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 1,221–1,240 of 1,376 reports, containing 4,429 recommendations
Sorted by latest release date
-
FDA is Issuing More Postmarketing Requirements, but Challenges with Oversight Persist
16-E-01-035.01FDA should provide a standardized form for Annual Status Reports (ASRs), ensure that they are complete, and require sponsors to submit them electronically.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/28/2024
- Legislative Related
- No
16-E-01-035.02FDA should build capacity in the Document Archiving, Reporting, and Regulatory Tracking System (DARRTS) to support postmarketing requirements (PMR) oversight.- Status
- Closed Implemented
- Responsible Agency
- FDA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/28/2024
- Legislative Related
- No
-
Adverse Events in Rehabilitation Hospitals: National Incidence Among Medicare Beneficiaries
16-E-06-034.03CMS should include information about potential events and patient harm in its quality guidance to rehab hospitals.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/08/2025
- Legislative Related
- No
-
Medicare Compliance Review of Excellent Home Care Services, LLC
16-A-02-169.01We recommend that the Agency refund to the Medicare contractor $6,382,323 in estimated net overpayments for claims incorrectly billed that are within the 3-year claims recovery period.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $1,531,015
- Last Update Received
- -
- Closed Date
- 11/01/2021
- Legislative Related
- No
-
Medicare Compliance Review of Houston Methodist Hospital for 2012 and 2013
16-A-06-165.01We recommend that the Hospital refund to the Medicare contractor $579,799 in estimated net overpayments for claims that were incorrectly billed during the 3-year recovery period.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $579,799
- Last Update Received
- -
- Closed Date
- 04/07/2023
- Legislative Related
- No
16-A-06-165.03We recommend that the Hospital work with the Medicare contractor to return overpayments that were made outside of the 3-year recovery period, which we estimate to be as much as $619,350 for our audit period, in accordance with the 60-day repayment rule.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/07/2023
- Legislative Related
- No
-
New York Overpaid Certain Medicaid Mental Health Services Providers
16-A-02-152.01We recommend that the State agency refund $8,106,746 to the Federal Government for COPS and CSP overpayments for the period 2009 through 2012.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $8,106,746
- Last Update Received
- -
- Closed Date
- 11/09/2023
- Legislative Related
- No
-
CMS Is Taking Steps To Improve Oversight of Provider-Based Facilities, But Vulnerabilities Remain
16-E-04-026.02CMS should require hospitals to submit attestations for all their provider-based facilities.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 05/24/2024
- Next Update Expected
- 07/15/2025
- Legislative Related
- No
16-E-04-026.04CMS should take appropriate action against hospitals and their off-campus provider-based facilities that we identified as not meeting requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/20/2023
- Legislative Related
- No
-
State Efforts to Exclude 340B Drugs from Medicaid Managed Care Rebates
16-E-05-025.01CMS should require the use of claim level methods to identify 340B claims.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 06/24/2025
- Next Update Expected
- 07/01/2025
- Legislative Related
- Yes
-
Medicaid: Vulnerabilities Related to Provider Enrollment and Ownership Disclosure
16-E-04-020.03CMS should require State Medicaid programs to verify the completeness and accuracy of provider ownership information.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 07/18/2018
- Next Update Expected
- 11/19/2016
- Legislative Related
- No
-
Medicaid Enhanced Provider Enrollment Screenings Have Not Been Fully Implemented
16-E-05-022.01CMS should assist States in implementing fingerprint-based criminal background checks for all high-risk providers.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/01/2022
- Legislative Related
- No
16-E-05-022.04CMS should develop a central system where States can submit and access screening results from other States.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/06/2023
- Legislative Related
- No
16-E-05-022.05CMS should strengthen minimum standards for fingerprint-based criminal background checks and site visits.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/06/2023
- Legislative Related
- No
16-E-05-022.06CMS should work with States to develop a plan to complete their revalidation screening in a timely way.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 02/02/2026
- Next Update Expected
- 11/07/2025
- Legislative Related
- No
-
Enhanced Enrollment Screening of Medicare Providers: Early Implementation Results
16-E-03-017.03CMS should revise and clarify site visit forms so that they can be more easily used by inspectors to determine whether a facility is operational.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/25/2021
- Legislative Related
- No
-
Medicare Compliance Review of Lafayette General Medical Center for Claims Paid During 2013 and 2014
16-A-06-124.01We recommend that the Hospital refund to the Medicare program $4,126,732 in estimated overpayments for claims that it incorrectly billed.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $4,126,732
- Last Update Received
- -
- Closed Date
- 10/29/2021
- Legislative Related
- No
-
Medicare Contractor Payments to Providers for Hospital Outpatient Dental Services in Jurisdiction H Generally Did Not Comply With Medicare Requirements
16-A-06-114.01We recommend that�Novitas �recover the $1,767,106 in unallowable payments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,767,106
