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HMS Holdings Corp.

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FY2016 Annual Report · HMS Holdings Corp.
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20

16 ANNUAL REPORT

Enterprising healthcare

hms.com

© 2017 HMS Holdings Corp. 

William C. Lucia
Chairman and Chief 
Executive Officer

Dear Shareholder,

2016 was a year of solid growth in total revenue and earnings 
per share. Adjusted EBITDA also increased, overall profitability 
and margins improved, and operating cash flow remained strong. 
In addition, we achieved a key strategic objective for the year 
by acquiring a care management platform. Beyond our financial 
performance, we are proud to have saved billions of dollars for our 
customers. Those savings represent an important contribution to 
bending the ever-rising healthcare cost curve in this nation.

Our 2016 commercial health plan revenue exceeded our state 
government revenue for the first time and significant sales throughout 
last year form the foundation for strong commercial revenue growth 
we expect again in 2017. We added over 17 million new commercial 
lives, including a sale in the second quarter to a single customer for 15 
million of their at-risk and ASO members, taking our commercial health 
plan lives over 100 million. We also sold additional products to existing 
health plan customers last year covering approximately 30 million of 
their members, compared to about 13 million in the prior year. 

Full-year adjusted earnings per share were up 30% in 2016. Operating cash flow increased 
22% and year-end cash of $176 million was 21% higher than the prior year-end, even after 
the $21 million purchase of Essette in the third quarter and $20 million of share repurchases 
(1.1 million shares) in the fourth quarter. Through year end we had purchased a total of 5.9 
million shares at an average price of $11.95 per share pursuant to a buyback plan instituted 
by our Board in August of 2015. We also completed a tax project in the third quarter – 
identifying certain credits and deductions that reduced our annual effective tax rate by 300 
bps to ~37%.

The Essette care management platform, acquired last fall, was the foundation for a new 
third business vertical, which was strengthened considerably by the acquisition of the Eliza 
Corporation consumer engagement platform completed in April of this year. Essette was 
designed and built from the ground up to serve as a “care traffic controller” –  helping risk 
bearing entities identify and manage at-risk populations. Eliza is a cloud-based technology 
platform which provides comprehensive and personalized health engagement solutions 
designed to improve clinical outcomes and reduce costs by motivating members to adopt 
targeted behaviors. Eliza has developed sophisticated communication techniques - based on 
proprietary patented predictive analytics, behavioral science and digital design techniques 
- to effectively engage members and achieve better health outcomes. We see these Essette 
and Eliza capabilities as a natural extension of the cost containment solutions we have 
offered historically, an opportunity to further leverage our data assets, and a strategic 
response to the need for payers to improve health outcomes and reduce costs for their 
highest risk members. We believe there will be significant opportunities to cross-sell our 
new care management and member engagement solutions to our health plan and state 
government customers.

Cynthia Nustad 

Executive Vice President and Chief Strategy Officer 

Jeffrey S. Sherman 

Executive Vice President, 

Chief Financial Officer and Treasurer 

Tracy A. South 

Executive Vice President, 

Human Resources and Chief Administrative Officer  

Douglas M. Williams 

President, Markets and Product

Corporate Headquarters:

5615 High Point Drive  

Irving, TX 75038 

Tel. 214.453.3000 

Fax. 214.453.3023 

Board of Directors:

Alex M. Azar II 

Chairman, Seraphim Strategies, LLC 

Former President, Lilly USA, LLC 

Robert Becker 

Former President and Chief Executive Officer, Wolters Kluwer Health 

Craig R. Callen 

Former Senior Advisor, Crestview Partners 

William C. Lucia  

Chairman of the Board, 

President and Chief Executive Officer, HMS Holdings Corp. 

William F. Miller III 

Healthcare Industry Advisor, KKR Advisors 

Former Chairman of the Board and Chief Executive Officer,  

HMS Holdings Corp. 

Ellen A. Rudnick 

Senior Advisor for Entrepreneurship, adjunct faculty, 

Polsky Center for Entrepreneurship and Innovation,  

University of Chicago Booth School of Business 

Bart M. Schwartz 

Chairman and Chief Executive Officer, 

SolutionPoint International, LLC  

Richard H. Stowe 

Lead Independent Director, HMS Holdings Corp. 

General Partner, Health Enterprise Partners, LP 

Cora M. Tellez 

President and Chief Executive Officer, Sterling HSA 

Executive Officers: 

William C. Lucia  

Chairman of the Board,  

President and Chief Executive Officer 

Meredith W. Bjorck 

Executive Vice President, 

General Counsel and Corporate Secretary 

Semone Neuman 

Executive Vice President, Operations and Information Technology 

The Company’s 2016 Form 10-K, as filed with the SEC, is included in this Annual Report in its entirety with the exception of certain exhibits. Copies of the 

Company’s quarterly earnings results and additional copies of the 2016 Form 10-K, including all exhibits, are available on the Internet at http://investor.hms.

com/sec.cfm or by accessing our filings with the SEC. In addition, shareholders may obtain a paper copy of these materials upon request from our Office of 

Form 10-K Report/Quarterly Reporting

Investor Relations by emailing dennis.oakes@hms.com.

Stock Registrar and Transfer Agent

Common stock of HMS Holdings Corp. is traded on the NASDAQ Stock Exchange under the symbol HMSY. Questions with regard to registered shares of HMSY 

should be submitted to: HMS Holdings Corp. c/o Broadridge Corporate Issuer Solutions, Inc., P.O. Box 1342, Brentwood, NY 11717. Phone: 855.418.5059.  

Email: shareholder@broadridge.com. Internet: http://www.broadridge.com.

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meaningful growth opportunities for our suite of cost containment solutions.

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We currently face some uncertainty as Congress and the Trump Administration consider various approaches to the 
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focused on preserving the dollars they receive than they are today. 

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William C. Lucia

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July 12, 2017

Safe Harbor:(cid:3)(cid:54)(cid:74)(cid:75)(cid:85)(cid:3)(cid:78)(cid:71)(cid:86)(cid:86)(cid:71)(cid:84)(cid:3)(cid:69)(cid:81)(cid:80)(cid:86)(cid:67)(cid:75)(cid:80)(cid:85)(cid:3)(cid:69)(cid:71)(cid:84)(cid:86)(cid:67)(cid:75)(cid:80)(cid:3)(cid:363)(cid:72)(cid:81)(cid:84)(cid:89)(cid:67)(cid:84)(cid:70)(cid:15)(cid:78)(cid:81)(cid:81)(cid:77)(cid:75)(cid:80)(cid:73)(cid:3)(cid:85)(cid:86)(cid:67)(cid:86)(cid:71)(cid:79)(cid:71)(cid:80)(cid:86)(cid:85)(cid:364)(cid:3)(cid:89)(cid:75)(cid:86)(cid:74)(cid:75)(cid:80)(cid:3)(cid:86)(cid:74)(cid:71)(cid:3)(cid:79)(cid:71)(cid:67)(cid:80)(cid:75)(cid:80)(cid:73)(cid:3)(cid:81)(cid:72)(cid:3)(cid:86)(cid:74)(cid:71)(cid:3)(cid:55)(cid:16)(cid:53)(cid:16)(cid:3)(cid:50)(cid:84)(cid:75)(cid:88)(cid:67)(cid:86)(cid:71)(cid:3)(cid:53)(cid:71)(cid:69)(cid:87)(cid:84)(cid:75)(cid:86)(cid:75)(cid:71)(cid:85)(cid:3)(cid:46)(cid:75)(cid:86)(cid:75)(cid:73)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)(cid:3)(cid:52)(cid:71)(cid:72)(cid:81)(cid:84)(cid:79)(cid:3)(cid:35)(cid:69)(cid:86)(cid:3)(cid:81)(cid:72)(cid:3)(cid:19)(cid:27)(cid:27)(cid:23)(cid:16)(cid:3)(cid:54)(cid:74)(cid:71)(cid:85)(cid:71)(cid:3)(cid:85)(cid:86)(cid:67)(cid:86)(cid:71)(cid:79)(cid:71)(cid:80)(cid:86)(cid:85)(cid:3)(cid:84)(cid:71)(cid:72)(cid:78)(cid:71)(cid:69)(cid:86)(cid:3)(cid:81)(cid:87)(cid:84)(cid:3)
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(cid:80)(cid:81)(cid:86)(cid:3)(cid:79)(cid:71)(cid:67)(cid:85)(cid:87)(cid:84)(cid:71)(cid:79)(cid:71)(cid:80)(cid:86)(cid:85)(cid:3)(cid:81)(cid:72)(cid:3)(cid:402)(cid:80)(cid:67)(cid:80)(cid:69)(cid:75)(cid:67)(cid:78)(cid:3)(cid:82)(cid:71)(cid:84)(cid:72)(cid:81)(cid:84)(cid:79)(cid:67)(cid:80)(cid:69)(cid:71)(cid:3)(cid:81)(cid:84)(cid:3)(cid:78)(cid:75)(cid:83)(cid:87)(cid:75)(cid:70)(cid:75)(cid:86)(cid:91)(cid:3)(cid:87)(cid:80)(cid:70)(cid:71)(cid:84)(cid:3)(cid:41)(cid:35)(cid:35)(cid:50)(cid:3)(cid:67)(cid:80)(cid:70)(cid:3)(cid:85)(cid:74)(cid:81)(cid:87)(cid:78)(cid:70)(cid:3)(cid:80)(cid:81)(cid:86)(cid:3)(cid:68)(cid:71)(cid:3)(cid:69)(cid:81)(cid:80)(cid:85)(cid:75)(cid:70)(cid:71)(cid:84)(cid:71)(cid:70)(cid:3)(cid:67)(cid:78)(cid:86)(cid:71)(cid:84)(cid:80)(cid:67)(cid:86)(cid:75)(cid:88)(cid:71)(cid:85)(cid:3)(cid:86)(cid:81)(cid:3)(cid:86)(cid:74)(cid:71)(cid:3)(cid:37)(cid:81)(cid:79)(cid:82)(cid:67)(cid:80)(cid:91)(cid:360)(cid:85)(cid:3)(cid:81)(cid:86)(cid:74)(cid:71)(cid:84)(cid:3)(cid:402)(cid:80)(cid:67)(cid:80)(cid:69)(cid:75)(cid:67)(cid:78)(cid:3)(cid:75)(cid:80)(cid:72)(cid:81)(cid:84)(cid:79)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)(cid:3)(cid:70)(cid:71)(cid:86)(cid:71)(cid:84)(cid:79)(cid:75)(cid:80)(cid:71)(cid:70)(cid:3)(cid:87)(cid:80)(cid:70)(cid:71)(cid:84)(cid:3)(cid:41)(cid:35)(cid:35)(cid:50)(cid:16)(cid:3)
(cid:40)(cid:81)(cid:84)(cid:3)(cid:84)(cid:71)(cid:69)(cid:81)(cid:80)(cid:69)(cid:75)(cid:78)(cid:75)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)(cid:85)(cid:3)(cid:81)(cid:72)(cid:3)(cid:86)(cid:74)(cid:71)(cid:85)(cid:71)(cid:3)(cid:80)(cid:81)(cid:80)(cid:15)(cid:41)(cid:35)(cid:35)(cid:50)(cid:3)(cid:79)(cid:71)(cid:67)(cid:85)(cid:87)(cid:84)(cid:71)(cid:85)(cid:14)(cid:3)(cid:82)(cid:78)(cid:71)(cid:67)(cid:85)(cid:71)(cid:3)(cid:84)(cid:71)(cid:72)(cid:71)(cid:84)(cid:3)(cid:86)(cid:81)(cid:3)(cid:35)(cid:82)(cid:82)(cid:71)(cid:80)(cid:70)(cid:75)(cid:90)(cid:3)(cid:35)(cid:16)

UNITED  STATES
SECURITIES  AND  EXCHANGE  COMMISSION
Washington,  D.C.  20549
Form  10-K
(cid:2) ANNUAL  REPORT  PURSUANT  TO  SECTION  13  OR  15(d)  OF  THE  SECURITIES  EXCHANGE  ACT  OF  1934
For  the  fiscal  year  ended  December  31,  2016
Or

(cid:3) TRANSITION  REPORT  PURSUANT  TO  SECTION  13  OR  15(d)  OF  THE  SECURITIES  EXCHANGE  ACT  OF  1934

For  the  transition  period  from 

  to 

Commission  File  Number  000-50194

28JUN201714152523

HMS  HOLDINGS  CORP.
(Exact  name  of  registrant  as  specified  in  its  charter)

Delaware
(State  or  other  jurisdiction  of
incorporation  or  organization)
5615  High  Point  Drive,  Irving,  TX
(Address  of  principal  executive  offices)

11-3656261
(I.R.S.  Employer
Identification  No.)
75038
(Zip  Code)

(Registrant’s  telephone  number,  including  area  code)
(214)  453-3000

Securities  registered  pursuant  to  Section  12(b)  of  the  Act:
Title  of  each  class

Common  Stock  $0.01  par  value

Securities  registered  pursuant  to  section  12(g)  of  the  Act:  None

Name  of  each  exchange  on  which  registered

The  NASDAQ  Stock  Market  LLC
(NASDAQ  Global  Select  Market)

Indicate  by  check  mark  if  the  registrant  is  a  well-known  seasoned  issuer,  as  defined  in  Rule  405  of  the  Securities  Act.  Yes  (cid:2) No  (cid:3)
Indicate  by  check  mark  if  the  registrant  is  not  required  to  file  reports  pursuant  to  Section  13  or  Section  15(d)  of  the  Act.  Yes  (cid:3) No  (cid:2)
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of
1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to
such  filing  requirements  for  the  past  90  days.  Yes  (cid:2) No  (cid:3)
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File
required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the
registrant  was  required  to  submit  and  post  such  files).  Yes  (cid:2) No  (cid:3)
Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein, and will not be contained, to
the  best  of  registrant’s  knowledge,  in  definitive  proxy  or  information  statements  incorporated  by  reference  in  Part  III  of  this  Form  10-K  or  any
amendment  to  this  Form  10-K.  (cid:2)
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or
an emerging growth company. See the definitions of ‘‘large accelerated filer,’’ ‘‘accelerated filer’’, ‘‘smaller reporting company’’ and ‘‘emerging growth
company’’  in  Rule  12b-2  of  the  Exchange  Act.
Large  Accelerated  Filer  (cid:2)

Smaller  reporting  company  (cid:3)

Accelerated  Filer  (cid:3)

Non-Accelerated  Filer  (cid:3)
(Do  not  check  if  a
smaller  reporting  company)

Emerging  growth  company  (cid:3)
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any
new  or  revised  financial  accounting  standards  provided  pursuant  to  Section  13(a)  of  the  Exchange  Act.  (cid:3)
Indicate  by  check  mark  whether  the  registrant  is  a  shell  company  (as  defined  in  Rule  12b-2  of  the  Act)  Yes  (cid:3) No  (cid:2)
The aggregate market value of the registrant’s common stock held by non-affiliates as of June 30, 2016, the last business day of the registrant’s most
recently completed second quarter was $1.5 billion based on the last reported sale price of the registrant’s common stock on the NASDAQ Global
Select Market on that date. Solely for purposes of this disclosure, shares of common stock held by executive officers, directors and persons who hold
10% or more of the outstanding shares of common stock of the registrant as of such date have been excluded because such persons may be
deemed  to  be  affiliates.  This  determination  is  not  necessarily  a  conclusive  determination  for  any  other  purposes.

There  were  83,909,845  shares  of  common  stock  outstanding  as  of  May  31,  2017.

Documents  Incorporated  by  Reference

None.

HMS HOLDINGS CORP. AND SUBSIDIARIES 
ANNUAL REPORT ON FORM 10-K 
TABLE OF CONTENTS 

Glossary of Terms and Abbreviations 

PART I 

Item 1. 
Item 1A. 
Item 1B. 
Item 2. 
Item 3. 
Item 4. 

PART II 

Item 5. 
Item 6. 
Item 7. 
Item 7A. 
Item 8. 
Item 9. 
Item 9A. 
Item 9B. 

PART III 

Item 10. 
Item 11. 
Item 12. 
Item 13. 
Item 14. 

PART IV 

Business 
Risk Factors 
Unresolved Staff Comments 
Properties 
Legal Proceedings 
Mine Safety Disclosures 

Market for Registrant’s Common Equity, Related Shareholder Matters and Issuer Purchases of Equity Securities 
Selected Financial Data 
Management’s Discussion and Analysis of Financial Condition and Results of Operations 
Quantitative and Qualitative Disclosures About Market Risk 
Consolidated Financial Statements and Supplementary Data 
Changes in and Disagreements with Accountants on Accounting and Financial Disclosure 
Controls and Procedures 
Other Information 

Directors, Executive Officers and Corporate Governance 
Executive Compensation 
Security Ownership of Certain Beneficial Owners and Management and Related Shareholder Matters 
Certain Relationships and Related Transactions and Director Independence 
Principal Accounting Fees and Services 

Item 15. 
Item 16.  

Exhibits, Financial Statement Schedules 
Form 10-K Summary 

Page
1

3
8
24
24
24
24

25
28
29
40
40
40
41
42

43
52
91
93
94

96
96

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Glossary of Terms and Abbreviations 

2016 Form 10-K
ACA

ACO
ADR
ALJ
ASC
ASO
CHIP
CMS
CMS NHE Projections
COSO
DMD
DRA
DSO
ERISA
Exchange Act
FASB
FFS
HIPAA
HITECH
IRS
LIBOR
Medicare Advantage
MMIS
PBM
PHI
PI
R&D Credits
RAC
RFI
RFP
SEC
Securities Act
Section 199 Deduction
SG&A
TPL
U.S. GAAP
VHA
Credit Agreement

2006 Stock Plan
2011 HDI Plan
2016 Omnibus Plan
401(k) Plan

Company's Annual Report on Form 10-K for the year ended December 31, 2016
Patient Protections and Affordable Care Act, as amended by the Health Care and Education 
Reconciliation Act of 2010
Accountable Care Organizations
Additional Documentation Request
Administrative Law Judges
Accounting Standards Codification
Administrative Service Only
Children's Health Insurance Program
Centers for Medicare & Medicaid Services
Centers for Medicare & Medicaid Services National Health Expenditures
Committee of Sponsoring Organizations of the Treadway Commission
Domestic Manufacturing Deduction
Deficit Reduction Act of 2005
Days Sales Outstanding
Employment Retirement Income Security Act of 1974
Securities Exchange Act of 1934, as amended
Financial Accounting Standards Board
Fee For Services
Health Insurance Portability and Accountability Act of 1996
Health Information Technology for Economic and Clinical Health
U.S Internal Revenue Service
Intercontinental Exchange London Interbank Offered Rate
Medicaid and Medicare managed care
Medicaid Management Information Systems
Pharmacy Benefit Managers
Protected health information
Payment Integrity
Research and Development Tax Credits
Recovery Audit Contractor
Request for information
Request for proposals
U.S. Securities and Exchange Commission
Securities Act of 1933, as amended
U.S. Production activities deduction
Selling, general and administrative expenses
Third-party liability
United States Generally Accepted Accounting Principles
Veterans Health Administration
The Credit Agreement dated December 16, 2011 among HMS Holdings Corp., the Guarantor 
Party thereto, the Lenders party thereto and Citibank, N.A. as Administrative Agent, as amended 
and restated in its entirety by the Amended and Restated Credit Agreement dated as of May 3, 
2013 among HMS Holdings Corp., the Guarantor Party thereto, the Lenders party thereto and 
Citibank, N. A. as Administrative Agent, as amended
HMS Holdings Corp. Fourth Amended and Restated 2006 Stock Plan
HDI Holdings, Inc. Amended 2011 Stock Option and Stock Issuance Plan
HMS Holdings Corp. 2016 Omnibus Incentive Plan
HMS Holdings Corp. 401(k) Plan

1 

 
 
 
Cautionary Note Regarding Forward-Looking Statements  

This Annual Report on Form 10-K of HMS Holdings Corp. (together with its subsidiaries, “HMS,” the “Company,” “we,” “our” or 
“us”) contains “forward-looking statements” within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. From 
time  to  time,  we  also  provide  forward-looking  statements  in  other  materials  we  release  to  the  public,  as  well  as  oral 
forward-looking statements. Such statements reflect our current expectations, projections and assumptions about our business, 
the economy and future events or conditions. They do not relate strictly to historical or current facts.  

We have tried to identify forward-looking statements by using words such as “aim,” “anticipate,” “believe,” “estimate,” “expect,” 
“forecast,” “intend,” “likely,” “may,” “plan,” “project,” “seek,” “target,” “will,” “would,” “could,” “should,” and similar expressions and 
references to guidance, although some forward-looking statements may be expressed differently. These statements include, 
among other things, information concerning our possible future actions, business plans, objectives and prospects, our future 
operating or financial performance, sales efforts and results of current and anticipated services, the benefits and synergies to 
be obtained from completed and future acquisitions, the future performance of companies we have acquired, sufficiency of our 
appeals reserves, the future effect of different accounting determinations or remediation activities, our ability to successfully 
remediate material weaknesses in our internal control over financial reporting, our future expenses, interest rates and financial 
results, and the impact of changes to U.S. healthcare legislation or healthcare spending affecting Medicare, Medicaid or other 
publicly funded or subsidized health programs. 

Forward-looking statements are not guarantees and involve risks, uncertainties and assumptions that are difficult to predict. 
Actual results may differ materially from past results and forward-looking statements if known or unknown risks or uncertainties 
materialize, or if underlying assumptions prove inaccurate. These risks and uncertainties include, among other things,  

(cid:131)  our ability to execute our business plans or growth strategy;  
(cid:131)  our ability to innovate, develop or implement new or enhanced solutions or services;  
(cid:131) 

the  nature  of  investment  and  acquisition  opportunities  we  are  pursuing,  and  the  successful  execution  of  such 
investments and acquisitions;  

variations in our results of operations;  

(cid:131)  our ability to successfully integrate acquired businesses and realize synergies;  
(cid:131) 
(cid:131)  our ability to accurately forecast the revenue under our contracts and solutions;  
(cid:131)  our  ability  to  protect  our  systems  from  damage,  interruption  or  breach,  and  to  maintain  effective  information  and 

technology systems and networks; 

(cid:131)  our ability to protect our intellectual property rights, proprietary technology, information processes, and know-how;  
(cid:131) 
(cid:131)  our failure to maintain a high level of customer retention or the unexpected reduction in scope or termination of key 

significant competition for our solutions and services;  

contracts with major customers; 
customer dissatisfaction, our non-compliance with contractual provisions or regulatory requirements; 
(cid:131) 
(cid:131)  our failure to meet performance standards triggering significant costs or liabilities under our contracts;  
(cid:131)  our inability to manage our relationships with information and data sources and suppliers;  
reliance on sub-contractors and other third party providers and parties to perform services; 
(cid:131) 
(cid:131)  our ability to continue to secure contracts and favorable contract terms through the competitive bidding process and to 

prevail in protests or challenges to contract awards;  

(cid:131)  pending or threatened litigation;  
(cid:131)  unfavorable outcomes in legal proceedings; 
(cid:131)  our success in attracting qualified employees and members of our management team;  
(cid:131)  our ability to generate sufficient cash to cover our interest and principal payments under our credit facility or to borrow 

or use credit;  

(cid:131)  unexpected changes in our effective tax rates;  
(cid:131)  unanticipated increases in the number or amount of claims for which we are self-insured; 
(cid:131) 

changes in the U.S. healthcare environment or healthcare financing system, including regulatory, budgetary or political 
actions that affect procurement practices and healthcare spending;  

(cid:131)  our failure to comply with applicable laws and regulations governing individual privacy and information security or to 

protect such information from theft and misuse;  

(cid:131)  negative results of government or customer reviews, audits or investigations;  

2 

 
 
 
 
state or federal limitations related to outsourcing or certain government programs or functions; 
restrictions on bidding or performing certain work due to perceived conflicts of interests;  
the market price of our common stock and lack of dividend payments; and 

(cid:131) 
(cid:131) 
(cid:131) 
(cid:131)  anti-takeover provisions in our corporate governance documents.  

These and other risks are discussed under the headings “Part I. Item 1. Business,” “Part I. Item 1A, Risk Factors,” “Part II, Item 
7. Management’s Discussion and Analysis of Financial Condition and Results of Operations,” and “Part II, Item 7A. Quantitative 
and Qualitative Disclosures about Market Risk” of this 2016 Form 10-K and in other documents we file with the SEC.  

Any forward-looking statements made by us in this 2016 Form 10-K speak only as of the date on which they are made. We 
undertake no obligation to publicly update forward-looking statements, whether as a result of new information, future events or 
otherwise, except as may be required by law. We caution readers not to place undue reliance upon any of these forward-looking 
statements. You are advised, however, to consult any further disclosures we make on related subjects in our Form 10-Q and 
Form 8-K reports and our other filings with the SEC.  

Market and Industry Data 

This 2016 Form 10-K contains market, industry and government data and forecasts that have been obtained from publicly 
available information, various industry publications and other published industry sources. We have not independently verified 
the information and cannot make any representation as to the accuracy or completeness of such information. None of the 
reports and other materials of third party sources referred to in this 2016 Form 10-K were prepared for use in, or in connection 
with, this report. 

Item 1.  Business 

PART I 

Founded in 1974, HMS is a leading provider of cost containment solutions in the U.S. healthcare marketplace. We use innovative 
technology, extensive data services and powerful analytics, to deliver coordination of benefits, payment integrity and health 
management  and  engagement  solutions  to  help  healthcare  payers  improve  performance  and  outcomes.  We  provide 
coordination of benefits services to government and commercial healthcare payers and sponsors to ensure that the responsible 
party pays healthcare claims. Our payment integrity services ensure healthcare claims billed are accurate and appropriate; and 
our care management technology helps risk-bearing organizations manage the care delivered to their members. Together these 
various services help customers recover amounts from liable third parties; prevent future improper payments; reduce fraud, 
waste and abuse; better manage the care that members receive; and ensure regulatory compliance.  

HMS began its operations as Health Management Systems, Inc., which became our wholly owned subsidiary in March 2003 
when we assumed its business in connection with the adoption of a holding company structure. Since then HMS has grown 
both organically and through targeted acquisitions of businesses that helped expand our product suite, including IntegriGuard, 
LLC (2009), HealthDataInsights, Inc.(“HDI”) (2011), Essette, Inc. (2016), Eliza Holding Corp. (2017) and others.  

We were originally incorporated in the State of New York in October 2002 and reincorporated in the State of Delaware in July 
2013. Our principal executive offices are located 5615 High Point Drive, Irving, Texas 75038 and our telephone number is (214) 
453-3000.  

We operate as one business segment with a single management team that reports to the Chief Executive Officer.  

Our Solutions 

Our coordination of benefits services draw principally upon proprietary information management and data mining techniques 
designed to ensure that the correct party pays a healthcare claim. Our payment integrity services are designed to ensure that 
healthcare billings and/or payments are accurate and appropriate. As a result of these services, customers received billions of 
dollars in cash recoveries in 2016, and saved billions more through the prevention of erroneous payments. In addition, our care 

3 

 
 
 
 
 
 
 
 
 
 
 
management solutions help risk-bearing organizations manage the care delivered to their members with a focus on improving 
outcomes and patient engagement.  

Our services are applicable to federal, state and commercial health plans and prevent and address errors across the payment 
continuum, from an individual’s enrollment in a program before any medical service is rendered, to pre-payment review of a 
claim by a payer, through recovery where discovery of an improper payment is made via audit. Our services address a wide 
spectrum of payment errors, from eligibility and coordination of benefits errors, to the identification and investigation of potential 
fraud, and extend to most claim types. Our services also assist customers in managing quality, risk, cost and compliance across 
all lines of business.  

In general, our range of services includes the following: 

(cid:131)  Coordination of benefits services 

We provide cost avoidance services, which  include  providing validated insurance coverage information that is  used  by 
government-sponsored  payers  to  coordinate  benefits  properly  for  future  claims.  With  validated  insurance  information, 
Medicaid payers can avoid unnecessary costs by ensuring that they pay only after all other benefits available have been 
exhausted, thereby complying with federal regulations that require Medicaid to be the payer of last resort. Nevertheless, 
due  to  a  variety  of  factors,  some  Medicaid  claims  are  paid  even  when  there  is  a  known  responsible  third  party.  Our 
government-sponsored program customers rely on us to identify those claims that were paid in error and recover these 
payments from the liable third party. Further, we also provide services to assist customers in identifying other third-party 
insurance and recovering medical expenses where a member is involved in a casualty or tort incident. Lastly, for Medicaid 
agencies exclusively, we provide estate recovery services to identify and recover Medicaid expenditures from the estates 
of deceased Medicaid members in accordance with state policies. For the years ended December 31, 2016, 2015 and 
2014, our coordination of benefits services represented 72.3%, 71.2% and 70.5% of our total revenue, respectively.  

(cid:131)  Payment integrity services  

Our payment integrity services are applicable to all markets that HMS serves, including the federal and state governments, 
commercial health plans and other at-risk entities. Our solutions are designed to verify that medical services are utilized, 
billed and paid appropriately. Our services combine data analytics, clinical expertise and proprietary technology to identify 
improper payments on both a pre-payment and post-payment basis; identify and recover overpayments/underpayments; 
detect and prevent fraud, waste and abuse; and identify process improvements. For the years ended December 31, 2016, 
2015 and 2014, our payment integrity services represented 24.3%, 24.5% and 24.5% of our total revenue, respectively. 

4 

 
 
 
 
 
 
 
 
(cid:131)  Care management and member analytics technologies  

We offer a web-based care management platform which helps risk-bearing healthcare organizations identify, engage, and 
manage at-risk patient populations to improve outcomes while managing costs.  

Customers  

For each of the years ended December 31, 2016, 2015 and 2014 no one individual Company customer accounted for more 
than 10% of our total revenue.  

The composition of our 10 largest customers changes periodically. For the years ended December 31, 2016, 2015 and 2014, 
our 10 largest customers represented 40.6%, 44.0% and 40.1% of our total revenue, respectively. The current terms of our 
agreements with these customers have expiration dates ranging between 2017 and 2020. Several of our contracts, including 
those with some of our largest customers, may be terminated for convenience. The early termination of a contract with one of 
our significant customers may have an adverse effect on our financial condition, results of operations and cash flows. 

We  provide  products  and  services  under  contracts  (or  sub-contracts)  that  contain  various  revenue  structures,  including 
contingent revenue and fixed-fee arrangements. Most of our contracts have terms ranging from three to five years, including 
renewal terms at the option of the customer. In many instances, we provide our services pursuant to agreements that are subject 
to periodic reprocurements. Because we provide our services pursuant to agreements that are open to competition from various 
businesses  in  the  U.S.  healthcare  insurance  benefit  cost  containment  marketplace,  we  cannot  provide  assurance  that  our 
contracts,  including  those  with  our  largest  customers,  will  not  be  terminated  for  convenience,  awarded  to  other  parties,  or 
renewed. Additionally, we cannot provide assurance that our contracts, if renewed, will have the same fee structures or otherwise 
be on satisfactory terms.  

Industry Trends and Opportunities 

U.S. healthcare expenditures continue to escalate and consume a large proportion of our GDP, presenting challenges for payers 
who wish to contain and reduce costs while also promoting quality healthcare outcomes. These aims are the same across all 
at-risk entities, including commercial health plans and government healthcare programs, such as Medicaid and Medicare. 

Within  the  commercial  market,  health  plans  sell  policies  directly  to  individuals  (on  the  open  market  or  via  health  insurance 
exchanges), contract with employers to underwrite their employees’ care, or contract with self-insured employers to oversee 
benefit administration to their employees. This market also includes a growing number of risk bearing provider-sponsored plans 
that operate and market health plan benefits. According to CMS NHE projections, private health insurance covered 195 million 
individuals in 2016 at a cost of $1.09 trillion.  

Several  commercial  health  plans  also  offer  government-sponsored  lines  of  business,  including  partnering  with  Medicare, 
Medicaid and CHIP to oversee care delivery for beneficiaries enrolled in those programs. Government managed care grew out 
of pressures to contain the growth of state and federal program spending and to address general concerns about healthcare 
access. Commercial health plan-related partnerships with government programs include the following: 

(cid:131)  Within the Medicaid program, 38 states and the District of Columbia presently contract with managed care organizations 
to provide care to some or all of their Medicaid beneficiaries. In addition, many states have expanded the use of managed 
care organizations to new regions or to serve beneficiaries with more complex conditions. Of the 32 states and the District 
of Columbia that opted to expand Medicaid eligibility levels pursuant to the ACA, all except 5 use Medicaid managed care 
organizations. The majority of new lives that have entered the Medicaid program as a result of the ACA are enrolled in 
managed care plans. It is unclear at this time how, if at all, efforts in Congress to “repeal and replace” the ACA could affect 
any of the state expansions or future growth of Medicaid lives and expenditures. 

(cid:131) 

Similarly, managed care health plans also continue to assume risk for Medicare lives, with the Kaiser Family Foundation 
estimating that in 2016, nearly one-third of all Medicare recipients were enrolled in a Medicare Advantage plan.  

5 

 
 
 
 
 
 
 
 
 
 
 
 
HMS also continues to serve government-sponsored agencies’ legacy fee-for-service programs at the state and federal level. 
These plans are generally reliant on and susceptible to the government appropriations process that determines their budget and 
governs the number of beneficiaries they serve.  

According  to  the  CMS  NHE  projections,  Medicare  programs  in  2016  covered  approximately  56 million  people  at  a  cost  of 
approximately $681 billion and Medicaid/CHIP covered approximately 77 million  people, costing approximately $593 billion. 
Altogether, it is projected that the government programs we serve covered approximately 130 million people at a total cost of 
approximately $1.3 trillion in 2016. Based on the CMS NHE Projections, Medicare spending is projected to grow 5.8% in 2017 
over 2016, and CMS projects Medicaid enrollment will grow by 1.7% in 2017 over 2016. Total Medicaid spending is projected 
to increase at a rate of 4.8% in 2017 over 2016.  

As  commercial  and  government  health  plans  continue  to  focus  on  strategies  to  contain  costs  across  their  different  lines  of 
business, we will continue to focus on serving them and meeting their evolving needs. Regardless of the program, coordinating 
benefits among a growing number of healthcare payers and ensuring that claims are paid appropriately represents an enormous 
challenge for our customers and an ongoing opportunity for us. 

Regulatory Environment 

The market for cost containment solutions is large and growing, driven by increasing healthcare costs and payment complexities. 
For 2017, Medicare and Medicaid are projected to pay approximately 45.9% of the nation’s healthcare expenditures and serve 
over 130 million beneficiaries. Many of these beneficiaries are enrolled in managed care plans, which have the responsibility for 
both patient care and claim adjudications. Since 1985, we have provided state Medicaid agencies with services to identify third 
parties with primary liability for Medicaid claims, and since 2005, we have provided similar services to Medicaid managed care 
plans. 

In 2006, Congress enacted the DRA and created the Medicaid Integrity Program under the Social Security Act to increase the 
government’s  capacity  to  prevent,  detect  and  address  fraud,  waste  and  abuse  in  the  Medicaid  program.  Later  that  year, 
Congress passed the Tax Relief and Health Care Act of 2006, which established the Medicare RAC program. HDI was awarded 
one of the first contracts under the program. In October 2016, CMS made a new round of awards and we again were awarded 
a region. These measures, at both the federal and state level, have strengthened our ability to identify and recover erroneous 
payments on behalf of our customers.  

The  ACA  was  signed  into  law  in  2010.  It  included  many  provisions  impacting  healthcare  delivery  and  payment  programs, 
including employer-sponsored health coverage, expansion of the Medicaid program, health insurance exchanges with premium 
subsidies, and payment integrity efforts. Following the 2016 Presidential and Congressional elections, some or all of the ACA 
provisions may be revised or repealed, although the scope and timing of such  Congressional efforts are yet to be defined. 
Options that have been discussed include issuing block grants or establishing per capita caps for state Medicaid populations, 
and looking at program design alternatives for future enrollment criteria. We will monitor ACA-related changes as they develop 
and assess their potential impact, as well as any opportunities they may present for our customers and for us.  

Competition 

The U.S. healthcare insurance benefit cost containment marketplace is a dynamic industry with a range of businesses currently 
able  to  offer  cost  containment  services,  both  directly  or  indirectly  (through  sub-contracting),  to  some  or  all  of  the  various 
healthcare payers. In addition, with improvements in technology and the growth in healthcare spending, new businesses are 
incentivized  to  enter  this  marketplace.  Many  healthcare  payers  also  have  the  ability  to  perform  some  or  all  of  these  cost 
containment services themselves and choose to exercise that option. Competition is therefore robust as customers have many 
alternatives available to them in their effort to contain healthcare costs. 

6 

 
 
 
 
 
 
 
 
 
 
We compete based on a variety of factors, including our ability to perform a wide range of coordination of benefits and payment 
integrity  related  functions;  proven  results  to  maximize  recoveries  and  cost  avoidance;  our  in-depth  government  healthcare 
program  experience;  clinical  staff  expertise;  extensive  insurance  eligibility  database;  proprietary  systems  and  processes; 
existing relationships with various customer and other industry shareholders; and our ability to provide customers with actionable 
intelligence to improve outcomes and patient engagement. 

Within our core coordination of benefits services, we compete primarily with large business outsourcing and technology firms, 
claims  processors  and  PBMs,  clearinghouses,  healthcare  consulting  firms,  smaller  regional  vendors  and  other  TPL  service 
providers.  In  addition,  we  frequently  work  with  customers  who  may  elect  to  perform  some  or  all  of  their  recovery  and  cost 
avoidance  functions  in-house.  The  competitive  environment  for  payment  integrity  services  includes  some  of  the  same 
companies that provide coordination of benefits services. Within the care management and risk analytics sector, we compete 
primarily with vendors who provide these and other population health management technology services. Companies with whom 
we compete across our product offerings include:  

(cid:131)  ChangeHealthcare 
(cid:131)  Cotiviti 
(cid:131)  HP  
(cid:131)  Optum, Inc. 
(cid:131)  Xerox 

Business Strategy 

(cid:131)  Experian Health 
(cid:131) 
IBM/Truven 
(cid:131)  LexisNexis 
(cid:131)  Performant Financial Corp. 
(cid:131)  SCIO Health Analytics 

(cid:131)  Verscend Technologies 
(cid:131)  CaseNet 
(cid:131)  MedHok 
(cid:131)  Trizetto 
(cid:131)  ZeOmega 

We believe that the steadily increasing enrollment and rising expenditures for Medicare and Medicaid, with most new enrollees 
entering managed care plans; an aging U.S. population with an increasing concentration of individuals with high cost chronic 
conditions; and the overall complexity of the healthcare claims payment system in the U.S. all combine to create substantial 
growth opportunities for the suite of cost containment solutions  which we offer. We also believe that these factors similarly 
present growth opportunities for our care management solutions. We expect to grow our business over the course of 2017 and 
beyond, both organically and inorganically, by leveraging existing key assets (e.g., our data, analytics and in-house expertise, 
and distribution channel) and pursuing a number of strategic objectives or initiatives, including: 

(cid:131)  Expanding the scope of our relationship with existing customers – by selling additional products and services.  

(cid:131)  Adding  new  customers  –  by  marketing  to  commercial  health  plans,  including  Medicaid  managed  care  and  Medicare 
Advantage plans, at-risk group and individual health lines of business and ASO; government healthcare payers, including 
Medicaid  agencies,  state  employee  health  benefit  plans  and  CHIP;  at-risk  provider  organizations  and  ACOs;  and 
commercial employers. 

(cid:131) 

Introducing new “homegrown” products and services – through internal development initiatives designed to enhance or 
expand our existing suite of cost containment products. 

(cid:131)  Utilizing big data – to create a more nimble operating environment and to identify new revenue opportunities within our 

current service delivery models. 

(cid:131)  Promoting  automation  and  innovation  to  improve  the  efficiency  and  effectiveness  of  our  services  –  by  continuing  to 
implement  new  technology  and  process  improvements  designed  to  increase  recovery  yields  and  increase  customer 
satisfaction. 

(cid:131)  Building  out  our  new  health  management  and  member  engagement  technology  platform  –    by  establishing  a  broad 
foundation of technology and service solutions to help customers better manage quality, cost and compliance across all 
lines  of  business.  Our  first  step  in  this  strategy  was  the  acquisition  of  Essette  Inc.,  a  care  management  platform,  in 
September  2016.  More  recently,  we  acquired  Eliza  Holding  Corp.,  which  provides  comprehensive  and  personalized 
outreach and health engagement solutions, in April 2017.  

7 

 
 
  
 
 
 
 
 
 
 
 
 
(cid:131)  Continuing opportunistic growth via acquisition – by selectively seeking assets to complement our core cost-containment 
expertise; build care management and care coordination adjacencies to complement the Essette and Eliza acquisitions; 
and expand our data analytics capabilities. Our focus is on acquisitions that have long-term growth potential; target high-
growth areas; are accretive to earnings; and fill a strategic need in our business portfolio as we seek to provide increasingly 
comprehensive solutions to our customers.  

Employees  

As of December 31, 2016, we had 2,315 employees, of which 2,287 were full-time. Of our total employees, 253 support SG&A 
activities. 

Intellectual Property 

Our ability to develop and maintain the proprietary aspects of our technology and operate without infringing the proprietary rights 
of  others  are  important  to  our  business  and  competitive  position.  We  establish  and  protect  our  proprietary  technology  and 
intellectual property through a combination of patents, patent applications, trademarks, copyrights, domain names, trade secrets, 
including know-how, confidentiality and invention assignment agreements, security measures, non-disclosure agreements with 
third parties, and other contractual rights. As a result of acquiring Eliza Holding Corp. on April 17, 2017, we now own a patent 
portfolio comprised of approximately 55 domestic and international patents and patent applications. We do not believe that any 
one individual technology is essential to our business.  

Available Information 

Additional information about HMS is available on our website at www.hms.com. The content on our website, or any website 
referred to in this Annual Report on Form 10-K, is not incorporated by reference into this Annual Report, unless expressly noted.  

Copies of our recent Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K and Proxy 
Statements, as well as amendments to these reports or statements, are available free of charge on our website through the 
Investor Relations page, as soon as reasonably practicable after we electronically file them with, or furnish them to, the SEC. 
These materials, as well as similar materials for SEC registrants, may be obtained directly from the SEC through their website 
at www.sec.gov. You may also read and copy any materials we file with the SEC at the SEC’s Public Reference Room at 100 F 
Street NE, Washington, D.C. 20549. Information on the operation of the Public Reference Room may be obtained by calling the 
SEC at 1-800-SEC-0330.  

Item 1A.  Risk Factors  

Our business is subject to significant risks, including the risks and uncertainties described below. You should carefully consider 
these risks, as well as the other information in this 2016 Form 10-K, including our Consolidated Financial Statements and the 
related Notes. The occurrence of any of these risks could adversely affect our business, financial condition, results of operations, 
and cash flows in a material way. 

Risks Relating to Our Company 

Our ability to expand our business will be adversely affected if we fail to implement our growth strategy. 

The size and the scope of our business operations have expanded over the past several years, and we currently intend to 
continue to grow and expand into new areas within the government and commercial healthcare space; however, such growth 
and expansion carries costs and risks that, if not properly managed, could adversely affect our business. Our future growth will 
depend, among other things, on our ability to successfully execute our business plans and continued efforts to improve our 
operations, all while remaining competitive. We must also be flexible and responsive to our customers’ needs and to changes 
in the political, economic and regulatory environment in which we operate. The greater size and complexity of our expanding 

8 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
business  puts  additional  strain  on  our  administrative,  operational  and  financial  resources  and  can  make  optimal  resource 
allocation more difficult to determine. We may not be able to maintain or accelerate our growth. A failure to anticipate or properly 
address the demands and challenges that our growth strategy and potential diversification may have on our resources and 
existing infrastructure may result in unanticipated costs and inefficiencies and could negatively impact our ability to execute on 
our business plans and growth goals, which could have a material adverse effect on our business, financial condition, results of 
operations and cash flows. 

If we fail to innovate and develop new or enhanced solutions and services, or if these solutions and services are not 
adopted  by  our  customers,  it  could  have  a  material  adverse  effect  on  our  business,  financial  condition,  results  of 
operations and cash flows. 

Part of our growth strategy depends on our ability to respond to the evolving healthcare landscape with new and enhanced 
solutions  and  services  that  our  existing  and  potential  customers  are  willing  to  adopt.  The  development,  marketing  and 
implementation of these solutions and services may require that we make substantial financial and resource investments. We 
face risks that our new or modified solutions and services may not be responsive to customer preferences or industry changes, 
and that the solution and service development initiatives that we prioritize may not yield the gains that we anticipate, if any. If 
we are unable to predict market preferences or healthcare industry changes, or if we are unable to develop or adapt solutions 
and services that are responsive to existing and potential customers’ needs, we may fail to expand our business, which could 
constrain our future revenue growth and materially adversely affect our business, financial condition, results of operations and 
cash flows. 

Our acquisition strategy may subject us to considerable business and financial risk. 

Historically, to achieve our strategic goals, we have made a significant number of acquisitions that have expanded the solutions 
and services we offer, provided a presence in complementary business lines, or expanded our geographic presence and/or 
customer base. For example, we acquired IntegriGuard, LLC in September 2009; Verify Solutions, Inc. in December 2009; Allied 
Management  Group-Special  Investigation  Unit in June  2010;  Chapman  Kelly,  Inc.  in  August  2010;  HDI in December 2011; 
MedRecovery Management, LLC in December 2012; Essette, Inc. in September 2016; and Eliza Holding Corp. in April 2017.  

We intend to pursue future acquisitions that will continue to expand and diversify our business and to periodically engage in 
discussions regarding such possible acquisitions. We are  subject  to risks and uncertainties relating to our  ability to identify 
suitable  potential  acquisition  candidates,  to  consummate  additional  acquisitions  that  will  be  advantageous  to  us,  and  to 
successfully integrate future acquisitions. Future and potential business acquisitions involve a number of risk factors that could 
affect our operations, including, but not limited to: 

(cid:131)  diversion of management’s attention and other resources; 
(cid:131)  our ability to integrate operational, accounting and technology functions, policies, processes, systems and controls, and to 
implement these functions, policies, processes, systems and controls, without incurring substantial expenses, delays or 
other issues; 

(cid:131)  our ability to integrate personnel and human resource systems as well as the cultures of the acquired business;  
(cid:131)  our ability to retain or replace the key personnel of the acquired business; 
(cid:131)  our ability to maintain relationships with the customers of the acquired business and further develop the acquired business; 
(cid:131)  our ability to cross-sell our solutions and services and the solutions and services of the acquired business to our respective 

customers; 
customer dissatisfaction or performance problems with the acquired business; 

(cid:131) 
(cid:131)  our ability to comply with regulatory requirements and avoid potential conflicts of interest in markets that we serve; 
(cid:131) 
(cid:131)  our ability to successfully enter into unfamiliar markets; 
(cid:131)  assumption  of  unanticipated  legal  or  financial  liabilities  and/or  negative  publicity  related  to  prior  acts  by  the  acquired 

the misuse of intellectual property by the personnel of the acquired business; 

business; 

9 

 
 
 
 
 
 
 
 
(cid:131)  we  may  become  subject  to  litigation  or  other  claims  in  connection  with  the  acquired  business,  including  claims  from 

terminated employees, customers, former shareholders or third parties; 

(cid:131)  we may become significantly leveraged as a result of incurring debt to finance an acquisition; 
(cid:131)  we may encounter unanticipated operating, accounting or management difficulties in connection with the acquired business;  
(cid:131) 
the acquired business may not perform as projected which could negatively impact earnings or contingent consideration; 
(cid:131)  we may suffer impairment of goodwill and other acquired intangible assets; and 
(cid:131)  we may suffer dilution to our earnings per share. 

If we fail to adequately address these risks, or to successfully integrate the businesses that we acquire, we may not realize cost 
efficiencies,  synergies  or  other  benefits  that  we  anticipated  when  selecting  our  acquisition  candidates,  and  our  reputation, 
business, financial condition, results of operations and cash flows could be materially adversely affected. 

You will not be able to rely on our operating results in any particular period as an indication of our future performance 
because they are subject to significant fluctuation which may cause the market price of our common stock to decrease 
significantly.  

Our operating results may fail to match our past or projected performance. We have experienced significant variations in our 
revenue between reporting periods due to the timing of periodic revenue recovery projects, the timing and delays in third party 
payers’ claim adjudication and ultimate payment to our customers where our revenue is contingent upon such collections and 
delays in receiving payment for our services. Our revenue and operating results have also been impacted from period to period 
as a result of a number of factors, some of which are outside of our control, including, but not limited to: 

fluctuations in sales activity given our sales cycle;  
the commencement, completion or termination of contracts during any particular quarter;  

(cid:131) 
(cid:131) 
(cid:131)  expenses related to certain contracts which may be incurred in periods prior to revenue being recognized;  
(cid:131) 
(cid:131) 
(cid:131) 
(cid:131) 

the timing of government contract awards;  
the time required to resolve bid protests; 
contract renewal discussions, which result in delayed payments for services already performed;  
technological and operational issues affecting our customers, including delays in payment receipt for previously recognized 
revenue due to delays in certain customers processing our findings through their systems; 

(cid:131)  adjustments to age/quality of receivables and accruals as a result of delays involving contract limitations and changes or 
sub-contractor  performance  deficiencies  or  internal  managerial  decision  not  to  pursue  identified  claim  revenue  from 
customers; and  
regulatory changes or general economic conditions as they affect healthcare providers and payers.  

(cid:131) 

Occasionally  our  state  and  federal  customers  are  requested  by  third  party  payers  to  refund  payments  that  we  previously 
recovered  for  our  customers.  If  our  state  and  federal  customers  choose  to  refund  money  in  response  to  these  requests, 
regardless of whether an error actually occurred in connection with the payments, we may also be required to return contingent 
revenue which we were previously paid associated with such refunded payments. We also typically face a long implementation 
period with a new customer or a new contract with an existing customer and may not be able to estimate with certainty the 
period in which implementation may be completed.   

We cannot predict the extent to which future variations could occur due to these or other factors. Although we have experienced 
some seasonal trends in our operational volume, we do not consider our operations to be seasonal to any material degree. 
Consequently, our operating results are subject to significant fluctuation for any particular quarter, fiscal year, or other period, 
and may not be indicative of future periods. Significant fluctuations in our operating results may cause the market price of our 
common stock to decrease significantly. 

10 

 
 
 
 
 
 
 
 
 
We  face  challenges  associated  with  forecasting  the  revenue  under  our  contracts  and  solutions,  and  any  failure  to 
accurately forecast such revenue could have a material adverse effect on our business, financial condition, results of 
operations and cash flows.  

We may not be able to accurately estimate the factors upon which we base our contract pricing, or the costs and timing for 
implementing and completing contracts. For a majority of our customer contracts, the payment of our fee is contingent upon the 
recoveries received by our customers. We also have cost-plus or time-and-material based contracts with the federal government 
where our revenue is recognized based on costs incurred plus an estimate of the negotiated fee earned. Our ability to earn a 
profit on these contracts requires that we accurately estimate the costs involved with these contracts and assess the probability 
of achieving certain outcomes or milestones within the contracted time period. In addition, we cannot predict with certainty the 
costs or the period in which implementation or contracts may be completed when we introduce new solutions or services into 
the marketplace. We may also face a long implementation period with a new customer or a new contract, making it difficult to 
reliably forecast revenue under those contracts. If we do not accurately estimate the costs and timing for completing projects, 
or if we encounter increased or unexpected costs, delays, failures, liabilities or risks, including those outside of our control, our 
contracts  could  prove  unprofitable  for  us  or  yield  lower  profit  margins  than  anticipated.  Although  we  believe  that  we  have 
recorded adequate provisions in our financial statements for losses on our fixed-price and cost-plus contracts where applicable, 
as required under U.S. GAAP, our contract loss provisions may not be adequate to cover all actual future losses.  

System interruptions or failures could expose us to liability and harm our business. 

Our data and operation centers are essential to our business and our operations depend on our ability to maintain and protect 
our information systems. We attempt to mitigate the potential adverse effects of a disruption, relocation or change in operating 
environment; however, the situations we plan for and the amount of insurance coverage that we maintain may not be adequate 
in every case. Despite systems redundancy and security measures, our systems and operations are vulnerable to damage or 
interruption from, among other sources: 

(cid:131)  power loss, transmission cable cuts and telecommunications failures; 
(cid:131)  damage or interruption caused by fire, earthquake and other natural disasters; 
(cid:131) 
(cid:131) 
(cid:131)  physical break-ins, sabotage, intentional acts of vandalism, terrorist attacks and other events beyond our control. 

software defects;  
cyber security breaches; and 

In addition, while there are backup systems in many of our operating facilities, an extended outage of utility or network services 
supplied by third party IT vendors or providers may delay or disrupt the delivery or performance of the solutions and services 
we provide for our customers. If we encounter a business interruption, or in the event our business continuity plans and business 
interruption  insurance  coverage  are  not  adequate  or  fail  to  compensate  us  on  a  timely  basis,  we  could  suffer  operational 
disruptions, disputes with customers, civil or criminal penalties, regulatory problems, increases in administrative expenses, loss 
of our ability to produce timely and accurate financial and other reports or other adverse consequences, any of which could have 
a material adverse effect on our business, financial condition, results of operations and cash flows.  

Our systems and networks and those of third parties on which we rely may be subject to cyber security breaches and 
other disruptions that could compromise our information and harm our business.  

In  the  ordinary  course  of  our  business,  we  rely  heavily  upon  our  technology  systems  and  networks  to  input,  maintain  and 
communicate the confidential and proprietary data we receive on behalf of our customers, as well as third-party products and 
services. In addition, sub-contractors, teaming partners or other third-party vendors may receive or utilize this information on 
our behalf.  The secure processing and maintenance of this information is critical to our operations and business strategy. Our 
security measures or those of third parties on which we rely could be compromised or breached as a result of computer hacking, 
acts of vandalism or theft, malware, computer viruses, employee error or malfeasance, catastrophes or other unforeseen events. 
As a result, our data, customers’ data, information technology or infrastructure could be accessed improperly, made unavailable, 
improperly modified, or corrupted or we could suffer system disruptions, shutdowns and denials of service. The occurrence of 

11 

 
 
 
 
 
 
 
 
 
any  of  these  events  could  cause  our  solutions  and  services  to  be  perceived  as  vulnerable,  cause  our  customers  to  lose 
confidence in our solutions and services, negatively affect our ability to attract new customers, cause existing customers to 
terminate or not renew our solutions and services and damage our reputation, all of which could reduce our revenue, increase 
our expenses and expose us to legal claims and regulatory actions. Similarly, we could be materially adversely affected by the 
loss of proprietary, trade secret or confidential technical and financial data if our internal networks are compromised. We may 
be unable to implement adequate preventive measures to protect against such compromises. We could also be forced to expend 
significant  resources  in  response  to  a  cyber-security  breach,  including  repairing  system  damage,  increasing  cyber  security 
protection  costs  by  deploying  additional  personnel  and  protection  technologies,  paying  regulatory  fines  and  litigating  and 
resolving legal claims and regulatory actions, all of which could increase our expenses, divert the attention of our management 
and key personnel away from our business operations and materially adversely affect our results of operations. 

