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
-
OHRP Generally Conducted Its Compliance Activities Independently, But Changes Would Strengthen Its Independence
17-E-01-028.01HHS should address factors that may limit OHRP's ability to operate independently.- Status
- Open Unimplemented
- Responsible Agency
- OASH
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 01/25/2019
- Legislative Related
- No
17-E-01-028.02OHRP should post the following on its website: (a) a description of its approach to oversight and (b) data (in aggregate) on the full array of its compliance activities.- Status
- Closed Implemented
- Responsible Agency
- OASH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/12/2024
- Legislative Related
- No
-
Some Hospitals in Medicare Jurisdiction E Claimed Residents as More Than One Full-Time Equivalent
17-A-02-141.01We recommend that Noridian recover $434,531 in excess Medicare GME reimbursement paid to 36 hospitals in MAC Jurisdiction E.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $434,531
- Last Update Received
- 05/19/2025
- Next Update Expected
- 05/14/2026
- Legislative Related
- No
-
Some Hospitals in Medicare Jurisdiction F Claimed Residents as More Than One Full-Time Equivalent
17-A-02-142.01We recommend that Noridian recover $365,387 in excess Medicare GME reimbursement paid to 21 hospitals in MAC Jurisdiction F.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $365,387
- Last Update Received
- -
- Closed Date
- 12/29/2022
- Legislative Related
- No
-
First Coast Service Options, Inc., Understated Its Medicare Segment and Overstated Its Other Segment Allocable Postretirement Benefit Costs
17-A-07-135.01We recommend that FCSO increase the Medicare segment PRB costs used to calculate its indirect cost rates by $50,387 for CYs 2008 through 2012.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/03/2022
- Legislative Related
- No
17-A-07-135.02We recommend that FCSO decrease the Other segment PRB costs used to calculate its indirect cost rates by $3,357,884 for CYs 2008 through 2012.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/03/2022
- Legislative Related
- No
-
First Coast Service Options, Inc., Overstated Its Medicare Segment Postretirement Benefit Assets
17-A-07-133.01We recommend that FCSO decrease its Medicare segment PRB assets by $4,997,091 as of January 1, 2013.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/03/2022
- Legislative Related
- No
-
Medicare Could Save Millions by Eliminating the Lump-Sum Purchase Option for All Power Mobility Devices
17-A-05-119.01We recommend that CMS seek legislation to eliminate the lump-sum payment option for all PMDs. If such legislation had been in place during CYs 2011 through 2014, Medicare could have saved at least an additional $10,245,539.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/04/2026
- Legislative Related
- Yes
-
HHS Did Not Identify and Report Antideficiency Act Violations
17-A-03-118.01We recommend that the PSC work with the HHS Office of the Secretary to report Antideficiency Act obligation violations totaling $20,256,755.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Non-Concur
- Potential Savings
- $20,256,755
- Last Update Received
- 02/13/2026
- Next Update Expected
- 05/12/2022
- Legislative Related
- No
17-A-03-118.02We recommend that the PSC work with the HHS Office of the Secretary to report Antideficiency Act expenditure violations totaling $29,188,270.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Non-Concur
- Potential Savings
- $29,188,270
- Last Update Received
- 02/13/2026
- Next Update Expected
- 05/12/2022
- Legislative Related
- No
17-A-03-118.03We recommend that the PSC collaborate with ASFR to identify changes to UFMS to ensure that contract expenditures for each program year are paid using the appropriate program year obligations.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/04/2025
- Legislative Related
- No
17-A-03-118.04We recommend that the PSC use �no cost� contract extensions for severable services contracts only when they do not extend the period of performance for a program year to more than 12 months.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/04/2025
- Legislative Related
- No
17-A-03-118.05We recommend that the PSC use product/service codes that accurately reflect the contract statement of work.- Status
- Closed Acceptable Alternative
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/04/2025
- Legislative Related
- No
-
California Incorrectly Claimed Additional Medicaid Funding Authorized Under the Recovery Act When Reclaiming Overpayments Made to Bankrupt or Out-of-Business Providers
17-A-09-102.02We recommend that the State agency ensure that it uses the FMAPs in effect when the original overpayments were made and refunded when claiming Federal reimbursement for uncollectible overpayments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/08/2023
- Legislative Related
- No
-
New Jersey Claimed Medicaid Reimbursement for Adult Partial Hospitalization Services That Did Not Comply With Federal and State Requirements
17-A-02-100.01We recommend that the State agency refund $30,744,840 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $30,744,840
- Last Update Received
- 09/09/2025
- Next Update Expected
- 03/12/2026
- Legislative Related
- No
17-A-02-100.05We recommend that the State agency review and revise payment controls to ensure the correct rates are paid for partial hospitalization services.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/04/2024
- Legislative Related
- No
