Quarterlytics / Communication Services / Specialty Business Services / HMS Holdings Corp.

HMS Holdings Corp.

hmsy · NASDAQ Communication Services
Claim this profile
Ticker hmsy
Exchange NASDAQ
Sector Communication Services
Industry Specialty Business Services
Employees 1001-5000
← All annual reports
FY2017 Annual Report · HMS Holdings Corp.
Sign in to download
Loading PDF…
William C. Lucia
Chairman and Chief 
Executive Officer

Dear Shareholder,

The healthcare industry is increasingly focused on enhancing the 
consumer experience and improving health outcomes by better 
engaging individuals in managing their own health. To capitalize 
on this trend, we completed an important strategic acquisition of 
Eliza Holding Corp. (“Eliza”) in April 2017. Together with the 2016 
purchase of the Essette care management platform, HMS now offers 
a significantly expanded suite of solutions to engage consumers 
and better manage their care. With our new care management and 
consumer engagement vertical, combined with our heritage cost-
containment businesses, HMS can address virtually every aspect of 
the estimated $1 trillion in annual U.S. healthcare spend lost to fraud, 
waste and abuse. As a result, we are a key partner for payers seeking 
to proactively manage the health of their members and to bend the 
unsustainable upward trajectory of the healthcare cost curve.

Eliza is a cloud-based technology platform that provides personalized 
health engagement solutions – at scale – to improve clinical 
outcomes and reduce costs by motivating members to adopt targeted 

behaviors. It creates expanded opportunities to leverage our three principal assets – data, 
analytics and an expansive customer base – and to partner with payers as they develop and 
execute strategies to become more consumer-centric. We also believe our new offerings 
will increase member satisfaction and retention rates, while positioning HMS to address 
other factors affecting healthcare, such as the increasing influence of artificial intelligence; 
a greater focus on price transparency; heightened recognition of the impact of social 
determinants; and the growing role of big data and technology-based analytics.

Eliza can, for example, identify social determinants during member outreach or health risk 
assessment activities and provide actionable insights to customers, so they can direct their 
members to appropriate assistance and care. This is important because socioeconomics, 
education levels, employment status and social networks are factors that significantly 
impact overall health but cannot be assessed from an enrollment file or medical claim.

Our 2017 financial performance included record full year coordination of benefits revenue, 
which was up more than 8% compared to the prior year; full year total company revenue 
which topped $500 million for the first time in our history; and continued strong operating 
cash flow. Execution challenges kept us from reaching our payment integrity (“PI”) revenue 
target for the year, but we made substantial progress on several initiatives we believe can 
drive double-digit growth for our PI business in the year ahead.

Throughout 2017, we made investments in people, technology, process improvements and 
innovation to accelerate the growth we believe is inherent in our business model. We began 
to see the expected payback in the fourth quarter, and plan to continue investing in our IT 
infrastructure and expanding our big data environment in 2018.

Beyond investing in growth, our priority this year is to deploy capital for acquisitions that complement our core business, 
broaden our data analytics capabilities or add to our capacity to detect fraud, waste and abuse. We will stay disciplined 
in reviewing such opportunities and continue to apply rigorous diligence standards as we consider any future purchases. 
We also have a $50 million share buyback program in place, with $14 million used in the fourth quarter of 2017, which 
we will deploy opportunistically. Our balance sheet remains strong, with low leverage and a newly amended and 
extended $500 million credit facility, finalized last December which increases flexibility and supplements our strong 
operating cash flow.

Our outlook for 2018 includes total company revenue growth of 7-9% and margin expansion of approximately 50 basis 
points. We will continue to prudently manage operating expenses and anticipate capital expenditures will be roughly 
flat compared to 2017. Our effective tax rate is expected to be below 30%, as a result of the federal legislation signed 
into law last December. We plan to reduce the inventory of sold but not implemented business over the course of 2018 
as we work through a backlog that grew throughout last year. We also took a number of steps in 2017 to improve the 
implementation process and will continue to focus this year on reducing the time it takes to produce the first dollars of 
revenue – particularly in our PI business.

Our strategic priorities for 2018 are designed to maximize total shareholder return and include the following:

ƒƒ Boost organic revenue growth across all of our products

ƒƒ Utilize technology, innovation and our scalable business model to expand margins

ƒƒ Maximize cross sales of our care management and consumer engagement solutions to existing customers

ƒƒ

Leverage technology to further strengthen the value of our vast healthcare database and sophisticated analytics

ƒƒ Seek to achieve higher levels of customer satisfaction and HMS employee engagement

We approach 2018 with enthusiasm and confidence in our ability to show year-over-year improvement on a number of 
key financial measures, and to continue positioning HMS for long-term revenue growth and enhanced profitability.

Sincerely,

William C. Lucia
Chairman and Chief Executive Officer
April 13, 2018

Safe Harbor: This letter contains certain “forward-looking statements” within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. These statements relate to 
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.  
For a discussion identifying important factors that could cause actual results to differ from those stated or implied in our forward-looking statements, see the Company’s filings with 
the SEC, including, but not limited to the “Cautionary Note Regarding Forward-Looking Statements,” “Risk Factors,” “Management’s Discussion and Analysis of Financial Condition 
and Results of Operations,” and “Quantitative and Qualitative Disclosures about Market Risk” in the Form 10-K portion of this Annual Report. With respect to our projected effective 
annual tax rate for 2018, this reflects our current reasonable estimate of the income tax effects of the recently enacted federal tax legislation; however, these are provisional 
amounts subject to adjustment during the one-year measurement period. 

UNITED STATES 
SECURITIES AND EXCHANGE COMMISSION 
Washington, D.C. 20549 
Form 10-K 

  ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 

For the fiscal year ended December 31, 2017 
Or 

 

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  

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

(State or other jurisdiction of incorporation or organization) 

Delaware 

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 No  
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 No  
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 No  
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 (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant 
was required to submit and post such files). Yes No  
Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K (§229.405 of this chapter) 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.  
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or 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  
Emerging growth company  
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.  
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act) Yes  No  
The aggregate market value of the registrant’s common stock held by non-affiliates as of June 30, 2017, 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 82,891,340 shares of common stock outstanding as of February 16, 2018.  

 Non-accelerated filer  
(Do not check if a smaller reporting company) 

Smaller reporting company 

Accelerated filer  

Documents Incorporated by Reference 
Unless provided in an amendment to this Annual Report on Form 10-K, the information required by Part III is incorporated by reference to the registrant’s 2018 proxy 
statement, to the extent stated herein. Such proxy statement or amendment will be filed with the SEC within 120 days of the registrant’s fiscal year ended December 
31, 2017. 

  
 
  
  
  
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

4
11
27
27
27
27

28
31
32
46
46
46
47
48

49
49
49
50
50

51
55

  
  
  
  
 
 
  
  
 
  
  
 
 
  
 
  
  
 
 
  
 
  
  
 
 
  
  
 
Glossary of Terms and Abbreviations 

2017 Form 10-K 
ACA 

ACO 
ADR 
ASC 
ASO 
ASU 
CHIP 
CMS 
CMS NHE 
COSO 
Credit Agreement 

DRA 
DSO 
ERISA 
Exchange Act 
FASB 
HIPAA 
HITECH 
IRC 
IRS 
LIBOR 
MCO 
MMIS 
PBM 
PHI 
PI 
R&D Credit 
RAC 
RFP 
SEC 
Securities Act 
Section 199 Deduction 
SG&A 
TPL 
U.S. GAAP 
VHA 
2011 HDI Plan 
2006 Stock Plan 

2016 Omnibus Plan 
2011 HDI Plan 
2017 Tax Act 
401(k) Plan 

  HMS Holdings Corp. Annual Report on Form 10-K for the year ended December 31, 2017 
Patient Protections and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 
2010 
  Accountable Care Organization 
  Additional Documentation Request 
  Accounting Standards Codification 
  Administrative Service Only 
  Accounting Standards Update 
  Children's Health Insurance Program 
  Centers for Medicare & Medicaid Services 
  CMS National Health Expenditures 
  Committee of Sponsoring Organizations of the Treadway Commission 
The Amended and Restated Credit Agreement dated as of May 3, 2013, as amended by Amendment No. 1 to 
Amended and Restated Credit Agreement dated as of March 8, 2017, and as further amended by Amendment 
No. 2 to Amended and Restated Credit Agreement, dated as of December 19, 2017, by and among HMS 
Holdings Corp., the Guarantors party thereto, the Lenders party thereto and Citibank, N.A. as Administrative 
Agent 
  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 
  Health Insurance Portability and Accountability Act of 1996 
  Health Information Technology for Economic and Clinical Health 
  Internal Revenue Code 
  U.S Internal Revenue Service 
  Intercontinental Exchange London Interbank Offered Rate 
  Managed care organization 
  Medicaid Management Information Systems 
  Pharmacy Benefit Manager 
  Protected health information 
  Payment Integrity 
  U.S. Research and Experimentation Tax Credit pursuant to IRC Section 41 
  Recovery Audit Contractor 
  Request for proposal 
  U.S. Securities and Exchange Commission 
  Securities Act of 1933, as amended 
  U.S. Production Activities Deduction pursuant to IRC Section 199 
  Selling, general and administrative 
  Third-party liability 
  United States Generally Accepted Accounting Principles 
  Veterans Health Administration 
  HDI Holdings, Inc. Amended 2011 Stock Option and Stock Issuance Plan 
HMS Holdings Corp. Fourth Amended and Restated 2006 Stock Plan, as amended by Amendment No. 1 to the 
HMS Holdings Corp. Fourth Amended and Restated 2006 Stock Plan dated as of February 16, 2012 
  HMS Holdings Corp. 2016 Omnibus Incentive Plan 
  HDI Holdings, Inc. Amended 2011 Stock Option and Stock Issuance Plan 
  Tax Cuts and Jobs Act of 2017 
  HMS Holdings Corp. 401(k) Plan 

1 

  
  
  
  
  
    
  
 
 
Cautionary Note Regarding Forward-Looking Statements  

For purposes of this 2017 Form 10-K, the terms “HMS,” “Company,” “we, “us, and “our” refer to HMS Holdings Corp. and its 
consolidated subsidiaries unless the context clearly indicates otherwise. Included in this 2017 Form 10-K are “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 relate to 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,” “future,” “intend,” “likely,” “may,” “plan,” “project,” “seek,” “strategy,” “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 future growth, business strategy, strategic or operational 
initiatives, our future operating or financial performance, our ability to invest in and utilize our data and analytics capabilities to 
expand our capabilities, the benefits and synergies to be obtained from completed and future acquisitions, the future performance 
of companies we have acquired, the future effect of different accounting determinations or remediation activities, the sufficiency 
of our sources of funding for working capital, capital expenditures, acquisitions, stock repurchases, debt repayments and other 
matters, our future expenses, interest rates, tax rates and financial results, the impact of changes to U.S. healthcare legislation 
or healthcare spending affecting Medicare, Medicaid or other publicly funded or subsidized health programs, and other statements 
regarding our possible future actions, business plans, objectives and prospects. 

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 from those indicated by such 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: 

  
  
  

  
  
  
  

  
  
  

  
  
  
  
  
  
  
  
  

  
  

our ability to execute our business plans or growth strategy;  
our ability to innovate, develop or implement new or enhanced solutions or services;  
the nature of investment and acquisition opportunities we are pursuing, and the successful execution of such investments
and acquisitions;  
our ability to successfully integrate acquired businesses and realize synergies;  
variations in our results of operations;  
our ability to accurately forecast the revenue under our contracts and solutions;  
our ability to protect our systems from damage, interruption or breach, and to maintain effective information and technology
systems and networks; 
our ability to protect our intellectual property rights, proprietary technology, information processes and know-how;  
significant competition for our solutions and services;  
our failure to maintain a high level of customer retention or the unexpected reduction in scope or termination of key contracts
with major customers; 
customer dissatisfaction, our non-compliance with contractual provisions or regulatory requirements; 
our failure to meet performance standards triggering significant costs or liabilities under our contracts;  
our inability to manage our relationships with information and data sources and suppliers;  
reliance on subcontractors and other third party providers and parties to perform services; 
our ability to continue to secure contracts and favorable contract terms through the competitive bidding process;  
pending or threatened litigation;  
unfavorable outcomes in legal proceedings; 
our success in attracting qualified employees and members of our management team;  
our ability to generate sufficient cash to cover our interest and principal payments under our credit facility, or to borrow or use 
credit;  
unexpected changes in tax laws, regulations or guidance and unexpected changes in our effective tax rate;  
unanticipated increases in the number or amount of claims for which we are self-insured; 

2 

  
  
  
  
 
 
  
  

  

  
  
  
  
  
  

our ability to develop, implement and maintain effective internal control over financial reporting; 
changes  in  the  U.S.  healthcare  environment  or  healthcare  financing  system,  including  regulatory,  budgetary  or  political
actions that affect healthcare spending or the practices and operations of healthcare organizations;  
our failure to comply with applicable laws and regulations governing individual privacy and information security or to protect
such information from theft and misuse;  
our ability to comply with current and future legal and regulatory requirements; 
negative results of government or customer reviews, audits or investigations;  
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 
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 2017 Form 10-K and in other documents we file with the SEC.  

Any forward-looking statements made by us in this 2017 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  2017  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 2017 Form 10-K were prepared for use in, or in connection with, this 
report. 

Trademarks and Tradenames 

We have a number of registered trademarks, including HMS®, as well as the corresponding HMS + logo design mark, HMS 
IntegritySource®, Eliza® and Essette®. These and other trademarks of ours appearing in this report are our property. Solely for 
convenience, trademarks and trade names of ours referred to in this 2017 Form 10-K may appear without the ® or ™ symbols, 
but such references are not intended to indicate, in any way, that we will not assert, to the fullest extent under applicable law, 
our rights or the right of the applicable licensor to these trademarks and trade names. This report contains additional trade names 
and trademarks of other companies. We do not intend our use or display of other companies' trade names or trademarks to 
imply an endorsement or sponsorship of us by such companies, or any relationship with any of these companies. 

3 

  
  
  
  
  
  
 
 
 
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  care 
management  and  consumer  engagement  solutions  to  help  healthcare  payers  improve  financial  performance  and  clinical 
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 and consumer engagement technology helps risk-bearing organizations to better 
engage  with  and  manage  the  care  delivered  to  their  members.  Together  these  various  services  help  customers  recover 
erroneously paid amounts from liable third parties; prevent future improper payments; reduce fraud, waste and abuse; better 
manage the care their members receive; engage healthcare consumers to improve clinical outcomes while increasing member 
satisfaction  and  retention;  and  achieve  regulatory  compliance.  We  currently  operate  as  one  business  segment  with  a  single 
management team that reports to the Chief Executive Officer. 

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. In recent years 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. (“Essette”) (2016), Eliza Holding Corp. (“Eliza”) (2017) and others. 
The acquisitions of Essette and Eliza significantly expanded the breadth of solutions we offer entities taking risk, creating a new 
care management and consumer engagement vertical for HMS. 

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 at 5615 High Point Drive, Irving, Texas 75038, and our telephone number is 
(214) 453-3000. As of December 31, 2017, we had approximately 2,500 employees. Additional information about HMS is available 
on our website at www.hms.com. 

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 
http://www.sec.gov. You may also read and copy materials we furnish to or 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. 

The content of any website referred to in this 2017 Form 10-K is not incorporated by reference into this filing unless expressly 
noted. References to the URLs for these websites are intended to be inactive textual references only. 

4 

  
  
  
  
  
  
 
 
Our Solutions 

Our services are applicable to federal, state and commercial health plans and other healthcare entities taking payment risk. Our 
coordination of benefits and payment integrity services are designed to address errors across the payment continuum, beginning 
with 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 identification of an improper payment is made via audit. Our services address a wide spectrum of payment 
errors,  including  eligibility  and  coordination  of  benefits  errors,  the  identification  and  investigation  of  potential  fraud,  and 
determinations that claim amounts paid were improper and our services extend to most claim types. Our care management and 
consumer engagement services also assist customers in managing quality, risk, cost and compliance across all lines of business. 
As a result of these services, customers received billions of dollars in cash recoveries in 2017, and saved billions more through 
the prevention of erroneous payments, improved clinical outcomes for their members, and reduced enrollment turnover. 

In general, our range of products and services include the following: 

COB SERVICES  

Coordination of Benefits  
Our coordination of benefits services are provided primarily for state governments and Medicaid managed care plans and draw 
principally upon proprietary information management and data mining techniques designed to ensure that the correct party pays 
a healthcare claim. We offer cost avoidance services, which include providing validated insurance coverage information that is 
used by 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  insurance  coverage  available  has  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, 2017, 2016 and 2015, our coordination of benefit services represented 73.4%, 72.2% and 
71.2% of our total revenue, respectively. 

5 

  
  
 
  
  
  
  
ANALYTICAL SERVICES  

Payment Integrity  
Our payment integrity services are designed to ensure that healthcare payments are accurate and appropriate. These services 
are applicable to all customers that HMS serves, including 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. We combine data 
analytics, clinical expertise and proprietary algorithms and 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, 2017, 2016 and 2015, our payment integrity services represented 
20.0%, 27.6% and 28.8% of our total revenue, respectively. 

Care Management and Consumer Engagement  
Our care management and consumer engagement solutions help our customers manage the care delivered to their members 
with a focus on improving clinical outcomes and patient engagement. We offer a broad foundation of technology and service 
solutions to support a health engagement management framework, which enable health plans and other risk-bearing entities to 
better  manage  costs  and  clinical  outcomes  and  improve  their  member  experience.  Our  care  management  and  consumer 
engagement vertical leverages HMS data and analytics with a combination of Essette and Eliza solutions currently aimed at care 
management, risk management and member engagement in order to provide customers with a tailored, integrated platform that 
addresses core healthcare industry challenges on an enterprise scale. For the years ended December 31, 2017 and 2016, our 
care management and consumer engagement services represented 6.6% and 0.2%, of our total revenue, respectively. 

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, and trade 
secrets,  including  know-how,  confidentiality  and  invention  assignment  agreements,  security  measures,  non-disclosure 
agreements with third parties, and other contractual rights. 

We  own  a  number  of  patents  and  trademarks  that  are  important  to  HMS.  As  of  December  31,  2017,  our  patent  portfolio  is 
comprised of approximately 50 domestic and international patents, and we are currently pursuing numerous patent applications 
in the United States and around the world. We have a number of registered trademarks, including HMS®, and the corresponding 
HMS + logo design mark, HMS IntegritySource®, Eliza®, Essette® and other registered and common law trademarks. We also hold 
copyrights relating to certain aspects of our products and services. While we consider all of these proprietary rights important in 
the operation of our business, we do not believe any one individual technology is essential to our business. 

Customers 

We provide our solutions to customers across a broad range of entities within the healthcare industry, including health plans, state 
agencies, federal programs, private employers and other at-risk providers. For the years ended December 31, 2017, 2016 and 
2015, our total revenue was $521.2 million, $489.7 million and $474.2 million, respectively. No single customer accounted for 
10% or more of our total revenue during any period presented. 

The composition of our 10 largest customers changes periodically. For the years ended December 31, 2017, 2016 and 2015, our 
10  largest  customers  represented  39.5%,  40.6%  and  44.0%  of  our  total  revenue,  respectively.  The  current  terms  of  our 
agreements with these customers have expiration dates ranging between 2018 and 2023. 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. 

6 

  
  
  
  
  
  
  
  
  
 
 
We provide products and services under contracts (or subcontracts) that contain various revenue structures, including contingent 
revenue and to a lesser extent fixed-fee arrangements. Many of our state government 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  arena,  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 the U.S. 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 approximately 
200.1 million individuals at a cost of $1.2 trillion in 2017. 

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. In most 
states, managed care is currently the predominant delivery system for Medicaid. As of July 2017, all states except three had some 
form of managed care in place, including the District of Columbia. Among the 39 Medicaid programs (38 states plus the District 
of Columbia) with comprehensive risk-based MCOs, 29 states reported that 75% or more of their Medicaid beneficiaries were 
enrolled in MCOs as of July 1, 2017. More states continue to carve-out complex populations as well as behavioral health services 
into MCO contracts. Of the 32 Medicaid programs (31 states plus the District of Columbia) that opted to expand Medicaid eligibility 
levels pursuant to the ACA, 27 states were using MCOs to cover newly eligible adults as of July, 2017. Of those 27 states, 24 
states covered more than 75% of beneficiaries in this group through risk-based managed care. 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 potential future growth of 
Medicaid lives and expenditures. As Congress continues to debate proposals to repeal major portions of the ACA, including the 
ACA’s  Marketplace  and  Medicaid  coverage  expansions,  as  well  as  other  proposals  to  fundamentally  restructure  Medicaid’s 
financing structure, the implications of these proposals remain unclear. 