If  we  are  unable  to  protect  our  proprietary  technology,  information,  processes,  know-how,  and  other  intellectual 
property and intellectual property rights, or become subject to claims of infringing or misappropriating the intellectual 
property of third parties, the value of our solutions and services may be diminished and our business may be materially 
adversely affected.  

Our  success  as  a  company  depends  in  part  upon  our  ability  to  protect  our  core  technology  and  intellectual  property.  Our 
expanding operations and efforts to develop new solutions and services also make protection of our intellectual property more 
critical. We seek to protect trade secrets and other proprietary information through confidentiality agreements and invention 
assignment agreements with employees, consultants and other third parties, as well as through the terms of our agreements 
with customers and vendors, and other security measures. However, the steps we have taken to deter misappropriation of 
intellectual property may be insufficient to protect our proprietary information. Misappropriation of our intellectual property by 
third parties, or any disclosure or dissemination of our confidential and proprietary business intelligence, queries, algorithms and 
other similar information by any means, could undermine any competitive advantage we currently derive or may derive from that 
intellectual property. For example, our current or former employees, consultants or other third parties may unintentionally or 
willfully disclose our trade secrets, know-how or other confidential and proprietary information to competitors. Competitors have 
also attempted to use state open records and/or federal Freedom of Information Act laws to obtain our proposal responses and 
other documents we provide to our government customers. We cannot be certain that our efforts to protect the confidential and 
proprietary trade secret information or intellectual property in these proposals or other documents will always be successful, due 
to  the  many  factors  underlying  the  various  state  and  federal  decisions  to  release  information  in  response  to  open  records 
requests (even in spite of our objections and efforts to protection information). On the other hand, third parties may claim that 
we are infringing upon or misappropriating their intellectual property. Our exposure to risks related to the use of intellectual 
property may also increase as a result of acquisitions because third parties may make infringement and similar or related claims 
after we have acquired technology. Any of these situations could cause us to expend significant time and resources and to incur 
substantial costs associated with litigation or legal proceedings that may be necessary to defend ourselves or to enforce our 
intellectual property rights, in which we may not ultimately prevail, and could result in our being prevented from furnishing certain 
solutions and services. If the protection of our proprietary rights is inadequate to prevent unauthorized use or appropriation by 
third parties or our employees, the value of our brand and other intangible assets may be diminished and others may be able to 
more effectively compete with our business by offering solutions or concepts that are substantially similar to ours, which could 
have a material adverse effect on our business, financial condition, results of operations and cash flows. 

We face significant competition for our solutions and services and we expect competition to increase, which could 
materially adversely affect our business, financial condition, results of operations and cash flows. 

The  market  for  healthcare  cost  containment  solutions  and  services  is  intensely  competitive,  driven  by  rapidly  changing 
technologies, evolving industry standards and customer demands to become more efficient. Our competitors range in size from 
large, diversified national companies to small, specialized firms, and could include current or former sub-contractors or teaming 
partners seeking to establish direct relationships with our customers in order to perform similar services as the prime contractor, 
as well as current and prospective customers that elect to perform recovery and cost avoidance functions in-house or to develop 
in-house capacities for solutions and services that we provide or hope to provide. Consolidation among vendors and healthcare 
providers, as well as the merging of some of our competitors or formation of business alliances with other competitors, have 

12 

 
 
 
 
 
 
contributed to the increasingly competitive environment. For example, certain state customers have combined or “bundled” TPL 
services under large-scale IT procurements, allowing MMIS vendors to partner with less experienced TPL identification vendors 
based  on  preferred  relationships  or  favorable  pricing.  In  addition,  companies  that  have  invested  in  proprietary  technology 
different from our own solution and service offerings, such as front-end analytics, have emerged as new competitors due to the 
rapidly evolving healthcare landscape. There is also increasing sophistication in the solutions and services that our competitors 
are developing that may become more efficient or appealing to our customers. In order to remain competitive, we may need to 
quickly develop and market new and enhanced solutions and services responsive to emerging technologies and changes in the 
healthcare industry, which may require that we make substantial financial and resource investments.   

We  may  not  be  able  to  compete  successfully  against  our  existing  or  future  competitors.  Some  of  these  competitors  have 
significantly greater financial and technical resources and market recognition than we do. They may be able to (i) offer lower 
prices or negotiate fee reductions on our current solutions and services, (ii) respond more quickly than we can to new and 
emerging technologies and changing customer requirements, (iii) devote greater resources to the sale of their solutions and 
services and the development and implementation of new and improved systems, solutions and services for customers that we 
serve, and (iv) pursue various acquisitions that allow them to rapidly amass a wide array of capabilities. We may be forced to 
lower our pricing, unexpectedly increase or enhance our technological or data capabilities, or modify our solution or service 
offerings.  Notwithstanding  any  changes  we  make  in  response  to  increased  competition,  the  demand  for  our  solutions  and 
services may decrease as a result of increased competition. A failure to be responsive to our existing and potential customers’ 
needs or the changing industry landscape could hinder our ability to maintain or expand our customer base, hire and retain new 
employees, pursue new business opportunities, complete future acquisitions and operate our business effectively. Any inability 
to compete effectively could materially adversely affect our business, financial condition, results of operations and cash flows. 

Our business could be materially adversely affected if we fail to maintain a high level of customer retention, if our 
customers elect to reduce the scope of our contracts or terminate them before their scheduled expiration dates or if 
we fail to meet performance standards under our customer contracts. 

We historically have derived and expect to continue to generate a significant portion of our revenue from a limited number of 
large customers at the federal and state level. Our contracts with these customers are subject to periodic renewal and some 
permit them to terminate their contracts on short notice, with or without cause. If a customer is dissatisfied with the quality of our 
work or if we fail to meet performance standards under our contracts, or if our solutions, technical infrastructure or services do 
not comply with the provisions of our contractual agreements or applicable regulatory requirements, customers might seek to 
reduce the scope of the services we perform or prematurely terminate their agreements with us, or we could incur additional 
costs that may impair the profitability of a contract and damage our ability to obtain additional work from that customer, or other 
current  or  prospective  customers.  For  example,  some  of  our  contracts  contain  liquidated  damages  provisions  and  financial 
penalties related to performance failures, which if triggered, could materially adversely affect our reputation, business, financial 
condition, results of operations and cash flows. We also may be required to disclose such liquidated damages or other financial 
penalties assessed against us in connection with future bids for services with other customers.  

In addition, government customers are subject to financial pressures or pressure from stakeholders that may cause them to 
terminate contracts for our services that may be regarded as non-essential or to redefine or reduce the scope of our contracts 
by, for example, significantly reducing the volume of data that we are permitted to audit. Despite our right to prompt and full 
payment under the terms of our contracts, we could face challenges in obtaining timely or full payments for our properly provided 
services from our customers. If there is a substantial reduction in the scope of our services under, or a termination of, any of our 
key contracts with our major customers, or if we are exposed to significant costs, liabilities or negative publicity, our ability to 
compete  for  new  contracts  with  current  or  prospective  customers  could  be  damaged  and  our  business,  financial  condition, 
reputation, results of operations and cash flows could be materially adversely affected. 

13 

 
 
 
 
 
 
 
Any failure to maintain effective information processing systems and the integrity of the data in, and operations of, 
those systems could materially adversely affect our business, financial condition, results of operations and cash flows.  

Our  ability  to  conduct  our  operations  and  accurately  report  our  financial  results  depends  on  the  integrity  of  the  data  in  our 
information  systems  and  the  processes  performed  by  those  systems.  These  information  systems  and  applications  require 
continual maintenance, upgrading and enhancement to meet our operational needs, satisfy customer requests and handle our 
expansion and growth. Despite our testing and quality control measures, we cannot be certain that errors or system deficiencies 
will  not  be  found  and  that  remediation  can  be  done  in  a  timeframe  that  is  acceptable  to  our  customers,  or  that  customer 
relationships will not be impaired by the occurrence of errors or the need for remediation. In addition, implementation of upgrades 
and enhancements may cost more, take longer or require more testing than originally expected. Given the large amount of data 
we collect and manage, it is possible that hardware failures or errors or technical deficiencies in our systems could result in data 
loss or corruption or cause the information that we collect, utilize or disseminate to be incomplete or contain inaccuracies that 
our customers regard as significant. Situations may also arise in which the accuracy of our data analysis or the content and 
quality of our work product is central to the disposition of claims, controversies or litigation between our customers and third 
parties that would require us to allocate significant resources to fulfilling our contractual obligations to provide our customers 
with full and complete access to records, analysis and back-up documentation of our work. Assuring our capacity to fulfill these 
obligations as well as actually fulfilling them could impose significant burdens on our infrastructure for data storage, maintenance 
and processing, and require us to incur increased costs to supplement our personnel, data storage and computing resources, 
which could materially and negatively impact other business operations. 

We depend on many different entities to supply information and an inability to successfully manage our relationships 
with a number of these suppliers may harm the quality and availability of our solutions and services. 

We obtain the data used in our solutions and services from many sources, including commercial health insurance plans, financial 
institutions, managed care organizations, government entities and non-government entities. From time to time, challenges arise 
in managing and maintaining our relationships with data sources that are not our customers and that furnish information to us 
pursuant to a combination of voluntary cooperation and legal obligations under laws and regulations that are often subject to 
differing interpretation. For example, data suppliers could seek to limit or end our access to and use of their data if they determine 
that certain uses of data for our customers are not permitted by our agreements, or such suppliers may make errors in compiling, 
transmitting or accurately characterizing data or have technological limitations that interfere with our receipt or use of the data 
we rely on them to provide. If a number of our information sources become unable or unwilling to provide us with certain data 
under terms of use that are acceptable to us and our customers, or if laws and regulations for use and protection of this data 
changes in a way that disincentivizes our suppliers, or imposes unacceptable or unreasonable conditions or risks on us, we may 
not be able to obtain new or favorable agreements with alternative data suppliers. In addition, our ability to normalize and fully 
utilize the information we have received from various data sources in order to enhance and improve current solutions for our 
customers is an important component of our growth strategy. Although we believe that we have the legal and contractual rights 
necessary to normalize and use the data we have obtained from these sources for potential or contemplated solution and service 
offerings, we cannot provide assurance that these entities will permit the use of their data for these purposes. If we lose a 
number of our data sources or access to certain data and are unable to identify and reach the requisite agreements with suitable 
alternative suppliers or fail to successfully integrate them into our solution and service offerings, or if there is a lack of integrity 
in the data that current or future suppliers provide, we could experience service disruptions, increased costs, reduced quality of 
our solutions and services, or performance penalties under our customer contracts, which could have a material adverse effect 
on our business, financial condition, results of operations and cash flows. 

We may rely on sub-contractors and other third party providers to provide customers with a single-source solution or 
service  or  we  may  serve  as  a  sub-contractor  to  a  third  party  prime  contractor.  If  these  parties  fail  to  satisfy  their 
obligations  to  us  or  if  we  are  unable  to  maintain  these  relationships,  our  business,  financial  condition,  results  of 
operations and cash flows could be materially adversely affected.  

In some areas of our business we may engage sub-contractors, teaming partners, vendors or other third party providers to 
provide our customers with a single-source solution or service for a broader range of service needs. These third parties include 

14 

 
 
 
 
 
 
 
software vendors, utility and network providers and other information technology service providers. Our ability to deliver and 
implement solutions and serve our customers effectively depends on our ability to obtain permissions from our customers, when 
necessary, to use these third party sub-contractors, or on these third parties meeting our service standards in both timeliness 
and quality. Similarly, we are and may in the future be engaged as a sub-contractor to a third party prime contractor. Sub-
contracting arrangements where we are not the prime contractor pose unique risks to us because we do not have control over 
the customer relationship, and our ability to generate revenue under such sub-contracts is dependent on the prime contractor, 
its performance and relationship with the customer, and its relationship with us. While we believe that we perform appropriate 
due  diligence  on  these  parties  and  take  adequate  measures  to  ensure  that  they  comply  with  the  appropriate  laws  and 
regulations, we cannot guarantee that they will comply with the terms set forth in their agreements with us or in the case of a 
prime  contractor,  their  agreement  with  the  customer  or  that  they  will  provide  adequate  and  timely  services,  construe  their 
contractual  rights  and  obligations  in  a  reasonable  way,  act  appropriately  in  dealing  with  us  or  customers,  and  remain  in 
compliance with the relevant laws, rules or regulations. As a result, we may have disputes with these parties arising from these 
or other matters. Performance deficiencies or misconduct by our prime contractors or sub-contractors may be perceived as 
inadequacies in our solutions or services or cause us to fail to fulfill our contractual obligations to our customers, which could 
materially adversely affect our customer relationships and reputation, result in termination of a customer contract or the sub-
contractor or partner, and subject us to a dispute with our customer or such third party. In addition, if our third party service 
providers terminate or refuse to renew their relationships with us or offer their products to us in the future on less advantageous 
terms, we may not be able to perform or deliver solutions or services for existing customers as expected. Likewise, we could 
suffer  losses  in  the  event  a  prime  contract,  under  which  we  serve  as  a  sub-contractor,  is  terminated,  whether  for  non-
performance by the prime contractor or otherwise. Upon any such termination of the prime contract, our sub-contract will similarly 
terminate, and the resulting contract loss could materially adversely affect our business, financial condition, results of operations 
and cash flows. 

We obtain a significant portion of our business through competitive bidding in response to government requests for 
proposals. Reprocurements and future contracts may not be awarded through this process on the same level or our 
contract awards may be challenged by interested parties which could materially adversely affect our business, financial 
condition, results of operations and cash flows.  

In order to market our solutions and services and compete for contracts with existing and potential state and federal customers, 
we  are  often required to respond to  government-issued  RFPs. These  RFP responses  typically require us to  assemble and 
submit a large volume of information within a rigid timetable, and to accurately estimate our cost structure for servicing the 
proposed contract, the time required to establish operations and the likely terms of any proposals submitted by our competitors. 
We may also be required to disclose the occurrence of any negative events suffered by our business, such as customer disputes, 
a government inquiry or an adverse judgment or settlement in litigation or a legal proceeding, which could impair our ability to 
win the contract at issue or have a material adverse effect on our reputation in the industry.  

Even if we win these contracts, we may fail to secure favorable contract terms and conditions, or a government’s determination 
to award us the contract may be challenged by an interested party. Under the state and federal laws and regulations governing 
procurements of goods and services, challenges and award protests may be filed even if there are no valid legal grounds on 
which to base the protest. The filing of such challenges could potentially delay the start or implementation of the contract if the 
government  agency  determines  to  withhold  a  contract  award  or  suspend  contract  performance  while  the  protest  is  being 
considered, or to take corrective action on its own, such as soliciting new bids or terminating the contract award or current 
procurement. In the event of irregularities, we perceive or learn of in the award or bidding process, we also may be forced to file 
protests  in  response  to  RFP  awards  to  other  bidders.  Resolution  of  a  protest,  even  in  our  favor,  could  force  us  to  expend 
considerable  funds  in  disputing  the  potential  award  or  to  incur  additional  expenses  to  maintain  our  ability  to  timely  start 
implementation, which may cause our actual results to differ materially and adversely from those anticipated. In addition, if we 
are  unable  to  win  reprocurements  or  protests  of  particular  contracts,  we  may  be  precluded  from  entering  certain  customer 
markets  for  the  term  of  the  contract  awarded  to  another  party.  Any  failure  to  continue  to  obtain  contracts  in  response  to 
government RFPs, to design proposals that result in profitable contracts, to win new contracts or re-procure current contracts 
after they expire or to prevail in protests or challenges of contract awards could have a material adverse effect on our business, 
financial condition, results of operations and cash flows. 

15 

 
 
 
 
 
Adverse  judgments  or  settlements  in  legal  proceedings  could  materially  harm  our  business,  financial  condition, 
operating results and cash flows. 

We are  subject  and may be  a  party to  lawsuits  and other  claims that arise  from time to  time  in the  ordinary course of  our 
business,  which  may  include  those  related  to,  for  example,  contracts,  sub-contracts,  teaming  agreements,  protection  of 
confidential  information  or  trade  secrets,  adversary  proceedings  arising  from  customer  bankruptcies,  employment  of  our 
workforce  and  immigration  requirements  or  compliance  with  any  of  a  wide  array  of  state  and  federal  statutes,  rules  and 
regulations that pertain to different aspects of our business. We may also be required to initiate expensive litigation or other 
proceedings to protect our business interests. There is a risk that we will not be successful or otherwise be able to satisfactorily 
resolve any pending or future litigation. In addition, litigation and other legal claims are subject to inherent uncertainties and 
management’s view of currently pending legal matters may change in the future. Those uncertainties include, but are not limited 
to,  litigation  costs  and  attorneys’  fees,  unpredictable  judicial  or  jury  decisions  and  the  differing  laws  and  judicial  proclivities 
regarding damage awards among the states in which we operate. Unexpected outcomes in such legal proceedings, or changes 
in  management’s  evaluation  or  predictions  of  the  likely  outcomes  of  such  proceedings  (possibly  resulting  in  changes  in 
established reserves), could have a material adverse effect on our business, financial condition, results of operations and cash 
flows. 

We may not be able to deliver our solutions and services efficiently if we are unable to attract and retain qualified 
employees. 

Our  successful  delivery  of  services  and  solutions  is  dependent  upon  our  ability  to  recruit,  employ,  train  and  retain  skilled 
personnel. Our ability to maintain our productivity and profitability is limited by our ability to attract and retain the skilled personnel 
necessary to sustain our business and operations. The success of recruitment and retention strategies depend on a number of 
factors, including the competitive demands for employees having the skills we need and the level of compensation required to 
hire and retain such employees. As our business expands and undergoes change, we may also find it difficult to preserve our 
corporate culture, which could reduce our ability to innovate and operate effectively or result in a loss of experienced personnel. 
In addition, our customers or competitors may hire away our qualified employees. We may not be able to recruit the appropriate 
personnel or maintain the personnel necessary to efficiently operate and support our business, and even if our recruitment and 
retention strategies are successful, our labor costs may increase significantly. Our inability to hire sufficient personnel on a timely 
basis without significantly increasing our labor costs could materially adversely affect our business, financial condition, results 
of operations and cash flows. 

Our future success depends, in part, on the continued service of members of our management team. 

Our  ability  to  execute  on  our  business  plans  and  future  success  requires  that  we  attract,  develop,  motivate  and  retain 
experienced and innovative executive officers and senior managers who have successfully managed, designed or implemented 
government  services  programs  or  information  technology  projects,  or  have  relevant  experience  in  other  sectors  of  data 
management or the healthcare industry. These individuals are in great demand and are likely to remain a limited resource in 
our  industry.  The  loss  of  services  of  one  or  more  members  of  our  management  team  could  materially  adversely  affect  our 
business, financial condition, results of operations and cash flows. In addition, to the extent we lose an executive officer or senior 
manager, we may incur increased expenses in connection with the hiring, promotion or replacement of these individuals and 
the transition of leadership and critical knowledge. 

Our outstanding indebtedness could materially adversely affect our financial condition and our ability to operate our 
business, and we may not be able to generate sufficient cash flows to meet our debt service obligations.  

As  of  December  31,  2016,  the  outstanding  principal  balance  due  under  our  Credit  Agreement  was  $197.8  million.  Our 
outstanding indebtedness and any additional indebtedness we incur may have important consequences for us, including, without 
limitation, that: (i) we may be required to use a substantial portion of our cash flow to pay the principal of and interest on our 
indebtedness; (ii) our indebtedness and leverage may increase our vulnerability to adverse changes in general economic and 
industry conditions, as well as to competitive pressures; (iii) our ability to obtain additional financing for working capital, capital 

16 

 
 
  
 
 
 
 
 
 
expenditures, acquisitions and for general corporate and other purposes may be limited; and (iv) our flexibility in planning for, 
or reacting to, changes in our business and our industry may be limited. 

In addition, our ability to make payments of principal and interest on our outstanding revolving credit facility depends upon our 
future performance and our ability to generate cash flows. Under the terms of the Credit Agreement, we are required to comply 
with specified financial and operating covenants, which may limit our ability to operate our business as we otherwise might 
operate  it.  For  example,  our  obligations  may  be  accelerated  upon  the  occurrence  of  an  event  of  default,  including,  without 
limitation, payment defaults, failure to perform affirmative covenants, failure to refrain from actions or omissions prohibited by 
negative covenants, the inaccuracy of representations or warranties, cross-defaults, bankruptcy and insolvency related defaults, 
defaults relating to judgments, defaults due to certain ERISA related events and a change of control default. If not cured, an 
event of default would result in any amounts outstanding, including any accrued interest and unpaid fees, becoming immediately 
due  and  payable,  which  would  require  us  to,  among  other  things:  seek  additional  financing  in  the  debt  or  equity  markets, 
refinance or restructure all or a portion of our indebtedness, sell selected assets, and/or reduce or delay planned capital or 
operating expenditures. Such measures might not be sufficient to enable us to service our debt, and any such financing or 
refinancing might not be available on economically favorable terms or at all. If we are not able to generate sufficient cash flows 
to meet  our  debt service obligations  or  are forced to take additional measures to  be  able to  service  our  indebtedness, our 
business, financial condition and results of operations could be materially and adversely affected.  

Changes in, or interpretations of, tax rules and regulations may materially adversely affect our effective tax rates.  

We are a United States-based company subject to various federal, state and local tax laws and regulations in multiple U.S. 
jurisdictions that govern numerous aspects of our business. As we expand our business, we may perform services for new 
customers located outside of the United States or in a U.S. Territory, which may subject us to foreign tax laws and regulations 
that could increase our exposure to additional tax liabilities. Unanticipated changes in our tax rates could affect our future results 
of operations. Our future effective tax rates could be unfavorably affected by changes in the tax rates in jurisdictions where our 
income is earned and taxed, by changes in, or our interpretation of, tax rules and regulations in the jurisdictions in which we do 
business,  by  providing  services  in  new  jurisdictions,  by  increases  in  expenses  not  deductible  for  tax  purposes  including 
impairments of goodwill, by changes in U.S. GAAP or by changes in the valuation of our deferred tax assets and liabilities. 
Furthermore, the results of the 2016 elections create uncertainty regarding future potential tax law reform. 

In addition, we are subject to the continual examination of our income tax returns by the IRS and other domestic tax authorities. 
We regularly assess the likelihood of outcomes resulting from these examinations to determine the adequacy of our provision 
for  income  taxes  and  have  reserved  for  potential  adjustments  that  may  result.  The  final  determination  of  any  of  these 
examinations could have a material adverse effect on our business, financial condition, results of operations and cash flows.  

Our  health  insurance  coverage  and  self-insurance  reserves  may  not  cover  future  claims,  which  could  materially 
adversely affect our business, financial condition, results of operations and cash flows.  

We maintain various insurance policies for company employee health, workers’ compensation, general liability and property 
damage. We are self-insured for our health plans, and have purchased a fully-insured stop loss policy to help offset our liability 
for both individual and aggregate claim costs. We are also responsible for losses up to a certain limit for workers’ compensation, 
general liability and property damage insurance. 

For policies under which we are responsible for losses, we record a liability that represents our estimated cost of claims incurred 
and unpaid as of the balance sheet date. Our estimated liability is not discounted and is based on a number of assumptions and 
factors, including historical trends, actuarial assumptions and economic conditions, and is closely monitored and adjusted when 
warranted by changing circumstances. Our prior growth could affect the accuracy of estimates based on historical experience. 
Should a greater amount of claims occur compared to what was estimated or medical costs increase beyond what was expected, 
our accrued liabilities might not be sufficient and we may be required to record additional expense. Unanticipated changes may 
also produce materially different amounts of expense than reported under these programs, which could materially adversely 
affect our business, financial condition, results of operations and cash flows.  

17 

 
 
 
 
 
 
 
 
 
We identified material weaknesses in our internal control over financial reporting, and if we fail to remedy them or other 
material weaknesses that we may identify in the future, our financial statements could be materially misstated. 

Our  management  is  responsible  for  establishing  and  maintaining  adequate  internal  control  over  our  financial  reporting,  as 
defined  in  Rule  13a-15(f)  under  the  Exchange  Act.  As  described  in  Part  II,  Item  9A  of  this  Annual  Report  on  Form  10-K, 
management identified material weaknesses in our internal control over financial reporting as of December 31, 2016 related to 
the calculation of the estimated liability for appeals balance in connection with our CMS reserve and the valuation of our accounts 
receivable allowance. These material weaknesses resulted in an immaterial reclassification error in revenue and selling, general 
and administrative expenses that was corrected prior to issuance of the consolidated financial statements. Until remediated, 
these material weaknesses could result in misstatements of account balances or disclosures that would result in a material 
misstatement to the annual or interim consolidated financial statements that will not be prevented or detected on a timely basis.   

We are actively revising and supplementing our control environment and our risk assessment process and the design of our 
process level controls in order to remediate these material weaknesses, including a set of compensating controls in the near 
term. We are enhancing and revising the design of controls and procedures to ensure the calculations of the CMS reserve and 
the  accounts  receivable  allowance  properly  utilize  historical  information  to  derive  the  period-end  balances.  Additionally, 
management will be supplementing the review controls over the CMS reserve  and the accounts receivable  allowance, and 
controls over the completeness and accuracy of the data used to calculate the balances, with additional levels of review involving 
senior members of our accounting department and will assess the need for additional remediation steps.   

We  cannot  predict  the  outcome  of  our  assessment  and  that  of  our  independent  registered  public  accounting  firm  in  future 
periods. If our remedial measures are insufficient to address the material weaknesses, or if additional material weaknesses or 
significant deficiencies in our internal controls are discovered or occur in the future, we may fail to meet our future reporting 
obligations on a timely basis, our financial statements may contain material misstatements, our operating results or financial 
condition may be negatively impacted, and we may be subject to litigation and regulatory actions, causing investor perceptions 
to be adversely affected and potentially resulting in a decline in the market price of our common stock. 

Risks Relating to Our Industry 

Our business could be materially adversely affected by changes in the U.S. healthcare environment or in laws relating 
to healthcare programs and policies, particularly as they relate to the ACA and the Medicare and Medicaid programs. 

The healthcare industry in the United States is subject to changing political, economic and regulatory influences that may affect 
the procurement practices and operations of federal, state and commercial healthcare organizations and agencies. The ACA’s 
emphasis on program integrity and cost containment, along with its expansion of Medicaid, created new opportunities to grow 
our business and our service offerings. However, due to a wide range of factors contributing to uncertainty of the healthcare 
landscape, including, among other factors, the results of the 2016 elections, Congressional activity to repeal the ACA, and the 
numerous, varying ACA replace measures that may encompass Medicaid, Medicare and commercial insurance, it is difficult to 
predict its full impact and influence on future changes to healthcare policy. Policies that fundamentally change the financial 
structure of the Medicaid program, currently funded jointly by the states and the U.S. Federal Government, could result in early 
termination  or  non-renewal  of  our  contracts  with  certain  state  government  customers.  Federal  changes  may  also  reduce 
reimbursement rates to states, establish new payment models, increase or decrease government involvement in healthcare, 
decrease  the  Medicare  RAC  Program,  or  otherwise  change  the  operating  environment  for  our  customers.  Healthcare 
organizations may react to such changed circumstances and financial pressures by taking actions to ramp up, curtail or defer 
their retention of cost containment providers like us, which could impact the demand for our solutions and services. While certain 
changes may present new opportunities to us, our business, financial condition, results of operations and cash flows could be 
materially adversely affected if efforts to waive, modify or otherwise change the ACA, in whole or in part, are successful, if we 
are unable to adapt our solutions and services to meet changing requirements or expand service delivery into new areas, or if 
the demand for our solutions and services is reduced. 

18 

 
 
 
 
 
 
 
  
Healthcare spending fluctuations, simplification of the healthcare payment process or other aspects of the healthcare 
financing system, budgetary pressures and/or programmatic changes diminishing the scope of program benefits, or 
limiting payment integrity initiatives, could reduce the need for and the price of our solutions and services, which 
would have a material adverse effect on our business, financial condition, results of operations and cash flows.  

Our projections and expectations are premised, in part, upon consistent growth rates in spending in the Medicare and Medicaid 
programs, the current healthcare financing system and the need for our solutions and services within that existing framework. 
Our success as a company is based on offering solutions and services that improve the ability of our customers to identify and 
recover revenue that would otherwise be lost often as a result  of procedural inefficiencies and complexities in that system. 
However, the need for our solutions and services, the price customers are willing to pay for them or the scope and profitability 
of our contracts could be negatively affected by a number of factors, including a lower than projected growth in Medicare and 
Medicaid programs due to developments such as the possible repeal of or modification to the ACA, and any action taken to 
reduce eligibility or services, or reform Medicaid spending. The absence of near-term compliance deadlines effected by the ACA 
and other legislation could additionally cause our revenue to decline. There can be no certainty that additional incentives will be 
created in regard to our solutions and services, or that any legislation or regulations that may be adopted would favorably impact 
our business. 

Modifications in provider billing behavior and habits, often in response to the success of our solutions and services or to changes 
that reduce healthcare spending, could also reduce the profitability of our contracts and reduce the need for our solutions and 
services. Compounding this are budgetary pressures that may drive changes at the state level. The demand for our solutions 
and  services  could  also  be  impacted  by  other  changes  in  government  healthcare  programs  or  in  the  level  of  government 
spending, such as:  

(cid:131) 

the simplification of the healthcare benefit and payment system through legislative or regulatory changes at the federal or 
state level (for example, legislative changes impacting the scope of mandatory audits; limiting or reducing the amount of 
reviewable claims and/or the look-back period for review in areas where we conduct audits);  

(cid:131)  unanticipated reductions in the scope of program benefits (such as, for example, state decisions to eliminate coverage of 

optional Medicaid populations or services or shifting lives into managed care plans); or 
limits placed on ongoing program integrity initiatives.  

(cid:131) 

For example,  during  2014  and  2015, our recovery audit  services  under HDI’s existing Medicare  RAC contract were limited 
because of significant delays in procurement activities for the new Medicare RAC contract awards, resulting from, in part, the 
cancellation of the original and second procurements following the denial of pre-award protests and ongoing litigation regarding 
certain payment terms proposed by CMS as part of the new Medicare RAC proposals. In October 2016, CMS announced the 
new awards, including the award of RAC Region 4 to our wholly owned subsidiary. These new Medicare RAC contracts are 
currently being implemented and we currently expect that audits will begin in Q2 2017. Our existing Medicare RAC contract 
ends on January 31, 2018, and we are required to maintain certain reserves related to pending appeals for this contract through 
at least this date. In addition, CMS has shifted the responsibility for initial medical reviews of short inpatient stays from the 
Medicare RACs to Quality Improvement Organizations, further restricting the Medicare RACs review to a small subset of claims 
for potential payment inaccuracies. CMS has also implemented new ADR limits for inpatient providers that reduces the ADR 
requirement  to  0.5%  under  the  new  contract,  down  from  the  2.0%  ADR  requirement  under  the  prior  contract.  This  change 
significantly impacts the volumes of claims Medicare RACs are permitted to review for inpatient providers and reduces their 
ability  to  identify  overpayments  and  underpayments  under  their  Medicare  RAC  contracts.  For  the  new  contract,  CMS  has 
continued to maintain the previously established ADR limits for institutional providers, originally established in January 2016, 
which reduced the ADR requirement to 0.5%. In April 2016, CMS instituted a new policy adjusting ADR limits based on provider 
denial rate after three (3) 45-day ADR cycles. This change significantly impacts the volumes of claims Medicare RACs are 
permitted to review for inpatient providers, and reduces their ability to identify overpayments and underpayments under their 
Medicare RAC contracts in the near term, pending the adjustment of ADR limits based on provider denial rates established 
following the first three (3) cycles of RAC reviews.  

19 

 
 
 
 
 
 
 
Further, in August 2014, CMS announced it would settle with hospitals willing to withdraw inpatient status claims currently pending 
in the RAC appeals process by offering to pay hospitals 68% for all eligible claims they had billed to Medicare. In June 2015, 
CMS notified HDI that based on the initial lists of finalized settlements, HDI owed  CMS approximately  $28.6  million  due  to 
adjustments  in  contingency  fees  under  our existing Medicare RAC contract.  HDI previously advised CMS that it disagrees 
with  CMS’  interpretation  of  the  contract  and  that  CMS  does  not  have  the  contractual  right,  among  other  things,  to  require 
repayment of fees already paid. The amount ultimately payable to CMS by HDI remains uncertain. In addition, in September 
2016, CMS announced that it would extend an opportunity for another round of settlements for hospitals that were eligible for 
but did not choose to participate in the 2014 settlement, with CMS offering to pay 66% for all eligible claims they had billed to 
Medicare.  We believe this settlement will be processed and evaluated by CMS over the course of 2017, and the number and 
amount of claims that will be subject to the 2016 settlement remains uncertain. There could be a material negative impact on our 
future revenue to the extent that (i) any final determination of amounts owed by us to  CMS  under  the  current  Medicare  RAC 
contract materially exceeds our accrued reserves for such appeals, (ii) we are required to increase or decrease our contractually 
required reserves with respect to pending appeals due to changes in appeal performance, changes in data provided to us from 
other entities in the RAC process, or other related factors, (iii) we are required  to  repay a portion of prior fees associated with 
the hospital settlement program, (iv) we are unable to obtain full payments for properly provided services, or (v) future fees 
payable to us by CMS are reduced. Although we do not anticipate our Medicare RAC contract will represent a significant portion 
of our business going forward, our Medicare RAC contract still represents a future business opportunity for us and any of these 
factors or other changes to the Medicare RAC program that materially reduce our revenue or profitability with such program 
could have a material adverse effect on our business, financial condition, results of operations and cash flows. 

A failure to comply with the laws and regulations that apply to companies in our industry regarding individual privacy 
and information security could subject us to legal actions, fines and penalties and negatively impact our reputation 
and operations. 

As a service provider, we often receive, process, transmit and store sensitive data, including PHI and personally identifiable 
information  of  individuals,  as  well  as  other  financial,  confidential  and  proprietary  information  belonging  to  our  customers, 
subsidiaries, data supplies and other third parties from which we obtain information. The use and disclosure of that information 
is regulated at the federal, state, international and industry levels and we are also obligated by our contractual requirements 
with customers. For example, we are subject to federal regulation under HIPAA, as amended by the HITECH Act, the Final 
Omnibus  Privacy,  Security,  Breach  Notification,  and  Enforcement  Rule,  which  modified  and  supplemented  many  of  the 
standards  and  regulations  under  HIPAA  and  the  HITECH  Act,  and  various  state  laws.  HIPAA  also  imposes  standards  and 
requirements on our business associates as defined under HIPAA.  

Even  though  we  take  measures  to  comply  with  all  applicable  regulations  and  to  ensure  our  business  associates  and  sub-
contractors comply with these laws, regulations and rules, we have less than complete control over our business associates’ 
and sub-contractors’ actions and practices. We may be exposed to data breach risk if there is unauthorized access to one of 
our or our sub-contractors’ secure facilities or from lost or stolen laptops, other portable media from current or former employee 
theft of data containing PHI, from misdirected mailings containing PHI, or other forms of administrative or operational error. If 
we or our sub-contractors fail to comply with applicable laws; if unauthorized parties gain physical access to one of our facilities 
and steals or misuses confidential information; if we erroneously use or disclose data in a way that is inconsistent with our 
granted rights; or if such information is misdirected, lost or stolen during transmission or transport, we may suffer damage to our 
reputation, potential loss of existing customers and difficulty attracting new customers. We could also be exposed to, among 
other things, unfavorable publicity, governmental inquiry and oversight, allegations by our customers that we have not performed 
our contractual obligations, costs to provide notifications to affected individuals, or litigation by affected parties and possible 
financial obligations for damages or indemnification obligations related to the theft or misuse of such information, any of which 
could have a material adverse effect on our business, financial condition, results of operations and cash flows.  

In addition, laws, rules and regulations concerning the protection of personal information are subject to frequent change by 
legislation, regulatory issuances or administrative interpretation. As regulatory focus on privacy issues continues to increase 
and these laws and regulations continue to expand and become more complex, these potential risks to our business could 
intensify. Changes in laws or regulations associated with the enhanced protection of certain types of sensitive data, such as 

20 

 
 
 
 
 
 
 
healthcare data or other personally identifiable information, along with increased customer demands for enhanced data security 
infrastructure, could greatly increase our cost of providing our solutions and services.  

We are subject to extensive government regulation, including government audits and investigations relating to our 
compliance with the laws and regulations applicable to companies in our industry, and a negative finding or other 
adverse determination could have a material adverse effect on our reputation, business, financial condition, results of 
operations and cash flows. 

Much of our business is regulated by the federal government and the states in which we operate. The laws and regulations 
governing  our  operations  are  generally  intended  to  benefit  and  protect  individual  citizens,  including  government  program 
beneficiaries, health plan members and providers, rather than shareholders, and the government agencies administering these 
laws and regulations have broad latitude to enforce them. As such, we are subject, on an ongoing basis, to various governmental 
reviews, audits and investigations to verify our compliance with our contracts and applicable laws and regulations, as well as 
legal actions and enforcement proceedings. For example, because we receive payments from federal and state governmental 
agencies, we are subject to  various laws, including the Federal Acquisition Regulations, the Foreign Corrupt Practices Act, 
federal and state employment, equal opportunity and affirmative action laws, federal and state prompt pay statutes. We are also 
subject to Federal False Claims Act and similar state statutes, which permit government law enforcement agencies to institute 
suits against us for violations and, in some cases, to seek double or treble damages, penalties and assessments. In addition, 
private citizens, acting as whistleblowers, can sue on behalf of the government under the “qui tam” provisions of the Federal 
False Claims Act and similar statutory provisions in many states.  

The expansion of our operations into new solutions and services may further expose us to requirements and potential liabilities 
under additional statutes and legislative schemes that have previously not been relevant to our business, such as banking and 
credit reporting statutes, that may both increase demands on our resources for compliance activities and subject us to potential 
penalties for noncompliance with statutory and regulatory standards. Increased involvement in analytic or audit work that can 
have an impact on the eligibility of individuals for medical coverage or specific benefits, or payments made by our customers to 
providers, could increase the likelihood and incidence of our being subjected to scrutiny or legal actions by parties other than 
our customers, based on alleged mistakes or deficiencies in our work, with significant resulting costs and strain on our resources. 

These laws and regulations, along with the terms of our government contracts, regulate how we do business, what solutions 
and  services  we  offer  and  how  we  interact  with  our  customers,  providers,  other  healthcare  payers  and  the  public.  If  the 
government discovers improper or illegal activities in the course of audits or investigations, we may be subject to various civil 
and criminal penalties and administrative sanctions, which may include termination of contracts, forfeiture of profits, suspension 
of payments, fines and suspensions and debarment from doing business with the government. Similarly, if our customers assert 
that we have failed to properly perform or comply with our contractual obligations, or if the carriers to which we send billings 
assert that we have failed to properly comply with applicable federal or state billing rules and regulations, we may be required 
to provide refunds or make payments to resolve such issues. The risks to which we are subject, particularly under the Federal 
False Claims Act and similar state fraud statutes, have also increased in recent years due to legislative changes that have 
(among other amendments) expanded the definition of a false  claim to include, potentially, any unreimbursed overpayment 
received from, or other monetary debt owed to, a government agency. This subjects us to potential liability for a false claim, for 
example,  where  we  may  be  overcharged  for  services  by  a  sub-contractor  and  may  pass  that  charge  on  to  a  government 
customer, or where we may have a good faith disagreement with a government agency’s view of whether an overpayment has 
occurred. If we are found to be in violation of any applicable law or regulation, or if we receive an adverse review, audit or 
investigation,  any  resulting  negative  publicity,  penalties  or  sanctions  could  have  an  adverse  effect  on  our  reputation  in  the 
industry, impair our ability to compete for new contracts or bid in response to RFPs in one or more jurisdictions and have a 
material adverse effect on our business, financial condition, results of operations and cash flows. 

21 

 
 
 
 
 
 
 
 
Federal and state governments may limit or prohibit outsourcing of certain programs or functions, refuse to grant 
consents  or  waivers  necessary  to  permit  private  entities  to  perform  such  work,  or  impose  other  limitations  on 
outsourcing or certain vendors that may obstruct cost-effective performance of our contracts. 

The federal government or a state could limit or prohibit private contractors like us from operating or performing elements of 
certain  government  functions  or  programs.  State  or  local  governments  could  be  required  to  operate  such  programs  with 
government employees as a condition of receiving federal funding. Moreover, under current law, in order to privatize certain 
functions of government programs, the federal government must grant a consent and/or waiver to the petitioning state or local 
agency. If the federal government does not grant a necessary consent or waiver, the state or local agency will be unable to 
outsource that function to a commercial entity. Such a situation could eliminate a contracting opportunity or reduce the value of 
an existing contract.  

Similarly, other state or federal limitations on outsourcing certain types of work to vendors that supplement our own workforce 
could make it more difficult for us to fulfill our contracts in a cost-effective manner. Certain segments of our operations use or 
involve  vendor  or  sub-contractor  personnel  located  outside  of  the  United  States,  who  may  (under  carefully  controlled 
circumstances)  access  certain  PHI  in  the  course  of  assisting  us  with  various  elements  of  the  services  we  provide  to  our 
customers. There is, however, increasing pressure from an expanding number of sources to prohibit the use of off-shore labor, 
particularly on government contracts. The federal government and a number of states have considered laws or issued rules, 
regulations,  and  orders  that  would  limit,  restrict  or  wholly  prohibit  the  use  of  off-shore  labor  in  performance  of  government 
contracts, or impose sanctions for the use of such resources. Some of our customers have already chosen to contractually limit 
or restrict our ability to use off-shore resources. Intensified restrictions of this type or associated penalties could raise our costs 
of doing business, expose us to unexpected fines or penalties, increase the prices we must charge to customers to realize a 
profit and eliminate or significantly reduce the value of existing contracts or potential contract opportunities, any of which could 
have a material adverse effect on our business, financial condition, results of operations and cash flows. 

We  may  be  precluded  from  bidding  on  or  performing  certain  work  due  to  work  we  currently  perform,  which  could 
materially adversely affect our business, financial condition, results of operations and cash flows. 

Various  laws,  regulations  and  administrative  policies  prohibit  companies  from  performing  work  for  government  agencies  in 
capacities that might be viewed to create an actual or perceived conflict of interest. In particular, CMS has stringent conflict of 
interest rules, which can limit our bidding for specific work for CMS, or for other contracts that might conflict, or be perceived by 
CMS to conflict, with contractual work for CMS. State governments and managed care organizations also have conflict of interest 
restrictions that could limit our ability to bid for certain work and impede our overall sales strategy. As we continue to expand 
and diversify our business operations, the likelihood that customers or potential customers will perceive conflicts of interest 
between  our  various  subsidiaries,  solutions,  services,  activities  and  customer  relationships  may  increase.  Such  conflicts, 
whether  real  or  perceived,  could  result  in  a  loss  of  contracts  or  additional  internal  structural  barriers  that  delay  operational 
efficiency, or may require that we divest ourselves of certain existing businesses or reorganize our current management and 
personnel structure, as well as our corporate organization and entity structure, in order to qualify for new contract awards or to 
appropriately mitigate conflicts and otherwise accommodate the needs as a company that is expanding in complexity. Our failure 
to devote sufficient care, attention and resources to managing these adjustments may result in technical or administrative errors 
that could expose us to potential liability or adverse regulatory action. In addition, conflict of interest rules and standards change 
frequently, and are subject to varying interpretations and varying degrees and consistency of enforcement at the federal, state 
and municipal levels, and we may not be successful in navigating these restrictions. If we are prevented from expanding our 
business or are unable to effectively implement our strategic initiatives due to real or perceived conflicts of interest, our business, 
financial condition, results of operations and cash flows could be materially adversely affected. 

22 

 
 
 
 
 
 
 
Risks Related to Our Common Stock 

The  market  price  of  our  common  stock  may  be  volatile,  and  fluctuations  in  the  price  of  our  common  stock  may 
materially  adversely  affect  our  business,  financial  condition,  results  of  operations  and  cash  flows  and  materially 
adversely affect our shareholders. 

The market price of our common stock has fluctuated widely and may continue to do so.  During the 52-week period ended 
May 31, 2017, the closing price of our common stock on the NASDAQ Global Select market ranged from a high of $23.46 per 
share, to a low of $16.18 per share. Our stock price is subject to fluctuation as a result of a variety of factors, including factors 
beyond our control including the risk factors described above and those which are related to: 

(cid:131) 

changes  in  estimates  of  our  performance  or  recommendations  by  securities  analysts  and  operating  and  stock  price 
performance of other companies that investors deem comparable to our company; 

(cid:131)  news  reports  relating  to  trends,  concerns  and  other  issues  in  the  healthcare  industry,  including  perceptions  in  the 

marketplace regarding us and our competitors; 
the financial projections we publicly provide and any changes in or failure to meet those projections; 
(cid:131) 
(cid:131) 
future sales of shares of common stock in the public market by our executive officers or directors; 
(cid:131)  any other changes in the amount of our outstanding shares, including as a result of share repurchases; 
(cid:131) 
(cid:131) 
(cid:131)  market conditions in the industry and the economy as a whole. 

the public’s response to our press releases, or other public announcements, including our filings with the SEC; 
securities class actions, shareholder lawsuits or other litigation; and 

In addition, the stock market often experiences significant price and volume fluctuations. These fluctuations are often unrelated 
to  the  operating  performance  of  particular  companies.  These  broad  market  fluctuations  may  materially  adversely  affect  the 
market price of our common stock. When the market price of a company’s stock drops significantly, shareholders may institute 
securities class action litigation against that company. Any litigation against us could cause us to incur substantial costs, divert 
the time and attention of our management and other resources or otherwise harm our business. 

Because  we  do  not  intend  to  pay  dividends,  you  will  benefit  from  an  investment  in  our  common  stock  only  if  it 
appreciates in value. 

We have paid no cash dividends on any of our capital stock to date and currently intend to retain our future earnings, if any, to 
fund the development and growth of our business. As a result, we do not expect to pay any cash dividends in the foreseeable 
future. The success of your investment in our common stock will likely depend entirely upon any future appreciation. There is 
no guarantee that our common stock will appreciate in value or even maintain the price at which you purchased your shares. 

Certain  provisions  of  our  certificate  of  incorporation  and  bylaws  could  discourage  unsolicited  takeover  attempts, 
which could depress the market price of our common stock. 

Our certificate of incorporation authorizes the issuance of up to 5,000,000 shares of “blank check” preferred stock with such 
designations, rights and preferences as may be determined by our Board of Directors. Accordingly, our Board of Directors is 
empowered, without shareholder approval, to issue preferred stock with dividend, liquidation, conversion, voting or other rights, 
that could adversely affect the voting power or other rights of holders of our common stock. In the event of issuance, preferred 
stock could be utilized, under certain circumstances, as a method of discouraging, delaying, or preventing a change in control. 
Although we have no present intention to issue any shares of preferred stock, it is possible that we will do so in the future. In 
addition, our bylaws provide for a classified Board of Directors, require advance notice of shareholder proposals for business to 
be conducted at meetings of our shareholders and for nominations of candidates for election to our Board of Directors and 
provide for Delaware as an exclusive forum for certain disputes with our shareholders, all of which could also have the effect of 
discouraging a change of control. 

23 

 
 
 
 
 
 
 
 
 
 
 
Item 1B.  Unresolved Staff Comments 

None. 

Item 2.  Properties 

Location
Irving, TX
Las Vegas, NV
Westerville, OH
Irvine, CA
New York City, NY
Charlestown, MA
All Other Locations

Approximate Square Footage
242,260
64,736
25,212
23,790
22,500
13,628
77,914

Owned/Leased
Owned
Leased
Leased
Leased
Leased
Leased
Leased

As of December 31, 2016, we leased approximately 78,000 square feet of office space in 21 other locations throughout the 
United States, the leases for which have expiration dates starting late 2017 through 2024. See Note 12 - “Commitments and 
Contingencies”  in  our  Notes  to  the  Consolidated  Financial  Statements  in  Item  8.  Consolidated  Financial  Statements  and 
Supplementary Data for additional information regarding our lease commitments. In general, we believe our facilities are suitable 
to meet our current and reasonably anticipated future needs. 

Item 3.  Legal Proceedings 

The information set forth under the caption “Litigation” in Note 12 of the Notes to the Consolidated Financial Statements included 
in Part II, Item 8. Consolidated Financial Statements and Supplementary Data is incorporated herein by reference. 

Item 4.  Mine Safety Disclosures 

Not applicable. 

24 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                    
                                     
                                     
                                     
                                     
                                     
                                     
PART II 

Item 5.  Market for Registrant’s Common Equity, Related Shareholder Matters and Issuer Purchases of Equity Securities 

Market Information 

Our common stock is included in the NASDAQ Global Select Market, under the symbol HMSY. The table below summarizes 
the high and low sales prices per share for our common stock for the periods indicated, as reported on the NASDAQ Global 
Select Market.  

Quarter Ended
Fiscal Year 2016

High 
Low

Fiscal Year 2015

High 
Low

March 31, 

June 30, 

September 30,  December 31, 

$     
$     

14.42
10.22

$     
$     

18.38
13.67

$                
$                

23.46
17.44

$             
$             

22.03
16.18

$     
$     

21.73
15.32

$     
$     

18.18
15.44

$                
$                  

17.10
8.24

$             
$                

13.05
8.64

Repurchases of Shares of Common Stock 

See Note 8 – Equity, in our Notes to the Consolidated Financial Statements under Item 8. Consolidated Financial Statements 
and  Supplementary  Data  for  additional  information  regarding  share  repurchases.  The  following  are  our  monthly  stock 
repurchases for the fourth quarter of fiscal year 2016, all of which were made as part of publicly announced plans or programs:  

Period
October 1, 2016 to October 31, 2016
November 1, 2016 to November 30, 2016
December 1, 2016 to December 31, 2016
October 1, 2016 to December 31, 2016

Total Number of 
Shares 
Purchased

— $

570,717
569,615
1,140,332

$

Average 
Price Paid 
Per Share
—
17.61
18.25
17.93

Total Number 
of Shares 
Purchased as 
Part of Publicly 
Announced 
Program(1)

Maximum 
Approximate 
Dollar Value 
of Shares That 
May Yet Be 
Purchased 
Under the 
Program

— $

570,717
569,615
1,140,332

$

—
15,000,000
5,000,000
5,000,000

(1)  On July 30, 2015, the Company's Board of Directors approved a share repurchase program authorizing the repurchase of 
up  to  $75  million  of  the  Company's  common  stock  from  time  to  time  on  the  open  market  or  in  privately  negotiated 
transactions, and the Company publicly announced the program in August 2015. The repurchase program is authorized 
through July 30, 2017, and may be suspended or discontinued at any time.  Repurchases may also be made under a 
Rule 10b5-1 plan. All repurchases for the periods presented were made under the program and using cash resources. 

Holders 

As of the close of business on May 31, 2017, there were 262 holders of record of our common stock. 

25 

 
 
 
 
 
 
  
 
 
 
 
 
 
 
              
       
            
     
              
       
            
       
           
       
         
       
Dividends 

We have not paid any cash dividends on our common stock and do not anticipate paying cash dividends in the foreseeable 
future. Our current intention is to retain earnings to support the future growth of our business. 

In addition, our Credit Agreement restricts our ability to make certain payments or distributions with respect to our capital stock, 
including  cash  dividends  to  our  shareholders.  These  restrictions  are  described  in  more  detail  in  Item 7.  Management’s 
Discussion and Analysis of Financial Condition and Results of Operations, under “Liquidity and Capital Resources” and in Note 7 
– “Credit Agreement”, in our Notes to the Consolidated Financial Statements under Item 8. Consolidated Financial Statements 
and Supplementary Data. 

26 

 
 
 
 
 
Comparative Stock Performance Graph 

The graph below compares the cumulative total shareholder return on our common stock with the cumulative total shareholder 
returns of the NASDAQ Composite Index, the NASDAQ Computer & Data Processing Index and the NASDAQ Health Services 
Index  assuming  an  investment  of  $100  on  December 31,  2011  and  the  reinvestment  of  dividends  through  the  year  ended 
December 31, 2016. 

COMPARISON OF 5 YEAR CUMULATIVE TOTAL RETURN
Among HMS Holdings Corp., the NASDAQ Composite Index, 
the NASDAQ Computer & Data Processing Index and the NASDAQ Health Services Index

$300

$250

$200

$150

$100

$50

$0

12/11

12/12

12/13

12/14

12/15

12/16

HMS Holdings Corp.

NASDAQ Composite

NASDAQ Computer & Data Processing

NASDAQ Health Services

HMS Holdings Corp.
NASDAQ Composite
NASDAQ Computer & Data Processing
NASDAQ Health Services

12/31/11
100.00
100.00
100.00
100.00

$    
$    
$    
$    

12/31/12
81.05
116.41
107.40
115.47

$       
$    
$    
$    

12/31/13
$       
70.98
$    
165.47
$    
164.63
$    
167.94

12/31/14
$       
66.10
$    
188.69
$    
189.15
$    
204.39

12/31/15
$       
38.59
$    
200.32
$    
223.06
$    
220.44

12/31/16
$       
56.79
$    
216.54
$    
242.34
$    
188.28

Notwithstanding anything to the contrary set forth in any of our previous or future filings under the Securities Act or the Exchange 
Act that might incorporate by reference this Annual Report on Form 10-K or future filings made by us under those statutes, the 
Comparative Stock Performance Graph is not deemed filed with the SEC, is not deemed soliciting material and shall not be 
deemed incorporated by reference into any of those prior filings or into any future filings we make under those statutes, except 
to the extent that we specifically incorporate such information by reference into a previous or future filing, or specifically request 
that such information be treated as soliciting material, in each case under those statutes. 

27 

 
 
 
 
 
 
Item 6.  Selected Financial Data 

The following table sets forth selected consolidated financial amounts at and for each of the five fiscal years in the period ended 
December 31, 2016. It should be read in conjunction with Management’s Discussion and Analysis of Financial Condition and 
Results of Operations, included in Item 7 of this Annual Report on Form 10-K and the Consolidated Financial Statements and 
Supplementary Data thereto, included in Item 8 of this Annual Report. 

