UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

FORM 10-Q

 

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

 

For the quarterly period ended March 31, 2016

 

Or

 

o 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)

 

Delaware   11-3656261
(State or Other Jurisdiction of Incorporation or Organization)   (I.R.S. Employer Identification No.)
     
5615 High Point Drive, Irving, TX   75038
(Address of principal executive offices)   (Zip Code)

 

(Registrant’s Telephone Number, Including Area Code)

(214) 453-3000

 

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  x   No  o

 

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 shorter period that the registrant was required to submit and post such files). x  Yes   o  No

 

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act. (Check one):

 

Large accelerated filer x   Accelerated filer o
     
Non-accelerated filer o   Smaller reporting company o

 

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes  o   No  x

 

As of May 5, 2016, there were approximately 84,155,107 shares of the registrant’s common stock (par value $0.01 per share) outstanding.

 

 

 

HMS HOLDINGS CORP. AND SUBSIDIARIES

QUARTERLY REPORT ON FORM 10-Q

FOR THE THREE MONTHS ENDED MARCH 31, 2016

INDEX

 

    Page
     
PART I - Financial Information 4
     
Item 1. Consolidated Financial Statements 4
     
  Consolidated Balance Sheets 4
  March 31, 2016 (unaudited) and December 31, 2015  
     
  Consolidated Statements of Income 5
  Three Months Ended March 31, 2016 and 2015 (unaudited)  
     
  Consolidated Statement of Shareholders’ Equity 6
  Three Months Ended March 31, 2016 (unaudited)  
     
  Consolidated Statements of Cash Flows 7
  Three months ended March 31, 2016 and 2015 (unaudited)  
     
  Notes to the Consolidated Financial Statements 8
  Three Months Ended March 31, 2016 and 2015 (unaudited)  
     
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations 17
     
Item 3. Quantitative and Qualitative Disclosures about Market Risk 21
     
Item 4. Controls and Procedures 21
     
PART II - Other Information 22
     
Item 1. Legal Proceedings 22
     
Item 1A. Risk Factors 22
     
Item 6. Exhibits 22
     
Signatures 23
   
Exhibit Index 24

 

2  

 

Cautionary Statement Regarding Forward-Looking Statements

 

This Quarterly Report on Form 10-Q contains “forward-looking statements” within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. From time to time, we also provide forward-looking statements in other materials we release to the public, as well as oral forward-looking statements. Such statements give our expectations or forecasts of future events; they do not relate strictly to historical or current facts.

 

We have tried, wherever possible, to identify such statements by using words such as “aim,” “anticipate,” “believe,” “estimate,” “expect,” “forecast,” “intend,” “likely,” “may,” “plan,” “project,” “seek,” “target,” “will,” “would,” “could,” “should,” and similar expressions and references to guidance, although some forward-looking statement may be expressed differently. In particular, these include statements relating to future actions, business plans, objectives and prospects, future operating or financial performance or results of current and anticipated services, acquisitions and the performance of companies we have acquired, sales efforts, expenses, interest rates, financial results, the outcome of contingencies, such as litigation, and the impact of current, pending and future U.S. healthcare legislation or changes to healthcare spending affecting Medicare, Medicaid or other publicly funded or subsidized health programs.

 

We cannot guarantee that any forward-looking statement will be realized. Forward-looking statements are based on our current expectations and assumptions regarding our business, the economy and other future conditions. Should known or unknown risks or uncertainties materialize, or should underlying assumptions prove inaccurate, actual results could differ materially from past results and those anticipated, estimated or projected. We caution you, therefore, against relying on any of these forward-looking statements. They are neither statements of historical fact nor guarantees or assurances of future performance. These risks and uncertainties include, among other things, negative or reduced growth rate of spending on Medicaid/Medicare; variations in our results of operations; our ability to execute our business plans or growth strategy; development and implementation of new product solutions or new process improvements; the risk that guidance may not be achieved; the nature of investment and acquisition opportunities we are pursuing, and the successful execution or integration of such investments and acquisitions; our failure to comply with applicable laws and regulations governing the conduct of certain electronic health transactions and the confidentiality of individually identifiable health information, such as HIPAA, or to protect such information from theft and misuse; our ability to maintain effective information and technology systems and networks, and to protect them from damage, interruption or breach; our reliance on subcontractors, vendors or other third party providers and sources to perform services; the unexpected reduction in scope or termination of a significant contract; customer dissatisfaction, our non-compliance with contractual provisions or regulatory requirements, or our failure to meet performance standards triggering significant costs or liabilities under our contracts; our ability to continue to secure contracts or favorable contract terms through the competitive bidding process; changes in the U.S. healthcare environment or healthcare financing system and steps we take in anticipation of such changes; pending or threatened litigation; our ability to retain customers or the loss of one or more major customers; the cancellation or delay of procurements or contract implementation due to protests or challenges to government awards; regulatory, budgetary or political actions that affect procurement practices; emergence of new competitors or competitors’ introduction of new or superior products or services; unanticipated changes in our effective tax rates; unfavorable outcomes in legal proceedings, including contract award protests; a failure to protect our intellectual property rights, confidential and proprietary information, or the confidential or proprietary information of others in our possession, despite our efforts; negative results of government or customer reviews, audits or investigations; restrictions on bidding or performing certain work due to perceived conflicts of interests; our cash flows from operations, available cash and ability to generate sufficient cash to cover our interest and principal payments under our credit facility or to borrow or use credit; and the market price of our common stock. These and other risks are discussed under the heading “Risk Factors” in Part I, Item 1A of our 2015 Annual Report on Form 10-K and in other documents we file with the Securities and Exchange Commission.

