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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 701–720 of 1,223 reports, containing 4,008 recommendations
Sorted by latest release date
-
The Centers for Medicare & Medicaid Services Could Improve Its Processes for Evaluating and Reporting Payment Recovery Savings Associated With the Fraud Prevention System
20-A-01-007.01We recommend that CMS continue to work with the Contractors and the MACs to develop strategies that improve timely coordination to give the MACs a better opportunity to recover overpayments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/11/2020
- Legislative Related
- No
20-A-01-007.02We recommend that CMS establish a uniform methodology for the Contractors to use when reporting estimates for the value of law enforcement referrals.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/11/2020
- Legislative Related
- No
20-A-01-007.03We recommend that CMS update the FPS's law enforcement referral adjustment factor.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/11/2020
- Legislative Related
- No
-
Rhode Island Hospital Submitted Some Inaccurate Wage Data
20-A-01-005.01We recommend that the Rhode Island Hospital ensure that all personnel involved in Medicare wage-data reporting are fully trained in compliance with the requirements in the Manual.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/04/2020
- Legislative Related
- No
20-A-01-005.02We recommend that the Rhode Island Hospital strengthen review and reconciliation procedures to ensure that the Medicare wage data it reports to CMS in the future are accurate, allowable, supportable, and in compliance with Medicare requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/04/2020
- Legislative Related
- No
-
Texas Did Not Ensure That Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions
20-A-06-004.01We recommend that the State agency work with the five MCOs to determine the portion of the $16,734,145 that was unallowable for claims containing PPCs and its impact on current- and future-year capitation payment rates.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/21/2019
- Legislative Related
- No
20-A-06-004.02We recommend that the State agency require all its MCOs to implement policies and procedures to prohibit payments for inpatient hospital services related to treating PPCs for all provider payment methodologies.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/30/2021
- Legislative Related
- No
20-A-06-004.03We recommend that the State agency require all its MCOs to review all claims for inpatient hospital services that were paid after our audit period to determine whether any payments for services related to treating PPCs were unallowable and adjust future capitation payment rates for any unallowable payments identified.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/21/2019
- Legislative Related
- No
20-A-06-004.04We recommend that the State agency strengthen its monitoring of all its MCOs to ensure the MCOs comply with Federal and State requirements and its managed-care contracts relating to the nonpayment of PPCs.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/30/2021
- Legislative Related
- No
20-A-06-004.05We recommend that the State agency ensure all MCOs implement edits to appropriately reduce or deny claims for other PPCs.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/30/2021
- Legislative Related
- No
20-A-06-004.06We recommend that the State agency consider enforcing the provision in its contracts that allows liquidated damages to be imposed on the five MCOs due to their failure to process claims in accordance with Federal laws and regulations.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/30/2021
- Legislative Related
- No
20-A-06-004.07We recommend that the State agency include specific measures in its contracts that would allow the State agency to recoup funds from all MCOs when contract provisions and Federal and State requirements are not met—a measure that, if incorporated, could result in cost savings for Medicaid.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/30/2021
- Legislative Related
- No
-
New York State Claimed Federal Reimbursement for Unallowable Childcare Subsidies Paid to New York City
20-A-02-002.01We recommend that the New York State Office of Children and Family Services refund $24,662,410 in unallowable childcare subsidies claimed for Federal reimbursement.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- $24,662,410
- Last Update Received
- -
- Closed Date
- 09/21/2020
- Legislative Related
- No
20-A-02-002.02We recommend that the New York State Office of Children and Family Services ensure that New York City's recently implemented CCDF program controls are properly functioning.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/21/2020
- Legislative Related
- No
-
The Minnesota State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths
20-A-05-001.01We recommend that the Minnesota Department of Human Services refund $3,243,531 to the Federal Government.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $3,243,531
- Last Update Received
- -
- Closed Date
- 01/26/2022
- Legislative Related
- No
20-A-05-001.02We recommend that the Minnesota Department of Human Services identify and recover unallowable payments made to MCOs during our audit period on behalf of the deceased beneficiaries, which we estimated to be at least $3,685,087.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/27/2022
- Legislative Related
- No
20-A-05-001.03We recommend that the Minnesota Department of Human Services identify capitation payments made on behalf of deceased beneficiaries before and after our audit period and repay the Federal share of amounts recovered.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/04/2021
- Legislative Related
- No