Statement of Operations Data

(in thousands, except per share amounts)

2016

2015

2014

2013

2012

Years ended December 31, 

Revenue
Total operating expenses

Operating income

Interest expense
Interest income
Other income, net

Income before income taxes

Income taxes

Net income

Net Income Per Common Share
Basic income per common share:

$  

489,720
432,051

$    

474,216
426,644

$  

443,225
409,021

$  

491,762
414,584

$  

473,696
374,184

57,669
(8,519)
321
—

47,572
(7,812)
49
—

34,204
(7,931)
57
—

49,471
11,835
37,636

$    

39,809
15,282
24,527

$       

26,330
12,383
13,947

$    

77,178
(12,460)
71
801
65,590
25,593
39,997

$    

99,512
(16,561)
12
382
83,345
32,829
50,516

$    

Net income per common share - basic

$         

0.45

$           

0.28

$         

0.16

$         

0.46

$         

0.59

Diluted income per common share:

Net income per common share - diluted

$         

0.43

$           

0.28

$         

0.16

$         

0.45

$         

0.57

Weighted average shares:

Basic  

Diluted   

Balance Sheet Data

(in thousands)
Cash and cash equivalents
Working capital
Total assets
Revolving credit facility
Term loan, less current portion
Total shareholders' equity 

84,221

86,987

87,881

88,361

87,673

88,164

87,598

88,344

86,204

88,365

Years ended December 31, 
2014
133,116
$    
226,271
$    
880,988
$    
197,796
$    
$           
-
$    
533,090

2015
145,610
$      
240,456
$      
850,597
$      
197,796
$      
$              
-
$      
524,702

2013
93,366
$      
199,069
$    
878,602
$    
232,796
$    
$           
-
$    
502,439

2012
135,227
$    
205,537
$    
$    
926,052
$           
-
$    
297,500
$    
462,874

2016
175,999
$    
277,478
$    
882,755
$    
197,796
$    
$           
-
$    
556,610

28 

 
 
 
 
  
 
 
 
 
 
    
       
    
    
    
      
         
      
      
      
       
          
       
     
     
            
                 
              
              
              
            
            
      
         
      
      
      
      
         
      
      
      
      
         
      
      
      
      
         
      
      
      
Item 7.  Management’s Discussion and Analysis of Financial Condition and Results of Operations 

The following Management’s Discussion and Analysis is intended to help the reader understand the results of operations and 
financial condition of HMS Holdings Corp. You should read this discussion and analysis in conjunction with the other sections 
of this Annual Report on Form 10-K, including the Cautionary Note Regarding Forward-Looking statements appearing prior to 
Part I, the Risk Factors appearing in Part I, Item 1A, and the Consolidated Financial Statements and Supplemental Data thereto 
appearing in Part II, Item 8. The historical results set forth in Part II, Item 6, Item 7, and Item 8 of this Annual Report should not 
be taken as necessarily indicative of our future operations. 

Business Overview  

HMS is a leading provider of cost containment solutions in the U.S. healthcare marketplace. Using innovative technology as 
well  as  extensive  data  services  and  powerful  analytics,  we  deliver  coordination  of  benefits,  payment  integrity  and  health 
management and engagement solutions through our operating subsidiaries to help healthcare payers improve performance and 
outcomes. We are managed and operate as one business segment with a single management team that reports to the Chief 
Executive  Officer.  We  serve  state  Medicaid  programs,  commercial  health  plans,  federal  government  health  agencies, 
government and private employers, child support agencies, and other healthcare payers and sponsors. Together our various 
services help our customers recover improper payments; prevent future improper payments; reduce fraud, waste and abuse; 
better manage the care that members receive; and ensure regulatory compliance.  

As of December 31, 2016: 
(cid:131)  We serve 46 state Medicaid programs and the District of Columbia, CMS and the VHA; 
(cid:131)  We provide services to approximately 255 health plans in support of their multiple lines of business, including Medicaid 

managed care, Medicare Advantage and group and individual health; and 

(cid:131)  We also serve as a sub-contractor for certain business outsourcing and technology firms. 

29 

 
 
 
 
 
 
 
2016 Highlights 

(cid:131)  Revenue increased $15.5 million, or 3.3% to $489.7 million 
(cid:131)  Operating income increased $10.1 million, or 21.2% to $57.7 million 
(cid:131)  Net income increased $13.1 million, or 53.5% to $37.6 million 
(cid:131)  Diluted earnings per share increased $0.15 or 53.6% to $0.43 per share 
(cid:131)  Shareholders’ equity increased $31.9 million, or 6.1% to $556.6 million 
(cid:131)  Cash flow from operations increased $16.7 million, or 23.1% to $89.0 million 

Outlook  

To date, we have grown our business organically through internal innovation and the development of new products and services, 
as  well  as  by  acquisition  of  businesses  whose  core  services  strengthen  our  overall  mission  to  help  our  customers  contain 
healthcare costs. Our largest growth during 2016 was with commercial health plan customers and we expect this marketplace 
to present the greatest opportunity for growth in the year ahead, particularly with the factors related to the macro healthcare 
environment including:  

(cid:131)  Growth of Medicare enrollment, particularly Medicare Advantage plans; 
(cid:131)  An aging U.S. population with a growing concentration of individuals with chronic conditions; and 
(cid:131)  The continued dominance of employee sponsored health insurance for a majority of working individuals and the demand 

by large self-insured employers for cost savings.  

We  plan  to  drive  our  future  growth  by  leveraging  our  expertise  to  expand  product  offerings,  attracting  new  customers  and 
broadening our relationships with current customers through the introduction of new services, audit strategies and claim types. 
Our goal is to develop and build on existing partnerships with our state, federal and commercial health plan customers to provide 
services  that  better  address  their  business  needs  and  promote  customer  satisfaction  in  the  constantly  evolving  healthcare 
marketplace, particularly as potentially significant changes to the ACA are considered by Congress. We also expect to continue 
increasing  recovery  yields  from  our  current  products  by  enhancing  our  operating  and  organizational  efficiency  and  by 
implementing new technology that will improve the quality and effectiveness of our service offerings.       

Critical Accounting Policies  

Our  consolidated  financial  statements  are  prepared  in  accordance  with  U.S.  GAAP.  The  preparation  of  these  consolidated 
financial  statements  requires  us  to  make  estimates  and  assumptions  that  affect  the  reported  amounts  of  assets,  liabilities, 
revenue, costs and expenses, and related disclosures. We evaluate our estimates and assumptions on an ongoing basis. Our 
estimates  are  based  on  historical  experience  and  various  other  assumptions  that  we  believe  to  be  reasonable  under  the 
circumstances. Our actual results could differ from these estimates. 

An accounting policy is deemed to be critical if it requires an accounting estimate to be made based on assumptions about 
matters that are highly uncertain at the time the estimate is made, if different estimates reasonably could have been used, or if 
changes  in  the  estimate  that  are  reasonably  possible  could  materially  impact  the  financial  statements.  We  believe  that  the 
assumptions  and  estimates  associated  with  revenue  recognition,  estimated  liability  for  appeals,  income  taxes,  share-based 
compensation, loss contingencies, and goodwill and intangible assets have the greatest potential impact on our consolidated 
financial statements. Therefore, we consider these to be our critical accounting policies and estimates. For further information 
on these critical accounting policies and all other significant accounting policies refer to Note 1 – “Business and Summary of 
Significant Accounting Policies” in our Notes to the Consolidated Financial Statements under Item 8. Consolidated Financial 
Statements and Supplementary Data.  

30 

 
 
 
 
 
 
 
 
 
 
 
Results of Operations 

Comparison of 2016 to 2015 and 2015 to 2014 

Years Ended December 31, 
Revenue
Cost of Services: 
Compensation
Data processing
Occupancy
Direct project expenses
Other operating expenses
Amortization of acquisition related software and intangible assets

Total cost of services

Selling, general and administrative expenses

Total operating expenses

Operating income

Interest expense
Interest income

Income before income taxes

Income taxes
Net income

(in thousands) 

% of Revenue
2015
100%

2016
100%

2014
100%

38.6
7.6
2.9
9.4
5.7
5.7
70.0
18.3
88.2
11.8
(1.7)
0.1
10.1
2.5
7.6%

37.6
8.6
3.3
10.9
6.1
5.9
72.4
17.6
90.0
10.0
(1.6)
0.0
8.4
3.2
5.2%

40.9
8.9
3.8
8.3
5.6
6.5
74.0
18.3
92.3
7.7
(1.8)
0.0
5.9
2.8
3.1%

31 

 
 
 
 
 
   
   
   
     
     
     
     
     
     
     
   
     
     
     
     
     
     
     
   
   
   
   
   
   
   
   
   
   
   
     
    
    
    
     
     
     
   
     
     
     
     
     
Revenue 

2016 vs. 2015 
During the year ended December 31, 2016, revenue was $489.7 million, an increase of $15.5 million or 3.3% compared to prior 
year revenue of $474.2 million. The increase was primarily due to commercial health plan revenue growth of $27.2 million or 
13.4% partially offset by decreases in both state government revenue of $7.0 million or 3.1%, and federal government revenue 
of $4.5 million or 11.7%. The reduction in federal government revenue includes a $3.4 million decrease related to the reduction 
of Medicare RAC activity.  

2015 vs. 2014 
During the year ended December 31, 2015, revenue was $474.2 million, an increase of $31.0 million, or 7.0%, compared to 
prior year revenue of $443.2 million. This increase was primarily due to commercial health plan revenue growth of $32.2 million 
or 18.8% partially offset by a decrease in federal government revenue of $1.2 million or 3.1%, primarily related to the reduction 
of Medicare RAC activity. 

(In thousands) 

Total Cost of Services 

Total cost of services consists of compensation, data processing, occupancy, direct project expenses, other operating expenses, 
and amortization of acquisition related software and intangible assets.  

2016 vs. 2015 
During the year ended December 31, 2016, total cost of services as a percentage of revenue was 70.0% compared to 72.4% 
for the year ended December 31, 2015. Total cost of services for the year ended December 31, 2016 was $342.7 million, a 
decrease of $0.8 million compared to $343.5 million for the year ended December 31, 2015. This change resulted primarily from 

32 

 
 
 
 
 
 
 
 
 
decreases in direct project costs, data processing costs, occupancy costs and other operating expenses. These decreases were 
partially offset by increases in compensation expense. 

2015 vs. 2014 
During the year ended December 31, 2015, total cost of services as a percentage of revenue was 72.4% compared to 74.0% 
for the year ended December 31, 2014. Total cost of services for the year ended December 31, 2015 was $343.5 million, an 
increase of $15.5 million compared to $328.0 million for the year ended December 31, 2014. This change resulted primarily 
from increases in  direct project costs  and  other  operating  expenses. These increases  were partially  offset by decreases in 
compensation expense. 

Compensation 

Compensation expense is primarily  composed  of salaries  and  wages, which include overtime,  health benefits, stock option 
expense, performance awards, commissions, employers share of FICA and fringe benefits.  

2016 vs. 2015 
During the year ended December 31, 2016, compensation expense as a percentage of revenue was 38.7% compared to 37.6% 
for the year ended December 31, 2015. Compensation expense for the year ended December 31, 2016 was $189.3 million, an 
increase  of  $11.0  million  compared  to  $178.3  million  for  the  year  ended  December  31,  2015.  This  change  resulted  from  a 
$13.1 million total increase in salaries, variable compensation expense, and fringe benefit expense, partially offset by a $2.1 
million  decrease  in  stock-based  compensation  expense.  For  the  year  ended  December  31,  2016,  we  averaged  2,030 
employees, a 1.1% increase from the year ended December 31, 2015, during which we averaged 2,007 employees.  

2015 vs. 2014 
During the year ended December 31, 2015, compensation expense as a percentage of revenue was 37.6% compared to 40.9% 
for the year ended December 31, 2014. Compensation expense for the year ended December 31, 2015 was $178.3 million, a 
decrease of $3.0 million compared to $181.3 million for the year ended December 31, 2014. This change resulted primarily from 
a  $4.9 million  decrease  in  salary,  severance  and  overtime  expense  partially  offset  by  a  $1.9  million  increase  in  variable 
compensation expense, stock compensation expense, and fringe benefit expense. For the year ended December 31, 2015, we 
averaged  2,007  employees,  a  7.4%  decrease  from  the  year  ended  December  31,  2014,  during  which  we  averaged  2,167 
employees. 

Data Processing 

2016 vs. 2015 
During the year ended December 31, 2016, data processing expense as a percentage of revenue was 7.6% compared to 8.6% 
for the year ended December 31, 2015. Data processing expense for the year ended December 31, 2016 was $37.3 million, a 
decrease of $3.6 million compared to $40.9 million for the year ended December 31, 2015. This change resulted primarily from 
a $4.0 million decrease in depreciation expense partially offset by an increase in software expenses.  

2015 vs. 2014 
During the year ended December 31, 2015, data processing expense as a percentage of revenue was 8.6% compared to 8.9% 
for the year ended December 31, 2014. Data processing expense for the year ended December 31, 2015 was $40.9 million, an 
increase of $1.2 million compared to $39.7 million for the year ended December 31, 2014. This change resulted primarily from 
a $3.0 million total increase in software and data expenses, partially offset by a decrease in depreciation expense. 

Occupancy 

2016 vs. 2015 
During the year ended December 31, 2016, occupancy expense as a percentage of revenue was 2.9% compared to 3.3% for 
the year ended December 31, 2015. Occupancy expense for the year ended December 31, 2016 was $14.0 million, a decrease 

33 

 
 
 
 
 
 
 
 
 
 
 
 
of $1.8 million compared to $15.8 million for the year ended December 31, 2015. This decrease was primarily related to the 
closure of one of our office locations in 2016. Additional savings were realized due to reductions in utilities and equipment rental 
expense.  

2015 vs. 2014 
During the year ended December 31, 2015, occupancy expense as a percentage of revenue was 3.3% compared to 3.8% for 
the year ended December 31, 2014. Occupancy expense for the year ended December 31, 2015 was $15.8 million, a decrease 
of  $1.2  million  compared  to  $17.0  million  for  the  year  ended  December  31,  2014.  This  decrease  was  primarily  related  to 
downsizing office space  and  relocation of  our offices  in Omaha, Nebraska and Albany, New  York. Additional savings were 
realized after closing several of our smaller field offices in 2014 and 2015. 

Direct Project Expenses 

2016 vs. 2015 
During the year ended December 31, 2016, direct project expense as a percentage of revenue was 9.4% compared to 10.9% 
for the year ended December 31, 2015. Direct project expense for the year ended December 31, 2016 was $46.3 million, a 
decrease of $5.2 million compared to $51.5 million for the year ended December 31, 2015. The reduction of Medicare RAC 
activity resulted in a $3.5 million decrease in sub-contractor fees from the prior year.  

2015 vs. 2014 
During the year ended December 31, 2015, direct project expense as a percentage of revenue was 10.9% compared to 8.3% 
for the year ended December 31, 2014. Direct project expense for the year ended December 31, 2015 was $51.5 million, an 
increase of $14.6 million compared to $36.9 million for the year ended December 31, 2014. This increase was partially due to a 
$9.6 million increase related to the transition of operational processes to sub-contractors. Additionally, data costs increased by 
$2.9 million in connection with an increase in the volume of patient charts we reviewed for our commercial health plan customers. 
The volume increase also resulted in a $1.4 million increase in key punch and data conversion due to the increase in reformatting 
electronic and hard copy remittance data. 

Other Operating Expenses 

2016 vs. 2015 
During the year ended December 31, 2016, other operating expenses as a percentage of revenue were 5.7% compared to 6.1% 
for the year ended December 31, 2015. Other operating expenses for the year ended December 31, 2016 were $27.8 million, a 
decrease of $1.1 million compared to $28.9 million for the year ended December 31, 2015. This decrease primarily resulted 
from a $2.3 million decrease in temporary staffing and sub-contractor fees, partially offset by a $0.9 million increase in consulting 
fees. 

2015 vs. 2014 
During the year ended December 31, 2015, other operating expenses as a percentage of revenue were 6.1% compared to 5.6% 
for the year ended December 31, 2014. Other operating expenses for the year ended December 31, 2015 were $28.9 million, 
an increase of $4.3 million compared to $24.6 million for the year ended December 31, 2014. This increase primarily resulted 
from a $3.6 million increase in temporary staffing and consulting expense. 

Amortization of Acquisition Related Software and Intangible Assets 

2016 vs. 2015 
During the year ended December 31, 2016, amortization of acquisition related software and intangibles as a percentage of 
revenue  was  5.7%  compared  to  5.9%  for  the  year  December  31,  2015.  Amortization  of  acquisition  related  software  and 
intangible  assets  for  2016  was  $28.0  million,  a  decrease  of  $0.1  million  compared  to  $28.1  million  for  the  year  ended 
December 31, 2015. This decrease resulted from intangibles becoming fully amortized in 2016, partially offset by additional 
expense related to the Essette acquisition. 

34 

 
 
 
 
 
 
 
 
 
 
 
2015 vs. 2014 
During the year ended December 31, 2015, amortization of acquisition related software and intangibles as a percentage of 
revenue  was  5.9%  compared  to  6.5%  for  the  year  December  31,  2014.  Amortization  of  acquisition  related  software  and 
intangible  assets  for  2015  was  $28.1  million,  a  decrease  of  $0.5  million  compared  to  $28.6  million  for  the  year  ended 
December 31, 2014. This decrease resulted from the completion of amortization in 2014 on restrictive covenants for our Verify 
Solutions, Inc. and MedRecovery Management, LLC acquisitions.    

Selling, General and Administrative expenses 

2016 vs. 2015 
During the year ended December 31, 2016, SG&A expense as a percentage of revenue was 18.3% compared to 17.6% for the 
year December 31, 2015.  SG&A expense for 2016 was $89.4 million, an increase of $6.3 million compared to $83.1 million for 
the year ended December 31, 2015. Increases totaling $14.1 million were comprised of consulting expense of $4.0 million, fringe 
benefits expense of $1.6 million, compensation costs of $6.1 million, and other expenses $2.4 million. These increases were 
partially offset by a $7.8 million reduction in legal fees and settlements. During the year ended December 31, 2016, we averaged 
236 employees in the SG&A group, an 8.3% increase over our average of 218 employees in that group during the year ended 
December 31, 2015.   

2015 vs. 2014 
During the year ended December 31, 2015, SG&A expense as a percentage of revenue was 17.6% compared to 18.3% for the 
year December 31, 2014.  SG&A expense for 2015 was $83.1 million, an increase of $2.0 million compared to $81.1 million for 
the year ended December 31, 2014. This increase was primarily due to a $2.8 million increase in salary expense which was 
partially offset by a $0.9 million decrease in software-related costs. During the year ended December 31, 2015, we averaged 
218 employees in the SG&A group, a 1.4% decrease over our average of 221 employees in that group during the year ended 
December 31, 2014. 

Operating Income 

2016 vs. 2015 
Operating income for the year ended December 31, 2016 was $57.7 million, or 11.8% of revenue, compared to $47.6 million or 
10.0% of revenue, for the prior year.  

2015 vs. 2014 
Operating income for the year ended December 31, 2015 was $47.6 million, or 10.0% of revenue, compared to $34.2 million, 
or 7.7% of revenue, for the prior year.  

Interest Expense  

Interest expense represents interest on borrowings under our revolving credit facility, amortization of deferred financing costs, 
commitment fees for our revolving credit facility and issuance fees for our letter of credit.  

2016 vs. 2015 
During the year ended December 31, 2016, interest expense was $8.5 million, an increase of $0.7 million compared to the prior 
year. This increase resulted from an increase on the variable interest rate on our outstanding debt. Amortization of deferred 
financing costs of $2.1 million in both periods is included within interest expense.  

2015 vs. 2014 
During the year ended December 31, 2015, interest expense was $7.8 million, a decrease of $0.1 million compared to the prior 
year. The decrease primarily relates to a reduction in interest on capital leases. Amortization of deferred financing costs of 
$2.1 million in both periods is included within interest expense.  

35 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Income Taxes 

2016 vs. 2015 
During  the  year  ended  December  31,  2016,  we  recorded  income  tax  expense  of  $11.8  million,  a  decrease  of  $3.5  million 
compared to the prior year. Net income before taxes of $49.5 million increased $9.7 million year-over-year, while income tax 
expense decreased $3.5 million. Our effective tax rate decreased from 38.4% to 23.9%, which reflects a $6.2 million tax benefit 
recognized in the third quarter of 2016 that was related to R&D Credits and Section 199 Deductions. Excluding that tax benefit 
would result in a normalized effective tax rate of 36.2%. The principal differences between the statutory rate and our effective 
rate were the R&D Credits, the Section 199 Deduction, other permanent items, unrecognized tax benefits and state taxes.  

2015 vs. 2014 
During  the  year  ended  December  31,  2015,  we  recorded  income  tax  expense  of  $15.3  million,  an  increase  of  $2.9  million 
compared to the prior year. Net income before taxes of $39.8 million increased $13.5 million year-over-year. Our effective tax 
rate decreased from 47.0% to 38.4% primarily due to a change in unitary state apportionments and permanent differences. The 
principal differences between the statutory rate and our effective rate were state taxes and permanent differences. 

Net Income 

2016 vs. 2015 
During the year ended December 31, 2016, net income was $37.6 million which represents a $13.1 million increase compared 
to net income of $24.5 million for 2015.  

2015 vs. 2014 
During the year ended December 31, 2015, net income was $24.5 million which represents a $10.6 million increase compared 
to net income of $13.9 million for 2014.  

Off-Balance Sheet Arrangements 

We do not have any off-balance sheet arrangements.  

Liquidity and Capital Resources 

The following tables should be read in conjunction with the Consolidated Financial Statements and Supplementary Data thereto, 
included in Item 8 of this Annual Report on Form 10-K. 

Our cash and cash equivalents, working capital and available borrowings under our credit facility (based upon the borrowing 
base and financial covenants in our Credit Agreement) were as follows:  

Years Ended December 31, 
2015
145,610
240,456
121,204

2016
175,999
277,478
183,913

$        
$        
$        

$        
$        
$        

(In thousands)
Cash and cash equivalents
Working capital 
Available borrowings under credit facility

36 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
A summary of our cash flows was as follows: 

(In thousands)
Net cash provided by operating activities
Net cash used in investing activities
Net cash used in financing activities

Net increase in cash and cash equivalents

Years Ended December 31, 

$         

$          

2016
88,639
(39,201)
(19,049)
30,389

2015
72,285
(11,817)
(47,974)
12,494

$ 

2014
100,556
(26,201)
(34,605)
39,750

$   

$         

$          

Our principal source of cash has been our cash flow from operations and our $500 million five-year revolving credit facility. Other 
sources of cash include proceeds from exercise of stock options and tax benefits associated with stock option exercises. The 
primary uses of cash are compensation expenses, data processing, direct project costs and SG&A expenses and acquisitions.  

We  believe  that  expected  cash  flows  from  operations,  available  cash  and  cash  equivalents,  and  funds  available  under  our 
revolving credit facility will be sufficient to meet our liquidity requirements for the following year, which include: 

the working capital requirements of our operations; 
(cid:131) 
(cid:131) 
investments in our business; 
(cid:131)  business development activities;  
(cid:131) 
(cid:131) 

repurchases of common stock; and 
repayment of our revolving credit facility. 

Any projections of future earnings and cash flows are subject to substantial uncertainty. We may need to access debt and equity 
markets in the future if unforeseen costs or opportunities arise, to fund acquisitions or to repay indebtedness under the Credit 
Agreement, which matures in May 2018. If we need to obtain new debt or equity financing in the future, the terms and availability 
of such financing may be impacted by economic and financial market conditions as well as our financial condition and results of 
operations at the time we seek additional financing. 

Cash Flows from Operating Activities 

Net cash provided by operating activities for the year ended December 31, 2016 was $89.0 million, a $16.7 million increase 
from net cash provided by operating activities of $72.3 million for the year ended December 31, 2015. The increase was primarily 
due to an increases in net income as adjusted for non-cash items including decreased stock-based compensation expense and 
deferred income taxes, as well as increase in accounts payable and other liabilities.  

Net cash provided by operating activities for the year ended December 31, 2015 was $72.3 million, a $28.3 million decrease 
from net cash provided by operating activities of $100.6 million  for the year ended December 31, 2014. This decrease was 
primarily due to an increase in accounts receivable and a decrease in our net deferred tax liabilities and accounts payable, 
partially offset by an increase in net income. 

Net cash provided by operating activities for the year ended December 31, 2014 was $100.6 million, a $0.6 million decrease 
from net cash provided by operating activities of $101.2 million for the year ended December 31, 2013. This decrease was 
driven primarily by a decrease in net income and the net changes in the estimated allowance for unbilled receivables, accounts 
receivable, accounts payable, accrued expenses and other liabilities and the provision for the accounts receivable allowance. 

Our DSO calculation can be derived by dividing total net accounts receivable at the end of period, by the daily average of the 
current quarter’s annualized revenue.  For the year ended  December  31, 2016, revenue was $489.7  million, an increase of 
$15.5 million compared to revenue of $474.2 million for the year ended December 31, 2015. DSO increased by 6 days to 124 
days as of December 31, 2016, as compared to 118 days as of December 31, 2015. The change was primarily due to delays in 
invoicing and receipt of payment for previously recognized revenue as a result of timing delays; offset by accelerated cash 
collections of invoiced balances; and a decrease in various operational issues including missing Explanation of Benefits which 
delay invoicing. 

37 

 
 
 
 
 
 
 
 
 
 
 
          
          
    
          
          
    
Higher accounts receivable balances and higher DSOs in future periods would reduce net cash from operating activities in those 
periods. We do not currently anticipate collection issues with our accounts receivable, however, nor do we currently expect that 
any extended collections will materially impact our liquidity. 

The  majority  of  our  customer  relationships  have  been  in  place  for  several  years.  Our  future  operating  cash  flows  could  be 
adversely affected by a decrease in a demand for our services, delayed payments from customers or if one or more contracts 
with our largest customers is terminated or not re-awarded. 

Cash Flows from Investing Activities 

Net cash used in investing activities for the year ended December 31, 2016 was $39.5 million, a $27.7 million increase compared 
to net cash used in investing activities of $11.8 million for the year ended December 31, 2015. This increase was primarily due 
to the use of approximately $20.7 million in the Essette acquisition during the third quarter of 2016. Purchases of property and 
equipment and investment in capital software also increased by $9.2 million. These increases were partially offset by the receipt 
of proceeds from the sale of a cost basis investment of approximately $2.5 million.  

Net  cash  used  in  investing  activities  for  the  year  ended  December  31,  2015  was  $11.8  million,  a  $14.4  million  decrease 
compared to net cash used in investing activities of $26.2 million for the year ended December 31, 2014. The decrease was 
primarily related to a $14.1 million decrease in purchase of property and equipment and a $0.3 million decrease in investment 
in capitalized software. 

Net cash used in investing activities for the year ended December 31, 2014 was $26.2 million, a $0.1 million decrease compared 
to net cash used in investing activities of $26.3 million for the year ended December 31, 2013. This decrease was primarily 
related to a $0.5 million decrease in investments in common stock and a $0.1 million decrease in investment in capitalized 
software, which were offset by a $0.5 million increase in purchases of property and equipment. 

We currently expect to incur capital expenditures of $28 million during the year ended December 31, 2017.  

Cash Flows from Financing Activities 

Net cash used in financing activities for the year ended December 31, 2016 was $19.0 million, a $29.0 million decrease from 
net  cash  used  in  financing  activities  of  $48.0  million  for  the  year  ended  December  31,  2015.  This  decrease  was  primarily 
attributable to a decrease in share repurchases as compared to the prior year. Approximately $20.5 million was used for share 
repurchases  of  1,140,332  of  our  shares  of  common  stock  at  a  weighted average price of $17.93 per share pursuant to an 
authorized share repurchase program as more fully described in Note 8 – “Equity” in our Notes to the Consolidated Financial 
Statements under Item 8. Consolidated Financial Statements and Supplementary Data.  

Net cash used in financing activities for the year ended December 31, 2015 was $48.0 million, a $13.4 million increase from net 
cash used in financing activities of $34.6 million for the year ended December 31, 2014. This increase was primarily attributable 
to $50.0 million used in 2015 for share repurchases of 4,747,441 of our shares of common stock at a weighted average price of 
$10.51 per share pursuant to an authorized share repurchase program, partially offset by a $35.0 million reduction in payments 
toward the principal outstanding on our revolving credit facility and. No share repurchases were made during the year ended 
December 31, 2014.  

Net cash used in financing activities for the year ended December 31, 2014 was $34.6 million, an $82.2 million decrease from 
net  cash  used  in  financing  activities  of  $116.8 million  for  the  year  ended  December  31,  2013.  This  decrease  was  primarily 
attributable  to  a  $60.0  million  reduction  in  payments  toward  the  principal  outstanding  on  our  revolving  credit  facility  and  a 
$25.0 million reduction for share repurchases. No share repurchases were made for the year ended December 31, 2014.  

38 

 
 
 
 
 
 
 
 
 
 
 
 
 
Credit Agreement 

In May 2013, we entered into the Credit Agreement with certain financial institutions and Citibank, N.A. as Administrative Agent. 
The Credit Agreement has a five-year term, provides for an initial $500 million revolving credit facility, and contains customary 
representations and warranties, affirmative and negative covenants, including financial covenants, and events of default. Our 
obligations and any amounts due under the Credit Agreement are guaranteed by our material 100% owned subsidiaries and 
secured  by  a  security  interest  in  all  or  substantially  all  of  our  and  our  subsidiaries’  physical  assets.  See  Note  7  –  “Credit 
Agreement”  in  our  Notes  to  the  Consolidated  Financial  Statements  under  Item  8.  Consolidated  Financial  Statements  and 
Supplementary Data for additional information regarding our Credit Agreement. 

As of December 31, 2016, the Company was in compliance with all the terms of the Credit Agreement. 

Share Repurchase Program 

During  the  year  ended  December  31,  2016,  we  repurchased  1.1  million  shares  of  our  common  stock  for  approximately 
$20.5 million using cash resources. See Note 8 – “Equity” in our Notes to the Consolidated Financial Statements under Item 8. 
Consolidated Financial Statements and Supplementary Data for additional information regarding share repurchases. 

Contractual Obligations 

The  following  table  represents  the  scheduled  maturities  of  our  contractual  cash  obligations  and  other  commitments  (in 
thousands): 

Contractual Obligations (7)
Operating leases (1)
Revolving credit facility (2)
Interest expense (3)
Commitment fee (4) 
Capital leases (5)
Letter of Credit fee (6)
T otal

____________________________ 

Payments Due by Period

Total

Less than 
1 year

1 - 3 years

3 -5  years

More 
than 5  
years

$     

38,568

$   

16,077

$    

10,598

$     

7,041

$ 

4,852

197,796

7,368

2,028

4

-

5,511

1,517

4

197,796

1,857

511

-

-

-

-

-

-

-

-

-

26
245,790

$  

26
23,135

$   

-
210,762

$ 

-
7,041

$     

-
4,852

$ 

(1) 

(2) 

(3) 

Represents the future minimum lease payments under non-cancelable operating leases. In addition to minimum rent, 
certain  leases  require  the  payment  for  insurance,  maintenance  and  other  costs.  These  costs  have  historically 
represented approximately 3% to 6% of the minimum rent amount. These additional amounts are not included in the 
table of contractual obligations as the timing or amounts of such payments are unknown. 

Represents scheduled repayments of principal on the revolving credit facility under the terms of our Credit Agreement. 
See  Note  7  -  “Credit  Agreement”  in  our  Notes  to  the  Consolidated  Financial  Statements  in  Item  8.  Consolidated 
Financial Statements and Supplementary Data for additional information regarding the Credit Agreement. 

Represents estimates of amounts due on revolving credit facility based on the interest rate as of December 31, 2016 
and on scheduled repayments of principal. See Note 7 - “Credit Agreement” in our Notes to the Consolidated Financial 

39 

 
 
 
 
 
 
 
 
  
 
 
     
            
    
            
        
         
        
        
            
        
         
        
            
            
        
                 
                
             
            
        
               
             
             
            
        
Statements in Item 8. Consolidated Financial Statements and Supplementary Data for additional information regarding 
the Credit Agreement. 

Represents the commitment fee due on the revolving credit facility. See Note 7 - “Credit Agreement” in our Notes to 
the  Consolidated  Financial  Statements  in  Item  8.  Consolidated  Financial  Statements  and  Supplementary  Data  for 
additional information regarding the Credit Agreement. 

Represents the future minimum lease payments under capital leases. 

Represents  the  fees  for  the  letter  of  credit  established  against  the  revolving  credit  facility.  See  Note 7  -  “Credit 
Agreement” in our Notes to the Consolidated Financial Statements in Item 8. Consolidated Financial Statements and 
Supplementary Data for additional information regarding the Credit Agreement. 

The Company has excluded long-term unrecognized tax benefits, including interest and penalties, of $7.4 million from 
the amounts presented as the timing of these obligations is uncertain.  

(4) 

(5) 

(6) 

(7) 

As part of our contractual agreement with a customer, we have an outstanding irrevocable letter of credit for $3.0 million, which 
we  established  against  our  existing  revolving  credit  facility.  On  May  1,  2017,  the  expiration  date  of  the  letter  of  credit  was 
extended to April 26, 2018. 

Recently Issued Accounting Pronouncements  

The  information  set  forth  under  the  caption  “Summary  of  Significant  Accounting  Policies”  in  Note  1  of  the  Notes  to  the 
Consolidated Financial Statements included in Part II, Item 8. Consolidated Financial Statements and Supplementary Data is 
incorporated herein by reference.  

Item 7A.  Quantitative and Qualitative Disclosures About Market Risk 

At December 31, 2016, we were not a party to any derivative financial instruments. We conduct all of our business in U.S. 
currency and hence do not have direct foreign currency risk. We are exposed to changes in interest rates, primarily with respect 
to our revolving credit facility under our Credit Agreement. If the effective interest rate for all of our variable rate debt were to 
increase by 100 basis points (1%), our annual interest expense would increase by a maximum of $2.0 million based on our debt 
balances outstanding  at December  31,  2016. Further, we currently invest substantially all  of  our  excess cash in short-term 
investments, primarily money market accounts, where returns effectively reflect current interest rates. As a result, market interest 
rate changes may impact our interest income or expense. The impact will depend on variables such as the magnitude of rate 
changes and the level of borrowings or excess cash balances. We do not consider this risk to be material. We manage such 
risk by continuing to evaluate the best investment rates available for short-term, high quality investments. 

Item 8.  Consolidated Financial Statements and Supplementary Data 

The information required by Item 8 is found on pages 102 to 125 of this Annual Report on Form 10-K 

Item 9.  Changes in and Disagreements with Accountants on Accounting and Financial Disclosure 

None. 

40 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Item 9A.  Controls and Procedures 

(a) Evaluation of Disclosure Controls and Procedures 

We are responsible for maintaining disclosure controls and procedures (as defined in Rule 13a-15(e) under the Exchange Act) 
that are designed to ensure that information required to be disclosed in our reports filed under the Exchange Act is recorded, 
processed, summarized and reported within the time periods specified in the SEC’s rules and forms and that such information 
is accumulated and communicated to our management, including our Chief Executive Officer and Chief Financial Officer, as 
appropriate, to allow for timely decisions regarding required disclosure. 

As required by Rule 13a-15(b) under the Exchange Act, management, with the participation of our Chief Executive Officer and 
Chief  Financial  Officer,  performed  an  evaluation  of  the  effectiveness  of  our  disclosure  controls  and  procedures  as  of 
December 31,  2016.  Based  on  our  evaluation,  our  Chief  Executive  Officer  and  Chief  Financial  Officer  concluded  that  our 
disclosure controls and procedures were not effective as of December 31, 2016 due to the identification of material weaknesses 
in our internal control over financial reporting as described in Management’s Report on Internal Control Over Financial Reporting 
below. 

(b) Management’s Report on Internal Control Over Financial Reporting 

Our management is responsible for establishing and maintaining adequate internal control over financial reporting and for the 
assessment of the effectiveness of internal control over financial reporting. As defined by Rule 13a-15(f) of the Exchange Act, 
internal control over financial reporting is a process designed by, or under the supervision of our Chief Executive Officer and 
our Chief Financial Officer and effected by our Board of Directors, management and other personnel, to provide reasonable 
assurance regarding the reliability of financial reporting and the preparation of the consolidated financial statements for external 
purposes in accordance with U.S. GAAP. 

Our internal control over financial reporting includes those policies and procedures that (i) pertain to the maintenance of records 
that, in reasonable detail, accurately and fairly reflect our transactions and dispositions of our assets; (ii) provide reasonable 
assurance  that  transactions  are  recorded  as  necessary  to  permit  preparation  of  the  consolidated  financial  statements  in 
accordance  with  generally  accepted  accounting  principles  and  that  our  receipts  and  expenditures  are  being  made  only  in 
accordance with authorizations of our management and directors; and (iii) provide reasonable assurance regarding prevention 
or  timely  detection  of  unauthorized  acquisition,  use  or  disposition  of  our  assets  that  could  have  a  material  effect  on  the 
consolidated financial statements. 

Because  of  its  inherent  limitations,  internal  control  over  financial  reporting  may  not  prevent  or  detect  misstatements.  Also, 
projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate 
because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. 

A material weakness is a deficiency, or combination of deficiencies, in internal control over financial reporting such that there is 
a  reasonable  possibility  that  a  material  misstatement  in  our  annual  or  interim  financial  statements  will  not  be  prevented  or 
detected on a timely basis. 

In connection with the preparation of our annual consolidated financial statements, management has undertaken an assessment 
of the effectiveness of our internal control over financial reporting as of December 31, 2016, based on criteria established in the 
Internal Control-Integrated Framework issued by COSO. Management’s assessment included an evaluation of the design of 
our internal control over financial reporting and testing of the operational effectiveness of those controls.  

Based on that assessment, management identified the following material weaknesses:  

We did not maintain an effective control environment based on lack of established reporting lines and defined 
authorities and responsibilities for financial reporting at our wholly owned subsidiary, HDI, and did not have 

41 

 
 
 
 
 
 
 
 
 
 
 
 
 
an  effective  risk  assessment  process  on  a  periodic  basis  to  assess  the  effects  of  changes  in  business 
operations and turnover of our employees that significantly impact our financial processes and internal control 
over financial reporting related to (i) our estimated liability for appeals associated with our contract with CMS 
(the “CMS Reserve”) and (ii) the valuation of our accounts receivable allowance (the “Allowance”). As a result, 
we did not design and implement effective process level control activities, specifically management review 
controls over the measurement and disclosure of the CMS Reserve and the Allowance and controls over the 
completeness and accuracy of data used to calculate the CMS Reserve and the Allowance.  

The material weaknesses identified above resulted in an immaterial reclassification error in revenue and selling, general and 
administrative  expenses  that  was  corrected  prior  to  the  issuance  of  the  consolidated  financial  statements.  These  material 
weaknesses create a reasonable possibility as of December 31, 2016 that a material misstatement to the consolidated financial 
statements will not be prevented or detected on a timely basis; therefore, we concluded that our internal control over financial 
reporting was not effective as of December 31, 2016.  

KPMG LLP, the independent registered public accounting firm that audited our consolidated financial statements included in 
this Annual Report on Form 10-K, has issued an adverse opinion in their report on the effectiveness of our internal control over 
financial reporting, a copy of which appears on page 100. 

(c) Changes in Internal Control Over Financial Reporting 

Except as relating to the material weaknesses identified in the current period and described under “Management’s Report on 
Internal Control Over Financial Reporting,” there have been no changes in our internal control over financial reporting identified 
in connection with the evaluation of our controls performed during the quarter ended December 31, 2016 that have materially 
affected, or are reasonably likely to materially affect, our internal control over financial reporting. 

(d) Remediation 

Management is currently revising and supplementing our control environment and our risk assessment process and the design 
of our process level controls in order to remediate the material weaknesses described above, including a set of compensating 
controls in the near term. We are enhancing and revising the design of controls and procedures to ensure the calculations of 
the  CMS  Reserve  and  the  Allowance  properly  utilize  historical  information  to  derive  the  period-end  balances.  Additionally, 
management  will  be  supplementing  the  review  controls  over  the  CMS  Reserve  and  the  Allowance,  and  controls  over  the 
completeness and accuracy of the data used to calculate the balances with additional levels of review involving senior members 
of our accounting department and will assess the need for additional remediation steps. We believe that the steps identified 
should remediate the control weaknesses identified. 

Item 9B.  Other Information 

None. 

42 

 
 
 
 
 
 
 
 
 
 
 
Item 10.  Directors, Executive Officers and Corporate Governance 

PART III 

BOARD OF DIRECTORS 

The Board of Directors is currently composed of nine members, eight of whom are non-employee directors. Pursuant to our 
Bylaws, our Board of Directors is currently divided into two classes, Class I and Class II, with one class standing for election 
each year for a term of two years. The following table sets forth certain information with respect to each of our directors. 

Age 

Has Served as a 
Director Since 
Name 
Class II Directors (Terms expire at the 2017 Annual Meeting) 
William F. Miller III 
Ellen A. Rudnick 
Richard H. Stowe 
Cora M. Tellez 
Class I Directors (Terms expire at the 2018 Annual Meeting) 
Alex M. Azar II(1)  
Robert Becker(2) 
Craig R. Callen 
William C. Lucia 

2016 
2016 
2013 
2009 

2000 
1997 
1989 
2012 

49 
63 
61 
59 

67 
66 
73 
67 

Bart M. Schwartz 

70 

2010 

Position with HMS 

Class II Director  
Class II Director  
Class II Director and Lead Independent Director 
Class II Director  

Class I Director  
Class I Director  
Class I Director  
Chairman, President and Chief Executive Officer, and Class I 
Director 
Class I Director  

(1)  In October 2016, the Board of Directors increased the size of the board to nine members and appointed Mr. Azar as a Class I director. 

(2)  The Board of Directors appointed Mr. Becker as a Class I director in January 2016 to fill a vacancy on the Board. 

Detailed biographical information of each director, as well as a description of the specific experience, qualifications, attributes 
and skills that led our Board to conclude that each director should serve as a member of our Board of Directors, is below. 

CLASS II DIRECTORS (TERMS EXPIRE AT THE 2017 ANNUAL MEETING) 

William F. Miller III 

Mr. Miller has served as one of our directors since October 2000. In 2013, Mr. Miller joined KKR 
Advisors, a global investment firm, as a healthcare industry advisor. From 2006 to 2013, Mr. Miller 
was  a  partner  at  Highlander  Partners,  a  private  equity  group  in  Dallas,  Texas  focused  on 
investments in healthcare products, services and technology. From October 2000 to April 2005, 
Mr. Miller served as our Chief Executive Officer and from December 2000 to April 2006, Mr. Miller 
served as our Chairman. From 1983 to 1999, Mr. Miller served as President and Chief Operating 
Officer of EmCare Holdings, Inc., a national healthcare services firm focused on the provision of 
to  1983,  Mr.  Miller  served  as 
emergency  physician  medical  services.  From  1980 
Administrator/Chief  Operating  Officer  of  Vail  Mountain  Medical.  From  1997  to  2012,  Mr.  Miller 
served as a director of Lincare Holdings, Inc.  

Mr. Miller brings to the Board of Directors both a thorough understanding of our business and the 
healthcare industry and extensive experience in the financial markets. His significant operational 
experience, both at HMS and at EmCare Holdings, makes him well-positioned to provide HMS with 

43 

 
 
 
 
 
 
Ellen A. Rudnick 

Richard H. Stowe 

insight on financial, operational and strategic issues and to serve as a member of the Compliance 
and Ethics Committee. 

Ms. Rudnick has served as one of our directors since 1997. Since 1999, Ms. Rudnick has served 
in various roles at the Polsky Center for Entrepreneurship and Innovation, University of Chicago 
Booth  School  of  Business,  including  her  current  role  as  Senior  Advisor  for  Entrepreneurship, 
adjunct faculty, and her prior role as Executive Director and Clinical Professor from 1999 through 
July  2016.  From  1993  to  1999,  Ms.  Rudnick  served  as  Chairman  of  Pacific  Biometrics,  Inc.,  a 
publicly  held  healthcare  biodiagnostics  company  and  its  predecessor,  Bioquant,  which  she  co-
founded. From 1990 to 1992, she served as President and Chief Executive Officer of Healthcare 
Knowledge Resources (HKR), a privately held healthcare information technology corporation and 
subsequently served as President of HCIA, Inc. (HCIA) following the acquisition of HKR by HCIA. 
From 1975 to 1990, Ms. Rudnick served in various positions at Baxter Health Care Corporation, 
including  Corporate  Vice  President  and  President  of  its  Management  Services  Division. 
Ms. Rudnick also serves as a director of Patterson Companies, Inc. and First Midwest Bancorp, 
Inc.  

Ms. Rudnick brings to the Board of Directors extensive business understanding and demonstrated 
management  expertise,  having  served  in  key  leadership  positions  at  a  number  of  healthcare 
companies.  Ms.  Rudnick  has  a  comprehensive  understanding  of  the  operational,  financial  and 
strategic challenges facing companies and knows how to make businesses work effectively and 
efficiently. Her management experience and service on other public company boards has provided 
her with a thorough understanding of the financial and other issues facing large companies, making 
her particularly valuable as the Chair of our Audit Committee and as a member of our Compliance 
and Ethics Committee and Nominating and Governance Committee.    

Mr. Stowe has served as one of our directors since 1989 and as Lead Independent Director of the 
Board since July 2015. Mr. Stowe has served as a general partner of Health Enterprise Partners 
LP, a private equity firm, since 2005. From 1999 to 2005, Mr. Stowe was a private investor, a senior 
advisor to the predecessor funds to Health Enterprise Partners, and a senior advisor to Capital 
Counsel LLC, an asset management firm. From 1979 until 1998, Mr. Stowe was a general partner 
of Welsh, Carson, Anderson & Stowe. Prior to 1979, he was a Vice President in the venture capital 
and corporate finance groups of New Court Securities Corporation (now Rothschild, Inc.). 

Mr. Stowe brings over 46 years of financial, capital markets and investment experience to our Board 
of Directors. Mr. Stowe’s background and extensive experience make him well-positioned to serve 
as  the  Chair  of  the  Compensation  Committee,  a  member  of  the  Nominating  and  Governance 
Committee  and  as  our  Lead  Independent  Director.  Mr.  Stowe  has  effectively  carried  out  his 
responsibilities  as  a  Chair  for  several  of  our  Board  committees  and  is  well-respected  by  the 
independent directors. The Board believes that Mr. Stowe is highly qualified and continues to be in 
the best position to serve as Lead Independent Director.   

44 

 
 
 
 
Cora M. Tellez 

Ms. Tellez has served as one of our directors since October 2012. Ms. Tellez is the President and 
Chief  Executive  Officer  of  Sterling  HSA,  an  independent  health  savings  accounts  administrator 
which she founded in 2004. Prior to starting Sterling HSA, Ms. Tellez served as President of the 
health plans division of Health Net, Inc., an insurance provider. She later served as President of 
Prudential’s  western health care  operations, CEO  of  Blue  Shield of  California, Bay Region  and 
Regional Manager for Kaiser Permanente of Hawaii. Ms. Tellez also serves as Chief Executive 
Officer  of  Amazing  CARE  Network,  Inc.,  a  company  she  founded  in  January  2015.  Ms.  Tellez 
serves on the boards of directors of Pacific Premier Bancorp, Inc. and CorMedix Inc., as well as on 
the boards of various nonprofit organizations such as the Institute for Medical Quality and UC San 
Diego’s Center for Integrative Medicine. 

Ms. Tellez brings over 25 years of healthcare policy and operations experience to the Board. Her 
public company operational, financial and corporate governance experience is a valuable resource 
for  our  Board  and  makes  her  well-positioned  to  serve  as  the  Chair  of  the  Nominating  and 
Governance Committee, a member of the Audit and Compensation Committees and as an audit 
committee financial expert. 

CLASS I DIRECTORS (TERMS EXPIRE AT THE 2018 ANNUAL MEETING) 

Alex M. Azar II 

Mr. Azar has served as one of our directors since October 2016.  Mr. Azar is currently Chairman of 
Seraphim  Strategies,  LLC,  a  firm  he  founded  in  2017,  which  provides  strategic  consulting  and 
counsel  on  the  biopharmaceutical  and  health  insurance  industries,  including  biopharmaceutical 
pricing, reimbursement, access, and distribution, as well as federal and state healthcare policy. 
From January 2012 to January 2017, Mr. Azar served as President of Lilly USA, LLC, the largest 
affiliate of global biopharmaceutical company Eli Lilly & Co. (Lilly), where he was responsible for 
directing the sales and marketing operations of Lilly’s U.S. commercial business and also directly 
led the U.S. Biomedicines division. From April 2009 to December 2011, he served as Lilly’s Vice 
President of Managed Healthcare Services and Puerto Rico, and from June 2007 to April 2009 as 
its Senior Vice President of Corporate Affairs and Communications responsible for the company’s 
global communications, government affairs, public policy, advocacy, and pricing, reimbursement 
and access organizations. Prior to joining Lilly, Mr. Azar served as the Deputy Secretary of the U.S. 
Department of Health  and  Human Services (HHS)  from 2005 to  2007, where  he  was the Chief 
Operating  Officer  of  the  largest  civilian  cabinet  department  in  the  U.S.  government.  Mr.  Azar 
supervised all operations of HHS, including the regulation of food and drugs, Medicare, Medicaid, 
medical  research,  public  health,  welfare,  child  and  family  services,  disease  prevention,  Indian 
health, mental health services, and others. Mr. Azar served as General Counsel of HHS from 2001 
to 2005. Prior to his service at HHS, Mr. Azar was in private legal practice.  He also served as a 
Law Clerk to U.S. Supreme Court Justice Antonin Scalia. Mr. Azar serves on the boards of the 
American Council on Germany and the Indianapolis Symphony Orchestra. 

Mr. Azar brings an important blend of government and healthcare industry experience to our Board 
of Directors.  He has an informed perspective on healthcare policy and extensive experience with 
big data, which is particularly relevant to us as we expand into the care management and data 
analytics field. 

45 

 
 
 
 
Robert Becker 

Craig R. Callen 

Mr. Becker has served as one of our directors since January 2016. Mr. Becker most recently served 
as  President  and  CEO  of  Wolters  Kluwer  Health,  a  provider  of  information  and  point  of  care 
solutions to the healthcare industry, from December 2008 until his retirement in May 2015. In his 
role at Wolters Kluwer Health, Mr. Becker reported to the Chairman of the Executive Board and had 
global  responsibility  for  Wolters  Kluwer’s  $1.2  billion  Health  division.  From  August  2003  to 
November  2008,  he  served  as  CEO  of  Wolters  Kluwer  Law  &  Business.  Mr.  Becker  led  the 
transformation of both the Health and Law & Business divisions from traditional publishers to world 
class providers of digital content and software solutions through a combination of organic growth 
and mergers and acquisitions. Prior to joining Wolters Kluwer, Mr. Becker served as President and 
CEO of Jupiter Media Metrix, a provider of comprehensive research and measurement products 
and  services  designed  to  assist  companies  in  utilizing  Internet  technologies  to  more  effectively 
operate their businesses. Mr. Becker also spent 13 years with The Thomson Corporation, 10 years 
as a CEO and three as a CFO of several global businesses. Mr. Becker, who is a CPA, began his 
career  at  PriceWaterhouse  auditing  numerous  public  and  privately  held  companies.  Mr.  Becker 
previously served on the board of directors of Symphony Health, a privately held portfolio company 
of Symphony Technology Group providing pharmacy claims and patient longitudinal health records 
to the pharmaceutical industry.  

Mr.  Becker’s  executive  leadership  experience  and  strong  background  in  technology  and  data 
analytics provide valuable insight into strategic planning and operations to the Board. Among other 
qualifications, Mr. Becker brings to the Board extensive financial expertise, including budgeting, 
forecasting and mergers and acquisitions, making him well-positioned to serve as a member of the 
Audit Committee and an audit committee financial expert, as well as a member of the Nominating 
and Governance Committee. 

Mr. Callen has served as one of our directors since October 2013. Mr. Callen was a Senior Advisor 
at Crestview Partners, a private equity firm, from 2009 through 2016. From 2004 to 2007, Mr. Callen 
was  Senior  Vice  President  and  Head  of  Strategic  Planning  and  Business  Development  and  a 
member of the Executive Committee for Aetna, Inc. In his role at Aetna, Mr. Callen reported directly 
to the Chairman and CEO and was responsible for oversight and development of Aetna’s corporate 
strategy, including mergers and acquisitions. During his tenure, Mr. Callen and his team led the 
acquisitions of seven companies, investing over $2.0 billion, broadening Aetna’s revenue, global 
presence, product line, targeted markets and participation in government programs. Prior to joining 
Aetna, Mr. Callen was a Managing Director and Head of U.S. Healthcare Investment Banking at 
Credit Suisse First Boston and Co-Head of Healthcare Investment Banking at Donaldson, Lufkin & 
Jenrette. Mr. Callen serves on the board of directors of Omega Healthcare Investors, Inc. 

Mr.  Callen  brings  over  20  years  of  healthcare  investment  banking  experience  and  corporate 
development  expertise  to  our  Board,  which  are  invaluable  to  us  as  we  evaluate,  develop  and 
implement  new  solutions  for  clients.  His  extensive  experience  in  a  corporate  setting  and  as  an 
advisor to public/private healthcare companies positions him well to serve on the Compensation 
and Nominating and Governance Committees.   

46 

 
 
 
 
William C. Lucia 

Bart M. Schwartz 

Mr. Lucia has served as our President and Chief Executive Officer since March 2009. He has been 
a member of our Board of Directors since May 2008 and was appointed Chairman of the Board in 
July 2015. From May 2005 to March 2009, Mr. Lucia served as our President and Chief Operating 
Officer. Since joining us in 1996, Mr. Lucia has held several positions with us, including: President 
of our subsidiary, Health Management Systems, Inc., from 2002 to 2009; President of our Payor 
Services Division from 2001 to 2002; Vice President and General Manager of our Payor Services 
Division from 2000 to 2001; Vice President of our Business Office Services from 1999 to 2000; 
Chief Operating Officer of our former subsidiary Quality Medical Adjudication, Incorporated (QMA) 
and  Vice  President  of  West  Coast  Operations  from  1998  to  1999;  Vice  President  and  General 
Manager of QMA from 1997 to 1998; and Director of Information Systems for QMA from 1996 to 
1997.  Prior  to  joining  us,  Mr. Lucia  served  in  various  executive  positions  including  Senior  Vice 
President, Operations and Chief Information Officer for Celtic Life Insurance Company, and Senior 
Vice President, Insurance Operations for North American Company for Life and Health Insurance. 
Mr. Lucia is a Fellow of the Life Management Institute Program through LOMA, an international 
association through which insurance and financial services companies around the world engage in 
research and educational activities to improve company operations. 

With  over  20  years  of  experience  with  HMS  working  across  multiple  divisions  and  his  prior 
experience in the insurance industry, Mr. Lucia brings to our Board in-depth knowledge of HMS and 
the  healthcare  and  insurance  industries,  the  evolving  healthcare  landscape  and  the  array  of 
challenges  to  be  faced  and  demonstrates  an  ability  to  formulate  and  implement  key  strategic 
initiatives, making him well-positioned to lead our management team and provide essential insight 
and leadership to the Board. 

Mr. Schwartz has served as one of our directors since July 2010. Mr. Schwartz currently serves as 
the Chairman and Chief Executive Officer of SolutionPoint International, LLC, which provides an 
integrated  array  of  business  intelligence,  security  and  compliance,  identity  assurance  and 
situational awareness solutions. In 2003, Mr. Schwartz founded his own law firm, which specializes 
in, among other areas, conducting independent investigations, monitoring and Independent Private 
Sector  Inspector  General  engagements  and  developing,  auditing  and  implementing  compliance 
programs.  From  1991  to  2003,  Mr.  Schwartz  served  as  the  Chief  Executive  Officer  of  Decision 
Strategies,  an  internationally  recognized investigative  and  security firm,  which was sold to  SPX 
Corporation  in  2001.  Mr.  Schwartz  has  over  30  years’  experience  managing  domestic  and 
international investigations, prosecutions and assessments for clients in both the public and private 
sectors.  He  currently  serves  as  the  federally  appointed  Monitor  of  GM  and  as  Chairman  of  the 
Board of Kadmon Holdings, Inc. 