Similarly, managed care health plans also continue to assume risk for Medicare lives, with the Kaiser Family Foundation estimating 
that 33% of all Medicare beneficiaries, or 19.0 million lives, were enrolled in a Medicare Advantage Plan in 2017. 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  2017  covered  approximately  57.7  million  people  at  a  cost  of 
approximately $718.7 billion and Medicaid/CHIP covered approximately 79.9 million people, costing approximately $604.1 billion. 
Altogether, it is projected that the government programs we serve covered approximately 137.6 million people at a total cost of 
approximately $1.32 trillion in 2017. 

CMS projects Medicaid spending and enrollment will grow 6.0% and 1.7%, respectively in 2018 over 2017. CHIP spending is 
expected to grow 6.7% in 2018 over 2017, and CHIP enrollment is expected to increase 3.5% in 2018 over 2017. 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. 

7 

  
  
  
  
  
  
  
  
Regulatory Environment 

The market for cost containment solutions is large and growing, driven by increasing healthcare costs and payment complexities. 
For 2018, Medicare and Medicaid are projected to pay approximately 45.3% of the nation’s healthcare expenditures and serve 
over 140.7 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. In 2017, Congress considered the revision or repeal of some or all of the ACA. Options that have 
been  considered  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 subcontracting), 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. 

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  customers  and  other  industry  stakeholders;  and  our  ability  to  provide  customers  with  actionable 
intelligence to improve clinical 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: 

Accenture 
CaseNet 
Change Healthcare 
Cognizant/TriZetto 

Healthcare Products 

Cotiviti Corporation  Inovalon 
LexisNexis 
Equian, LLC 
MedHok 
Experian Health 
DXC Technology Solutions 
Optum 
IBM Watson Health  Performant Financial Corp. 

SCIO Health Analytics 
Verscend Technologies, Inc. 
Welltok 
Conduent 
ZeOmega 

8 

  
  
  
  
  
  
  
  
  
 
 
Business Strategy 

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 often co-morbidities; 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 we offer. 

We also believe these factors present growth opportunities for our care management and consumer engagement solutions. We 
expect to grow our business over the course of 2018 and beyond, both organically and inorganically, by leveraging existing key 
assets (e.g., our data, analytics, in-house expertise, and distribution channel) and pursuing a number of strategic objectives or 
initiatives, including: 

   Expanding the scope of our relationship with existing customers – by selling additional products and services, including those

designed to improve member engagement and improve clinical outcomes.  

   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. 

  

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

   Utilizing big data – to create a more nimble operating environment, create operating efficiencies, improve the yield on our

existing product suite and identify new revenue opportunities within our current service delivery models. 

9 

  
  
 
  
  
  
  
  
  
 
 
   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,  increase  customer  satisfaction,  and
achieve greater operating efficiencies. 

   Building out our new care management and consumer engagement technology platform – by continuing to grow a broad 
foundation of technology and service solutions to help customers better manage quality, cost and compliance across all lines
of business. Our first steps in this strategy were the acquisition of Essette and Eliza.  

   Prudent deployment of capital – by investing in internal growth initiatives; selectively investing in capabilities, technologies,
and  assets  to  complement  our  core  cost-containment  expertise;  building  care  management  and  care  coordination
adjacencies to complement the Essette and Eliza acquisitions; and expanding our data analytics capabilities. Our focus may
include acquisitions that represent 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. We
may also repurchase our shares, pursuant to a two-year $50 million authority granted by our Board of Directors in November 
2017. 

10 

  
  
  
  
  
  
  
  
 
 
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 2017 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 of the healthcare industry; however, such growth and expansion carries costs and risks that, 
if not properly managed, could adversely affect our business. Our future growth will depend on, among other things, our ability to 
successfully execute our business plans, which includes retaining existing customers, attracting new customers and improving 
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 
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 in September 2016; and Eliza in April 2017. 

11 

  
  
  
  
  
  
  
  
  
  
 
 
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: 

  
  

  
  
  
  

diversion of management’s attention and other resources; 
our ability to successfully and timely 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, difficulties or other issues; 
our ability to integrate personnel and human resource systems as well as the cultures of the acquired business;  
our ability to retain or replace the key personnel of the acquired business; 
our ability to maintain relationships with the customers of the acquired business and further develop the acquired business; 
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; 
  
our ability to comply with regulatory requirements and avoid potential conflicts of interest in markets that we serve; 
  
the misuse of intellectual property by the personnel of the acquired business; 
  
our ability to successfully enter into unfamiliar markets; 
  
assumption of unanticipated legal or financial liabilities and/or negative publicity related to prior acts by the acquired business;
   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; 

the acquired business may not perform as projected which could negatively impact earnings or contingent consideration; 

   we may become significantly leveraged as a result of incurring debt to finance an acquisition; 
  
   we may suffer impairment of goodwill and other acquired intangible assets; and 
   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 revenue and operating results may fail to match our past or projected performance and could vary significantly from period-
to-period as a result of a number of factors, some of which are outside of our control. We have experienced fluctuations in our 
revenue and operating results in the past and they may vary in the future for reasons that include, but are not limited to: 

  
  
  
  
  
  
  

  
  
  

fluctuations in sales activity given our sales cycle;  
the length of contract and implementation periods; 
the commencement, completion or termination of contracts during any particular quarter;  
contract costs and expenses, which may be incurred in periods prior to revenue being recognized;  
the timing of period revenue recovery projects and third party payers’ claim adjudication;  
the billing and budgeting cycles of our customers; 
the timing of government procurement activities, including when contract awards are announced and the time required to 
resolve bid protests;  
contract renewal discussions, which may result in delayed payments for services already performed; 
changes in the pricing structure or other significant terms in our contract, or the scope of services we perform;  
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, and restrictions on our ability to
use or access certain data or a lack of integrity or quality in the data or information we receive from certain data sources; 

12 

  
  
  
  
  
  

  

  
  
  

adjustments to age/quality of receivables and accruals as a result of factors such as delays involving contract limitations or
changes, subcontractor performance deficiencies or internal managerial decisions not to pursue identified claim revenue from
customers;  
the impact of service disruptions or delays in the systems or operations of subcontractors, partners, vendors and other third
party providers on which we rely on to deliver a single-source solution or service to our customers; 
changes in applicable laws; 
changes in accounting policies or guidelines concerning the timing of recognition of revenue; and  
regulatory changes or general economic conditions as they affect healthcare providers and payers.  

We cannot predict the extent to which future variations could occur due to these or other factors. In addition, 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 payment. 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. Our business is also subject to 
seasonal patterns resulting from increased efforts at year-end by certain customers to generate additional savings, complete 
compliance obligations and close gaps in care. However, taken as a whole, we do not consider our operations to be seasonal to 
any  material  degree.  Due  to  all  of  these  factors,  our  revenue  and  operating  results  are  difficult  to  predict  and  are  subject  to 
significant fluctuation, which may cause the market price of our common stock to decrease significantly. 

We face challenges associated with forecasting the revenue under our contracts, 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 with an existing customer, 
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: 

  
  
  
  
  
  

power loss, transmission cable cuts and telecommunications failures; 
fire, flood, earthquake and other natural disasters; 
hardware failures or software defects;  
operator error; 
cyber security breaches; and 
physical break-ins, sabotage, intentional acts of vandalism, terrorist attacks and other events beyond our control. 

13 

  
  
  
  
  
  
  
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 lengthy 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, damage to our reputation or customer relationships 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, as well as on the products 
and services of third-party providers, to input, transmit, maintain and communicate the confidential and proprietary data we receive 
from our customers and other data suppliers (e.g. private insurance plans, financial institutions, etc.). In addition, subcontractors, 
teaming partners or other third-party vendors may receive or utilize this information on our behalf in support of the services we 
perform for our customers. The secure processing and maintenance of this information is critical to our operations and business 
strategy.  Although  we  have  spent  significant  resources  to  implement  security  and  privacy  programs  and  controls,  train  our 
workforce  and  augment  our  security  measures  with  the  implementation  of  new  technologies  and  processes,  our  information 
technology and infrastructure, and those of third parties on which we rely, have been, and will likely continue to be subject to 
computer hacking, acts of vandalism or theft, malware, computer viruses or other malicious codes, phishing, employee error or 
malfeasance, catastrophes, unforeseen events or other cyber-attacks. To date, we have seen no material impact on our business 
or operations from these attacks, however, we may be unable to implement adequate preventive measures to protect against 
such compromises in the future or to effectively adapt our security measures to evolving security risks. As a result, our technology 
systems, including  our  data  and our customers’  data, could be accessed improperly,  made unavailable, improperly modified, 
corrupted  or  otherwise  breached  or  compromised,  or  we  could  suffer  system  disruptions,  shutdowns  and  denials  of  service. 
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. The occurrence of any of these events could harm the market perception of the 
effectiveness of our security measures, lead to reputational damage or the loss of our customers’ 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, or to deter them from using our solutions or services in the future, all of which could reduce our revenue, increase 
our expenses and expose us to potential liability under privacy, security or other applicable laws and regulations. We could also 
be  forced  to  expend  significant  resources  in  response  to  a  security  breach,  including  investigating  the  cause  of  the  breach, 
repairing system damage, remediating vulnerabilities in our security procedures, increasing cyber security protection costs by 
deploying additional personnel and protection technologies, paying regulatory fines and litigation costs, 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 business, financial condition, results of operations and cash 
flows. 

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 our intellectual property and other proprietary information through a combination of patent, trademark, copyright, 
trade  secret  and  unfair  competition  laws,  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 

14 

  
  
  
  
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 
protect such information). In addition, there remains the possibility that others will independently develop competing technologies 
that  may  be  equivalent  or  superior  to  ours.  If  our  efforts  to  protect  our  intellectual  property  and  other  proprietary  rights  are 
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. 

In addition, third parties may claim that we are infringing upon or misappropriating their intellectual property, or assert other legal 
challenges to our 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. 

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 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 subcontractors 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 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 others have longer operating histories and greater name recognition 
than we do in certain markets. 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 products 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. 

15 

  
  
  
  
  
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 or renewing the contract at lower performance 
fee levels. 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  customer  could  be 
damaged and our business, financial condition, reputation, results of operations and cash flows could be materially adversely 
affected. 

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. As a result of the services we provide, we process a number 
of complex transactions that require us to access, store, retrieve, manipulate, manage and transmit our customers’ information 
and data, external data, as well as our own data. Although we have invested a great deal of time and resources in developing 
systems,  processes  and  controls  that  protect  the  integrity  of  the  data,  such  measures  cannot  provide  absolute  security.  It  is 
possible that failures or errors in hardware and software, including those in third-party technology, or technical deficiencies in our 
systems could result in data loss or corruption, or cause the data that we collect, utilize or disseminate to be incomplete or contain 
inaccuracies that our customers regard as significant. In addition, 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. 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. 

16 

  
  
  
  
  
 
 
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 products 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 solutions and services, or if there is a lack of accuracy or 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 subcontractors and other third party providers to provide customers with a single-source solution or 
service  or  we  may  serve  as  a  subcontractor  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 subcontractors, 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 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 these third parties meeting our service standards in both timeliness and 
quality, and in certain instances, on our ability to obtain customer approval for the use of these third party subcontractors. While 
we believe that we perform appropriate due diligence on these third 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. Performance deficiencies or misconduct by subcontractors, teaming partners, vendors or other third party 
providers 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, and subject us to a dispute with our customer. 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. 

Similarly,  we  are  and  may  in  the  future  be  engaged  as  a  subcontractor  to  a  third  party  prime  contractor.  Subcontracting 
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 subcontracts is dependent on the prime contractor, its performance 
and  relationship  with  the  customer,  and  its  relationship  with  us.  We  cannot  be  certain  that  the  prime  contractor  will  provide 
adequate and timely services to the customer, comply with the terms of its prime contract with the customer or its subcontract 
agreement with us, or that it will construe its 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. Any failure of the prime contractor to 
adequately  perform  its  obligations  under  the  prime  contract  or  to  comply  with  applicable  laws,  rules  and  regulations  could 
materially adversely affect our reputation and subject us to a dispute with the prime contractor or the customer. In the event a 
prime contract is terminated, whether for non-performance by the prime contractor or otherwise, our subcontract will similarly 

17 

  
  
  
  
terminate, and the resulting contract loss could materially adversely affect our business, financial condition, results of operations 
and cash flows. 

We obtain a 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 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. 

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 legal proceedings and claims that arise from time to time in the ordinary course of our 
business,  which  may  include  those  related  to,  for  example,  claims  brought  by  our  customers  in  connection  with  billing  and 
contractual disputes, subcontracts and teaming agreements, protection of confidential information or trade secrets, claims relating 
to  pending,  terminated  or  completed  acquisitions  or  dispositions,  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. Resolution may also require that HMS accept some 
amount of loss or liability in  order to avoid  customer  abrasion, negative  marketplace perceptions and other  disadvantageous 
results. 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. 

18 

  
  
  
  
  
  
 
 
As previously reported, in November 2017, the Company was the subject of an adverse verdict in a breach of contract claim 
against the Company arising out of an acquisition in 2010. The adverse verdict resulted in a jury award of $60 million in damages 
to the plaintiffs. The Company intends to appeal the verdict and believes that strong grounds exist to overturn or greatly reduce 
the damages awarded by the jury. See the information under “Litigation” in Note 13 to the Consolidated Financial Statements in 
Part II, Item 8 for further discussion about this proceeding. 

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 solutions and services and ability to maintain our productivity and profitability is dependent on our ability 
to identify, recruit, employ, train and retain skilled personnel. 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, customers or competitors may hire away our qualified employees. We may not be able to recruit or maintain 
the personnel necessary to efficiently operate and support our business in the future, 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 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  or  capital 
requirements.  

On December 19, 2017, HMS and certain subsidiaries entered into Amendment No. 2 to Amended and Restated Credit Agreement 
(the “Amendment”), which amends our existing Credit Agreement. Among other things, the Amendment provides for a senior 
secured revolving facility in an aggregate principal amount equal to $500 million and extends the maturity date of the revolving 
facility to December 19, 2022 (the “Amended Revolving Facility”). The Amended Revolving Facility is secured, subject to certain 
customary carve-outs and exceptions, by a first priority lien and security interest in substantially all of our tangible and intangible 
assets. 

19 

  
  
  
  
  
  
  
 
 
As of December 31, 2017, the outstanding principal balance due under our Credit Agreement was $240.0 million. Our outstanding 
indebtedness and any additional indebtedness we incur may have important consequences for us, including, without limitation, 
that: 

   we may be required to use a substantial portion of our cash flow to pay the principal of and interest on our indebtedness;  
  

our  indebtedness  and  leverage  may  increase  our  vulnerability  to  adverse  changes  in  general  economic  and  industry
conditions, as well as to competitive pressures;  
our indebtedness may expose us to the risk of increased interest rates because certain of our borrowings are and will be at
variable interest rates; 
our ability to obtain additional financing for working capital, capital expenditures, acquisitions and for general corporate and 
other purposes may be limited;  
our indebtedness and leverage may prevent us from taking advantage of business opportunities as they arise or successfully
carrying out our plans to expand our business; and  
our flexibility in planning for, or reacting to, changes in our business and our industry may be limited. 

  

  

  

  

Under the Credit Agreement, we are also required to comply with specified financial and operating covenants, which may limit our 
ability to operate our business as we otherwise might operate it. The Amended Revolving Facility contains (i) certain affirmative 
covenants that impose certain reporting and/or performance obligations on us and our restricted subsidiaries, (ii) certain negative 
covenants  that  generally  limit,  subject  to  various  exceptions,  us  and  our  restricted  subsidiaries  from  taking  certain  actions, 
including, without limitation, incurring indebtedness, creating liens, engaging in mergers and consolidations, disposing of certain 
assets or property, making certain investments and acquisitions, entering into certain transactions with affiliates, swap agreements 
or sale-leasebacks, making certain restricted payments, including dividends and share repurchases, changing our fiscal year or 
the lines of business that we or our restricted subsidiaries conduct to a material extent, and prepaying certain junior indebtedness, 
(iii) financial covenants consisting of a maximum consolidated leverage ratio and a minimum interest coverage ratio, and (iv) 
customary events of default for financings of this type. 

Our obligations under the Amended Revolving Facility may be declared due and payable upon the occurrence and during the 
continuance of an event of default, which includes, without limitation: non-payment of principal or reimbursement obligation when 
due; non-payment of interest, fees and other amounts for a period of five business days after the due date; material inaccuracies 
of representations and warranties; failure to perform or observe covenants, conditions or agreements (subject to any applicable 
grace periods); cross-defaults to certain indebtedness; inability to pay debts; certain acts of bankruptcy or insolvency; certain 
ERISA events; failure to pay certain material judgments; and a change of control as defined in the Credit Agreement. If not cured, 
an event of default could result in any amounts outstanding, including any accrued interest and unpaid fees, becoming immediately 
due and payable, and would give our lenders the right to proceed against the collateral granted to them to secure the debt, 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. Our ability to make payments of principal and interest on our outstanding credit facility 
depends upon our future performance and our ability to generate cash flows, and if we are unable 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. Our future effective tax rates could also be materially 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 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. The 
2017 Tax Act was enacted on December 22, 2017 and is generally effective for tax years beginning after December 31, 2017. 
The 2017 Tax Act, among other things, includes a reduction to the U.S. corporate tax rate, modifications to the limitations on 
certain deductions for executive compensation, new limitations on interest deductions, repeal of the section 199 Deduction, and 

20 

  
  
  
  
  
capital investment deductions in certain circumstances, and a shift of the U.S. taxation of multinational corporations from a tax on 
worldwide income to a territorial system. We are currently in the process of analyzing the effects of this new legislation on our 
business, and although we believe that the impact of the new legislation might be beneficial to us at this time, the ultimate outcome 
of the new legislation on our business and financial condition is uncertain. Any unanticipated changes in our tax rates could affect 
our future results of operations. 

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. 

Although  we believe  that  we  have  remediated  previously  identified  material  weaknesses  in our  internal  control  over 
financial reporting, our financial statements could be materially misstated if we fail to remedy other material weaknesses 
that we may identify in the future, or if we are unable to develop, implement and maintain effective internal control over 
financial reporting in future periods. 

In connection with management’s assessment of our internal control over financial reporting for the December 31, 2016 reporting 
period, we identified material weaknesses 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. As further described under the heading “Changes 
in Internal Control Over Financial Reporting” in Part II, Item 9A of this 2017 Form 10-K, we have implemented measures to address 
these material weaknesses and have successfully completed the testing necessary to conclude that the material weaknesses 
have been remediated. 

In future periods, these remedial measures may not operate effectively, or we may fail to design or implement effective controls 
or  to  otherwise  maintain  effective  internal  control  over  financial  reporting,  and  additional  material  weaknesses  or  significant 
deficiencies in our internal control over financial reporting may occur or be discovered. As a result, we may fail to meet our future 
reporting obligations on a timely basis, our financial statements may contain material misstatements or our operating results or 
financial condition may otherwise be negatively impacted, and we may be subject to litigation and regulatory actions, any of which 
may cause us to incur substantial costs, adversely affect investor perceptions and potentially result in a decline in the market price 
of our common stock. In addition, these failures may also cause us to incur substantial additional costs in future periods relating 
to  the  implementation  of  remedial  measures  or  limit  our  ability  to  obtain  financing  under  our  Credit  Agreement,  which  could 
adversely impact our business, financial condition, results of operations and cash flows. 

21 

  
  
  
  
  
  
  
  
 
 
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 which we operate is subject to changing political, economic and regulatory influences that directly affect 
the practices and operations of federal, state and commercial healthcare organizations in the United States. In March 2010, the 
ACA was passed, and its 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,  some  of  the  provisions  of  the  ACA  have  yet  to  be 
implemented and there have been a number of judicial and legal challenges to certain aspects of the ACA. Since January 2017, 
the President has signed two executive orders and other directives designed to waive, defer, grant exemptions from or delay the 
implementation of certain requirements mandated by the ACA.  Concurrently, Congress has considered legislation that would 
repeal or repeal and replace all or part of the ACA. In December 2017, the Tax Act was enacted and signed into law, one part of 
which repeals the “individual mandate” introduced by the ACA effective January 1, 2019. There have also been a number of 
proposed and adopted legislative initiatives and healthcare reform proposals from state and federal governments, including, (i) 
initiatives and proposals that would fundamentally change the financial structure of the Medicaid program (currently funded jointly 
by the states and the U.S. Federal Government) that could result in early termination or non-renewal of our contracts with certain 
state government customers, and (ii) initiatives and proposals at the federal level that may 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 and our ability to increase or maintain sales of our existing 
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 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 as 
a result of efforts to waive, modify or otherwise change the ACA, in whole or in part, and as a result of other future legislative 
changes  affecting  Medicare,  Medicaid  or  other  publicly  funded  or  subsidized  health  programs.  Although  we  will  continue  to 
evaluate the effect that the ACA and its possible repeal and replacement may have on our business, it is difficult to predict the full 
impact and influence that the ACA and the varying healthcare reform measures may have on the U.S. healthcare industry or 
policy, and any resulting changes may take time to unfold. 

