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 December 17, 2025
1,189
Unimplemented
recommendations
3,163
Implemented and Closed
recommendations since FY 2017
Views
OIG Recommendations Grouped by Report
Showing 1,241–1,260 of 1,352 reports, containing 4,352 recommendations
Sorted by latest release date
-
The University of California at Irvine's Pilot Payroll Certification System Could Not Be Assessed
15-A-04-041.01We recommended that the University reconcile the $491,291,290 it reported on its FFRs to its accounting records.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- $491,291,290
- Last Update Received
- -
- Closed Date
- 03/28/2022
- Legislative Related
- No
15-A-04-041.02We recommended that the University modify its financial management system to ensure that amounts it reports on its FFRs can be supported by amounts recorded in its accounting records.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/28/2022
- Legislative Related
- No
-
Access to Care: Provider Availability in Medicaid Managed Care
15-E-02-009.01CMS should work with States to assess the number of providers offering appointments and improve the accuracy of plan information.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/12/2022
- Legislative Related
- No
15-E-02-009.02CMS should work with States to ensure that plans' networks are adequate and meet the needs of their Medicaid managed care enrollees.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/12/2022
- Legislative Related
- No
15-E-02-009.03CMS should work with States to ensure that plans are complying with existing State standards and assess whether additional standards are needed.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/12/2022
- Legislative Related
- No
-
New Jersey Claimed Excessive Medicaid Disproportionate Share Hospital Payments for Five County-Operated Psychiatric Facilities
15-A-02-026.01We recommend that the State agency refund $11,855,610 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $11,855,610
- Last Update Received
- 10/08/2025
- Next Update Expected
- 04/08/2026
- Legislative Related
- No
-
Missouri Claimed Unallowable Medicaid Payments for Targeted Case Management Services Provided to Individuals With Developmental Disabilities
15-A-07-019.01We recommend that the State agency refund $11,464,069 to the Federal Government, adjust future payment rates for TCM services and work with the Centers for Medicare & Medicaid Services to determine the unallowable Medicaid payments that should be refunded to the Federal Government, and follow the State plan requirements for the calculation of rebased payment rates for TCM services.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $11,464,069
- Last Update Received
- 10/02/2025
- Next Update Expected
- 04/02/2026
- Legislative Related
- No
15-A-07-019.02We recommend that the State agency adjust future payment rates for TCM services and work with the Centers for Medicare & Medicaid Services to determine the unallowable Medicaid payments that should be refunded to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 10/02/2025
- Next Update Expected
- 04/02/2026
- Legislative Related
- No
-
Texas Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Medical Transportation Program
15-A-06-008.01We recommend that the State agency refund $30,385,925 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $30,385,925
- Last Update Received
- 09/16/2025
- Next Update Expected
- 03/17/2026
- Legislative Related
- No
-
Medicare Beneficiaries Paid Nearly Half of the Costs for Outpatient Services at Critical Access Hospitals
15-E-05-001.01CMS should seek legislative authority to modify how coinsurance is calculated for outpatient services received at Critical Access Hospitals.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 06/23/2025
- Next Update Expected
- 07/01/2025
- Legislative Related
- Yes
-
State Standards for Access to Care in Medicaid Managed Care
14-E-02-078.01CMS should strengthen its oversight of State standards and ensure that States develop standards for key providers.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/17/2023
- Legislative Related
- No
14-E-02-078.02CMS should strengthen its oversight of States' methods to assess plan compliance and ensure that States conduct direct tests of access standards.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/17/2023
- Legislative Related
- No
14-E-02-078.03CMS should improve States' efforts to identify and address violations of access standards.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/17/2023
- Legislative Related
- No
-
Medicare Part B Prescription Drug Dispensing and Supplying Fee Payment Rates Are Considerably Higher Than the Rates Paid by Other Government Programs