Mr. Schwartz brings extensive legal and compliance experience to our Board, which is particularly 
valuable  as  we  continue  to  expand  our  business.  Mr.  Schwartz’s  background  makes  him  well-
positioned to serve as the Chair of the Compliance and Ethics Committee and as a member of the 
Audit and Nominating and Governance Committees. 

47 

 
 
 
 
 
 
 
EXECUTIVE OFFICERS 

The following table sets forth certain information with respect to each person who currently serves as one of our executive 
officers as of the date of this Annual Report on Form 10-K. Our executive officers are elected annually by our Board of Directors 
and generally serve at the discretion of our Board of Directors. There are no arrangements or understandings between any of 
our executive officers and any other person pursuant to which they were selected as an officer. None of our directors or executive 
officers are related to any other director or executive officer of HMS or any of its subsidiaries by blood, marriage or adoption.  

Name 

William C. Lucia 
Meredith W. Bjorck 
Semone Neuman 
Cynthia Nustad 
Jeffrey S. Sherman 
Tracy A. South 
Douglas M. Williams 

Age 

  Position 

59 
41 
53 
46 
51 
58 
58 

  Chairman, President and Chief Executive Officer  
  Executive Vice President, General Counsel and Corporate Secretary 
  Executive Vice President, Operations and Information Technology 
  Executive Vice President, Chief Strategy Officer 
  Executive Vice President, Chief Financial Officer and Treasurer 
  Executive Vice President, Human Resources and Chief Administrative Officer  
  President, Markets and Product 

The  principal  occupations  for  the  last  five  years,  as  well  as  certain  other  biographical  information,  for  each  of  our  current 
executive  officers  who  are  not  directors  are  set  forth  below.    See  “Class  I  Directors”  above  for  biographical  information  for 
Mr. Lucia. 

Meredith W. Bjorck 

Ms. Bjorck has served as our Executive Vice President, General Counsel and Corporate Secretary 
since April 2016. Ms. Bjorck previously served as Senior Vice President, General Counsel and 
Corporate Secretary for Tuesday Morning Corporation, a national off-price retailer, from January 
2013 to March 2016. From April 2008 until January 2013, Ms. Bjorck served in various capacities 
for  CEC  Entertainment,  Inc.,  an  international  restaurant  chain,  including  as  Deputy  General 
Counsel, Chief Compliance Officer and Corporate Secretary. Prior to joining CEC Entertainment, 
Ms. Bjorck was an attorney at Fulbright & Jaworski L.L.P. (now Norton Rose Fulbright) and Vinson 
& Elkins L.L.P., where she specialized in corporate securities and mergers and acquisitions. 

Semone Neuman 

Ms. Neuman has served as our Executive Vice President, Operations and Information Technology 
since  December  2016,  responsible  for  our  operations  for  coordination  of  benefits,  premium 
protection and subrogation services and information technology.  From April 2013 to December 
2016,  she  served  as  our  Executive  Vice  President  of  Operations.  Ms.  Neuman  has  extensive 
experience in healthcare claims processing, operations and reengineering. She has a track record 
for  leading  change,  driving  quality  performance  and  reducing  unit  costs  in  complex  operating 
environments.  Prior  to  joining  HMS,  Ms.  Neuman  served  as  Senior  Vice  President  of  Claim 
Operations at United HealthCare (UHC), from 2009 to 2013, where she oversaw the operations 
for all business lines and major platforms processing over 500 million claims annually. Under her 
leadership,  UHC  achieved  industry-leading  performance  levels,  earning  the  American  Medical 
Association designation for the industry’s best claim operation in 2011 and 2012. 

48 

 
 
 
 
 
Cynthia Nustad 

Jeffrey S. Sherman 

Tracy A. South 

Ms. Nustad has served as our Executive Vice President, Chief Strategy Officer since December 
2016, and is responsible for strategy development, evolution and growth of our technology and 
analytics  software  and  services  and  care  management  solutions.  From  February  2011  to 
December 2016, she served as our Executive Vice President, Chief Information Officer. Prior to 
joining HMS, Ms. Nustad served as Vice President of Architecture and Technology for Regence 
Blue Cross Blue Shield (now Cambia Health Solutions), where she was responsible for servicing 
a  large  corporation  across  multiple  sites  and  states  from  January  2005  to  January  2011. 
Ms. Nustad  has  over  20 years  of  management  experience  in  the  healthcare  information 
technology 
technology,  business 
transformation, product development and innovation.  Ms. Nustad and her teams have earned 
numerous industry awards, including the Computerworld Premier 100 IT Leader award in 2013. 

including  executive  experience 

in  enterprise 

industry, 

Mr. Sherman has served as our Executive Vice President, Chief Financial Officer and Treasurer 
since September 2014, and is also responsible for corporate development, investor relations, risk 
management and corporate security. Mr. Sherman has over 25 years of experience in healthcare 
operations, strategic planning and financial performance in senior financial executive positions. 
Prior to joining HMS, Mr. Sherman served as Executive Vice President and Chief Financial Officer 
of AccentCare, a healthcare delivery organization, from September 2013 to August 2014. From 
April 2009 to September 2013, he served as Executive Vice President and Chief Financial Officer 
of Lifepoint Hospitals, Inc. From September 2005 until April 2009, Mr. Sherman served as Vice 
President and Treasurer of Tenet Healthcare, where he managed all aspects of corporate finance, 
including  cash  flow  management  and  capital  structure,  and  was  also  responsible  for  risk 
management. Mr. Sherman served in various capacities for Tenet Healthcare and its predecessor 
company since 1990, including as a hospital chief financial officer and regional vice president. 

Ms.  South  has  served  as  our  Executive  Vice  President,  Human  Resources  and  Chief 
Administrative  Officer  since  May  2014.  She  served  as  our  Senior  Vice  President  of  Human 
Resources from December 2011 to May 2014. Ms. South has over 21 years of executive-level 
human resources experience, including at national healthcare organizations. From 2003 to 2011, 
Ms. South served as the Senior Vice President, Chief Human Resources Officer at Mosaic Sales 
Solutions,  a  privately-held  full-service  marketing  agency  in  Irving,  Texas.  During  her  tenure  at 
Mosaic,  she  built  the  company’s  North  America  Human  Resources  department,  focusing  on 
attracting and training a dispersed workforce of over 10,000 employees hired to represent world 
class  brands  at  retail,  in  the  community  and  online.  In  her  role,  Ms. South  oversaw  Talent 
Acquisition,  HR  Services  and  Organizational  Effectiveness.  Ms. South  has  also  served  in  HR 
leadership roles at Tenet Healthcare and Aetna US Healthcare. 

49 

 
 
 
 
 
Douglas M. Williams 

Mr.  Williams  has  served  as  our  President,  Markets  and  Product  since  December  2016,  with 
responsibility  for  leading  sales  and  marketing,  product  management  and  payment  integrity 
solutions. From January 2015 to December 2016, he served as our Division President of Markets 
with responsibility for leading the state and federal government and commercial markets, sales 
and marketing. From December 2013 to January 2015, he served as our Division President of 
Commercial Solutions, responsible for leading our commercial product and business development 
strategy. Prior to joining HMS, Mr. Williams served as Chief Information Officer of Aveta Inc. (now 
part of Optum, Inc.), a provider of managed healthcare services, from 2010 to 2013. Mr. Williams 
has over 25 years of experience in healthcare information technology, sales, and operations.  

SECTION 16(a) BENEFICIAL OWNERSHIP REPORTING COMPLIANCE  

Pursuant  to  Section  16(a)  of  the  Exchange  Act  our  executive  officers,  directors  and  persons  owning  more  than  10%  of  a 
registered class of our equity securities are required to file reports of ownership and changes in ownership of common stock 
with the SEC. Copies of such reports are required to be furnished to us.  

Based solely on a review of the copies of such reports furnished to us, or written representations that no other reports were 
required, we believe that during fiscal 2016, all of the reporting persons complied with the requirements of Section 16(a). 

CORPORATE GOVERNANCE 

BOARD COMMITTEES AND RELATED MATTERS 

The Board of Directors has the following standing committees: Audit Committee, Compensation Committee, Compliance and 
Ethics Committee and Nominating and Governance Committee, each of which operates pursuant to a separate charter that has 
been approved by the Board of Directors. A current copy of each charter is available on our website under the “Investors—
Corporate  Governance” 
the 
appropriateness of its charter on an annual basis, as required by its charter, and recommends any changes to the Board of 
Directors for approval.   

tabs  at  http://investor.hms.com/corporate-governance.cfm.  Each  committee 

reviews 

The Board of Directors makes committee and committee chair assignments annually at its meeting following the annual meeting 
of shareholders, although further changes to committee assignments are made from time to time as deemed appropriate by the 
Board of Directors. The membership of each standing committee as of the date of this Annual Report on Form 10-K and the 
number of meetings held by each committee during 2016 are summarized in the table below.   

50 

 
 
 
Committee 

Board 

Audit(2) 

Compensation(3)

Compliance 
and Ethics 

Nominating and 
Governance 

Chairman 

Lead Independent 
Director 

Chair 

Chair 

Chair 

Director 

Alex M. Azar II(1)(4) 
Robert Becker(1)(5) 
Craig R. Callen(1) 
William C. Lucia 
William F. Miller III(1)(6) 
Ellen A. Rudnick(1) 
Bart M. Schwartz(1) 

Richard H. Stowe(1) 

Cora M. Tellez(1)(7) 

Chair 

7 

Number of Meetings in 2016 

8 

6 

7 

5 

(1)  The Board has determined that the director is independent as defined in the NASDAQ Marketplace Rules. 

(2)  The  Board  has  determined  that  each  member  of  the  Audit  Committee  meets  NASDAQ’s  financial  knowledge  and  sophistication 
requirements.  In  addition,  the  Board  has  determined  that  Mr.  Becker  and  Ms.  Tellez  each  qualify  as  an  “audit  committee  financial 
expert,” as such term is defined in Item 407(d)(5)(ii) of Regulation S-K. 

(3)  The  Board  has  determined  that  each  member  of  the  Compensation  Committee  is  an  independent  director,  as  independence  for 
compensation committee members is defined in the NASDAQ Marketplace Rules. Each of Messrs. Callen and Stowe and Ms. Tellez 
also qualifies as an “outside director” within the meaning of Section 162(m) of the Internal Revenue Code of 1986 (the “Code”) and as 
a “non-employee” director under Rule 16b-3 of the Exchange Act. 

(4)  Mr. Azar was appointed as an independent member of the Board of Directors in October 2016. 

(5)  Mr.  Becker  was  appointed  as  a  member  of  the  Audit  Committee  and  the  Nominating  and  Governance  Committee  effective  as  of 

February 19, 2016. 

(6)  Mr. Miller was appointed as a member of the Compliance and Ethics Committee effective as of July 28, 2016. 

(7)  Ms. Tellez stepped down from the Compliance and Ethics Committee and was appointed as a member of the Compensation Committee 

effective as of July 28, 2016. 

CODE OF CONDUCT 

Our Board of Directors has adopted a Code of Conduct applicable to all of our directors, officers and employees, including all 
employees, officers, directors, contractors, contingent workers and business affiliates of HMS subsidiaries. The Code of Conduct 
is  publicly  available  on  our  website  under  the  “Investors—Corporate  Governance”  tab  at  http://investor.hms.com/corporate-
governance.cfm and can also be obtained free of charge by sending a written request to our Corporate Secretary. To the extent 
permissible under NASDAQ Marketplace Rules, we intend to disclose amendments to our Code of Conduct, as well as waivers 
of  the  provisions  thereof,  that  relate  to  our  principal  executive  officer,  principal  financial  officer,  principal  accounting  officer, 
controller or persons performing similar functions on the Company’s website under the “Investors—Corporate Governance” tab 
at http://investor.hms.com/corporate-governance.cfm. 

51 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Item 11.  Executive Compensation 

EXECUTIVE COMPENSATION 

COMPENSATION DISCUSSION AND ANALYSIS  

This Compensation Discussion and Analysis (“CD&A”), describes our 2016 executive compensation program and certain actions 
with respect to our 2017 executive compensation program and should be read in conjunction with the compensation tables that 
follow  this  CD&A.  In  particular,  this  CD&A  explains  how  the  Compensation  Committee  of  the  Board  of  Directors  made  its 
compensation decisions for our named executive officers for fiscal 2016.  

For 2016, our named executive officers are:  

(cid:131)  William C. Lucia, Chairman, President and Chief Executive Officer (“CEO”); 
Jeffrey S. Sherman, Executive Vice President, Chief Financial Officer and Treasurer; 
(cid:131) 
(cid:131)  Semone Neuman, Executive Vice President, Operations and Information Technology; 
(cid:131)  Cynthia Nustad, Executive Vice President, Chief Strategy Officer; and 
(cid:131)  Douglas Williams, President, Markets and Product. 

2016 Say-on-Pay Vote  

At our 2016 Annual Meeting of Shareholders, over 97% of the votes cast on the say-on-pay proposal were in favor of our 2015 
executive compensation program described in our 2016 Proxy Statement. The Compensation Committee believes that this vote, 
and the consistent high level of support from our shareholders of our executive compensation program year over year, affirms 
our  shareholders’  strong  support  of  HMS’s  general  approach  to  executive  compensation.  Therefore,  the  Compensation 
Committee  did  not  change  its  compensation  philosophy  as  it  made  decisions  for  2016.  As  market  practices  on  executive 
compensation policies evolve, the Compensation Committee will continue to evaluate and, if needed, make changes to our 
executive  compensation  program  to  ensure  that  the  program  continues  to  reflect  our  pay-for-performance  compensation 
philosophy and objectives. The Compensation Committee will also continue to consider the outcome of HMS’s say-on-pay votes 
when making future compensation decisions for executive officers.  

Executive Summary 

2016 FINANCIAL PERFORMANCE OVERVIEW 

Our full year 2016 financial performance included solid growth in revenue, operating income and adjusted EPS, margin 
expansion, higher adjusted EBITDA, strong operating cash flow and prudent capital deployment – including the Essette 
acquisition and share repurchases. 

The following is an overview of our financial performance for the year ended December 31, 2016. 

(cid:131)  We reported total revenue of $489.7 million, a 3.3% increase compared to total revenue for fiscal 2015 of $474.2 million.  

(cid:131)  We reported net income of $37.6 million or $0.43 per diluted share, a 53.6% increase compared to net income for fiscal 

2015 of $24.5 million or $0.28 per diluted share.  

(cid:131)  We reported adjusted earnings before interest, income taxes, depreciation and amortization, stock-based compensation 
and non-recurring legal expense (“adjusted EBITDA”) of $117.4 million, a 4.4% increase compared to adjusted EBITDA for 
fiscal 2015 of $112.5 million.  

(cid:131)  We reported adjusted earnings per diluted share (“adjusted EPS”) of $0.75, a 31.6% increase compared to adjusted EPS 

for fiscal 2015 of $0.57. 

52 

 
 
 
 
(cid:131)  Our stock price increased by 47.2% for the one-year period ending December 30, 2016, from $12.34 per share to $18.16 

per share.  

A reconciliation of the non-GAAP financial measures (adjusted EBITDA and adjusted EPS) to the most directly comparable 
GAAP measures is set forth below under the heading "Non-GAAP Financial Measures".   

KEY 2016 COMPENSATION ACTIONS 

The following highlights key decisions and actions of the Compensation Committee with respect to executive compensation for 
2016.  These  decisions  and  actions  were  made  with  the  advice  of  the  Compensation  Committee’s  independent  consultant, 
Frederic W. Cook & Co., Inc. (“FW Cook”) (see “Role of the Independent Compensation Consultant” below), and are discussed 
in greater detail later in this CD&A. 

(cid:131)  Executive Compensation Peer Group.  In January 2016, the Compensation Committee approved certain changes to its 

executive compensation peer group, resulting in a new 14 company peer group. 

(cid:131)  Merit-Based Salary Increases.  In February 2016, the Compensation Committee approved merit-based salary increases for 

the named executive officers, other than the CEO. 

(cid:131)  Annual Short-Term Incentive Plan Performance Metrics.  In February 2016, the Compensation Committee introduced a 
fourth performance metric, adjusted EPS, under the 2016 Short-Term Incentive Plan (the “2016 STIP”), in addition to the 
metrics  used  under  the  prior  year’s  short-term  incentive  plan  of  revenue,  adjusted  EBITDA,  and  corporate  strategic 
performance.  

(cid:131)  Performance-Based Long-Term Incentive Awards.  In February 2016, in light of our strong shareholder support evidenced 
by the results of the say-on-pay vote at our 2015 Annual Meeting of Shareholders, the Compensation Committee continued 
to grant annual long-term incentive awards to our executive officers consisting, on a substantially equal value basis, of 50% 
non-qualified stock options and 50% restricted stock units, half of which are subject to stock price performance conditions. 

(cid:131)  Earned and Unearned Performance Awards. The Compensation Committee determined that the performance conditions 
for the long-term incentive awards granted on March 4, 2015, May 13, 2015 and March 2, 2016 had been achieved during 
2016 (within the 3-year award period), and therefore, the awards have been earned subject only to any remaining time-
based vesting and other terms applicable to the awards. In addition, the Compensation Committee determined that the 
performance conditions for the long-term incentive awards granted on November 15, 2013 had not been achieved within 
the 3-year award period and therefore, the awards were forfeited during 2016. 

53 

 
 
KEY COMPENSATION PRACTICES AND GOVERNANCE FEATURES 

Our executive compensation program reflects a number of best practices used by the Compensation Committee and the Board 
of Directors. 

What We Do 

What We Don’t Do 

No Repricing.  We have not reduced the exercise price, repriced 
or provided cash payment for underwater stock options. 

No Hedging or Pledging.  We do not permit pledging of our 
securities as collateral for a loan or entering into hedging and 
derivative transactions with respect to our securities by 
employees or directors. 

No Evergreen Equity Plans.  Our equity plan does not permit 
evergreen share authorizations or liberal share recycling. 

No Pensions or Supplemental Executive Retirement Plans.  
We only provide retirement benefits to executives that are 
generally available to all other employees. 

No Change-in-Control-Related Excise Tax Gross-ups.  We do 
not include change-in-control excise tax gross-up provisions in 
employment agreements. 

No Single Trigger Change-in-Control Compensation.  We 
provide double trigger change-in-control compensation. 

Pay-for-Performance.  Payment of a significant amount of our 
executives’ total direct compensation is contingent upon 
satisfaction of certain pre-determined financial and non-financial 
objectives.  

Annual Say-on-Pay Votes.  We have annual say-on-pay votes 
and recommend continued annual votes. 

Independent Compensation Consultant.  The Compensation 
Committee retains a compensation consultant that is 
independent from management to provide advice to the 
committee on executive and director compensation, as well as 
other compensation and benefits matters. 

Limited Use of Executive Perquisites.  We offer limited 
executive perquisites in order to attract and retain top executive 
talent and to maintain competitiveness.  

Stock Ownership Guidelines.  Our CEO is required to hold 
five times his base salary in our common stock and all other 
executive officers are required to hold two times their base 
salary in our common stock, aligning the executive officer’s 
interests with those of our shareholders and mitigating the risk 
of focusing only on short-term goals.  

Compensation Recovery (Clawback Policy).  We are 
permitted to recover from any of HMS’s current or former 
executive officers any incentive bonus and equity compensation 
gains attributable to such executive officer’s misconduct 
occurring after January 1, 2015, that causes a subsequent 
restatement of our financial statements. 

Employment Agreements.  Each of our executive officers has 
entered into an employment agreement and restrictive covenant 
agreement with HMS. 

CEO Compensation.  All of our independent directors as a 
group approve the compensation of our CEO, taking into 
account the recommendation of the Compensation Committee. 

Philosophy, Objectives and Principles of Our Executive Compensation Program   

Our mission is to make the healthcare system work better for everyone. In order to support that mission and Board-approved 
strategic objectives, while providing adequate returns to our shareholders, we must compete for, attract, develop, motivate and 
retain  top  quality  executive  talent  at  the  corporate  and  operating  business  unit  levels  during  periods  of  both  favorable  and 
unfavorable business conditions.  

54 

 
 
 
 
 
Our executive compensation program is a critical management tool in achieving these objectives. “Pay-for-performance” is the 
underlying philosophy for our executive compensation program. The program is designed and administered to:  

(cid:131) 

reward performance that drives the achievement of our short and long-term goals;  

(cid:131)  align  the  interests  of  our  senior  executives  with  the  interests  of  our  shareholders,  thus  rewarding  individual  and  team 

achievements that contribute to the attainment of our business goals;  

(cid:131) 

foster  teamwork  and  encourage  our  senior  executives  to  work  together  with  key  personnel  in  the  interest  of  company 
performance; 

(cid:131)  attract,  develop,  motivate  and  retain  high-performing  senior  executives  by  providing  a  balance  of  total  compensation 
opportunities, including salary and short and long-term incentives that are competitive with similarly situated companies 
and reflective of our performance; 

(cid:131)  maximize the financial efficiency of the overall compensation program from tax, accounting and cash flow perspectives; 

and 

(cid:131)  motivate our senior executives to pursue objectives that create long-term shareholder value and discourage behavior that 
could lead to excessive risk, by balancing our fixed and at-risk pay (both short and long-term incentives) and choosing 
multiple financial metrics for our short and long-term incentives.  

PAY-FOR-PERFORMANCE 

We design our compensation programs to make a meaningful amount of target total direct compensation (salary, plus 
target  annual  incentive  compensation,  plus  target  annual  long-term  incentive  compensation)  dependent  on  the 
achievement of performance objectives.  

To illustrate this, in the chart that follows, we compare the aggregate target total direct compensation for our CEO for the last 
three fiscal years to the aggregate compensation for the last three fiscal years that had been earned or that may be considered 
realizable (based on the methodology described below) as of December 31, 2016. The chart illustrates that our annual and long-
term incentive programs over the past three fiscal years have been designed to make a meaningful amount of our CEO’s target 
total direct compensation dependent on the achievement of performance objectives and have resulted in actual compensation 
significantly less than the target amount. 

55 

 
 
(1)  “Target Level Compensation” equals the sum of (i) annual base salary paid in each of the last three fiscal years, (ii) the 
target value of short-term cash incentive awards for each of the last three fiscal years and (iii) stock awards and option 
awards granted in each of the last three fiscal years valued at the grant date fair value, the same value at which such awards 
are  required  to  be  reflected  in  the  Summary  Compensation  Table  included  in  this  Annual  Report  on  Form  10-K,  under 
applicable SEC regulations. Target Level Compensation does not include amounts under All Other Compensation in the 
Summary Compensation Table. 

(2)  “Realizable Compensation” equals the sum of (i) annual base salary paid in each of the last three fiscal years, (ii) actual 
short-term cash incentive awards earned in each of the last three fiscal years, (iii) the value as of their vesting date of any 
portion of stock awards granted in each of the last three fiscal years that vested prior to December 31, 2016, (iv) an assumed 
realizable value for any portion of stock awards granted in each of the last three fiscal years that remained unvested on 
December 31, 2016, based on the closing market price per share of our common stock on December 30, 2016, the last 
trading day in 2016, of $18.16 per share and (v) the intrinsic value of option awards granted during fiscal 2015 and 2016 
based on the difference between the option exercise prices of $16.77 per share and $13.94 per share, respectively, and 
the closing market price per share of our common stock on December 30, 2016 of $18.16 per share. For purposes of this 
table, the intrinsic value of the option award granted during 2014 is zero because the award has an exercise price per share 
that is greater than the closing market price per share of our common stock on December 30, 2016. For purposes of this 
table, all performance-based stock awards and option awards are considered earned and all option awards (whether time-
based or performance-based) are considered fully vested. The value that may be realized by our CEO on such stock awards 
and option awards in the future, if any, will depend on the extent to which the performance-based stock awards and option 
awards are earned and vest, the extent to which time-based stock awards and option awards vest, the market price of our 
common stock on the vesting date for stock awards and the extent to which there is appreciation in the market price of our 
common stock over the respective exercise price per share of stock options at the time such options are exercised.   

56 

 
 
 
 
How We Determine Executive Compensation 

ROLE OF MANAGEMENT   

Our  CEO,  together  with  our  Chief  Financial  Officer  and  Executive  Vice  President  of  Human  Resources,  develop 
recommendations regarding the design of our executive compensation program. In addition, they are involved in setting the 
financial and strategic objectives that, subject to the approval of the Board and the Compensation Committee, are used as the 
performance measures for the short and long-term incentive plans. Both the CEO and the Chief Financial Officer provide the 
Compensation Committee with information relevant to determining the achievement of financial and non-financial performance 
objectives and related funding levels under our short-term cash incentive plan. Also, as part of its review process in determining 
executive compensation, the Compensation Committee receives from our CEO an assessment of each other executive officer’s 
performance against individual objectives and compensation recommendations for such officer, including base salary and short 
and long-term incentives. 

ROLE OF THE COMPENSATION COMMITTEE 

Our  executive  compensation  program  is  administered  by  the  Compensation  Committee,  which  is  composed  entirely  of 
independent  directors.  The  Compensation  Committee  is  responsible  for  designing  our  executive  compensation  program, 
including  each  element  of  the  program,  and  determining  and  approving  total  executive  remuneration.  Each  year,  the 
Compensation Committee reviews a competitive analysis and assessment of the compensation provided to executive officers 
and approves executive compensation based on this review, as well as an evaluation of recommendations presented by our 
CEO with respect to the other executive officers and the advice of FW Cook. Our CEO does not participate in the Compensation 
Committee’s deliberations or decisions with regard to his own compensation, and the Compensation Committee’s decisions with 
respect to our CEO’s compensation are reviewed and approved by the independent members of the Board of Directors as a 
group. 

ROLE OF THE INDEPENDENT COMPENSATION CONSULTANT  

The Compensation Committee is authorized to engage its own independent advisors to assist in carrying out its responsibilities. 
The Compensation Committee has retained FW Cook as its independent compensation consultant. Representatives of FW 
Cook regularly attend Compensation Committee meetings and communicate with the Chair of the Compensation Committee 
outside of meetings. FW Cook reports directly to the Compensation Committee and the Compensation Committee oversees the 
fees paid for its services. FW Cook provides the Compensation Committee with independent and objective guidance on a variety 
of matters related to our executive and director compensation programs and general compensation and benefits matters. In 
addition, FW Cook provides objective guidance regarding management’s executive compensation recommendations, with the 
instruction that FW Cook is to advise the Compensation Committee independent of management and to provide such advice for 
the  benefit  of  HMS  and  its  shareholders.  FW  Cook  does  not  provide  any  consulting  services  to  HMS  beyond  its  role  as  a 
consultant to the Compensation Committee. The Compensation Committee conducts an assessment of the independence of its 
compensation consultant annually, pursuant to SEC rules and, following its most recent assessment in April 2017, concluded 
that no conflict of interest exists that would prevent FW Cook from serving as an independent consultant to the Compensation 
Committee. 

During fiscal 2016, FW Cook provided the following services to the Compensation Committee: 

(cid:131) 

(cid:131) 

(cid:131) 

(cid:131) 

(cid:131) 

(cid:131) 

assisted in the design and development of all elements of the 2016 executive and director compensation program; 
consulted on the composition of the peer group and provided competitive benchmarking and market data analysis based 
on the peer group;  
evaluated management’s compensation recommendations and proposals; 
consulted on the design of the 2016 Omnibus Incentive Plan and amendments to the Annual Incentive Compensation Plan 
in light of best practices, industry trends and voting policies of proxy advisory firms; 
reviewed and provided advice on the design of the 2016 Short-Term Incentive Plan; 
reviewed agendas for the Compensation Committee meetings held in 2016; 

57 

 
 
(cid:131) 

(cid:131) 

(cid:131) 

(cid:131) 

reviewed HMS’s 2016 compensation risk assessment; 
consulted on compliance with Section 162(m) of the Code; 
provided  updates  regarding  evolving  regulatory  requirements,  emerging  trends  and  best  practices  in  executive 
compensation; and 
reviewed and provided advice on HMS’s executive compensation-related disclosures in the 2016 Proxy Statement and 
reviewed the compensation-related disclosures and proposals in the 2017 Proxy Statement.  

Competitive Pay Positioning and Peer Group Analyses 

The  Compensation  Committee  believes that  competitive  pay  positioning is a key factor in  helping to  achieve  our  executive 
compensation program objectives.  As part of our annual pay-setting process, the Compensation Committee uses benchmarking 
data to evaluate each executive officer’s target compensation levels compared to similarly situated executives at peer group 
companies.    

The Compensation Committee does not target the level of total direct compensation (or any specific element of compensation) 
for our executive officers to a specific percentile of our peer group. Instead, the Compensation Committee exercises its discretion 
in setting target compensation levels annually based on a variety of factors to achieve our compensation objectives:  

(cid:131)  each executive’s competitive pay positioning relative to similarly situated executives among our peer companies,  
(cid:131)  each executive’s scope of responsibilities, individual performance and expected contributions going forward,  
(cid:131) 
(cid:131) 
(cid:131) 
(cid:131)  prior year target and actual compensation levels. 

tenure,  
relative internal pay levels,  
recommendations by the CEO for the other executive officers, and  

Our peer group companies are selected by the Compensation Committee based on their similarity to us in size, financial profile 
and scope of operations, as well as potential to compete for executive talent. The Compensation Committee’s general practice 
is to select companies that position HMS at approximately the peer group median across these metrics. The Compensation 
Committee reviews the peer group annually with guidance from FW Cook and may make modifications from time to time to 
ensure that it continues to provide an appropriate benchmark for competitive pay analyses. 

In January 2016, the Compensation Committee, with guidance from FW Cook, reviewed and modified the peer group used to 
benchmark executive compensation for 2016. The peer group established by the Compensation Committee for 2016 consists 
of the 14 companies listed below, grouped by sub-industry (the “2016 Peer Group”). 

2016 Peer Group Companies 

Heath Care Technology 

Application Software 

Data Processing and Outsourced 
Services 

Allscripts Healthcare Solutions, Inc. 

Blackbaud, Inc. 

ExlService Holdings, Inc. 

athenahealth, Inc. 

Bottomline Technologies (de), Inc. 

MAXIMUS, Inc. 

Computer Programs & Systems, Inc. 

RealPage, Inc. 

WEX Inc. 

HealthStream, Inc. 

Medidata Solutions, Inc. 

Omnicell, Inc. 

Quality Systems, Inc. 

Tyler Technologies, Inc.  

58 

 
 
 
 
The Compensation Committee made the changes listed below to the peer group at the time of its review.   

Company 

Peers Added 

Rationale 

Blackbaud, Inc. 

(cid:131)  Comparably-sized  

Computer Programs & 
Systems, Inc. 

Healthstream, 
Inc.

(cid:131)  Application software industry 
(cid:131)  Peer of peers 
(cid:131)  Health care technology industry 

(cid:131)  Peer of peers 
(cid:131)  Health care technology industry 

(cid:131)  Peer of peer 

Peers Removed 

Company 

Rationale 

Dealertrack 
Technologies 

(cid:131)  Acquired by Cox Automotive 

MedAssets 

(cid:131)  Acquired by Pamplona Capital 

Management 

Acxiom 

(cid:131)  Not comparably-sized  

(cid:131)  Not in a sub-industry referenced 

above 

RealPage, Inc. 

(cid:131)  Comparably-sized  

Fair Isaac 

(cid:131)  Not comparably-sized 

(cid:131)  Application software industry 
(cid:131)  Peer of peers 

NeuStar 

(cid:131)  Not comparably sized 

The  chart  below  compares  our  revenue,  net  income,  EBITDA  (income  before  interest,  income  taxes,  depreciation  and 
amortization) and market capitalization to the median of those four measures for our 2016 Peer Group at the time the 2016 Peer 
Group was established in January 2016, and at the time it was subsequently reviewed in October 2016. In January 2016, our 
revenue,  net  income  and  market  capitalization  were  below  the  2016  Peer  Group  median,  and  our  EBITDA  was  above  the 
median.  Increases  in  our  stock  price  between  January  2016  and  October  2016  repositioned  HMS’s  market  capitalization 
considerably closer to the peer median and net income increased above the peer median. 

(in millions)  
Revenue(1) 
Net Income(1)(2) 
EBITDA(1) 
Market Capitalization(3) 

January 2016 Review 

October 2016 Review 

 2016 Peer 
Group 
Median  
($) 
529 
23 
68 
2,244 

HMS 
Percentile 
Rank 
(%) 
32 
34 
60 
20 

HMS 
($) 

458 
13 
85 
1,061 

 2016 Peer 
Group 
Median  
($) 

HMS 
Percentile 
Rank 
(%) 

633 
12 
78 
2,260 

30 
69 
57 
42 

HMS 
($) 
490 
29 
94 
1,872 

(1)  Based on most recently reported four quarters as of January 25, 2016 and October 31, 2016 for the January 2016 review and the 

October 2016 review, respectively. 

(2)  Before extraordinary items and discontinued operations. 
(3)  As of December 31, 2015 and September 30, 2016 for the January 2016 review and the October 2016 review, respectively. 

During the first quarter of 2016, the Compensation Committee evaluated competitive market data from our 2016 Peer Group 
with guidance from FW Cook. The analysis included benchmarking data on several factors: 

(cid:131) 

target total direct compensation (comprised of base salary, target bonus and recommended long-term incentive awards) 
for our executive officers relative to the compensation of similarly situated executives in the 2016 Peer Group based on the 
most recent proxy data,  

(cid:131)  equity usage (shares granted in equity plans as a percentage of weighted average shares outstanding), and 

59 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(cid:131)  equity allocation, in both absolute dollar value and percentage of annual equity granted, among (i) the CEO, (ii) the next 

four most highly paid executives, (iii) the remaining executives and (iv) all other employees.   

2016 Executive Compensation Elements 

The elements of our executive compensation program for 2016 are summarized in the table below. 

Element 

  Type 

Objective 

Annual Base Salary 

Fixed cash compensation for 
performing day-to-day responsibilities 

Recognizes skills, experience, knowledge and 
responsibilities 

Annual Short-Term Incentive 
Compensation 

Performance-based cash compensation 
awards based on the achievement of 
short-term financial goals and strategic 
objectives measured over a specific 
year 

Promotes and rewards short-term corporate 
performance based on achievement of both 
financial and non-financial objectives 

Annual Long-Term Incentive 
Compensation 

Restricted stock units, 50% 
performance-based 

Nonqualified stock options, 50% 
performance-based 

Limited Executive Perquisites 

Executive disability income insurance  

Executive financial consulting services 

Builds executive stock ownership, retains 
executives and aligns compensation with the 
achievement of our long-term financial goals 
of creating shareholder value and our 
strategic objectives as measured over multi-
year periods 

Maintains competitiveness in the market 
among our peer companies for both retention 
and recruitment purposes 

Other Elements of Compensation 

Broad-based benefits available to all 
employees 

Attractive benefits package attracts and 
retains talent 

Severance and change-in-control 
benefits 

Supports executive retention and encourages 
executive independence and objectivity in 
considering a potential change in control 
transaction 

Compensation Mix 

The  Compensation  Committee  does  not  have  a  formal  or  informal  policy  or  target  for  allocating  target  total  compensation 
between short-term and long-term compensation, performance and non-performance-based compensation, cash and non-cash 
compensation, or among the different forms of non-cash compensation. In allocating compensation between the different forms 
of compensation, we, with guidance from FW Cook, determine what we believe in our business judgment is the appropriate 
level with respect to each element of total direct compensation to achieve the objectives of our executive compensation program. 
The allocation of the primary elements of compensation for 2016 at target levels for both our CEO and the average of our other 
named executive officers is shown below. 

60 

 
 
 
 
 
 
 
 
 
(1)  For purposes of this illustration, we include all stock options as performance-based compensation. One half of the stock options are 
subject to additional, predetermined performance-based vesting criteria based on stock price performance. See “Grants of Plan Based 
Awards for the Year Ended December 31, 2016” for a description of the  vesting and other terms of the option awards granted on 
March 2, 2016. 

(2) 

Includes named executive officers other than the CEO. 

Annual Base Salary 

Base salary is used to recognize the experience, skills, knowledge and responsibilities of our employees, including our named 
executive officers, and to provide a competitive level of fixed compensation to balance performance-based risks. The key factors 
in determining base salary are individual and Company performance, job responsibilities, the competitive rate among our peers 
for positions of like responsibility and internal pay equity among our employees with similar responsibilities and tenure. As noted 
above, the Compensation Committee does not target the amount of base salary or other components of compensation for our 
executive officers to a specific percentile of our peer group, but rather considers the peer group analysis together with a variety 
of factors in determining compensation.  

The Compensation Committee reviews base salaries annually and, if appropriate, makes adjustments to reflect market levels 
generally  every  two  years  after  taking  into  account  individual  responsibilities,  performance  and  experience,  the 
recommendations of the CEO and the benchmarking data provided by FW Cook. The Compensation Committee also reviews 
salaries on an interim basis as it determines appropriate based on significant changes in an executive’s scope of responsibilities.  

In February 2016, the Compensation Committee approved merit-based increases in base salary for each of our named executive 
officers, other than the CEO. The table below shows the annual base salaries for 2014 through 2016 for our named executive 
officers. 

61 

 
 
 
Named Executive Officer 

Lucia 
Sherman  
Neuman 
Nustad 
Williams 

2014 Year End 
Salary 
($) 
650,000 
500,000 
475,000 
425,000 
400,000 

Increase 
(%) 
0 
0 
0 
0 
18.8 

2015 Year End 
Salary  
($) 
650,000 
500,000 
475,000 
425,000 
475,000 

Increase (1) 
(%) 
0 
3.0 
5.3 
3.0 
5.3 

2016 Salary (1) 
($) 
650,000 
515,000 
500,000 
437,750 
500,000 

(1)  Effective February 29, 2016 

Annual Short-Term Incentive Compensation 

The Compensation Committee awards annual short-term cash incentive compensation to our named executive officers that 
reflects financial and strategic achievements based on both objective and subjective criteria, as well as individual performance. 
Our annual short-term incentive compensation is at-risk compensation. The Compensation Committee believes that this element 
of  our  executive  compensation  program  promotes  our  performance-based  compensation  philosophy  by  providing  named 
executive  officers  with  direct  financial  incentives  to  achieve  specific  short-term  performance  goals  intended  to  increase 
shareholder value and rewards both overall short-term corporate  performance and individual  contributions to attaining such 
performance.  Our  annual  short-term  cash  incentive  awards  are  paid  in  a  lump  sum  during  the  first  quarter  following  the 
completion of the fiscal year.  

Each of our named executive officers was eligible to participate in the 2016 STIP. The target incentive opportunity for each of 
the named executive officers under the 2016 STIP, as approved by the Compensation Committee, is shown in the table below 
expressed as a percentage of base salary. The target incentive opportunities were determined based upon a number of factors, 
including salary levels, job responsibilities and the appropriate targeted level of short-term incentive opportunity for each named 
executive officer. 

Named Executive Officer 

Lucia 
Sherman  
Neuman 
Nustad 
Williams 

2016 PERFORMANCE GOALS 

Target Incentive Opportunity 
(as a % of base salary) 
100% 
65% 
65% 
65% 
65% 

Bonus  payouts  under  the  2016  STIP  were  subject  to  the  achievement  of  pre-determined  performance  goals  based  on  the 
following financial and non-financial measures and relative weights: 

Financial Measures 
Revenue (25%) 
Adjusted EBITDA (25%) 
Adjusted EPS (25%) 

Non-Financial Measures 
Strategic Objectives (25%) 

We chose revenue, adjusted EBITDA and adjusted EPS as financial measures under the 2016 STIP because we believe each 
is a strong indicator of our overall financial performance, a key indicator used by industry analysts to evaluate our operating 
performance  and  motivates  our  executives  to  drive  company  growth  and  profitability.  Adjusted  EPS  was  introduced  as  an 
additional financial metric for 2016 to further diversify the performance measures and further align the performance metrics with 
the interest of shareholders. Consistent with 2015, the Committee determined that payout of 50% of the bonus pool should be 

62 

 
 
 
 
 
 
 
based on performance against earnings targets (by lowering the relative weighting of the adjusted EBITDA measure compared 
to 2015 and adding adjusted EPS) in order to drive profitability and long-term shareholder value. 

We define adjusted EBITDA, which is a non-GAAP measure, as earnings before interest, income taxes, depreciation 
and amortization, stock-based compensation and non-recurring legal expense. 

We  define  adjusted  EPS,  which  is  a  non-GAAP  measure,  as  earnings  per  share  adjusted  for  stock-based 
compensation expense, non-recurring legal expense, amortization of acquisition related software and intangible 
assets and for the related taxes.  

In addition, we chose to include strategic objectives under the 2016 STIP that are designed to enhance profitability and create 
long-term shareholder value. 

Financial Objectives. Financial objectives are established based on the annual financial plan approved by the Board of Directors 
during the first quarter of the year and are intended to be challenging. For 2016, the revenue target was set higher than 2015 
performance based on expectations of increased growth in our commercial health plan market, while the adjusted EBITDA and 
adjusted EPS targets were set at levels higher than 2015 performance after normalizing for anticipated changes in Medicare 
RAC and state revenues. 

A threshold level of performance against each of the financial targets is required in order for the respective portion of the bonus 
pool to be funded. If the threshold level is met, the actual payout amount is calculated based on the funding curves below, which 
provide for funding greater than the target level only if results exceed 105% of target.  

Adjusted EBITDA (25%) & Adjusted EPS (25%) Funding Curve 

Percent of Target Achieved 
<85% 
85% 
86% - 94% 
95 - 105% 
106% - 130% 

Percent of Target Achieved 
<90% 
90% 
91% - 94% 
95 - 105% 
106% - 120% 

% Funding of Bonus Pool 
— 
50% 
Payout is straight line from 50% to 100% 
100% 
Payout is straight line from 100% to 200% 

Revenue (25%) Funding Curve 

% Funding of Bonus Pool 
— 
50% 
Payout is straight line from 50% to 100% 
100% 
Payout is straight line from 100% to 200% 

The 2016 STIP authorized the Compensation Committee, in its discretion, to include or exclude the impact of acquisitions and/or 
dispositions  of  businesses  during  the  performance  period  that  would  distort  HMS’s  2016  financial  results;  however,  the 
Compensation Committee did not make any such adjustments in 2016. 

Non-financial Objectives.  The Compensation Committee established the following strategic objectives under the 2016 STIP: 
(i) achieve  revenue  growth  by  product  and  market;  (ii)  increase  customer  loyalty  and  retention;  (iii)  achieve  certain  growth 
objectives; (iv) achieve certain margin objectives; and (v) increase employee engagement. The level of achievement of the 
strategic objectives is determined in the Compensation Committee’s sole discretion based on its review of the measured results. 

63 

 
 
 
 
 
 
RESULTS UNDER THE 2016 SHORT-TERM INCENTIVE PLAN 

For fiscal 2016, we reported the following results under the financial performance measures that are used in determining payouts 
under our 2016 STIP.  

For purposes of calculating the funding percentage under the 2016 STIP, the reported adjusted EBITDA and adjusted EPS 
results were reduced to include the impact of certain non-recurring legal fees, which resulted in lower payouts under the 2016 
STIP. In addition, based on its evaluation of performance against the 2016 strategic objectives measures shown above, the 
Compensation Committee determined that a 90% payout for the strategic objectives was appropriate based on slightly lower 
than expected results in revenue growth in certain markets and products. The table below sets forth the calculated funding level 
under the 2016 STIP.   

Performance 
Objectives 
Revenue  
Adjusted EBITDA 
Adjusted EPS 
Strategic Objectives 
Total 

Performance 
Objective 
Weighting 
25% 
25% 
25% 
25% 
100% 

Performance 
Target 
 $477.9M 
 $109.5M 
$  0.57 
 100% 

Results under 
2016 STIP 
$489.7M 
$115.9M 
$  0.74 
90.0% 

Achievement of 
Performance 
Objective 
102.5% 
105.8% 
129.8% 
90.0% 

(1)  Based on the funding curves shown above with respect to revenue, adjusted EBITDA and adjusted EPS. 

2016 STIP Funding 
Percentage(1) 
100.0% 
103.4% 
199.3% 
90.0% 
123.2% 

2016 BONUS PAYOUTS 

Bonus  payouts  for  2016  reflect  the  Company’s  strong  financial  performance  for  fiscal  2016  and  above-target 
achievement of key financial metrics under the 2016 STIP. 

Each of the named executive officers’ short-term incentive awards for 2016 were determined by applying the formula set forth 
below, which,  as provided under the 2016 STIP, includes the  Committee’s ability to use discretion to modify the calculated 
payout based on individual performance. 

Base Salary 

x 

Target Incentive 
Opportunity  

x 

2016 STIP funding percentage of 123.2% 
based on achievement of: 
• 
• 
• 
• 

25% Adjusted EBITDA Target 
25% Adjusted EPS Target 
25% Revenue Target 
25% Strategic Objectives  

Cash Incentive Award 

= 

(may be modified 
based on individual 
performance)  

64 

 
 
 
 
  
  
  
  
 
  
 
 
 
The Compensation Committee considered the CEO’s recommendations regarding individual bonus  amounts for the named 
executive officers (other than himself) based on both corporate performance (as determined by the level of achievement under 
the 2016 STIP) and the officers’ individual performance and determined to modify the awards for Mses. Neuman and Nustad 
and Messrs. Sherman and Williams based on performance within their respective business units. Mr. Lucia’s bonus amount was 
determined solely based on corporate performance under the 2016 STIP, and all of the independent members of the Board as 
a group approved and ratified the Compensation Committee’s decision with respect to the CEO’s bonus amount. The table 
below compares target bonus amounts to actual bonus amounts paid to the named executive officers under the 2016 STIP.  

Named Executive Officer 
Lucia 
Sherman 
Neuman  
Nustad  
Williams 

OTHER CONSIDERATIONS 

Actual 
Percentage of 
Target Bonus 
Paid 
(%) 
123.2 
130.0 
120.0 
120.0 
120.0 

Target Bonus 
($) 
650,000 
334,750 
325,000 
284,538 
325,000 

Actual Bonus  
($) 
800,800 
435,175 
390,000 
341,445 
390,000 

The 2016 STIP operates as a sub-plan under our Annual Incentive Compensation Plan as amended and restated (the “AIP”), 
which was adopted by the Board and approved by our shareholders in order to qualify incentive awards as performance-based 
compensation that is intended to be deductible (to the extent possible) for federal income tax purposes under the Code. Each 
of the named executive officers was a participant in the AIP for 2016 and was eligible to receive a maximum bonus award of 
$2,000,000 for the 2016 performance period, subject to the Compensation Committee’s authority to use negative discretion, if 
the predetermined objective goal for the fiscal year was met. This limit is in addition to the limit on performance-based cash 
awards under the 2016 Omnibus Plan. EBITDA was selected as the performance metric under the AIP for fiscal 2016 because 
it is one of the primary metrics used to measure our operating performance and although it is a non-GAAP financial measure, 
its components are calculated based on U.S. GAAP. EBITDA is defined as income before interest, income taxes, depreciation 
and amortization. The Compensation  Committee  establishes  an  initial performance requirement under the AIP, pursuant to 
which an executive may earn the initial right to receive the maximum bonus under the AIP. The performance requirement for 
fiscal 2016 was established at $50 million in EBITDA. The 2016 STIP then establishes a second performance requirement, 
consisting of the performance goals and objectives described above. The potentially achievable incentive compensation under 
this second performance requirement is less than or equal to the maximum possible bonus specified in the AIP which was 
approved by the shareholders. 

Annual Long-Term Incentive Compensation 

We believe that equity awards provide our named executive officers with a strong link to our long-term performance in order to 
create an ownership culture and help to align their interests with those of our shareholders. Annual long-term incentive awards 
are granted pursuant to our 2016 Omnibus Incentive Plan, which replaced and superseded the 2006 Stock Plan, upon approval 
by our shareholders on June 23, 2016. The 2016 Omnibus Plan, which is administered by the Compensation Committee, is 
intended  to  furnish  a  material  incentive  to  employees  by  making  available  to  them  the  benefits  of  a  larger  common  stock 
ownership in HMS through stock options and other awards. The Board of Directors and the Compensation Committee believe 
that these increased incentives align compensation with the achievement of our long-term financial goal of creating shareholder 
value and our strategic objectives as measured over multi-year periods, as well as assist in the retention of employees. 

TYPES OF LONG-TERM INCENTIVE AWARDS 

For 2016, the Compensation Committee granted 50% of the total annual long-term incentive award value to our named executive 
officers in nonqualified stock options (50% of which are subject to stock price performance conditions) and 50% in restricted 
stock units (50% of which are subject to stock price performance conditions), pursuant to the 2006 Stock Plan. We believe that 

65 

 
 
 
 
 
 
 
 
 
 
the mix of performance-based and non-performance-based stock options and restricted stock units is appropriate because it 
represents  a  balanced  approach  that  reinforces  our  emphasis  on  pay-for-performance  while  retaining,  incentivizing  and 
compensating named executive officers for achievement of long-term goals intended to increase shareholder value. 

Time-Based Stock Options.  We believe stock options strongly support our objective of ensuring that pay is aligned with changes 
in shareholder value. We set the exercise price of all stock options equal to or above the closing price of our common stock on 
the NASDAQ Global Select Market on the day of the grant. Accordingly, a stock option is intended to provide a return to the 
executive only if the market price of our common stock appreciates from the exercise price of the stock option and the executive 
remains employed during the vesting period. To foster retention and long-term performance, time-based stock options vest in 
one-third increments on the first, second and third anniversaries of the date of grant. 

Time-Based Restricted Stock Units.  We believe restricted stock unit grants support the goal of retaining our named executive 
officers and further align the interests of our executives with shareholders by increasing their stock ownership. Because these 
restricted stock units vest in installments over time, these awards will provide a return to the executive only if the executive 
remains employed during the vesting period. The value of restricted stock unit awards increases or decreases as the market 
price of our common stock increases or decreases, further supporting our objective of ensuring that pay is aligned with changes 
in shareholder value. In addition, restricted  stock  units generally are  perceived as  more  valuable than stock options during 
periods of stock price volatility. Time-based restricted stock units vest in one-third increments on the first, second and third 
anniversaries of the date of grant. 

Performance-Based Awards. To drive long-term performance and shareholder value, we establish performance conditions with 
respect to 50% of the stock option awards and 50% of the restricted stock unit awards granted to the named executive officers. 
Performance-based awards are earned only to the extent pre-established performance goals are met, and, if earned, are subject 
to the time-based vesting requirements described above. For awards granted in 2016, both the performance-based stock options 
and performance-based restricted stock units will be earned only if our average closing price per share for the trading days 
during any 30-day calendar period preceding the first, second and/or third anniversaries of the date of grant is at least 25% 
higher than the closing price per share on the date of grant. If the performance condition is met prior to the first anniversary of 
the grant date, one-third of the performance-based stock options and restricted stock units will vest in three equal installments 
on the first, second and third anniversaries of the grant date; if the performance condition is met after the first anniversary but 
prior to the second anniversary of the grant date, two-thirds of the performance-based stock options and restricted stock units 
will vest on the second anniversary of the grant date and one-third will vest on the third anniversary of the grant date; if the 
performance condition is met after the second anniversary but  prior to the third anniversary of the grant date, 100% of the 
performance-based stock options and restricted stock units will vest on the third anniversary of the grant date. If the performance 
condition is not achieved before the third anniversary of the grant date, the performance-based stock options and restricted 
stock units will be forfeited. The named executive officer must remain employed by the Company as of each vesting date. 

The table below includes certain information regarding performance-based awards previously granted to our named executive 
officers that, during 2016, were either (i) earned at the target level, following the Compensation Committee’s certification of the 
achievement of the respective performance goals (and are subject to time-based vesting according to the previously-approved 
award terms) or (ii) forfeited, following the Compensation Committee’s determination that the performance goal had not been 
achieved during the 3-year award period. 

66 

 
 
Name 
Lucia 

Sherman 

Neuman 

Nustad 

Williams 

Award Type 
Stock Options 
Stock Options 
Restricted Stock Units 
Stock Options 
Restricted Stock Units 
Stock Options 
Restricted Stock Units 
Stock Options 
Restricted Stock Units 
Stock Options 
Restricted Stock Units 
Stock Options 
Stock Options 
Restricted Stock Units 
Stock Options 
Restricted Stock Units 
Stock Options 
Restricted Stock Units 
Stock Options 
Stock Options 
Restricted Stock Units 
Stock Options 
Restricted Stock Units 
Stock Options 
Restricted Stock Units 
Stock Options 
Restricted Stock Units 
Stock Options 
Restricted Stock Units 

Performance-
Based Awards 
Earned in 2016
(#) 

— 
96,488 
33,915 
104,166 
40,800 
59,377 
20,871 
21,193 
7,512 
51,282 
20,086 
— 
50,895 
17,889 
21,193 
7,512 
45,787 
17,934 
— 
42,412 
14,908 
36,859 
14,437 
50,895 
17,889 
21,193 
7,512 
45,787 
17,934 

Performance-
Based Awards 
Forfeited in 
2016 
(#) 
86,083 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
32,281 
— 
— 
— 
— 
— 
— 
28,694 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 

Exercise Price 
of Options 
($/Sh) 
21.36 
16.77 
— 
13.94 
— 
16.77 
— 
16.64 
— 
13.94 
— 
21.36 
16.77 
— 
16.64 
— 
13.94 
— 
21.36 
16.77 
— 
13.94 
— 
16.77 
— 
16.64 
— 
13.94 
— 

Grant Date 
Fair Value of 
Performance-
Based Awards 
($) 
599,387 
568,749 
568,755 
568,746 
568,752 
349,998 
350,007 
125,001 
125,000 
280,000 
279,999 
224,769 
300,001 
299,999 
125,001 
125,000 
249,997 
250,000 
199,793 
249,998 
250,007 
201,250 
201,252 
300,001 
299,999 
125,001 
125,000 
249,997 
250,000 

Grant Date 
11/15/2013 
3/4/2015 
3/4/2015 
3/2/2016 
3/2/2016 
3/4/2015 
3/4/2015 
5/13/2015 
5/13/2015 
3/2/2016 
3/2/2016 
11/15/2013 
3/4/2015 
3/4/2015 
5/13/2015 
5/13/2015 
3/2/2016 
3/2/2016 
11/15/2013 
3/4/2015 
3/4/2015 
3/2/2016 
3/2/2016 
3/4/2015 
3/4/2015 
5/13/2015 
5/13/2015 
3/2/2016 
3/2/2016 

2016 ANNUAL LONG-TERM INCENTIVE COMPENSATION 

The 2016 annual long-term incentive awards for the named executive officers were determined based upon the Compensation 
Committee’s subjective evaluation of the factors set forth below and guidance from FW Cook:  

(cid:131) 
(cid:131) 
(cid:131) 
(cid:131) 

competitive positioning among our peer group companies; 
corporate performance; 
relative shareholder return (for CEO’s evaluation); 
recommendations of the CEO, based on individual performance, expected contributions going forward and appropriateness 
of the grant depending upon the level of responsibility (for executives other than the CEO); 

comparative share ownership and outstanding equity awards of HMS executives; 

(cid:131)  perceived retention value of the award; 
(cid:131) 
(cid:131)  awards granted to each executive in prior years; and 
(cid:131)  potential wealth creation. 

