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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 April 17, 2025
1,213
Unimplemented
recommendations
2,931
Implemented and Closed
recommendations since FY 2017
Views
OIG Recommendations Grouped by Report
Showing 101–120 of 1,267 reports, containing 4,144 recommendations
Sorted by latest release date
-
California Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements
24-A-09-070.01We recommend that the California Department of Health Care Services redetermine eligibility for the nine sampled enrollees whose eligibility was incorrectly determined and the five sampled enrollees whose eligibility may have been incorrectly determined.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- Legislative Related
- No
24-A-09-070.02We recommend that the California Department of Health Care Services provide caseworkers additional training to reduce errors related to: (1) calculating and verifying income, (2) entering income information into the county case management system, and (3) using electronic data sources when verifying enrollees' reported income.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 04/07/2025
- Legislative Related
- No
24-A-09-070.03We recommend that the California Department of Health Care Services revise its guidance to instruct counties to document in case files essential information to support enrollees' continuing eligibility, including: (1) attempts to review enrollees' eligibility on a manual ex parte basis and (2) income and household information provided by the enrollee in person.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 01/15/10
- Next Update Expected
- 10/07/2025
- Legislative Related
- No
24-A-09-070.04We recommend that the California Department of Health Care Services identify and correct the system issues that prevented the State agency from renewing enrollees' eligibility on an ex parte basis when those enrollees should have been determined eligible and from sending a notice of termination to enrollees.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 01/15/10
- Next Update Expected
- 10/07/2025
- Legislative Related
- No
-
The Office of Intergovernmental and External Affairs’ Purchase Card Program Did Not Comply With Federal and HHS Requirements
24-A-03-069.01We recommend that the Office of Intergovernmental and External Affairs create and maintain a centralized database to store supporting documentation for all purchase card transactions to align with Program Guide requirements.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/25/2024
- Legislative Related
- No
24-A-03-069.02We recommend that the Office of Intergovernmental and External Affairs remind cardholders and AOs of the documentation and reconciliation requirements outlined in Federal and HHS requirements and provide them with a copy of the Program Guide as part of the annual refresher training process.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/25/2024
- Legislative Related
- No
24-A-03-069.03We recommend that the Office of Intergovernmental and External Affairs remind AOs to notify the Property Management Office when purchases of accountable property are made by IEA cardholders to ensure accountability and timely updating of the property records in the PMIS.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/25/2024
- Legislative Related
- No
24-A-03-069.04We recommend that the Office of Intergovernmental and External Affairs provide to all cardholders and AOs training that encompasses the requirements related to the purchase of sensitive items, including properly completing the HHS-755 and tracking purchases in the PMIS.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/25/2024
- Legislative Related
- No
24-A-03-069.05We recommend that the Office of Intergovernmental and External Affairs remind AOs to provide timely notice of separated cardholders to the A/OPC and remind cardholders to contact their AO timely before separating so that all outstanding purchase card transactions can be processed and reconciled before separation from employment as part of the annual refresher training process.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/25/2024
- Legislative Related
- No
24-A-03-069.06We recommend that the Office of Intergovernmental and External Affairs work with the HHS A/OPC to create and maintain a centralized database as required by the Program Guide that captures the training certificates of all cardholders and AOs, including certificates for the annual refresher training.- Status
- Open Unimplemented
- Responsible Agency
- OS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 10/25/2024
- Legislative Related
- No
-
West Virginia Lacked Effective Oversight of Its Opioid Response Grants
24-A-06-067.01We recommend that West Virginia's Bureau of Behavioral Health include requirements in its procedures to maintain documentation used to prepare the annual progress report.- Status
- Open Unimplemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 02/06/2025
- Next Update Expected
- 08/11/2025
- Legislative Related
- No
24-A-06-067.02We recommend that West Virginia's Bureau of Behavioral Health conduct a periodic review of supporting documentation (e.g., invoices, payroll registers, and time-and-effort reports) for any subrecipient expenditures submitted to BBH.- Status
- Open Unimplemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 02/06/2025
- Next Update Expected
- 08/11/2025
- Legislative Related
- No
24-A-06-067.03We recommend that West Virginia's Bureau of Behavioral Health revise pre-designed progress reports to capture the necessary data to determine whether program goals are being met.- Status
