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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—a subset that we think, if implemented, would have the most impact (learn more). Notable differences from our previous Top Unimplemented Recommendations report include:
- The list is comprised of individual recommendations from OIG reports, not rolled up by topic.
- No arbitrary cap is imposed on the number of recommendations included.
- Status updates as recommendations are implemented.
Summary of All Recommendations
Updated Monthly · Last updated on November 15, 2024
1,310
Unimplemented
recommendations
$270.4B
Potential savingsfrom unimplemented recommendations
2,698
Implemented and Closed
recommendations since FY 2017
Views
OIG Recommendations Grouped by Report
Showing 581–600 of 1,223 reports, containing 4,008 recommendations
Sorted by latest release date
-
CMS Could Have Saved $192 Million by Targeting Home Health Claims for Review With Visits Slightly Above the Threshold That Triggers a Higher Medicare Payment
20-A-09-125.01We recommend that the Centers for Medicare & Medicaid Services direct the MACs to recover the $41,613 in identified overpayments made to HHAs for the sampled claims.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $41,613
- Last Update Received
- -
- Closed Date
- 08/09/2021
- Legislative Related
- No
20-A-09-125.02We recommend that the Centers for Medicare & Medicaid Services require the MACs to perform data analysis and risk assessments of claims with visits slightly above the applicable LUPA threshold and target these claims for additional review.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/09/2021
- Legislative Related
- No
20-A-09-125.03We recommend that the Centers for Medicare & Medicaid Services instruct the MACs to educate HHA providers on properly billing for home health services with visits slightly above the applicable LUPA threshold, which could have saved Medicare as much as $191,773,995 during our audit period.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $191,773,995
- Last Update Received
- -
- Closed Date
- 08/09/2021
- Legislative Related
- No
-
HRSA's Monitoring Did Not Always Ensure Health Centers' Compliance With Federal Requirements for HRSA's Access Increases In Mental Health and Substance Abuse Services Supplemental Grant Funding
20-A-02-121.01We recommend that the Health Resources and Services Administration assess health centers' progress toward meeting AIMS grant award conditions to increase personnel and patients' access to care and follow up with appropriate corrective action, such as providing technical assistance or discontinuing or reducing future AIMS grant funds.- Status
- Closed Implemented
- Responsible Agency
- HRSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/17/2021
- Legislative Related
- No
20-A-02-121.02We recommend that the Health Resources and Services Administration review BPRs to identify health centers that did not report progress toward meeting their health IT or training goals.- Status
- Closed Implemented
- Responsible Agency
- HRSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/17/2021
- Legislative Related
- No
20-A-02-121.03We recommend that the Health Resources and Services Administration ensure that it follows its policy for timely responding to health centers' requests to carry over grant funds.- Status
- Closed Implemented
- Responsible Agency
- HRSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/16/2021
- Legislative Related
- No
-
On-Site Psychological Services, P.C.: Audit of Medicare Payments for Psychotherapy Services
20-A-02-124.01We recommend that On-Site Psychological Services, P.C. refund to the Medicare program the estimated $3,373,440 overpayment.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $3,373,440
- Last Update Received
- -
- Closed Date
- 02/01/2024
- Legislative Related
- No
20-A-02-124.02We recommend that On-Site Psychological Services, P.C. based upon the results of this audit, exercise reasonable diligence to identify, report, and return any overpayments in accordance with the 60-day rule25 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
- 08/10/2023
- Legislative Related
- No
20-A-02-124.03We recommend that On-Site Psychological Services, P.C. strengthen its management oversight to ensure that it properly maintains treatment plans that contain all required elements, therapeutic maneuvers utilized by clinicians are properly documented in treatment notes, and it properly maintains reliable treatment notes to support services billed.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/09/2020
- Legislative Related
- No
20-A-02-124.04We recommend that On-Site Psychological Services, P.C. implement controls for authenticating signatures on treatment notes.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/09/2020
- Legislative Related
- No
-
Utah's Monitoring Process Generally Ensured Child Care Provider Compliance With State Criminal Background Check Requirements
20-A-07-122.01We recommend that the Utah Department of Health consider improving its policies and procedures for the monitoring of criminal background checks so that it routinely obtains wage information from DWS prior to the inspections of child care providers, so as to reduce the State agency's dependence on provider disclosure of prospective covered individuals.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/06/2023
