories, lack of OpDiv adherence to HHS information security policies) due to their federated environment and document an appropriate risk response (e.g., accept, avoid, mitigate, share, or transfer).- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2023
- Legislative Related
- No
22-A-18-053.04HHS OCIO work with all OpDivs to develop a process to monitor information system contingency plans to ensure they are developed, maintained, and integrated with other continuity requirements by information systems.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/01/2022
- Legislative Related
- No
22-A-18-053.05HHS OCIO work with all OpDivs to ensure that all operational systems have SSPs and FIPS 199 categorizations completed for information systems in accordance with HHS policy.- Status
- Closed Superseded
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/23/2025
- Legislative Related
- No
22-A-18-053.06HHS OCIO work with all OpDivs to ensure that all OpDivs are completing security controls system assessments and POA&Ms at least quarterly or more frequently as defined by the OpDiv.- Status
- Closed Superseded
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/23/2025
- Legislative Related
- No
22-A-18-053.07HHS OCIO work with all OpDivs to ensure that baseline configuration requirements are implemented and maintained across all systems within its environment. Additionally, ensure that system owners implement procedures to document and retain evidence of current baseline configurations.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/01/2022
- Legislative Related
- No
22-A-18-053.08HHS OCIO work with all OpDivs to ensure that all systems implement processes to track system changes throughout the change management process, to include testing, validation, and documentation. Additionally, procedures should be implemented to retain evidence of all changes.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/13/2022
- Legislative Related
- No
22-A-18-053.09HHS OCIO work with all OpDivs to develop a management approved Configuration Management policy that addresses purpose, scope, roles, responsibilities, management commitment and coordination among organizational entities. This document should be tailored to the OpDivs' needs and be reviewed and updated according to HHS policy (at least every 3 years).- Status
- Closed Superseded
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/23/2025
- Legislative Related
- No
22-A-18-053.10HHS OCIO work with the OpDivs to ensure that all OpDivs update and implement its personnel security policies to clearly articulate the personnel screening process along with the required access agreements that need to be completed prior to being granted system access. In addition, OpDivs should update and implement their procedures for retrieving and archiving user access agreements for internal control purposes.- Status
- Closed Superseded
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/23/2025
- Legislative Related
- No
22-A-18-053.11HHS OCIO work with the OpDivs to ensure that all OpDivs develop and implement an ICAM strategy and authenticator management policy to ensure all information systems undergo a digital identity risk assessment to determine which systems require strong authentication. Once a risk assessment is complete, OpDivs should ensure that authentication mechanisms are implemented for all information systems.- Status
- Closed Superseded
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/23/2025
- Legislative Related
- No
22-A-18-053.12HHS OCIO work with the OpDivs to ensure that all OpDivs establish a process for the review of privileged users on an annual basis to ensure compliance with HHS Policy. In addition, OpDivs should ensure that this process is created to identify user access is still needed; user rights subscribe to the principle of least privileged; and user actions are captured and monitored appropriately as dictated by HHS policy.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/10/2023
- Legislative Related
- No
22-A-18-053.13HHS OCIO work with the OpDivs to ensure that all OpDivs iImplement a process to ensure that privileged user's access is reviewed at least within every 365 days by all system owners in compliance with HHS Information System Security and Privacy Policy (IS2P). Evidence of privileged users access reviews should be retained and provided upon request.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/01/2022
- Legislative Related
- No
22-A-18-053.14HHS OCIO work with all OpDivs to ensure that all systems on the network have a valid ATO. OpDivs should ensure that security authorization policies and procedures are fully developed and disseminated to the appropriate personnel to ensure that all OpDiv personnel understand the requirements for completing the ATO process.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2023
- Legislative Related
- No
22-A-18-053.15HHS OCIO work with all OpDivs to ensure that ISCM strategy and procedures should clearly define critical reporting metrics for reports utilized by internal and external stakeholders. Additionally, OpDivs should coordinate reporting efforts with the OCIO to ensure the definitions and reporting requirements are consistently implemented.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/28/2025
- Legislative Related
- No
22-A-18-053.16HHS OCIO work with all OpDivs to ensure that accurate system inventory listings are reported to HHS OCIO. OpDivs and HHS OCIO should also implement a process to ensure that ATO status in the HSDW system reporting tool are regularly updated and current.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/01/2022
- Legislative Related
- No
22-A-18-053.17HHS OCIO work with all OpDivs to ensure that a process exists for monitoring contingency plan testing to prevent CPTs from not being performed in accordance with the established HHS policies. Additionally, OpDiv management should improve their HSDW reporting process by educating system owners on required fields for reportable metrics and validating those fields are provided to the OCIO when consolidating HHS wide data.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/01/2022
- Legislative Related
- No
22-A-18-053.18HHS OCIO work with all OpDivs to ensure that OpDivs should improve their processes for monitoring contingency plan testing for all systems to prevent CPTs from not being performed annually in accordance with the established policies.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/14/2023
- Legislative Related
- No
