On June 21, 2022, the Supreme Court denied certiorari in the case of UnitedHealthcare Co., et al v. Becerra et al., Case No. 21-1140, wherein UnitedHealthcare attempted to overturn the D.C. Circuit Court’s revival of CMS’s 2014 overpayment rule for Medicare Advantage insurers found at 79 Fed. Reg. 29,844, 29,918-25 (the 2014 Overpayment Rule). Accordingly, the 2014 Overpayment Rule for Medicare Advantage plans remains in effect. The U.S. Supreme Court’s Order denying certiorari can be found here.

The 2014 Overpayment Rule extended False Claims Act (FCA) liability to Medicare Advantage plans who fail to return overpayments to CMS within 60 days of identifying the overpayment. UnitedHealthcare argued, among other things, that CMS’s 2014 Overpayment Rule required a higher level of accuracy for Medicare Advantage than that which applied to traditional Medicare, thereby violating the statute’s requirement for “actuarial equivalence.” UnitedHealthcare filed litigation in 2016 challenging the 2014 Overpayment Rule. In 2018, United Healthcare achieved victory in the United States District Court for the District of Columbia when the court vacated the rule. More details on the specifics of this case and the District Court’s ruling can be found here. The verdict was appealed. In August 2021, the D.C. Circuit Court overturned UnitedHealthcare’s victory in the lower court, reviving the 2014 Overpayment Rule. Prior coverage of the D.C. Circuit’s decision and a copy of the D.C. Circuit’s ruling can be found here. UnitedHealthcare sought U.S. Supreme Court review. The denial of certiorari leaves the D.C. Circuit Court’s decision reviving the 2014 Overpayment Rule intact.