17-A-02-100.06We recommend that the State agency work with CMS to identify claims outside of our audit period that were paid at an incorrect rate or for services that were not provided by a facility licensed as a hospital.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 09/09/2025
- Next Update Expected
- 03/12/2026
- Legislative Related
- No
-
New York Improperly Claimed Federal Medicaid Reimbursement for Partial Hospitalization Services
17-A-02-078.02We recommend that the State agency work with OMH to reinforce to partial hospitalization providers the requirements for claiming Medicaid reimbursement for partial hospitalization services.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/16/2022
- Legislative Related
- No
17-A-02-078.03We recommend that the State agency instruct OMH to look for the types of noncompliance we identified in this report when it performs its licensing renewal visits.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/16/2022
- Legislative Related
- No
-
Medicare Contractors' Payments to Providers for Hospital Outpatient Dental Services Generally Did Not Comply With Medicare Requirements
17-A-06-079.01We recommend that CMS implement national edits for hospital outpatient dental services.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/25/2025
- Legislative Related
- No
-
Nebraska Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Transportation Program
17-A-07-077.01We recommend that the State agency refund to the Federal Government $1,911,138 (Federal share) in estimated overpayments. for NET claims that were in error and did not comply with Federal and State requirements.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,911,138
- Last Update Received
- 07/24/2017
- Next Update Expected
- 09/01/2022
- Legislative Related
- No
17-A-07-077.02We recommend that the State agency strengthen its policies and procedures to ensure that transportation services are provided only to recipients who are receiving Medicaid-covered services on the dates that they are receiving NET services; NET providers maintain records documenting that recipients are actually transported in the vehicles for all trips on the dates that NET services are rendered; NET providers maintain records to document the services provided; it does not pay NET providers or claim Federal reimbursement for non-covered transportation services; NET providers complete the required background checks on all potential drivers before permitting them to render NET services and annually thereafter, and maintain documentation of these checks; NET providers maintain records of all vehicle maintenance checks; and NET providers maintain documentation verifying that their drivers are qualified with current and valid driver�s licenses.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 07/24/2017
- Next Update Expected
- 09/01/2022
- Legislative Related
- No
-
The University of California at Riverside's Pilot Payroll Certification System Did Not Provide Accountability Over Payroll Charges to Federal Awards
17-A-04-072.01We recommended that the University strengthen oversight of payroll charges to Federal awards by ensuring that, if the University returns to its prior effort-reporting system, it updates the system to adequately account for nonsponsored activities to ensure that payroll costs are properly allocated to Federal awards.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/16/2022
- Legislative Related
- No
17-A-04-072.02We recommended that the University strengthen oversight of payroll charges to Federal awards by ensuring that suitable means exist for a PI to verify that salary charges made to an award are reasonable in relation to the work performed.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/16/2022
- Legislative Related
- No
17-A-04-072.03We recommended that the University strengthen oversight of payroll charges to Federal awards by ensuring that suitable means exist to document that salary charges represent the actual work performed on a grant and not just budget estimates.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/16/2022
- Legislative Related
- No
17-A-04-072.04We recommended that the University strengthen oversight of payroll charges to Federal awards by requiring and documenting prior approval and justification for adjustments made after grant expenditures have been reported to the Federal Government.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/16/2022
- Legislative Related
- No
17-A-04-072.05We recommended that the University strengthen oversight of payroll charges to Federal awards by requiring and documenting prior approval and justification for charging administrative and clerical salaries as direct costs.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/16/2022
- Legislative Related
- No
17-A-04-072.06We recommended that the University strengthen oversight of payroll charges to Federal awards by requiring and documenting prior approval and justification for cost transfers.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/16/2022
- Legislative Related
- No
17-A-04-072.07We recommended that the University strengthen oversight of payroll charges to Federal awards by developing payroll procedures to ensure that salaries are properly allocated and that salaries charged to all activities do not exceed 100 percent.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/16/2022
- Legislative Related
- No
17-A-04-072.08We recommended that the University strengthen oversight of payroll charges to Federal awards by following Federal requirements for supporting payroll costs claimed.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/16/2022
- Legislative Related
- No
17-A-04-072.09We recommended that the University strengthen its general IT controls for systems used to support the pilot PCS by improving restrictions for remote access.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/16/2022