No mathematical weighting was applied to any individual factor. All of the independent directors as a group approved and ratified 
the 2016 annual long-term incentive award for the CEO. 

67 

 
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
The following long-term incentive awards were granted to our named executive officers, effective March 2, 2016: 

Named Executive Officer 
Lucia 
Sherman 
Neuman 
Nustad 
Williams 

Value of Options 
Granted 
($) 

1,137,500  
560,000  
500,000  
402,500  
500,000  

Number of 
Options 
Granted (1)(2) 
(#) 
208,333  
102,564  
91,575  
73,718  
91,575  

Value of 
Restricted 
Stock Units 
Granted 
($) 

1,137,500  
560,000  
500,000  
402,500  
500,000  

Number of 
Restricted Stock 
Units 
Granted(1)(2) 
(#) 
81,600  
40,172  
35,868  
28,874  
35,868  

(1)  See “Grants of Plan Based Awards For the Year Ended December 31, 2016” for a description of the vesting and other terms of the 

option and restricted stock unit awards. 

(2)  The options have an exercise price of $13.94 per share. 

Limited Executive Perquisites 

In order to enhance our ability to recruit and retain highly qualified executive talent, we offer Guaranteed Standard Issue, or 
individual  disability  income  insurance,  to  employees  earning  more  than  $300,000  in  annualized  base  salary,  and  financial 
counseling services to the CEO and any officers who report directly to the CEO. In addition, beginning in 2017, we also offer 
preventative health program benefits to our CEO and executives who report directly to the CEO. The Compensation Committee 
believes these benefits are reasonable and comparable to benefits offered by companies of a similar size to ours and better 
enable us to maintain competitiveness by providing high-performing executives with benefits that will facilitate strong, focused 
performance, while optimizing physical health. The cost of these perquisites constitutes a small percentage of each executive’s 
total compensation. Each of the named executive officers is eligible to receive these benefits. Mr. Williams opted not to receive 
financial counseling services during 2016, as reflected in the Summary Compensation Table.  

Other Elements of Compensation 

BENEFITS AND OTHER COMPENSATION  

We maintain broad-based benefits that are provided to all employees, including health and dental insurance, life and disability 
insurance and a 401(k) plan. Our named executive officers are eligible to participate in all of our employee benefit plans, in each 
case on the same basis as other employees.    

SEVERANCE AND CHANGE-IN-CONTROL BENEFITS   

To  enable  us  to  offer  competitive  total  compensation  packages  to  our  senior  executives,  as  well  as  to  ensure  the  ongoing 
retention of these individuals when considering transactions that may create uncertainty as to their future employment with us, 
in 2011, the Compensation Committee approved standardizing the terms of employment of our senior executives, which included 
providing consistent separation and change-in-control protection.  

Based on information provided by FW Cook, the Compensation Committee believes that the protection afforded by the revised 
terms of employment described above provides a level of benefits that are estimated to be within a reasonable range based on 
competitive practices with respect to comparable positions. We believe that the benefits provided under these agreements are 
consistent with our objective of attracting and retaining highly qualified executives and provide reasonable assurance so that 
our senior executives are not distracted from their duties during the uncertainty that may accompany a possible change in control 
and as well as encourage executive independence and objectivity in considering any such transaction. The agreements and 
equity plans provide a "double trigger" for the payment of benefits upon a change of control, so that vesting occurs if a qualifying 
termination event occurs in connection with the change-in-control. The Compensation Committee believes that a “double trigger” 
is  more  appropriate  than  a  “single  trigger”  because  a  double  trigger  prevents  the  unnecessary  payment  of  benefits  to  an 

68 

 
 
 
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
executive officer in the event that the change in control does not result in a qualifying termination event with respect to the 
executive's employment. 

We have provided detailed information about Mr. Lucia’s employment agreement and our agreements with the other named 
executive  officers  and  the  benefits  provided  to  Mr.  Lucia  and  the  other  named  executive  officers  under  their  respective 
agreements,  along  with  estimates  of  the  value  of  such  benefits  under  various  circumstances,  under  the  heading  “Potential 
Payments Upon Termination of Employment or Change in Control” below. 

EQUITY AWARD GRANT PRACTICES 

Annual  equity  awards  to  eligible  employees,  including  the  named  executive  officers,  are  considered  by  the  Compensation 
Committee at its regularly scheduled meeting held in the first quarter of each year. At this meeting, the Compensation Committee 
meets with management and FW Cook to discuss and consider annual long-term incentive awards and to approve individual 
award amounts and terms for the executive officers and other employees subject to Section 16 of the Exchange Act. The grant 
date for the 2016 annual equity awards was established as the second business day after the date that HMS filed its annual 
report on Form 10-K with the SEC. 

The Compensation Committee also approves off-cycle initial equity grants to attract and retain key new hires. Generally, the 
grant value and equity mix is based on management’s negotiations with new hire candidates. If the Company is in a blackout 
period when an individual is hired, then the grant date is established as the third trading day following the Company’s public 
announcement of material non-public information. If the Company is not in a blackout period when an individual is hired, then 
the grant date is established on the date of the new hire’s commencement of employment.  Equity grants to new hires are 
subject to service-based vesting over four years. The Compensation Committee has delegated authority to the CEO to grant 
new hire awards, subject to certain limitations, on terms pre-established by the Compensation Committee to employees who 
are not subject to Section 16 of the Exchange Act. Grants approved by the CEO pursuant to this delegation are reviewed at the 
Compensation Committee’s next regularly scheduled meeting. 

The grant date for other off-cycle equity grants that may be approved by the Compensation Committee from time to time is 
established as the second business day after the date that HMS files its next annual or quarterly report with the SEC. 

STOCK OWNERSHIP GUIDELINES FOR EXECUTIVE OFFICERS  

The Board of Directors has established significant stock ownership guidelines for our executive officers to encourage them to 
own and hold a meaningful equity stake in HMS in order to further align their interests and actions with the interests of HMS and 
its shareholders. The guidelines for executive officers are based on a multiple of the executive’s base salary. 

Title  

CEO  
Other Executive Officers 

Value of Shares Required to be Owned 

5 X Annual Base Salary 
2 X Annual Base Salary 

For purposes of satisfying these guidelines, an executive officer’s shares owned outright, directly or indirectly, and restricted 
stock  and  restricted  stock  units,  whether  or  not  vested,  are  counted  in  determining  the  executive’s  stock  ownership.  Each 
executive is required to meet his or her respective ownership guideline within five years after election (or promotion to a covered 
position), or in the case of executives in office at the time the guidelines were adopted, within five years of the date of adoption. 
To mitigate the impact of stock price fluctuation, the number of shares required to be held by each executive to satisfy the 
guidelines remains fixed through December 1, 2019. The Compensation Committee monitors compliance with these guidelines 
on an annual basis. 

69 

 
 
 
 
 
 
The following graph summarizes the stock ownership of each of our named executive officers as of December 1, 2016, as a 
multiple of base salary in effect as of December 1, 2016, pursuant to our Stock Ownership Guidelines.  

(1)  Rounded down to the nearest multiple    

CLAWBACK POLICY  

The Board of Directors has adopted a clawback policy that covers each of our current and former executive officers and applies 
to  all  forms  of  executive  incentive  compensation.  Our  clawback  policy  provides  that  the  Board  of  Directors  (or  a  Board 
committee) is authorized to recover from any current or former executive officer any bonus, incentive compensation or equity-
based compensation gains resulting from certain misconduct occurring after January 1, 2015 that causes a restatement of our 
financial statements. The Board is required to review all circumstances and actions causing such restatement and to take action 
as it deems appropriate. We are monitoring this policy to ensure that it is consistent with applicable laws, and to the extent that 
the SEC adopts rules for clawback policies, we will revise our policy to reflect any necessary changes.   

PROHIBITION ON HEDGING AND PLEDGING 

Our Insider Trading Policy prohibits our employees and directors from, among many other actions, purchasing our securities on 
margin, borrowing against our securities held in a margin account, pledging our securities as collateral for a loan and entering 
into hedging and derivative transactions with respect to our securities.  

TAX CONSIDERATIONS  

Section 162(m) of the Code prohibits us from deducting from taxable income any compensation in excess of $1 million paid to 
our CEO and the three other most highly compensated named executive officers employed at the end of the year (other than 
our Chief Financial Officer), except to the extent that such compensation is paid pursuant to a shareholder approved plan upon 
the attainment of specified performance objectives. The Compensation Committee believes that tax deductibility is an important 
factor,  but  not  the  sole  factor,  to  be  considered  in  setting  executive  compensation  policy.  Accordingly,  the  Compensation 
Committee periodically reviews the potential consequences of Section 162(m) of the Code and generally intends to take such 
reasonable  steps  as  are  required  to  avoid  the  loss  of  a  tax  deduction  due  to  Section  162(m)  of  the  Code.  However,  the 
Compensation Committee may, in its judgment, authorize compensation payments or arrangements that do not comply with the 
exemptions in Section 162(m) of the Code when it believes that such payments are appropriate to attract and retain executive 
talent.  In addition, because of the uncertainties associated with the application and interpretation of Section 162(m) of the Code 

70 

 
 
 
and the regulations issued thereunder, there can be no assurance that compensation intended to satisfy the requirements for 
deductibility under Section  162(m)  of the  Code will  in fact  be  deductible.  We obtained  shareholder  approval of the  AIP, as 
amended and restated, and the 2016 Omnibus Plan in 2016 in order to qualify awards under such plans, to the extent structured 
to comply with Section 162(m) of the Code, as performance-based compensation that is tax deductible under Section 162(m) 
of the Code.  

EARLY 2017 COMPENSATION ACTIONS 

The following is a brief summary of certain changes to the compensation of the named executive officers for fiscal 2017, which 
is intended to provide additional information to shareholders in their review of our compensation program for fiscal 2016. A more 
detailed description of compensation for fiscal 2017 will be included in the proxy statement for the 2018 Annual Meeting of 
Shareholders. 

2017 Annual Base Salary 

In February 2017, the Compensation Committee increased Mr. Lucia’s annual base salary to $700,000, effective February 27, 
2017, following its annual review of executive compensation. The Compensation Committee did not increase the annual base 
salary of any other named executive officer for 2017. 

2017 Short-Term Incentive Plan Design 

In  February  2017,  the  Compensation  Committee  established  the  2017  Short-Term  Incentive  Plan  (“2017  STIP”)  for  eligible 
employees, including our named executive officers. The 2017 STIP is substantially similar to the 2016 STIP with respect to the 
performance  criteria  and  funding  curves,  and  provides  additional  items  for  which  the  Compensation  Committee  may  make 
adjustments in determining the level of achievement of the financial objectives. To ensure a minimum amount of earnings is 
achieved before bonuses are paid and to further align the plan design with shareholder interests, the Committee determined 
that if either the adjusted EBITDA or adjusted EPS results for fiscal 2017 do not meet the minimum threshold for funding under 
the 2017 STIP, the Committee may use negative discretion to reduce the entire bonus plan funding from the calculated amount. 
For a discussion of the performance goals under the 2016 STIP, see “2016 Performance Goals” earlier in this CD&A. Payouts 
under the 2017 STIP generally are capped at 200% of target and will be determined in early 2018.   

2017 Long-Term Incentive Awards 

In April 2017, the Compensation Committee approved the grant of annual long-term incentive awards to the named executive 
officers in the form of non-qualified stock options and restricted stock units, on a substantially equal value basis, pursuant to the 
2016 Omnibus Plan. Due to the delay in filing the Company’s annual report on Form 10-K for the year-ended December 31, 
2016 with the SEC, the Committee determined to make the awards effective on the third business day following the filing of our 
quarterly report on Form 10-Q for the period ended March 31, 2017, with the SEC. One-half of the stock options and one-half 
of the restricted stock units are subject to stock price performance conditions. 

Named Executive Officer 
Lucia 
Sherman 
Neuman 
Nustad 
Williams 

Grant Date  
Fair Value of 
Options Granted (1) 
($) 
1,500,000
850,000
600,000
350,000
600,000

Grant Date  
Fair Value of  
RSUs Granted (1) 
($) 
1,500,000
850,000
600,000
350,000
600,000

(1)  The non-qualified stock options and restricted stock units vest as follows: 50% vest in three equal installments on the first, second and 
third anniversaries of the grant date, and the remaining 50% are earned upon the Company’s achievement of the following performance 
condition and vest as set forth below: the Company’s average closing price per share must be at least 25% higher than the closing price 
on the grant date for a period of 30 consecutive trading days preceding the first, second or third anniversaries of the grant date.  If the 

71 

 
 
performance condition is met prior to the first anniversary of the grant date, one-third of the performance-based stock options  and 
restricted stock units will vest in three equal installments on the first, second and third anniversaries of the grant date; if the performance 
condition is met after the first anniversary but prior to the second anniversary of the grant date, two-thirds of the performance-based 
stock  options  and  restricted  stock  units  will  vest  on  the  second  anniversary  of  the  grant  date  and  one-third  will  vest  on  the  third 
anniversary of the grant date; if the performance condition is met after the second anniversary but prior to the third anniversary of the 
grant date, 100% of the performance-based stock options and restricted stock units will vest on the third anniversary of the grant date. 
If the performance condition is not achieved before the third anniversary of the grant date, the performance-based stock options and 
restricted stock units will be forfeited. The named executive officer must remain employed by the Company as of each vesting date. 

NON-GAAP FINANCIAL MEASURES 

The  Company  believes  that  the  non-GAAP  financial  measures  presented  in  this  CD&A  provide  useful  information  to  the 
Company's management, investors, and other interested parties about the Company's operating performance because they 
allow them to understand and compare the Company's operating results during the current periods to the prior year periods in 
a more consistent manner. The non-GAAP measures presented in this CD&A may not be comparable to similarly titled measures 
used by other companies. These non-GAAP financial measures are used in addition to and in conjunction with results presented 
in accordance with GAAP and reflect an additional way of viewing aspects of the Company's operations that, when viewed with 
GAAP results and the accompanying reconciliations to corresponding GAAP financial measures, provides a more complete 
understanding of the results of operations and trends affecting the Company's business. These non-GAAP financial measures 
should be considered as a supplement to, and not as a substitute for, or superior to financial measures calculated in accordance 
with GAAP. 

Reconciliation of Net Income to EBITDA and Adjusted EBITDA 
(in thousands) 

Net income  
Net interest expense 
Income taxes 
Depreciation and amortization, net of deferred financing costs, included in net interest expense 
Earnings before interest, taxes, depreciation and amortization  (EBITDA) 
Stock based compensation expense 
Non-recurring legal fees (1) 
Adjusted EBITDA 

FY 2016 
 $  37,636 
8,198 
11,835 
44,930 
$102,599 
13,277 
1,563 
 $117,439 

FY 2015 
 $  24,527 
7,763 
15,282 
50,598 
$  98,170 
14,297 
- 
$112,467 

(1) 

In periods prior to 2016, legal fees related to disputes involving PCG were not included in adjusted earnings because they were not 
considered non-recurring at the time. For the twelve months ended December 31, 2015, related legal fees were $5.5 million. 

72 

 
 
 
 
 
  
  
  
  
  
  
  
  
  
  
Reconciliation of Net Income to GAAP EPS and Adjusted EPS 
(in thousands, except per share amounts) 

Net Income 
Stock-based compensation expense 
Non-recurring legal fees (1) 
Amortization of acquisition related software and intangible assets 

Income tax related to adjustments  

     Sub-total 

Weighted average common shares, diluted 

Diluted GAAP EPS 
Diluted adjusted EPS 

FY 2016 
 $  37,636 
13,277 
1,563 
28,030 
 (15,536) 

FY 2015 
 $  24,527 
14,297 
- 
28,148 
(16,295) 

$  64,970 

 $  50,677 

86,987 

88,361 

0.43 
0.75 

 $      0.28 
 $      0.57 

(1)  Related legal fees were not considered non-recurring in 2015. For the twelve months ended December 31, 2015, related legal fees 
were approximately $5.5 million and income taxes on related legal fees were approximately $2.1 million or the equivalent of $0.04 per 
diluted Adjusted EPS. 

COMPENSATION COMMITTEE REPORT 

The Compensation Committee of the Board of Directors of HMS Holdings Corp. has reviewed and discussed the Compensation 
Discussion and Analysis required by Item 402(b) of Regulation S-K with management. Based on this review and discussion, the 
Compensation Committee recommended to the Board of Directors that the Compensation Discussion and Analysis be included 
in this Annual Report on Form 10-K. 

By the Compensation Committee of the Board of Directors of HMS Holdings Corp. 

Richard H. Stowe, Chair 
Craig R. Callen 
Cora M. Tellez 

The information contained in the Compensation Committee Report shall not be deemed to be “soliciting material” or to be “filed” 
with the Securities and Exchange Commission, nor shall such information be incorporated by reference into any future filing 
under the Securities Act of 1933, as amended, or the Securities Exchange Act of 1934, as amended, except to the extent that 
we specifically incorporate it by reference in such filing. 

73 

 
 
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
 
SUMMARY COMPENSATION TABLE 

The following table sets forth the cash and non-cash compensation awarded to or earned by our named executive officers for 
the fiscal years ended December 31, 2016, 2015 and 2014. 

Name and Principal Position 

William C. Lucia 

Chairman, President 

and CEO 

Jeffrey S. Sherman 

EVP, Chief Financial  

Officer and Treasurer 

Semone Neuman 

EVP, Operations and 
     Information Technology  

Cynthia Nustad 
EVP, Chief  

Strategy Officer 

Douglas M. Williams 
President, Markets 

   and Product 

Year 
2016 
2015 
2014 

2016 
2015 
2014 

2016 
2015 
2014 

2016 
2015 
2014 

2016 
2015 
2014 

Salary (1) 
($) 
650,000
650,000
650,000

512,115
500,000
136,538(7)

495,192
475,000
470,192

435,298
425,000
421,731

495,192
469,231
396,923

Bonus (2) 
($) 

—
—
—

—
—
355,000

—
—
—

—
—
—

—
—
50,000

Stock 
Awards(3)
($) 
1,137,504
1,137,493
1,412,490

Option 
Awards(4) 
($) 
1,137,498
1,137,498
737,497

559,998
949,997
337,493

500,000
849,998
787,480

402,504
499,997
649,996

500,000
849,998
499,980

559,999
1,933,332
1,087,493

500,000
1,833,332
287,494

402,500
1,237,501
249,994

500,000
1,833,332
274,994

Non-
Equity 
Incentive 
Plan 
Compen-
sation(5) 
($) 
800,800 
606,385 
468,000 

435,175 
303,193 
— 

390,000 
288,033 
265,000 

341,445 
257,714 
200,000 

390,000 
288,033 
230,000 

All Other 
Compen-
sation(6) 
($) 
33,421
31,491
10,400

Total 
Compen-
sation 
($) 
3,759,223
3,562,867
3,278,387

28,391
28,194
—

28,773
29,893
13,677

27,826
29,387
10,400

13,595
12,646
8,885

2,095,678
3,714,716
1,916,524

1,913,965
3,476,256
1,823,843

1,609,573
2,449,599
1,532,121

1,898,787
3,453,240
1,460,782

(1)  The amounts in this column consist of base salary earned for the fiscal year. 

(2)  The amounts in this column consist of (i) with respect to Mr. Sherman, a sign-on bonus of $200,000 paid in 2014 and a bonus payment 
of $155,000 ($150,000 of which was guaranteed) earned for 2014 and paid in 2015 and (ii) with respect to Mr. Williams, a sign-on bonus 
of $50,000 paid in 2014, pursuant to the terms of their respective employment agreements. 

(3)  The amounts in this column represent the aggregate grant date fair value of the restricted stock unit awards computed in accordance 
with FASB guidance on stock-based compensation. The grant date fair value of restricted stock units is determined based on the number 
of units awarded and the fair value of our common stock on the grant date, which is the closing sales price per share of our common 
stock reported on the NASDAQ Global Select Market on that date. 

(4)  The amounts in this column represent the aggregate grant date fair value of the stock option awards computed in accordance with 
FASB guidance on stock-based compensation. The relevant assumptions made in the valuations for the 2016, 2015 and 2014 stock 
option awards may be found in (i) Note 1 of the Notes to the Consolidated Financial Statements in this Annual Report on Form 10-K for 
the fiscal year ended December 31, 2016, (ii) Note 10 of the Notes to the Consolidated Financial Statements in our Annual Report on 
Form 10-K for the fiscal year ended December 31, 2015 and (iii) Note 11 of the Notes to the Consolidated Financial Statements in our 
Annual Report on Form 10-K for the fiscal year ended December 31, 2014, respectively. The grant date fair value of stock options is 
determined based on the number of options awarded and the fair value of the stock option on the grant date based upon the Black 
Scholes pricing model. 

(5)  The amounts in this column consist of amounts earned pursuant to the short-term (cash) incentive plan for the fiscal year reported, 

which are paid in the following fiscal year. 

(6)  The table below shows the components of “All Other Compensation” for the named executive officers for 2016. 

(7)  The amount reported consists of base salary earned by Mr. Sherman, prorated from his date of employment on September 8, 2014. 

74 

 
 
 
  
  
  
  
 
 
 
 
  
  
  
  
 
 
 
 
 
 
 
 
 
 
FISCAL 2016 ALL OTHER COMPENSATION TABLE 

401(k) Savings 
Plan Employer 
Matching 
Contributions(1) 
($) 
10,600 
10,600 
10,600 
10,600 
10,600 

Executive 
Disability 
Insurance(2) 
($) 
3,003 
2,791 
2,849 
2,226 
2,995 

Financial 
Counseling(3)
($) 
15,000 
15,000 
15,000 
15,000 
— 

Name 
Lucia 
Sherman 
Neuman 
Nustad 
Williams 

Other(4) 
($) 
3,356 
— 
316 
— 
— 

Tax Gross-ups(5) 
($) 
1,462 
— 
8 
— 
— 

Total All Other  
Compensation 
($) 
33,421 
28,391 
28,773 
27,826 
13,595 

(1)  These amounts represent Company matching contributions to our named executive officers in the Company’s 401(k) savings plan. 

(2)  These  amounts  represent  the  premiums  paid  by  the  Company  on  behalf  of  our  named  executive  officers  for  executive  disability 

insurance. 

(3)  These amounts represent the amounts paid on behalf of our named executive officers for financial counseling services. 

(4)  These amounts represent the cost of Company gifts given to the named executive officer in celebration of certain events. 

(5)  These amounts represent the amounts paid to the named executive officer for taxes incurred on Company gifts. 

GRANTS OF PLAN-BASED AWARDS FOR THE YEAR ENDED DECEMBER 31, 2016 

The following table provides information concerning each grant of an award made to our named executive officers in fiscal 2016 
under our AIP, 2016 STIP and 2006 Stock Plan. 

Compensa-
tion 
Committee 
Approval 
Date 

— 
2/18/2016 
2/18/2016 

— 
2/18/2016 
2/18/2016 

— 
2/18/2016 
2/18/2016 

— 
2/18/2016 
2/18/2016 

— 
2/18/2016 
2/18/2016 

Grant 
Date 

— 
3/2/2016 
3/2/2016 

— 
3/2/2016 
3/2/2016 

— 
3/2/2016 
3/2/2016 

— 
3/2/2016 
3/2/2016 

— 
3/2/2016 
3/2/2016 

Name 
Lucia 

Sherman 

Neuman 

Nustad 

Williams 

Award Type 
AIP/2016 STIP 
Stock Options (7) 
RSUs (7) 

AIP/2016 STIP 
Stock Options (7) 
RSUs (7) 

AIP/2016 STIP 
Stock Options (7) 
RSUs (7) 

AIP/2016 STIP 
Stock Options (7) 
RSUs (7) 

AIP/2016 STIP 
Stock Options (7) 
RSUs (7) 

All Other 
Stock 
Awards: 
Number 
of 
Shares 
of Stock 
or 
Units(3) 
(#) 

— 
— 
40,800 

— 
— 
20,086 

— 
— 
17,934 

— 
— 
14,437 

— 
— 
17,934 

All Other 
Option 
Awards: 
Number of 
Securities 
Underlying 
Options(4) 
(#) 

— 
104,167 
— 

— 
51,282 
— 

— 
45,788 
— 

— 
36,859 
— 

— 
45,788 
— 

Grant 
Date Fair 
Value of 
Stock and 
Option 
Awards(6) 
($) 

— 
1,137,498 
1,137,504 

— 
559,999 
559,998 

— 
500,000 
500,000 

— 
402,500 
402,504 

— 
500,000 
500,000 

Exercise 
or Base 
Price of 
Options(5) 
($/Sh) 

— 
13.94 
— 

— 
13.94 
— 

— 
13.94 
— 

— 
13.94 
— 

— 
13.94 
— 

Estimated 
Future 
Payouts 
Under 
Equity 
Incentive 
Plan 
Awards (2) 

Estimated Possible 
Payouts Under Non-
Equity Incentive Plan 
Awards(1) 

Target 
($) 
650,000 
— 
— 

334,750 
— 
— 

325,000 
— 
— 

284,538 
— 
— 

325,000 
— 
— 

Maximum
($) 
2,000,000 
— 
— 

Target 
(#) 

— 
104,166 
40,800 

— 
51,282 
20,086 

— 
45,787 
17,934 

— 
36,859 
14,437 

— 
45,787 
17,934 

2,000,000 
— 
— 

2,000,000 
— 
— 

2,000,000 
— 
— 

2,000,000 
— 
— 

75 

 
 
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
 
 
 
 
 
 
 
 
 
(1)  Amounts represent the target and maximum short-term (cash) incentive compensation payouts that could be earned by the named 
executive officers for 2016. The target amount shown is 100% of the individual’s target annual award opportunity and assumes that the 
named executive officer achieves all related pre-determined financial and non-financial objectives. The maximum amount shown is the 
shareholder-approved maximum payout under the AIP. There are no threshold amounts under the 2016 STIP or the AIP. The actual 
short-term (cash) incentive compensation paid for 2016 is shown in the Summary Compensation Table in the “Non-Equity Incentive 
Plan  Compensation”  column.  The  AIP  and  our  2016  STIP  are  described  in  the  Compensation  Discussion  and  Analysis,  under  the 
heading “Annual Short-Term Incentive Compensation.” For 2016, Mr. Lucia’s target award opportunity was 100% of his base salary. 
The target award opportunity for Messrs. Sherman and Williams and Mses. Neuman and Nustad was 65% of his/her base salary.  

(2)  Amounts represent the portion of the award made to each named executive officer in 2016 that is dependent on certain pre-defined 
performance conditions and continued service for both non-qualified stock options and restricted stock units. These grants are discussed 
in the Compensation Discussion and Analysis under the heading “Annual Long-Term Incentive Compensation.” 

(3)  Amounts represent the portion of the restricted stock unit award made to each named executive officer in 2016 that is conditioned on 
continued service. These restricted stock unit awards are discussed in the Compensation Discussion and Analysis under the heading 
“Annual Long-Term Incentive Compensation.”  

(4)  Amounts represent the portion of the non-qualified stock option award made to the named executive officers in 2016 that is conditioned 
on  continued  service.  These  stock  option  awards  are  discussed  in  the  Compensation  Discussion  and  Analysis  under  the  heading 
“Annual Long-Term Incentive Compensation.” 

(5)  Represents the closing price of our common stock on the date of the grant. 

(6)  Amounts in this column represent the grant date fair value of each stock option grant and each restricted stock unit grant computed in 
accordance with FASB guidance on stock-based compensation, and exclude the impact of estimated forfeitures related to service-
based vesting conditions. The relevant assumptions made in the valuations may be found in Note 1 of the Notes to the Consolidated 
Financial Statements in this Annual Report on Form 10-K for the fiscal year ended December 31, 2016. 

(7)  The non-qualified stock options and restricted stock units vest as follows: 50% vests in three equal installments on the first, second and 
third anniversaries of the grant date, and the remaining 50% vests upon the Company’s achievement of the following performance 
condition: the Company’s average closing price per share must be at least 25% higher than the closing price on the grant date for a 
period of 30 consecutive trading days preceding the first, second or third anniversaries of the grant date.  If the performance condition 
is met prior to the first anniversary of the grant date, one-third of the performance-based stock options and restricted stock units will 
vest in three equal installments on the first, second and third anniversaries of the grant date; if the performance condition is met after 
the  first  anniversary  but  prior  to  the  second  anniversary  of  the  grant  date,  two-thirds  of  the  performance-based  stock  options  and 
restricted stock units will vest on the second anniversary of the grant date and one-third will vest on the third anniversary of the grant 
date; if the performance condition is met after the second anniversary but prior to the third anniversary of the grant date, 100% of the 
performance-based  stock  options  and  restricted  stock  units  will  vest  on  the  third  anniversary  of  the  grant  date.  If  the  performance 
condition is not achieved before the third anniversary of the grant date, the performance-based stock options and restricted stock units 
will be forfeited. The named executive officer must remain employed by the Company as of each vesting date. The non-qualified stock 
options are exercisable over a term of ten years. 

76 

 
 
 
OUTSTANDING EQUITY AWARDS AT DECEMBER 31, 2016 

Option Awards 

Stock Awards 

Name 

Lucia 

Sherman 

Neuman 

Nustad 

Number of 
Securities 
Underlying 
Unexercised 
Options  
(#) 
Exercisable 

Number of 
Securities 
Underlying 
Unexercised 
Options 
 (#) 
Unexercisable 

Equity 
Incentive 
Plan Awards: 
Number of 
Securities 
Underlying 
Unexercised 
Unearned 
Options 
 (#) 

Option 
Exercise 
Price  
($) 

30,000 
71,628 
64,100 
86,083 
32,410 
32,163 
— 
— 
— 
— 
— 
— 

51,796 
14,831 
19,792 
7,064 
33,334 
33,334 
— 
— 
— 
— 
— 

32,281 
12,634 
16,965 
7,064 
33,334 
33,334 
— 
— 
— 
— 
— 
— 
— 

11,247 
22,384 
10,015 
10,016 
28,694 
10,986 
14,137 
25,000 
25,000 
— 

— 
— 
— 
— 
16,205 (2) 
160,813 (4) 
208,333 (12) 
— 
— 
— 
— 
— 

51,795 (7) 
7,416 (2) 
98,962 (4) 
35,321 (9) 
66,666 (10) 
66,666 (10) 
102,564 (12) 
— 
— 
— 
— 

— 
6,317 (2) 
84,824 (4) 
35,321 (9) 
66,666 (10) 
66,666 (10) 
91,575 (12) 
— 
— 
— 
— 
— 
— 

— 
— 
— 
— 
— 
5,493 (2) 
70,687 (4) 
50,000 (10) 
50,000 (10) 
73,718 (5) 

— 
— 
— 
— 
48,616 (3) 
— 
— 
— 
— 
— 
— 
— 

— 
22,248 (3) 
— 
— 
— 
— 
— 
— 
— 
— 
— 

— 
18,952 (3) 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 

— 
— 
— 
— 
— 
16,480 (3) 
— 
— 
— 
— 

19.77 
22.95 
27.79 
21.36 
21.63 
16.77 
13.94 
— 
— 
— 
— 
— 

20.71 
21.63 
16.77 
16.64 
11.20 
14.00 
13.94 
— 
— 
— 
— 

21.36 
21.63 
16.77 
16.64 
11.20 
14.00 
13.94 
— 
— 
— 
— 
— 
— 

22.47 
22.95 
27.79 
27.79 
21.36 
21.63 
16.77 
11.20 
14.00 
13.94 

77 

Option 
Expiration 
Date 

9/30/2017 
9/30/2018 
10/4/2019 
11/14/2020 
11/11/2021 
3/3/2022 
3/3/2023 
— 
— 
— 
— 
— 

9/8/2021 
11/11/2021 
3/3/2022 
5/13/2022 
11/10/2022 
11/10/2022 
3/3/2023 
— 
— 
— 
— 

11/14/2020 
11/11/2021 
3/3/2022 
5/13/2022 
11/10/2022 
11/10/2022 
3/3/2023 
— 
— 
— 
— 
— 
— 

2/8/2018 
9/30/2018 
10/4/2019 
10/4/2019 
11/14/2020 
11/11/2021 
3/3/2022 
11/10/2022 
11/10/2022 
3/3/2023 

Equity 
Incentive 
Plan 
Awards: 
Market or 
Payout 
Value of 
Unearned 
Shares, 
Units or 
Other 
Rights That 
Have Not 
Vested  
($) 

— 
— 
— 
— 
— 
— 
— 
— 
— 
309,592 
— 
— 

— 
— 
— 
— 
— 
— 
— 
141,684 
— 
— 
— 

— 
— 
— 
— 
— 
— 
— 
— 
— 
120,691 
— 
— 
— 

— 
— 
— 
— 
— 
— 
— 
— 
— 
— 

Equity 
Incentive 
Plan 
Awards: 
Number of 
Unearned 
Shares, 
Units or 
other 
Rights 
That Have 
Not 
Vested (#) 

— 
— 
— 
— 
— 
— 
— 
— 
— 
17,048 (3) 
— 
— 

— 
— 
— 
— 
— 
— 
— 
7,802 (3) 
— 
— 
— 

— 
— 
— 
— 
— 
— 
— 
— 
— 
6,646 (3) 
— 
— 
— 

— 
— 
— 
— 
— 
— 
— 
— 
— 
— 

Market 
Value of 
Shares or 
Units of 
Stock that 
Have Not 
Vested (1)  
($) 

— 
— 
— 
— 
— 
— 
— 
213,253 
303,272 
103,203 
1,026,494 
1,481,856 

— 
— 
— 
— 
— 
— 
— 
47,234 
631,696 
227,363 
729,524 

— 
— 
— 
— 
— 
— 
— 
82,646 
224,639 
40,224 
541,440 
227,363 
651,363 

— 
— 
— 
— 
— 
— 
— 
— 
— 
— 

Number of 
Shares or 
Units of 
Stock That 
Have Not 
Vested (#) 

— 
— 
— 
— 
— 
— 
— 
11,743 (5) 
16,700 (6) 
5,683 (2) 
56,525 (4) 
81,600 (12) 

— 
— 
— 
— 
— 
— 
— 
2,601 (2) 
34,785 (4) 
12,520 (9) 
40,172 (12) 

— 
— 
— 
— 
— 
— 
— 
4,551 (8) 
12,370 (6) 
2,215 (2) 
29,815 (4) 
12,520 (9) 
35,868 (12) 

— 
— 
— 
— 
— 
— 
— 
— 
— 
— 

 
 
 
 
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
Williams 

— 
— 
— 
— 
— 

38,285 
12,084 
16,965 
7,064 
33,334 
33,334 
— 
— 
— 
— 
— 
— 

— 
— 
— 
— 
— 

12,762 (11) 
6,043 (2) 
84,824 (4) 
35,321 (9) 
66,666 (10) 
66,666 (10) 
91,575 (12) 
— 
— 
— 
— 
— 

— 
— 
— 
— 
— 

— 
18,128 (3) 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 

— 
— 
— 
— 
— 

22.54 
21.63 
16.77 
16.64 
11.20 
14.00 
13.94 
— 
— 
— 
— 
— 

— 
— 
— 
— 
— 

12/8/2020 
11/11/2021 
3/3/2022 
5/13/2022 
11/10/2022 
11/10/2022 
3/3/2023 
— 
— 
— 
— 
— 

8,699 (5) 
9,896 (6) 
1,927 (2) 
24,846 (4) 
28,874 (12) 

— 
— 
— 
— 
— 
— 
— 
5,567 (6) 
2,119 (2) 
29,815 (4) 
12,520 (9) 
35,868 (12) 

157,974 
179,711 
34,994 
451,203 
524,352 

— 
— 
— 
— 
— 
— 
— 
101,097 
38,481 
541,440 
227,363 
651,363 

— 
— 
5,779 (3) 
— 
— 

— 
— 
— 
— 
— 
— 
— 
— 
6,357 (3) 
— 
— 
— 

— 
— 
104,947 
— 
— 

— 
— 
— 
— 
— 
— 
— 
— 
115,443 
— 
— 
— 

(1)  The market value of shares or units of stock that have not vested is calculated by multiplying the closing market price per share of our 
common stock on December 30, 2016, the last trading day in 2016, of $18.16 per share by the number of shares or units of stock that 
have not vested. 

(2)  Represents stock options and restricted stock units granted on November 12, 2014. The remaining stock options and restricted stock 

units are scheduled to vest on November 12, 2017. 

(3)  Represents performance-based stock options and restricted stock units granted on November 12, 2014 that have not been earned. The 
stock options and restricted stock units are scheduled to vest on November 12, 2017, subject to satisfaction of the following performance 
condition: an increase in the average closing price per share of our common stock during the applicable trading days in any consecutive 
30 calendar day period preceding the third anniversary of the grant date of at least 25% over the option exercise price. 

(4)  Represents stock options and restricted stock units granted on March 4, 2015. One-half of the stock options and restricted stock units 
granted are subject to time-based vesting in one-third increments. Of the remaining two-thirds that were unexercisable or that had not 
vested as of December 30, 2016, one-third vested on March 4, 2017, and one-third is scheduled to vest on March 4, 2018. One-half of 
the stock options and restricted stock units granted were subject to performance-based conditions that have been satisfied and subject 
to time-based vesting conditions. Two-thirds of these performance-based stock options and restricted stock units vested on March 4, 
2017, and one-third is scheduled to vest on March 4, 2018.  

(5)  Represents restricted stock units granted on February 27, 2013 that were subject to performance-based conditions that have been 
satisfied and subject to time-based vesting conditions. Of the remaining restricted stock units that had not vested as of December 30, 
2016, one-half vested on February 27, 2017, and one-half is scheduled to vest on February 27, 2018. 

(6)  Represents restricted stock units granted on March 5, 2014 that were subject to performance-based conditions that have been satisfied 
and subject to time-based vesting conditions. Of the remaining restricted stock units that had not vested as of December 30, 2016, one-
half vested on March 5, 2017, and one-half is scheduled to vest on March 5, 2018.  

(7)  Represents  stock  options  granted  on  September  8,  2014.    One-half  of  the  remaining  stock  options  are  scheduled  to  vest  on 

September 8, 2017, and one-half are scheduled to vest on September 8, 2018. 

(8)  Represents restricted stock units granted on April 1, 2013.  All of the remaining restricted stock units vested on April 1, 2017. 

(9)  Represents stock options and restricted stock units granted on May 13, 2015. One-half of the stock options and restricted stock units 
granted are subject to time-based vesting in one-third increments. Of the remaining two-thirds that were unexercisable or that had not 
vested as of December 30, 2016, one-third is scheduled to vest on May 13, 2017, and one-third is scheduled to vest on May 13, 2018. 
One-half of the stock options and restricted stock units granted were subject to performance-based conditions that have been satisfied 
and  subject  to  time-based  vesting  conditions.  Two-thirds  of  these  performance-based  stock  options  and  restricted  stock  units  are 
scheduled to vest on May 13, 2017, and one-third are scheduled to vest on May 13, 2018.  

(10)  Represents stock options granted on November 11, 2015. Of the remaining two-thirds that were unexercisable as of December 30, 

2016, one-third is scheduled to vest on November 11, 2017, and one-third is scheduled to vest on November 11, 2018. 

(11)  Represents stock options granted on December 9, 2013. All of the remaining stock options are scheduled to vest on December 9, 2017. 

(12)  Represents stock options and restricted stock units granted on March 2, 2016. One-half of the stock options and restricted stock units 
granted are subject to time-based vesting in one-third increments. One-third of the time-based stock options and restricted stock units 

78 

 
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
 
 
 
 
 
 
 
 
 
vested on March 2, 2017, and one-third is scheduled to vest on each of March 2, 2018 and March 2, 2019. One-half of the stock options 
and restricted stock units granted were subject to performance-based conditions that have been satisfied and subject to time-based 
vesting conditions. One-third of these performance-based stock options and restricted stock units vested on March 2, 2017, and one-
third is scheduled to vest on each of March 2, 2018 and March 2, 2019.

OPTION EXERCISES AND STOCK VESTED IN 2016 

The following table sets forth certain information concerning the stock options exercised and stock awards that vested for our 
named executive officers during the year ended December 31, 2016.  

Option Awards 

Stock Awards 

Number of Shares 
Acquired on 
Exercise  
(#) 
339,328 
— 
— 
— 
— 

Value Realized 
on Exercise(1) 
($) 
4,504,336 
— 
— 
— 
— 

Number of Shares 
Acquired on Vesting  
(#) 
44,906 
12,060 
21,417 
16,192 
13,369 

Value Realized on 
Vesting(2) 
($) 
604,649 
179,971 
310,316 
227,287 
197,093 

Name 
Lucia 
Sherman 
Neuman 
Nustad 
Williams 

(1)  The value realized on the exercise of stock options is based on the difference between the exercise price and the market price (used 

for tax purposes) of our common stock on the date of exercise. 

(2)  The value realized on vesting represents the number of shares acquired on vesting multiplied by the market value of shares of our 

common stock on the vesting date, which is the closing price of our common stock on: 

(i) 

(ii) 

(iii) 

(iv) 

(v) 

(vi) 

(vii) 

February 18, 2016 of $11.61 for Mr. Lucia (13,697 shares); 

February 27, 2016 of $12.99 for Mr. Lucia (5,872 shares) and Ms. Nustad (4,349 shares);  

March 4, 2016 of $14.01 for Messrs. Lucia (11,304 shares), Sherman (6,956 shares) and Williams (5,963 shares) and 
Mses. Neuman (5,963 shares) and Nustad (4,969 shares);  

March 5, 2016 of $14.01 for Messrs. Lucia (8,350 shares) and Williams (2,783 shares) and Mses. Neuman (6,185 shares) 
and Nustad (4,948 shares);  

April 1, 2016 of $14.06 for Ms. Neuman (4,550 shares);  

May  13,  2016  of  $15.78  for  Messrs.  Sherman  (2,504  shares)  and  Williams  (2,504  shares)  and  Ms.  Neuman 
(2,504 shares); and  

November 12, 2016 of $16.54 for Messrs. Lucia (5,683 shares), Sherman (2,600 shares) and Williams (2,119 shares) 
and Mses. Neuman (2,215 shares) and Nustad (1,926 shares). 

POTENTIAL PAYMENTS UPON TERMINATION OF EMPLOYMENT OR CHANGE IN CONTROL 

The  information  and  table  in  this  section  summarize  the  estimated  compensation  payable  to  each  of  our  named  executive 
officers in the event of termination of employment or a change in control. This compensation is payable pursuant to (i) the terms 
of the employment agreement with each of our named executive officers, and (ii) the terms of our equity incentive plans and 
related award agreements. Regardless of the manner in which the named executive officer’s employment terminates, each 
executive  is  generally  entitled  to  receive  earned,  unpaid  salary  and  accrued  but  unused  paid  time  off  through  the  date  of 
termination under his or her employment agreement.  Each named executive officer is also  entitled to receive any earned, 
unpaid bonus for the calendar year preceding the calendar year in which his or her employment ends unless such termination 
is for Cause. The definitions of “Cause,” Change in Control,” “Disability,” and “Good Reason” appear at the end of the next 
section under the heading “Key Terms.” 

In addition to the compensation discussed above, the following table reflects the compensation and benefits that would have 
been  paid  to  the  named  executive  officers  had  their  employment  terminated  on  December  31,  2016  under  the  termination 

79 

 
 
 
 
 
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
scenarios shown below, and assumes a closing price of our common stock as of December 30, 2016, the last trading day in 
2016  ($18.16).  The  table  also  assumes  that  each  named  executive  officer  executes  a  separation  agreement  and  general 
release,  as  required  under  the  terms  of  their  employment  agreements,  and  complies  with  certain  restrictive  covenants  and 
confidentiality provisions contained in their employment agreements and Restrictive Covenants Agreements (as defined and 
described under the heading “Restrictive Covenants Agreements”). The table does not include any amounts due for unused 
paid time off for 2016 or the value of immediately exercisable stock options at the date of termination (where vesting was not 
accelerated as a result of the termination). Due to a number of factors that may affect the availability, nature and amount of 
compensation upon termination, any actual amounts paid or distributed to named executive officers may be different from the 
amounts provided in this section. In addition, in connection with any actual termination or change in control situation, we may 
determine to enter into agreements or establish arrangements that alter the terms below. 

Named Executive Officer and Type of 
Payment 
Lucia 

Cash severance 
Bonus compensation(6) 
Continued health insurance coverage 
RSUs(7)(9) 
Stock Options(8)(9) 

Total  

Sherman 

Cash severance 
Continued health insurance coverage 
RSUs(7) 
Stock Options(8) 

Total  

Neuman 

Cash severance 
Continued health insurance coverage 
RSUs(7) 
Stock Options(8) 

Total  

Nustad 

Cash severance 
Continued health insurance coverage 
RSUs(7) 
Stock Options(8) 

Total  

Williams 

Cash severance 
Continued health insurance coverage 
RSUs(7) 
Stock Options(8) 

Total  

Termination 
without 
Cause(1)  
($)  

Resignation 
for Good 
Reason(2)  
($)  

Termination 
without 
Cause 
following a 
Change in 
Control(3) 
($) 

Resignation 
for Good 
Reason 
following a 
Change in 
Control(3)  
($) 

Disability(4) 
($) 

Death or 
Retirement(5) 
($) 

1,300,000
1,300,000
22,833
3,437,670
1,102,695
7,163,198

515,000
16,407
—
—
531,407

500,000
10,669
—
—
510,669

437,750
16,407
—
—
454,157

500,000
16,407
—
—
516,407

1,300,000
1,300,000
22,833
3,437,670
1,102,695
7,163,198

515,000
16,407
—
—
531,407

—
—
—
—
—

—
—
—
—
—

—
—
—
—
—

1,300,000
1,300,000
22,833
3,437,670
1,102,695
7,163,198

515,000
16,407
1,777,501
1,365,391
3,674,299

500,000
10,669
1,888,368
1,299,366
3,698,402

437,750
16,407
1,453,181
965,345
2,872,683

500,000
16,407
1,675,187
1,299,366
3,490,960

1,300,000 
1,300,000 
22,833 
3,437,670 
1,102,695 
7,163,198 

— 
— 
1,777,501 
1,365,391 
3,142,892 

500,000 
10,669 
1,888,368 
1,299,366 
3,698,402 

437,750 
16,407 
1,453,181 
965,345 
2,872,683 

500,000 
16,407 
1,675,187 
1,299,366 
3,490,960 

1,300,000
1,300,000
22,833
3,437,670
1,102,695
7,163,198

—
—
1,777,501
1,365,391
3,142,892

—
—
1,888,368
1,299,366
3,187,733

—
—
1,453,181
965,345
2,418,526

—
—
1,675,187
1,299,366
2,974,553

—
—
—
3,437,670
1,102,695
4,540,365

—
—
1,777,501
1,365,391
3,142,892

—
—
1,888,368
1,299,366
3,187,733

—
—
1,453,181
965,345
2,418,526

—
—
1,675,187
1,299,366
2,974,553

(1)  Assuming involuntary termination without Cause, Messrs. Sherman and Williams and Mses. Neuman and Nustad would be entitled to 
cash severance in an amount equal to 12 times their monthly base salary paid ratably in equal installments over a 12 month period, and 
a lump sum amount equal to 12 times the difference between the monthly COBRA coverage premium for the same type of medical and 
dental coverage they are receiving as of the date their employment ends and their monthly employee contribution. Mr. Lucia would be 
entitled to cash severance in an amount equal to 24 times his monthly base salary paid ratably in equal installments over a 24-month 
period, continued health coverage for 24 months or until he becomes eligible for health coverage from another employer, whichever is 
earlier, and twice his bonus component. The bonus component varies depending upon whether the bonus for the year of termination is 
intended to be “performance-based” compensation and performance is satisfied, in which case it will be paid when bonuses are paid to 
our other senior executive officers, or whether the bonus is under a different program, in which case it will be his target bonus. In 
addition, Mr. Lucia would be treated as continuing in service for purposes of the vesting of any equity award under the terms of his 
employment agreement. 

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(2)  The amounts in this column represent the amounts payable to the named executive officer in the event he resigns for Good Reason, 

as defined in his employment Agreement, which will be paid on the same schedule as if he were terminated without Cause.  

(3)  If within 24 months following a Change in Control, the named executive officer’s employment is terminated without cause or the named 
executive officer resigns for Good Reason, Messrs. Sherman and Williams and Mses. Neuman and Nustad would receive the amount 
of cash severance equal to 12 times their monthly base salary in a single lump sum, and Mr. Lucia would receive the amount of his 
cash severance equal to 24 times his monthly base salary and twice his bonus component in a single lump sum. In addition, if Mr. Lucia 
is terminated without Cause or resigns for Good Reason within six months prior to a Change in Control, Mr. Lucia would receive a lump 
sum cash payment equal to the excess of the amount he would have received for any equity awards outstanding or deemed to be 
outstanding, or canceled or forfeited, as a result of termination or Change in Control, over the amount he actually received. The named 
executive officers would also be entitled to continued health coverage, and accelerated vesting of stock awards and option awards 
pursuant to the terms of the applicable agreements. Since the employment agreements of named executive officers and the equity 
awards have double-trigger Change in Control provisions (except with respect to equity awards not assumed by the acquiring entity), 
the table assumes that both a Change in Control and a subsequent termination of employment has occurred.     

(4)  In the event the employment of Messrs. Sherman or Williams, or Mses. Neuman or Nustad is terminated due to the executive’s Disability, 
all outstanding stock awards will immediately vest and all option awards will become vested and fully exercisable pursuant to the terms 
of the applicable award agreements. A termination of Mr. Lucia’s employment due to Disability would be treated as a termination without 
Cause pursuant to his employment agreement.   

(5)  The amounts in this column represent the amounts payable to the named executive officer if his or her employment is terminated upon 
death or Retirement. If the named executive officer’s employment is terminated as a result of death, all outstanding stock awards will 
immediately vest and all option awards will become vested and fully exercisable upon termination pursuant to the terms of the applicable 
award agreements. If the named executive officer’s employment is terminated as a result of Retirement, the named executive officer 
will be treated as continuing in service for vesting purposes and the vested portion of options shall remain exercisable until the second 
anniversary of such executive’s Retirement, or until the last applicable vesting date or option expiration date under the applicable award 
agreement, whichever is sooner.  Under the award agreements, “Retirement” means cessation of employment on or after attaining the 
age of 60 and having at least 5 years of continuous service with the Company. None of the named executive officers qualified for 
Retirement as of December 31, 2016.  

(6)  Amounts represent the target annual short-term (cash) incentive compensation that Mr. Lucia would be entitled to receive under his 
employment agreement as of the date his employment ends, and not the amount that the Compensation Committee determined to pay 
Mr. Lucia as set forth in the Non-Equity Incentive Plan Compensation” column of the Summary Compensation Table.  

(7)  Except for the amounts reported for Mr. Lucia in the columns entitled Termination Without Cause or Resignation for Good Reason, the 
amounts reported represent the estimated market value of unvested restricted stock units (including any performance-based restricted 
stock units) that would have vested as of December 31, 2016 under the termination scenarios in the table, calculated based on the 
aggregate  number  of  accelerated  restricted  stock  units  multiplied  by  the  closing  market  price  per  share  of  our  common  stock  on 
December 30, 2016, the last trading day in 2016, of $18.16 per share. 

(8)  Except for the amounts reported for Mr. Lucia in the columns entitled Termination Without Cause or Resignation for Good Reason, the 
amounts reported represent the estimated market value of outstanding stock options, which are not then exercisable (including any 
performance-based stock options), that would have become exercisable as of December 31, 2016 under the termination scenarios in 
the table, calculated based on the difference between the aggregate exercise price of all accelerated options and the aggregate market 
value of the underlying shares as of December 30, 2016, the last trading day in 2016, based on the closing market price per share of 
our common stock on December 30, 2016 of $18.16 per share. 

(9)  The amounts reported for Mr. Lucia in the columns entitled Termination Without Cause or Resignation for Good Reason represent the 
estimated  market  value  of  his  (i)  unvested  restricted  stock  units  (including  any  performance-based  restricted  stock  units)  as  of 
December 31, 2016, calculated based on the aggregate number of restricted stock units multiplied by the closing market price per share 
of our common stock on December 30, 2016, the last trading day in 2016, of $18.16 per share and (ii) and outstanding stock options, 
which are not then exercisable (including any performance-based stock options) as of December 31, 2016, calculated based on the 
difference  between  the  aggregate  exercise  price  of  such  options  and  the  aggregate  market  value  of  the  underlying  shares  as  of 
December 30, 2016, the last trading day in 2016, based on the closing market price per share of our common stock on December 30, 
2016 of $18.16 per share, which would continue to vest under these termination scenarios pursuant to the terms of his employment 
agreement. The amounts reported assume that these restricted stock units and stock options are earned, to the extent such awards 
are performance-based, and fully vest. 

81 

 
Executive Employment Agreements 

EMPLOYMENT AGREEMENT WITH MR. LUCIA 

HMS and Mr. Lucia entered into the second amendment to his executive employment agreement, effective March 1, 2015, 
extending the term of his agreement to February 28, 2018. Under his employment agreement, Mr. Lucia is entitled to a minimum 
annual base salary of $650,000, subject to increase from time to time by the Board of Directors or the Compensation Committee, 
and a targeted annual short-term (cash) incentive award opportunity of 100% of his base salary. If we terminate Mr. Lucia’s 
employment without Cause, in connection with a Change in Control or otherwise, or if his employment ceases because of his 
disability or if he terminates his employment with Good Reason, then provided that Mr. Lucia executes and does not revoke a 
separation agreement and release, and complies with his Restrictive Covenants Agreement, (i) he will be entitled to receive 
cash severance in an amount equal to (A) 24 times his monthly base salary paid ratably in equal installments over a 24 month 
period (unless his termination/resignation is in connection with a Change in Control, in which case the payment will be in a single 
lump sum), and (B) twice his bonus component that will vary depending upon whether the bonus for the year of termination is 
intended to be “performance-based” compensation and performance is satisfied, in which case it will be paid when bonuses are 
paid to our other senior executive officers, or whether the bonus is under a different program, in which case it will be his target 
bonus and will be paid on the same schedule as (A) above (unless his termination/resignation is in connection with a Change 
in Control, in which case the payment will be in a single lump sum), (ii) he will be entitled to continued health coverage for 
24 months or until he becomes eligible for health coverage from another employer, whichever is earlier, and (iii) he will be treated 
as continuing in service for purposes of the vesting of any equity award until the earliest of: (x) the end of the Noncompetition 
Period (as defined in Mr. Lucia’s Restrictive Covenants Agreement), (y) the last of the applicable vesting dates under such 
awards, or (z) the termination or violation of the Restrictive Covenants Agreement.   

In addition, if we terminate Mr. Lucia’s employment without Cause or Mr. Lucia resigns for Good Reason, and such termination 
occurs within a six-month period before a Change in Control, Mr. Lucia will receive a cash payment equal to the excess of the 
amount he would have received for such equity awards if he were continuing in service as of the date of the Change in Control 
and terminated immediately thereafter over the amount actually received, paid in a single lump sum payment at the time provided 
in the agreement. In the event that any payments and benefits, including any benefits provided to Mr. Lucia or for Mr. Lucia’s 
benefit under the agreement or any other company plan or agreement, become subject to the excise tax under Section 4999 of 
the Code, such payments and benefits will be “cut-back” to an amount that is less than such amount that would cause the excise 
tax to the extent that such reduction would result in Mr. Lucia retaining a larger amount on an after-tax basis. 