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 the Medicare and Medicaid programs and 
in government spending on these programs, and in 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 the healthcare delivery and payment system. However, the need for our solutions and services, the price 
customers are willing to pay for them and the scope and profitability of our contracts could be negatively affected by a number of 
factors, including, but not limited to: 

  
  

  

  

a lower than projected growth in Medicare and Medicaid programs and expenditures;  
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);  
changes in the level of federal government spending due to budgetary or deficit considerations, including the continuance of
existing programs, as well as budgetary pressures that may drive changes at the state level; 
the transition of healthcare beneficiaries from fee-for-service plans to value-based plans;  

22 

  
  
  
  
  
  
 
 
  

unanticipated reductions in the scope of healthcare program benefits (such  as, for example, state decisions to eliminate
coverage of optional Medicaid populations or services or shifting lives into managed care plans);  

   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; 
customer improvements and enhancements to their internal healthcare claims and billing processes;  
the adoption of healthcare plans with significantly higher deductibles;  
limits placed on ongoing program integrity initiatives, including the Medicare RAC program; and 
legislative healthcare reforms and developments, including the absence of near-term compliance deadlines effected by the
ACA, the possible repeal or modification of the ACA, and other legislative actions to reduce program eligibility or services, or 
reform Medicaid spending. 

For example, during 2014 and 2015, our recovery audit services under HDI’s 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 response to the delays, CMS allowed the Medicare RAC 
contractors,  including  HDI,  to  perform  active  recovery  auditing  through  July  2016  and  certain  limited  administrative  activities, 
including collections, related to findings through January 31, 2018. 

In October 2016, CMS announced the new Medicare RAC contract awards, including the award of RAC Region 4 to our wholly 
owned  subsidiary.  Under  the  new  Medicare  RAC  contracts,  CMS  implemented  modified  ADR  limits  that  reduces  the  ADR 
requirement to 0.5%. The modified ADR limits, which CMS first announced in January 2016, is a 75% reduction from the 2.0% 
ADR limit established for the HDI Medicare RAC contract. In addition, in April 2016, CMS instituted a sliding scale policy adjusting 
ADR limits based on provider denial rate after three 45-day ADR cycles. In January 2018, CMS further modified this methodology, 
indicating  that  underpayments  identified  by  the  RAC  would  be  precluded  from  the  sliding  scale  policy.  These  changes  have 
significant impact on the volumes of claims that Medicare RACs are permitted to review for inpatient providers and reduces their 
ability to identify overpayments and underpayments under the new Medicare RAC contracts. HMS is currently waiting for CMS to 
operationalize the sliding scale under the new Medicare RAC contract, which is expected to increase the current ADR limit to a 
requirement less than the 2.0% limit that was previously set under the prior contracts. 

Further, in connection with our first Medicare RAC contract, CMS announced in 2014 that 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 refunding fees already paid. 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.  The  implication  of  these 
settlements related to the claims for which HDI already has been paid remains uncertain. 

Although we do not anticipate that our new 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. However, 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 HDI’s 
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 settlements, (iv) we are unable to obtain full payments for properly provided services, or (v) future 
fees payable to us by CMS are reduced. The occurrence of any of these events or other changes to the Medicare RAC program 
that materially reduce our revenue or profitability with such program may have an adverse effect on our future business, financial 
condition, results of operations and cash flows. 

23 

  
  
  
  
   
 
 
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 HITECH, and the Final Omnibus 
Privacy, Security, Breach Notification, and Enforcement Rule, as well as 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 
subcontractors comply with these laws, regulations and rules, we have less than complete control over our business associates’ 
and subcontractors’ actions and practices. We may be exposed to data breach risk if there is unauthorized access to one of our 
or our subcontractors’ secure facilities or from lost or stolen laptops or other portable media from current or former employee theft 
of data containing PHI, from computer hacking, malware, computer viruses or other malicious codes, phishing or other cyber-
attacks, from misdirected mailings containing PHI, or other forms of administrative or operational error. If we or our subcontractors 
fail  to  comply  with  applicable  laws;  if  unauthorized  parties  gain  physical  access  to  one  of  our  facilities  and  steal  or  misuse 
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,  fines  or  other  penalties  imposed  by  government  regulatory  agencies,  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 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, and may subject us to additional liabilities. 

We  are  subject  to  extensive  government  regulation,  including  government  and  customer  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, other health plan members and providers, and the federal and state governmental agencies administering these 
laws and regulations have broad latitude to enforce them. As such, we are subject, on an ongoing basis, to various governmental 
and customer 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 laws, such as the Federal Acquisition Regulations, the U.S. Foreign Corrupt Practices 
Act, federal and state employment, equal opportunity and affirmative action laws, and federal and state prompt pay statutes. We 
are also subject to the 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. 

24 

  
  
  
  
  
  
As we expand into new areas of the healthcare industry, we may develop new or enhanced solutions that may further expose us 
to requirements under additional statutes and legislative schemes that have previously not been relevant to our business, such 
as  banking  and  credit  reporting  statutes.  For  example,  in  connection  with  our  acquisition  of  Eliza,  we  became  subject  to  the 
Telephone Consumer Protection Act of 1991, state and federal audio and telephone recording laws, and other related state and 
federal laws and regulations as a result of the member engagement services that we perform. 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  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. If we are found to be in violation of any applicable law or regulation, or if we receive an 
adverse  review,  audit  or  investigation  from  a  government  agency  or  customer  related  to  our  compliance  with  such  laws  or 
regulations  or  the  terms  of  our  government  contracts,  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. 

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. 

Federal or state governments could limit or prohibit private contractors like us from operating or performing elements of certain 
government functions or programs. As a condition of receiving federal funding, state, and local governments may be required to 
operate such  programs with  government employees.  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 workforce could 
make it more difficult for us to fulfill our contracts in a cost-effective manner. Certain areas of our operations use or involve vendor 
or  subcontractor  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.  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  offshore  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 offshore 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. 

25 

  
  
  
  
  
  
 
 
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. We may also 
need to divest 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. 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. 

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 
December 31, 2017, our common stock intra-day traded on the Nasdaq Global Select Market as high as $20.90 per share and as 
low as $11.01 per share. Our stock price is subject to fluctuation as a result of a variety of factors, including factors beyond our 
control, such as the risk factors described above and those which are related to: 

  
  

  

quarterly or annual earnings results or those of other companies in our industry;  
changes in estimates of our  performance or recommendations by securities analysts or in the operating and stock price 
performance of other companies that investors deem comparable to our company; 
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; 
future sales of shares of common stock in the public market by our executive officers or directors; 
any other changes in the amount of our outstanding shares, including as a result of share repurchases; 
actual or proposed changes in federal or state laws affecting the healthcare industry; 
changes in accounting principles;  
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 

  
  
  
  
  
  
  
   market conditions in the industry and the economy as a whole. 

In addition, the stock market often experiences significant price and volume fluctuations. These broad market fluctuations may 
materially adversely affect the market price of our common stock regardless of our operating performance. 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. 

26 

  
  
  
  
  
  
   
 
 
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 not paid or declared 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 continued growth of our business and repurchase shares opportunistically from time to time. 
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 currently 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. 

Item 1B. Unresolved Staff Comments 

None. 

Item 2. Properties 

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

Approximate 
Square 
Footage 

     Owned/Leased 

242,260    
63,593    
25,212    
23,790    
12,259    
13,628    
77,914    

Owned 
Leased 
Leased 
Leased 
Leased 
Leased 
Leased 

As of December 31, 2017, we leased approximately 111,000 square feet of office space in 20 other locations throughout the 
United States, the leases for which have expiration dates through 2024. See “Lease Commitments” in Note 13 to the Consolidated 
Financial Statements in Part II, Item 8 for additional information. 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 13 to the Consolidated Financial Statements in Part II, Item 8 is 
incorporated herein by reference. 

Item 4. Mine Safety Disclosures 

Not applicable. 

27 

  
  
  
  
  
  
  
  
    
    
    
    
    
    
    
  
  
  
  
  
  
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 closing sales prices per share for our common stock for the periods indicated, as reported on the Nasdaq Global 
Select Market. 

Quarter Ended 
Fiscal Year 2017 

High 
Low 

Fiscal Year 2016 

High 
Low 

March 31,    

June 30,     September 30,     December 31,   

  $ 
  $ 

  $ 
  $ 

20.33    $ 
17.76    $ 

20.68    $ 
17.91    $ 

20.15    $ 
17.36    $ 

14.42    $ 
10.22    $ 

18.38    $ 
13.67    $ 

23.46    $ 
17.44    $ 

20.32  
15.55  

22.03  
16.18  

Repurchases of Shares of Common Stock 

See  “Equity’  in  Note  9  to  the  Consolidated  Financial  Statements  in  Part  II,  Item  8  for  additional  information  regarding  share 
repurchases. The following are our monthly stock repurchases for the fourth quarter of fiscal year 2017, all of which were made 
as part of publicly announced plans or programs: 

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 

—    $ 

—  
674,813       39,044,882  
190,502       35,880,666  
865,315      

Total 
Number of 
Shares 

Purchased      

—    $ 
674,813      
190,502      
865,315    $ 

Average 
Price Paid 
Per Share      
—      
16.23      
16.61      
16.33      

Period 
October 1, 2017 to October 31, 2017 
November 1, 2017 to November 30, 2017 
December 1, 2017 to December 31, 2017 
October 1, 2017 to December 31, 2017 

 (1)  On  November  1,  2017,  the  Board  of  Directors  of  the  Company  approved  a  share  repurchase  program  authorizing  the
Company to repurchase up to $50.0 million of shares of its common stock from time to time on the open market or in privately
negotiated  or  other  transactions.  We  publicly  announced  the  program  in  November  2017.  The  repurchase  program  is
authorized  for  a  period  of  up  to  two  years,  and  may  be  suspended  or  discontinued  at  any  time.  In  order  to  facilitate
repurchases, the Company may enter into a Rule 10b5-1 plan from time to time, which would permit shares to be repurchased
when the Company might otherwise be precluded from doing so under insider trading laws or because of a self-imposed 
trading blackout period. All repurchases for the periods presented were made under the program and using cash resources.

28 

  
  
  
  
  
    
       
       
       
   
  
    
       
       
       
   
    
       
       
       
   
  
  
  
  
  
    
    
    
    
   
  
  
 
 
Holders 

As of the close of business on February 16, 2018, there were 263 holders of record of our common stock. 

Dividends 

We have  not  paid  or  declared  any cash  dividends on  our common stock and  do  not  anticipate paying  cash  dividends in the 
foreseeable future. Our current intention is to retain future earnings to support the continued growth of our business and possibly 
for the repurchase of shares from time to time. Our Board of Directors will evaluate various factors, including, without limitation, 
our future earnings, operating cash flows, financial condition, results of operations and capital requirements in determining whether 
to pay any cash dividends in the future. In addition, our Credit Agreement generally limits, subject to certain exceptions, 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 under the headings “Credit Agreement” and “Liquidity and Capital Resources” in Part II, 
Item  7.  Management’s  Discussion  and  Analysis  of  Financial  Condition  and  Results  of  Operations,  and  in  Note  8  to  the 
Consolidated Financial Statements in Part II, Item 8. 

29 

  
  
  
  
  
  
  
  
  
  
 
 
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, 2012 and the reinvestment of dividends through the year ended December 31, 
2017. 

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

12/31/12     

  $ 
  $ 
  $ 
  $ 

100.00     $ 
100.00     $ 
100.00     $ 
100.00     $ 

12/31/13     12/31/14       12/31/15       12/31/16       12/31/17    
65.39  
242.29  
315.58  
177.93  

47.61    $ 
173.33    $ 
208.25    $ 
187.09    $ 

81.56    $ 
162.09    $ 
173.50    $ 
173.97    $ 

87.58    $ 
141.63    $ 
151.54    $ 
139.64    $ 

70.06    $ 
187.19    $ 
224.83    $ 
155.05    $ 

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 2017 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. 

30 

  
 
  
  
  
  
  
  
 
 
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, 2017. It should be read in conjunction with Part II, Item 7. Management’s Discussion and Analysis of Financial 
Condition and Results of Operations, and the Consolidated Financial Statements and Notes thereto, in Part II, Item 8 of this 2017 
Form 10-K. 

Statement of Operations Data 

(in thousands, except per share amounts) 

2017 

Years ended December 31, 
2015 

2016 

2014 

2013 

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: 

Net income per common share - basic 

Diluted income per common share: 

Net income per common share - diluted 

Weighted average shares: 

Basic 
Diluted 

Balance Sheet Data 

(in thousands) 
Cash and cash equivalents 
Working capital 
Total assets 
Revolving credit facility 
Total shareholders' equity 

  $  521,212    $  489,720    $  474,216    $  443,225    $  491,762  
     470,781       432,051       426,644       409,021       414,584  
77,178  
(12,460) 
71  
801  
65,590  
25,593  
39,997  

50,431      
(10,871)     
295      
—      
39,855      
(199)     
40,054    $ 

57,669      
(8,519)     
321      
—      
49,471      
11,835      
37,636    $ 

47,572      
(7,812)     
49      
—      
39,809      
15,282      
24,527    $ 

34,204      
(7,931)     
57      
—      
26,330      
12,383      
13,947    $ 

  $ 

  $ 

  $ 

0.48    $ 

0.45    $ 

0.28    $ 

0.16    $ 

0.46  

0.47    $ 

0.43    $ 

0.28    $ 

0.16    $ 

0.45  

83,821      
85,088      

84,221      
86,987      

87,881      
88,361      

87,673      
88,164      

87,598  
88,344  

Years ended December 31, 
2015 

2014 

2016 

2017 
83,313    $  175,999    $  145,610    $  133,116    $ 

2013 
  $ 
93,366  
  $  199,967    $  277,478    $  240,456    $  226,271    $  199,069  
  $  975,160    $  882,755    $  850,597    $  880,988    $  878,602  
  $  240,000    $  197,796    $  197,796    $  197,796    $  232,796  
  $  606,229    $  556,610    $  524,702    $  533,090    $  502,439  

31 

  
  
  
  
  
  
  
    
    
    
    
  
  
  
       
      
      
      
  
    
    
    
    
    
    
  
    
       
       
       
       
   
    
       
       
       
       
   
    
       
       
       
       
   
    
       
       
       
       
   
    
       
       
       
       
   
    
    
  
  
  
  
  
  
    
    
    
    
  
  
 
 
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. You should read this discussion and analysis in conjunction with the other sections of this 2017 Form 
10-K, including the Cautionary Note Regarding Forward-Looking Statements appearing prior to Part I, the information in Part I, 
Item 1A, and the Consolidated Financial Statements and Notes thereto in Part II, Item 8. The historical results set forth in Part II, 
Item 6, Item 7 and Item 8 of this 2017 Form 10-K should not be taken as necessarily indicative of our future operations or financial 
results. 

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 care management 
and consumer 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.  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;  engage  healthcare  consumers  to 
improve outcomes and increase retention; and achieve regulatory compliance. 

We  serve  state  Medicaid  programs,  commercial  health  plans,  federal  government  health  agencies,  government  and  private 
employers, CHIPs and other healthcare payers and sponsors. We also serve as a subcontractor for certain business outsourcing 
and technology firms. As of December 31, 2017, our customer base included the following: 

  
  

over 40 state Medicaid programs; 
approximately 325 health plans, including 23 of the top 25 health plans nationally (based on membership) in support of their
multiple lines of business, including Medicaid managed care, Medicare Advantage and group and individual health;  
over 225 private employers; 

  
   CMS, the Centers for Disease Control and Prevention, and the Department of Veterans Affairs; and 
   PBMs,  third-party  administrators  and  other  risk-bearing  entities,  including  independent  practice  associations,  hospital

systems, ACOs and specialty care organizations. 

Outlook 

We have grown our business both organically, through internal innovation and the development of new products and services, as 
well  as  by  acquisition  of  businesses  whose  core  services  strengthened  our  overall  mission  to  help  our  customers  contain 
healthcare  costs.  Our  largest  growth  during  2017  was  with  commercial  health  plan  customers,  both  organically  and  via  the 
acquisition of Eliza, and we currently expect this marketplace to present the greatest opportunity for growth in the year ahead. In 
addition to cross-sales of care management and consumer engagement solutions and other internal growth initiatives in 2018, 
various factors related to the macro healthcare environment are expected to contribute to our expected growth, including: 

 
  

an aging U.S. population with high-cost, chronic conditions and often co-morbidities.  
projected growth in Medicare enrollment from 2016 to 2025 is estimated by CMS to be at 28%, with a projected increase in
spending of 88% during this same time period; 

   Medicaid expenditures are projected to grow 64% from 2016 to 2025 based on CMS NHE projections; 

32 

  
  
  
  
 
  
  
  
  
  
government program payment error rates remain high at approximately 10%; 

  
   more than half of the U.S. population is projected by CMS to remain covered by employer-sponsored plans; and 
  

increased  healthcare  industry  focus  on  improved  population  health,  enhanced  consumer  outcomes  and  experience,  and
reduced costs. 

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 consumer engagement and satisfaction in the constantly evolving 
healthcare  marketplace.  We  also  expect  to  continue  increasing  recovery  yields  from  our  current  products  by  enhancing  our 
operating  and  organizational  efficiency  and  by  implementing  new  big  data  technologies  that  will  improve  the  quality  and 
effectiveness of our service offerings. 

Critical Accounting Policies and Estimates 

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. The accounting policies that we believe to be the most critical to an understanding 
of our financial condition and results of operations and that require the most complex and subjective management judgments are 
below: 

Revenue Recognition 

Effect if Actual Results Differ from 
Assumptions 

If we were to change any of these judgments 
or  estimates,  it  could  cause  a  material 
increase  or  decrease  in  the  amount  of 
revenue we report in a particular period. 

Description 

Judgments and Uncertainties 

fee  structures, 

We  provide  services  under  contracts  that 
contain  various 
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 a limited number 
of  contracts  with  the  federal  government 
which  are  generally  cost-plus  or  time  and 
materials  based.  Revenue  on  cost-plus 
is  recognized  based  on  costs 
contracts 
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  our 
contracts  may  include  customer  acceptance 
provisions. 

Formal  customer  sign-off  is  not  always 
necessary  to  recognize  revenue,  provided 
we objectively demonstrate 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.  A  portion  of  our 
revenue  is  recorded  net  of  an  estimate  of 
revenue  adjustments,  with  an 
future 
receivable 
to  accounts 
offsetting  entry 
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. 

33 

   
  
  
  
  
  
  
  
 
 
Effect if Actual Results Differ from 
Assumptions 

To the extent the amount to be returned to 
providers  following  a  successful  appeal 
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  our  customer 
contract, 
the 
including  modifications 
Medicare  RAC  contract,  may  require  us  to 
apply  different  assumptions 
that  could 
materially  affect  both 
the  Company’s 
revenue and estimated liability for appeals in 
future periods. 

to 

Effect if Actual Results Differ from 
Assumptions 

The  use  of  different  valuation  techniques 
and  assumptions  are  highly  subjective  and 
inherently uncertain and, as a result, actual 
results may differ materially from estimates. 

Estimated Liability for Appeals  

Description 

Judgments and Uncertainties 

Under our contracts with certain commercial 
health plan customers and our Medicare RAC 
contracts  with  CMS,  we  recognize  revenue 
when  HMS  claim  findings  are  sent  to  the 
Company’s customers for offset against future 
claim payments to providers. These contracts 
permit providers the right to appeal HMS claim 
findings  and  to  pursue  additional  appeals  if 
the  initial  appeal  is  found  in  favor  of  HMS’s 
customer.  The  total  estimated  liability  for 
appeals balance was $30.8 million as of each 
of  December  31,  2017  and  December  31, 
2016. 