- Open Unimplemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 02/06/2025
- Next Update Expected
- 08/11/2025
- Legislative Related
- No
24-A-06-067.04We recommend that West Virginia's Bureau of Behavioral Health provide training to program managers to ensure that advanced payments are being approved as close as administratively feasible to actual disbursements by the subrecipient.- Status
- Open Unimplemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 02/06/2025
- Next Update Expected
- 08/11/2025
- Legislative Related
- No
24-A-06-067.05We recommend that West Virginia's Bureau of Behavioral Health revise procedures to ensure that subrecipient agreements are finalized and closed out with returned funds recorded in the general ledger prior to filing the Federal financial report.- Status
- Open Unimplemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 02/06/2025
- Next Update Expected
- 08/11/2025
- Legislative Related
- No
-
Ohio Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements
24-A-05-066.01We recommend that the Ohio Department of Medicaid take appropriate action with respect to the incorrect Medicaid eligibility determinations identified in our sample.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 05/30/2024
- Legislative Related
- No
24-A-05-066.02We recommend that the Ohio Department of Medicaid provide periodic training to caseworkers about verifying and documenting enrollees' income during the renewal process.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/21/2025
- Legislative Related
- No
24-A-05-066.03We recommend that the Ohio Department of Medicaid provide additional training to caseworkers about using current information when conducting enrollee eligibility determinations.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/21/2025
- Legislative Related
- No
-
CMS Could Improve Its Procedures for Setting Medicare Clinical Diagnostic Laboratory Test Rates Under the Clinical Laboratory Fee Schedule for Future Public Health Emergencies
24-A-01-065.01We recommend that the Centers for Medicare & Medicaid Services establish procedures to improve communication among all stakeholders involved in setting new CDLT rates during a PHE.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2025
- Next Update Expected
- 10/09/2025
- Legislative Related
- No
24-A-01-065.02We recommend that the Centers for Medicare & Medicaid Services improve its procedures, which may require seeking legislative authority, for setting and adjusting rates for new CDLTs during a PHE by providing the MACs with the flexibility needed to set and adjust payment rates that would cover the laboratory costs of providing services when responding to a PHE.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 03/28/2025
- Next Update Expected
- 10/09/2025
- Legislative Related
- No
-
Missouri May Not Have Used All CARES Act Funds for the Older Americans Act Nutrition Services Program in Accordance With Federal and State Requirements
24-A-07-064.01We recommend that the Missouri Department of Health and Senior Services require Area Agencies on Aging (AAAs) to track expenditures for supplemental awards by funding source, when required by Federal guidance, especially in instances of pandemic-related or other disaster relief funding.- Status
- Open Unimplemented
- Responsible Agency
- ACL
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2025
- Next Update Expected
- 09/05/2025
- Legislative Related
- No
24-A-07-064.02We recommend that the Missouri Department of Health and Senior Services consider implementing additional monitoring activities whenever the State receives large supplemental funding disbursements.- Status
- Open Unimplemented
- Responsible Agency
- ACL
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/04/2025
- Next Update Expected
- 09/05/2025
- Legislative Related
- No
-
Fiscal Year 2018 and 2019 Biomedical Advanced Research and Development Authority Appropriations May Not Have Been Used for Their Intended Purpose in Accordance With Federal Requirements
24-A-03-059.01We recommend that the Administration for Strategic Preparedness and Response develop internal written policies and procedures for the JFA process that align with Federal requirements and include the use of allocation methodologies that accurately reflect the benefiting offices' use of the product or service.- Status
- Open Unimplemented
- Responsible Agency
- ASPR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 11/07/2024
- Next Update Expected
- 09/30/2024
- Legislative Related
- No
24-A-03-059.02We recommend that the Administration for Strategic Preparedness and Response review the FY 2018 and 2019 JFA allocation methodologies along with the methodologies used during subsequent FYs to determine whether the costs were allocated to each office based on appropriate methodologies, and correct any improper allocations to avoid potential Antideficiency Act violations.- Status
- Open Unimplemented
- Responsible Agency
- ASPR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 11/07/2024
- Next Update Expected
- 09/19/2025
- Legislative Related
- No
24-A-03-059.03We recommend that the Administration for Strategic Preparedness and Response maintain documentation of the work performed by employees whose salaries are paid using BARDA funds to ensure that appropriations are used for their intended purposes in accordance with Federal requirements.- Status
- Closed Implemented
- Responsible Agency
- ASPR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 03/19/2025
- Legislative Related
- No
