Every year the U.S. Department of Health and Human Services (HHS) publishes the Office of Inspector General's (OIG's) Top Unimplemented Recommendations: Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs (https://oig.hhs.gov). In its recently published 2022 edition of almost 100 pages, it focused on 25 unimplemented recommendations that HHS viewed would most positively affect cost savings, public health and safety, as well as program effectiveness and efficiency, if implemented. The numbering of recommendations does not necessarily indicate prioritization. Some recommendations of this edition appear for the first time.