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Fallout from Obamacare probe as shares of dialysis firms drop

A woman undergoes dialysis three times a week in Orange, Calif.
Mark Boster | Los Angeles Times | Getty Images
A woman undergoes dialysis three times a week in Orange, Calif.

Dialysis services firms are under pressure, after federal health care officials launched an investigation into complaints some providers may be steering patients into Obamacare plans, in order to obtain higher reimbursement fees.

Shares of dialysis DaVita Healthcare fell more than 4 percent, Fresenius Medical Care fell nearly 4 percent, while American Renal Associates shares plunged as much as 18 percent, well below its April IPO price of $22. ARA shares later recovered some losses and ended the day down more than 10 percent.

Regulators from the Centers for Medicare and Medicaid Services issued a request for information seeking public comment into the prevalence of the practice late Thursday, after health insurers raised concerns about the issue.

Aetna, Anthem and UnitedHealthcare group all remarked on a trend of higher dialysis claims on their Affordable Care Act plans in the second quarter.

CMS issued a warning letter to Medicare-enrolled dialysis firms saying that agency is considering changes to enrollment provisions that now allow some charitable groups to pay for Obamacare plan premiums, and potential penalties for those found to be abusing the system.

Leerink analyst Ana Gupte said the changes could reduce American Renal Associates earnings by about 10 percent, not including potential penalties.

"If the practice involves patients already receiving services paid by Medicaid and Medicare, it is punishable by civil monetary penalties or potentially even imprisonment. CMS says it is also considering further regulatory and operational policy to prohibit these practices," Gupte wrote in the note to clients.

She noted that American Renal Associates reported higher year-over-year revenues in the second quarter because of a shift of patients to ACA plans, which resulted in reimbursement rates two- to three-times the Medicare rate.

UnitedHealth has sued American Renal over the issue, claiming the company has funneled funds to charitable organizations in order to pay for patients to switch from government health plans to Obmacare coverage.

American Renal Associations has denied the allegations and said the suit without merit. The company declined to comment about the CMS probe.