20-A-05-001.04We recommend that the Minnesota Department of Human Services ensure that State agency staff are properly trained to process dates of death and eligibility termination in accordance with State agency internal policies.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/15/2020
- Legislative Related
- No
20-A-05-001.05We recommend that the Minnesota Department of Human Services utilize additional sources to identify dates of death to help reduce unallowable payments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/05/2022
- Legislative Related
- No
-
Wisconsin Physicians Service Needs Enhanced Guidance and Provider Education Related to Phlebotomy Travel Allowances
19-A-06-163.01We recommend that Wisconsin Physicians Service work with the Centers for Medicare and Medicaid Services to clarify guidance to providers, which could have resulted in savings totaling an estimated $353,755 during our audit period.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $353,755
- Last Update Received
- -
- Closed Date
- 09/30/2019
- Legislative Related
- No
19-A-06-163.02We recommend that Wisconsin Physicians Service educate providers on how to correctly calculate the prorated mileage for phlebotomy travel allowance payments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/30/2019
- Legislative Related
- No
19-A-06-163.03We recommend that Wisconsin Physicians Service educate providers on their responsibility to bring any previously paid claims to their Medicare administrative contractor's attention if they were paid using the wrong rate.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/30/2019
- Legislative Related
- No
19-A-06-163.04We recommend that Wisconsin Physicians Service educate providers on their responsibility to maintain adequate documentation to support payment for phlebotomy travel allowance payments.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/30/2019
- Legislative Related
- No
-
California Needs To Improve Oversight of Community-Based Adult Services Providers' Compliance With Health and Safety and Administrative Requirements
19-A-09-164.01We recommend that the California Department of Health Care Services ensure that the 24 providers we reviewed correct the 290 instances of noncompliance identified in this report.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/13/2020
- Legislative Related
- No
19-A-09-164.02We recommend that the California Department of Health Care Services work with the other administering departments to improve the oversight of providers to ensure that relicensing surveys are conducted within the required 2-year timeframe and recertification inspections evaluate all applicable compliance areas.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/13/2020
- Legislative Related
- No
-
The Next Door Foundation Claimed Unallowable Indirect Costs and Did Not Document the Funding Source of Program Expenditures in Accordance With Federal Requirements
19-A-05-162.01We recommend that the Next Door Foundation, Inc. refund $142,104 in unallowable indirect costs and work with its HHS funding agencies to ensure proper claiming of indirect costs.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- $142,104
- Last Update Received
- -
- Closed Date
- 03/17/2022
- Legislative Related
- No
19-A-05-162.02We recommend that the Next Door Foundation, Inc. ensure that contractual agreements are signed and in place before services are provided.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/17/2022
- Legislative Related
- No
19-A-05-162.03We recommend that the Next Door Foundation, Inc. ensure that cost transfers meet applicable criteria and are fully documented.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/17/2022
- Legislative Related
- No
19-A-05-162.04We recommend that the Next Door Foundation, Inc. ensure that the financial management system accurately matches expenditures with the source of funds.- Status
- Closed Implemented
- Responsible Agency
- ACF
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/17/2022
- Legislative Related
- No
-
National Government Services, Inc., Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals
19-A-07-157.01We recommend that NGS work with CMS to ensure that its final settlement of contract costs reflects a decrease in Medicare pension costs of $1,780,718 for CYs 2007-2014.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $1,780,718
- Last Update Received
- -
- Closed Date
- 09/09/2020
- Legislative Related
- No
-
National Government Services, Inc., Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan Costs Through Its Incurred Cost Proposals
19-A-07-158.01We recommend that NGS work with CMS to revise its ICPs for CYs 2007-2014 reduce its claimed Medicare SERP costs by $268,633.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $268,633
- Last Update Received
- -
- Closed Date
- 09/09/2020
- Legislative Related
- No
-
National Government Services, Inc., Did Not Claim Some Medicare Postretirement Benefit Plan Costs Through Its Incurred Cost Proposals
19-A-07-159.01We recommend that NGS work with CMS to ensure that its final settlement of contract costs reflects an increase in Medicare PRB costs of $2,955,882 for CYs 2007-2014.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/26/2020
- Legislative Related
- No
-
National Government Services, Inc., Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Incurred Cost Proposals
19-A-07-160.01We recommend that NGS work with CMS to ensure that its final settlement of contract costs reflects a decrease in Medicare nonqualified costs of $971829 for CYs 2007-2014.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $971,820
- Last Update Received
- -
- Closed Date
- 09/09/2020
- Legislative Related
- No
-
Patient Safety Organizations: Hospital Participation, Value, and Challenges
19-E-01-044.01AHRQ should develop and execute a communications strategy to increase hospitals' awareness of the program and its value to participants.- Status
- Closed Implemented
- Responsible Agency
- AHRQ
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/19/2021
