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 1,081–1,100 of 1,376 reports, containing 4,429 recommendations
Sorted by latest release date
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Cahaba Government Benefits Administrators, LLC, Understated Medicare Administrative Contract Allowable Pension Costs
18-A-07-099.01We recommend that Cahaba GBA work with CMS to ensure that its final settlement of contract costs reflects an increase in Medicare pension costs of $2.6 million for CYs 2008 through 2013.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/24/2019
- Legislative Related
- No
-
Cahaba Safeguard Administrators, LLC, Understated Medicare Administrative Contract Allowable Pension Costs
18-A-07-100.01We recommend that Cahaba CSA work with CMS to ensure that its final settlement of contract costs reflects an increase in Medicare pension costs of $104,958 for CYs 2008 through 2013.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/24/2019
- Legislative Related
- No
-
Florida Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid
18-A-04-097.01We recommend that the State agency improve its practices for verifying nursing homes� correction of identified deficiencies by obtaining nursing homes� evidence of correction for less serious deficiencies.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/19/2019
- Legislative Related
- No
18-A-04-097.02We recommend that the State agency update information system controls to ensure that survey system data is protected against unauthorized or unintended modification or loss.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/19/2019
- Legislative Related
- No
-
Cahaba Government Benefits Administrators, LLC, Overstated Its Medicare Segment Pension Assets
18-A-07-095.01We recommend that Cahaba GBA decrease the Medicare segment pension assets by $622,074 and recognize $25,526,227 as the Medicare segment pension assets as of January 1, 2014.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/21/2018
- Legislative Related
- No
18-A-07-095.02We recommend that Cahaba GBA establish policies and procedures to ensure compliance with Federal requirements and the pension segmentation language of the Medicare contracts.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/21/2018
- Legislative Related
- No
-
Cahaba Safeguard Administrators, LLC, Understated Its Medicare Segment Pension Assets
18-A-07-096.01We recommend that Cahaba CSA increase the Medicare segment pension assets by $290,831 and recognize $7,653,570 as the Medicare segment pension assets as of January 1, 2014.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $290,831
- Last Update Received
- -
- Closed Date
- 10/23/2018
- Legislative Related
- No
18-A-07-096.02We recommend that Cahaba CSA establish policies and procedures to ensure compliance with Federal requirements.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/23/2018
- Legislative Related
- No
-
Most of New York's Claims for Federal Reimbursement for Monthly Personal Emergency Response Service Charges Did Not Comply With Medicaid Requirements
18-A-02-093.01We recommended that New York refund $5,516,838 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $5,516,838
- Last Update Received
- 09/15/2025
- Next Update Expected
- 03/16/2026
- Legislative Related
- No
18-A-02-093.02Reinforce with the local districts Medicaid requirements related to claiming Federal reimbursement for PERS.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/31/2018
- Legislative Related
- No
18-A-02-093.03Provide oversight of the local districts to ensure PERS comply with Medicaid requirements.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/31/2018
- Legislative Related
- No
-
Colorado Did Not Always Comply With Federal Requirements When Expending Federal Establishment Grant Funds Allocated for Its Shared Eligibility System Costs
18-A-07-092.01We recommend that the Colorado marketplace develop and implement a cost allocation methodology that is based on relative benefits received by the Colorado marketplace and that is based on updated, better data regarding expected transactions and program population as the data become available.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/21/2025
- Legislative Related
- No
18-A-07-092.02We recommend that the Colorado marketplace develop and implement written policies, reinforced by adequate internal controls, that explain how to develop a CAP based on relative benefits received, expected transactions, and expected population; how to provide formal input to HCPF and CMS during the development of cost allocation ratios; and how to adequately document the development of those ratios.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/21/2025
- Legislative Related
- No
18-A-07-092.03We recommend that the Colorado marketplace develop and implement written policies and procedures to ensure that future Federal grant award costs are allocated to it in the appropriate period in accordance with Federal requirements.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/21/2025
- Legislative Related
- No
-
CMS's Policies and Procedures Were Generally Effective in Ensuring That Prescription Drug Coverage Capitation Payments Were Not Made After the Beneficiaries' Dates of Death
18-A-07-090.01We recommend that CMS use the information in this report and the detailed data previously provided to recoup the $1,099,603 in capitation payments made to sponsors for Medicare Part D coverage on behalf of deceased beneficiaries.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,099,603
- Last Update Received
- -
- Closed Date
- 11/06/2018
- Legislative Related
- No
18-A-07-090.02We recommend that CMS continue to implement system enhancements to identify, adjust, and recoup improper capitation payments in the future.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/06/2018
- Legislative Related
- No
-
The Indian Health Service's Controls Were Not Effective in Ensuring That Its Travel Card Program Complied With Federal Requirements and Its Own Policy
18-A-07-091.01We recommend that IHS reemphasize the requirements for the use of the travel card to ensure that all travel cardholders are aware of the requirements- Status
- Closed Implemented
- Responsible Agency
- IHS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/24/2020
- Legislative Related
- No
18-A-07-091.02We recommend that IHS ensure that travel card usage is adequately monitored for compliance with the travel card requirements.- Status
- Closed Implemented
- Responsible Agency
- IHS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/24/2020
- Legislative Related
- No
-