- Last Update Received
- -
- Closed Date
- 02/08/2023
- Legislative Related
- No
-
Opportunities for Program Improvements Related to States' Withdrawals of Federal Medicaid Funds
16-A-06-104.01We recommend that CMS issue guidance that clarifies existing requirements and provides further interpretation of the "as needed" language in 42 CFR � 430.30(d)(3) as it relates to the withdrawal of Medicaid funds.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2024
- Legislative Related
- No
16-A-06-104.02We recommend that CMS publish regulations that are consistent with the Treasury provisions in 31 CFR part 205 and educate States.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/20/2024
- Legislative Related
- No
16-A-06-104.03We recommend that CMS publish and enforce formal guidance based on the November 8, 2011, email, so that States are aware of the appropriate PMS account from which to withdraw or return fund.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2024
- Legislative Related
- No
16-A-06-104.04We recommend that CMS require States to reconcile total Federal Medicaid funds withdrawn with the Federal share of net expenditures and issue appropriate reconciliation guidelines.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/05/2024
- Legislative Related
- No
-
California Improperly Claimed Enhanced Federal Reimbursement for Selected Claim Lines for Medicaid Family Planning Drugs and Supplies in Los Angeles and Orange Counties
16-A-09-098.04We recommend that the State agency ensure that providers comply with State agency policies and procedures requiring them to verify the accuracy of submitted claims for family planning drugs and supplies.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/31/2021
- Legislative Related
- No
-
Missouri Claimed Unallowable Medicaid Payments for Individualized Supported Living Habilitation Services
16-A-07-093.01We recommend that the State agency refund $1,455,378 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,455,378
- Last Update Received
- 10/02/2025
- Next Update Expected
- 04/02/2026
- Legislative Related
- No
-
Nevada Misallocated Costs for Establishing a Health Insurance Marketplace to Its Establishment Grants
16-A-09-079.01We recommend that the Nevada marketplace refund to CMS $893,464, consisting of $26,685 that was misallocated to the establishment grants by not using updated, better data and $866,779 that was misallocated to the establishment grants for BOS components that also benefited Medicaid, or work with CMS to resolve the amounts misallocated to the establishment grants.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $893,464
- Last Update Received
- -
- Closed Date
- 01/10/2025
- Legislative Related
- No
16-A-09-079.02We recommend that the Nevada marketplace work with CMS to ensure that costs claimed after our audit period are allocated correctly, using an updated cost allocation methodology.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/10/2025
- Legislative Related
- No
16-A-09-079.03We recommend that the Nevada marketplace develop a written policy that explains how to perform cost allocations and emphasizes the necessity to use updated, better data when available.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/10/2025
- Legislative Related
- No
16-A-09-079.04We recommend that the Nevada marketplace strengthen staff oversight to ensure (1) application of updated, better data to properly allocate costs and (2) allocation of costs for all allocable project components.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/10/2025
- Legislative Related
- No
-
Promise Hospital of Ascension Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor
16-A-03-073.01We recommend that Promise Healthcare refund to the Medicare program $465,079 for the incorrectly coded claims.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $465,079
- Last Update Received
- -
- Closed Date
- 12/23/2021
- Legislative Related
- No
-
Most Children With Medicaid in Four States Are Not Receiving Required Dental Services
16-E-02-008.02CMS should develop benchmarks for dental services and require States to create mandatory action plans to meet them.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/05/2024
- Legislative Related
- No
16-E-02-008.04CMS should work with States to analyze the effects of Medicaid payments on access to dental providers.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/09/2025
- Legislative Related
- No
16-E-02-008.06CMS should work with States to track children�s utilization of required dental services.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/05/2024
- Legislative Related
- No
-
Not All of the Colorado Marketplace's Internal Controls Were Effective in Ensuring That Individuals Were Enrolled in Qualified Health Plans According to Federal Requirements
16-A-07-050.01We recommend that the Colorado marketplace improve the design of its enrollment system to verify the eligibility of applicants who opted not to participate in the insurance affordability programs and who enrolled in a QHP.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/03/2022
- Legislative Related
- No
16-A-07-050.02We recommend that the Colorado marketplace improve the design of its enrollment system to verify eligibility by obtaining OPM or non-ESI data through the Data Hub.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/03/2022
- Legislative Related
- No
-
New York State Improperly Claimed Medicaid Reimbursement for Some Adult Day Health Care Services
16-A-02-049.01We recommend that the State agency refund $70,486,492 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Partial Concur
- Potential Savings
- $70,486,492
- Last Update Received
- 09/11/2025
- Next Update Expected
- 03/11/2026
- Legislative Related
- No