24-A-03-059.04We recommend that the Administration for Strategic Preparedness and Response review the 10 remaining sampled employees that we could not interview to determine whether any salaries were improperly charged to BARDA appropriations and identify potential Antideficiency Act violations.- Status
- Open Unimplemented
- Responsible Agency
- ASPR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 11/07/2024
- Next Update Expected
- 10/16/2025
- Legislative Related
- No
24-A-03-059.05We recommend that the Administration for Strategic Preparedness and Response report any Antideficiency Act violations identified.- Status
- Open Unimplemented
- Responsible Agency
- ASPR
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 11/07/2024
- Next Update Expected
- 10/16/2025
- Legislative Related
- No
-
Alabama Claimed Federal Medicaid Reimbursement for Millions of Dollars in Targeted Case Management Services That Did Not Comply With Federal and State Requirements
24-A-07-060.01We recommend that the Alabama Medicaid Agency refund to the Federal government $5,039,433 (Federal Share) in overpayments.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $5,039,433
- Last Update Received
- 04/09/2025
- Next Update Expected
- 10/09/2025
- Legislative Related
- No
24-A-07-060.02We recommend that the Alabama Medicaid Agency improve TCM program oversight by giving additional guidance to TCM providers regarding: billing of services, to verify that they are allowable and nonduplicative; case manager hiring practices, to verify adherence with the State plan's qualification requirements; target group eligibility screening processes, so that only eligible individuals receive TCM services; and the maintenance of supporting documentation for billed services.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/09/2025
- Next Update Expected
- 10/09/2025
- Legislative Related
- No
-
ACF Has Enhanced Some Cybersecurity Controls Over the Unaccompanied Children Portal and Data But Improvements Are Needed
24-A-18-058.01We recommend that the Administration for Children and Families consistently perform user account reviews in accordance with its access control policy.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/28/2024
- Legislative Related
- No
24-A-18-058.02We recommend that the Administration for Children and Families fully implement the 30 required minimum controls identified in the UC Portal system security plan as being in various stages of implementation.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/28/2024
- Legislative Related
- No
-
Concerns Remain About Safeguards To Protect Residents During Facility-Initiated Discharges From Nursing Homes
24-E-01-012.01CMS should provide a standard notice template to help nursing homes provide complete and accurate information to residents facing discharge and Ombudsmen.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 05/10/2024
- Next Update Expected
- 05/21/2025
- Legislative Related
- No
24-E-01-012.02CMS should require nursing homes to systematically document facility-initiated discharges in information available to CMS and States to enhance oversight.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Non-Concur
- Potential Savings
- -
- Last Update Received
- 05/10/2024
- Next Update Expected
- 05/21/2025
- Legislative Related
- No
-
A Lack of Behavioral Health Providers in Medicare and Medicaid Impedes Enrollees’ Access to Care
24-E-02-014.01CMS should take steps to encourage more behavioral health providers to serve Medicare and Medicaid enrollees.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 11/20/2024
- Next Update Expected
- 12/19/2025
- Legislative Related
- No
24-E-02-014.02CMS should explore options to expand Medicare and Medicaid coverage to additional behavioral health providers.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 11/20/2024
- Next Update Expected
- 12/19/2025
- Legislative Related
- No
24-E-02-014.03CMS should use network adequacy standards to drive an increase in behavioral health providers in Medicare Advantage and Medicaid.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 10/24/2024
- Next Update Expected
- 12/18/2025
- Legislative Related
- No
24-E-02-014.04CMS should increase monitoring of Medicare and Medicaid enrollees' use of behavioral health services and identify vulnerabilities.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 01/23/2025
- Next Update Expected
- 02/04/2026
- Legislative Related
- No
-
New Jersey Significantly Improved Its Oversight of Medicaid Adult Partial Care Services Except for Those Provided Using Telehealth During the COVID-19 Public Health Emergency
24-A-02-054.01New Jersey Department of Human Services should work with CMS to refund the recommended disallowance of $94,830,718 from a prior audit.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/17/2024
- Legislative Related
- No
24-A-02-054.02New Jersey Department of Human Services should refund $18,826,714 associated with deficiencies identified in the current audit.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $18,826,714
- Last Update Received
- 03/27/2025
- Next Update Expected
- 09/27/2025
- Legislative Related
- No
24-A-02-054.03New Jersey Department of Human Services should provide training or guidance to providers to address noncompliance issues it identifies during site visits or audits to ensure Medicaid enrollees receive required services with the necessary amount of care.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/17/2024
- Legislative Related
- No
-
