A recent OIG report, “Surety Bonds Remain an Unused Tool to Protect Medicare from Home Health Overpayments,” faults CMS for not implementing its January 1998 final rule requiring every home health agency (HHA) participating in Medicare to obtain a surety bond in the amount of $50,000 or 15% of annual Medicare payments to the HHA, whichever is greater. As of the end of February 2012, 2,004 HHAs owed CMS a total of approximately $408 million out of $590 million in overpayments CMS identified between 2007 and 2011. According to the OIG’s calculations, CMS could have recovered at least $39 million if this amount if the agency had required each HHA to obtain a $50,000 surety bond. By not implementing this requirement after almost 15 years, the OIG charges CMS placing “Medicare at risk of losing millions of dollars in overpayments.” The OIG therefore recommend that CMS implement the HHA surety bond requirement, and consider increasing the surety bond amounts for HHAs with high overall Medicare payment amounts. CMS agreed that implementing a surety bond requirement for HHAs may help reduce potential program vulnerabilities, and stated that it is currently evaluating its options in implementing this requirement.