- Legislative Related
- No
-
Alaska Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs
20-A-09-123.01Refund to the Federal Government $1,541,303 ($939,361 Federal share) for claims for single-source physician-administered drugs that were ineligible for Federal reimbursement;- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $939,361
- Last Update Received
- -
- Closed Date
- 12/11/2020
- Legislative Related
- No
20-A-09-123.02Refund to the Federal Government $115,712 ($73,892 Federal share) for claims for top 20 multiple-source physician-administered drugs that were ineligible for Federal reimbursement- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $73,892
- Last Update Received
- -
- Closed Date
- 12/11/2020
- Legislative Related
- No
20-A-09-123.03Work with CMS to determine the unallowable portion of $7,229 ($3,615 Federal share) for claims for other physician-administered drugs that were submitted with invalid NDCs and that may have been ineligible for Federal reimbursement and refund that amount.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $3,615
- Last Update Received
- -
- Closed Date
- 05/17/2021
- Legislative Related
- No
20-A-09-123.04Work with CMS to determine whether the remaining $300,266 ($185,066 Federal share) for claims for other physician-administered drugs could have been billed to the manufacturers to receive rebates and, if so, upon receipt of the rebates, refund the Federal share of the manufacturers' rebates for those claims.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $185,066
- Last Update Received
- -
- Closed Date
- 05/17/2021
- Legislative Related
- No
20-A-09-123.05Work with CMS to determine and refund the unallowable portion of Federal reimbursement for physician-administered drugs that were not billed for rebates after December 31, 2017.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/17/2021
- Legislative Related
- No
20-A-09-123.06Strengthen its internal controls to ensure that it bills manufacturers for rebates for all physician-administered drugs that are eligible for rebates.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/17/2021
- Legislative Related
- No
-
CMS Did Not Administer and Manage Strategic Communications Services Contracts in Accordance With Federal Requirements
20-A-12-120.01We recommend HHS determine whether any HHS contractors or subcontractors are performing inherently governmental functions and whether any active CMS service contracts or task orders are being administered as personal services contracts, and take action to correct their administration.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/25/2024
- Legislative Related
- No
20-A-12-120.02We recommend HHS work with CMS's Office of the Administrator, in consultation with the HHS Office of Grants and Acquisition Policy and Accountability and the HHS Office of General Counsel, to improve contract management and ensure compliance with the FAR.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/09/2021
- Legislative Related
- No
20-A-12-120.03We recommend HHS provide training to political appointees and senior leaders related to proper contract administration.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/13/2023
- Next Update Expected
- 10/13/2023
- Legislative Related
- No
20-A-12-120.04We recommend CMS provide training to program staff and contracting personnel, such as the contracting officers and CORs, on FAR requirements specifying that contracts must not be used for the performance of inherently governmental functions and related to written consent for the use of subcontractors.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/04/2022
- Legislative Related
- No
20-A-12-120.05We recommend CMS ensure that contracting personnel, such as the contracting officer, review contracts before they are awarded to determine whether they include language that could lead to those contracts being administered as personal services contracts.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/01/2022
- Legislative Related
- No
20-A-12-120.06We recommend CMS ensure that for all future contracts CMS receives and accepts deliverables in accordance with the SOW, CORs maintain working contract files, and CORs document all changes made to the SOW.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/04/2022
- Legislative Related
- No
20-A-12-120.07We recommend CMS review contractor costs incurred under TO 1 and TO 2 during the overlap of performance periods to determine whether duplicate payments were made and take appropriate action, as necessary.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/23/2020
- Legislative Related
- No
20-A-12-120.08We recommend CMS expand the “COR Invoice Approval Operating Guidance” to include a description of acceptable documentation to support contractor payments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/01/2022
- Legislative Related
- No
20-A-12-120.09We recommend CMS review contractor invoices identified in this report that contained questionable costs, determine the allowability of those costs, and take appropriate action to recoup any improperly paid amounts.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/23/2020
- Legislative Related
- No
-
Ohio Did Not Ensure the Accuracy and Completeness of Psychotropic and Opioid Medication Information Recorded in Its Child Welfare Information System for Children in Foster Care