Business Combinations  

The  appeal  process  established  under  the 
Medicare  RAC  contract  with  CMS  includes 
five  levels  of  appeals  and  resolution  of 
appeals can take substantial time to resolve. 
HMS records (i) a liability for findings which 
have been adjudicated in favor of providers 
and  (ii)  an  estimated  liability  based  on  the 
amount of revenue that is subject to appeals 
and which is probable of being adjudicated 
in 
their 
successful appeal. Our estimate is based on 
the Company’s historical experience. 

favor  of  providers 

following 

Description 

Judgments and Uncertainties 

businesses. 

their  acquisition  date 

We  record  assets  acquired  and  liabilities 
assumed  in  a  business  combination  based 
fair  values. 
upon 
Goodwill  is  the  excess  of  acquisition  costs 
over the fair values of assets and liabilities of 
acquired 
the 
measurement period, which is up to one year 
from  the  acquisition  date,  we  may  record 
adjustments  to  the  assets  acquired  and 
liabilities  assumed,  with  the  corresponding 
offset to goodwill. Upon the conclusion of the 
subsequent 
measurement  period,  any 
adjustments are recorded to earnings. 

During 

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. 
We  determine  fair  value  through  various 
valuation  techniques  including  discounted 
cash flow models, quoted market values and 
independent  appraisals,  as 
third  party 
necessary. 
considered 
Significant 
assumptions  used 
techniques 
in 
include, but are not limited to, growth rates, 
discount  rates,  customer  attrition  rates, 
expected levels of revenues, earnings, cash 
flows and tax rates. 

those 

34 

  
  
  
  
  
  
  
  
  
  
  
 
 
Impairment of Goodwill 

Description 

Judgments and Uncertainties 

Effect if Actual Results Differ from 
Assumptions 

Goodwill is subject to a periodic assessment 
for 
impairment.  We  assess  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 
we operate as a single reporting unit. 

We have the option to perform a qualitative 
assessment  to  determine  if  impairment  is 
more likely than not to have occurred. 

When the optional qualitative assessment of 
goodwill impairment is performed, significant 
judgment  is  required  in  the  assessment  of 
qualitative factors including but not limited to 
an evaluation of macroeconomic conditions 
as they relate to our business, industry and 
market trends, as well as the overall future 
financial performance of our reporting units 
and  future  opportunities  in  the  markets  in 
which they operate. 

We completed the annual impairment test as 
the  optional 
of  June  30,  2017  using 
qualitative  assessment  and  determined  no 
impairment 
existed.  The  Company’s 
carrying  amount  of  goodwill  was  $487.6 
million as of December 31, 2017. There were 
no  impairment  charges  related  to  goodwill 
during the years ended December 31, 2017, 
2016 or 2015. However, if actual results are 
not  consistent  with  our  estimates  or 
assumptions,  we  may  be  exposed  to  an 
impairment  charge  that  could  materially 
adversely impact our consolidated financial 
position and results of operations. 

If  we  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  using 
the  optional  qualitative 
assessment,  then  the  Company  would  not 
need  to  perform  the  two-step  impairment 
test. 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 the reporting unit 
with its carrying amount, including goodwill. 

Impairment of Long-Lived and Intangible Assets 

Description 

Judgments and Uncertainties 

We  use  significant  judgment  in  assessing 
events  or  changes  in  circumstances  which 
indicate that the carrying amount of the asset 
may not be recoverable. 

indicators 

Long-lived  assets,  including  property  and 
intangible  assets,  are 
equipment  and 
reviewed for impairment whenever events or 
changes  in  circumstances  indicate  that  the 
carrying  amount  of  the  asset  may  not  be 
recoverable.  When 
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 
and charged to earnings is measured by the 
amount  by  which  the  carrying  value  of  the 
asset  group  exceeds  the  fair  value  of  the 
assets. 

Effect if Actual Results Differ from 
Assumptions 

The  Company’s  carrying  amount  of  Long-
including  property  and 
lived  assets, 
equipment and intangible assets was $190.1 
million  as  of  December  31,  2017.  The 
Company did not recognize any impairment 
charges related to long-lived and intangible 
assets  during  the  years  ended  December 
31, 2017, 2016 or 2015. However, if actual 
results are not consistent with our estimates 
or assumptions, we may be exposed to an 
impairment  charge  that  could  materially 
adversely impact our consolidated financial 
position and results of operations. 

35 

  
  
  
  
  
  
  
  
  
  
  
  
 
 
Effect if Actual Results Differ from 
Assumptions 

If we were to change any of these judgments 
or  estimates,  it  could  cause  a  material 
increase or decrease in the amount of stock 
compensation  expense  we  report 
in  a 
particular  period.  For  example,  if  actual 
forfeitures vary from estimates, a difference 
in compensation expense will be recognized 
in the period the actual forfeitures occur. 

Effect if Actual Results Differ from 
Assumptions 

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. 

reserved 

for  uncertain 

Although  the  Company  believes  that  it  has 
tax 
adequately 
positions (including interest and penalties), it 
can provide no assurance that the final tax 
outcome  of 
these  matters  will  not  be 
materially different. 

Valuation of Stock-Based Compensation  

Description 

Judgments and Uncertainties 

The  determination  of  the  fair  value  of  the 
options  on  the  grant  date  using  the  Black-
Scholes pricing model and/or the Monte Carlo 
Simulation 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 
expected 
and 
dividends.  The  fair  value  of  all  awards  also 
includes an estimate of expected forfeitures. 

rate; 

any 

We estimate stock price volatility based on 
the  historical  volatility  of  the  Company’s 
common  stock  and  estimate  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 
the  option  valuation  models. 
Forfeitures are estimated based on historical 
experience. 

in 

Income Taxes  

Description 

Judgments and Uncertainties 

tax  assets  and 

Income  taxes  are  accounted  for  under  the 
asset and liability method. Under this method, 
deferred 
liabilities  are 
recognized  for  the  future  tax  consequences 
attributable to temporary differences between 
the  financial  statement  carrying  amounts  of 
existing  assets  and 
their 
respective 
tax  bases.  This  method  also 
requires the recognition of future tax benefits 
for net operating loss carry-forwards. 

liabilities  and 

those 

tax  assets  and 

liabilities  are 
Deferred 
measured using enacted tax rates expected 
to  apply  to  taxable  income  in  the  years  in 
which 
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. 

income 

financial 

tax  positions  are 
Uncertain 
accounted  for  by  prescribing  a  minimum 
recognition  threshold  that  a  tax  position  is 
required to meet before being recognized in 
statements.  We  make 
the 
adjustments 
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. 

reserves 

these 

to 

36 

  
  
  
  
  
  
  
  
  
  
  
 
 
Contingencies 

Description 

Judgments and Uncertainties 

Effect if Actual Results Differ from 
Assumptions 

in 

From  time  to  time,  we  are  involved  in  legal 
the  ordinary  course  of 
proceedings 
business.  We  assess  the  likelihood  of  any 
adverse  judgments  or  outcomes  to  these 
contingencies  as  well  as  potential  ranges  or 
reserves 
losses  and  establish 
probable 
accordingly. 

We  record  accruals  for  outstanding  legal 
matters when we believe 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.  We  review  these 
provisions at least quarterly and adjusts the 
provisions 
impact  of 
reflect 
negotiations, settlements, rulings, advice of 
legal counsel and updated information. 

the 

to 

in 

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 
to  new 
developments in each matter or changes in 
approach  to  a  matter  such  as  a  change  in 
settlement  strategy  which  could  have  a 
material  impact  on  our  financial  condition 
and operating results. 

future  periods  due 

For further information on these critical accounting policies and all other significant accounting policies refer to the discussion 
under “Business and Summary of Significant Accounting Policies” in our Note 1 to the Consolidated Financial Statements in Part 
II, Item 8. 

37 

  
  
  
  
  
  
  
 
 
Results of Operations 

2017 Highlights 

   Significantly expanded market penetration with the acquisition of Eliza; 
   Amended our existing Credit Agreement; and 
   Repurchased approximately 865,000 shares of common stock for $14.1 million.  

Comparison of 2017 to 2016 and 2016 to 2015 

Dollars in millions 

  $

Revenue 
Cost of Services : 
Compensation 
Data Processing 
Occupancy 
Direct project costs 
Other operating costs 
Amortization of acquisition 
related software and 
intangible assets 
Total Cost of Services 

Selling, general and 

Year ended December 31, 
2016 

2015 

2017 

521.2    $

489.7    $

474.2    $ 

   $ Change     % Change     % Change    % Change 

2017 vs 2016 
31.5      

6.4%  $ 

2016 vs 2015 
15.5      

3.3 %

202.0      
45.7      
17.2      
41.4      
28.4      

189.3      
37.3      
14.0      
46.3      
27.8      

178.3      
40.9      
15.8      
51.5      
28.9      

12.7      
8.4      
3.2      
(4.9)     
0.6      

6.7       
22.5       
22.9       
(10.6)      
2.2       

11.0      
(3.6)     
(1.8)     
(5.2)     
(1.1)     

6.2   
(8.8 ) 
(11.4 ) 
(10.1 ) 
(3.8 ) 

30.4      
365.1      

28.0      
342.7      

28.1      
343.5      

2.4      
22.4      

8.6       
6.5       

(0.1)     
(0.8)     

(0.4 ) 
(0.2 ) 

administrative expenses 

105.7      

89.4      

83.1      

16.3      

18.2       

6.3      

7.6   

Total Operating 
Expenses 
Operating Income 

Interest expense 
Interest income 

Income before income 

taxes 
Income taxes 
Net Income 

Revenue 

470.8      
50.4      
(10.8)     
0.3      

39.9      
(0.2)     
40.1    $

432.1      
57.6      
(8.5)     
0.3      

49.4      
11.8      
37.6    $

426.6      
47.6      
(7.8)     
-      

38.7      
(7.2)     
(2.3)     
-      

9.0       
(12.5)      
27.1       
-       

39.8      
15.3      
24.5    $ 

(9.5)     
(12.0)     
2.5      

(19.2)      
(101.7)      
6.6%  $ 

5.5      
10.0      
(0.7)     
0.3      

9.6      
(3.5)     
13.1      

1.3   
21.0   
9.0   
-   

24.1   
(22.9 ) 
53.5 %

  $

Revenue in Millions 

38 

  
  
  
  
  
  
  
  
  
  
  
    
       
       
       
       
        
       
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
  
  
 
2017 vs. 2016 
During the year ended December 31, 2017, revenue was $521.2 million, an increase of $31.5 million or 6.4% compared to $489.7 
million for the year ended December 31, 2016. 

  By product: 

o  Coordination  of  benefits  product  revenue  increased  $29.0  million  or  8.2%  which  was  attributable  to  yield
improvements and the addition of Medicaid enrollees which entered our customer eligibility files in 2017. 
o  Analytical services product revenue increased $2.5 million or 1.9% which was attributable to Eliza contributing
revenue of $30.4 million since its acquisition in April 2017 and revenue from Essette increasing $2.9 million as
compared to prior year. These increases were offset by decreases totaling $30.8 million comprised of Medicare 
RAC revenue of $14.7 million because the Medicare RAC D program ceased generating revenue in late 2016,
as expected, and program integrity revenue of $16.1 million due to various contract completions and expirations.

  By market:  

o  Commercial  health  plan  market  revenue  increased  $39.0  million  or  17.0%  which  was  attributable  to  Eliza
contributing revenue of $30.4 million since its acquisition in April 2017, Essette increasing revenue $2.9 million
as compared to prior year and expanded commercial health plan scopes, including the addition of health plans
to current contracts and yield improvements. 

o  State government market revenue grew by $7.9 million or 3.6%, which was attributable to expanded scopes

and yield improvements. 

o  Federal government market revenue decreased $15.4 million, which was primarily attributable to a reduction of
Medicare RAC revenue because the Medicare RAC D program ceased generating revenue in late 2016, as
expected. 

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 $474.2 
million for the year ended December 31, 2015. 

  By product: 

o  Coordination of benefits product revenue increased $16.2 million or 4.8% which was primarily attributable to an

increase in subrogation revenue.  

o  Analytical  services  product  revenue  decreased  $0.7  million  or  0.5%  which  was  attributable  to  decreases  in
Medicare  RAC  revenue  of  $3.4  million,  employer  services  revenue  of  $1.8  million  due  to  various  contract
completions and expirations and eligibility services revenue of $0.5 million. These decreases were offset by a
$4.1 million increase in our program integrity revenue which was attributable to expanded scopes and yield
improvements and $0.9 million of revenue contributed by Essette in 2016 after the date of its acquisition.  

  By market:  

o  Commercial health plan market revenue increased $27.2 million or 13.4%, which was attributable to expanded
scopes, including adding additional health plans to current customer contracts, and yield improvements. 
o  State government market revenue  decreased $7.0 million  or 3.1%,  which was attributable to a reduction in

revenue from certain customers. 

o  Federal government market revenue decreased $4.7 million or 10.3%, which was primarily attributable to a

reduction of Medicare RAC activity due to delays in contract reprocurement. 

39 

 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
  
 
 
Cost of Services 

Cost of Services in millions 

2017 vs. 2016 
During  the  year  ended  December  31,  2017,  total  cost  of  services  was  $365.1  million,  an  increase  of  $22.4  million  or  6.5% 
compared to $342.7 million for the year ended December 31, 2016. This change resulted primarily from increases in compensation 
expense of $12.8 million, data processing expense of $8.4 million, and amortization of intangibles expense of $2.4 million. 

  The  Eliza  acquisition  and  the  related  compensation,  data  processing,  occupancy  and  amortization  of  intangibles

expenses incurred since the transaction represents $23.4 million of the increase. 

  Excluding Eliza, total cost of services decreased by $1.0 million which was primarily related to a reduction in direct project

costs partially offset by increases in data processing and compensation expenses. 

2016 vs. 2015 
During the year ended December 31, 2016, total cost of services was $342.7 million, a decrease of $0.8 million or 0.2% compared 
to $343.5 million for the year ended December 31, 2015. 

  Direct project costs decreased by $5.2 million primarily related to the reduction of Medicare RAC activity. 
  Data processing expense decreased by $3.6 million primarily related to a reduction in depreciation expense. 
  Occupancy expense decreased by $1.8 million related to the closure of an office in 2015. 
  Other operating expenses decreased by $1.1 million related to net decreases of temporary staff, subcontractors and

consulting fees. 

  Compensation  expense  increased  by  $11.1  million  related  to  additional  salaries,  variable  compensation  and  fringe

benefits expenses partially offset by a decrease in stock-based compensation expense. 

40 

  
 
  
  
  
  
 
 
 
 
 
  
 
 
Selling, General and Administrative expenses 

SG&A in millions 

2017 vs. 2016 
During the year ended December 31, 2017, SG&A expense was $105.7 million, an increase of $16.3 million or 18.2% compared 
to $89.4 million for the year ended December 31, 2016. 

  The Eliza acquisition and related transaction fees and other SG&A expenses incurred since its acquisition represented

$8.7 million of the increase.  

  Excluding  Eliza,  stock  compensation  expense  also  increased  by  $7.3  million  primarily  due  to  stock  compensation 

expense for retirement eligible employees. 

2016 vs. 2015 
During the year ended December 31, 2016, SG&A expense was $89.4 million, an increase of $6.3 million or 7.6% compared to 
$83.1 million for the year ended December 31, 2015. 

 

Increases totaling $14.1 million were comprised of compensation costs of $6.1 million, consulting expense of $4.0 million,
fringe benefits expense of $1.6 million, and other expenses of $2.4 million.  

  These increases were partially offset by a $7.8 million reduction in legal fees and settlements. 

Income Taxes 

2017 vs. 2016 
During the year ended December 31, 2017, we recorded an income tax benefit of ($0.2) million, a decrease of $12.0 million 
compared to the year ended December 31, 2016. 

  On December 22, 2017, the 2017 Tax Act was signed into law and includes provisions reducing the federal tax rate for

years beginning in 2018 from 35% to 21%. 

  Our effective tax rate was (0.5%) for the year ended December 31, 2017 compared to an effective tax rate of 23.9% for 
the year ended December 31, 2016. The decrease is primarily due to the revaluation of our deferred tax liabilities based
on the reduced federal tax rate described above.  

  Our normalized effective tax rate of 36.1% for 2017 is comparable to our normalized effective tax rate of 36.2% for 2016.

41 

  
 
  
 
 
  
 
 
  
  
 
 
 
  
 
 
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 year ended December 31, 2015. 

  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 prior period R&D Credits and Section 199 Deductions.  

Off-Balance Sheet Arrangements 

We do not have any off-balance sheet arrangements. 

Credit Agreement 

In May 2013, we entered into the Credit Agreement with certain lenders and Citibank, N.A. as administrative agent. The Credit 
Agreement originally provided for an initial $500 million five-year revolving credit facility maturing on May 3, 2018. The obligations 
and amounts due under the original revolving credit facility were secured by a first security priority interest in all or substantially 
all  of  our  and  our  material  100%  owned  subsidiaries’  assets.  The  original  revolving  credit  facility  contained  customary 
representations and warranties, affirmative and negative covenants, including financial covenants, and events of default. 

In March 2017, we amended the Credit Agreement to allow, among other things, an extension of our requirement to furnish to 
Citibank, N.A., as administrative agent, and the lenders party to the Credit Agreement, copies of financial statements and other 
information within 90 days of the fiscal year-end to 180 days for the fiscal year-ended December 31, 2016. We furnished the 
required  financial  statements,  which  included  our  audited  consolidated  balance  sheet  and  related  statements  of  income, 
stockholders’ equity and cash flows, within the extended time period. 

Amended Revolving Facility 

On  December  19,  2017,  we  entered  into  an  amendment  to  the  Credit  Agreement  that,  among  other  things,  provides  for  an 
extension of the maturity date of our existing senior secured revolving credit facility, which includes a $50 million sublimit for the 
issuance of letters of credit and a $25 million sublimit for swingline loans. In addition, the Amended Revolving Facility includes an 
accordion feature that permits us to increase the revolving facility up to the sum of (a) the greater of $120 million and 100% of 
Consolidated EBITDA (as defined in the Credit Agreement) and (b) additional amounts so long as our first lien leverage ratio (as 
defined in the Credit Agreement) on a pro forma basis is not greater than 3.00:1.00, in each case subject to obtaining commitments 
from lenders therefor and meeting certain other conditions. The Amended Revolving Facility will mature on December 19, 2022. 

As of December 31, 2017, the outstanding principal balance due on the Amended Revolving Facility was $240.0 million. 

Our obligations under the Amended Revolving Facility are secured, subject to certain customary carve-outs and exceptions, by a 
first  priority  lien  and  security  interest  in  substantially  all  of  our  tangible  and  intangible  assets  and  our  material  restricted 
subsidiaries’.  The  Amended  Revolving  Facility  contains  customary  representations  and  warranties,  affirmative  and  negative 
covenants, including financial covenants and restrictions on share repurchases, and events of default applicable to us and our 
restricted  subsidiaries.  We  are  required  to  comply,  on  a  quarterly  basis,  with  two  financial  covenants:(i)  a  minimum  interest 
coverage ratio of 3:00:1:00, and (ii) a maximum consolidated leverage ratio of 4.75:1.00 through December 2019 and 4.25:1.00 
from and after January 2020 (in each case, as such ratios are defined in the Credit Agreement). The consolidated leverage ratio 
is subject to a step-up to 5.25:1.00 for four full consecutive fiscal quarters following a permitted acquisition or similar investment. 

Borrowings under the Amended Revolving Facility bear interest at a rate equal to either (a) a base rate plus an interest margin 
ranging from 0.50% to 1.00% or (b) an adjusted LIBO rate, plus an interest margin ranging from 1.50% to 2.00% based on the 
Company’s consolidated leverage ratio for the applicable period. 

42 

 
  
  
  
  
  
  
  
  
  
  
  
 
 
We paid lender, legal and other fees of $2.3 million and accrued interest of $1.5 million. Proceeds of the Amended Revolving 
Facility may be used to provide working capital from time to time for the Company, and for other general corporate purposes and 
activities permitted by the Credit Agreement. 

As of December 31, 2017, we were in compliance with all terms of the Credit Agreement. 

As part of a contractual agreement with a customer, the Company has an outstanding irrevocable letter of credit for $5.4 million, 
which is issued against the Amended Revolving Facility and expires April 26, 2018. 

See Note 8 to the Consolidated Financial Statements in Part II, Item 8 for additional information regarding our Credit Agreement. 