- Legislative Related
- No
17-A-04-072.10We recommended that the University strengthen its general IT controls for systems used to support the pilot PCS by implementing a password setting that requires password changes periodically.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/16/2022
- Legislative Related
- No
17-A-04-072.11We recommended that the University strengthen its general IT controls for systems used to support the pilot PCS by implementing a patch management system for its desktop computers.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/16/2022
- Legislative Related
- No
17-A-04-072.12We recommended that the University strengthen its general IT controls for systems used to support the pilot PCS by implementing procedures to ensure that vendor support does not expire on the University�s operating system.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/16/2022
- Legislative Related
- No
-
Kentucky Misallocated Millions to Establishment Grants for a Health Insurance Marketplace
17-A-04-070.01We recommend that the State agency work with CMS to determine what portion of the $23.6 million was properly allocated in accordance with the relative benefits the establishment grants received from October 1, 2013, through April 15, 2014.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/23/2025
- Legislative Related
- No
17-A-04-070.02We recommend that the State agency refund $25.5 million to CMS that was misallocated to the establishment grants by not using updated, better data, or work with CMS to resolve the amount misallocated to the establishment grants, from April 16 through December 31, 2014.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $25,530,429
- Last Update Received
- -
- Closed Date
- 07/23/2025
- Legislative Related
- No
17-A-04-070.03We recommend that the State agency work with CMS to ensure that the $123.3 million that was allocated to the establishment grants on the basis of a flawed cost-allocation methodology from November 2010 through September 2013 was allocated correctly and refund any unallowable amount.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/23/2025
- Legislative Related
- No
17-A-04-070.04We recommend that the State agency work with CMS to ensure that costs claimed after our audit period were allocated correctly using updated, better data, and refund any unallowable amount.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/23/2025
- Legislative Related
- No
17-A-04-070.05We recommend that the State agency issue a written policy that explains how to develop and perform cost allocations on the basis of relative benefits received and to reassess and revise allocations when necessary.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/23/2025
- Legislative Related
- No
-
Colorado Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs
17-A-07-055.06We recommend that the State agency strengthen its internal controls to ensure that all physician-administered drugs eligible for rebates are invoiced.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/20/2024
- Legislative Related
- No
-
Louisiana Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Medical Transportation Program
17-A-06-053.03We recommend that the State agency, (i) strengthen its policies and procedures to ensure that providers, (ii) keep records that are necessary to document the services provided, (iii) provide transportation services only to beneficiaries receiving Medicaid-covered services, (iv) submit claims that match approved rates, and (v) do not submit claims for cancelled trips.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/08/2022
- Legislative Related
- No
17-A-06-053.04We recommend the State agency strengthen its controls over its process for reporting expenditures claimed for NEMT services.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/08/2022
- Legislative Related
- No
-
Northside Medical Center Incorrectly Billed Medicare Inpatient Claims with Severe Malnutrition
17-A-03-052.01We recommend that the Hospital refund to the Medicare program $1,280,761 for the incorrectly coded claims.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $1,280,761
- Last Update Received
- -
- Closed Date
- 04/04/2022
- Legislative Related
- No
-
Delaware Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations
17-A-03-051.01We recommend that the State agency work with CMS to resolve the drug utilization without valid NDCs for which we were not able to determine an estimate by determining the correct NDCs and rebates due, billing manufacturers for the rebates, and refunding the Federal share of rebates collected.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/09/2022
- Legislative Related
- No
17-A-03-051.03We recommend that the State agency ensure that MCOs submit drug utilization data containing NDCs for all physician-administered drugs.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/09/2022
- Legislative Related
- No
-
New Jersey Claimed Medicaid Adult Mental Health Partial Care Services That Were Not in Compliance With Federal and State Requirements
17-A-02-047.01We recommended that the State agency refund $94,830,718 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $94,830,718
- Last Update Received
- 09/09/2025
- Next Update Expected
- 03/12/2026
- Legislative Related
- No
-
Virginia Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations
17-A-03-043.03We recommend that the State agency ensure that MCOs submit drug utilization data containing NDCs for all physician-administered drugs.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/09/2022
- Legislative Related
- No