A new OIG report found that the Center for Medicare &Medicaid Services (CMS) does not have a systematic process to track whether States return certain Medicaid managed care dollars to the Federal Government, when required. This money is owed by States that choose to require their managed care plans to refund medical loss ratio (MLR) remittance amounts. Specifically, plans are required to refund MLR remittance amounts if they fail to spend enough of their Medicaid revenue on enrollees’ health care and quality improvements. States must return a portion of the amount received from these plans to the Federal Government—which added up to hundreds of millions in taxpayer dollars owed for the 2-year period reviewed. CMS agreed to implement OIG’s five recommendations, which will improve CMS’s ability to track that States return the amounts of MLR remittances owed to the Federal Government.