20-A-05-118.01We recommend that the Ohio Department of Job and Family Services improve monitoring to ensure that the county agencies maintain the required documentation in the Ohio SACWIS14 for the medications prescribed for children in its custody.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/29/2022
- Legislative Related
- No
20-A-05-118.02We recommend that the Ohio Department of Job and Family Services continue its efforts to obtain access to Medicaid claim data for children in its custody.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/29/2022
- Legislative Related
- No
20-A-05-118.03We recommend that the Ohio Department of Job and Family Services implement procedures for the monitoring of opioid medications prescribed for children in its custody.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/29/2022
- Legislative Related
- No
20-A-05-118.04We recommend that the Ohio Department of Job and Family Services review and update the medication list in the Ohio SACWIS on a regular schedule, at least once a year and as medications are approved or discontinued, to improve the reliability and relevancy of the list.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/29/2022
- Legislative Related
- No
20-A-05-118.05We recommend that the Ohio Department of Job and Family Services provide training and technical assistance to county agency workers who input medical and medication information into the Ohio SACWIS.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/29/2022
- Legislative Related
- No
-
Hospitals Overbilled Medicare $1 Billion by Incorrectly Assigning Severe Malnutrition Diagnosis Codes to Inpatient Hospital Claims
20-A-03-117.01We recommend that the Centers for Medicare & Medicaid Services collect the portion of the $914,128 for the incorrectly billed hospital claims that are within the reopening period.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $914,128
- Last Update Received
- -
- Closed Date
- 02/10/2021
- Legislative Related
- No
20-A-03-117.02We recommend that the Centers for Medicare & Medicaid Services notify appropriate providers (i.e., those for whom CMS determines this audit constitutes credible information of potential overpayments) so that the providers 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
- 02/10/2021
- Legislative Related
- No
20-A-03-117.03We recommend that the Centers for Medicare & Medicaid Services review the 224,175 inpatient claims in our sampling frame that were not part of our sample but were within the reopening period to identify which were incorrectly billed and recover identified overpayments.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,024,623,449
- Last Update Received
- -
- Closed Date
- 12/19/2022
- Legislative Related
- No
20-A-03-117.04We recommend that the Centers for Medicare & Medicaid Services review how hospitals are using diagnosis code E41 for nutritional marasmus and diagnosis code E43 for unspecified severe protein-calorie malnutrition and work with hospitals to ensure that they correctly bill Medicare when using severe malnutrition diagnosis codes.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/27/2023
- Legislative Related
- No
-
Medicaid Data Can Be Used To Identify Instances of Potential Child Abuse or Neglect
20-A-01-116.01We recommend that the Centers for Medicare & Medicaid Services issue guidance, such as an Informational Bulletin, to inform States that performing a data analysis to identify Medicaid claims containing one or more diagnosis codes indicating potential child abuse or neglect could help identify incidents of potential child abuse or neglect and help ensure compliance with the States' mandatory reporting laws.- Status
- Closed Acceptable Alternative
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/24/2024
- Legislative Related
- No
20-A-01-116.02We recommend that the Centers for Medicare & Medicaid Services assess the sufficiency of existing Federal requirements to report suspected child abuse and neglect of Medicaid beneficiaries to determine whether it should strengthen those requirements or seek additional authorities to provide oversight over the reporting of suspected child abuse and neglect of Medicaid beneficiaries.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/13/2021
- Legislative Related
- No
-
Texas Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities
20-A-06-115.01We recommend that the Texas Health and Human Services Commission implement procedures to ensure that ensure that procedures are followed to detect unreported deaths.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/09/2020
- Legislative Related
- No
20-A-06-115.02We recommend that the Texas Health and Human Services Commission implement a system to ensure that it can track complaints not closed within 10 days.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/09/2020
- Legislative Related
- No
20-A-06-115.03We recommend that the Texas Health and Human Services Commission implement procedures to ensure that investigations of abuse, neglect, and exploitation are entered in the Health and Human Services Enterprise Administration Reporting and Tracking system database.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/09/2020
- Legislative Related
- No
-
Sharon Baptist Head Start Claimed Unallowable Rent and Failed To Return Embezzled Funds