The National Institute of Health in Mozambique Did Not Always Manage and Expend the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements
18-A-04-089.01We recommend that the Institute refund to CDC $431,458 of unallowable expenditures: $379,243 that it could not adequately support and $52,215 that it used to support non-PEPFAR activities.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- $431,458
- Last Update Received
- -
- Closed Date
- 05/23/2019
- Legislative Related
- No
18-A-04-089.02We recommend that the Institute, implement an adequate accounting system that complies with 45 CFR � 92.20(b)(1) and allows it to accurately manage and account for Federal funds; reconcile accounting records to the FFR; segregate PEPFAR expenditures from other expenditures; allocate expenditures across projects; account for funds advanced to subrecipients; and accurately classify transactions in the correct budget category.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/23/2019
- Legislative Related
- No
18-A-04-089.03We recommend that the Institute, work with CDC to determine the allowability of the $1,289,859 in personnel costs expended during the audit period.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- $1,289,859
- Last Update Received
- -
- Closed Date
- 02/12/2021
- Legislative Related
- No
18-A-04-089.04We recommend that the Institute, ensure that it maintains documentation to fully support expenditures.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/23/2019
- Legislative Related
- No
18-A-04-089.05We recommend that the Institute, adhere to Federal regulations and Government of Mozambique policies when procuring assets with PEPFAR funds.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/04/2020
- Legislative Related
- No
18-A-04-089.06We recommend that the Institute, allocate expenses across all projects to ensure that award funds are used solely for authorized purposes.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/23/2019
- Legislative Related
- No
18-A-04-089.07We recommend that the Institute, implement a time and attendance system that can adequately document and allocate the time that employees work on PEPFAR-funded activities.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/28/2022
- Legislative Related
- No
18-A-04-089.08We recommend that the Institute, work with CDC to obtain VAT reimbursement from the Government of Mozambique.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/23/2019
- Legislative Related
- No
18-A-04-089.09We recommend that the Institute, establish a PMS account that will be used only for PEPFAR funds.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/23/2019
- Legislative Related
- No
18-A-04-089.10We recommend that the Institute, implement policies and procedures that address the payment of VAT using PEPFAR funds.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/23/2019
- Legislative Related
- No
-
CMS Paid Practitioners for Telehealth Services That Did Not Meet Medicare Requirements
18-A-05-086.01We recommend that CMS take the following actions, which we estimate could have saved approximately $3,699,848 for calendar years 2014 and 2015; conduct periodic postpayment reviews to disallow payments for errors for which telehealth claim edits cannot be implemented (for example, unallowable originating sites or unallowable means of communication).- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $3,699,848
- Last Update Received
- -
- Closed Date
- 02/06/2023
- Legislative Related
- No
18-A-05-086.02We recommend that CMS work with Medicare contractors to implement all telehealth claims edits listed in the Manual.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/24/2023
- Legislative Related
- No
18-A-05-086.03We recommend that CMS take the following actions, which we estimate could have saved approximately $3,699,848 for calendar years 2014 and 2015: offer education and training sessions to practitioners on Medicare telehealth requirements and related resources.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/27/2019
- Legislative Related
- No
-
Texas Did Not Make Increased Primary Care Provider Payments and Claim Reimbursement in Accordance With Federal Requirements
18-A-06-084.01We recommend that Texas refund $20.7 million to the Federal Government that it received for incorrectly claimed and unallowable payments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $20,714,957
- Last Update Received
- -
- Closed Date
- 02/10/2022
- Legislative Related
- No
18-A-06-084.02We recommend that Texas work with the Centers for Medicare & Medicaid Services to determine the portion of the $1.1 million that it received for payments that exceeded providers� billed charges should be refunded to the Federal Government.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $292,170
- Last Update Received
- -
- Closed Date
- 02/10/2022
- Legislative Related
- No
-
Colorado Claimed Some Unallowable Medicaid Payments for Targeted Case Management Services
18-A-07-085.01We recommend that the State agency refund $2,160,743 to the Federal Government for unallowable TCM claims.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $2,160,743
- Last Update Received
- -
- Closed Date
- 11/04/2019
- Legislative Related
- No
18-A-07-085.02We recommend that the State agency strengthen its policies and procedures to ensure that TCM providers maintain documentation to document that case managers are qualified to perform TCM services, TCM providers maintain documentation to support the TCM services provided, it does not pay TCM providers or claim Federal reimbursement for services that are not TCM services, and TCM providers maintain documentation for eligibility determinations for recipients of TCM services.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/04/2019
- Legislative Related
- No
-
Idaho Received Millions in Unallowable Bonus Payments
18-A-04-083.01We recommend that Idaho refund $3,103,167 to the Federal government.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $3,103,167
- Last Update Received
- -
- Closed Date
- 08/13/2019
- Legislative Related
- No
-
Drug Supply Chain Security: Dispensers Received Most Tracing Information
18-E-05-012.01FDA should provide educational outreach to dispensers about DSCSA requirements for receiving drug product tracing information.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/11/2020
- Legislative Related
- No
-
New Jersey Claimed Federal Medicaid Reimbursement for Children's Partial Hospitalization Services That Did Not Meet Federal and State Requirements