IHS Did Not Coordinate Supply Service Center Operations Before and During the COVID-19 Pandemic and Should Consider Upgrading Supply Centers’ Inventory Management Systems and Implementing Policies and Procedures To Enhance Coordination and Alignment
24-A-07-055.01We recommend that Indian Health Service develop and implement policies and procedures that enable the NSSC and the GRSSC to coordinate their operations and communicate directly with one another, align their inventory management systems, and use the same vendors when feasible.- Status
- Open Unimplemented
- Responsible Agency
- IHS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/27/2024
- Legislative Related
- No
24-A-07-055.02We recommend that Indian Health Service consider upgrading the GRSSC's inventory system or implement other strategies to better coordinate the delivery of supplies to all customers.- Status
- Open Unimplemented
- Responsible Agency
- IHS
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/27/2024
- Legislative Related
- No
-
Administration for Children and Families Data Hosted in Certain Cloud Information Systems May Be at a High Risk of Compromise
24-A-18-057.01We recommend ACF update and maintain a complete and accurate inventory of information systems hosted in the cloud.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/27/2024
- Legislative Related
- No
24-A-18-057.02We reccomend ACF remediate the 19 security control findings in accordance with NIST SP 800-53.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/27/2024
- Legislative Related
- No
24-A-18-057.03We recommend ACF update its cloud security procedures to include detailed steps for operational staff to effectively implement cloud security baselines in accordance with HHS requirements.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/27/2024
- Legislative Related
- No
24-A-18-057.04We reccomend ACF leverage cloud security assessment tools to identify misconfigurations and weak cybersecurity controls in its cloud infrastructure.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/27/2024
- Legislative Related
- No
24-A-18-057.05We recommend ACF conduct testing of its cloud information systems that includes the emulation of an adversary's tactics and techniques on a defined reoccurring basis.- Status
- Open Unimplemented
- Responsible Agency
- ACF
- Response
- Overdue
- Potential Savings
- -
- Last Update Received
- -
- Next Update Expected
- 09/27/2024
- Legislative Related
- No
-
Alabama MMIS and E&E System Security Controls Were Adequate, but Some Improvements Are Needed
24-A-18-056.01We recommend that the Alabama Medicaid Agency remediate the six control findings OIG identified.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 10/04/2024
- Next Update Expected
- 04/04/2025
- Legislative Related
- No
24-A-18-056.02We recommend Alabama evaluate its current vulnerability scanning tools and update if necessary in order to better detect system flaws (e.g., common web server vulnerabilities) in its MMIS and E&E system and software components.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 10/04/2024
- Legislative Related
- No
24-A-18-056.03We recommend Alabama require its developers to follow secure coding standards and best practices, at a minimum, such as those recommended by NIST SP 800-218 or the Open Web Application Security Project (OWASP), when developing web applications.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 10/04/2024
- Next Update Expected
- 04/04/2025
- Legislative Related
- No
24-A-18-056.04We recommend Alabama implement procedures to periodically verify that its developers are adhering to secure coding standards and remediating vulnerabilities before releasing code to production.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 10/04/2024
- Next Update Expected
- 04/04/2025
- Legislative Related
- No
24-A-18-056.05We recommend Alabama perform more robust technical testing of web-facing systems that includes the emulation of an adversary's tactics and techniques on a defined reoccurring basis in order to better assess the effectiveness of NIST 800-53 controls.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 10/04/2024
- Next Update Expected
- 04/04/2025
- Legislative Related
- No
-
New Jersey Complied With Federal Regulations When Implementing Programs Under SAMHSA’s Opioid Response Grants, But Did Not Meet Its Program Services Goals
24-A-02-053.01We recommend that DMHAS identify factors that could delay grant-funded activities when estimating goals for future STR and SOR grant applications.- Status
- Closed Implemented
- Responsible Agency
- SAMHSA
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 08/22/2024
- Legislative Related
- No
-
The Thailand Ministry of Public Health Managed PEPFAR Funds According to Federal Regulations but Internal Controls Could Be Improved
24-A-04-052.01We recommend that Thailand's Ministry of Public Health develop and implement policies and procedures that address the retention of employee timesheets and FFR and audit reporting requirements for Federal awards.- Status
- Open Unimplemented
- Responsible Agency
- CDC
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 01/27/2025
- Next Update Expected
- 09/12/2025
- Legislative Related
- No
-
Delaware Made Capitation Payments to Medicaid Managed Care Organizations After Enrollees’ Deaths
24-A-03-051.01We recommend that the Delaware Division of Medicaid and Medical Assistance refund $3,484,904 to the Federal Government.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $3,484,904
- Last Update Received
- 03/27/2025
- Next Update Expected
- 09/28/2025
- Legislative Related
- No