22-A-18-053.19HHS OCIO work with all OpDivs to ensure that OpDiv management ensure that all systems are implementing information system backup and storage as documented in HHS policies and procedures. Additionally, management should require that evidence is retained to document backup and storage procedures.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/01/2022
- Legislative Related
- No
-
California Improperly Claimed at Least $23 Million of $260 Million in Total Medicaid Reimbursement for Opioid Treatment Program Services
22-A-09-051.01We recommend that the California Department of Health Care Services refund $23,139,767 to the Federal Government.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $23,139,767
- Last Update Received
- -
- Closed Date
- 08/16/2022
- Legislative Related
- No
22-A-09-051.02We recommend that the California Department of Health Care Services verify that deficiencies identified during annual provider-licensing inspections were corrected and that OTPs implemented their corrective action plans.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/30/2025
- Legislative Related
- No
22-A-09-051.03We recommend that the California Department of Health Care Services consider performing additional postservice prepayment monitoring and postservice postpayment utilization reviews.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/22/2024
- Legislative Related
- No
22-A-09-051.04We recommend that the California Department of Health Care Services implement a system edit for identifying claims with an unreasonable number of counseling service units in 1 day and take appropriate action for the claims identified.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 07/19/0010
- Next Update Expected
- 10/21/2026
- Legislative Related
- No
22-A-09-051.05We recommend that the California Department of Health Care Services revise the Drug Medi-Cal Billing Manual or provide additional guidance to OTPs regarding the allowable number of counseling service units and work with counties to ensure that their OTP billing manuals do not conflict with State regulations.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/27/2024
- Legislative Related
- No
22-A-09-051.06We recommend that the California Department of Health Care Services take actions to ensure that OTPs comply with Federal and State requirements for providing and claiming reimbursement for OTP services.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/30/2025
- Legislative Related
- No
22-A-09-051.07We recommend that the California Department of Health Care Services take actions to ensure that OTPs provide the number of counseling services specified in a beneficiary's treatment plan or document the reasons that counseling services were not provided as specified in the treatment plan.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/30/2025
- Legislative Related
- No
22-A-09-051.08We recommend that the California Department of Health Care Services take actions to ensure that OTPs maintain documentation supporting that a complete physical evaluation of a patient was performed, including the results of drug use, tuberculosis, and syphilis tests and the identity of the person who performed the physical evaluation.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/30/2025
- Legislative Related
- No
22-A-09-051.09We recommend that the California Department of Health Care Services take actions to ensure that OTPs have their physicians review and countersign beneficiaries' treatment plans within the 14-day period as required.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/13/2025
- Legislative Related
- No
-
Louisiana Faced Compliance and Contracting Challenges in Implementing Opioid Response Grant Programs
22-A-06-050.01We recommend that Louisiana's Office of Behavioral Health develop a process to ensure accurate reporting on the Annual Progress Reports.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/26/2022
- Legislative Related
- No
22-A-06-050.02We recommend that Louisiana's Office of Behavioral Health Improve monitoring of subrecipients to ensure that the distribution of naloxone kits is tracked and that distribution requirements are met.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/26/2022
- Legislative Related
- No
22-A-06-050.03We recommend that Louisiana's Office of Behavioral Health work with the LGEs and OTPs to identify ways to support clients' access to transportation to obtain treatment and determine how transportation could be addressed in each specific region of the State.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/26/2022
- Legislative Related
- No
22-A-06-050.04We recommend that Louisiana's Office of Behavioral Health review the contracting process to determine whether there are ways to expedite the process to provide funds to subrecipients and outside organizations in a timely manner.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/26/2022
- Legislative Related
- No
-
South Carolina Did Not Fully Comply With Requirements for Reporting and Monitoring Critical Events Involving Medicaid Beneficiaries With Developmental Disabilities
22-A-04-048.01We recommend that the South Carolina Department of Health and Human Services work with the Department of Disabilities and Special Needs to ensure that providers follow the reporting requirements for critical events.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/24/2026
- Legislative Related
- No
22-A-04-048.02We recommend that the South Carolina Department of Health and Human Services work with the Department of Disabilities and Special Needs to provide training to providers on recognizing and reporting critical incidents according to reporting requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/19/2026
- Legislative Related
- No
22-A-04-048.03We recommend that the South Carolina Department of Health and Human Services work with the Department of Disabilities and Special Needs to perform analytical procedures, such as data matches, on Medicaid claims data to identify any unreported critical incidents, and investigate as needed.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/24/2026
- Legislative Related
- No
22-A-04-048.04We recommend that the South Carolina Department of Health and Human Services work with the Department of Disabilities and Special Needs to ensure that providers submit all incident reports to DDSN through the IMS within 24 hours of an incident or the next business day.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/29/2023
- Legislative Related
- No