EMPLOYMENT AGREEMENTS WITH OTHER NAMED EXECUTIVE OFFICERS 

We have employment agreements that are at-will, subject to certain notice and/or severance provisions, with Mr. Sherman, 
Ms. Neuman,  Ms.  Nustad  and  Mr.  Williams.  These  employment  agreements  set  forth  the  named  executive  officer’s  initial 
annualized base salary as follows: (i) Mr. Sherman at $500,000, (ii) Ms. Neuman at $450,000, (iii) Ms. Nustad at $350,000 and 
(iv) Mr. Williams at $400,000, subject to increase from time to time by the Board of Directors or the Compensation Committee. 
In addition, under the terms of these agreements, the named executive officers are eligible to receive bonus compensation from 
us in respect of each fiscal year (or portion thereof) during the term of their employment, in each case as may be determined by 
our Compensation Committee in its sole discretion on the basis of such performance-based or other criteria as it determines 
appropriate. For 2016, the targeted annual short-term (cash) incentive award opportunity for each other named executive was 
65% of his/her base salary. 

In the event any of these named executive officers is terminated without Cause, in connection with a Change in Control or 
otherwise, then provided that such named executive officer executes and does not revoke a separation agreement and release, 
and complies with the Restrictive Covenants Agreement, the executive will be entitled to receive (i) cash severance in an amount 
equal to 12 times the executive’s  monthly base salary paid ratably in equal installments over a 12 month period, (ii) a lump sum 
amount equal to 12 times the difference between the monthly COBRA coverage premium for the same type of medical and 
dental coverage (single, family, or other) the executive is receiving as of the date employment ends and then monthly employee 
contribution, which amount may be used for any purpose, and (iii) any earned but unpaid annual bonus for the calendar year 
preceding the calendar year in which employment ends. If within 24 months following a Change in Control, Mr. Williams’ or 
Mses. Neuman’s or Nustad’s employment is terminated without Cause or resigns for Good Reason, provided that the executive 
executes a separation agreement and release, and complies with the Restrictive Covenants Agreement, he or she will receive 
the amounts set forth in (i) above in a single lump sum payment, rather than in installments as applies outside of a Change in 
Control.  

82 

 
Restrictive Covenants Agreements 

We  also  have  entered  into  a  Noncompetition,  Nonsolicitation,  Proprietary  and  Confidential  Information  and  Developments 
Agreement  (the  “Restrictive  Covenants  Agreement”)  with  each  of  our  named  executive  officers.  Under  the  terms  of  the 
Restrictive Covenants Agreements, in Mr. Lucia’s case, for the 24 months following the termination of his employment for any 
reason, and in the case of the other named executive officers, for the 12 months following the termination of employment for 
any reason, the named executive officer is generally prohibited from (i) engaging or assisting others to engage in any business 
or  enterprise  in  the  United  States  that  competes  with  HMS’s  business,  products  or  services,  (ii)  soliciting  or  diverting,  or 
attempting to solicit or divert, the business of any of HMS’s current or prospective clients, (iii) soliciting, recruiting or inducing or 
attempting to solicit, recruit or induce any company employee or independent contractor to leave HMS’s employ (or, in some 
situations, hire any such company employee or independent contractor), and (iv) disclosing or utilizing for the benefit of any 
entity other than HMS, any system or product development ideas discussed or explored, even if not implemented, during the 
named executive officer’s employment with HMS. The Restrictive Covenants Agreements also set forth certain obligations with 
respect to proprietary and confidential information and developments and inventions.   

Equity Incentive Plans 

All named executive officers participated in the Company’s equity plans in 2016. 

With respect to stock awards and option awards under the 2006 Stock Plan, the 2016 Omnibus Plan, and the related award 
agreements, such awards generally require that the named executive officer remain employed by the Company (or continue to 
serve on the Board of Directors if no longer employed by the Company) during the period designated by the Compensation 
Committee, subject to acceleration of vesting or continued vesting of equity awards in the termination scenarios described in 
the table under “Potential Payments Upon Termination of Employment or Change in Control.” If the named executive officer’s 
employment  or  Board  membership  ends  before  the  designated  period  for  any  reason  (other  than  upon  death,  Disability, 
Retirement, termination without Cause or resignation for Good Reason following a Change in Control, or as otherwise specified 
in the executive’s employment agreement), all unvested restricted stock units will be forfeited and all unexercisable portions of 
option awards  will expire  immediately. If we  terminate the  named executive  officer’s  employment  or Board membership for 
Cause, all stock awards and option awards will immediately terminate without regard to whether such awards are vested or 
exercisable, respectively.   

In general, the treatment of equity upon a Change in Control depends on if the awards are assumed by the successor company. 
Upon a Change in Control, and unless provided otherwise in the terms of an award agreement or employment agreement, 
awards  granted  under  the  2006  Stock  Plan  and  the  2016  Omnibus  Plan  vest  on  an  accelerated  basis  only  if  a  qualifying 
termination occurs within 24 months after a Change in Control.  In this case, restricted stock unit awards will immediately vest 
and become free of restrictions, and any outstanding option awards will become fully vested and immediately exercisable.  Such 
options will remain exercisable for 12 months following the qualifying termination, but not beyond the option expiration date set 
forth in the applicable award agreement. To the extent an award under the 2016 Omnibus Plan is not assumed in a Change in 
Control, accelerated vesting generally occurs upon a Change in Control. 

Key Definitions   

The capitalized terms used in the sections under the headings “Potential Payments Upon Termination of Employment or Change 
in Control” and “Executive Employment Agreements” are defined as below. These definitions are subject to further limitations if 
necessary to conform to Section 409A of the Code. 

“CAUSE”  

(cid:131)  Under the employment agreements for each of the named executive officers, “Cause” means: (i) fraud with respect to HMS 
or any of its subsidiaries and affiliates; (ii) material misrepresentation to any regulatory agency, governmental authority, 
outside or internal auditors, internal or external company counsel, or the Board of Directors concerning the operation or 
financial status of HMS or of any of its subsidiaries and affiliates; (iii) theft or embezzlement of assets of HMS or any of its 
subsidiaries or affiliates; (iv) conviction, or plea of guilty or nolo contendere to any felony (or to a felony charge reduced to 
a misdemeanor), or, with respect to the named executive officer’s employment, to any misdemeanor (other than a traffic 
violation); (v) material failure to follow HMS’s conduct and ethics policies that have been provided or made available to the 
named  executive  officer;  (vi)  a  material  breach  of  the  named  executive  officer’s  employment  agreement  or  Restrictive 

83 

 
Covenants  Agreement;  and/or  (vii)  continued  failure  to  attempt  in  good  faith  to  perform  his/her  duties  as  reasonably 
assigned by the Board, in Mr. Lucia’s case, or by his/her supervisor in the case of the other named executive officers. 
Certain of the foregoing definitions permit the named executive officer to attempt to cure the grounds for Cause prior to 
termination. 

(cid:131)  Under  the  2006  Stock  Plan  and  the  related  award  agreements,  “Cause”  is  equated  with  “gross  misconduct,”  and  is 

determined by the Compensation Committee or our Board of Directors. 

(cid:131)  During fiscal 2016, we adopted forms of Non-Qualified Stock Option Award Agreement and Restricted Stock Unit Award 
Agreement for awards under the 2016 Omnibus Plan, under which, “Gross Misconduct” is equated with “Cause” as defined 
in the employment agreements for the named executive officers. For participants that have not entered into employment 
agreements  with  HMS,  “Gross  Misconduct”  means,  for  purposes  of  these  awards,  a  conviction  of  any  felony,  or  a 
misdemeanor  with  respect  to  the  participant’s  employment,  or  the  entering  of  a  plea  guilty  or  nolo  contendere  to  such 
charge, the embezzlement or theft of HMS property, or a violation of a restrictive covenants or similar agreement with HMS.  

“CHANGE IN CONTROL” 

(cid:131)  Under  the  employment  agreements  and  the  terms  of  the  2006  Stock  Plan  and  the  2016  Omnibus  Plan,  a  “Change  in 

Control” generally occurs, subject to specific exceptions, when: 

- 

- 

- 

a person or group beneficially owns 50.01% or more of our outstanding shares of common stock or the combined 
voting power of outstanding company securities entitled to vote in the election of directors; 

there is a merger, consolidation, reorganization, recapitalization or share exchange involving HMS or a sale or other 
disposition of all or substantially all of HMS’s assets, unless, immediately after the transaction (i) all or substantially all 
of the beneficial owners of HMS’s outstanding common stock and outstanding voting securities prior to the transaction 
own, directly or indirectly, more than 50% of such securities after the transaction in substantially the same proportions 
as their initial ownership and (ii) no person beneficially owns 50.01%, or more of the outstanding shares of common 
stock or voting securities of the acquiring corporation (unless such ownership level existed prior to the transaction); or 

during any one year-period, the individuals who are the continuing directors (as determined under the 2016 Omnibus 
Plan) cease for any reason to constitute a majority of the Board of Directors or the Board of a successor corporation. 

“DISABILITY”  

(cid:131)  Under the employment agreements, “Disability” exists when the Company determines that based upon appropriate medical 
evidence, the named executive officer has become physically or mentally incapacitated so as to render such executive 
incapable of performing the executive’s usual and customary duties, with or without a reasonable accommodation, for at 
least 180 days (or in Mr. Sherman’s case, for at least 120 days), whether or not consecutive, during any 12-month period, 
or if the named executive officer is found to be disabled within the Company’s long-term disability insurance as then in 
effect.  

(cid:131)  Under the related award agreements to the 2006 Stock Plan and the 2016 Omnibus Plan, “Disability” means permanent 

and total disability as defined by Section 22(e)(3) of the Code.  

“GOOD REASON”  

(cid:131)  Under the employment agreements, “Good Reason” means, the occurrence, without the named executive officer’s prior 
written consent, of any of the following events: (i) a material diminution in his/her authority, duties or responsibilities (in 
Mr. Lucia’s case, other than in connection with a portion of his authority, duties or responsibilities being assigned to or 
carried out by a President); (ii) a requirement that, in Mr. Lucia’s case, he report to an officer rather than to the Board, and 
in  the  case  of  the  other  named  executive  officers,  that  they  report  to  a  new  supervisor  who  has  materially  diminished 
authority, duties or responsibilities in comparison to his/her previous supervisor;  (iii)  a material reduction in the  named 
executive officer’s base salary (or, in Mr. Sherman’s case, his base salary or target bonus percentage); (iv) HMS’s requiring, 
(a) in the case of Messrs. Lucia and Sherman, that they perform their principal services in a geographic area more than 50 
miles from HMS’s offices in Irving, Texas, or such other place at which they have agreed to provide such services, and (b) 

84 

 
 
 
 
 
 
 
 
in  the  case  of  Mses.  Neuman  and  Nustad  and  Mr.  Williams,  that  they  perform  their  principal  services  primarily  in  a 
geographic area more than 50 miles from HMS’s offices in Dallas, Texas and New York, New York, or such other place of 
primary employment at which they have agreed to provide such services; or (v) a material breach by HMS of any material 
provision of the named executive officer’s employment agreement. Good Reason is also subject to certain timing restrictions 
and our ability to cure the proposed Good Reason. 

COMPENSATION-RELATED RISK 

We regularly assess risks related to our compensation programs for all employees, including non-executive officers. In February 
2017,  HMS’s  management  and  Compensation  Committee,  with  the  assistance  of  FW  Cook,  conducted  a  comprehensive 
assessment of the risks associated with our compensation policies and practices as they relate to risk management practices 
and risk-taking incentives. The Compensation Committee took into consideration our current compensation structure and the 
possible risks and mitigation factors associated with each compensation element, including the mix of cash, equity and fixed 
compensation with short- and long-term incentives, the use of multi-year vesting periods and performance criteria for equity 
awards, clawback provisions that apply to long-term incentive awards, stock ownership guidelines for executive officers and a 
cap on bonus pool funding and individual payouts for all short-term incentive awards. Based on the results of this assessment, 
the Compensation Committee does not believe our compensation policies and practices for employees create risks that are 
reasonably likely to have a material adverse effect on our company.  

As discussed in more detail under the heading “Compensation Discussion and Analysis” above, the Compensation Committee 
reviews and approves executive compensation programs that focus on having the appropriate balance of features that mitigate 
compensation-related risk without diminishing the incentive nature of the compensation. 

COMPENSATION COMMITTEE INTERLOCKS AND INSIDER PARTICIPATION 

None  of  the  persons  who  served  on  the  Compensation  Committee  during  2016  (Messrs.  Stowe  (Chair)  and  Callen  and 
Ms. Tellez) were or are an officer or employee of HMS or had a related person transaction involving HMS requiring disclosure 
under Item 404 of Regulation S-K. During 2016, none of our executive officers (i) served as a member of the board of directors 
or compensation committee (or equivalent entity) of any other entity that had one or more of its executive officers serving as a 
member of our Compensation Committee or (ii) served as a member of the compensation committee (or equivalent entity) of 
any other entity that had one or more of its executive officers serving as a member of our Board of Directors. 

DIRECTOR COMPENSATION 

The  Compensation  Committee  has  the  responsibility  for  recommending  to  the  Board  of  Directors  the  form  and  amount  of 
compensation for directors, which are subject to review and adjustment by the Board of Directors from time to time. Directors 
who are employed by HMS do not receive compensation for their service on the Board of Directors. Directors who are not our 
employees (non-employee directors) receive cash and equity-based compensation for their services as a director. All of our 
directors are reimbursed for reasonable expenses incurred in connection with attendance at meetings of the Board of Directors 
or its committees.   

STANDARD COMPENSATION ARRANGEMENTS FOR NON-EMPLOYEE DIRECTORS 

Our  standard  compensation  arrangements  for  non-employee  directors  for  fiscal  2016  are  summarized  in  the  table  below. 
Amounts  effective  during  the  periods  from  January  1,  2016  through  October  31,  2016,  and  November  1,  2016  through 
December 31, 2016, are shown separately to illustrate certain changes approved by the Board of Directors that became effective 
on November 1, 2016, as discussed in more detail below. Other than the meeting fees, the amounts shown in the table below 
are per annum.  

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Cash Compensation 
Board Cash Retainer(1) 
Committee Chair Cash Retainer(1)(2) 

Committee Member Cash Retainer(1) 

Additional Cash Retainer(1) 
Meeting Fees 

Equity-Based Compensation 
Annual Equity Retainer(3) 

Effective  
1/1/16- 
10/31/16 
($) 

Effective 
11/1/16- 
12/31/16 
($) 

50,000  
20,000  
15,000 
15,000 
15,000 
7,000  
5,000  
5,000  
5,000  
25,000 
2,000  

60,000  
20,000 
15,000 
15,000 
15,000 
7,000  
5,000  
5,000  
5,000  
25,000 
2,000 

Board Member 
Audit 
Compensation 
Compliance and Ethics 
Nominating and Governance 
Audit 
Compensation 
Compliance and Ethics 
Nominating and Governance 
Lead Independent Director 
Per meeting fee for board meetings in excess of 
eight during fiscal year; does not include 
committee meetings 

Board Member 

130,000 

165,000  

(1)  All  cash  retainer  fees,  unless  deferred  by  a  director  pursuant  to  the  Director  Deferred  Compensation  Plan,  are  paid  in  quarterly 

installments in arrears. Cash retainer fees are pro-rated for partial periods of service.  

(2)  Committee chair cash retainers are paid in lieu of the respective committee member cash retainer. 

(3)  The annual equity retainer to non-employee directors is in the form of a substantially equal number of non-qualified stock options and 
restricted stock units. See “2016 Non-Employee Director Compensation Decisions” below for a discussion of the 2016 annual equity 
retainer awards.   

2016 Non-Employee Director Compensation Decisions 

In October 2016, the Compensation Committee reviewed the design and competitive positioning of our non-employee director 
compensation program in relation to our peer group. For a discussion regarding our peer group, see “Competitive Pay Position 
and Peer Group Analyses” under the subsection entitled “Compensation Discussion and Analysis.” The peer group analysis 
included  benchmarking  data  on  total  director  compensation  (taking  into  account  our  board  and  committee  structure,  board 
leadership  structure,  and  number  of  meetings  held  during  2016),  as  well  as  pay  mix,  cash  compensation  and  equity 
compensation levels, and general practices such as committee chair and member retainers and stock ownership guidelines. 
With guidance from FW Cook, the Compensation Committee recommended, and the Board approved, certain changes to our 
non-employee  director  compensation, effective as of  November 1, 2016,  as reflected in the table  above under the heading 
“Standard  Compensation  Arrangements  for  Non-Employee  Directors.”  These  changes  resulted  in  our  total  non-employee 
director compensation approximating the median level of our peer group companies.   

Based on the recommendation of the Compensation Committee, in November 2016 the Board of Directors determined to change 
the timing of the annual non-employee director equity grant, which is typically granted during the fourth quarter, to the date of 
the annual meeting of shareholders beginning in 2017, primarily to align the vesting of the award with the directors’ year of 
service. To compensate the non-employee directors for their board membership from November 2016 through the anticipated 
date of our 2017 annual meeting of shareholders, the Board approved a pro-rated grant, effective as of November 11, 2016, for 
each non-employee director (other than Mr. Azar), pursuant to the 2016 Omnibus Incentive Plan, or the 2016 Omnibus Plan, 
with an aggregate grant date fair value of $87,450. In connection with Mr. Azar’s appointment to the Board in October 2016, 
Mr. Azar received  an initial  equity grant  with an aggregate grant  date fair value  of $165,000,  effective November 11,  2016, 
pursuant to the 2016 Omnibus Plan. In addition, in connection with Mr. Becker’s appointment to the Board in January, 2016, Mr. 
Becker  received  an  initial  equity  grant  with  an  aggregate  grant  date  fair  value  of  $130,000,  effective  as  of  March  2,  2016, 
pursuant  to  the  then-effective  Fourth  Amended  and  Restated  2006  Stock  Plan,  as  amended  (the  “2006  Stock  Plan”).  For 
additional information regarding the 2016 non-employee director equity awards, see “2016 Director Compensation” below. 

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Equity-Based Compensation 

Equity compensation provided to our non-employee directors consists of a substantially equal number of stock options and 
restricted stock units granted pursuant to the 2016 Omnibus Plan. Notwithstanding the changes in director grant timing that 
were approved in November 2016 for grants to be awarded beginning in 2017 (described above), equity grants to our non-
employee directors historically have been approved annually in the fourth quarter of the fiscal year, are effective two business 
days following the filing of our next quarterly report on Form 10-Q with the SEC and vest in four equal installments, with 25% 
vesting on the last day of the calendar quarter in which the grant was effective and 25% vesting on the last day of each of the 
next three calendar quarters, provided that the non-employee director remains a member of our Board of Directors through each 
vesting date. Equity grants for new directors joining the Board are approved by the Compensation Committee at its next meeting 
following the director’s appointment or election and are effective two business days following the filing of our next quarterly 
report on Form 10-Q or annual report on Form 10-K, as applicable, with the SEC. 

Director Compensation Limits 

Under the terms of the 2016 Omnibus Plan, the maximum number of shares subject to awards granted during a single fiscal 
year to any non-employee director, taken together with any cash fees paid to such non-employee director during the fiscal year, 
is limited to $500,000 in total value (calculating the value of any such awards based on the grant date fair value of such award 
for financial reporting purposes). The Compensation Committee may make exceptions to this limit for a non-executive chair of 
the Board or, in extraordinary circumstances, for other individual non-employee directors, as the Committee may determine in 
its discretion, provided that the non-employee director receiving such additional compensation may not participate in the decision 
to award such compensation.   

Deferred Compensation 

Each of our non-employee directors is eligible to participate in our Director Deferred Compensation Plan, under which the non-
employee director may elect annually to defer payment of all or a portion of his or her cash retainer fees and annual restricted 
stock unit grants until the termination of his or her service as a member of the Board. The amount of any cash compensation 
deferred by a non-employee director is converted into a number of deferred stock units, determined based upon the closing 
price of our common stock on the NASDAQ Global Select Market on the date such fees would otherwise have been payable, 
and credited to a deferred compensation account maintained in his or her name. Any restricted stock units that are deferred by 
a non-employee director are credited to the non-employee director’s account in the form of deferred stock units on a share-for-
share  basis  on  the  date  such  restricted  stock  units  would  otherwise  have  been  payable.  The  account  will  be  credited  with 
additional deferred stock units on the payment date for any dividends declared on our common stock, calculated based on the 
closing price of our common stock on the payment date. On the tenth business day of January of the year following a director’s 
termination of service for any reason, the amounts accumulated in the deferred compensation account will be paid in a lump 
sum in shares of our common stock under the 2016 Omnibus Plan equal to the number of whole deferred stock units in the 
account and cash in lieu of any fractional shares. 

The following table sets forth the number of deferred stock units credited to the accounts of our non-employee directors as of 
December 31, 2016.   

Name 
Azar 
Becker 
Callen 
Holster 
Miller 
Rudnick 
Schwartz 
Stowe 
Tellez 

Deferred Stock Units 
(#) 
  7,785 
  10,441 
  19,041 
  35,213 
  4,058 
  13,490 
  23,592 
  50,381 
  35,948 

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STOCK OWNERSHIP GUIDELINES FOR NON-EMPLOYEE DIRECTORS 

The Board of Directors has established significant stock ownership guidelines for our non-employee directors to encourage non-
employee directors to own and hold a meaningful ownership stake in HMS in order to further align their interests and actions 
with the interests of HMS and its shareholders. Our non-employee directors are required to own shares of HMS common stock 
equal in value to at least five times their annual cash retainer. For purposes of satisfying these guidelines, a non-employee 
director’s shares owned outright, directly or indirectly, restricted stock and restricted stock units, whether or not vested, and 
deferred stock units are counted in determining the non-employee director’s stock ownership. Each non-employee director is 
required to achieve his or her respective ownership guidelines within five years after election to the Board of Directors, or in the 
case of non-employee directors serving at the time the guidelines were adopted (July 28, 2016), within five years of the date of 
adoption. To mitigate the impact of stock price fluctuation, the number of shares required to be held by each non-employee 
director to satisfy the guidelines remains fixed through December 1, 2019. The Compensation Committee monitors compliance 
with these guidelines on an annual basis. 

The following graph summarizes the stock ownership of each of our non-employee directors as of December 1, 2016, as a 
multiple of annual cash retainer in effect as of December 1, 2016, pursuant to our Stock Ownership Guidelines.  

(1)  Messrs. Azar and Becker joined the Board on October 11, 2016 and January 29, 2016, respectively.  Pursuant to our stock ownership 
guidelines, Mr. Azar has until October 11, 2021 to achieve the ownership guideline, and Mr. Becker has until July 28, 2021 to achieve 
the ownership guideline. 

(2)  Rounded down to the nearest multiple. 

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2016 DIRECTOR COMPENSATION 

The following table sets forth compensation earned by each of our non-employee directors for services as a director during 
fiscal 2016.  

Name 
Alex M. Azar 
Robert Becker 
Craig R. Callen 
Robert M. Holster (5) 
William F. Miller 
Ellen A. Rudnick 
Bart M. Schwartz 
Richard H. Stowe 
Cora M. Tellez 

Fees Earned or 
Paid in Cash(1) 
($) 
13,217  
41,039  
61,720  
24,038  
54,860  
81,720  
78,720  
96,720  
79,360  

Stock 
Awards(2)(3) 
($) 
116,723  
155,272  
61,860  
— 
61,860  
61,860  
61,860  
61,860  
61,860  

Option 
Awards(2)(4) 
($) 
48,270  
62,169  
25,582  
— 
25,582  
25,582  
25,582  
25,582  
25,582  

Total 
($) 
178,210 
258,480 
149,162 
24,038 
142,302 
169,162 
166,162 
184,162 
166,802 

(1)  The amounts in this column include the value of fully vested deferred stock units received under our Director Deferred Compensation 
Plan in lieu of all or a specified portion of the non-employee director’s cash retainer fees, calculated based on the fair market value of 
the underlying shares on the dates the cash retainer fees would otherwise have been paid. The aggregate number of deferred stock 
units credited to non-employee directors in lieu of all or a specified portion of the non-employee director’s cash retainer fees for 2016, 
pursuant to each director’s election, and the aggregate fair market value (calculated as of the date the units were credited to the non-
employee director) of such deferred stock units are shown in Figure 1 below. 

(2)  The number of outstanding stock options and unvested restricted stock units, whether or not deferred under the Director Deferred 

Compensation Plan, held by the non-employee directors as of December 31, 2016 is shown in Figure 2 below. 

(3)  The amounts in this column represent the grant date fair value of the restricted stock units granted to the non-employee directors during 
fiscal  2016,  whether  or  not  deferred,  computed  in  accordance  with  FASB  guidance  on  stock-based  compensation.  The  relevant 
assumptions made in the valuations may be found in Note 1 of the Notes to the Consolidated Financial Statements in this Annual Report 
on Form 10-K for the fiscal year ended December 31, 2016. The number of restricted stock units granted to each non-employee director 
during fiscal 2016 and the number of such restricted stock units that were deferred under our Director Deferred Compensation Plan, 
pursuant to each director’s election, are shown in Figure 3 below. The restricted stock units, whether or not deferred, vest in four equal 
increments, with the first 25% vesting  on the last day of the calendar quarter of the date of grant, and 25% vesting on the last day of each 
of the next three calendar quarters. 

(4)  The amounts in this column represent the grant date fair value of the nonqualified stock options granted to the non-employee directors 
during fiscal 2016, computed in accordance with FASB guidance on stock-based compensation. The relevant assumptions made in the 
valuations may be found in Note 1 of the Notes to the Consolidated Financial Statements in this Annual Report on Form 10-K for the 
fiscal year ended December 31, 2016. The number of nonqualified stock options granted to each non-employee director during fiscal 
2016 is shown in Figure 4 below. The stock options vest in four equal increments, with the first 25% vesting  on the last day of the 
calendar quarter of the date of grant, and 25% vesting on the last day of each of the next three calendar quarters. 

(5)  Mr. Holster retired from the Board of Directors effective as of the 2016 Annual Meeting held on June 23, 2016, and therefore did not 

receive an equity grant during fiscal 2016. 

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FIGURE 1 – DEFERRED STOCK UNITS RECEIVED IN LIEU OF CASH DURING FISCAL 2016 

Name 
Azar 
Schwartz 
Stowe 
Tellez 

Deferred Stock Units 
Received in Lieu of 2016 
Cash Compensation 
(#) 
728 
2,229 
5,478 
4,486 

Fair Market Value 
($) 
13,220 
39,362 
96,728 
79,352 

FIGURE 2 – OUTSTANDING STOCK OPTIONS AND UNVESTED RESTRICTED STOCK UNITS 
AT DECEMBER 31, 2016 

Name 
Azar 
Becker 
Callen 
Holster 
Miller 
Rudnick 
Schwartz 
Stowe 
Tellez 

Outstanding 
Stock Options 
(#) 
7,057 
10,441 
19,041 
35,213 
26,983 
26,983 
26,983 
26,983 
21,725 

Unvested Restricted 
Stock Units 
(#) 
5,293 
2,805 
2,805 
— 
2,805 
2,806 
2,806 
2,805 
2,805 

FIGURE 3 – RESTRICTED STOCK UNITS GRANTED DURING FISCAL 2016 

Name 
Azar 
Becker 
Callen 
Miller 
Rudnick 
Schwartz 
Stowe 
Tellez 

Restricted Stock Units 
Granted(1) 
(#) 
7,057 
10,441 
3,740 
3,740 
3,740 
3,740 
3,740 
3,740 

Restricted Stock Units 
Deferred 
(#) 
7,057 
10,441 
3,740 
— 
1,870 
1,870 
3,740 
3,740 

(1)  The amount shown represents the number of restricted stock units granted to each non-employee director (other than Mr. Becker) on 
November 11, 2016. The amount shown for Mr. Becker represents the aggregate number of restricted stock units granted on March 2, 
2016 (6,701) and November 11, 2016 (3,740). 

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FIGURE 4 – STOCK OPTIONS GRANTED DURING FISCAL 2016 

Name 
Azar 
Becker 
Callen 
Miller 
Rudnick 
Schwartz 
Stowe 
Tellez 

Nonqualified Stock 
Options Granted(1) 
(#) 
7,057 
10,441 
3,740 
3,740 
3,740 
3,740 
3,740 
3,740 

(1)  The amount shown represents the number of nonqualified stock options granted to each non-employee director (other than Mr. Becker) 
on November 11, 2016. The amount shown for Mr. Becker represents the aggregate number of nonqualified stock options granted on 
March 2, 2016 (6,701) and November 11, 2016 (3,740). 

Item 12.  Security Ownership of Certain Beneficial Owners and Management and Related Shareholder Matters  

EQUITY COMPENSATION PLAN INFORMATION 

The following table summarizes information  about our equity compensation plans as  of December 31, 2016. For additional 
information about our equity compensation plans see Note 10 – “Stock-Based Compensation” in our Notes to the Consolidated 
Financial Statements in Item 8. Consolidated Financial Statements and Supplemental Data.  

Number of 
securities 
remaining 
available for future 
issuance under 
equity 
compensation 
plans (excluding 
securities reflected 
in column (a))
 (c)

7,142,562

—

Number of 
securities to be 
issued upon 
exercise of 
outstanding 
options, warrants 
and rights
(a)

Weighted-
average exercise 
price of 
outstanding 
options, 
warrants and 
rights
(b)

(1)

(2)

$                    

17.35

$                    

22.58

6,515,239

52,140
6,567,379

Plan Category

Equity compensation plans approved by shareholders 

Equity compensation plans not approved by shareholders
Total

(1)  This includes stock options and restricted stock units granted under our 2006 Stock Plan and 2016 Omnibus Plan. 

(2)  This  includes  stock  options  granted  under  the  2011  HDI  Plan,  which  was  assumed  in  connection  with  our  acquisition  of  HDI  and 

approved by the Compensation Committee of our Board.  

SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT 

The following tables set forth information known to us with respect to the beneficial ownership of our common stock as of May 15, 
2017 by (i) each of our directors, (ii) each of Messrs. Lucia, Sherman and Williams and Mses. Neuman and Nustad, our named 
executive officers for fiscal 2016, (iii) all of our directors and current executive officers as a group and (iv) each person (or group 
of affiliated persons) known by us to be the beneficial owner of more than 5% of our common stock. 

The tables are based upon information supplied to us by directors, executive officers and principal shareholders and filings 
under the Exchange Act. We have based our calculation of the percentage of beneficial ownership on 83,909,845 shares of our 

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common stock outstanding as of May 15, 2017, unless otherwise noted. The beneficial ownership reported in the following 
tables is determined in accordance with the applicable rules of the SEC and does not necessarily indicate beneficial ownership 
for any other purpose. For purposes of the following tables, an entity or individual is considered the beneficial owner of shares 
of common stock if the entity or individual directly or indirectly has or shares voting power or investment power, as defined in 
the rules of the SEC, with respect to such shares or has the right to acquire beneficial ownership of such shares within 60 days 
of May 15, 2017.  

Unless otherwise noted and subject to applicable community property laws, to our knowledge each shareholder named in the 
following table possesses sole voting and investment power over the shares listed. The address of each person listed in the 
table is c/o HMS Holdings Corp., 5615 High Point Drive, Irving, Texas 75038. To our knowledge, as of May 15, 2017, none of 
our officers or directors has pledged any of the shares that they respectively beneficially own as security.  

SECURITY OWNERSHIP OF MANAGEMENT 

Number of 
Shares 
Underlying 
Options 
Exercisable 
Within 60 
Days(1) 

Number of 
Shares 
Underlying 
Restricted 
Stock Units 
that will Vest 
Within 60 
Days(2)(3) 

Number of 
Outstanding Shares 
of Common Stock 

—
5,000   
19,000
 164,940 (4) 
42,980
 20,306   
25,000

 580   

522,092 (5) 
35,280   
32,209
50,507 (6) 
43,532

5,292 
 9,506 
18,106 
 26,048 
26,048 
26,048 
26,048 
 20,790 

482,316 
238,222 
224,462 
274,907 
243,676 

— 
— 
— 
935 
467 
467 
— 
— 

— 
— 
— 
— 
— 

995,664 (8) 

1,784,002 

1,869 

Percent 
of Class 

* 
* 
* 
* 
* 
* 
* 
* 

1.2% 
* 
* 
* 
* 

3.3% 

Name of Beneficial Owner 
Directors (who are not officers): 
Alex M. Azar II 
Robert Becker 
Craig R. Callen 
William F. Miller III 
Ellen A. Rudnick 
Bart M. Schwartz 
Richard H. Stowe 
Cora M. Tellez 
Named Executive Officers: 
William C. Lucia 
Semone Neuman 
Cynthia Nustad 
Jeffrey S. Sherman 
Douglas Williams 
All current directors and executive officers as a group (15 
persons)(7) 

* Less than 1% of outstanding shares 

(1) 

(2) 

Includes the number of shares that could be purchased by exercise of options exercisable at May 15, 2017 or within 60 days thereafter. 
The amounts reported in this column are excluded from the amounts reported in the column “Number of Outstanding Shares of Common 
Stock.” 

Includes the number of shares underlying restricted stock units that are not subject to outstanding performance conditions and vest 
within 60 days of May 15, 2017, and excludes vested and unvested deferred stock units acquired pursuant to the Director Deferred 
Compensation Plan. Restricted stock units do not have voting power and are payable solely in shares of HMS common stock. The 
amounts reported in this column are excluded from the amounts reported in the column “Number of Outstanding Shares of Common 
Stock.” 

(3)  Excludes deferred stock units (whether or not vested) held by non-employee directors pursuant to the Director Deferred Compensation 
Plan as follows: Mr. Azar (8,523), Mr. Becker (10,441), Mr. Callen (19,041), Mr. Miller (4,058), Ms. Rudnick (13,490), Mr. Schwartz 
(24,127), Mr. Stowe (51,672), and Ms. Tellez (37,018). 

(4) 

Includes 9,000 shares of common stock held in trusts for the benefit of Mr. Miller’s family. Mr. Miller disclaims beneficial ownership of 
the shares of common stock held by the trusts. 

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(5) 

(6) 

Includes 522,092 shares of common stock held by the William C. Lucia Family Trust, a revocable trust for which Mr. Lucia serves as 
trustee. 

Includes  10,760  shares  of  common  stock  held  by  a  revocable  family  trust  for  the  benefit  of  Mr.  Sherman’s  children  and  for  which 
Mr. Sherman and his spouse serve as trustees. 

(7) 

Includes the named executive officers, the current directors and Mses. Bjorck and South.  

(8) 

Includes the shares reported in footnotes (4), (5) and (6). 

Based on a review of filings with the SEC, the following entities hold more than 5% of our outstanding shares of common stock 
as of the date indicated on the respective filing. 

SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS 

Name and Address of Beneficial Owner 
BlackRock, Inc.(1) 
The Vanguard Group(2) 
T. Rowe Price Associates, Inc.(3) 

Number of Outstanding 
Shares of Common Stock  
(#) 
9,836,431 
7,907,910 
6,819,568 

Percent of Class 
(%) 
11.6 
9.3 
8.0 

(1)  Based solely on a Schedule 13G/A filed with the SEC on January 12, 2017. According to the Schedule 13G/A, BlackRock, Inc., in its 
capacity as a parent holding company or control person of subsidiaries that acquired the reported securities, has sole voting power over 
9,442,892 shares and sole dispositive power over 9,836,431 shares. The Schedule 13G/A was filed on BlackRock’s behalf and on 
behalf of its subsidiaries BlackRock (Netherlands) B.V.; BlackRock Advisors, LLC; BlackRock Asset Management Canada Limited; 
BlackRock Asset Management Ireland Limited; BlackRock Asset Management Schweiz AG; BlackRock Financial Management, Inc.; 
BlackRock  Fund  Advisors;  BlackRock  Institutional  Trust  Company,  N.A.;  BlackRock  Investment  Management  (Australia)  Limited; 
BlackRock Investment Management (UK) Ltd and BlackRock Investment Management, LLC. BlackRock Fund Advisors beneficially 
owns 5% or greater of the outstanding shares of the class. BlackRock’s principal business address is 55 East 52nd Street, New York, 
NY 10055. 

(2)  Based solely on a Schedule 13G/A filed with the SEC on February 13, 2017. According to the Schedule 13G/A, The Vanguard Group, 
a registered investment advisor, has sole voting power over 167,345 shares, shared voting power over 12,078 shares, sole dispositive 
power over 7,732,809 shares and shared dispositive power over 175,101 shares. Vanguard Fiduciary Trust Company, a wholly-owned 
subsidiary of The Vanguard Group, Inc., is the beneficial owner of 163,023 shares as a result of its serving as investment manager of 
collective trust accounts. Vanguard Investments Australia, Ltd., a wholly-owned subsidiary of The Vanguard Group, Inc., is the beneficial 
owner of 16,400 shares as a result of its serving as investment manager of Australian investment offerings. The Vanguard Group’s 
principal business address is 100 Vanguard Boulevard, Malvern, PA 19355.  

(3)  Based solely on a Schedule 13G filed with the SEC on February 2, 2017. According to the Schedule 13G, T. Rowe Price Associates, 
Inc., a registered investment advisor (“Price Associates”), has sole voting power over 957,740 shares and sole dispositive power over 
6,819,568 shares. Price Associates does not serve as custodian of the assets of any of its clients; accordingly, in each instance only 
the client or the client's custodian or trustee bank has the right to receive dividends paid with respect to, and proceeds from the sale of, 
such securities. The ultimate power to direct the receipt of dividends paid with respect to, and the proceeds from the sale of, such 
securities,  is  vested  in  the  individual  and  institutional  clients  which  Price  Associates  serves  as  investment  adviser.  Any  and  all 
discretionary authority which has been delegated to Price Associates may be revoked in whole or in part at any time.  Price Associates’ 
principal business address is 100 E. Pratt Street, Baltimore, MD 21202. 

Item 13.  Certain Relationships and Related Transactions and Director Independence 

CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS 

Related Person Transaction Policy 

The Audit Committee is responsible for reviewing all transactions with related persons on an ongoing basis for potential conflict 
of interest situations, and all such transactions must be approved by the Audit Committee. Our Board of Directors has adopted 
a written Related Person Transaction Policy to assist the Audit Committee in reviewing proposed transactions between HMS 
and certain individuals deemed to be “related persons.” The policy applies to our executive officers, directors, director nominees 
and 5% shareholders (and their immediate family members), each of whom we refer to as a “related person,” and governs the 

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review of any transaction, arrangement or relationship in which we are a participant, the amount involved exceeds $120,000 
and a related person has a direct or indirect material interest. We refer to such a transaction, arrangement or relationship as a 
“related person transaction.”  

Review and Approval of Related Person Transactions 

Pursuant to our Related Person Transaction Policy, a related person must notify the Corporate Secretary of any plan to enter 
into,  extend  or  modify  any  transaction  with  HMS  or  its  affiliates  that  could  be  a  related  person  transaction.  The  proposed 
transaction is reviewed and, if deemed appropriate, approved by the Audit Committee prior to entry into the transaction. Under 
the policy, any related person transactions that are ongoing in nature and previously approved by the Audit Committee will be 
reviewed annually. A transaction with a related person reviewed under the policy will be considered approved or ratified if it is 
authorized by the Audit Committee after full disclosure of the related person’s interest in the transaction. The Audit Committee 
will review and consider all relevant information regarding the transaction, including the impact on a director’s independence or 
a Board committee’s composition in the event the related person is a director, as it deems appropriate under the circumstances.  

The  Audit  Committee  may  approve  or  ratify  the  transaction  only  if  the  Audit  Committee  determines  that,  under  all  of  the 
circumstances,  the  transaction  is  in,  or  is  not  inconsistent  with,  the  best  interests  of  HMS.  In  connection  with  approving  a 
transaction with a related person, the Audit Committee may impose any conditions on the transaction that it deems appropriate. 
All related person transactions will be disclosed in applicable SEC filings to the extent required by the Securities Act and the 
Exchange Act and related rules and regulations. There have been no transactions with related persons since the beginning of 
fiscal 2016 reportable pursuant to applicable SEC rules. 

DIRECTOR INDEPENDENCE 

A majority of our Board of Directors must be comprised of “independent directors” in accordance with the NASDAQ Marketplace 
Rules. Under Rule 5605(a)(2) of the NASDAQ Marketplace Rules, a director will only qualify as an “independent director” if, in 
the  opinion  of  our  Board  of  Directors,  that  person  does  not  have  a  relationship  which  would  interfere  with  the  exercise  of 
independent judgment in carrying out the responsibilities of a director. Based  on its review of the  applicable independence 
standards and answers to annual questionnaires completed by the directors, our Board of Directors has determined that each 
of Messrs. Azar, Becker, Callen, Miller, Schwartz and Stowe and Mses. Rudnick and Tellez is an “independent director” as 
defined under the NASDAQ Marketplace Rules. The Board of Directors previously determined that Mr. Robert M. Holster, who 
retired from our Board of Directors effective at the 2016 annual meeting of shareholders, was an independent director during 
the time he served on the Board in 2016. 

Item 14.  Principal Accounting Fees and Services 

INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM   

KPMG LLP (“KPMG”) has served as our (and our predecessor’s) independent registered public accounting firm since 1981. The 
aggregate fees for the services rendered by KPMG during the past two fiscal years are set forth in the table below. 

Audit and Non-Audit Fees  

Type of Fee 
Audit Fees(1) 
Audit-Related Fees(2) 
Tax Fees(3) 
All Other Fees(4) 
Total Fees for Services Provided(5) 

2016 
($) 
1,600,000 
— 
1,757,388 
— 
3,357,388 

2015 
($) 
945,000 
— 
320,000 
— 
1,265,000 

 (1)  Audit fees consist of fees for professional services rendered for the audit of our consolidated financial statements, review of interim 
financial statements and services normally provided by the independent registered public accounting firm in connection with regulatory 
filings, including registration statements. The amount shown for fiscal 2016 represents the aggregate fees estimated to be billed by 
KPMG for the services rendered.  

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(2)  Audit-related fees may consist of fees for audits of benefit plans and due diligence related to mergers and acquisitions. KPMG did not 

perform any audit-related services during fiscal years 2015 and 2016. 

(3)  Tax fees consist of fees for permissible tax services, including tax compliance, tax analysis and tax implementation provided during the 

ordinary course of operations. 

(4)  All other fees consist of services not included in the categories above. KPMG did not perform any other services during fiscal years 

2015 and 2016. 

(5)  All audit and non-audit services disclosed in the table were pre-approved by the Audit Committee prior to the provision of the services.     

Audit Committee Pre-Approval Policies and Procedures 

In accordance with its Charter, the Audit Committee pre-approves all audit and permissible non-audit services provided by our 
independent  registered  public  accounting  firm.  At  the  time  of  the  annual  engagement  of  our  independent  registered  public 
accounting firm or as soon as practicable thereafter, the Audit Committee pre-approves specific services and/or categories of 
services that may be provided during the year by the independent registered public accounting firm and the estimated fees for 
such  services.  During  the  year,  circumstances  may  arise  when  it  may  become  necessary  or  appropriate  to  engage  the 
independent  registered  public  accounting  firm  for  additional  services  not  contemplated  in  the  original  pre-approval.  In  such 
circumstances, our senior management seeks approval from the Audit Committee to engage the independent registered public 
accounting firm for such additional services. A description of any proposed non-audit services is provided to the Audit Committee 
along with the estimated fees for its pre-approval. For each proposed service, the independent registered public accounting firm 
is  required  to  provide  detailed  supporting  documentation  at  the  time  of  approval  to  permit  the  Audit  Committee  to  make  a 
determination  whether the  performance of  such services  would impair the  auditor’s independence. The  Audit  Committee is 
regularly informed of any non-audit services provided by the independent auditor pursuant to this pre-approval process. 

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Item 15.  Exhibits and Financial Statement Schedules 

1. 

Financial Statements. 

PART IV 

The financial statements are listed in the Index to Consolidated Financial Statements on page 102. 

2. 

Financial Statement Schedules. 

Financial  Statement  Schedule II-Valuation  and  Qualifying  Accounts  is  set  forth  on  page  126.  All  other  financial 
statement schedules have been omitted as they are either not required, not applicable or the information is otherwise 
included. 

3. 

Exhibits. 

The Exhibits are set forth on the Exhibit Index on page 127 and incorporated herein by reference. The Exhibits include 
agreements to which the Company is a party or has a beneficial interest. The agreements have been filed to provide 
investors with information regarding their respective terms. The agreements are not intended to  provide  any  other 
actual  information  about  the  Company  or  its  business  or  operations.  In  particular,  the  assertions  embodied  in  any 
representations, warranties, and covenants contained in the agreements may be subject to qualifications with respect 
to  knowledge  and  materiality  different  from  those  applicable  to  investors  and  may  be  qualified  by  information  in 
confidential disclosure schedules not included with the exhibits. These disclosure schedules may contain information 
that  modifies,  qualifies  and  creates  exceptions  to  the  representations,  warranties  and  covenants  set  forth  in  the 
agreements. Moreover, certain representations, warranties, and covenants in the agreements may have been used for 
the  purpose  of  allocating  risk  between  parties,  rather  than  establishing  matters  as  facts.  In  addition,  information 
concerning the subject matter of the representations, warranties and covenants may have changed after the date of 
the respective agreement, which subsequent information may or may not be fully reflected in the Company’s public 
disclosures. Accordingly, investors should not rely on the representations, warranties and covenants in the agreements 
as characterizations of the actual state of facts about the Company or its business or operations on the date hereof. 

Item 16. Form 10-K Summary  

None.  

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SIGNATURES 

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, as amended, the Registrant has 
duly caused this Annual Report on Form 10-K to be signed on  its behalf by the undersigned, thereunto duly authorized on 
June 6, 2017.  

HMS Holdings Corp.  

/s/ WILLIAM C. LUCIA 
William C. Lucia 
Chairman of the Board, President and Chief 
Executive Officer 

Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, this Annual Report on Form 10-K has been 
signed below by the following persons on behalf of the Registrant and in the capacities indicated on June 6, 2017.  

Signature 

Title 

/s/ WILLIAM C. LUCIA 
William C. Lucia 

/s/ JEFFREY S. SHERMAN    
Jeffrey S. Sherman 

/s/ GREG D. AUNAN 
Greg D. Aunan 

/s/ ALEX M. AZAR II 
Alex M. Azar II 

/s/ ROBERT BECKER 
Robert Becker 

/s/ CRAIG R. CALLEN 
Craig R. Callen 

/s/ WILLIAM F. MILLER III 
William F. Miller III 

/s/ ELLEN A. RUDNICK 
Ellen A. Rudnick 

/s/ BART M. SCHWARTZ 
Bart M. Schwartz 

/s/ RICHARD H. STOWE 
Richard H. Stowe 

/s/ CORA M. TELLEZ 
Cora M. Tellez 

Director, Chairman of the Board, President and Chief Executive 
Officer (Principal Executive Officer) 

Executive Vice President, Chief Financial Officer and Treasurer 
(Principal Financial Officer) 

Senior Vice President and Chief Accounting Officer (Principal 
Accounting Officer) 

Director 

Director 

Director 

Director 

Director 

Director 

Director 

Director 

97 

 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
HMS HOLDINGS CORP. AND SUBSIDIARIES 
INDEX TO CONSOLIDATED FINANCIAL STATEMENTS 

Consolidated Financial Statements: 
Reports of Independent Registered Public Accounting Firm 
Consolidated Balance Sheets as of December 31, 2016 and 2015 
Consolidated Statements of Income for the Years Ended December 31, 2016, 2015, and 2014 
Consolidated Statements of Shareholders’ Equity for the Years Ended December 31, 2016, 2015, and 2014  
Consolidated Statements of Cash Flows for the Years Ended December 31, 2016, 2015, and 2014  
Notes to the Consolidated Financial Statements 

Financial Statement Schedule: 
Schedule II - Valuation and Qualifying Accounts 

Page 
Number 

99 - 101 
102 
103 
104 
105 
106 

126 

98 

 
 
 
 
 
 
 
 
 
 
 
 
 
Report of Independent Registered Public Accounting Firm 

The Board of Directors and Shareholders 
HMS Holdings Corp.: 

We have audited the accompanying consolidated balance sheets of HMS Holdings Corp. and subsidiaries as of December 31, 
2016 and 2015, and the related consolidated statements of income, shareholders’ equity, and cash flows for each of the years 
in the three-year period ended December 31, 2016. In connection with our audits of the consolidated financial statements, we 
also have audited financial statement schedule II. These consolidated financial statements and financial statement schedule 
are the responsibility of the Company’s management. Our responsibility is to express an opinion on these consolidated financial 
statements and financial statement schedule based on our audits. 

We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States). 
Those  standards  require  that  we  plan  and  perform  the  audit  to  obtain  reasonable  assurance  about  whether  the  financial 
statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts 
and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant 
estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits 
provide a reasonable basis for our opinion. 

In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position 
of HMS Holdings Corp. and subsidiaries as of December 31, 2016 and 2015, and the results of their operations and their cash 
flows  for  each  of  the  years  in  the  three-year  period  ended  December 31,  2016,  in  conformity  with  U.S. generally  accepted 
accounting principles. Also in our opinion, the related financial statement schedule, when considered in relation to the basic 
consolidated financial statements taken as a whole, presents fairly, in all material respects, the information set forth therein. 

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), 
HMS Holdings Corp.’s internal control over financial reporting as of December 31, 2016, based on criteria established in Internal 
Control – Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission 
(COSO), and our report dated June 6, 2017 expressed an adverse opinion on the effectiveness of the  Company’s internal 
control over financial reporting. 

/s/ KPMG LLP 
KPMG LLP 
Dallas, Texas 
June 6, 2017 

99 

 
 
 
 
 
 
 
 
 
 
Report of Independent Registered Public Accounting Firm 

The Board of Directors and Shareholders 
HMS Holdings Corp.: 

We have audited HMS Holdings Corp.’s internal control over financial reporting as of December 31, 2016, based on criteria 
established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the 
Treadway Commission (COSO). HMS Holdings Corp.'s management is responsible for maintaining effective internal control 
over financial reporting and for its assessment of the effectiveness of internal control over financial reporting, included in the 
accompanying Management’s Report on Internal Control Over Financial Reporting. Our responsibility is to express an opinion 
on the Company's internal control over financial reporting based on our audit. 

We conducted our audit in accordance with the standards of the Public Company Accounting Oversight Board (United States). 
Those standards require that we plan and perform the audit to obtain reasonable assurance about whether effective internal 
control over financial reporting was maintained in all material respects. Our audit included obtaining an understanding of internal 
control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and 
operating effectiveness of internal control based on the assessed risk. Our audit also included performing such other procedures 
as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion. 

A  company's  internal  control  over  financial  reporting  is  a  process  designed  to  provide  reasonable  assurance  regarding  the 
reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally 
accepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures 
that  (1)  pertain  to  the  maintenance  of  records  that,  in  reasonable  detail,  accurately  and  fairly  reflect  the  transactions  and 
dispositions of the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary to 
permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and 
expenditures  of  the  company  are  being  made  only  in  accordance  with  authorizations  of  management  and  directors  of  the 
company; and (3) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or 
disposition of the company’s assets that could have a material effect on the financial statements. 

Because  of its inherent  limitations, internal  control  over financial reporting may not prevent  or  detect  misstatements.  Also, 
projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate 
because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. 

A material weakness is a deficiency, or a combination of deficiencies, in internal control over financial reporting, such that there 
is  a  reasonable  possibility  that  a  material  misstatement  of  the  company’s  annual  or  interim  financial  statements  will  not  be 
prevented or detected on a timely basis. Material weaknesses existed related to the Company not maintaining an effective 
control  environment  based  on  a  lack  of  established  reporting  lines  and  defined  authorities  and  responsibilities  for  financial 
reporting, and not conducting an effective risk assessment process on a periodic basis to assess the effects of changes in 
business operations and turnover of its employees that significantly impacts its financial processes and internal control over 
financial reporting. As a result, the Company did not design and implement effective control activities and management review 
controls over the estimated liability of appeals and the accounts receivable allowance, including controls over the completeness 
and accuracy of data used to calculate the respective account balances. These material weaknesses have been identified and 
included  in  management’s  assessment.  We  also  have  audited,  in  accordance  with  the  standards  of  the  Public  Company 
Accounting Oversight Board (United States), the consolidated balance sheets of HMS Holdings Corp. and subsidiaries as of 
December 31, 2016 and 2015, and the related consolidated statements of income, shareholders’ equity and cash flows for each 
of the years in the three-year period ended December 31, 2016. These material weaknesses were considered in determining 
the nature, timing, and extent of audit tests applied in our audit of the 2016 consolidated financial statements, and this report 
does  not  affect  our  report  dated  June  6,  2017,  which  expressed  an  unqualified  opinion  on  those  consolidated  financial 
statements. 

100 

 
 
 
 
In our opinion, because of the effect of the aforementioned material weaknesses on the achievement of the objectives of the 
control criteria, HMS Holdings Corp. has not maintained effective internal control over financial reporting as of December 31, 
2016, based on criteria established in Internal Control—Integrated Framework (2013) issued by the Committee of Sponsoring 
Organizations of the Treadway Commission (COSO). 

/s/ KPMG LLP 
KPMG LLP 
Dallas, Texas 
June 6, 2017 

101 

 
 
 
 
 
HMS HOLDINGS CORP. AND SUBSIDIARIES 
CONSOLIDATED BALANCE SHEETS 
(in thousands, except share and per share amounts)  

December 31, 
2016

December 31, 
2015

$        

$       

175,999
173,582
13,699
3,354
1,001
367,635
92,167
379,716
37,797
2,790
2,650
882,755

145,610
169,146
11,261
-
3,051
329,068
96,551
361,468
54,308
4,873
4,329
850,597

$        

$       

$          

59,402
30,755
-
90,157

$         

51,661
33,078
3,873
88,612

197,796
22,717
5,427
10,048
235,988
326,145

197,796
30,961
6,006
2,520
237,283
325,895

-

-

959
345,025
326,110
(115,484)

556,610

952
330,290
288,474
(95,014)

524,702

$        

882,755

$       

850,597

Assets
Current assets:

Cash and cash equivalents
Accounts receivable, net of allowance of $10,772 and $11,464, at December 31, 2016 and 2015, respectively
Prepaid expenses
Income tax receivable
Other current assets
Total current assets
Property and equipment, net
Goodwill
Intangible assets, net
Deferred financing costs, net
Other assets

Total assets

Liabilities and Shareholders' Equity
Current liabilities: 

Accounts payable, accrued expenses and other liabilities
Estimated liability for appeals
Income taxes payable
Total current liabilities

Long-term liabilities: 

Revolving credit facility
Net deferred tax liabilities
Deferred rent
Other liabilities

Total long-term liabilities

Total liabilities

Commitments and contingencies (Note 12) 

Shareholders' equity: 
Preferred stock -- $0.01 par value; 5,000,000 shares authorized; none issued
Common stock -- $0.01 par value; 175,000,000 shares authorized; 95,966,852 shares issued and 83,552,774 shares

outstanding at December 31, 2016; 95,263,461 shares issued and 83,989,715 shares outstanding at December 31, 2015

Capital in excess of par value
Retained earnings
Treasury stock, at cost -- 12,414,078 shares at December 31, 2016 and 11,273,746 shares December 31, 2015

Total shareholders' equity

Total liabilities and shareholders' equity

See accompanying notes to the consolidated financial statements. 