20-A-02-114.01We recommend that Sharon Baptist Head Start refund to the Federal Government the $36,264 in unallowable rent expense charged to its direct Head Start grant during our audit period.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- $36,264
- Last Update Received
- -
- Closed Date
- 07/08/2020
- Legislative Related
- No
20-A-02-114.02We recommend that Sharon Baptist Head Start work with ACF to determine the portion of the $489,564 in rent expense from prior periods that should be refunded and refund the appropriate amount.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- $489,564
- Last Update Received
- -
- Closed Date
- 07/08/2020
- Legislative Related
- No
20-A-02-114.03We recommend that Sharon Baptist Head Start refund to the Federal Government the $171,000 in embezzled funds.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- $171,000
- Last Update Received
- -
- Closed Date
- 07/08/2020
- Legislative Related
- No
20-A-02-114.04Disallow unallowable rental costs claimed by Sharon Baptist of $1,025,657.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- $1,018,478
- Last Update Received
- -
- Closed Date
- 04/26/2021
- Legislative Related
- No
-
Freedom Orthotics, Inc.: Audit of Medicare Payments for Orthotic Braces
20-A-09-113.01We recommend that Freedom Orthotics, Inc. refund to the DME MACs $6,987,413 in estimated overpayments for orthotic braces.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $6,987,413
- Last Update Received
- -
- Closed Date
- 11/05/2020
- Legislative Related
- No
20-A-09-113.02We recommend that Freedom Orthotics, Inc. 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 Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/05/2020
- Legislative Related
- No
20-A-09-113.03We recommend that Freedom Orthotics Inc. obtain as much information from beneficiary medical records as it determines necessary to assure itself that claims for orthotic braces meet Medicare requirements for medical necessity- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/05/2020
- Legislative Related
- No
-
Hawaii Medicaid Fraud Control Unit: 2019 Onsite Review
20-E-06-026.01Develop and implement a plan to increase Medicaid fraud referrals from the Medicaid agency and other stakeholders.- Status
- Closed Implemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/20/2020
- Legislative Related
- No
20-E-06-026.02Develop and expedite an in-house Medicaid fraud training program for Unit investigators.- Status
- Closed Implemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/12/2022
- Legislative Related
- No
20-E-06-026.03Revise the Unit's agreement with Adult Protective Services to establish minimum criteria for a complaint to be sent to the MFCU.- Status
- Closed Implemented
- Responsible Agency
- MFCU
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/20/2020
- Legislative Related
- No
-
Unaccompanied Alien Children Program Care Provider Facilities Do Not Include All Required Security Measures in Their Checklists
20-E-05-025.01ACF should work with ORR to develop and implement methods to ensure that care providers' facilities inspection checklists include all required physical security measures.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/02/2022
- Legislative Related
- No
20-E-05-025.02ACF should work with ORR to develop and implement methods to ensure that care providers regularly report inspection checklist results to ORR.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/02/2022
- Legislative Related
- No
20-E-05-025.03ACF should work with ORR to conduct a review to determine whether to enhance required physical security measures.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 10/15/2024
- Next Update Expected
- 09/12/2024
- Legislative Related
- No
-
The Office of Refugee Resettlement's Incident Reporting System Is Not Effectively Capturing Data To Assist Its Efforts To Ensure the Safety of Minors in HHS Custody
20-E-09-024.01ACF should work with ORR to systematically collect key information about incidents that allows for efficient and effective oversight to ensure that facilities are taking appropriate actions to protect minors.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/15/2024
- Legislative Related
- No
20-E-09-024.02ACF should work with ORR to track and trend incident report information to better safeguard minors in ORR care.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/15/2024
- Legislative Related
- No
20-E-09-024.03ACF should work with ORR to work with care provider facilities to address staffing shortages of youth care workers that impact the ability to prevent, detect, and report incidents.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/15/2024
- Legislative Related
- No
20-E-09-024.04ACF should work with ORR to improve ORR's guidance to facilities to help them consistently identify and report significant incidents.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/15/2024
- Legislative Related
- No
-
New Jersey Did Not Ensure That Its Managed Care Organizations Adequately Assessed and Covered Medicaid Beneficiaries' Needs for Long-Term Services and Supports
20-A-02-110.01We recommend that the New Jersey Department of Human Services improve its monitoring and follow-up activities to ensure that its MCOs comply with Federal and State requirements detailed in its contracts with the MCOs for providing services to beneficiaries according to personalized care plans and actively coordinating, monitoring, and documenting beneficiaries' physical health, behavioral health, and long-term-care needs.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 08/13/2020