22-A-04-048.05We recommend that the South Carolina Department of Health and Human Services work with the Department of Disabilities and Special Needs to impose sanctions on providers to compel compliance with timely reporting requirements for allegations of ANE and deaths.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/22/2024
- Legislative Related
- No
22-A-04-048.06We recommend that the South Carolina Department of Health and Human Services work with the Department of Disabilities and Special Needs to require that the IMC contact providers before the results of internal reviews are due to ensure that providers submit such results within required timeframes.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/24/2026
- Legislative Related
- No
22-A-04-048.07We recommend that the South Carolina Department of Health and Human Services work with the Department of Disabilities and Special Needs to ensure that backup staff members are available to work on incident management activities whenever the primary IMC is unavailable.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/29/2023
- Legislative Related
- No
22-A-04-048.08We recommend that the South Carolina Department of Health and Human Services work with the Department of Disabilities and Special Needs to develop and implement strategies and processes to prevent future ANE incidents and unexplained beneficiary deaths.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/19/2026
- Legislative Related
- No
-
Medicare Part D and Beneficiaries Could Realize Significant Spending Reductions With Increased Biosimilar Use
22-E-05-014.01CMS should encourage Part D plans to increase access to and use of biosimilars.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/20/2025
- Legislative Related
- No
22-E-05-014.02CMS should Monitor Part D plans' submitted formularies to determine whether they discourage beneficiaries from using biosimilars.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/14/2024
- Legislative Related
- No
-
Psychotherapy Services Billed by a New York City Provider Did Not Comply With Medicare Requirements
22-A-02-047.01We recommend that the New York City provider refund to the Medicare program the estimated $1,118,789 overpayment.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,118,789
- Last Update Received
- -
- Closed Date
- 07/11/2024
- Legislative Related
- No
22-A-02-047.02We recommend that the New York City provider based upon 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 Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/16/2025
- Legislative Related
- No
22-A-02-047.03We recommend that the New York City provider develop policies and procedures to ensure that treatment plans contain all required elements, are maintained and are signed by the treating physician; the performing therapists and supervising physicians comply with the requirements related to incident-to services; psychotherapy services are conducted by therapists that meet Medicare qualification requirements; time spent on psychotherapy services is documented; and treatment notes are signed and maintained to support the services billed.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/21/2023
- Legislative Related
- No
22-A-02-047.04We recommend that the New York City provider provide training to its therapists on how to properly develop and maintain treatment plans; document that incident-to services were performed under the direct supervision of a physician; document time spent on psychotherapy services; and document and maintain treatment notes to support the services billed.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/28/2022
- Legislative Related
- No
-
New York Verified That Medicaid Assisted Living Program Providers Met Life Safety and Emergency Planning Requirements But Did Not Always Ensure That Assisted Living Program Services Met Federal and State Requirements
22-A-02-046.01We recommend that the New York State Department of Health (the State Agency) refund $1,943,190 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,943,190
- Last Update Received
- 04/09/2026
- Next Update Expected
- 10/09/2026
- Legislative Related
- No
22-A-02-046.02We recommend that the New York State Department of Health (the State Agency) strengthen its oversight and monitoring of ALP providers to ensure that the providers 1) conduct timely and valid assessments, including nursing and social assessments; 2) bill only for services provided; 3) maintain required documentation; and 4) provide services only under a valid care plan.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/30/2022
- Legislative Related
- No
-
New Mexico Did Not Claim $12.4 Million of $222.6 Million in Medicaid Payments for Services Provided by Indian Health Service Facilities in Accordance With Federal and State Requirements
22-A-06-045.01We recommend that the New Mexico Human Services Department refund $12,422,181 to the Federal Government.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $12,422,181
- Last Update Received
- -
- Closed Date
- 12/03/2024
- Legislative Related
- No
22-A-06-045.02We recommend that the New Mexico Human Services Department work with CMS to determine the appropriate amount of the additional $750,811 that it should have claimed and refund the Federal share difference.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/29/2023
- Legislative Related
- No
22-A-06-045.03We recommend that the New Mexico Human Services Department establish policies and procedures to account for adjustments MCOs make to IHS encounter data after reconciliations are completed.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/29/2023
- Legislative Related
- No
22-A-06-045.04We recommend that the New Mexico Human Services Department use the entered date to determine whether the MCO submitted an encounter within the 2-year limit.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/29/2023
- Legislative Related
- No
22-A-06-045.05We recommend that the New Mexico Human Services Department turn on the edit for encounter data that compares calculated days to paid days to limit the State agency's acceptance of encounter data with dates-of-service spans that do not support the paid days.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/29/2023
- Legislative Related
- No
22-A-06-045.06We recommend that the New Mexico Human Services Department strengthen the edit by removing the 3-day allowance to ensure that dates-of-service spans fully support paid days.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/29/2023
- Legislative Related
- No