102 

 
 
 
 
 
 
 
 
 
          
         
            
           
              
                
              
            
          
         
            
           
          
         
            
           
              
            
              
            
            
           
                 
            
            
           
          
         
            
           
              
            
            
            
          
         
          
         
                 
                
                
               
          
         
          
         
         
          
          
         
HMS HOLDINGS CORP. AND SUBSIDIARIES 
CONSOLIDATED STATEMENTS OF INCOME 
(in thousands, except per share amounts)  

Revenue
Cost of services:
Compensation
Data processing
Occupancy
Direct project expenses
Other operating expenses
Amortization of acquisition related software and intangible assets

Total cost of services

Selling, general and administrative expenses

Total operating expenses

Operating income

Interest expense
Interest income

Income before income taxes

Income tax expense
Net income

Basic income per common share:

Years Ended December 31, 
2015
$ 
474,216

2016
$ 
489,720

$ 

2014
443,225

189,271
37,337
14,000
46,254
27,778
28,030
342,670
89,381
432,051
57,669
(8,519)
321
49,471
11,835
37,636

$   

178,272
40,915
15,766
51,527
28,895
28,148
343,523
83,121
426,644
47,572
(7,812)
49
39,809
15,282
24,527

$   

181,273
39,661
16,950
36,866
24,588
28,612
327,950
81,071
409,021
34,204
(7,931)
57
26,330
12,383
13,947

$   

Net income per common share -- basic

$      

0.45

$      

0.28

$      

0.16

Diluted income per common share:

Net income per common share -- diluted

$      

0.43

$      

0.28

$      

0.16

Weighted average shares: 

Basic 
Diluted  

84,221
86,987

87,881
88,361

87,673
88,164

See accompanying notes to the consolidated financial statements

103 

 
   
 
  
   
   
   
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
   
   
   
     
     
     
   
   
   
     
     
     
     
     
     
         
           
           
     
     
     
     
     
     
     
     
     
     
     
     
HMS HOLDINGS CORP. AND SUBSIDIARIES 
CONSOLIDATED STATEMENTS OF SHAREHOLDERS’ EQUITY  
(in thousands except share and per share amounts)  

Balance at January 1, 2014

Common Stock

Treasury Stock

# of Shares 
Issued
93,826,453

Par Value
$         
936

Capital in 
Excess of 
Par Value
$ 
296,517

Retained 
Earnings
$ 
250,000

# of Shares
6,526,305

Amount
$     

(45,014)

Total 
Shareholders' 
Equity

$         

502,439

Net income
Stock-based compensation expense
Exercise of stock options
Vesting of restricted stock awards and units, net of shares withheld for employee tax
Excess tax benefit from exercise of stock options
Shortfall due to exercise of stock options
Deferred tax asset reversal for unexercised stock options

-
-
516,552
168,439
-
-
-

5
2

-
-

-
-
-

-
13,356
4,105
(1,660)
1,795
(323)
(576)

13,947
-
-
-
-
-
-

-
-
-
-
-
-
-

-
-
-
-
-
-
-

13,947
13,356
4,110
(1,658)
1,795
(323)
(576)

Balance at December 31, 2014

94,511,444

943

313,214

263,947

6,526,305

(45,014)

533,090

Net income
Stock-based compensation expense
Purchase of treasury stock
Exercise of stock options
Vesting of restricted stock awards and units, net of shares withheld for employee tax
Excess tax benefit from exercise of stock options
Shortfall due to exercise of stock options
Deferred tax asset reversal for unexercised stock options

-
-
-
577,559
174,458
-
-
-

-
-
-

-
-
-

7
2

-
14,297
-
4,180
(1,031)
1,569
(827)
(1,112)

24,527
-
-
-
-
-
-
-

-
-

4,747,441

-
-
-
-
-

Balance at December 31, 2015

95,263,461

952

330,290

288,474

11,273,746

Net income
Stock-based compensation expense
Purchase of treasury stock
Exercise of stock options
Vesting of restricted stock awards and units, net of shares withheld for employee tax

-
-
-
510,512
192,879

-
-
-

5
2

-
13,277
-
2,935
(1,477)

37,636
-
-
-
-

-
-

1,140,332

-
-

-
-
(50,000)
-
-
-
-
-

(95,014)

-
-
(20,470)
-
-

24,527
14,297
(50,000)
4,187
(1,029)
1,569
(827)
(1,112)

524,702

37,636
13,277
(20,470)
2,940
(1,475)

Balance at December 31, 2016

95,966,852

$         

959

$ 

345,025

$ 

326,110

12,414,078

$  

(115,484)

$         

556,610

See accompanying notes to the consolidated financial statements. 

104 

 
 
 
    
    
                   
            
             
      
                
               
              
                   
            
      
             
                
               
              
          
                
        
             
                
               
                
          
                
       
             
                
               
               
                   
            
        
             
                
               
                
                   
            
          
             
                
               
                  
                   
            
          
             
                
               
                  
    
           
    
    
    
       
            
                   
            
             
      
                
               
              
                   
            
      
             
                
               
              
                   
            
             
             
    
       
             
          
                
        
             
                
               
                
          
                
       
             
                
               
               
                   
            
        
             
                
               
                
                   
            
          
             
                
               
                  
                   
            
       
             
                
               
               
    
           
    
    
 
       
            
                   
            
             
      
                
               
              
                   
            
      
             
                
               
              
                   
            
             
             
    
       
             
          
                
        
             
                
               
                
          
                
       
             
                
               
               
    
 
HMS HOLDINGS CORP. AND SUBSIDIARIES 
CONSOLIDATED STATEMENTS OF CASH FLOWS 
(in thousands)  

Years ended December 31, 
2015

2014

2016

Operating activities:

Net income 

$    

37,636

$     

24,527

$   

13,947

Adjustments to reconcile net income to net cash provided by operating activities:

Depreciation and amortization of property and equipment
Amortization of intangible assets
Amortization of deferred financing costs
Stock-based compensation expense
Deferred income taxes
(Gain) / Loss on disposal of assets
Change in fair value of contingent consideration
Changes in operating assets and liabilities, net of the effect of acquistions: 

Accounts receivable
Prepaid expenses
Prepaid income taxes
Other current assets
Other assets
Income taxes receivable / (payable)
Accounts payable, accrued expenses and other liabilities
Estimated liability for appeals
Net cash provided by operating acitivties

Investing activities: 

Acquisition of a business, net of cash acquired
Proceeds from sale of cost basis investment
Purchases of land, property and equipment
Investment in capitalized software

Net cash used in investing activities

Financing activities: 

Repayment of revolving credit facility
Proceeds from exercise of stock options
Payments of tax withholdings on behalf of employees for net-share

settlement for stock-based compensation

Payments on capital lease obligations
Payments on contingent consideration
Purchases of treasury stock

Net cash used in financing activities

Net increase in cash and cash equivalents
Cash and cash equivalents
    Cash and cash equivalents at beginning of year
    Cash and cash equivalents at end of year

Supplemental disclosure of cash flow information:

Cash paid for income taxes

Cash paid for interest

Supplemental disclosure of noncash activities: 

24,882
20,164
2,083
13,277
(7,368)
(948)
-

(3,554)
(2,399)
-
2,066
234
(7,227)
12,116
(2,323)
88,639

(20,678)
2,496
(13,703)
(7,316)
(39,201)

-
2,940

(1,475)
(44)
-
(20,470)
(19,049)
30,389

30,328
20,270
2,084
14,297
(14,020)
84
-

(12,045)
549
6,711
(412)
10
3,873
(250)
(3,721)
72,285

-
-
(8,620)
(3,197)
(11,817)

-
4,187

(1,029)
(1,132)
-
(50,000)
(47,974)
12,494

32,864
20,734
2,084
13,356
(12,290)
219
(517)

14,625
1,132
3,445
(2,150)
121
-
18,039
(5,053)
100,556

-
-
(22,687)
(3,514)
(26,201)

(35,000)
4,110

(1,658)
(1,629)
(428)
-
(34,605)
39,750

145,610
175,999

$ 

133,116
145,610

$  

93,366
$ 
133,116

$    

20,326

$      

6,196

$     

22,878

$       

5,694

$   

21,144

$     

4,458

Change in balance of accrued property and equipment purchases

$         

684

$          

729

$     

1,610

See accompanying notes to the consolidated financial statements. 

105 

 
 
 
 
      
       
     
      
       
     
        
         
        
      
       
     
       
      
    
          
               
           
             
              
          
       
      
     
       
             
        
             
         
        
        
           
      
            
               
           
       
         
            
      
           
     
       
        
      
      
       
   
     
              
            
        
              
            
     
        
    
       
        
      
     
      
    
             
              
    
        
         
        
       
        
      
             
        
      
             
              
          
     
      
            
     
      
    
      
       
     
    
     
     
  HMS HOLDINGS CORP. AND SUBSIDIARIES 
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS 

1. 

Business and Summary of Significant Accounting Policies  

(a) Business 

HMS is a leading provider of cost containment solutions in the U.S. healthcare marketplace. Using innovative technology as 
well as extensive data services and powerful analytics, the Company delivers coordination of benefits, payment integrity and 
care management solutions through its operating subsidiaries to help healthcare payers improve performance and outcomes. 
The Company is managed and operates as one business segment with a single management team that reports to the Chief 
Executive  Officer.  The  Company  serves  state  Medicaid  programs,  commercial  health  plans,  federal  government  health 
agencies, government and private employers, child support agencies, and other healthcare payers and sponsors. Together the 
various services help the Company’s customers recover improper payments; prevent future improper payments; reduce fraud, 
waste and abuse; and ensure regulatory compliance.  

(b) Summary of Significant Accounting Policies 

(i)  Principles of Consolidation 

The consolidated financial statements include the Company’s accounts and transactions and those of the Company’s wholly 
owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation. 

(ii)   Use of Estimates 

The preparation of the consolidated financial statements in conformity with United States Generally Accepted Accounting 
Principles (“U.S. GAAP”) requires management to make estimates and assumptions that affect the reported amounts of 
assets  and  liabilities  and  disclosure  of  contingent  assets  and  liabilities  at  the  date  of  the  financial  statements  and  the 
reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. 

(iii)  Reclassifications 

In  the  2015  Consolidated  Balance  Sheets,  the  Company  reported  Accounts  Receivable,  net  of  allowance  for  doubtful 
accounts and estimated allowance for appeals. In the 2016 Consolidated Balance Sheets, Accounts Receivable, net of 
allowance includes the allowance for doubtful accounts, revenue adjustments and the estimated allowance for appeals.  

(iv)  Cash and Cash Equivalents 

The Company considers all highly liquid investments with an original maturity of three months or less to be cash equivalents. 
Cash equivalents consist of deposits that are readily convertible into cash. 

(v)  Concentration of Credit Risk 

The Company’s policy is to limit credit exposure by placing cash in accounts which are exposed to minimal interest rate 
and credit risk. HMS maintains cash and cash equivalents in cash depository accounts with large financial institutions with 
a minimum credit rating of A1/P1 or better, as defined by Standard and Poor’s. The balance at these institutions generally 
exceeds the maximum balance insured by the Federal Deposit Insurance Corporation of up to $250,000 per entity. HMS 
has not experienced any losses in cash and cash equivalents and believes these cash and cash equivalents do not expose 
the Company to any significant credit risk. 

The Company is subject to potential credit risk related to changes in economic conditions within the healthcare market. 
However,  HMS  believes  that  the  billing  and  collection  policies  are  adequate  to  minimize  the  potential  credit  risk.  The 
Company performs ongoing credit evaluations of customers and generally does not require collateral.  

106 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(vi)  Property and Equipment 

Property and equipment are stated at cost less accumulated  depreciation. Depreciation is provided over the estimated 
useful lives of the assets utilizing the straight-line method. HMS amortizes leasehold improvements on a straight-line basis 
over the term of the related lease which is typically five years, including any anticipated renewal periods, or the life of the 
leasehold improvement, whichever is shorter. Equipment leased under capital leases is depreciated over the shorter of 
(i) the term of the lease and (ii) the estimated useful life of the equipment. Capitalized software costs related to software 
that is acquired or developed for internal use while in the application development stage. All other costs to develop software 
for internal use, either in the preliminary project stage or post-implementation stage, are expensed as incurred. Amortization 
of capitalized software is calculated on a straight-line basis over the expected economic life. Land is not depreciated.  

Estimated useful lives are as follows: 

Property and Equipment
Equipment
Leasehold improvements
Furniture and fixtures
Capitalized software
Building and building improvements

Useful Life
2 - 3 years
3 - 10 years
3 - 5 years
3 - 10 years
up to 39.5 years

Property and equipment is reviewed for impairment whenever events or changes in circumstances indicate that the carrying 
amount of an asset may not be recoverable. When indicators exist, recoverability of assets is measured by a comparison 
of the carrying value of the asset group to the estimated undiscounted future net cash flows expected to be generated by 
the asset. If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by 
which the carrying value of the asset group exceeds the fair value of the assets, which amount is charged to earnings. Fair 
value is based on a projection of the estimated discounted future net cash flows expected to result from the asset group, 
using a discount rate reflective of the Company’s cost of funds. The Company did not recognize any impairment charges 
related to property and equipment during the years ended December 31, 2016, 2015 or 2014. 

(vii) Intangible Assets 

The Company records assets acquired and liabilities assumed in a business combination based upon their acquisition date 
fair values. In most instances there is not a readily defined or listed market price for individual assets and liabilities acquired 
in connection with a business, including intangible assets. The determination of fair value for individual assets and liabilities 
in many instances requires a high degree of estimation and the valuation of intangible assets, in particular, is subjective. 
Significant estimates in intangible assets include, but are not limited to, growth rates, discount rates, customer attrition 
rates,  expected  levels  of  revenues,  earnings,  cash  flows  and  tax  rates.  The  use  of  different  valuation  techniques  and 
assumptions are inherently uncertain and unpredictable and, as a result, actual results may differ from estimates. All of the 
Company’s  intangible  assets  are  subject  to  amortization  and  are  amortized  using  the  straight-line  method  over  their 
estimated period of benefit. Estimated useful lives are as follows: 

Intangible Assets
Customer relationships
Restrictive covenants
Trade name
Intellectual property

Useful Life
5 - 10 years
3 - 7 years
3 - 5 years
5 years

Intangible assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying 
amount of an asset may not be recoverable. When indicators exist, recoverability of assets is measured by a comparison 
of the carrying value of the asset group to the estimated undiscounted future net cash flows expected to be generated by 
the asset. If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by 

107 

 
 
 
 
 
 
 
 
 
 
 
which the carrying value of the asset group exceeds the fair value of the assets, which amount is charged to earnings. Fair 
value is based on a projection of the estimated discounted future net cash flows expected to result from the asset group, 
using a discount rate reflective of the Company’s cost of funds. The Company did not recognize any impairment charges 
related to intangible assets during the years ended December 31, 2016, 2015 or 2014. 

(viii) Goodwill 

Goodwill is the excess of acquisition costs over the fair values of assets and liabilities of acquired businesses. During the 
measurement period, which is up to one year from the acquisition date, the Company may record adjustments to the assets 
acquired and liabilities assumed, with the corresponding offset to goodwill. Upon the conclusion of the measurement period, 
any subsequent adjustments are recorded to earnings. 

Goodwill is subject to a periodic assessment for impairment. HMS assesses goodwill for impairment on an annual basis as 
of June 30th of each year or more frequently if an event occurs or changes in circumstances would more likely than not 
reduce  the  fair  value  of  a  reporting  unit  below  its  carrying  amount.  Assessment  of  goodwill  impairment  is  at  the  HMS 
Holdings Corp. entity level as the Company operates as a single reporting unit. The Company has the option to perform a 
qualitative assessment to determine if impairment is more likely than not to have occurred. If the Company can support the 
conclusion that it is more likely than not that the fair value of a reporting unit is greater than its carrying amount, then HMS 
would not need to perform the two-step impairment test for that reporting unit.  If the Company cannot support such a 
conclusion,  or  the  Company  does  not  elect  to  perform  the  qualitative  assessment,  then  the  first  step  of  the  goodwill 
impairment test is used to identify  potential impairment by comparing the fair value of a reporting  unit with its carrying 
amount, including goodwill. HMS completed the annual impairment test as of June 30, 2016 using the optional qualitative 
assessment and determined no impairment existed. There were no impairment charges related to goodwill during the years 
ended December 31, 2016, 2015 or 2014.    

(ix)  Income Taxes 

Income taxes are accounted for under the asset and liability method. Under this method, deferred tax assets and liabilities 
are  recognized  for  the  future  tax  consequences  attributable  to  temporary  differences  between  the  financial  statement 
carrying amounts of existing assets and liabilities and their respective tax bases. This method also requires the recognition 
of future tax benefits for net operating loss carry-forwards. Deferred tax assets and liabilities are measured using enacted 
tax  rates  expected  to  apply  to  taxable  income  in  the  years  in  which  those  temporary  differences  are  expected  to  be 
recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized as income or 
expense in the period that includes the enactment date. A valuation allowance is provided against deferred tax assets to 
the extent their realization is not more likely than not. Uncertain income tax positions are accounted for by prescribing a 
minimum recognition threshold that a tax position is required to meet before being recognized in the financial statements. 
Although the Company believes that it has adequately reserved for uncertain tax positions (including interest and penalties), 
it can provide no assurance that the final tax outcome of these matters will not be materially different. The Company makes 
adjustments  to  these  reserves  in  accordance  with  the  income  tax  accounting  guidance  when  facts  and  circumstances 
change, such as the closing of a tax audit or the refinement of an estimate. To the extent that the final tax outcome of these 
matters is different than the amounts recorded, such differences will affect the provision for income taxes in the period in 
which such determination is made, and could have a material impact on our financial condition and operating results. 

(x)  Revenue Recognition  

The Company provides services under contracts that contain various fee structures, including contingency fee and fixed 
fee arrangements. Revenue is recognized when a contract exists, services have been provided to the customer, the fee is 
fixed and determinable, and collectability is reasonably assured. In addition, the Company has contracts with the federal 
government which are generally cost-plus or time and material based. Revenue on cost-plus contracts is recognized based 
on costs incurred plus the negotiated fee earned. Revenue on time and materials contracts is recognized based on hours 
worked and expenses incurred. In addition, some of the Company’s contracts may include customer acceptance provisions. 
Formal customer sign-off is not always necessary to recognize revenue, provided HMS objectively demonstrates that the 
criteria specified in the acceptance provision are satisfied. Due to the range of products and services that HMS provides 
and the differing fee structures associated with each type of contract, revenue may be recognized in irregular increments. 

108 

 
 
 
 
 
 
 
 
A portion of our revenue is recorded net of an estimate of future revenue adjustments, with an offsetting entry to accounts 
receivable  allowance,  based  on  historical  patterns  of  billing  adjustments,  length  of  operating  and  collection  cycle  and 
customer negotiations, behaviors and payment patterns. Changes in these estimates are recorded to revenue in the period 
of change.  

(xi)  Estimated Liability for Appeals  

Under  the  Company’s  Recovery  Audit  Contractor  (“RAC”)  contract  with  Centers  for  Medicare  and  Medicaid  Services 
(“CMS”), the Medicaid RAC contracts with various states, and similar contracts for commercial health plan customers, HMS 
recognizes revenue when findings are sent to the customer for offset against future claims payments. Providers have the 
right to appeal a finding and may pursue additional appeals if the initial appeal is found in favor of the customer. HMS 
records a) a liability for findings which have been adjudicated in favor of providers and b) an estimated liability for findings 
that are probable of being returned to providers following a successful appeal. Resolution of appeals can take substantial 
time to resolve as there is a significant backlog in the system for resolving appeals, as over the course of the Company’s 
existing RAC contract, healthcare providers have increased their pursuit of appeals beyond the first and second levels of 
appeals  to  the  third  level  of  appeal,  where  cases  are  heard  by  Administrative  Law  Judges  (“ALJs”).  In  the  Company’s 
experience, decisions at the third level of appeal are the least favorable as ALJs exercise greater discretion and there is 
less predictability in the ALJ decisions as compared to appeals for the first or second levels. The estimated liability is based 
on the amount of revenue that is subject to appeals, closures or other adjustments and the Company’s historical experience 
with appeals. The liability for appeals is an offset to revenue to the Company’s Consolidated Statements of Income. The 
total liability for appeals balance of $30.8 million and $33.1 million as of December 31, 2016 and 2015, respectively, includes 
$17.3 million and $15.9 million, respectively, of CMS liabilities which represents findings which have been adjudicated in 
favor  of  providers  and  $11.1  million  and  $12.8  million,  respectively,  of  CMS  liabilities  which  represents  an  estimate  of 
findings that are probable of being returned to providers following a successful appeal. To the extent the amount to be 
returned  to  providers  following  a  successful  appeal,  closure  or  other  adjustment  exceeds  or  is  less  than  the  amount 
recorded, revenue in the applicable period would be reduced or increased by such amount. Any future changes to any of 
the Company’s customer contracts, including further modifications to the transition plan for incumbent Medicare RACs may 
require the Company to apply different assumptions that could materially affect the Company’s liability for future periods.  

(xii) Expense Classifications 

HMS  cost  of  services  is  presented  in  the  categories  set  forth  below.  Each  category  within  cost  of  services  excludes 
expenses relating to Selling, general and administrative expenses (“SG&A”) functions, which are presented separately as 
a component of total operating costs. A description of the primary expenses included in each category is as follows:  

Cost of Services: 

(cid:131)  Compensation: Salary, fringe benefits, bonus and stock-based compensation. 
(cid:131)  Data processing: Hardware, software and data communication costs.  
(cid:131)  Occupancy: Rent, utilities, depreciation, office equipment and repair and maintenance costs.  
(cid:131)  Direct  project  expense:  Variable  costs  incurred  from  third  party  providers  that  are  directly  associated  with  specific 

revenue generating projects and employee travel expenses.  

(cid:131)  Other  operating  expense:  Professional  fees,  temporary  staffing,  travel  and  entertainment,  insurance  and  local  and 

property tax costs.  

(cid:131)  Amortization  of  acquisition  related  software  and  intangible  assets:  Amortization  of  the  cost  of  acquisition  related 

software and intangible assets.  

SG&A:  

(cid:131)  Expenses related to general management, marketing and administration activities.  

109 

 
 
 
 
 
 
 
 
 
 
 
(xiii) Estimating Valuation Allowances and Accrued Liabilities 

The preparation of financial statements requires management to make estimates and assumptions that affect the reported 
amount of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and 
the reported amount of revenue and expenses during the reported period. In particular, management must make estimates 
of the probability of collecting accounts receivable. When evaluating the adequacy of the accounts receivable allowance, 
management  reviews  the  accounts  receivables  based  on  an  analysis  of  historical  revenue  adjustments,  bad  debts, 
customer concentrations, customer credit-worthiness, current economic trends and changes in customer payment terms. 
As  of  December  31,  2016  and  2015,  the  accounts  receivable  balance  was  $173.6  million  and  $169.1  million,  net  of 
allowance of $10.8 million and $11.5 million, respectively.  

(xiv) Stock-Based Compensation 

Long-Term Incentive Award Plans 

The  Company  grants  equity-based  compensation  awards,  including  stock  options  and  restricted  stock  units,  to  HMS 
employees  and  non-employee  directors  under  the  2016  Omnibus  Plan,  which  was  approved  by  the  Company’s 
shareholders on June 23, 2016. The 2016 Omnibus Plan replaced and superseded the Company’s 2006 Stock Plan and 
2011 HDI Plan. All of the Company’s employees as well as HMS non-employee directors are eligible to participate in the 
2016 Omnibus Plan. Awards granted under the 2016 Omnibus Plan generally vest over one to four years. The exercise 
price of stock options granted under the 2016 Omnibus Plan may not be less than the fair market value of a share of stock 
on the grant date, as measured by the closing price of the Company’s common stock on the NASDAQ Global Select Market 
and the term of a stock option may not exceed ten years. Certain stock option and restricted stock unit awards granted to 
senior  executives  are  subject  to  performance-based  vesting  conditions.  The  performance-based  awards  are  market 
condition  awards  as  the  performance  condition  is  based  on  the  Company’s  common  stock  price  over  the  applicable 
performance period. 

Stock-Based Compensation Expense 

For  awards  subject  to  service-based  vesting  conditions,  the  Company  recognizes  stock-based  compensation  expense 
equal to the grant date fair value of the award on a straight-line basis over the requisite service period, which is generally 
the vesting term. For the performance-based awards subject to market conditions, the Company recognizes stock-based 
compensation expense equal to the grant date fair value of the stock options on a straight-line basis over the requisite 
service period.  

The fair value of each option grant with service-based conditions is estimated using the Black-Scholes pricing model. The 
fair value of each option grant with market-based conditions is estimated using a Monte Carlo simulation model. The fair 
value of each restricted stock unit is calculated based on the closing sale price of the Company’s common stock on the 
grant date.  

The  determination  of  the  fair  value  of  the  stock  options  on  the  grant  date  using  the  models  above  is  affected  by  the 
Company’s  stock  price,  as  well  as  assumptions  regarding  a  number  of  complex  and  subjective  variables.  Certain  key 
variables include: the Company’s expected stock price volatility over the expected term of the awards; a risk-free interest 
rate;  and  any  expected  dividends. The  Company  estimates  stock  price  volatility  based  on  the  historical  volatility  of  the 
Company’s  common  stock  and  estimates  the  expected  term  of  the  awards  based  on  the  Company’s  historical  option 
exercises  for  similar  types  of  stock  option  awards.  The  assumed  risk-free  interest  rate  is  based  on  the  yield  on  the 
measurement date of a zero-coupon U.S. Treasury bond with a maturity period equal to the option’s expected term. The 
Company does not anticipate paying any cash dividends in the foreseeable future and therefore, uses an expected dividend 
yield of zero in the option valuation models. The fair value of all awards also includes an estimate of expected forfeitures. 
Forfeitures  are  estimated  based  on  historical  experience.  If  actual  forfeitures  vary  from  estimates,  a  difference  in 
compensation expense will be recognized in the period the actual forfeitures occur. Upon the exercise of stock options or 
the vesting of restricted stock units, the resulting excess tax benefits or deficiencies, if any, are recognized as income tax 
expense or benefit. Additionally, excess tax benefits are required to be reflected as a cash flow operating activity. 

110 

 
 
 
 
 
 
 
 
 
 
(xv) Fair Value of Financial Instruments 

Financial instruments are categorized into a three-level fair value hierarchy that prioritizes the inputs to valuation techniques 
used to measure fair value into three broad levels. The fair value hierarchy gives the highest priority to quoted prices in 
active markets for identical assets or liabilities (Level 1) and the lowest priority to unobservable inputs (Level 3). If the inputs 
used to measure fair value fall within different levels of the hierarchy, the category level is based on the lowest priority level 
input that is significant to the fair value measurement of the instrument. In the event the fair value is not readily available or 
determinable, the financial instrument is carried at cost and referred to as a cost method investment. The fair value hierarchy 
is as follows: 

(cid:131)  Level 1: Observable inputs such as quoted prices in active markets; 
(cid:131)  Level 2: Inputs, other than the quoted prices in active markets, that are observable either directly or indirectly; and 
(cid:131)  Level 3: Unobservable inputs in which there is little or no market data, which require the reporting entity to develop its 

own assumptions. 

Financial  instruments  (principally  cash  and  cash  equivalents,  accounts  receivable,  accounts  payable  and  accrued 
expenses)  are  carried  at  cost,  which  approximates  fair  value  due  to  the  short-term  maturity  of  these  instruments.  The 
Company’s long-term credit facility is carried at cost. Due to the variable interest rate associated with the revolving credit 
facility and the variable interest margin based upon the Company’s consolidated leverage ratio, cost approximates its fair 
value. The fair value of the contingent consideration liability is determined using Level 3 inputs. See Note 4 – “Acquisitions” 
in our Notes to the Consolidated Financial Statements under Item 8. Consolidated Financial Statements and Supplementary 
Data for additional information regarding the fair value of financial instruments.  

(xvi) Leases 

HMS accounts for the lease agreements as either operating or capital leases, depending on certain defined criteria. Lease 
costs are amortized on a straight-line basis without regard to deferred payment terms, such as rent holidays, that defer the 
commencement date of required payments. Additionally, incentives such as tenant improvement allowances, are capitalized 
and are treated as a reduction of rental expense over the term of the lease agreement. 

(xvii) Contingencies 

From time to time, HMS is involved in legal proceedings in the ordinary course of business. The Company assesses the 
likelihood of any adverse judgments or outcomes to these contingencies as well as potential ranges or probable losses and 
establish reserves accordingly. HMS records accruals for outstanding legal matters when it believes it is probable that a 
loss  will  be  incurred  and  the  amount  can  be  reasonable  estimated.  Significant  judgment  is  required  to  determine  both 
probability and the estimated amount. HMS reviews these provisions at least quarterly and adjusts the provisions to reflect 
the impact of negotiations, settlements, rulings, advice of legal counsel and updated information. Litigation is inherently 
unpredictable and is subject to significant uncertainties, some of which are beyond the Company’s control. The amount of 
reserves required may change in future periods due to new developments in each matter or changes in approach to a 
matter such as a change in settlement strategy.  

(xviii) Recent Accounting Guidance 

Recently Adopted Accounting Guidance 

In April 2015, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2015-05, 
Intangibles – Goodwill and Other – Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Fees Paid in a 
Cloud Computing Arrangement (“ASU 2015-05”). ASU 2015-05 provides explicit guidance to help companies evaluate the 
accounting  for  fees  paid  by  a  customer  in  a  cloud  computing  arrangement  and  clarifies  that  if  a  cloud  computing 
arrangement includes a software license, the customer should account for the license consistent with its accounting for 
other  software  licenses.  If  the  arrangement  does  not  include  a  software  license,  the  customer  should  account  for  the 
arrangement as a service contract. ASU 2015-05 is effective for annual reporting periods beginning after December 15, 

111 

 
 
 
 
 
 
 
 
 
 
 
 
 
2015, including interim periods within such annual reporting periods with early adoption permitted. The adoption of this 
guidance did not have a material effect on the Company’s consolidated financial statements. 

In November 2015, the FASB issued ASU 2015-17, Income Taxes (Topic 740): Balance Sheet Classification of Deferred 
Taxes (“ASU 2015-17”). ASU 2015-17 simplifies the current presentation of separately classifying deferred tax assets and 
deferred tax liabilities as current and noncurrent in a classified balance sheet by requiring companies to present them as 
noncurrent.  ASU  2015-17,  as  amended,  is  effective  for  annual  reporting  periods  beginning  after  December  15,  2016, 
including interim periods within such annual reporting periods with early adoption permitted. The Company elected to early 
adopt  the  new  guidance  in  the  fourth  quarter  of  fiscal  year  2016.  The  Company  elected  to  apply  the  presentation 
requirements for the balance sheet retrospectively to all periods presented which resulted in a decrease to total current 
assets and total long term liabilities of $7.5 million at December 31, 2015.  

In March 2016, the FASB issued ASU No. 2016-09, Compensation – Stock Compensation (Topic 718): Improvements to 
Employee Share-Based Payment Accounting, (“ASU 2016-09”) that changes the accounting for certain aspects of share-
based payments to employees. The new guidance requires excess tax benefits and tax deficiencies to be recorded in the 
income statement when stock awards vest or are settled. In addition, cash flows related to excess tax benefits will no longer 
be separately classified as a financing activity apart from other income tax cash flows. The standard also allows Companies 
to repurchase more of an employee’s vesting shares for tax withholding purposes without triggering liability accounting, 
clarifies that all cash payments made to tax authorities on an employee’s behalf for withheld shares should be presented 
as a financing activity on the cash flows statement and provides an accounting policy election to account for forfeitures as 
they occur. ASU 2016-09 is effective for annual reporting periods beginning after December 15, 2016, including interim 
periods within such annual reporting periods with early adoption permitted. The Company elected to early adopt the new 
guidance in the fourth quarter of fiscal year 2016 which requires us to reflect any adjustments as of January 1, 2016, the 
beginning  of  the  annual  period  that  includes  the  interim  period  of  adoption.  The  primary  impact  of  adoption  was  the 
recognition of excess tax benefits in the provision for income taxes rather than paid-in capital for all periods in fiscal year 
2016. Additional amendments to the accounting for income taxes and minimum statutory withholding tax requirements had 
no impact to retained earnings as of January 1, 2016, where the cumulative effect of these changes are required to be 
recorded.  The  Company  elected  to  continue  to  estimate  forfeitures  expected  to  occur  to  determine  the  amount  of 
compensation  cost to be recognized in each period. We elected to apply the presentation requirements for cash flows 
related to excess tax benefits retrospectively to all periods presented which resulted in an increase to both net cash from 
operations and net cash used in financing of $1.6 million and $1.8 million for the years ended December 31, 2015 and 
2014, respectively. Adoption of the new standard resulted in the recognition of net excess tax benefits in the provision for 
income  taxes  rather  than  paid-in  capital  of  $1.9  million  for  the  year  ended  December  31,  2016.  The  presentation 
requirements  for  cash  flows  related  to  employee  taxes  paid  for  withheld  shares  had  no  impact  to  any  of  the  periods 
presented  on  the  consolidated  statements  of  cash  flow  since  such  cash  flows  have  historically  been  presented  as  a 
financing activity. 

Recent Accounting Guidance Not Yet Adopted 

In May 2014, the FASB issued ASU 2014-09, Revenue from Contracts with Customers (Topic 606) (“ASU 2014-09”), which 
is the new comprehensive revenue recognition standard that will supersede all existing revenue recognition guidance under 
U.S.  GAAP.  The  FASB  has  recently  issued  several  amendments  to  the  standard,  including:  principal  versus  agent 
considerations;  clarification  on  accounting  for  licenses  of  intellectual  property  and  identifying  performance  obligations; 
narrow  scope-improvements  and  practical  expedients;  and  technical  corrections  and  improvements.  ASU  2014-09  is 
effective for  annual  reporting  periods  beginning after  December 15,  2017, including interim  periods  within such annual 
reporting periods with early adoption permitted. The Company does not plan to early adopt this guidance and therefore will 
adopt on January 1, 2018. The guidance permits two methods of adoption: retrospectively to each prior reporting period 
presented  (full  retrospective  method),  or  retrospectively  with  the  cumulative  effect  of  initially  applying  the  guidance 
recognized at the date of initial application (modified retrospective method). The Company is in the process of determining 
the adoption method but preliminarily expects to use the modified retrospective method. The Company, with the assistance 
of external consultants, has developed and is currently following a preliminary implementation plan. One major element of 
this plan involves reviewing historical contracts to quantify the impact that adoption will have on the Company’s operations. 
Depending  on  the  results  of  the  Company’s  review,  there  could  be  material  changes  to  the  timing  and  recognition  of 
revenues and certain associated expenses. The Company expects to complete the review of historical contracts and the 

112 

 
 
 
  
 
overall assessment process, including selecting a transition plan and an assessment of the overall impact to the results of 
operations by the end of the third quarter of 2017. 

In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) (“ASU 2016-02”). ASU 2016-02 will require most 
lessees to recognize a majority of the Company’s leases on the balance sheet, which will increase reported assets and 
liabilities. ASU 2016-02 is effective for annual reporting periods beginning after December 15, 2018 including interim periods 
within such annual reporting periods with early adoption permitted. The Company has not early adopted this guidance and 
is currently evaluating the impact on the Company’s consolidated financial statements.  

In August 2016, the FASB issued ASU No. 2016-15, Statements of Cash Flows (Topic 230): Classification of Certain Cash 
Receipts and Cash Payments (“ASU 2016-15”). The amendment clarifies where certain cash receipts and cash payments 
are presented and classified in the statement of cash flows. Current guidance does not include specific guidance on the 
eight classification issues presented in the amendments, which are intended to reduce diversity in practice with respect to 
classification and presentation of such cash receipts and payments. The amendments are effective for annual reporting 
periods beginning after December 15, 2017, and for interim reporting periods within such annual periods. The Company is 
currently evaluating the impact on the Company’s financial statements. 

In January 2017, the FASB issued ASU No. 2017-01, Business Combinations (Topic 805) – Clarifying the Definition of a 
Business (“ASU 2017-01”). ASU 2017-01 finalizes previous proposals regarding shareholder concerns that the definition of 
a business is applied too broadly. The guidance assists entities with evaluating whether transactions should be accounted 
for as acquisitions of assets or of businesses. The amendments are effective for annual periods beginning after December 
15, 2017, including interim periods within those periods. The Company is currently evaluating the impact on the Company’s 
financial statements of adopting this guidance. 

In January 2017, the FASB issued ASU No. 2017-04, Goodwill and Other (Topic 350): Simplifying the Test for Goodwill 
Impairment  (“ASU  2017-04”).  This  amendment  simplifies  the  manner  in  which  an  entity  is  required  to  test  for  goodwill 
impairment by eliminating Step 2 from the goodwill impairment test. Step 2 measures goodwill impairment loss by comparing 
the implied fair value of a reporting unit’s goodwill with the carrying amount of that goodwill. The amendment simplifies this 
approach by having the entity (1) perform its annual or interim goodwill impairment test by comparing the fair value of a 
reporting unit with its carrying amount, and (2) recognize an impairment charge for the amount by which the carrying amount 
exceeds the reporting unit’s fair value, with the understanding that the loss recognized should not exceed the total amount 
of  goodwill  allocated  to  that  reporting  unit.  The  amendment  is  effective  for  public  entities  that  are  U.S.  Securities  and 
Exchange Commission (“SEC”) filers prospectively for their annual, or any interim, goodwill impairment tests in fiscal years 
beginning after December 15, 2019. Early adoption is permitted for all entities for interim or annual goodwill impairment 
tests performed on testing dates after January 1, 2017. The Company is currently evaluating the impact on the Company’s 
financial statements of adopting this guidance.  

Other  new  pronouncements  issued  but  not  effective  until  after  December 31,  2016,  if  any,  are  not  expected  to  have  a 
material impact on the Company’s financial position, results of operations or liquidity. 

113 

 
 
 
 
 
 
 
2. 

Property and Equipment 

Property and equipment consisted of the following (in thousands):  

December 31, 

Equipment
Leasehold improvements
Building
Building improvements
Land
Furniture and fixtures
Capitalized software

Less: accumulated depreciation and amortization
Property and equipment, net

(in millions)
Depreciation and amortization expense related to property and equipment

2016
$        

24.9

2016

$      

94,345
8,637
8,624
12,671
2,769
10,728
110,696
248,470
(156,303)
92,167
December 31, 
2015
$         

30.3

$  

2015
90,496
8,512
8,624
11,367
2,769
10,858
104,266
236,892
(140,341)
96,551

2014

$     

32.9

Net capital leases included as part of equipment were approximately $4,000 and $51,000 at December 31, 2016 and 2015, 
respectively. Accumulated depreciation for equipment under capital leases was approximately $6.1 million and $6.0 million for 
the years ended December 31, 2016 and 2015. Depreciation expense for equipment under capital leases for the years ended 
December 31, 2016, 2015 and 2014 was approximately $40,000, $1.2 million, and $1.6 million, respectively.  

3. 

Intangible Assets 

Intangible assets consisted of the following (in thousands):  

Gross 
Carrying 
Amount

Accumulated 
Amortization

Net Carrying 
Amount

December 31, 2016

Customer relationships
Trade name
Intellectual property
Restrictive covenants

Total

December 31, 2015

Customer relationships
Trade name
Restrictive covenants

Total

$        

$         

$        

(71,914)
(11,393)
(140)
(15)
(83,462)

(57,497)
(10,221)
(13,580)
(81,298)

$        

$         

$        

$        

$         

$        

$        

$         

$        

103,090
15,936
2,100
133
121,259

101,806
17,000
16,800
135,606

31,176
4,543
1,960
118
37,797

44,309
6,779
3,220
54,308

In 2016, the Company wrote-off approximately $16.8 million of fully amortized restrictive covenant intangibles and $1.2 million 
of fully amortized trade name intangibles.  

114 

 
 
  
 
 
 
 
 
  
 
 
 
         
     
         
     
        
    
         
     
        
    
      
  
      
  
     
 
        
    
           
           
           
             
                
           
                
                 
              
           
           
           
           
           
           
Amortization expense of intangible assets is expected to approximate the following (in thousands): 

Year ending December 31, 
2017
2018
2019
2020
2021
Thereafter

$        

17,306
16,685
2,245
791
463
307

For the years ended December 31, 2016, 2015 and 2014, amortization expense related to intangible assets was $20.2 million, 
$20.3 million and $20.7 million, respectively. 

4. 

Acquisitions 

On  September  2,  2016,  the  Company  acquired  the  outstanding  capital  stock  of  Essette,  a  care  management  technology 
company which helps risk-bearing organizations manage the care delivered to their members, for aggregate consideration of 
$24.2 million, which is primarily comprised of cash payments of $21.3 million. To fund the purchase price, the Company utilized 
cash on hand. The acquisition is subject to adjustment based upon the final amount of adjusted working capital of Essette at 
closing.  

The Company allocated the purchase price, net of cash acquired, to a) at their acquisition date fair values, the following tangible 
assets: net deferred tax assets of $0.9 million and other net assets of $0.9 million and b) at their acquisition date fair values, the 
following  amortizing  intangible  assets:  intellectual  property  of  $2.1  million,  customer  relationships  of  $1.3  million,  restrictive 
covenants of $0.1 million, and trade name of $0.1 million. Goodwill of $18.2 million represents the excess purchase price over 
the net identifiable tangible and intangible assets. The intangible assets are valued using various methods which requires several 
judgments, including growth rates, discount rates, customer attrition rates, and expected levels of revenues, earnings, cash 
flows and tax rates. The intangible assets are amortized over their estimated useful lives on a straight-line basis and are not 
expected to be deductible for tax purposes. The goodwill recognized from the acquisition was a result of expected synergies to 
be realized from future revenue growth, is not expected to be deductible for tax purposes, has an indefinite useful life and will 
be included in the Company’s annual impairment testing. Contingent consideration, up to an aggregate maximum $12.0 million, 
will be payable in calendar years 2017, 2018, or 2019, respectively, should Essette achieve certain revenue targets as defined 
in the stock purchase agreement. The contingent consideration is valued using a method which requires several judgments but 
primarily include discount rates and expected levels of revenues. In the fourth quarter 2016, purchase accounting adjustments 
included a $1.1 million increase to total transaction consideration and to goodwill, a $0.7 million increase to other net assets, 
and a $0.2 million increase in the customer relationship intangible. The amounts shown above may change in the near term as 
management continues to assess the fair value of acquired assets and liabilities.  

The  acquisition  was  not  significant  to  the  Company’s  consolidated  financial  statements;  therefore,  pro  forma  results  of  the 
operations related to this business acquisition for the year ended December 31, 2015 have not been presented. The immaterial 
results of Essette’s operations since September 2, 2016 have been included in the Company’s consolidated financial statements.  

There were no changes in the carrying amount of goodwill for the years ended December 31, 2015 and 2014. 

5. 

Accounts Payable, Accrued Expenses and Other Liabilities 

Accounts payable, accrued expenses and other liabilities consisted of the following (in thousands):    

Accounts payable, trade
Accrued compensation and other
Accrued operating expenses
Total accounts payable, accrued expenses and other liabilities

115 

December 31,
 2016

$          

December 31, 
2015
$          

13,847
28,507
17,048
59,402

7,790
21,948
21,923
51,661

$          

$         

 
 
 
 
  
 
 
 
 
 
    
 
          
            
               
               
               
            
          
            
          
6. 

Income Taxes  

Income tax expense is as follows (in thousands):  

Current tax expense:

Federal 
State

Total current tax expense: 
Deferred tax expense (benefit):

Federal
State

Total deferred tax benefit: 
Total income tax expense

December 31, 
2015

2016

2014

$  

16,274
2,929
19,203

(7,115)
(253)
(7,368)
11,835

$  

$   

25,852
3,450
29,302

(12,571)
(1,449)
(14,020)
15,282

$   

$  

20,244
4,429
24,673

(12,421)
131
(12,290)
$  
12,383

A reconciliation of the income tax expense calculated using the applicable federal statutory rate to the actual income tax expense 
is as follows (in thousands):  

Computed at federal statutory rate
State and local tax expense, net of federal benefit
Net perm deduction and credit tax benefits from prior years 
Net perm deduction and credit tax benefits from current year 
Other, net
Total income tax expense

2016
17,315
2,448
(6,213)
(1,509)
(206)
11,835

$  

$  

%
35.0
5.0
(12.6)
(3.1)
(0.4)
23.9

December 31, 
2015
%
35.0
13,934
2.6
1,038
-
-
-
-
0.8
310
38.4
15,282

$   

$   

$    

2014
9,215
2,973
-
-
195
12,383

$  

%
35.0
11.3
-
-
0.7
47.0

The Company’s effective tax rate decreased to 23.9% for the year ended December 31, 2016 from 38.4% for the year ended 
December 31, 2015, primarily due to the Company’s recognition of tax benefits for R&D Credits and the Section 199 Deduction, 
as discussed below.  

As a result of an analysis performed during 2016 the Company determined certain activities it performs qualify for (i) Research 
and Development Tax Credits (“R&D Credits”) provided in Internal Revenue Code (“IRC”) Section 41 and (ii) the U.S. Production 
activities deduction (“Section 199 Deduction”) provided  in IRC Section  199. During the  third  quarter of 2016, the  Company 
determined it was economically viable to claim the R&D Credits and the Section 199 Deduction for all open tax years. As a 
result, the Company recognized net tax benefits during the year ended December 31, 2016 of $2.2 million and $5.7 million for 
federal and state R&D Credits and the Section 199 Deduction, respectively, relating to tax years 2012 through 2016.  

Deferred income taxes are recognized for the future tax consequences of temporary differences between the financial statement 
and tax bases of assets and liabilities. The tax effect of temporary differences that give rise to a significant portion of the deferred 
tax assets and deferred tax liabilities are as follows (in thousands):  

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Deferred tax assets: 

Stock-based compensation
Goodwill and intangible assets
Allowance for doubtful accounts
Deferred rent
Tenant improvements
Estimated liability for appeals
Net operating loss carry-forwards
Property and equipment
Accrued expenses and other

Total deferred tax assets
Deferred tax liabilities:

Goodwill and intangible assets
Section 481(a) adjustment
Property and equipment
Capitalized software cost
Total deferred tax liabilities
Total net deferred tax liabilities

December 31, 

2016

2015

$  

10,373
10,711
4,108
1,120
1,226
11,596
2,141
79
7,811
49,165

52,729
14,757
-
4,396
71,882
22,717

$  

$    

9,059
10,449
1,766
1,119
1,392
-
113
-
6,298
30,196

56,790
-
894
3,473
61,157
30,961

$  

Included  in  Other  liabilities  on  the  Consolidated  Balance  Sheets,  are  the  total  amount  of  unrecognized  tax  benefits  of 
approximately $7.4 million and $1.3 million as of December 31, 2016 and 2015, respectively, (net of the federal benefit for state 
issues) that, if recognized, would favorably affect the Company’s future effective tax rate. Also included in Other Liabilities on 
the Consolidated Balance Sheets, are accrued liabilities for interest expense and penalties related to unrecognized tax benefits 
of $0.6 million and $0.4 million as of December 31, 2016 and 2015, respectively. HMS includes interest expense and penalties 
in the provision for income taxes in the Consolidated Statements of Income. The amount of interest expense (net of federal and 
state income tax benefits) and penalties in the Consolidated Statements of Income for the years ended December 31, 2016, 
2015 and 2014 was $0.2 million, $0.6 million and $0.4 million, respectively. The Company believes it is reasonably possible the 
amount of unrecognized tax benefits may decrease by $0.9 million during 2017, due to the expiration of the statute of limitations 
in various state jurisdictions.  

A reconciliation of the beginning and ending amounts of unrecognized tax benefits are as follows (in thousands):  

December 31, 

Unrecognized tax benefits at January 1

Additions for tax positions taken during prior periods
Additions for tax positions taken during current period including amended prior years
Reductions related to the expiration of statutes of limitations

Unrecognized tax benefits at December 31

$    

$    

2016
1,329
763
5,931
(590)
7,433

2015
1,329
565
-
(565)
1,329

$    

$    

The Company increased the provision for unrecognized tax benefits by $5.9 million during the year ended December 31, 2016, 
related to tax benefits recognized associated with R&D Credits and the Section 199 Deduction for all open tax years.   

At December 31, 2016, HMS had federal and state pre-tax net operating loss carryforwards of approximately $13.8 million, 
which will be available to offset future taxable income. If not used, these carryforwards will expire between 2020 and 2036.The 
Company files income tax returns with the U.S. Federal government and various state jurisdictions. HMS is no longer subject to 

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U.S. Federal income tax examinations for years before 2012. The Company received notification the Internal Revenue Service 
intends to audit years 2013 and 2014. HMS operates in a number of state and local jurisdictions, most of which have never 
audited the Company’s records. Accordingly, HMS is subject to state and local income tax examinations based upon the various 
statutes of limitations in each jurisdiction. The Company is currently being examined by the State of New York. 

7. 

Credit Agreement 

During the years ended December 31, 2016 and 2015, no principal payments were made against the Company’s revolving 
credit  facility.  The  $197.8  million  principal  balance  of  the  revolving  credit  facility  is  due  in  May  2018.  The  Company  has 
commenced discussions to extend or refinance the revolving credit facility.  

The  Credit  Agreement  provides  for  an  initial  $500  million  revolving  credit  facility,  and,  under  specified  circumstances,  the 
revolving  credit  facility  can  be  increased  or  one  or  more  incremental  term  loan  facilities  can  be  added,  provided  that  the 
incremental credit facilities do not exceed in the aggregate the sum of (a) $75 million plus (b) an additional amount not less than 
$25 million, so long as the total secured leverage ratio, calculated giving pro forma effect to the requested incremental borrowing 
and other customary and appropriate pro forma adjustment events, including any permitted acquisitions, is no greater than 
2.5:1.0.  The  Company’s  obligations  and  any amounts  due under the  Credit Agreement are  guaranteed  by the  Company’s 
material  100%  owned  subsidiaries  and  secured  by  a  security  interest  in  all  or  substantially  all  of  the  Company’s  and  the 
Company’s subsidiaries’ physical assets. 

The Credit Agreement requires the Company to comply with certain principal financial covenants and other covenants, including 
a maximum consolidated leverage ratio reducing from 3.50:1.00 to 3.25:1.00 over the next five years and a minimum interest 
coverage ratio of 3.00:1.00. See Note 14 – “Subsequent Events” in our Notes to the Consolidated Financial Statements under 
Item 8. Consolidated Financial Statements and Supplementary Data for additional information regarding the amendment to our 
Credit Agreement.  

The interest rates applicable to the revolving credit facility are, at the Company’s option, either: 

a) 

the LIBOR multiplied by the statutory reserve rate plus an interest margin ranging from 1.50% to 2.25% based on the 
Company’s consolidated leverage ratio, or  

b)  a base rate (which is equal to the greatest of (i) Citibank’s prime rate, (ii) the federal funds effective rate plus 0.50% 
and  (iii)  the  one-month  LIBOR  plus  1.00%  plus  an  interest  margin  ranging  from  0.50%  to  1.25%  based  on  the 
Company’s consolidated leverage ratio.  

HMS pays an unused commitment fee on the revolving credit facility during the term of the Credit Agreement ranging from 
0.375% to 0.50% per annum based on the consolidated leverage ratio. 

Interest expense and the commitment fees on the unused portion of the Company’s revolving credit facility are as follows (in 
thousands):  

Interest expense
Commitment fees

2016
4,837
1,518

$    
$    

December 31, 

2015
4,117
1,513

$         
$         

2014
4,186
1,465

$      
$      

At  December  31,  2016  and  2015,  the  unamortized  balance  of  deferred  financing  costs  was  $2.8  million  and  $4.9  million, 
respectively. HMS amortized $2.1 million in December 31, 2016, 2015 and 2014, respectively, of interest expense related to the 
Company’s deferred financing costs.   

As part of a contractual agreement with a customer, the Company has an outstanding irrevocable letter of credit for $3.0 million, 
which was established against the existing revolving credit facility. On May 1, 2017, the expiration date of the letter of credit was 
extended to April 26, 2018. 

118 

 
 
 
  
  
 
 
 
  
 
 
 
8. 

Equity 

(a)  Share Repurchase 

On July 30, 2015, the Company’s Board of Directors approved a share repurchase program authorizing the repurchase of up to 
$75 million of the Company’s common stock from time to time on the open market or in privately negotiated transactions. The 
repurchase program is authorized through July 30, 2017, and may be suspended or discontinued at any time. Repurchased 
shares will be available for use in connection with issuance under the Company’s stock plans and for other corporate purposes. 
Repurchases may also be made under a Rule 10b5-1 plan, which would permit shares to be repurchased when HMS might 
otherwise be precluded from doing so under insider trading laws. The timing and amount of any shares repurchased under the 
program will be determined by management based on its evaluation of market conditions and other factors. During the year 
ended  December  31,  2016,  the  Company  repurchased  $20  million  of  the  Company’s  common  stock  pursuant  to  this 
authorization and 10b5-1 plans. All repurchases were made using cash resources.  

Following are the Company’s monthly stock repurchases for the fourth quarter of fiscal year 2016, all of which were made as 
part of publicly announced plans or programs: 

Period
October 1, 2016 to October 31, 2016
November 1, 2016 to November 30, 2016
December 1, 2016 to December 31, 2016
October 1, 2016 to December 31, 2016

Total Number of 
Shares 
Purchased

— $

570,717
569,615
1,140,332

$

Average 
Price Paid 
Per Share
—
17.61
18.25
17.93

Total Number 
of Shares 
Purchased as 
Part of Publicly 
Announced 
Program(1)

Maximum 
Approximate 
Dollar Value 
of Shares That 
May Yet Be 
Purchased 
Under the 
Program

— $

570,717
569,615
1,140,332

$

—
15,000,000
5,000,000
5,000,000

(1)  Represents shares repurchased through the Company’s Share Repurchase Program publicly announced in August 2015.  

(b)  Preferred Stock 

The Company’s certificate of incorporation, as amended, authorizes the issuance of up to 5,000,000 shares of “blank check” 
preferred stock with such designations, rights and preferences as may be determined by the Company’s Board of Directors. As 
of December 31, 2016, no preferred stock had been issued. 

9. 

Employee Benefit Plan 

The Company sponsors the 401(k) Plan for eligible employees. Eligible employees must complete 90 days of service in order 
to enroll in the 401(k) Plan. Participants may make voluntary contributions to the 401(k) Plan of up to 60% of their annual base 
pre-tax  compensation  not  to  exceed  the  federally  determined  maximum  allowable  contribution.  In  addition,  the  401(k)  Plan 
permits the Company to make discretionary contributions. During 2016, 2015 and 2014 HMS matched 100% of the first 3% of 
pay contributed by each eligible employee and 50%  on the next 2%  of pay contributed. These matching contributions vest 
immediately and are not in the form of the Company’s common stock. 

For  the  years  ended  December  31,  2016,  2015  and  2014,  HMS  contributed  $4.8  million,  $4.8  million  and  $5.0  million, 
respectively, to the 401(k) Plan in the form of matching contributions. 