18-A-02-082.01We recommend a disallowance of $54,732,002 based on all 100 State agency's claims for Federal Medicaid reimbursement for children's partial hospitalization services that we reviewed did not comply with Federal and State requirements, and 94 contained more than 1 deficiency. These deficiencies included services not documented or supported, services not provided by a licensed hospital, group therapy limitation requirement not met, services provided by unqualified staff, and progress notes not documented.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $54,732,002
- Last Update Received
- -
- Closed Date
- 07/13/2018
- Legislative Related
- No
18-A-02-082.02We recommend that the State agency work with the State�s DOH to ensure children�s partial hospitalization services are provided by appropriately licensed hospitals- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/31/2018
- Legislative Related
- No
18-A-02-082.03We recommend the State agency work with DOH to ensure that licensure standards, as well as any other State requirements for providing Medicaid-covered partial hospitalization services, promote high-quality care and support efficiency and integrity in service delivery.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/31/2018
- Legislative Related
- No
18-A-02-082.04We recommend the State agency improve its monitoring of children�s partial hospitalization services providers and adequately test specific services to ensure compliance with Federal and State requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/31/2018
- Legislative Related
- No
18-A-02-082.05We recommend that the State agency issue guidance to providers on Federal and State requirements for claiming Medicaid reimbursement for children�s partial hospitalization services.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/27/2018
- Legislative Related
- No
18-A-02-082.06We recommend that the State agency work with CMS to identify claims outside of our audit period that were paid for services that were not provided by a facility licensed as a hospital.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/31/2018
- Legislative Related
- No
-
New York Did Not Comply With Federal Grant Requirements for Claiming Marketplace Contract Costs to Medicaid and the Children's Health Insurance Program
18-A-02-081.01We recommend that the State agency: refund to CMS $852,992 for unallowable profit fees or work with CMS to determine the appropriate amount that should have been claimed to Medicaid and CHIP.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $852,992
- Last Update Received
- -
- Closed Date
- 10/23/2018
- Legislative Related
- No
18-A-02-081.02We recommend that the State agency refund to CMS $101,529 for unallowable G&A costs and related profit fees.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $101,529
- Last Update Received
- -
- Closed Date
- 10/23/2018
- Legislative Related
- No
-
Some Washington State Group-Care Facilities for Children in Foster Care Did Not Always Comply With State Health and Safety Requirements
18-A-09-080.01We recommend that the State agency ensure that all instances of noncompliance that we identified are documented and corrected.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2018
- Legislative Related
- No
18-A-09-080.02We recommend that the State agency conduct unannounced visits for health and safety reviews of group care facilities.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2018
- Legislative Related
- No
18-A-09-080.03We recommend that the State agency ensure that regional licensors perform and document a site inspection during each health and safety visit at a group care facility.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2018
- Legislative Related
- No
18-A-09-080.04We recommend that the State agency ensure that regional licensors and group care facilities have adequate training and guidance on the best practices for administering medications and maintaining related documentation.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2018
- Legislative Related
- No
18-A-09-080.05We recommend that the State agency provide regional licensors and group care facilities with adequate guidance and supervision regarding background check requirements to ensure that employees with uncleared, pending, or incomplete background checks do not have unsupervised access to children.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2018
- Legislative Related
- No
18-A-09-080.06We recommend that the State agency ensure that the handbook Minimum Licensing Requirements for Group Care Facilities is updated with the latest background check requirements.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2018
- Legislative Related
- No
18-A-09-080.07We recommend that the State agency consider requiring FBI fingerprint-based background checks for all group care facility employees, seeking additional legislative authority as needed.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2018
- Legislative Related
- No
-
Aurum Institute Generally Managed and Expended the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements
18-A-04-079.01We recommend that Aurum continue to implement segregation of duties among different key personnel.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/25/2018
- Legislative Related
- No
18-A-04-079.02We recommend that Aurum continue to upgrade its procurement-management and accounting systems to effectively track procurements.- Status
- Closed Implemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/25/2018
- Legislative Related
- No
-
Many Medicare Claims for Outpatient Physical Therapy Services Did Not Comply With Medicare Requirements
18-A-05-078.01We recommend that CMS instruct the MACs to notify providers of potential overpayments so that those providers can exercise reasonable diligence to investigate and return any identified overpayments, in accordance with the 60-day rule, and identify and track any returned overpayments made in accordance with this recommendation.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/03/2018
- Legislative Related
- No
18-A-05-078.02We recommended that CMS establish mechanisms to better monitor the appropriateness of outpatient physical therapy claims.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/16/2021
- Legislative Related
- No
18-A-05-078.03We recommended that CMS review current educational efforts about Medicare requirements for submitting outpatient physical therapy claims for reimbursement and improve or increase these educational efforts as needed to reduce the 61-percent error rate and promote provider compliance.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/13/2019
- Legislative Related
- No