- Legislative Related
- No
19-E-01-044.02AHRQ should take steps to encourage PSOs to participate in the NPSD, including accepting data into the NPSD in other formats, in addition to the Common Formats.- Status
- Closed Implemented
- Responsible Agency
- AHRQ
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/25/2022
- Legislative Related
- No
19-E-01-044.03AHRQ should update guidance for PSOs on the initial and continued listing processes.- Status
- Closed Implemented
- Responsible Agency
- AHRQ
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/25/2022
- Legislative Related
- No
-
Vetting Peer Reviewers at NIH's Center for Scientific Review: Strengths and Limitations
19-E-01-046.01NIH should update its guidance on vetting peer reviewer nominees to identify potential foreign threats to research integrity, in consultation with national security experts, as needed.- Status
- Closed Acceptable Alternative
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/17/2023
- Legislative Related
- No
19-E-01-046.02NIH should work with the HHS Office of National Security to develop a risk-based approach for identifying those peer reviewer nominees who warrant additional vetting.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 01/17/2023
- Legislative Related
- No
-
NIH Has Made Strides in Reviewing Financial Conflicts of Interest in Extramural Research, But Could Do More
19-E-03-045.01NIH should perform periodic quality assurance reviews of information in the FCOI module to ensure the adequacy of oversight regarding FCOIs.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 11/05/2020
- Legislative Related
- No
19-E-03-045.02NIH should use information regarding foreign affiliations and support that it collects during the pre-award process to decide whether to revise its FCOI review process to address concerns regarding foreign influence.- Status
- Closed Superseded
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 07/01/2022
- Legislative Related
- No
-
The National Institutes of Health Has Limited Policies, Procedures, and Controls in Place for Helping To Ensure That Institutions Report All Sources of Research Support, Financial Interests, and Affiliations
19-A-03-156.01We recommend NIH determine whether the 1,013 institutions identified by this review as not having FCOI policies on their website have FCOI policies and have the institutions post their policies.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 06/17/2022
- Legislative Related
- No
19-A-03-156.02We recommend NIH enhance its FCOI compliance program to review grantee websites and ensure that they have FCOI policies.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 06/08/2022
- Next Update Expected
- 05/15/2024
- Legislative Related
- No
19-A-03-156.03We recommend NIH enhance the FCOI program to ensure that institutions resolve identified deficiencies.- Status
- Open Unimplemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 06/08/2022
- Next Update Expected
- 05/15/2024
- Legislative Related
- No
19-A-03-156.04We recommend NIH implement procedures to ensure that institutions have FCOI policies and make them publicly accessible.- Status
- Closed Implemented
- Responsible Agency
- NIH
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 12/07/2020
- Legislative Related
- No
-
National Government Services, Inc., Claimed Some Unallowable Supplemental Executive Retirement Plan Costs Through Its Final Administrative Cost Proposals
19-A-07-153.01We recommend that NGS work with CMS to revise its FACPs for FYs 2007-2013 to reduce its claimed Medicare SERP costs by $36,524.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- $36,524
- Last Update Received
- -
- Closed Date
- 03/26/2020
- Legislative Related
- No
-
National Government Services, Inc., Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Final Administrative Cost Proposals
19-A-07-154.01We recommend that NGS revise its FACPS for FYs 2007 through 2013 to reduce its claimed nonqualified plan costs by $426,123.- Status
- Closed Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $426,123
- Last Update Received
- -
- Closed Date
- 03/26/2020
- Legislative Related
- No
-
Department of Health and Human Services Had Email Requirements for Political Appointees, but Office of the Secretary Lacked Effective Monitoring and Enforcement
19-A-18-152.01We recommend that HHS implement a policy requiring all HHS agencies and offices to implement automated controls to block employees from accessing personal email accounts from HHS networks.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 08/10/2023
- Next Update Expected
- 02/10/2024
- Legislative Related
- No
19-A-18-152.02We recommend that OS implement a process to ensure that all OS political appointees, employees, and contractors complete the required security awareness trainings in a timely manner.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/06/2021
- Legislative Related
- No
19-A-18-152.03We recommend that OS implement procedures to ensure that all its staff are properly listed and classified in the categories of political appointees, employees, contractors, and supervisors.- Status
- Closed Implemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/29/2022
- Legislative Related
- No
-
CMS Paid Over $277 Million in Unallowable CHIPRA Bonus Payments Based on Incorrect Enrollment Data
19-A-04-151.01We recommend that CMS continue to work with States to collect the remaining $188,923,287 in unallowable payments from the $277,242,948 that we previously identified in the reports listed in Appendix B of this report.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/23/2019
- Legislative Related
- No
19-A-04-151.02We recommend that CMS consider the results of these reviews when implementing similar programs to ensure that timely and accurate data are available for adequate oversight, followup, and verification.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/23/2019
- Legislative Related
- No