Liquidity and Capital Resources 

The following tables should be read in conjunction with the Consolidated Financial Statements and Notes thereto, in Part II, Item 8 
of this 2017 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: 

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

A summary of our cash flows was as follows: 

Years Ended December 31, 

2017    
83,313    $ 
199,967    $ 
254,600    $ 

2016   
175,999  
277,478  
183,881  

  $ 
  $ 
  $ 

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

Net (decrease) / increase in cash and cash equivalents 

Years Ended December 31, 

2017    
86,464    $ 
(204,364)     
25,214      
(92,686)   $ 

  $ 

  $ 

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

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

Our cash and cash equivalents and working capital were lower as of December 31, 2017 as compared to December 31, 2016, 
primarily  as  a  result  of  cash  used  for  our  acquisition  of  Eliza  on  April  17,  2017.  Our  available  borrowings  were  higher  as  of 
December 31, 2017 as compared to December 31, 2016 as a result of the Amended Revolving Facility as described above. 

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 capital investments, compensation expenses, data processing, direct project costs and SG&A expenses 
and acquisitions. We may also use available cash to repurchase shares of our common stock. 

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; 
investments in our business; 
business development activities;  
repurchases of common stock; and 
repayment of our revolving credit facility. 

43 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
    
    
  
  
  
  
  
 
 
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 meet working capital requirements, fund acquisitions or repay 
our indebtedness under the Credit Agreement. 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, 2017 was $86.5 million, a $2.1 million decrease from 
net cash provided by operating activities of $88.6 million for the year ended December 31, 2016. The decrease was primarily due 
to a decrease in deferred income taxes of $13.0 million related to our revaluation of the Company’s deferred tax balances from 
the federal tax rate of 35% to 21% under the 2017 Tax Act, offset by an increase in stock based compensation expense $10.9 
million primarily related to retirement eligible employees. The decrease was also impacted by changes in operating assets and 
liabilities and offset by increases in net income, and depreciation and amortization expenses. 

Net cash provided by operating activities for the year ended December 31, 2016 was $88.6 million, a $16.3 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 increase in net income as adjusted for non-cash items including decreased stock-based compensation expense and deferred 
income taxes, as well as an 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. 

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, 2017, revenue was $521.2 million, an increase of $31.5 
million compared to revenue of $489.7 million for the year ended December 31, 2016. DSO decreased by 9 days to 115 days as 
of December 31, 2017, as compared to 124 days as of December 31, 2016. The change was due to strong cash collections as 
well as an increase in revenue in the fourth quarter of the current year as compared to the fourth quarter of the prior year. 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 renewed. 

Cash Flows from Investing Activities 

Net  cash  used  in  investing  activities  for  the  year  ended  December  31,  2017  was  $204.4  million,  a  $165.2  million  increase 
compared to net cash used in investing activities of $39.2 million for the year ended December 31, 2016. This increase was 
primarily  due  to  the  use  of  approximately  $171.2  million  for  the  Eliza  acquisition  in  April  2017  as  compared  to  the  use  of 
approximately $20.7 million for the Essette acquisition in September 2016. Purchases of property and equipment and investment 
in capitalized software also increased by $12.0 million year over year. 

Net cash used in investing activities for the year ended December 31, 2016 was $39.2 million, a $27.4 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 for the Essette acquisition in September 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. 

44 

  
  
  
  
  
  
  
  
  
  
 
 
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. 

We currently expect to incur capital expenditures of $33.0 million during the year ended December 31, 2018. 

Cash Flows from Financing Activities 

Net cash provided by financing activities for the year ended December 31, 2017 was $25.2 million, a $44.2 million increase from 
net cash used in financing activities of $19.0 million for the year ended December 31, 2016. This increase was primarily attributable 
to $42.2 million of proceeds from additional borrowings under our amended credit facility. 

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 of $20.5 million as compared to the prior year of $50.0 million. 

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, partially offset by a $35.0 million reduction in payments toward the principal 
outstanding on our revolving credit facility. 

Share Repurchase Program 

During the year ended December 31, 2017, we repurchased 0.9 million shares of our common stock for approximately $14.1 
million using cash resources. See the discussion under “Repurchases of Shares of Common Stock” under Part II, Item 5 and 
“Equity”  in  Note  9  to  the  Consolidated  Financial  Statements  under  Part  II,  Item  8  for  additional  information  regarding  share 
repurchases. 

Contractual Obligations 

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

Contractual Obligations (8) 
Operating leases (1) 
Revolving credit facility (2) 
Interest expense (3) 
Commitment fee (4)  
Capital leases (5) 
Letter of Credit fee (6) 
Purchase obligations and commitments (7) 
Total 

  $ 

  $ 

Payments Due by Period (in thousands) 

Total 

Less than 1 
year 

     1 - 3 years       3 -5 years      

More than  
5 years 

19,938     $ 
240,000       
40,633       
4,789       
198       
34       
2,476       
308,068     $ 

6,393    $ 
-      
8,212      
968      
190      
34      
2,476      
18,273    $ 

8,773    $ 
-      
24,636      
2,904      
8      
-      
-      
36,321    $ 

4,772    $ 
240,000      
7,785      
917      
-      
-      
-      
253,474    $ 

-  
-  
-  
-  
-  
-  
-  
-  

45 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
    
  
    
    
    
    
    
    
  
 
 
 (1) 

 (2) 

 (3) 

 (4) 

 (5) 

 (6) 

 (7) 

 (8) 

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  additional  amounts  are  not 
included in the table of contractual obligations as the timing and/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 8 to the Consolidated Financial Statements in Part II, Item 8 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, 2017
and on scheduled repayments of principal. See Note 8 to the Consolidated Financial Statements in Part II, Item 8 for
additional information regarding the Credit Agreement. 

Represents the commitment fee due on the revolving credit facility. See Note 8 to the Consolidated Financial Statements
in Part II, Item 8 for additional information regarding the Credit Agreement. 

Represents the future minimum lease payments under capital leases. 

Represents the fees for the letter of credit issued against the revolving credit facility. See Note 8 to the Consolidated 
Financial Statements in Part II, Item 8 for additional information regarding the Credit Agreement. 

Represents future purchases related to outstanding purchase orders and supplier requisitions. 

The Company has excluded long-term unrecognized tax benefits, net of interest and penalties, of $8.2 million from the
amounts presented as the timing of these obligations is uncertain. 

Recently Issued Accounting Pronouncements  

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

Item 7A. Quantitative and Qualitative Disclosures About Market Risk 

At December 31, 2017, 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 $2.4 million based on our debt balances 
outstanding at December 31, 2017. 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 61 to 64 of this 2017 Form 10-K. 

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

None. 

46 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
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. In designing and evaluating the disclosure controls and 
procedures, management recognizes that any controls and procedures, no matter how well designed and operated, can provide 
only reasonable assurance of achieving the desired  control  objectives,  and management  is required to apply  its judgment in 
evaluating the cost-benefit relationship of possible controls and procedures  

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, 2017. Based on that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls 
and procedures were effective as of the end of the period covered by the 2017 Form 10-K. 

(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. 

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, 2017, 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, 
we believe that the Company’s internal control over financial reporting was effective based on those criteria as of December 31, 
2017. 

On April 17, 2017, we completed our acquisition of Eliza. We are in the process of evaluating the existing controls and procedures 
of Eliza and integrating Eliza into our internal control over financial reporting. In accordance with SEC Staff guidance permitting a 
company to exclude an acquired business from management’s assessment of the effectiveness of internal control over financial 
reporting for the year in which the acquisition is completed, we have excluded the Eliza business acquired in  2017 from our 
assessment of the effectiveness of internal control over financial reporting as of December 31, 2017. Eliza represented twenty 
percent of the Company’s total assets as of December 31, 2017, and six percent of the Company’s revenues for the year ended 
December 31, 2017. The scope of management’s assessment of the effectiveness of the design and operation of the Company’s 
disclosure controls and procedures as of December 31, 2017 includes all of the Company’s consolidated operations except for 
those disclosure controls and procedures of Eliza that are subsumed by internal control over financial reporting. 

Our independent registered public accounting firm, Grant Thornton LLP, audited our consolidated financial statements and has 
issued an attestation report on the effectiveness of our internal control over financial reporting as of December 31, 2017, a copy 
of which appears on page 60 of this filing. 

47 

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. 

(c) Changes in Internal Control Over Financial Reporting 

During the quarter ended December 31, 2016, management identified material weaknesses in our internal control over financial 
reporting related to (i) the calculation 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”). 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. 

As  described  in  Management’s  Report  on  Internal  Control  Over  Financial  Reporting  in  Item  9A  of  our  2016  Form  10-K, 
management determined that 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  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. 

To remediate the material weaknesses described above we: 

  

  

  

  

  

  
  

  

clarified  our  risk  assessment  process  in  regards  to  external  factors,  such  as  conditions  in  the  Company's  industry  and
environment,  and  internal  factors,  such  as  personnel  who  may  lack  the  necessary  financial  reporting  competencies,
information systems that may fail to accurately capture business transactions, or financial reporting processes that may not
be adequately aligned with the requirements in the applicable financial reporting framework; 
restructured  and  redefined  certain  individuals’  responsibilities  in  regards  to  internal  control  over  financial  reporting  and
have  added  additional  full  time  personnel  which  we  believe  will  continue  to  strengthen  internal  control  over  financial
reporting specifically related to our risk assessment process;  
realigned  existing  subsidiary  and  corporate  reporting  lines  which  we  believe  will  clarify  existing  subsidiary  authorities
and responsibilities for financial reporting and will enhance corporate-level oversight of the subsidiary activities; 
engaged  an  independent  third  party  professional  services  firm  to  assist  in  enhancing  and  clarifying  process  flows  and
the underlying process level controls around the CMS Reserve and the Allowance;  
implemented  additional  process  level  controls  surrounding  the  completeness  and  accuracy  of  the  underlying  data  and
reports; 
trained personnel with respect to supporting documentation used in process level controls;  
enhanced and clarified existing review control procedures over our models for the CMS Reserve and the Allowance including
adding additional specific review criteria utilized; and 
implemented  additional  layers  of  review  controls  specifically  over  the  CMS  Reserve  and  the  Allowance,  including  the
review by more experienced personnel. 

Management completed testing during the quarter ended December 31, 2017 and determined that the measures described above 
were effectively designed and demonstrated effective operation for a sufficient period of time to enable the Company to conclude 
that the material weaknesses have been remediated. 

Except as noted above, there have been no changes to the Company’s internal control over financial reporting as of December 
31, 2017 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting. 

Item 9B. Other Information 

None. 

48 

 
  
  
  
  
  
  
  
  
  
Item 10. Directors, Executive Officers and Corporate Governance 

PART III 

The information required by this Item 10 is incorporated herein by reference to the applicable disclosure found in our definitive 
proxy statement to be filed with the SEC pursuant to Regulation 14A under the Exchange Act in connection with HMS Holdings 
Corp.’s  2018  Annual  Meeting  of  Shareholders  under  the  captions  “Proposal  One:  Election  of  Class  I  Directors,”  “Executive 
Officers,” “Section 16(a) Beneficial Ownership Reporting Compliance,” “Director Nomination Process,” “Additional Information—
Shareholder Proposals and Director Nominations for 2019 Annual Meeting,” and “Board Committees and Related Matters.” 

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 the 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. 

Item 11. Executive Compensation 

The information required by this Item 11 is incorporated herein by reference to the applicable disclosure found in our definitive 
proxy statement to be filed with the SEC pursuant to Regulation 14A under the Exchange Act in connection with HMS Holdings 
Corp.’s 2018 Annual Meeting of Shareholders under the captions “Executive Compensation,” “Director Compensation,” 
“Compensation Committee Interlocks and Insider Participation,” and “Compensation Committee Report.” 

Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Shareholder Matters  

Except as provided below, the information required by this Item 12 is incorporated herein by reference to the applicable disclosure 
found in our definitive proxy statement to be filed with the SEC pursuant to Regulation 14A under the Exchange Act in connection 
with HMS Holdings Corp.’s 2018 Annual Meeting of Shareholders under the caption “Ownership of HMS Common Stock.” 

Equity Compensation Plan Information 

The  following  table  summarizes  information  about  our  equity  compensation  plans  as  of  December  31,  2017.  For  additional 
information about our equity compensation plans see the discussion set forth under the caption “Stock-Based Compensation” in 
Note 11 to the Consolidated Financial Statements in Part II, Item 8. 

49 

  
  
  
  
  
  
  
  
  
 
 
 
Number of 
securities 
remaining 
available for 
future 
issuance 
under equity 
compensation 
plans 
(excluding 
securities 
reflected in 
column (a)) 
(c) 
6,031,544  
—  

Weighted-
average 
exercise price 
of outstanding 
options, 
warrants and 
rights 
(b) 

Number of 
securities to 
be issued 
upon exercise 
of outstanding 
options, 
warrants and 
rights 
(a) 
6,869,758(1)   $ 
31,300(2)   $ 
6,901,058       

17.42      
17.89      

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. 

Item 13. Certain Relationships and Related Transactions and Director Independence 

The information required by this Item 13 is incorporated herein by reference to the applicable disclosure found in our definitive 
proxy statement to be filed with the SEC pursuant to Regulation 14A under the Exchange Act in connection with HMS Holdings 
Corp.’s 2018 Annual Meeting of Shareholders under the captions “Certain Relationships and Related Transactions” and “Director 
Independence.” 

Item 14. Principal Accounting Fees and Services 

The  information  required  by  this  Item  14  is  incorporated  herein  by  reference  to  the  applicable  disclosure  from  the  proposal 
captioned “Ratification of the Selection of Independent Registered Public Accounting Firm” found in our definitive proxy statement 
to be filed with the SEC pursuant to Regulation 14A under the Exchange Act in connection with HMS Holdings Corp.’s 2018 
Annual Meeting of Shareholders. 

50 

  
  
     
    
  
  
     
    
  
    
    
    
       
   
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
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 58. 

 2. 

Financial Statement Schedules. 

Financial Statement Schedule II-Valuation and Qualifying Accounts is set forth on page 88. 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 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. 

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 

  2.3 

  3.1 

   Description 
   Agreement and Plan  of Merger,  dated December  16, 2002, among Health Management Systems, Inc., HMS
Holdings Corp. and HMS Acquisition Corp. (incorporated by reference to Exhibit A to the Company’s Prospectus
and Proxy Statement (Reg No. 333-100521) as filed with the SEC on January 24, 2003) 

   Agreement  and  Plan  of  Merger,  dated  July  17,  2013,  by  and  between  HMS  Holdings  Corp.,  a  Delaware
corporation, and HMS Holdings Corp., a New York corporation (incorporated by reference to Exhibit 2.1 to the
Company’s Current Report on Form 8-K/12g-3 (File No. 000-50194) as filed with the SEC on July 23, 2013) 
   Agreement and Plan of Merger, dated March 10, 2017, by and among HMS Holdings Corp., Echo Acquisition
Sub, Inc., Eliza Holding Corp., and Parthenon Investors III, L.P., solely in its capacity as the representative for
equity holders of Eliza Holding Corp. (incorporated by reference to Exhibit 2.1 to the Company’s Quarterly Report
on Form 10-Q (File No. 000-50194) as filed with the SEC on June 6, 2017) 

   Conformed  copy  of  Certificate  of  Incorporation  of  HMS  Holdings  Corp.,  as  amended  through  July  9,  2015
(incorporated by reference to Exhibit 3.1 to the Company’s Quarterly Report on Form 10-Q (File No. 000-50194)
as filed with the SEC on August 10, 2015) 

51 

  
  
  
  
  
  
  
  
  
 
 
Exhibit 
Number 
  3.2 

  4.1 

10.1.1 

10.1.2 

10.1.3 

10.1.4 

10.1.5 

10.1.6 

10.1.7 

10.1.8 

10.1.9 

10.1.10 

10.1.11 

10.1.12 

10.1.13 

   Description 
   Amended and Restated Bylaws of HMS Holdings Corp. dated May 4, 2016 (incorporated by reference to Exhibit
3.2 to the Company’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 the Company’s Current Report

on Form 8-K/12g-3 (File No. 000-50194) as filed with the SEC on July 23, 2013) 

   HMS Holdings Corp. Fourth Amended and Restated 2006 Stock Plan (incorporated by reference to Exhibit 99.2
to the Company’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 HMS Holdings Corp. Fourth Amended and Restated 2006 Stock Plan (incorporated by
reference to Exhibit 10.6 to the Company’s Annual Report on Form 10-K (File No. 000-50194) as filed with the
SEC on February 29, 2012)† 

   Form  of  2011  Director  Non-Qualified  Stock  Option  Agreement  under  the  2006  Stock  Plan  (incorporated  by
reference to Exhibit 10.16 to the Company’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 the Company’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 the Company’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 the Company’s Annual Report on Form 10-K (File No. 000-50194) as filed with the
SEC on March 1, 2013)† 

   Form of 2013 Executive Restricted Stock Unit Agreement under the 2006 Stock Plan (incorporated by reference
to Exhibit 10.24 to the Company’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 the Company’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 the Company’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 the Company’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 the Company’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 the Company’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 the Company’s Annual Report on Form 10-K (File No. 000-50194) as filed with the
SEC on March 2, 2015)† 

52 

 
 
Exhibit 
Number 
10.1.14 

10.1.15 

10.1.16 

10.1.17 

10.1.18 

10.1.19 

10.1.20 

   Description 
   Form of March 2015 Executive Non-Qualified Stock Option Agreement under the 2006 Stock Plan (incorporated
by reference Exhibit 10.1 to the Company’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 the Company’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 the Company’s Annual Report on Form 10-K (File No. 000-50194) as filed with the
SEC on February 29, 2016)† 

   Form of 2015 Director Restricted Stock Unit Agreement under the 2006 Stock Plan (incorporated by reference to
Exhibit  10.22  to  the  Company’s  Annual  Report  on  Form  10-K  (File  No.  000-50194)  as  filed  with  the  SEC  on
February 29, 2016)† 

   Form  of  November  2015  Executive  Non-Qualified  Stock  Option  Agreement  under  the  2006  Stock  Plan
(incorporated by reference to Exhibit 10.23 to the Company’s Annual Report on Form 10-K (File No. 000-50194)
as filed with the SEC on February 29, 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 the Company’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 the Company’s Quarterly Report on Form 10-Q (File No. 000-50194)
as filed with the SEC on May 10, 2016)† 

10.2.1 

   HMS Holdings Corp. 2016 Omnibus Incentive Plan (incorporated by reference to Exhibit 10.2 to the Company’s

10.2.2 

10.2.3 

10.2.4 

10.2.5 

10.3.1 

10.3.2 

Current Report on Form 8-K (File No. 000-50194) as filed with the SEC on June 27, 2016)† 

   Form  of  Non-Qualified  Stock  Option  Award  Agreement  for  Employees  under  the  2016  Omnibus  Plan
(incorporated by reference to Exhibit 10.1 to the Company’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 10.2 to the Company’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 the Company’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 the Company’s Quarterly Report on Form 10-Q (File No. 000-50194)
as filed with the SEC on November 9, 2016)† 

   Executive Employment Agreement, dated March 1, 2013, by and between William C. Lucia and HMS Holdings
Corp. (incorporated by reference to Exhibit 10.29 to the Company’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, dated April 30, 2013, by and between William C.
Lucia and HMS Holdings Corp. (incorporated by reference to Exhibit 10.1 to Amendment No. 1 to the Company’s
Annual Report on Form 10-K/A (File No. 000-50194) as filed with the SEC on April 30, 2013)† 

53 

 
 
Exhibit 
Number 
10.3.3 

10.3.4 

10.4 

10.5 

10.6 

10.7 

10.8 

10.9 

10.10 

10.11.1 

10.11.2 

10.11.3 

   Description 
   Second  Amendment  to  Executive  Employment  Agreement,  dated  January  20,  2015,  by  and  between  HMS
Holdings Corp. and William C. Lucia (incorporated by reference to Exhibit 10.1 to the Company’s Current Report
on Form 8-K (File No. 000-50194) as filed with the SEC on January 23, 2015)† 

   Third Amendment to Executive Employment Agreement, dated February 21, 2018, by and between William C.
Lucia and HMS Holdings Corp. (incorporated by reference to Exhibit 10.1 to the Company’s Current Report on
Form 8-K (File No. 000-50194) as filed with the SEC on February 23, 2018)† 

   Employment Agreement, dated July 28, 2014, by and between Jeffrey S. Sherman and HMS Holdings Corp.
(incorporated by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K (File No. 000-50194) 
as filed with the SEC on September 8, 2014)† 