24-A-03-051.02We recommend that the Delaware Division of Medicaid and Medical Assistance identify and recover unallowable capitation payments, which we estimate to be at least $4,246,759, made to MCOs during our audit period on behalf of deceased enrollees.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- $4,246,759
- Last Update Received
- 03/27/2025
- Next Update Expected
- 09/28/2025
- Legislative Related
- No
24-A-03-051.03We recommend that the Delaware Division of Medicaid and Medical Assistance identify and recover unallowable capitation payments made on behalf of deceased enrollees in 2022 and 2023 (the years after our audit period), and repay the Federal share of amounts recovered.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/27/2025
- Next Update Expected
- 09/28/2025
- Legislative Related
- No
24-A-03-051.04We recommend that the Delaware Division of Medicaid and Medical Assistance develop and implement quality assurance steps, including supervisory review, within its policies and procedures to verify that State agency personnel correctly enter enrollees' information into the MMIS system.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 03/27/2025
- Next Update Expected
- 09/28/2025
- Legislative Related
- No
-
CMS Did Not Ensure That Selected States Complied With Medicaid Managed Care Mental Health and Substance Use Disorder Parity Requirements
24-A-02-050.01We recommend that the Centers for Medicare & Medicaid Services improve its oversight of States' compliance with MH/SUD parity requirements, including strengthening its followup procedures, including regular communication with States, to verify that States perform parity analyses across their MH/SUD delivery systems.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/16/2025
- Next Update Expected
- 10/17/2025
- Legislative Related
- No
24-A-02-050.02We recommend that the Centers for Medicare & Medicaid Services improve its oversight of States' compliance with MH/SUD parity requirements, including requiring States in which MCOs are responsible for the parity analysis to submit information MCOs provided regarding compliance with parity requirements to CMS for its review as part of the contract approval process and, if necessary, seeking additional regulatory authority to do so.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/13/2024
- Legislative Related
- No
24-A-02-050.03We recommend that the Centers for Medicare & Medicaid Services improve its oversight of States' compliance with MH/SUD parity requirements, including following up with any States that have identified any noncompliance with parity requirements to verify that the States have taken actions to address the noncompliance.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/16/2025
- Next Update Expected
- 10/17/2025
- Legislative Related
- No
24-A-02-050.04We recommend that the Centers for Medicare & Medicaid Services improve its oversight of States' compliance with MH/SUD parity requirements, including maintaining documentation of its communications with States related to compliance with MH/SUD parity requirements and actions taken to correct any identified deficiencies.- Status
- Open Unimplemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- 04/16/2025
- Next Update Expected
- 10/17/2025
- Legislative Related
- No
24-A-02-050.05We recommend that the Centers for Medicare & Medicaid Services require States to improve their monitoring of MCOs' ongoing compliance with MH/SUD parity requirements by modifying State policies and procedures for reviewing MCOs' compliance with contract provisions to include written procedures for reviewing compliance with MH/SUD parity requirements.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/13/2024
- Legislative Related
- No
24-A-02-050.06We recommend that the Centers for Medicare & Medicaid Services require States to improve their monitoring of MCOs' ongoing compliance with MH/SUD parity requirements by requiring MCOs to update parity analyses when benefits change or deficiencies are corrected.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/13/2024
- Legislative Related
- No
24-A-02-050.07We recommend that the Centers for Medicare & Medicaid Services require States to improve their monitoring of MCOs' ongoing compliance with MH/SUD parity requirements by requiring newly added MCOs to conduct parity analyses.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/13/2024
- Legislative Related
- No
24-A-02-050.08We recommend that the Centers for Medicare & Medicaid Services require States to improve their monitoring of MCOs' ongoing compliance with MH/SUD parity requirements by conducting followup in a timely manner with MCOs that have identified noncompliance with parity requirements to verify that the MCOs take corrective actions to address the noncompliance.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 09/13/2024
- Legislative Related
- No
-
Utah MMIS and E&E System Had Adequate Security Controls In Place, but Improvements Are Needed
24-A-18-048.01We recommend that the Utah Department of Health remediate the remaining three security control findings identified by OIG.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/03/2025
- Legislative Related
- No
24-A-18-048.02We recommend that the Utah Department of Health revise flaw remediation procedures such that they fully implement the flaw remediation requirements defined in the CMS Acceptable Risk Safeguards (ARS), SI-02 Flaw Remediation (High; Moderate; Low) control.- Status
- Closed Implemented
- Responsible Agency
- CMS
- Response
- Concur
- Potential Savings
- -
- Last Update Received
- -
- Closed Date
- 02/03/2025
- Legislative Related
- No