14-A-06-280.01We recommend that CMS amend current regulations to decrease the Part B payment rates for dispensing and supplying fees to rates similar to those of other payers, such as Part D and Medicaid.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/20/2023
- Legislative Related
- No
-
CMS Has Yet To Enforce a Statutory Provision Related to Rural Health Clinics
14-E-05-074.01CMS should issue regulations to ensure that RHCs determined to be essential providers remain certified as RHCs.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 04/29/2024
- Next Update Expected
- 07/02/2025
- Legislative Related
- No
-
The District of Columbia Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs
14-A-03-263.01We recommend the State Agency refund to the Federal Government $2,392,539 (Federal share) for single-source and top-20 multiple-source physician-administered drug claims that were ineligible for Federal reimbursement.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $2,392,539
- Last Update Received
- -
- Closed Date
- 11/01/2021
- Legislative Related
- No
14-A-03-263.03We recommend the State agency work with CMS to determine and refund the unallowable Federal reimbursement for physician-administered drugs claimed without NDCs after January 1, 2011.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/17/2024
- Legislative Related
- No
14-A-03-263.04We recommend the State agency ensure that its MMIS edits require valid NDCs for payment on all drug claims.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/09/2022
- Legislative Related
- No
14-A-03-263.05We recommend that the State agency improve its rebate processes to ensure that all physician-administered drug claims are submitted for rebates.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/09/2022
- Legislative Related
- No
-
Servicios Suplementarios de Salud, Inc., Improperly Claimed Medicare Reimbursement for Some Hospice Services
14-A-02-244.01We recommend that the Hospice refund $453,558 to the Federal Government.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $453,558
- Last Update Received
- -
- Closed Date
- 11/18/2019
- Legislative Related
- No
-
Virginia Improperly Claimed Federal Reimbursement for Most Reviewed Medicaid Payments to Catawba Hospital
14-A-05-220.01We recommend that the State Medicaid agency refund $17,395,647 to the Federal Government for its share of payments to Catawba for inpatient hospital services it provided to patients aged 65 or older on dates outside the regulatory gap period.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $17,395,647
- Last Update Received
- 09/30/2025
- Next Update Expected
- 03/30/2026
- Legislative Related
- No
14-A-05-220.02We recommend that the State Medicaid agency work with CMS to determine whether the State Medicaid agency should refund an additional $1,212,002 to the Federal Government for its share of payments to Catawba for inpatient hospital services it provided to patients aged 65 or older on dates during the regulatory gap period.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,212,002
- Last Update Received
- 09/30/2025
- Next Update Expected
- 03/30/2026
- Legislative Related
- No
14-A-05-220.03We recommend that the State Medicaid agency identify and refund the Federal share of any additional Medicaid payments to Catawba for inpatient hospital services it provided to patients aged 65 or older on dates after the audit period if neither the State Medicaid agency nor Catawba can demonstrate Catawba's compliance with Federal requirements for those services.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 09/30/2025
- Next Update Expected
- 03/30/2026
- Legislative Related
- No
14-A-05-220.04We recommend that the State Medicaid agency ensure that it claims Federal reimbursement for Medicaid payments for inpatient hospital services provided to patients aged 65 or older in IMDs only if those IMDs can demonstrate compliance with the special Medicare CoP.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 09/30/2025
- Next Update Expected
- 03/30/2026
- Legislative Related
- No
-
Virginia Improperly Claimed Federal Reimbursement for Most Reviewed Medicaid Payments to Piedmont Geriatric Hospital
14-A-05-221.01We recommend that the State Medicaid agency refund $36,903,169 to the Federal Government for its share of payments to Piedmont for inpatient hospital services it provided to patients aged 65 or older on dates outside the regulatory gap period.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $36,903,169
- Last Update Received
- 09/30/2025
- Next Update Expected
- 03/30/2026
- Legislative Related
- No