- Next Update Expected
- 06/01/2022
- Legislative Related
- No
20-A-02-110.02We recommend that the New Jersey Department of Human Services take actions, including imposing corrective action plans, fines, or other financial disincentives on MCOs, to address the MCOs' noncompliance affecting $721 million ($386 million Federal share) in capitation payments in CY 2016 and ensure future compliance with contract requirements.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $385,867,495
- Last Update Received
- 08/13/2020
- Next Update Expected
- 06/01/2022
- Legislative Related
- No
-
The National Cancer Institute Needs To Strengthen Procedures in Its Pre-Award Process To Assess Risk for Higher Risk Applicants
20-A-03-111.01Update and strengthen written procedures for conducting and documenting applicant financial capability reviews as required by the GPAM and for determining how to manage risks identified by NCI Specialists- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/01/2021
- Legislative Related
- No
20-A-03-111.02Provide training to NCI Specialists about how to adequately document their evaluation of the financial capability of applicants.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/01/2021
- Legislative Related
- No
-
Medicare Hospital Provider Compliance Audit: The Ohio State University Hospital
20-A-05-107.01We recommend that The Ohio State University Hospital refund to the Medicare contractor $3,736,490 (of which $335,832 was net overpayments identified in our sample) in estimated overpayments for incorrectly billed services that are within the 4-year claim reopening period.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $3,736,490
- Last Update Received
- -
- Closed Date
- 12/22/2022
- Legislative Related
- No
20-A-05-107.02We recommend that The Ohio State University Hospital 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
- $90,398
- Last Update Received
- -
- Closed Date
- 06/10/2021
- Legislative Related
- No
20-A-05-107.03We recommend that The Ohio State University Hospital strengthen controls to ensure full compliance with Medicare requirements; specifically, ensure that all IRF beneficiaries meet Medicare criteria for acute inpatient rehabilitation; all inpatient beneficiaries meet Medicare criteria for inpatient hospital services; diagnosis and discharge status codes are supported in the medical records and staff are properly trained, and medical records accurately document the appropriate number of units and distinct procedural services and that staff are properly trained.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/13/2021
- Legislative Related
- No
-
The National Eye Institute Generally Had Adequate Procedures To Assess an Applicant's Risk During the Pre-Award Process
20-A-05-108.01We recommend that the National Institutes of Health direct the National Eye Institute to develop written procedures for conducting and documenting the financial capability review required by the HHS GPAM.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/07/2020
- Legislative Related
- No
20-A-05-108.02We recommend that the National Institutes of Health direct the National Eye Institute to provide training to NEI Specialists about how to adequately document their review of a grant applicant's financial statements and the organization's financial status.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/07/2020
- Legislative Related
- No
-
U.S. Department of Health and Human Services Met Many Requirements of the Improper Payments Information Act of 2002 but Did Not Fully Comply for Fiscal Year 2019
20-A-17-106.01We recommend that HHS continue to work with OMB and other stakeholders to develop and implement an approach to reporting on TANF improper payments in FY 2020.- Status
- Closed Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/11/2020
- Legislative Related
- No
20-A-17-106.02We recommend that HHS focus on the root causes of the improper payment percentage and evaluate critical and feasible action steps to assist states with their compliance efforts for these new requirements.- Status
- Closed Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/11/2020
- Legislative Related
- No
20-A-17-106.03We recommend that HHS focus on the root causes of the improper payment percentage and evaluate critical and feasible action steps to assist states with their compliance efforts for these new requirements.- Status
- Closed Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/11/2020
- Legislative Related
- No
20-A-17-106.04We recommend that HHS continue to explore alternative vehicles to conduct recovery audits that will fit into the larger Medicare Part C.- Status
- Closed Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/11/2020
- Legislative Related
- No
20-A-17-106.05We recommend that HHS continue to focus on developing and implementing an approach to reporting on TANF improper payments, as this process will aid in identifying root causes of TANF improper payments. In addition, we recommend that HHS develop and publish corrective action plans after implementing an approach.- Status
- Closed Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/11/2020
- Legislative Related
- No