   Employment Agreement, dated May 15, 2012, by and between Cynthia Nustad and HMS Business Services, Inc.
(incorporated by reference to Exhibit 10.47 to Amendment No. 1 to the Company’s Annual Report on Form 10-
K/A (File No. 000-50194) as filed with the SEC on April 30, 2015)† 

   Employment Agreement, dated January 16, 2013, by and between Semone Wagner and HMS Holdings Corp.
(incorporated by reference to Exhibit 99.1 to the Company’s Annual Report on Form 10-K (File No. 000-50194)
as filed with the SEC on March 3, 2014)† 

   Employment Agreement, dated November 13, 2013, by and between Douglas M. Williams and HMS Holdings
Corp. (incorporated by reference to Exhibit 10.33 to the Company’s Annual Report on Form 10-K (File No. 000-
50194) as filed with the SEC on February 29, 2016)† 

   Form of Indemnification Agreement (incorporated by reference to Exhibit 10.1 to the Company’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 the Company’s Quarterly Report on Form 10-Q (File No. 000-50194) as filed with 
the SEC on August 9, 2016)† 

   HMS Holdings Corp. Annual Incentive Compensation Plan as amended and restated (incorporated by reference
to Exhibit 10.1 to the Company’s Current Report on Form 8-K (File No. 000-50194) as filed with the SEC on June
27, 2016)† 

   Amended and Restated Credit Agreement, dated May 3, 2013, as amended by Amendment No. 1 to Amended
and Restated Credit Agreement dated as of March 8, 2017, and as further amended by Amendment No. 2 to
Amended and Restated Credit Agreement, dated as of December 19, 2017, by and among HMS Holdings Corp.,
the Guarantors party thereto, the Lenders party thereto and Citibank, N.A., as Administrative Agent (incorporated
by reference to Exhibit 10.2 to the Company’s Current Report on Form 8-K (File No. 000-50194) as filed with the 
SEC on December 21, 2017) 

   Amendment No. 2 to Amended and Restated Credit Agreement, dated December 19, 2017, by and among HMS
Holdings Corp., the other Loan Parties party thereto, Citibank, N.A., as Administrative Agent, the Issuing Bank,
the  Swingline  Lender  and  the  other  Lenders  party  thereto  (incorporated  by  reference  to  Exhibit  10.1  to  the
Company’s Current Report on Form 8-K (File No. 000-50194) as filed with the SEC on December 21, 2017) 
   Amended and Restated Security Agreement, dated December 19, 2017, by and among HMS Holdings Corp., the
Subsidiary Securing Parties party thereto and Citibank, N.A., as Collateral Agent (incorporated by reference to
Exhibit  10.3  to  the  Company’s  Current  Report  on  Form  8-K  (File  No.  000-50194)  as  filed  with  the  SEC  on
December 21, 2017) 

21.1 
23.1 
23.2 

   HMS Holdings Corp. List of Subsidiaries 
   Consent of Grant Thornton LLP 
   Consent of KPMG LLP 

54 

 
 
Exhibit 
Number 
31.1 

31.2 

32.1 

32.2 

   Description 
   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* 

XBRL Instance Document 

XBRL Taxonomy Extension Calculation Linkbase Document 

101.INS 
101.SCH  XBRL Taxonomy Extension Schema Document 
101.CAL 
101.DEF  XBRL Taxonomy Extension Definition Linkbase Document 
101.LAB 
101.PRE  XBRL Taxonomy Extension Presentation Linkbase Document 
______________________ 

XBRL Taxonomy Extension Label Linkbase Document 

 † 
 * 

Indicates a management contract or compensatory plan, contract or arrangement 
The certifications attached hereto as Exhibit 32.1 and Exhibit 32.2 are furnished with this 2017 Form 10-K and shall not 
be deemed “filed” by the Company for purposes of Section 18 of the Securities Exchange Act of 1934, as amended. 

Item 16. Form 10-K Summary  

None. 

55 

  
  
  
  
  
 
 
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 February 
27, 2018. 

SIGNATURES 

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 February 27, 2018. 

Signature 

  Title 

/s/ WILLIAM C. LUCIA 
William C. Lucia 

/s/ JEFFREY S. SHERMAN    
Jeffrey S. Sherman 

/s/ GREG D. AUNAN 
Greg D. Aunan 

/s/ ROBERT BECKER 
Robert Becker 

/s/ CRAIG R. CALLEN 
Craig R. Callen 

/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 

56 

  
  
  
  
  
  
  
  
  
  
  
  
  
    
 
  
  
  
  
  
  
  
  
  
  
  
  
  
    
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
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, 2017 and 2016  
Consolidated Statements of Income for the Years Ended December 31, 2017, 2016, and 2015  
Consolidated Statements of Shareholders’ Equity for the Years Ended December 31, 2017, 2016, and 2015  
Consolidated Statements of Cash Flows for the Years Ended December 31, 2017, 2016, and 2015  
Notes to the Consolidated Financial Statements  

Financial Statement Schedule: 
Schedule II - Valuation and Qualifying Accounts  

Page 
Number 

58 
61 
62 
63 
64 
65 

87 

57 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
Report of Independent Registered Public Accounting Firm 

Board of Directors and Shareholders 
HMS Holdings Corp. 

Opinion on the financial statements 
We have audited the accompanying consolidated balance sheet of HMS Holdings Corp. (a Delaware corporation) and subsidiaries 
(the “Company”) as of December 31, 2017, the related consolidated statements of income, changes in shareholders’ equity, and 
cash flows for the year ended December 31, 2017 and the related notes and schedule (collectively referred to as the “financial 
statements”). In our opinion, the financial statements present fairly, in all material respects, the financial position of the Company 
as of December 31, 2017, and the results of its operations and its cash flows for the year ended December 31, 2017, in conformity 
with accounting principles generally accepted in the United States of America. 

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) 
(“PCAOB”), the Company’s internal control over financial reporting as of December 31, 2017, based on criteria established in the 
2013 Internal Control—Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission 
(“COSO”), and our report dated February 27, 2018 expressed an unmodified opinion. 

Basis for opinion 
These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on 
the Company’s financial statements based on our audit. We are a public accounting firm registered with the PCAOB and are 
required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable 
rules and regulations of the Securities and Exchange Commission and the PCAOB. 

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the 
audit to obtain reasonable assurance about whether the financial statements are free of material misstatement, whether due to 
error or fraud. Our audit included performing procedures to assess the risks of material misstatement of the financial statements, 
whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a 
test basis, evidence supporting the amounts and disclosures in the financial statements. Our audit also included evaluating the 
accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the 
financial statements. We believe that our audit provides a reasonable basis for our opinion. 

We have served as the Company’s auditor since 2017. 

/s/ Grant Thornton LLP 
Grant Thornton LLP 
Dallas, Texas 
February 27, 2018 

58 

  
  
  
  
  
  
  
  
  
  
  
 
 
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 the related consolidated statements of income, shareholders’ equity, and cash flows for each of the years in the two-
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 the results of their operations and their cash flows for 
each  of  the  years  in  the  two-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. 

/s/ KPMG LLP 
KPMG LLP 
Dallas, Texas 
June 6, 2017 

59 

  
  
  
  
   
  
  
  
  
  
 
 
Report of Independent Registered Public Accounting Firm 

Board of Directors and Shareholders 
HMS Holdings Corp. 

Opinion on internal control over financial reporting 

We have audited the internal control over financial reporting of HMS Holdings Corp. (a Delaware corporation) and subsidiaries (the “Company”) 
as  of  December  31,  2017,  based  on  criteria  established  in  the  2013  Internal  Control—Integrated  Framework  issued  by  the  Committee  of 
Sponsoring Organizations of the Treadway Commission (“COSO”). In our opinion, the Company maintained, in all material respects, effective 
internal  control  over  financial  reporting  as  of  December  31,  2017,  based  on  criteria  established  in  the  2013  Internal  Control—Integrated 
Framework issued by COSO. 

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (“PCAOB”), the 
consolidated financial statements of the Company as of and for the year ended December 31, 2017, and our report dated February 27, 2018 
expressed an unqualified opinion on those financial statements. 

Basis for opinion 

The Company’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  Management’s  Report  on  Internal  Control  and  Financial  Reporting 
(“Management’s Report”). Our responsibility is to express an opinion on the Company’s internal control over financial reporting based on our 
audit.  We  are  a  public  accounting  firm  registered  with  the  PCAOB  and  are  required  to  be  independent  with  respect  to  the  Company  in 
accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the 
PCAOB. 

We conducted our audit in accordance with the standards of the PCAOB. 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, testing and 
evaluating the design and operating effectiveness of internal control based on the assessed risk, and performing such other procedures as we 
considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion. 

Our audit of, and opinion on, the Company’s internal control over financial reporting does not include the internal control over financial reporting 
of Eliza Holding Corp., a wholly-owned subsidiary, whose financial statements reflect total assets and revenues constituting twenty and six 
percent, respectively, of the related consolidated financial statement amounts as of and for the year ended December 31, 2017. As indicated 
in the accompanying Management’s Report, Eliza Holding Corp. was acquired during 2017. Management’s assertion on the effectiveness of 
the Company’s internal control over financial reporting excluded internal control over financial reporting of Eliza Holding Corp. 

Definition and limitations of internal control over financial reporting 

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  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. 

/s/ Grant Thornton LLP 
Grant Thornton LLP 
Dallas, Texas 
February 27, 2018 

60 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
HMS HOLDINGS CORP. AND SUBSIDIARIES 
CONSOLIDATED BALANCE SHEETS 
(in thousands, except share and per share amounts) 

Assets 
Current assets: 

Cash and cash equivalents 
Accounts receivable, net of allowance of $14,799 and $10,772, at December 31, 2017 and 

  $ 

83,313    $ 

175,999  

December 31, 
2017 

December 31, 
2016 

2016, respectively 

Prepaid expenses 
Income tax receivable 
Deferred financing costs, net 
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 
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 13) 

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; 96,536,251 shares 

issued and 83,256,858 shares outstanding at December 31, 2017; 95,966,852 shares 
issued and 83,552,774 shares outstanding at December 31, 2016 

Capital in excess of par value 
Retained earnings 
Treasury stock, at cost -- 13,279,393 shares at December 31, 2017 and 12,414,078 shares 

at December 31, 2016 

Total shareholders' equity 

  $ 

  $ 

189,460      
16,589      
1,892      
564      
836      
292,654      
98,581      
487,617      
91,482      
2,237      
2,589      
975,160    $ 

61,900    $ 
30,787      
92,687      

240,000      
21,989      
4,852      
9,403      
276,244      
368,931      

173,582  
13,699  
3,354  
-  
1,001  
367,635  
92,167  
379,716  
37,797  
2,790  
2,650  
882,755  

59,402  
30,755  
90,157  

197,796  
22,717  
5,427  
10,048  
235,988  
326,145  

-      

-  

965      
368,721      
366,164      

959  
345,025  
326,110  

(129,621)     

(115,484) 

606,229      

556,610  

Total liabilities and shareholders' equity 

  $ 

975,160    $ 

882,755  

See accompanying notes to the consolidated financial statements.  

61 

  
  
  
    
  
    
       
   
    
       
   
    
    
    
    
    
    
    
    
    
    
    
  
    
       
   
    
       
   
    
       
   
    
    
    
       
   
    
    
    
    
    
    
  
    
       
   
    
       
   
  
    
       
   
    
       
   
    
    
    
    
    
  
    
       
   
    
  
    
       
   
  
HMS HOLDINGS CORP. AND SUBSIDIARIES 
CONSOLIDATED STATEMENTS OF INCOME 
(in thousands, except per share amounts) 

Years Ended December 31, 
2016 

2017 

2015 

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: 

Net income per common share -- basic 

Diluted income per common share: 

Net income per common share -- diluted 

Weighted average shares: 

Basic 
Diluted 

  $ 

521,212    $ 

489,720    $ 

474,216  

202,049      
45,723      
17,190      
41,347      
28,425      
30,393      
365,127      
105,654      
470,781      
50,431      
(10,871)     
295      
39,855      
(199)     
40,054    $ 

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  

0.48    $ 

0.45    $ 

0.28  

0.47    $ 

0.43    $ 

0.28  

83,821      
85,088      

84,221      
86,987      

87,881  
88,361  

  $ 

  $ 

  $ 

See accompanying notes to the consolidated financial statements 

62 

  
  
  
  
  
  
    
    
  
    
       
       
   
    
    
    
    
    
    
    
    
    
    
    
    
    
    
  
    
       
       
   
    
       
       
   
    
       
       
   
    
       
       
   
    
    
  
  
 
 
HMS HOLDINGS CORP. AND SUBSIDIARIES 
CONSOLIDATED STATEMENTS OF SHAREHOLDERS’ EQUITY  
(in thousands except share and per share amounts) 

  Common Stock       

Treasury Stock 

Capital 
in 
Excess 
of Par 
Value     

# of 
Shares 
Issued 

Par 
Value    

   Amount     
   94,511,444   $  943    $ 313,214   $ 263,947     6,526,305    $ (45,014)   $ 

Retained 
Earnings    

# of 
Shares 

Total 
Shareholders' 
Equity 

Balance at January 1, 2015 

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     

-      
-       14,297     
-     
-      
4,180     
7      

-      
-      
-      24,527    
-    
-      
-      
-     4,747,441       (50,000)     
-      
-      
-    

174,458     

2      

(1,031)    

-     
-     

-     

-      
-      

1,569     
(827)    

-      

(1,112)    

-    

-    
-    

-    

-      

-      
-      

-      

-      

-      
-      

-      

533,090  

24,527  
14,297  
(50,000) 
4,187  

(1,029) 

1,569  
(827) 

(1,112) 

Balance at December 31, 2015 

   95,263,461   $  952    $ 330,290   $ 288,474    11,273,746    $ (95,014)   $ 

524,702  

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     

-      
-       13,277     
-     
-      
2,935     
5      

-      
-      
-      37,636    
-    
-      
-      
-     1,140,332       (20,470)     
-      
-      
-    

37,636  
13,277  
(20,470) 
2,940  

192,879     

2      

(1,477)    

-    

-      

-      

(1,475) 

Balance at December 31, 2016 

   95,966,852      959      345,025      326,110    12,414,078      (115,484)     

556,610  

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 

-     
-     
-     
172,326     

-      
-       24,143     
-     
-      
2,718     
2      

-      40,054    
-    
-    
-    

-      
-      

-      
-      
865,315       (14,137)     
-      

-      

40,054  
24,143  
(14,137) 
2,720  

397,073     

4      

(3,165)    

-    

-      

-      

(3,161) 

Balance at December 31, 2017 

   96,536,251   $  965    $ 368,721   $ 366,164    13,279,393    $(129,621)   $ 

606,229  

See accompanying notes to the consolidated financial statements. 

63 

  
  
     
   
      
  
  
 
   
  
  
   
      
       
      
     
       
       
   
   
   
   
   
   
   
   
   
  
   
      
       
      
     
       
       
   
  
   
      
       
      
     
       
       
   
   
   
   
   
   
  
   
      
       
      
     
       
       
   
  
   
      
       
      
     
       
       
   
   
   
   
   
   
  
   
      
       
      
     
       
       
   
  
  
 
 
HMS HOLDINGS CORP. AND SUBSIDIARIES 
CONSOLIDATED STATEMENTS OF CASH FLOWS 
(in thousands) 

Operating activities: 

Net income 

  $ 
Adjustments to reconcile net income to net cash provided by operating activities:     

40,054    $ 

37,636    $ 

24,527  

Years ended December 31, 
2016 

2015 

2017 

Depreciation and amortization of property, equipment and software 
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 acquisitions: 

Accounts receivable 
Prepaid expenses 
Prepaid income taxes 
Other current assets 
Other assets 
Income taxes receivable / (payable) 
Accounts payable, accrued expenses, deferred rent and other liabilities 
Estimated liability for appeals 
Net cash provided by operating activities 

Investing activities: 

Acquisition of a business, net of cash acquired 
Proceeds from sale of cost basis investment 
Purchases of property and equipment 
Investment in capitalized software 

Net cash used in investing activities 

Financing activities: 

Proceeds from credit facility 
Payments for deferred financing costs 
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 
Purchases of treasury stock 

Net cash provided by / (used in) financing activities 

Net (decrease) / 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: 

Change in balance of accrued property and equipment purchases 

27,515      
22,555      
2,258      
24,143      
(20,409)     
209      
(2,865)     

(6,976)     
(1,463)     
-      
165      
124      
1,462      
(340)     
32      
86,464      

(171,321)     
-      
(17,318)     
(15,725)     
(204,364)     

42,204      
(2,269)     
2,720      

(3,161)     
(143)     
(14,137)     
25,214      
(92,686)     

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  

175,999      
83,313    $ 

145,610      
175,999    $ 

133,116  
145,610  

17,995    $ 
9,944    $ 

20,326    $ 
6,196    $ 

22,878  
5,694  

51    $ 

684    $ 

729  

  $ 

  $ 
  $ 

  $ 

See accompanying notes to the consolidated financial statements. 

64 

  
  
  
  
  
  
    
    
  
    
       
       
   
       
       
   
    
    
    
    
    
    
    
    
       
       
   
    
    
    
    
    
    
    
    
    
    
       
       
   
    
    
    
    
    
    
       
       
   
    
    
    
    
    
    
    
    
    
       
       
   
    
  
    
       
       
   
    
       
       
   
  
    
       
       
   
    
       
       
   
  
  
 
 
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.  We  use  innovative  technology, 
extensive data services and powerful analytics to deliver coordination of benefits, payment integrity and care management and 
consumer engagement solutions to help healthcare payers improve financial performance and clinical 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 and consumer engagement technology helps risk-bearing organizations to better engage with and manage 
the care delivered to their members. Together these various services help customers recover erroneously paid amounts from 
liable third parties; prevent future improper payments; reduce fraud, waste and abuse; better manage the care their members 
receive; engage healthcare consumers to improve clinical outcomes while increasing member satisfaction and retention; and 
achieve regulatory compliance. We currently operate as one business segment with a single management team that reports to 
the Chief Executive Officer. 

(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  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)  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. 

(iv)  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. 

65 

  
  
  
  
  
 
  
  
 
  
  
 
  
  
 
  
  
  
 
 
(v)  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 which is 
typically five to ten years. 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 relate 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 
(in years) 
to 
to 
5 
to 
up to 39.5

3 
10 

10 

2 
5 

3 

Property and equipment is reviewed for impairment whenever events or changes in circumstances indicate that the carrying 
amount of the 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 and charged to earnings is measured 
by the amount by which the carrying value of the asset group exceeds the fair value of the assets. The Company did not 
recognize any impairment charges related to property and equipment during the years ended December 31, 2017, 2016 or 
2015. 

(vi)  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 Company determines fair value through various valuation 
techniques  including  discounted  cash  flow  models,  quoted  market  values  and  third  party  independent  appraisals,  as 
considered necessary. Significant assumptions used in those techniques 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 highly subjective and inherently uncertain and, as a result, actual results may differ materially 
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 names 
Intellectual property 

66 

Useful Life 
(in years) 
- 
- 
- 
- 

5 
1 
1.5 
3 

15 
3 
7 
5 

 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
  
  
  
  
  
  
  
  
  
 
 
Intangible assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount 
of the 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 and charged to earnings is measured by the 
amount by which the carrying value of the asset group exceeds the fair value of the assets. The Company did not recognize 
any impairment charges related to intangible assets during the years ended December 31, 2017, 2016 or 2015. 

(vii) 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. The Company 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. When the optional qualitative 
assessment of goodwill impairment is performed, significant judgment is required in the assessment of qualitative factors 
including but not limited to an evaluation of macroeconomic conditions as they relate to our business, industry and market 
trends, as well as the overall future financial performance of our reporting units and future opportunities in the markets in 
which they operate. 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  using  the  optional  qualitative  assessment,  then  the  Company  would  not  need  to 
perform the two-step impairment test. 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 the reporting unit with its carrying amount, including goodwill. The Company completed the 
annual impairment test as of June 30, 2017 using the optional qualitative assessment and determined no impairment existed. 
There were no impairment charges related to goodwill during the years ended December 31, 2017, 2016 or 2015. 

(viii)  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. 

67 

  
 
  
  
  
 
  
  
 
 
(ix)  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.  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. 