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10. 

Stock-Based Compensation  

Stock-Based Compensation Expense 

Total stock-based compensation expense in the Company’s Consolidated Statements of Income related to the Company’s long-
term incentive award plans was as follows (in thousands):  

Cost of services-compensation
Selling, general and administrative
Total

Stock Options 

December 31, 
2015
6,242
8,055
14,297

$   

$ 

$   

2014
5,075
8,280
13,355

$ 

$   

2016
3,805
9,472
13,277

$ 

Stock-based compensation expense related to stock options was approximately $6.9 million, $6.4 million and $7.6 million for 
the years ended December 31, 2016, 2015 and 2014, respectively. 

Presented below is a summary of stock option activity for the year ended December 31, 2016 (in thousands except for weighted 
average exercise price and weighted average remaining contractual terms):  

Outstanding balance at December 31, 2015

Granted
Exercised
Forfeitures
Expired

Outstanding balance at December 31, 2016

Expected to vest at December 31, 2016
Exercisable at December 31, 2016

Number 
of 
Options
5,030
1,078
(511)
(67)
(339)
5,191

Weighted
Average
Exercise
Price

$      

17.37
14.07
7.03
17.76
22.67
17.35

2,207
2,150

15.22
20.25

$      

Weighted
Average
Remaining
Contractual
Terms

Aggregate
Intrinsic
Value

5.00

$           

12,854

5.72
4.02

7,219
3,042

$             

The weighted average grant date fair value per share of the stock options granted during the years ended December 31, 2016, 
2015 and 2014 was $5.55, $5.37 and $7.59, respectively. HMS estimated the fair value of each stock option grant on the date 
of grant using a Black-Scholes option pricing model and weighted–average assumptions set forth in the following table:  

Expected dividend yield
Risk-free interest rate
Expected volatility
Expected life (years)

December 31, 

2016
(cid:888)
1.20%
44.01%
4.90

2015
(cid:888)
1.54%
40.62%
4.89

2014
(cid:888)
1.57%
38.18%
4.82

During the years ended  December  31, 2016, 2015  and  2014, the Company issued  510,512, 577,559  and 516,552 shares, 
respectively,  of  the  Company’s  common  stock  upon  the  exercise  of  outstanding  stock  options  and  received  proceeds  of 

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$2.9 million, $4.2 million and $4.1 million, respectively. The total intrinsic value of stock options exercised during the years ended 
December 31, 2016, 2015 and 2014 was $6.3 million, $5.9 million and $6.5 million, respectively. 

As of December 31, 2016, there was approximately  $12.7 million of total unrecognized  compensation  cost related to stock 
options outstanding, which is expected to be recognized over a weighted average period of 1.05 years. 

The  excess  tax  benefit  from  the  exercise  of  stock  options  for  the  years  ended  December  31,  2016,  2015  and  2014  was 
$1.9 million, $1.6 million and $1.8 million, respectively. 

Restricted Stock Units 

Stock-based compensation expense related to restricted stock units was $6.4 million, $7.9 million and $5.7 million for the years 
ended December 31, 2016, 2015 and 2014, respectively. 

Presented below is a summary of restricted stock units activity for the year ended December 31, 2016 (in thousands, except for 
weighted average grant date fair value per unit): 

Outstanding balance at December 31, 2015
Granted
Vesting of restricted stock units, net of units withheld for taxes
Units withheld for taxes
Forfeitures
Outstanding balance at December 31, 2016

Weighted 
Average
Grant Date Fair
Value per Unit
$18.85
14.26
18.64
18.64
16.95
$16.44

Number of 
Units

1,154
637
(193)
(102)
(83)
1,413

As of December 31, 2016, 1,231,736 restricted stock units remained unvested and there was approximately $14.1 million of 
unrecognized compensation cost related to restricted stock units, which is expected to be recognized over a weighted average 
vesting period of 0.92 years. 

11. 

Earnings per Share 

The following table sets forth the computation of basic and diluted earnings per share (in thousands, except per share data): 

Years ended December 31, 
2015

2016

2014

Net income

Weighted average common shares outstanding-basic
Plus: net effect of dilutive stock options and restricted stock units
Weighted average common shares outstanding-diluted
Net income per common share-basic 
Net income per common share-diluted

$   

37,636

$  

24,527

$  

13,947

84,221
2,766
86,987
0.45
0.43

$       
$       

87,881
480
88,361
0.28
0.28

$     
$     

87,673
491
88,164
0.16
0.16

$     
$     

For the years ended December 31, 2016, 2015 and 2014, 2,070,771, 3,480,458 and 2,442,628 stock options, respectively, were 
not included in the diluted earnings per share calculation because the effect would have been anti-dilutive. For the years ended 
December 31, 2016, 2015 and 2014, restricted stock units representing 46,651, 305,999 and 90,905 shares of common stock, 
respectively, were not included in the diluted earnings per share calculation because the effect would have been anti-dilutive.  

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12. 

Commitments and Contingencies 

(a) Lease Commitments 

The Company leases office space, data processing equipment and software licenses under operating leases that expire on 
various dates through 2024. The lease agreements provide for rent escalations. Lease expense, exclusive of sublease income, 
for the year ended December 31, 2016, 2015 and 2014 was $5.0 million, $5.4 million and $6.9 million, respectively. Lease and 
sublease income was approximately $27,000, $25,000 and $42,000 for the years ended December 31, 2016, 2015 and 2014, 
respectively. 

Minimum annual lease payments to be made both under capital leases and operating leases, net of nominal sublease payments 
to be received for each of the next five years ending December 31 and thereafter are as follows (in thousands):  

2017
2018
2019
2020
2021
Thereafter

Total 
Less: Interest
Total 

(b) Litigation  

Capital Lease Payments
$                                   
4
-
-
-
-
-

4

-
$                                   
4

Operating Lease Payments
16,077
$                              
6,304
4,294
3,815
3,226
4,852
38,568

$                              

Dennis Demetre and Lori Lewis: In July 2012, Dennis Demetre and Lori Lewis (the “Plaintiffs”), filed an action in the Supreme 
Court of the State of New York against HMS Holdings Corp., claiming an undetermined amount of damages alleging that various 
actions by HMS unlawfully deprived the Plaintiffs of the acquisition earn-out portion of the purchase price for Allied Management 
Group  Special  Investigation  Unit  (“AMG”)  under  the  applicable  Stock  Purchase  Agreement  (the  “SPA”)  and  that  HMS  had 
breached certain contractual provisions under the SPA. The Plaintiffs filed a second amended complaint with two causes of 
action for breach of contract and one cause of action for breach of implied covenant of good faith and fair dealing. HMS asserted 
a counterclaim against Plaintiffs for breach of contract based on contractual indemnification costs, including attorneys’ fees 
arising out of the Company’s defense of AMG in Kern Health Systems v. AMG, Dennis Demetre and Lori Lewis (the “California 
Action”), which are recoverable under the SPA. Mediation took place in September 2014 but the matter was not resolved. In 
June 2016, Kern Health Systems and AMG entered into a settlement agreement that resolved all claims in the California Action.  

In January 2016, HMS moved for summary judgment on its counterclaim for breach of contract and for summary judgment on 
the Plaintiffs’ breach of contract causes of action against HMS (HMS did not move for summary judgment on Plaintiffs’ breach 
of implied covenant of good faith and fair dealing claim). The motions were argued on June 22, 2016. A decision on the motions 
has not yet been issued by the Court and a trial date has not been set. HMS continues to believe that the Plaintiffs’ claims are 
without merit and will continue to vigorously defend against them. 

Shareholder Proceedings: On March 3, 2017, a putative securities class action was filed in the Federal District Court for the 
District of New Jersey, entitled Danahar v. HMS Holdings Corp., et al.  The complaint names the Company, its Chief Executive 
Officer, and its Chief Financial Officer as defendants and arises out of the Company’s disclosure on March 2, 2017 that the filing 
of its 2016 Form 10-K would be delayed in order to permit the Company to complete the Company’s previously disclosed review 
of its estimated liability for appeals and related internal control over financial reporting, and that the Company’s auditor had 
informed the Company that it had identified what it believed was a material weakness in the Company’s internal control over 
financial reporting related to the CMS reserves. The complaint alleges that the Company’s Form 10-K for the period ended 
December 31, 2015 and its quarterly reports on Form 10-Q for the period January 1, 2016 to September 30, 2016 were false 
and misleading for failing to disclose the matters set forth above. On May 19, 2017, the New Jersey District Court granted the 

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defendants’ motion to transfer the action to the United States District Court for the Northern District of Texas. The action is at its 
early stages, and the Company has not yet responded to the complaint. 

From time to time, HMS may be subject to investigations, legal proceedings and other disputes arising in the ordinary course of 
the Company’s business, including but not limited to regulatory audits, billing and contractual disputes, employment-related 
matters and post-closing disputes related to acquisitions. Due to the Company’s contractual relationships, including those with 
federal and state government entities, HMS’s operations, billing and business practices are subject to scrutiny and audit by 
those  entities  and  other  multiple  agencies  and  levels  of  government,  as  well  as  to  frequent  transitions  and  changes  in  the 
personnel responsible for oversight of the Company’s contractual performance. HMS may have contractual disputes with its 
customers arising from differing interpretations of contractual provisions that define the Company’s rights, obligations, scope of 
work or terms of payment, and with associated claims of liability for inaccurate or improper billing for reimbursement of contract 
fees, or for sanctions or damages for alleged performance deficiencies. Resolution of such disputes may involve litigation or 
may  require  that  HMS  accept  some  amount  of  loss  or  liability  in  order  to  avoid  customer  abrasion,  negative  marketplace 
perceptions  and  other  disadvantageous  results  that  could  affect  the  Company’s  business,  financial  condition,  results  of 
operations and cash flows.   

HMS records accruals for outstanding legal matters when it believes it is probable that a loss will be incurred and the amount 
can be reasonably estimated. The Company evaluates, on a quarterly basis, developments in legal matters that could affect the 
amount of any accrual and developments that would make a loss contingency both probable and reasonably estimable. If a loss 
contingency is not both probable and estimable, HMS does not establish an accrued liability.  

13. 

Customer Concentration  

(a) Geographic Information 

The Company operates within the United States. 

(b) Major Customers 

For the years ended December 31, 2016, 2015 and 2014 no one individual Company customer accounted for more than 10% 
of the Company’s total revenue.  

(c) Concentration of Revenue 

The composition of the Company’s ten largest customer’s changes periodically. For the years ended December 31, 2016, 2015 
and 2014, the Company’s ten largest customers represented 40.6%, 44.0% and 40.1% of HMS’ total revenue, respectively. The 
Company’s agreements with the ten current largest customers expire between 2017 and 2020. In many instances, HMS provides 
services  pursuant  to  agreements  that  may  be  renewed  or  subject  to  a  competitive  reprocurement  process.  Several  of  the 
Company’s contracts, including those with some of its largest customers, may be terminated for convenience.  

14. 

Subsequent Events  

(a)  Credit Agreement 

On  March  8,  2017,  Amendment  No.  1  to  the  Credit  Agreement  was  executed  which  amended,  among  other  things,  the 
Company’s requirement to furnish to Citibank, N.A., as administrative agent, and the lenders party to the Credit Agreement, 
financial statements and other information within 90 days of the fiscal year end to 180 days for the fiscal year ended December 
31,  2016.  These  financial  statements  include  the  audited  consolidated  balance  sheet  and  related  statements  of  income, 
stockholders’ equity and cash flows of the Company and its subsidiaries. 

(b)  Eliza Holding Corp. Acquisition  

On April 17, 2017, the Company completed its previously announced acquisition of Eliza Holding Corp. (“Eliza”), a Delaware 
Company, pursuant to an Agreement and Plan of Merger dated March 10, 2017 (the “Merger Agreement”), for a cash purchase 

123 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
price of approximately $172.0 million, after adjustments for working capital, cash, transaction expenses and indebtedness. The 
acquisition  was  funded  with  available  liquidity,  consisting  of  approximately  75%  cash  on  hand  and  approximately  25%  of 
borrowings under the Company’s credit facility. The purchase price is subject to certain post-closing purchase price adjustments.  
The Merger Agreement was entered into by and among the Company, Echo Acquisition Sub, Inc., a Delaware corporation and 
an indirect wholly owned subsidiary of the Company (the “Merger Sub”), Eliza, and Parthenon Investors III, L.P., a Delaware 
limited  partnership,  solely  in  its  capacity  as  the  representative  for  equity  holders  of  Eliza.  Under  the  terms  of  the  Merger 
Agreement, the Merger Sub merged with and into Eliza (the “Merger”) and Eliza continued as the surviving corporation becoming 
an indirect wholly owned subsidiary of the Company.  

The Merger Agreement contains customary representations, warranties and covenants. The Merger Agreement also contains 
indemnification provisions that are subject to specified limitations, including recourse to a representation and warranty insurance 
policy for certain losses.  

In connection with the preparation of these audited consolidated financial statements, an evaluation of subsequent events was 
performed through the date these audited consolidated financial statements were issued and, other than the events above, 
there are no other events that have occurred that would require adjustments or disclosure to the Company’s audited consolidated 
financial statements. 

15. 

Quarterly Financial Data (Unaudited) 

The table below summarizes the Company’s unaudited quarterly operating results for the last two fiscal years (in thousands, 
except per share amounts): 

Year ended December 31, 2016
Revenue
Operating income
Net income
Net income per common share - basic
Net income per common share - diluted

First
Quarter

$       
$            
$            
$              
$              

119,763
9,909
4,560
0.05
0.05

Second 
Quarter

$       
$          
$            
$              
$              

123,550
16,352
8,566
0.10
0.10

Third
Quarter

$       
$          
$          
$              
$              

124,604
12,650
13,508
0.16
0.16

Revenue, as reported
Revenue, as revised

$       
$       

119,763
119,758

$       
$       

123,550
121,512

$       
$       

124,604
122,860

Fourth
Quarter

$     
$       
$       
$            
$            

125,590
18,758
11,002
0.13
0.13

$     

125,590

Selling, general and administrative expenses, as reported
Selling, general and administrative expenses, as revised

$          
$          

22,930
22,925

$          
$          

22,227
20,189

$          
$          

24,875
23,131

$       

23,136

During  the  fourth  quarter  of  2016,  the  Company  identified  a  material  weakness  in  accounting  for  its  accounts  receivable 
allowance, resulting in overstatements of revenue and of selling, general and administrative expenses for the quarters ended 
March 31, 2016 of $5,050, June 30, 2016 of $2,038,000, and September 30, 2016 of $1,744,244. Due to the immaterial nature 
of the error, the Company revised the quarterly financial information above, and will revise the quarterly information for 2016 
when it is presented in future filings. 

124 

 
 
 
 
 
 
 
 
 
Year ended December 31, 2015
Revenue
Operating income
Net income
Net income per common share - basic
Net income per common share - diluted

First
Quarter
$  
110,324
$       
7,981
$       
3,522
$         
0.04
$         
0.04

Second 
Quarter
$  
116,934
$    
11,752
$       
5,418
$         
0.06
$         
0.06

Third
Quarter

$    
$       
$         
$           
$           

118,444
13,016
6,862
0.08
0.08

Fourth
Quarter
$  
128,514
$    
14,823
$       
8,725
$         
0.10
$         
0.10

125 

 
SCHEDULE II – VALUATION AND QUALIFYING ACCOUNTS 
For the years ended December 31, 2016, 2015 and 2014 

Accounts receivable allowance and Estimated liability for appeals as of December 31, 2016, 2015 and 2014 are as follows:  

Accounts receivable allowance (in thousands): 

Year ended December 31, 2014
Year ended December 31, 2015
Year ended December 31, 2016

Balance at 
Beginning of Year
$                  
15,899
$                    
9,359
$                  
11,464

Provision
12,861
8,046
21,583

Recoveries
(17)
(100)
108

Charge-offs
(19,384)
(5,841)
(22,383)

Balance at 
End of Year
$         
9,359
$       
11,464
$       
10,772

Estimated liability for appeals (in thousands): 

Year ended December 31, 2014
Year ended December 31, 2015
Year ended December 31, 2016

Balance at 
Beginning of Year
$                  
19,853
$                  
19,314
$                  
12,801

Provision
1,459
2,610
721

Appeals found in providers favor

(1,998)
(9,123)
(2,396)

Balance at End 
of Year

$          
$          
$          

19,314
12,801
11,126

The above chart represents the CMS estimated reserve liability only. See Note 1 - "Business and Summary of Significant 
Accounting Policies" in our Notes to the Consolidated Financial Statements under Item 8. Consolidated Financial Statements 
and Supplementary Data for additional information regarding the estimated liability for appeals. 

126 

 
 
 
 
 
 
  
 
 
 
 
 
     
             
         
       
            
          
     
             
         
     
                                              
     
                                              
        
                                              
HMS HOLDINGS CORP. AND SUBSIDIARIES 
Exhibit Index 

Where an exhibit is filed by incorporation by reference to a previously filed registration statement or report, such registration 
statement or report is identified after the description of the exhibit. 

Exhibit 
Number 

  2.1 

  2.2 

  3.1 

  3.2 

  4.1 

  4.2 

10.1† 

10.2† 

10.3† 

10.4† 

10.5† 

10.6† 

10.7† 

10.8† 

Description 

Agreement and Plan of Merger among Health Management Systems, Inc., HMS Holdings Corp. and 
HMS  Acquisition  Corp.  dated  December  16,  2002  (incorporated  by  reference  to  Exhibit  A  to  HMS 
Holdings  Corp.’s  Prospectus  and  Proxy  Statement  (Reg  No.  333-100521)  as  filed  with  the  SEC  on 
January 24, 2003) 

Agreement and Plan of Merger, between the HMS Holdings Corp., a Delaware corporation and HMS 
Holdings Corp., a New York corporation dated July 17, 2013 (incorporated by reference to Exhibit 2.1 
to HMS Holding Corp.'s Current Report on Form 8-K/12g-3 (File No. 000-50194) as filed with the SEC 
on July 23, 2013) 

Conformed copy of Certificate of Incorporation of HMS Holdings Corp., as amended through July 9, 
2015 (incorporated by reference to Exhibit 3.1 to HMS Holding Corp.'s Quarterly Report on Form 10-Q 
(File No. 000-50194) as filed with the SEC on August 10, 2015) 

Amended and Restated Bylaws of HMS Holdings Corp. dated May 4, 2016 (incorporated by reference 
to Exhibit 3.2 to HMS Holdings Corp.’s Current Report on Form 8-K (File No. 000-50194) as filed with 
the SEC on May 5, 2016) 

Specimen Common Stock Certificate (incorporated by reference to Exhibit 4.1 to HMS Holding Corp.'s 
Current Report on Form 8-K/12g-3 (File No. 000-50194) as filed with the SEC on July 23, 2013) 

See Exhibits 3.1 and 3.2 for provisions defining the rights of holders of common stock of HMS Holdings 
Corp. 

HMS  Holdings  Corp.  Fourth  Amended  and  Restated  2006  Stock  Plan  (the  “2006  Stock  Plan”) 
(incorporated by reference to Exhibit 3.1 to HMS Holdings Corp.’s Current Report on Form 8-K (File 
No. 000-50194) as filed with the SEC on July 12, 2011) 

Amendment No. 1 to the 2006 Stock Plan (incorporated by reference to Exhibit 10.6 to HMS Holdings 
Corp.’s Annual Report on Form 10-K (File No. 000-50194) as filed with the SEC on February 29, 2012)

Form of 2010 Director Non-Qualified Stock Option Agreement under the 2006 Stock Plan (incorporated 
by reference to Exhibit 10.2 to HMS Holdings Corp.’s Quarterly Report on Form 10-Q (File No. 000-
50194) as filed with the SEC on November 8, 2010) 

Form 2010 Employee Non-Qualified Stock Option Agreement under the 2006 Stock Plan (incorporated 
by reference to Exhibit 10.4 to HMS Holdings Corp.’s Quarterly Report on Form 10-Q (File No. 000-
50194) filed with the SEC on November 8, 2010) 

Form of 2011 Director Non-Qualified Stock Option Agreement under the 2006 Stock Plan (incorporated 
by reference to Exhibit 10.16 to HMS Holdings Corp.’s Annual Report on Form 10-K (File No. 000-
50194) as filed with the SEC on February 29, 2012) 

Form  of  2011  Employee  Non-Qualified  Stock  Option  Agreement  under  the  2006  Stock  Plan 
(incorporated by reference to Exhibit 10.18 to HMS Holdings Corp.’s Annual Report on Form 10-K (File 
No. 000-50194) as filed with the SEC on February 29, 2012) 

Form of 2012 Director Non-Qualified Stock Option Agreement under the 2006 Stock Plan (incorporated 
by reference to Exhibit 10.20 to HMS Holdings Corp.’s Annual Report on Form 10-K (File No. 000-
50194) as filed with the SEC on March 1, 2013) 

Form  of  2012  Executive  Non-Qualified  Stock  Option  Agreement  under  the  2006  Stock  Plan 
(incorporated by reference to Exhibit 10.22 to HMS Holdings Corp.’s Annual Report on Form 10-K (File 
No. 000-50194) as filed with the SEC on March 1, 2013) 

127 

 
 
 
Exhibit 
Number 

10.9† 

10.10† 

10.11† 

10.12† 

10.13† 

10.14† 

10.15† 

10.16† 

10.17† 

10.18† 

10.19† 

10.20† 

10.21† 

10.22† 

10.23† 

Description 

Form of 2013 Executive Restricted Stock Unit Agreement under the 2006 Stock Plan (incorporated by 
reference to Exhibit 10.24 to HMS Holdings Corp.’s Annual Report on Form 10-K (File No. 000-50194) 
as filed with the SEC on March 1, 2013) 

Form of 2013 Director Non-Qualified Stock Option Agreement under the 2006 Stock Plan (incorporated 
by reference to Exhibit 10.1 to HMS Holding Corp.’s Quarterly Report on Form 10-Q (File No. 000-
50194) as filed with the SEC on May 12, 2014) 

Form  of  2013  Executive  Non-Qualified  Stock  Option  Agreement  under  the  2006  Stock  Plan 
(incorporated by reference to Exhibit 10.3 to HMS Holding Corp.’s Quarterly Report on Form 10-Q (File 
No. 000-50194) as filed with the SEC on May 12, 2014) 

Form  of  March  2014  Executive  Restricted  Stock  Unit  Agreement  under  the  2006  Stock  Plan 
(incorporated by reference to Exhibit 10.4 to HMS Holding Corp.’s Quarterly Report on Form 10-Q (File 
No. 000-50194) as filed with the SEC on May 12, 2014) 

Form  of  November  2014  Executive  Restricted  Stock  Unit  Agreement  under  the  2006  Stock  Plan 
(incorporated by reference to Exhibit 10.1 to HMS Holding Corp.’s Quarterly Report on Form 10-Q (File 
No. 000-50194) as filed with the SEC on November 10, 2014)   

Form of 2014 Director Non-Qualified Stock Option Agreement under the 2006 Stock Plan (incorporated 
by reference to Exhibit 10.26 to HMS Holding Corp.’s Annual Report on Form 10-K (File No. 000-50194) 
as filed with the SEC on March 2, 2015) 

Form  of  2014  Executive  Non-Qualified  Stock  Option  Agreement  under  the  2006  Stock  Plan 
(incorporated by reference to Exhibit 10.28 to HMS Holding Corp.’s Annual Report on Form 10-K (File 
No. 000-50194) as filed with the SEC on March 2, 2015) 

Form  of  March  2015  Executive  Non-Qualified  Stock  Option  Agreement  under  the  2006  Stock  Plan 
(incorporated by reference Exhibit 10.1 to HMS Holding Corp.'s Quarterly Report on Form 10-Q (File 
No. 000-50194) as filed with the SEC on May 11, 2015) 

Form  of  March  2015  Executive  Restricted  Stock  Unit  Agreement  under  the  2006  Stock  Plan 
(incorporated by reference Exhibit 10.2 to HMS Holding Corp.'s Quarterly Report on Form 10-Q (File 
No. 000-50194) as filed with the SEC on May 11, 2015) 

Form of 2015 Director Non-Qualified Stock Option Agreement under the 2006 Stock Plan (incorporated 
by reference to Exhibit 10.21 to HMS Holdings Corp.’s Annual Report on Form 10-K (File No. 000-
50194) as filed with the SEC on March 1, 2016) 

Form of 2015 Director Restricted Stock Unit Agreement under the 2006 Stock Plan (incorporated by 
reference to Exhibit 10.22 to HMS Holdings Corp.’s Annual Report on Form 10-K (File No. 000-50194) 
as filed with the SEC on March 1, 2016) 

Form of November 2015 Executive Non-Qualified Stock Option Agreement under the 2006 Stock Plan 
(incorporated by reference to Exhibit 10.23 to HMS Holdings Corp.’s Annual Report on Form 10-K (File 
No. 000-50194) as filed with the SEC on March 1, 2016) 

Form of 2016 Executive and Senior Vice President Non-Qualified Stock Option Agreement under the 
2006 Stock Plan (incorporated by reference to Exhibit 10.1 to HMS Holdings Corp.’s Quarterly Report 
on Form 10-Q (File No. 000-50194) as filed with the SEC on May 10, 2016) 

Form of 2016 Executive and Senior Vice President Restricted Stock Unit Agreement under the 2006 
Stock Plan (incorporated by reference to Exhibit 10.2 to HMS Holdings Corp.’s Quarterly Report on 
Form 10-Q (File No. 000-50194) as filed with the SEC on May 10, 2016) 

HMS  Holdings  Corp.  2016  Omnibus  Incentive  Plan  (“the  “2016  Omnibus  Plan”)  (incorporated  by 
reference to Exhibit 10.2 to HMS Holdings Corp.’s Current Report on Form 8-K (File No. 000-50194) as 
filed with the SEC on June 27, 2016) 

128 

 
 
Exhibit 
Number 

10.24† 

10.25† 

10.26† 

10.27† 

10.28† 

10.29† 

10.30† 

10.31† 

10.32† 

10.33† 

10.34† 

10.35† 

10.36† 

10.37† 

10.38† 

Description 

Form of Non-Qualified Stock Option Award Agreement for Employees under the 2016 Omnibus Plan 
(incorporated by reference to Exhibit 10.1 to HMS Holdings Corp.’s Quarterly Report on Form 10-Q 
(File No. 000-50194) as filed with the SEC on November 9, 2016) 

Form  of  Restricted  Stock  Unit  Award  Agreement  for  Employees  under  the  2016  Omnibus  Plan 
(incorporated by reference to Exhibit 10. to HMS Holdings Corp.’s Quarterly Report on Form 10-Q (File 
No. 000-50194) as filed with the SEC on November 9, 2016) 

Form of Non-Qualified Stock Option Award Agreement  for Non-Employee Directors under the 2016 
Omnibus Plan (incorporated by reference to Exhibit 10.3 to HMS Holdings Corp.’s Quarterly Report on 
Form 10-Q (File No. 000-50194) as filed with the SEC on November 9, 2016) 

Form of Restricted Stock Unit Award Agreement for Non-Employee Directors under the 2016 Omnibus 
Plan (incorporated by reference to Exhibit 10.4 to HMS Holdings Corp.’s Quarterly Report on Form 10-
Q (File No. 000-50194) as filed with the SEC on November 9, 2016) 

HDI Holdings, Inc. Amended 2011 Stock Option and Stock Issuance Plan (the “HDI 2011 Stock Plan”) 
(incorporated by reference to Exhibit 10.21 to HMS Holdings Corp.’s Annual Report on Form 10-K (File 
No. 000-50194) as filed with the SEC on February 29, 2012) 

Form  of  2011  Employee  Non-Qualified  Stock  Option  Agreement  under  the  HDI  2011  Stock  Plan 
(incorporated by reference to Exhibit 10.22 to HMS Holdings Corp.’s Annual Report on Form 10-K (File 
No. 000-50194) as filed with the SEC on February 29, 2012) 

Executive Employment Agreement between William C. Lucia and HMS Holdings Corp. dated March 1, 
2013 (incorporated by reference to Exhibit 10.20 to HMS Holdings Corp.’s Annual Report on Form 10-
K (File No. 000-50194) as filed with the SEC on March 1, 2013) 

Letter  of  Amendment  to  Executive  Employment  Agreement  between  William  C.  Lucia  and  HMS 
Holdings Corp. dated April 30, 2013 (incorporated by reference to Exhibit 10.1 to Amendment No. 1 to 
HMS Holdings Corp.’s Annual Report on Form 10-K/A (File No. 000-50194) as filed with the SEC on 
April 30, 2013) 

Second Amendment to Executive Employment Agreement between HMS Holdings Corp. and William 
C. Lucia dated January 20, 2015 (incorporated by reference to Exhibit 10.1 to HMS Holding Corp.’s 
Current Report on Form 8-K (Filed No. 000-50194) as filed with the SEC on January 23, 2015) 

Employment Agreement between Jeffrey S. Sherman and HMS Holdings Corp. dated July 28, 2014 
(incorporated by reference to Exhibit 10.1 to HMS Holdings Corp.’s Current Report on Form 8-K (File 
No. 000-50194) as filed with the SEC on September 8, 2014) 

Employment Agreement between Semone Wagner and HMS Holdings Corp. dated January 16, 2013 
(incorporated by reference to Exhibit 99.2 to HMS Holding Corp.’s Annual Report on Form 10-K (File 
No. 000-50194) as filed with the SEC on March 3, 2014) 

Employment  Agreement  between  Cynthia  Nustad  and  HMS  Business  Services,  Inc.  dated  May  15, 
2012 (incorporated by reference to Exhibit 10.47 to Amendment No. 1 to HMS Holding Corp.’s Annual 
Report on Form 10-K/A (File No. 000-50194) as filed with the SEC on April 30, 2015) 

Employment Agreement between Douglas M. Williams and HMS Holdings Corp. dated November 13, 
2013 (incorporated by reference to Exhibit 10.33 to HMS Holdings Corp.’s Annual Report on Form 10-
K (File No. 000-50194) as filed with the SEC on March 1, 2016)  

Form of Indemnification Agreement (incorporated by reference to Exhibit 10.1 to HMS Holdings Corp.’s 
Current Report on Form 8-K (File No. 000-50194) as  filed with the SEC on August 6, 2014) 

HMS  Holdings  Corp.  Director  Deferred  Compensation  Plan,  as  amended  through  June  29,  2016 
(incorporated by reference to Exhibit 10.3 to HMS Holdings Corp.’s Quarterly Report on Form 10-Q 
(File No. 000-50194) as filed with the SEC on August 9, 2016) 

129 

 
 
Exhibit 
Number 

10.39† 

10.40 

10.41 

21.1* 

23.1* 

31.1* 

31.2* 

32.1‡ 

32.2‡ 

Description 

2016  HMS  Holdings  Corp.  Annual  Incentive  Compensation  Plan  as  amended  and  restated 
(incorporated by reference to Exhibit 10.1 to HMS Holdings Corp.’s Current Report on Form 8-K (File 
No. 000-50194) as filed with the SEC on June 27, 2016) 

Credit Agreement dated May 3, 2013 among HMS Holdings Corp., the Guarantors Party thereto, the 
Lenders party thereto and Citibank, N.A. as Administrative Agent (incorporated by reference to Exhibit 
10.1 to HMS Holdings Corp.’s Current Report on Form 8-K (File No. 000-50194) as filed with the SEC 
on May 6, 2013) 

HDI Lease between New Russell One LLC and HMS Business Services, Inc. dated February 27, 2014 
(incorporated by reference to Exhibit 10.5 to HMS Holdings Corp.’s Quarterly Report on Form 10-Q 
(File No. 000-50194) as filed with the SEC on May 12, 2014) 

HMS Holdings Corp. List of Subsidiaries 

Consent of Independent Registered Public Accounting Firm 

Rule 13a-14(a)/15d-14(a)  Certification of the Principal Executive Officer  of HMS Holdings Corp., as 
adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 

Rule  13a-14(a)/15d-14(a)  Certification  of  the  Principal  Financial  Officer  of  HMS  Holdings  Corp.,  as 
adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 

Section  1350  Certification  of  the  Principal  Executive  Officer  of  HMS  Holdings  Corp.,  as  adopted 
pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 

Section 1350 Certification of the Principal Financial Officer of HMS Holdings Corp., as adopted pursuant 
to Section 906 of the Sarbanes-Oxley Act of 2002 

101.INS* 

XBRL Instance Document 

101.SCH*  XBRL Taxonomy Extension Schema Document 

101.CAL*  XBRL Taxonomy Extension Calculation Linkbase Document 

101.DEF*  XBRL Taxonomy Extension Definition Linkbase Document 

101.LAB* 

XBRL Taxonomy Extension Label Linkbase Document 

101.PRE*  XBRL Taxonomy Extension Presentation Linkbase Document 

† 
* 
‡ 

Indicates a management contract or compensatory plan, contract or arrangement 
Filed herewith 
Furnished herewith 

130 

 
 
 
 
(This page has been left blank intentionally.) 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Appendix A 

HMS Holdings Corp. and Subsidiaries

Reconciliation of Net Income to EBITDA and Adjusted EBITDA 
(in thousands)

(cid:48)(cid:71)(cid:86)(cid:3)(cid:75)(cid:80)(cid:69)(cid:81)(cid:79)(cid:71)

(cid:48)(cid:71)(cid:86)(cid:3)(cid:75)(cid:80)(cid:86)(cid:71)(cid:84)(cid:71)(cid:85)(cid:86)(cid:3)(cid:71)(cid:90)(cid:82)(cid:71)(cid:80)(cid:85)(cid:71)

Income taxes

(cid:38)(cid:71)(cid:82)(cid:84)(cid:71)(cid:69)(cid:75)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)(cid:3)(cid:67)(cid:80)(cid:70)(cid:3)(cid:67)(cid:79)(cid:81)(cid:84)(cid:86)(cid:75)(cid:92)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)(cid:14)(cid:3)(cid:80)(cid:71)(cid:86)(cid:3)(cid:81)(cid:72)(cid:3)(cid:70)(cid:71)(cid:72)(cid:71)(cid:84)(cid:84)(cid:71)(cid:70)(cid:3)(cid:402)(cid:80)(cid:67)(cid:80)(cid:69)(cid:75)(cid:80)(cid:73)(cid:3)(cid:69)(cid:81)(cid:85)(cid:86)(cid:85)(cid:14)(cid:3)(cid:75)(cid:80)(cid:69)(cid:78)(cid:87)(cid:70)(cid:71)(cid:70)(cid:3)(cid:75)(cid:80)(cid:3)(cid:80)(cid:71)(cid:86)(cid:3)(cid:75)(cid:80)(cid:86)(cid:71)(cid:84)(cid:71)(cid:85)(cid:86)(cid:3)(cid:71)(cid:90)(cid:82)(cid:71)(cid:80)(cid:85)(cid:71)

FY 2016

FY 2015

(cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:21)(cid:25)(cid:14)(cid:24)(cid:21)(cid:24)

(cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:20)(cid:22)(cid:14)(cid:23)(cid:20)(cid:25)

(cid:26)(cid:14)(cid:19)(cid:27)(cid:26)

(cid:19)(cid:19)(cid:14)(cid:26)(cid:21)(cid:23)

(cid:22)(cid:22)(cid:14)(cid:27)(cid:21)(cid:18)

7,763

(cid:19)(cid:23)(cid:14)(cid:20)(cid:26)(cid:20)

(cid:23)(cid:18)(cid:14)(cid:23)(cid:27)(cid:26)

(cid:39)(cid:67)(cid:84)(cid:80)(cid:75)(cid:80)(cid:73)(cid:85)(cid:3)(cid:68)(cid:71)(cid:72)(cid:81)(cid:84)(cid:71)(cid:3)(cid:75)(cid:80)(cid:86)(cid:71)(cid:84)(cid:71)(cid:85)(cid:86)(cid:14)(cid:3)(cid:86)(cid:67)(cid:90)(cid:71)(cid:85)(cid:14)(cid:3)(cid:70)(cid:71)(cid:82)(cid:84)(cid:71)(cid:69)(cid:75)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)(cid:3)(cid:67)(cid:80)(cid:70)(cid:3)(cid:67)(cid:79)(cid:81)(cid:84)(cid:86)(cid:75)(cid:92)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)(cid:3)(cid:3)(cid:10)(cid:39)(cid:36)(cid:43)(cid:54)(cid:38)(cid:35)(cid:11)(cid:3)

(cid:3)(cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:19)(cid:18)(cid:20)(cid:14)(cid:23)(cid:27)(cid:27)

(cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:27)(cid:26)(cid:14)(cid:19)(cid:25)(cid:18)

(cid:53)(cid:86)(cid:81)(cid:69)(cid:77)(cid:3)(cid:68)(cid:67)(cid:85)(cid:71)(cid:70)(cid:3)(cid:69)(cid:81)(cid:79)(cid:82)(cid:71)(cid:80)(cid:85)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)(cid:3)(cid:71)(cid:90)(cid:82)(cid:71)(cid:80)(cid:85)(cid:71)

(cid:48)(cid:81)(cid:80)(cid:15)(cid:84)(cid:71)(cid:69)(cid:87)(cid:84)(cid:84)(cid:75)(cid:80)(cid:73)(cid:3)(cid:78)(cid:71)(cid:73)(cid:67)(cid:78)(cid:3)(cid:72)(cid:71)(cid:71)(cid:85)(cid:3)(1)

Adjusted EBITDA

13,277

(cid:19)(cid:14)(cid:23)(cid:24)(cid:21)

(cid:19)(cid:22)(cid:14)(cid:20)(cid:27)(cid:25)

(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)

(cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:19)(cid:19)(cid:25)(cid:14)(cid:22)(cid:21)(cid:27) (cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:19)(cid:19)(cid:20)(cid:14)(cid:22)(cid:24)(cid:25)

(cid:10)(cid:19)(cid:11)(cid:3)(cid:43)(cid:80)(cid:3)(cid:82)(cid:71)(cid:84)(cid:75)(cid:81)(cid:70)(cid:85)(cid:3)(cid:82)(cid:84)(cid:75)(cid:81)(cid:84)(cid:3)(cid:86)(cid:81)(cid:3)(cid:20)(cid:18)(cid:19)(cid:24)(cid:14)(cid:3)(cid:78)(cid:71)(cid:73)(cid:67)(cid:78)(cid:3)(cid:72)(cid:71)(cid:71)(cid:85)(cid:3)(cid:84)(cid:71)(cid:78)(cid:67)(cid:86)(cid:71)(cid:70)(cid:3)(cid:86)(cid:81)(cid:3)(cid:70)(cid:75)(cid:85)(cid:82)(cid:87)(cid:86)(cid:71)(cid:85)(cid:3)(cid:75)(cid:80)(cid:88)(cid:81)(cid:78)(cid:88)(cid:75)(cid:80)(cid:73)(cid:3)(cid:50)(cid:37)(cid:41)(cid:3)(cid:89)(cid:71)(cid:84)(cid:71)(cid:3)(cid:80)(cid:81)(cid:86)(cid:3)(cid:75)(cid:80)(cid:69)(cid:78)(cid:87)(cid:70)(cid:71)(cid:70)(cid:3)(cid:75)(cid:80)(cid:3)(cid:67)(cid:70)(cid:76)(cid:87)(cid:85)(cid:86)(cid:71)(cid:70)(cid:3)(cid:71)(cid:67)(cid:84)(cid:80)(cid:75)(cid:80)(cid:73)(cid:85)(cid:3)(cid:3)(cid:3)
(cid:68)(cid:71)(cid:69)(cid:67)(cid:87)(cid:85)(cid:71)(cid:3)(cid:86)(cid:74)(cid:71)(cid:91)(cid:3)(cid:89)(cid:71)(cid:84)(cid:71)(cid:3)(cid:80)(cid:81)(cid:86)(cid:3)(cid:69)(cid:81)(cid:80)(cid:85)(cid:75)(cid:70)(cid:71)(cid:84)(cid:71)(cid:70)(cid:3)(cid:80)(cid:81)(cid:80)(cid:15)(cid:84)(cid:71)(cid:69)(cid:87)(cid:84)(cid:84)(cid:75)(cid:80)(cid:73)(cid:3)(cid:67)(cid:86)(cid:3)(cid:86)(cid:74)(cid:71)(cid:3)(cid:86)(cid:75)(cid:79)(cid:71)(cid:16)(cid:3)(cid:40)(cid:81)(cid:84)(cid:3)(cid:86)(cid:74)(cid:71)(cid:3)(cid:86)(cid:89)(cid:71)(cid:78)(cid:88)(cid:71)(cid:3)(cid:79)(cid:81)(cid:80)(cid:86)(cid:74)(cid:85)(cid:3)(cid:71)(cid:80)(cid:70)(cid:71)(cid:70)(cid:3)(cid:38)(cid:71)(cid:69)(cid:71)(cid:79)(cid:68)(cid:71)(cid:84)(cid:3)(cid:21)(cid:19)(cid:14)(cid:3)(cid:20)(cid:18)(cid:19)(cid:23)(cid:14)(cid:3)
(cid:84)(cid:71)(cid:78)(cid:67)(cid:86)(cid:71)(cid:70)(cid:3)(cid:78)(cid:71)(cid:73)(cid:67)(cid:78)(cid:3)(cid:72)(cid:71)(cid:71)(cid:85)(cid:3)(cid:89)(cid:71)(cid:84)(cid:71)(cid:3)(cid:6)(cid:23)(cid:16)(cid:23)(cid:3)(cid:79)(cid:75)(cid:78)(cid:78)(cid:75)(cid:81)(cid:80)(cid:16)

Reconciliation of Net Income to GAAP EPS and Adjusted EPS 
(in thousands, except per share amounts) 

(cid:48)(cid:71)(cid:86)(cid:3)(cid:75)(cid:80)(cid:69)(cid:81)(cid:79)(cid:71)

(cid:53)(cid:86)(cid:81)(cid:69)(cid:77)(cid:15)(cid:68)(cid:67)(cid:85)(cid:71)(cid:70)(cid:3)(cid:69)(cid:81)(cid:79)(cid:82)(cid:71)(cid:80)(cid:85)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)

(cid:48)(cid:81)(cid:80)(cid:15)(cid:84)(cid:71)(cid:69)(cid:87)(cid:84)(cid:84)(cid:75)(cid:80)(cid:73)(cid:3)(cid:78)(cid:71)(cid:73)(cid:67)(cid:78)(cid:3)(cid:72)(cid:71)(cid:71)(cid:85) (1)

(cid:35)(cid:79)(cid:81)(cid:84)(cid:86)(cid:75)(cid:92)(cid:67)(cid:86)(cid:75)(cid:81)(cid:80)(cid:3)(cid:81)(cid:72)(cid:3)(cid:67)(cid:69)(cid:83)(cid:87)(cid:75)(cid:85)(cid:75)(cid:86)(cid:75)(cid:81)(cid:80)(cid:3)(cid:84)(cid:71)(cid:78)(cid:67)(cid:86)(cid:71)(cid:70)(cid:3)(cid:85)(cid:81)(cid:72)(cid:86)(cid:89)(cid:67)(cid:84)(cid:71)(cid:3)(cid:67)(cid:80)(cid:70)(cid:3)(cid:75)(cid:80)(cid:86)(cid:67)(cid:80)(cid:73)(cid:75)(cid:68)(cid:78)(cid:71)(cid:3)(cid:67)(cid:85)(cid:85)(cid:71)(cid:86)(cid:85)

Income tax related adjustments

(cid:53)(cid:87)(cid:68)(cid:15)(cid:86)(cid:81)(cid:86)(cid:67)(cid:78)

Weighted average common shares, diluted

(cid:38)(cid:75)(cid:78)(cid:87)(cid:86)(cid:71)(cid:70)(cid:3)(cid:41)(cid:35)(cid:35)(cid:50)(cid:3)(cid:39)(cid:50)(cid:53)

(cid:38)(cid:75)(cid:78)(cid:87)(cid:86)(cid:71)(cid:70)(cid:3)(cid:35)(cid:70)(cid:76)(cid:87)(cid:85)(cid:86)(cid:71)(cid:70)(cid:3)(cid:39)(cid:50)(cid:53)

FY 2016

FY 2015

(cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:21)(cid:25)(cid:14)(cid:24)(cid:21)(cid:24) (cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:20)(cid:22)(cid:14)(cid:23)(cid:20)(cid:25)

13,277

(cid:19)(cid:14)(cid:23)(cid:24)(cid:21)

28,030

(cid:19)(cid:22)(cid:14)(cid:20)(cid:27)(cid:25)

(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:15)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)

(cid:20)(cid:26)(cid:14)(cid:19)(cid:22)(cid:26)

(cid:10)(cid:19)(cid:23)(cid:14)(cid:23)(cid:21)(cid:24)(cid:11)

(cid:10)(cid:19)(cid:24)(cid:14)(cid:20)(cid:27)(cid:23)(cid:11)

(cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:24)(cid:22)(cid:14)(cid:27)(cid:25)(cid:18) (cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:23)(cid:18)(cid:14)(cid:24)(cid:25)(cid:25)

(cid:26)(cid:24)(cid:14)(cid:27)(cid:26)(cid:25)

88,361

(cid:3)(cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:18)(cid:16)(cid:22)(cid:21) (cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:18)(cid:16)(cid:20)(cid:26)

(cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:18)(cid:16)(cid:25)(cid:23) (cid:6)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:3)(cid:18)(cid:16)(cid:23)(cid:25)

(cid:10)(cid:19)(cid:11)(cid:3)(cid:46)(cid:71)(cid:73)(cid:67)(cid:78)(cid:3)(cid:72)(cid:71)(cid:71)(cid:85)(cid:3)(cid:84)(cid:71)(cid:78)(cid:67)(cid:86)(cid:71)(cid:70)(cid:3)(cid:86)(cid:81)(cid:3)(cid:70)(cid:75)(cid:85)(cid:82)(cid:87)(cid:86)(cid:71)(cid:85)(cid:3)(cid:75)(cid:80)(cid:88)(cid:81)(cid:78)(cid:88)(cid:75)(cid:80)(cid:73)(cid:3)(cid:50)(cid:37)(cid:41)(cid:3)(cid:89)(cid:71)(cid:84)(cid:71)(cid:3)(cid:80)(cid:81)(cid:86)(cid:3)(cid:69)(cid:81)(cid:80)(cid:85)(cid:75)(cid:70)(cid:71)(cid:84)(cid:71)(cid:70)(cid:3)(cid:80)(cid:81)(cid:80)(cid:15)(cid:84)(cid:71)(cid:69)(cid:87)(cid:84)(cid:84)(cid:75)(cid:80)(cid:73)(cid:3)(cid:75)(cid:80)(cid:3)(cid:20)(cid:18)(cid:19)(cid:23)(cid:16)(cid:3)(cid:40)(cid:81)(cid:84)(cid:3)(cid:86)(cid:74)(cid:71)(cid:3)(cid:86)(cid:89)(cid:71)(cid:78)(cid:88)(cid:71)(cid:3)(cid:79)(cid:81)(cid:80)(cid:86)(cid:74)(cid:85)(cid:3)
(cid:71)(cid:80)(cid:70)(cid:71)(cid:70)(cid:3)(cid:38)(cid:71)(cid:69)(cid:71)(cid:79)(cid:68)(cid:71)(cid:84)(cid:3)(cid:21)(cid:19)(cid:14)(cid:3)(cid:20)(cid:18)(cid:19)(cid:23)(cid:14)(cid:3)(cid:84)(cid:71)(cid:78)(cid:67)(cid:86)(cid:71)(cid:70)(cid:3)(cid:78)(cid:71)(cid:73)(cid:67)(cid:78)(cid:3)(cid:72)(cid:71)(cid:71)(cid:85)(cid:3)(cid:89)(cid:71)(cid:84)(cid:71)(cid:3)(cid:67)(cid:82)(cid:82)(cid:84)(cid:81)(cid:90)(cid:75)(cid:79)(cid:67)(cid:86)(cid:71)(cid:78)(cid:91)(cid:3)(cid:6)(cid:23)(cid:16)(cid:23)(cid:3)(cid:79)(cid:75)(cid:78)(cid:78)(cid:75)(cid:81)(cid:80)(cid:3)(cid:67)(cid:80)(cid:70)(cid:3)(cid:75)(cid:80)(cid:69)(cid:81)(cid:79)(cid:71)(cid:3)(cid:86)(cid:67)(cid:90)(cid:71)(cid:85)(cid:3)(cid:81)(cid:80)(cid:3)(cid:84)(cid:71)(cid:78)(cid:67)(cid:86)(cid:71)(cid:70)(cid:3)(cid:78)(cid:71)(cid:73)(cid:67)(cid:78)(cid:3)
(cid:72)(cid:71)(cid:71)(cid:85)(cid:3)(cid:89)(cid:71)(cid:84)(cid:71)(cid:3)(cid:67)(cid:82)(cid:82)(cid:84)(cid:81)(cid:90)(cid:75)(cid:79)(cid:67)(cid:86)(cid:71)(cid:78)(cid:91)(cid:3)(cid:6)(cid:20)(cid:16)(cid:19)(cid:3)(cid:79)(cid:75)(cid:78)(cid:78)(cid:75)(cid:81)(cid:80)(cid:3)(cid:81)(cid:84)(cid:3)(cid:86)(cid:74)(cid:71)(cid:3)(cid:71)(cid:83)(cid:87)(cid:75)(cid:88)(cid:67)(cid:78)(cid:71)(cid:80)(cid:86)(cid:3)(cid:81)(cid:72)(cid:3)(cid:6)(cid:18)(cid:16)(cid:18)(cid:22)(cid:3)(cid:82)(cid:71)(cid:84)(cid:3)(cid:70)(cid:75)(cid:78)(cid:87)(cid:86)(cid:71)(cid:70)(cid:3)(cid:35)(cid:70)(cid:76)(cid:87)(cid:85)(cid:86)(cid:71)(cid:70)(cid:3)(cid:39)(cid:50)(cid:53)(cid:16)(cid:3)

William C. Lucia

Chairman and Chief 

Executive Officer

Dear Shareholder,

2016 was a year of solid growth in total revenue and earnings 

per share. Adjusted EBITDA also increased, overall profitability 

and margins improved, and operating cash flow remained strong. 

In addition, we achieved a key strategic objective for the year 

by acquiring a care management platform. Beyond our financial 

performance, we are proud to have saved billions of dollars for our 

customers. Those savings represent an important contribution to 

bending the ever-rising healthcare cost curve in this nation.

Our 2016 commercial health plan revenue exceeded our state 

government revenue for the first time and significant sales throughout 

last year form the foundation for strong commercial revenue growth 

we expect again in 2017. We added over 17 million new commercial 

lives, including a sale in the second quarter to a single customer for 15 

million of their at-risk and ASO members, taking our commercial health 

plan lives over 100 million. We also sold additional products to existing 

health plan customers last year covering approximately 30 million of 

their members, compared to about 13 million in the prior year. 

Full-year adjusted earnings per share were up 30% in 2016. Operating cash flow increased 

22% and year-end cash of $176 million was 21% higher than the prior year-end, even after 

the $21 million purchase of Essette in the third quarter and $20 million of share repurchases 

(1.1 million shares) in the fourth quarter. Through year end we had purchased a total of 5.9 

million shares at an average price of $11.95 per share pursuant to a buyback plan instituted 

by our Board in August of 2015. We also completed a tax project in the third quarter – 

identifying certain credits and deductions that reduced our annual effective tax rate by 300 

bps to ~37%.

The Essette care management platform, acquired last fall, was the foundation for a new 

third business vertical, which was strengthened considerably by the acquisition of the Eliza 

Corporation consumer engagement platform completed in April of this year. Essette was 

designed and built from the ground up to serve as a “care traffic controller” –  helping risk 

bearing entities identify and manage at-risk populations. Eliza is a cloud-based technology 

platform which provides comprehensive and personalized health engagement solutions 

designed to improve clinical outcomes and reduce costs by motivating members to adopt 

targeted behaviors. Eliza has developed sophisticated communication techniques - based on 

proprietary patented predictive analytics, behavioral science and digital design techniques 

- to effectively engage members and achieve better health outcomes. We see these Essette 

and Eliza capabilities as a natural extension of the cost containment solutions we have 

offered historically, an opportunity to further leverage our data assets, and a strategic 

response to the need for payers to improve health outcomes and reduce costs for their 

highest risk members. We believe there will be significant opportunities to cross-sell our 

new care management and member engagement solutions to our health plan and state 

government customers.

Cynthia Nustad 
Executive Vice President and Chief Strategy Officer 

Jeffrey S. Sherman 
Executive Vice President, 
Chief Financial Officer and Treasurer 

Tracy A. South 
Executive Vice President, 
Human Resources and Chief Administrative Officer  

Douglas M. Williams 
President, Markets and Product

Corporate Headquarters:

5615 High Point Drive  
Irving, TX 75038 
Tel. 214.453.3000 
Fax. 214.453.3023 

Board of Directors:

Alex M. Azar II 
Chairman, Seraphim Strategies, LLC 
Former President, Lilly USA, LLC 

Robert Becker 
Former President and Chief Executive Officer, Wolters Kluwer Health 

Craig R. Callen 
Former Senior Advisor, Crestview Partners 

William C. Lucia  
Chairman of the Board, 
President and Chief Executive Officer, HMS Holdings Corp. 

William F. Miller III 
Healthcare Industry Advisor, KKR Advisors 
Former Chairman of the Board and Chief Executive Officer,  
HMS Holdings Corp. 

Ellen A. Rudnick 
Senior Advisor for Entrepreneurship, adjunct faculty, 
Polsky Center for Entrepreneurship and Innovation,  
University of Chicago Booth School of Business 

Bart M. Schwartz 
Chairman and Chief Executive Officer, 
SolutionPoint International, LLC  

Richard H. Stowe 
Lead Independent Director, HMS Holdings Corp. 
General Partner, Health Enterprise Partners, LP 

Cora M. Tellez 
President and Chief Executive Officer, Sterling HSA 

Executive Officers: 

William C. Lucia  
Chairman of the Board,  
President and Chief Executive Officer 

Meredith W. Bjorck 
Executive Vice President, 
General Counsel and Corporate Secretary 

Semone Neuman 
Executive Vice President, Operations and Information Technology 

Form 10-K Report/Quarterly Reporting

The Company’s 2016 Form 10-K, as filed with the SEC, is included in this Annual Report in its entirety with the exception of certain exhibits. Copies of the 
Company’s quarterly earnings results and additional copies of the 2016 Form 10-K, including all exhibits, are available on the Internet at http://investor.hms.
com/sec.cfm or by accessing our filings with the SEC. In addition, shareholders may obtain a paper copy of these materials upon request from our Office of 
Investor Relations by emailing dennis.oakes@hms.com.

Stock Registrar and Transfer Agent

Common stock of HMS Holdings Corp. is traded on the NASDAQ Stock Exchange under the symbol HMSY. Questions with regard to registered shares of HMSY 
should be submitted to: HMS Holdings Corp. c/o Broadridge Corporate Issuer Solutions, Inc., P.O. Box 1342, Brentwood, NY 11717. Phone: 855.418.5059.  
Email: shareholder@broadridge.com. Internet: http://www.broadridge.com.

20

16 ANNUAL REPORT

Enterprising healthcare

hms.com

© 2017 HMS Holdings Corp.