14-A-05-221.02We recommend that the State Medicaid agency work with CMS to determine whether the State Medicaid agency should refund an additional $2,462,157 to the Federal Government for its share of payments to Piedmont for inpatient hospital services it provided to patients aged 65 or older on dates during the regulatory gap period.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $2,462,157
- Last Update Received
- 09/30/2025
- Next Update Expected
- 03/30/2026
- Legislative Related
- No
14-A-05-221.03We recommend that the State Medicaid agency ensure that it claims Federal reimbursement for Medicaid payments for inpatient hospital services provided to patients aged 65 or older in IMDs only if those IMDs can demonstrate compliance with the special Medicare CoP.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 09/30/2025
- Next Update Expected
- 03/30/2026
- Legislative Related
- No
-
New York Claimed Nonhospital-Based Continuing Day Treatment Services That Were Not in Compliance With Federal and State Requirements
14-A-02-213.01We recommend the State agency refund $18,093,953 to the Federal government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Partial Concur
- Potential Savings
- $14,108,014
- Last Update Received
- 09/15/2025
- Next Update Expected
- 03/30/2026
- Legislative Related
- No
-
Medicare Compliance Review of University of Cincinnati Medical Center for Calendar Years 2010 and 2011
14-A-05-193.01We recommend that the Hospital refund to the Medicare contractor $9,818,296 (of which $603,267 was net overpayments identified in our sample) in estimated net overpayments for CYs 2010 and 2011 that it incorrectly billed.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $9,818,296
- Last Update Received
- -
- Closed Date
- 02/11/2022
- Legislative Related
- No
-
Vulnerabilities in Medicare's Interrupted-Stay Policy for Long-Term Care Hospitals
14-E-04-052.02CMS should conduct additional analysis to determine the extent to which financial incentives influence LTCH readmission decisions.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/18/2024
- Legislative Related
- No
-
The Medicare Contractors for Jurisdiction H Overpaid Providers for Selected Outpatient Drugs
14-A-06-174.01We recommend that Novitas recover the $3,341,188 in identified overpayments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $3,341,188
- Last Update Received
- -
- Closed Date
- 12/03/2015
- Legislative Related
- No
-
Compounded Drugs Under Medicare Part B: Payment and Oversight
14-E-03-048.02CMS should explore the possibility of requiring providers to identify on the Part B claim the pharmacy that produced the compounded drug.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/22/2024
- Legislative Related
- No
14-E-03-048.03CMS should explore the possibility of conducting descriptive analyses of Part B claims for compounded drugs.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 02/24/2022
- Next Update Expected
- 03/10/2023
- Legislative Related
- No
-
Vulnerabilities in the HHS Small Business Innovation Research Program
14-E-04-047.03HHS OpDivs should ensure compliance with SBIR eligibility requirements.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 06/14/2024
- Next Update Expected
- 07/02/2025
- Legislative Related
- No
14-E-04-047.04HHS OpDivs should improve procedures to check for duplicative awards.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 06/14/2024
- Next Update Expected
- 07/02/2025
- Legislative Related
- No
-
Medicare and Beneficiaries Could Save Billions If CMS Reduces Hospital Outpatient Department Payment Rates for Ambulatory Surgical Center-Approved Procedures to Ambulatory Surgical Center Payment Rates
14-A-05-157.01Seek legislation that would exempt the reduced expenditures as a result of lower OPPS payment rates from budget neutrality adjustments for ASC-approved procedures.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 06/30/2025
- Next Update Expected
- 07/01/2025
- Legislative Related
- Yes
14-A-05-157.02Reduce OPPS payment rates for ASC-approved procedures on beneficiaries with no-risk or low-risk clinical needs in outpatient departments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 06/30/2025
- Next Update Expected
- 01/07/2026
- Legislative Related
- No
14-A-05-157.03Develop and implement a payment strategy in which outpatient departments would continue to receive the standard OPPS payment rate for ASC-approved procedures that must be provided in an outpatient department because of a beneficiary's individual clinical needs.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $15,000,000,000
- Last Update Received
- 06/30/2025
- Next Update Expected
- 01/07/2026
- Legislative Related
- No