(x)  Estimated Liability for Appeals  

Under the Company’s contracts with certain commercial health plan customers and its Medicare RAC contracts with CMS, 
HMS recognizes revenue when HMS claim findings are sent to the Company’s customers for offset against future claim 
payments to providers. These contracts permit providers the right to appeal HMS claim findings and to pursue additional 
appeals if the initial appeal is found in favor of HMS’s customer. The appeal process established under the Medicare RAC 
contract with CMS includes five levels of appeals, and resolution of appeals can take substantial time to resolve. HMS records 
a) a liability for findings which have been adjudicated in favor of providers and b) an estimated liability based on the amount 
of  revenue  that  is  subject  to  appeals  and  which  are  probable  of  being  adjudicated  in  favor  of  providers  following  their 
successful appeal. The Company’s estimate is based on the Company’s historical experience. 

The  total  estimated  liability  for  appeals  balance  of  $30.8  million  as  of  December  31,  2017  and  December  31,  2016, 
respectively,  includes  $19.3  million  and  $17.3  million,  respectively,  of  Medicare  RAC  claim  findings  which  have  been 
adjudicated in favor of providers, and $8.5 million and $11.1 million, respectively, of the Company’s estimate of the potential 
amount of Medicare RAC repayments that are probable of being adjudicated in favor of providers following a successful 
appeal.  Additionally,  the  total  estimated  liability  for  appeals  balance  includes  $3.0  million  and  $2.4  million  related  to 
commercial customers claim appeals. The provision included in the estimated liability for appeals is an offset to revenue in 
the Company’s Consolidated Statements of Income. 

To  the  extent  the  amount  to  be  returned  to  providers  following  a  successful  appeal  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 modifications to the Medicare RAC contract, may require the Company to apply 
different assumptions that could materially affect both the Company’s revenue and estimated liability for appeals in future 
periods. 

68 

 
  
  
 
  
  
  
  
  
  
 
 
(xi)  Expense Classifications 

HMS cost of services is presented in the categories set forth below. Each category within cost of services excludes expenses 
relating to 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: 

  Compensation: Salary, fringe benefits, bonus and stock-based compensation. 
  Data processing: Hardware, software and data communication costs. 
  Occupancy: Rent, utilities, depreciation, office equipment and repair and maintenance costs. 
  Direct project expense: Variable costs incurred from third party providers that are directly associated with specific revenue

generating projects and employee travel expenses.  

  Other  operating  expenses:  Professional  fees,  temporary  staffing,  travel  and  entertainment,  insurance  and  local  and

property tax costs.  

  Amortization of acquisition related software and intangible assets: Amortization of the cost of acquisition related software

and intangible assets.  

SG&A:  

  Expenses related to general management, marketing and administrative activities.  

(xii) 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, 2017 and 2016, the accounts receivable balance was $189.5 million and $173.6 million, net of allowance of 
$14.8 million and $10.8 million, respectively. 

(xiii)  Stock-Based Compensation 

Long-Term Incentive Award Plans 

The  Company  grants  stock  options  and  restricted  stock  units  (“equity  awards”)  to  HMS  employees  and  non-employee 
directors under the 2016 Omnibus Plan, as 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. The number of securities remaining 
available for future issuance under equity compensation plans, excluding securities to be issued upon exercise of outstanding 
options and vesting of restricted stock units, is 6,031,554 shares. 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. The Company 
currently grants two types of equity awards: 1) equity awards with service conditions and 2) equity awards with market and 
service conditions. The market condition is based on the Company’s common stock price during the applicable measurement 
period. 

Stock-Based Compensation Expense 

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. 

69 

 
  
  
  
 
 
 
 
 
 
  
  
 
  
 
  
  
 
  
  
  
  
The fair value of each option grant with only service-based conditions is estimated using the Black-Scholes pricing model. 
The fair value of each option grant with market and service-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 options on the grant date using the Black-Scholes pricing model and/or the Monte 
Carlo simulation model 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. 

(xiv)  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: 

 
 
 

Level 1: Observable inputs such as quoted prices in active markets; 
Level 2: Inputs, other than the quoted prices in active markets, that are observable either directly or indirectly; and 
Level 3: Unobservable inputs in which there is little or no market data, which require the reporting entity to develop its
own assumptions. 

(xv) Leases 

HMS accounts for 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. 

(xvi)  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 
establishes 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. 

70 

  
  
 
  
  
 
 
 
  
 
  
  
 
  
   
 
 
(xvii) Recent Accounting Guidance 

Recently Adopted Accounting Guidance 

In April 2015, the FASB issued ASU No. 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, 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 September 2015, the FASB issued ASU No. 2015-16, Simplifying the Accounting for Measurement-Period Adjustments, 
(“ASU  2015-16”).  ASU  2015-16  eliminates  the  requirement  to  restate  prior  period  financial  statements  for  business 
combination  measurement  period  adjustments.  ASU  2015-16  requires  the  cumulative  impact  of  a  measurement  period 
adjustment, including the impact of prior periods, be recognized in the reporting period in which the adjustment is identified. 
The guidance requires an acquirer to present separately on the face of the income statement, or disclose in the notes, the 
portion of the adjustment recorded in current-period earnings by line item that would have been recorded in previous reporting 
periods, if the adjustment to the provisional amounts had been recognized as of the acquisition date. ASU 2015-16 is applied 
prospectively and is effective for public business entities for interim and annual periods beginning after December 15, 2015. 
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 No. 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.  The  Company  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 for the year ended December 31, 2015. 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 

71 

 
  
  
  
  
  
any the 2016 and 2015 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 No. 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. 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 will adopt ASU 2014-09 using the modified retrospective 
method.  The  Company,  with  the  assistance  of  external  consultants,  developed  and  followed  a  formal  implementation 
program,  which  included  analyzing  the  standard’s  impact  on  our  contract  portfolio,  comparing  our  historical  accounting 
policies and practices to the requirements of the new standard, and identifying differences from applying the requirements of 
the new standard to our contracts, We also developed transitional internal controls to ensure the adequate implementation 
of this guidance including, reporting on the progress of the implementation to those in charge of governance on a regular 
basis during the project’s duration. We have completed our assessment and contract review. Based on the analysis, the 
Company believes the impact of adopting the new guidance is not material to the results of operations; however, adoption of 
this guidance will require changes to business processes and systems to support the new revenue recognition accounting 
and  additional  required  disclosures.  The  Company  does  not  anticipate  that  our  internal  control  framework  will  materially 
change, but rather that existing internal controls will be modified and augmented as necessary. 

In February 2016, the FASB issued ASU No. 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 of adopting this guidance. The Company 
does not expect this guidance to have a material impact to the Company’s results of operations. 

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”). ASU 2016-15 clarifies where certain cash receipts and cash payments are 
presented and classified in the statement of cash flows. The amendments are effective for annual reporting periods beginning 
after December 15, 2017, and for interim reporting periods within such annual periods. The adoption of this guidance is not 
expected to have a material effect on the Company’s consolidated 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 adoption of this guidance is not expected to have a material 
effect on the Company’s consolidated financial statements. 

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 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 

72 

  
  
  
  
  
  
1, 2017. The Company does not expect this guidance to have a material impact to the Company’s financial position or results 
of operations. 

In May 2017, the FASB issued ASU No. 2017-09, Compensation – Stock Compensation (Topic 718): Scope of Modification 
Accounting, (“ASU 2017-09”). ASU 2017-09 requires entities to apply modification accounting to changes made to a share-
based payment award. The new guidance specifies that entities will apply modification accounting to changes to a share-
based payment award only if any of the following are not the same immediately before and after the change: 1) The award’s 
fair value (or calculated value or intrinsic value, if those measurement methods are used), 2) the award’s vesting conditions, 
and 3) the award’s classification as an equity or liability instrument. ASU 2017-09 is effective for annual reporting periods 
beginning after December 15, 2017, including interim periods within such annual periods, with early adoption permitted. The 
Company does not plan to early adopt this guidance and therefore will adopt on January 1, 2018. The Company does not 
expect this guidance to have a material impact to the Company’s financial position or results of operations. 

2.  

  Fair Value of Financial Instruments 

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, which due to the variable interest rate associated with the revolving credit facility, cost approximates its 
fair value. The Company has no Level 1 or Level 2 financial instruments and there were no transfers between Level 1 or Level 2 
financial  instruments.  Included  in  Other  liabilities  on  the  Consolidated  Balance  Sheets  at  December  31,  2017  is  a  $35,000 
contingent  consideration  liability  classified  as  Level  3.  The  liability  is  valued  using  a  Monte  Carlo  simulation  and  includes 
unobservable inputs such as expected levels of revenues and discount rates. Changes in the unobservable inputs in the fair value 
measurement of this instrument could result in a significant change in the fair value measurement. 

The following table summarizes the changes in fair value for all financial instruments measured at fair value on a recurring basis 
using significant unobservable inputs (Level 3) (in thousands): 

Beginning balance as of January 1, 2016 

Sales 
Settlements 
Purchases 
Issuances 
Net (gains)/losses included in selling, general and administrative expenses 
Transfers into Level 3 
Transfers out of Level 3 

Ending balance as of December 31, 2016 

Sales 
Settlements 
Purchases 
Issuances 
Net (gains)/losses included in selling, general and administrative expenses 
Transfers into Level 3 
Transfers out of Level 3 

Ending balance as of December 31, 2017 

-   
-  
-  
-  
2,900  
-  
-  
-  
2,900  
-  
-  
-  
-  
(2,865) 
-  
-  
35  

  $ 

  $ 

73 

  
  
  
  
  
  
    
    
    
    
    
    
    
    
    
    
    
    
    
    
  
 
 
3. 

  Acquisitions 

(a) 

  Eliza Holding Corp. 

On April 17, 2017, the Company completed the acquisition of 100% of the outstanding capital stock of Eliza, for a preliminary 
purchase price of $171.6 million funded with available liquidity of approximately 75% cash on hand and 25% from the Company’s 
existing  credit  line.  Eliza  is  a  cloud  based  technology  platform  which  provides  comprehensive  and  personalized  health 
engagement solutions designed to improve clinical outcomes and reduce costs. Eliza reaches and engages members through a 
proprietary, scalable technology solution that leverages a multi-channel communications platform incorporating consumer and 
proprietary data sources, analytics, and behavior-driven program design to help clients achieve desired outcomes. 

The purchase price was subject to certain post-closing purchase price adjustments and the initial purchase price allocation as of 
the date of acquisition was based on a preliminary valuation. Estimates and assumptions for which the Company is still obtaining 
or  evaluating  information  are  subject  to  change  up  to  one  year  from  the  acquisition  date  as  additional  information  becomes 
available and adjustments may require a change in the amounts allocated to goodwill during the periods in which the adjustments 
are  determined. 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 taxable 
purposes. As such, the Company recorded a net deferred tax liability which is comprised of deferred tax liabilities recognized in 
connection with the acquired intangible assets partially offset by deferred tax assets associated with acquired net operating loss 
carryforwards and credits. Goodwill was determined based on the difference between the purchase price and the fair values of 
the tangible and intangible assets acquired. Goodwill recognized from the acquisition was a result of synergies to be realized from 
future revenue growth is not deductible for tax purposes, has an indefinite useful life and will be included in the Company’s annual 
impairment testing or between annual tests if an indicator of impairment exists. 

During the third and fourth quarters of fiscal 2017, the Company made adjustments to the preliminary purchase price allocation 
which resulted in an increase of $8.9 million to the fair value of acquired intangible assets, a decrease of $1.8 million to the fair 
value of the acquired tangible assets, an increase of $3.6 million to the deferred tax liability associated with the acquired intangible 
assets and a decrease of $3.5 million to goodwill. The Company also changed the estimated useful life of the acquired customer 
relationships intangible asset from 36 years to 15 years. The updated allocation of the purchase price to the fair value of the 
assets acquired and the liabilities assumed as of April 17, 2017, the effective date of the acquisition, is as follows (in thousands): 

Cash and cash equivalents 
Accounts receivable 
Prepaid expenses 
Property and equipment 
Intangible assets 
Goodwill 
Other assets 
Accounts payable 
Deferred tax liability 
Other liabilities 
Total purchase price 

  $ 

  $ 

435  
8,902  
1,427  
1,146  
76,240  
107,754  
63  
(2,620) 
(19,681) 
(2,057) 
171,609  

74 

  
  
  
  
  
    
    
    
    
    
    
    
    
    
  
 
 
The purchase price allocated to the intangibles acquired was as follows (in thousands): 

Customer relationships 
Intellectual property 
Trade name 
Restrictive covenants 
Fair value of intangibles acquired 

Useful Life 
(in years) 
15  
6  
1.5  
1  

Acquisition costs recorded to selling, general and administrative expenses were as follows (in thousands): 

Other operating expenses - consulting fees 
Other operating expenses - legal fees 
Other operating expenses - transaction costs 
Acquisition-related costs 

  $ 

  $ 

  $ 

  $ 

56,200  
19,600  
310  
130  
76,240  

3,515  
832  
185  
4,532  

The financial results of Eliza have been included in the Company’s consolidated financial statements since the date of acquisition. 
Eliza  contributed  approximately  $30.4  million  in  revenue  to  HMS  results  of  operations  from  the  date  of  acquisition  through 
December 31, 2017. 

(b) 

  Essette 

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 purchase price was 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 of $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. In the second quarter of 2017, the Company recorded a final working 
capital adjustment of $147,000 to goodwill. 

The  immaterial  results  of  Essette’s  operations  since  September  2,  2016  have  been  included  in  the  Company’s  consolidated 
financial statements. 

75 

  
  
  
    
  
  
  
    
  
    
  
    
  
  
  
  
    
    
  
  
  
  
  
  
 
 
As a result of the Eliza acquisition and subsequent adjustment related to Essette, the changes in the carrying amount of goodwill 
were as follows (in thousands): 

Balance at December 31, 2017 

Eliza acquisition 
Essette adjustment 

Balance at December 31, 2016 

Essette acquisition 

Balance at December 30, 2015 

4. 

  Property and Equipment 

Property and equipment consisted of the following (in thousands): 

Equipment 
Leasehold improvements 
Building 
Building improvements 
Land 
Furniture and fixtures 
Capitalized software 

Less: accumulated depreciation and amortization 
Property and equipment, net 

  $ 

  $ 

  $ 

487,617  
107,754  
147  
379,716  
18,248  
361,468  

December 31, 

2017 

2016 

  $ 

  $ 

106,768    $ 
8,357      
8,624      
14,546      
2,769      
10,352      
125,655      
277,071      
(178,490)     
98,581    $ 

94,345  
8,637  
8,624  
12,671  
2,769  
10,728  
110,696  
248,470  
(156,303) 
92,167  

(in thousands) 
Depreciation and amortization expense related to property and 

2017 

December 31, 
2016 

2015 

equipment 

  $ 

27,515    $ 

24,882    $ 

30,328  

76 

  
    
    
    
  
  
  
  
  
  
  
  
    
  
    
    
    
    
    
    
  
    
    
  
  
  
  
  
    
    
  
  
 
  
 
 
5. 

  Intangible Assets 

Intangible assets consisted of the following (in thousands): 

December 31, 2017 

Customer relationships 
Trade names 
Intellectual property 
Restrictive covenants 

Total 

December 31, 2016 

Customer relationships 
Trade names 
Intellectual property 
Restrictive covenants 

Total 

Gross Carrying 
Amount 

Accumulated  
Amortization      

Net Carrying 
Amount 

Weighted 
Average 
Amortization 
Period  
(in years) 

  $ 

  $ 

159,290    $ 
16,246      
21,700      
263      
197,499    $ 

(89,106)   $ 
(13,916)     
(2,874)     
(121)     
(106,017)   $ 

70,184       
2,330       
18,826       
142       
91,482       

11.3 
1 
5.2 
1.3 
18.6 

Gross Carrying 
Amount 

Accumulated  
Amortization      

Net Carrying 
Amount 

Weighted 
Average 
Amortization 
Period  
(in years) 

  $ 

  $ 

103,090    $ 
15,936      
2,100      
133      
121,259    $ 

(71,914)   $ 
(11,393)     
(140)     
(15)     
(83,462)   $ 

31,176       
4,543       
1,960       
118       
37,797       

11.3 
1 
5.2 
1.3 
18.6 

Amortization expense of intangible assets is expected to approximate the following (in thousands): 

Year ending December 31, 
2018 
2019 
2020 
2021 
2022 
Thereafter 
Total 

  $ 

  $ 

23,858  
9,258  
7,804  
7,477  
7,197  
35,888  
91,482  

For the years ended December 31, 2017, 2016 and 2015, amortization expense related to intangible assets was $22.6 million, 
$20.2 million and $20.3 million, respectively. 

6. 

  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 

77 

December 31, 
2017 

December 31,  
2016 

  $ 

  $ 

19,330    $ 
24,072      
18,498      
61,900    $ 

13,847  
28,507  
17,048  
59,402  

  
  
  
  
    
    
  
    
       
       
        
  
  
  
    
  
    
  
    
  
  
  
  
  
    
    
  
    
       
       
        
  
  
  
    
  
    
  
    
  
  
  
  
    
  
    
    
    
    
    
  
  
  
  
  
  
    
  
    
    
7. 

  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 

2017 

December 31, 
2016 

2015 

  $ 

  $ 

17,008    $ 
3,201      
20,209      

(19,425)     
(983)     
(20,408)     
(199)   $ 

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  

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): 

December 31, 
     2016       % 

     % 

   2017 
  $ 13,949       35.0    $17,315       35.0    $13,934       35.0  
Computed at federal statutory rate 
2.6  
     2,226      
State and local tax expense, net of federal benefit 
Net permanent deduction and credit tax benefits from prior years 
-      
-       (6,213)      (12.6)     
-  
Net permanent deduction and credit tax benefits from current year      (1,513)     
-  
(3.1)     
Tax Reform - Revaluation of Deferrals 
    (15,130)      (38.0)     
-  
-      
Acquisition adjustments 
     (1,003)     
-  
-      
(2.5)     
Acquisition costs 
-  
0.4      
1.7      
697      
Other, net 
1.5      
575      
0.8  
(0.8)     
(199)     
Total income tax expense 
(0.5)   $11,835       23.9    $15,282       38.4  

5.0       1,038      
-      
-      
-      
-      
-      
310      

(3.8)      (1,509)     
-      
-      
203      
(409)     

     2015       % 

5.6       2,448      

  $

The Company’s effective tax rate decreased to (0.5%) for the year ended December 31, 2017 from 23.9% for the year ended 
December 31, 2016, primarily due to the revaluation of the Company’s deferred tax balances from the federal tax rate reduction 
of 35% to 21% under the 2017 Tax Act which was signed into law on December 22, 2017. The net benefits for the 2017 Tax Act 
as recorded as provisional amounts as of December 31, 2017, represent the Company's best estimate using information available 
to the Company as of February 27, 2018. The Company anticipates U.S. regulatory agencies will issue further regulations over 
the next year which may alter this estimate. The Company is still evaluating, among other things, the application of limitations for 
executive  compensation  related  to  contracts  existing  prior  to  November  2,  2017.  The  Company  will  refine  its  estimates  to 
incorporate new or better information as it comes available through the filing date of its 2017 U.S. income tax returns in the fourth 
quarter of 2018. 

As a result of an analysis performed during 2016, the Company determined certain activities it performs qualify for (i) R&D Credits 
provided in IRC Section 41 and (ii) the Section 199 Deduction provided in IRC Section 199. As a result, the Company recognized 
net tax benefits during the year ended December 31, 2016 of $6.2 million for federal and state R&D Credits and the Section 199 
Deduction relating to tax years 2012 through 2015. 

78 

  
  
  
  
  
  
  
    
    
  
    
       
       
   
    
    
    
       
       
   
    
    
    
  
  
  
  
  
  
  
    
    
    
  
  
  
 
 
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): 

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 
Tax credit carry-forwards 
Property and equipment 
Accrued expenses and other 

Total deferred tax assets 
Deferred tax liabilities: 

Goodwill and intangible assets 
Section 481(a) adjustment 
Prepaid expenses 
Capitalized software cost 
Total deferred tax liabilities 
Total net deferred tax liabilities 

December 31, 

2017 

2016 

  $ 

  $ 

9,980    $ 
6,524      
3,822      
909      
669      
7,775      
3,358      
3,667      
256      
3,615      
40,575      

48,186      
7,413      
624      
6,341      
62,564      
21,989    $ 

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  

Included  in  Other  liabilities  on  the  Consolidated  Balance  Sheets,  are  the  total  amount  of  unrecognized  tax  benefits  of 
approximately $8.2 million and $7.4 million as of December 31, 2017 and 2016, 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 at both December 31, 2017 and 2016. 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, 2017, 2016 and 2015 was $0.02 million, 
$0.2  million  and  $0.6  million,  respectively.  The  Company  believes  it  is  reasonably  possible  the  amount  of  unrecognized  tax 
benefits may decrease by $1.8 million during 2018, due to the expiration of the statute of limitations in various jurisdictions. 

A reconciliation of the beginning and ending amounts of unrecognized tax benefits are as follows (in thousands): 

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 

December 31, 

2017 

2016 

  $ 

  $ 

7,433    $ 
599      
1,174      
(972)     
8,234    $ 

1,329  
763  
5,931  
(590) 
7,433  

The Company increased the provision for unrecognized tax benefits by $1.2 million during the year ended December 31, 2017, 
related to tax benefits recognized associated with R&D Credits and the Section 199 Deduction for all open tax years. 

79 

  
  
  
  
  
  
    
  
    
       
   
    
    
    
    
    
    
    
    
    
    
    
       
   
    
    
    
    
    
  
  
  
  
  
  
  
  
    
  
    
    
    
  
  
 
 
At December 31, 2017, HMS had federal and state pre-tax net operating loss and tax credit carryforwards of approximately $34.1 
million and $3.7 million, respectively, which will be available to offset future taxable income. If not used, these net operating loss 
and tax credit carryforwards will begin to expire in 2021 and 2019, respectively. The Company files income tax returns with the 
U.S. Federal government and various state jurisdictions. HMS is no longer subject to U.S. Federal income tax examinations for 
years before 2012. The Company is currently under  audit  by the Internal Revenue Service for years  2013  and  2014 and  no 
assessments have been received. HMS operates in a number of state and local jurisdictions. Accordingly, HMS is subject to state 
and local income tax examinations based upon the various statutes of limitations in each jurisdiction. Previously recognized Texas 
refund claims are currently being examined by the state. The Company is currently being examined by the State of Illinois and 
has received preliminary assessments of an immaterial amount which the Company is reviewing. 

8. 

  Credit Agreement 

On December 19, 2017, the Company entered into an amendment to the Credit Agreement, which, among other things, extended 
the maturity of its then existing revolving credit facility by five years to December 2022. The availability of funds under the Amended 
Revolving Facility includes sublimits for (a) up to $50 million for the issuance of letters of credit and (b) up to $25 million for 
swingline loans. In addition, the Company may increase the commitments under the Amended Revolving Facility and/or add one 
or more incremental term loan facilities, provided that such incremental facilities do not exceed in the aggregate the sum of (i) the 
greater of $120 million and 100% of Consolidated EBITDA (as defined in the Credit Agreement) and (ii) an additional amount so 
long as our first lien leverage ratio (as defined in the Credit Agreement) on a pro forma basis is not greater than 3.00:1.00, subject 
to obtaining commitments from lenders therefor and meeting certain other conditions. 

During the year ended December 31, 2016, no principal payments were made against the Company’s then existing revolving 
credit facility. As of December 31, 2017, the outstanding principal balance due on the Amended Revolving Facility was $240.0 
million. 

Borrowings under the Amended Revolving Facility will bear interest at a rate equal to, at the Company’s election (except with 
respect to swingline borrowings, which will accrue interest based only at the base rate), either: 

  

  

a base rate determined by reference to the greatest of (a) the prime or base commercial lending rate of the administrative
agent as in effect on the relevant date, (b) the federal funds effective rate plus 0.50% and (c) the one-month LIBO rate plus 
1.00%, plus an interest margin ranging from 0.50% to 1.00% based on the Company’s consolidated leverage ratio for the
applicable period; or  

an adjusted LIBO rate, equal to the LIBO rate for the applicable interest period multiplied by the statutory reserve rate (equal 
to (x) one divided by (y) one minus the aggregate of the  maximum reserve percentage (including any marginal, special,
emergency or supplemental reserves) established by the Board of Governors of the Federal Reserve System of the United
States), plus an interest margin ranging from 1.50% to 2.00% based on the Company’s consolidated leverage ratio for the
applicable period. 

In  addition  to  paying  interest  on  the  outstanding  principal,  the  Company  is  required  to  pay  unused  commitment  fees  on  the 
revolving  credit  facility  during  the  term  of  the  Credit  Agreement  ranging  from  0.375%  to  0.250%  per  annum  based  on  the 
Company’s consolidated leverage ratio and letter of credit fees equal to 0.125% per annum on the aggregate face amount of each 
letter of credit, as well as customary agency fees. 

The Amended Revolving Facility is secured, subject to certain customary carve-outs and exceptions, by a first priority lien and 
security interest in substantially all tangible and intangible assets of the Company and certain subsidiaries of the Company. The 
Amended Revolving Facility contains certain restrictive covenants, which affect, among other things, the ability of the Company 
and its subsidiaries to incur indebtedness, create liens, make investments, sell or otherwise dispose of assets, engage in mergers 
or  consolidations  with  other  entities,  and  pay  dividends  or  repurchase  stock.  The  Company  is  also  required  to  comply,  on  a 
quarterly basis, with two financial covenants: (i) a minimum interest coverage ratio of 3:00:1:00, and (ii) a maximum consolidated 
leverage ratio of 4.75:1.00 through December 2019 and 4.25:1.00 from and after January 2020. The consolidated leverage ratio 
is subject to a step-up to 5.25:1.00 for four full consecutive fiscal quarters following a permitted acquisition or similar investment. 
As of December 31, 2017, the Company was in compliance with all terms of the Credit Agreement. 

80 

  
  
  
  
  
  
  
  
  
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 

December 31, 

  $ 
  $ 

2017    
7,170    $ 
1,359    $ 

2016    
4,837    $ 
1,518    $ 

2015   
4,117  
1,513  

The  Company  deferred  $2.3  million  of financing fees  associated  with the amendment.  At December  31,  2017 and  2016, the 
unamortized balance of deferred financing costs was $2.8 million, in both periods. The Company amortized deferred financing 
costs of $2.3 million in in the year ended December 31, 2017 and $2.1 million in in the years ended December 31, 2016 and 2015. 

As part of a contractual agreement with a customer, the Company has an outstanding irrevocable letter of credit for $5.4 million, 
which is issued against the Amended Revolving Facility and expires April 26, 2018. 

9. 

  Equity 

(a) Share Repurchase 

On November 1, 2017, the Board of Directors of the Company approved a share repurchase program authorizing the Company 
to repurchase up to $50.0 million in shares of its common stock from time to time on the open market or in privately negotiated or 
other transactions. The repurchase program is authorized for a period of up to two years, and may be suspended or discontinued 
at any time. Repurchased shares will be available for use in connection with reissuance under the Company’s stock plans and for 
other  corporate  purposes.  The  timing  and  amount  of  any  shares  repurchased  under  the  program  will  be  determined  by  the 
Company’s  management  based  on  its  evaluation  of  market  conditions,  share  price  and  other  factors.  In  order  to  facilitate 
repurchases, the Company may enter into a Rule 10b5-1 plan from time to time, which would permit shares to be repurchased 
when the Company might otherwise be precluded from doing so under insider trading laws or because of a self-imposed trading 
blackout period. All repurchases in fiscal year 2017 were made in the fourth quarter. All repurchases for the periods presented 
were made under the program and using cash resources. 

Following are the Company’s monthly stock repurchases for the fourth quarter of fiscal year 2017, all of which were made as part 
of publicly announced plans or programs: 

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 

Total Number 
of Shares 
Purchased      

Average Price 
Paid Per 
Share 

—    $ 
674,813      
190,502      
865,315    $ 

—      
16.23      
16.61      
16.33      

—    $ 
674,813      
190,502      
865,315      

—  
39,044,882  
35,880,666  

Period 
October 1, 2017 to October 31, 2017 
November 1, 2017 to November 30, 2017 
December 1, 2017 to December 31, 2017 
October 1, 2017 to December 31, 2017 

(1)  Represents shares repurchased through the Company’s Share Repurchase Program publicly announced in November 2017. 

81 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
    
    
  
    
    
    
    
   
  
  
 
 
(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, 2017, no preferred stock had been issued. 

10. 

  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  2017,  2016  and  2015,  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, 2017, 2016 and 2015, HMS contributed $5.9 million, $4.8 million and $4.8 million, respectively, 
to the 401(k) Plan in the form of matching contributions. 

11. 

  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, 

2017    
7,354    $ 
16,789      
24,143    $ 

2016    
3,805    $ 
9,472      
13,277    $ 

  $ 

  $ 

2015   
6,242  
8,055  
14,297  

Stock-based compensation expense related to stock options was approximately $10.3 million, $6.9 million and $6.4 million for the 
years ended December 31, 2017, 2016 and 2015, respectively. 

82 

  
  
  
  
  
  
  
  
  
  
  
  
  
    
  
  
  
  
 
 
Presented below is a summary of stock option activity for the year ended December 31, 2017 (in thousands except for weighted 
average exercise price and weighted average remaining contractual terms): 

Outstanding balance at December 31, 2016 

Granted 
Exercised 
Forfeitures 
Expired 

Outstanding balance at December 31, 2017 

Expected to vest at December 31, 2017 
Exercisable at December 31, 2017 

Number of

Options    

5,191    $ 
1,003      
(172)     
(146)     
(322)     
5,554      

1,543      
3,180    $ 

Weighted
Average
Exercise

Price    
17.35      
18.91      
15.96      
16.09      
22.34      
17.35      

16.14      
18.24      

Weighted
Average
Remaining
Contractual

Terms    

Aggregate 
Intrinsic 
Value   

5.00    $ 

8,274  

6.64      
3.77    $ 

2,489  
4,663  

As of December 31, 2017 and 2016, the company had 2,372,682 and 3,039,844, respectively, in unvested options with a weighted-
average-grant-date fair value of $6.39 and $5.70, respectively. The weighted average grant date fair value per share of the stock 
options granted during the years ended December 31, 2017, 2016 and 2015 was $7.66, $5.55 and $5.37, respectively. HMS 
estimated the fair value of each stock option grant on the date of grant using a Black-Scholes option pricing model. Weighted–
average assumptions are set forth in the following table: 

Expected dividend yield 
Risk-free interest rate 
Expected volatility 
Expected life (years) 

Expected dividend yield 
Risk-free interest rate 
Expected volatility 
Expected life (years) 

December 31, 
2016 

-        
1.2 %    
44.0 %    
4.9        

December 31, 
2016 

-        
1.6 %    
40.5 %    
4.9        

2017     
-       
1.8%     
44.2%     
5.0       

2017     
-       
2.2%     
52.5%     
6.5       

2015  
-   
1.5 %
40.6 %
4.9   

2015  
-   
2.0 %
39.6 %
4.9   

HMS  estimated  the  fair  value  of  market  condition  option  grants  on  the  date  of  grant  using  a  Monte-Carlo  simulation  model. 
Assumptions are set forth in the following table: 

During  the  years  ended  December  31,  2017,  2016  and  2015,  the  Company  issued  172,326,  510,512  and  577,559  shares, 
respectively, of the Company’s common stock upon the exercise of outstanding stock options and received proceeds of $2.7 
million, $2.9 million and $4.2 million, respectively. The total intrinsic value of stock options exercised during the years ended 
December 31, 2017, 2016 and 2015 was $0.5 million, $6.3 million and $5.9 million, respectively. 

As of December 31, 2017, there was approximately $8.4 million of total unrecognized compensation cost related to stock options 
outstanding, which is expected to be recognized over a weighted average period of 2.11 years. 

The total tax benefits recognized on stock-based compensation for the years ended December 31, 2017, 2016 and 2015 was 
$4.0 million, $4.1 million and $3.4 million, respectively. 

83 

  
  
  
    
       
   
    
       
   
    
       
   
    
       
   
    
       
   
    
  
    
       
       
       
   
    
    
  
  
  
  
  
  
  
     
    
    
    
    
  
  
  
  
  
  
  
     
    
    
    
    
  
  
  
  
 
 
Restricted Stock Units 

Stock-based compensation expense related to restricted stock units was $13.8 million, $6.4 million and $7.9 million for the years 
ended December 31, 2017, 2016 and 2015, respectively. 

Presented below is a summary of restricted stock units activity for the year ended December 31, 2017 (in thousands, except for 
weighted average grant date fair value per unit): 

Outstanding balance at December 31, 2016 
Granted 
Vesting of restricted stock units, net of units withheld for taxes 
Units withheld for taxes 
Forfeitures 
Outstanding balance at December 31, 2017 

Number of 

Weighted 
Average 
Grant Date Fair 
Value per Unit   
16.44  
18.86  
15.39  
15.39  
15.37  
17.65  

Units    
1,413    $ 
612      
(397)     
(172)     
(110)     
1,346    $ 

As of December 31, 2017, approximately 1,117,245 restricted stock units remained unvested and there was approximately $10.0 
million of unrecognized compensation cost related to restricted stock units, which is expected to be recognized over a weighted 
average vesting period of 0.83 years. 

12. 

  Earnings per Share 

The following table sets forth the computation of basic and diluted earnings per share (in thousands, except per share data): 

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 

Years ended December 31, 

2017    
40,054    $ 

83,821      
1,267      
85,088      
0.48    $ 
0.47    $ 

2016    
37,636    $ 

84,221      
2,766      
86,987      
0.45    $ 
0.43    $ 

2015   
24,527  

87,881  
480  
88,361  
0.28  
0.28  

  $ 

  $ 
  $ 

For the years ended December 31, 2017, 2016 and 2015: (i) 2,646,100, 2,070,771 and 3,480,458 stock options, respectively, and 
(ii) restricted stock units representing 31,155, 46,651 and 305,999 shares of common stock, respectively, were not included in the 
diluted earnings per share calculation because the effect would have been anti-dilutive. 

13. 

  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 immaterial sublease income, 
for the years ended December 31, 2017, 2016 and 2015 was $5.1 million, $5.0 million and $5.4 million, respectively. 

84 

  
  
  
  
  
    
    
    
    
    
    
  
  
  
  
  
  
  
  
  
  
    
       
       
   
    
    
    
  
  
  
  
  
 
 
Minimum annual lease payments to be made under operating leases, net of nominal sublease payments to be received and 
exclusive nominal capital leases, for each of the next five years ending December 31 and thereafter are as follows (in thousands): 

2018 
2019 
2020 
2021 
2022 
Thereafter 
Total 

(b) Litigation  

Operating 
Lease 
Payments 

  $ 

  $ 

6,393  
3,509  
3,183  
2,081  
1,836  
2,936  
19,938  

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.  In  June  2016,  Kern  Health  Systems  and  AMG  entered  into  a  settlement  agreement  that  resolved  all  claims  in  the 
California Action. In July 2017, the Court issued a decision on the Company’s motion for partial summary judgment and granted 
the motion in part, dismissing one of Plaintiffs’ breach of contract causes of action against HMS. On November 3, 2017, following 
a jury trial, a verdict was returned in favor of the Plaintiffs on a breach of contract claim, and the jury awarded $60 million in 
damages  to  the  Plaintiffs.  On  November  20,  2017,  the  Company  filed  a  post-trial  motion  for  an  order  granting  it  judgment 
notwithstanding the verdict or, alternatively, setting aside the jury’s award of damages. A hearing on the motion is set for March 
2018. The Company continues to believe that strong grounds exist to overturn or greatly reduce the damages awarded by the 
jury. In light of the Company’s belief that the jury award was unsupportable as a matter of law, the Company has not recorded a 
reserve for this pending litigation. HMS will continue to monitor developments in assessing the probability and measurability of 
any related loss contingency. 

In February 2018, the Company received a Civil Investigative Demand from the Texas Attorney General, purporting to investigate 
possible unspecified violations of the Texas Medicaid Fraud Prevention Act. HMS intends to cooperate with the investigation. 

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. 

85 

  
  
  
  
    
    
    
    
    
  
  
  
  
  
14. 

  Customer Concentration 

(a) Geographic Information 

The Company operates within the United States. 

(b) Major Customers 

For the years ended December 31, 2017, 2016 and 2015 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, 2017, 2016 
and 2015, the Company’s ten largest customers represented 39.5%, 40.6% and 44.0% of HMS’ total revenue, respectively. The 
Company’s agreements with the ten current largest customers expire between 2018 and 2023. 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. 

15. 

  Subsequent Events 

Annual Grants to Employees  

On February 15, 2018, the Compensation Committee of the Board of Directors approved approximately $18.6 million in stock 
option and restricted stock unit awards to employees. The awards generally will vest over three years and will be issued three 
business days subsequent to the filing of this 2017 Form 10-K. 

In connection with the preparation of our consolidated financial statements, an evaluation of subsequent events was performed 
through the date of filing and there were no events that have occurred that would require adjustments to the financial statements 
or disclosure. 

16. 

  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): 

2017 
Revenue 
Operating income 
Net income 
Net income per common share - basic 
Net income per common share - diluted 

2016 
Revenue 
Operating income 
Net income 
Net income per common share - basic 
Net income per common share - diluted 

  $ 
  $ 
  $ 
  $ 
  $ 

  $ 
  $ 
  $ 
  $ 
  $ 

First 
Quarter 

Second  
Quarter 

Third 
Quarter 

Fourth 
Quarter 

113,733     $ 
3,943     $ 
1,442     $ 
0.02     $ 
0.02     $ 

133,313    $ 
14,361    $ 
6,517    $ 
0.08    $ 
0.08    $ 

125,673    $ 
12,861    $ 
6,372    $ 
0.08    $ 
0.07    $ 

First 
Quarter 

Second  
Quarter 

Third 
Quarter 

Fourth 
Quarter 

119,763     $ 
9,909     $ 
4,570     $ 
0.05     $ 
0.05     $ 

123,550    $ 
16,352    $ 
9,869    $ 
0.12    $ 
0.11    $ 

124,604    $ 
12,650    $ 
14,046    $ 
0.17    $ 
0.16    $ 

86 

     Year Ended   
521,212  
50,431  
40,054  
0.48  
0.47  

148,493    $ 
19,266    $ 
25,723    $ 
0.30    $ 
0.30    $ 

     Year Ended   
489,720  
57,669  
37,636  
0.45  
0.43  

125,590    $ 
18,758    $ 
9,151    $ 
0.11    $ 
0.11    $ 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
    
    
    
  
  
    
    
    
  
 
 
Balance at 
End of Year   
11,464  
10,772  
14,799  

(5,841)   $ 
(22,383)   $ 
(16,206)   $ 

Appeals 
found in 
providers 
favor 

Balance at 
End of Year   
12,801  
11,126  
8,544  

(9,123)   $ 
(2,396)   $ 
(2,665)   $ 

SCHEDULE II – VALUATION AND QUALIFYING ACCOUNTS 
For the years ended December 31, 2017, 2016 and 2015 

Accounts receivable allowance and Estimated liability for appeals as of December 31, 2017, 2016 and 2015 are as follows: 

Accounts receivable allowance (in thousands): 

Balance at 
Beginning of 
Year 

     Provision 

     Recoveries       Charge-offs     

Year ended December 31, 2015 
Year ended December 31, 2016 
Year ended December 31, 2017 

  $ 
  $ 
  $ 

9,359       
11,464       
10,772       

8,046      
21,583      
20,233      

(100)     
108      
-      

Estimated liability for appeals (in thousands): 

Year ended December 31, 2015 
Year ended December 31, 2016 
Year ended December 31, 2017 

Balance at 
Beginning of 
Year 

     Provision 

  $ 
  $ 
  $ 

19,314       
12,801       
11,126       

2,610      
721      
83      

The above chart represents the CMS estimated reserve liability only. 

87 

  
  
  
  
  
  
  
  
  
  
    
    
  
  
  
  
  
  
  
 
Board of Directors:

Executive Officers: 

Robert Becker 
Retired President and Chief Executive Officer, Wolters Kluwer Health 

William C. Lucia  
Chairman of the Board, President and Chief Executive Officer 

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 
Senior Executive Advisor, Beecken Petty O’Keefe & Company 
Healthcare Industry Advisor, KKR healthcare services affiliate 
Former Chairman of the Board and Chief Executive Officer,  
HMS Holdings Corp. 

Ellen A. Rudnick 
Senior Advisor for Entrepreneurship, adjunct faculty,  
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 

Meredith W. Bjorck 
Executive Vice President, General Counsel and Corporate Secretary 

Semone Neuman 
Executive Vice President, Operations and Information Technology 

Cynthia Nustad 
Executive Vice President, Chief Strategy Officer 

Emmet O’Gara 
Executive Vice President, Total Population Management

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 Jr. 
President, Markets and Product

Corporate Headquarters:

5615 High Point Drive  
Irving, TX 75038 
Tel. 214.453.3000 
Fax. 214.453.3023 

Form 10-K Report/Quarterly Reporting

The Company’s 2017 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 2017 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.