 

Any forward-looking statements made by us in this Quarterly Report on Form 10-Q speak only as of the date on which they are made. Factors or events that could cause actual results to differ may emerge from time to time and it is not possible for us to predict all of them. 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. You are advised, however, to consult any further disclosures we make on related subjects in our other filings with the Securities and Exchange Commission, including, but not limited to, our Current Reports on Form 8-K.

 

 

3  

 

HMS HOLDINGS CORP. AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

(in thousands, except share and per share amounts)

 

    March 31,
2016
  December 31,
2015
Assets   (unaudited)    
Current assets:                
Cash and cash equivalents   $ 143,451     $ 145,610  
Accounts receivable, net of allowance for doubtful accounts of $5,157 and $4,849, and estimated allowance for appeals of $5,348 and $6,614, at March 31, 2016 and December 31, 2015, respectively     165,796       169,146  
Prepaid expenses     13,623       11,261  
Deferred tax assets     4,226       7,460  
Other current assets     2,723       3,051  
Total current assets     329,819       336,528  
Property and equipment, net     91,841       96,551  
Goodwill     361,468       361,468  
Intangible assets, net     49,265       54,308  
Deferred financing costs, net     4,352       4,873  
Other assets     4,278       4,329  
Total assets   $ 841,023     $ 858,057  
                 
Liabilities and Shareholders' Equity                
Current liabilities:                
Accounts payable, accrued expenses and other liabilities   $ 34,402     $ 51,661  
Estimated liability for appeals     30,613       33,078  
Income taxes payable     274       3,873  
Total current liabilities     65,289       88,612  
Long-term liabilities:                
Revolving credit facility     197,796       197,796  
Deferred tax liabilities     37,147       38,421  
Deferred rent     5,901       6,006  
Other liabilities     3,006       2,520  
Total long-term liabilities     243,850       244,743  
Total liabilities     309,139       333,355  
Commitments and contingencies (Note 11)                
Shareholders' equity:                
Preferred stock -- $0.01 par value; 5,000,000 shares authorized; none issued     -       -  
Common stock -- $0.01 par value; 175,000,000 shares authorized; 95,406,154 shares issued and 84,132,408 shares outstanding at March 31, 2016; 95,263,461 shares issued and 83,989,715 shares outstanding at December 31, 2015     954       952  
Capital in excess of par value     332,910       330,290  
Retained earnings     293,034       288,474  
Treasury stock, at cost: 11,273,746  shares at March 31, 2016 and December 31, 2015     (95,014 )     (95,014 )
                 
Total shareholders' equity     531,884       524,702  
                 
Total liabilities and shareholders' equity   $ 841,023     $ 858,057  

 

See accompanying notes to unaudited consolidated financial statements.

4  

 

HMS HOLDINGS CORP. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF INCOME

(in thousands, except per share amounts)

(unaudited)

 

    Three Months Ended
March 31,
    2016   2015
Revenue   $ 119,763     $ 110,324  
Cost of services:                
Compensation     46,401       44,067  
Data processing     9,624       10,045  
Occupancy     3,627       4,007  
Direct project expenses     14,483       10,478  
Other operating expenses     5,776       6,738  
Amortization of acquisition related software and intangible assets     7,013       7,047  
Total cost of services     86,924       82,382  
Selling, general and administrative expenses     22,930       19,961  
Total operating expenses     109,854       102,343  
Operating income     9,909       7,981  
Interest expense     (2,091 )     (1,954 )
Interest income     47       11  
Income before income taxes     7,865       6,038  
Income taxes     3,305       2,516  
Net income   $ 4,560     $ 3,522  
                 
Basic income per common share:                
Net income per common share -- basic   $ 0.05     $ 0.04  
Diluted income per common share:                
Net income per common share -- diluted   $ 0.05     $ 0.04  
Weighted average shares:                
Basic     84,033       88,246  
Diluted     84,479       88,624  

 

See accompanying notes to unaudited consolidated financial statements.

 

5  

 

HMS HOLDINGS CORP. AND SUBSIDIARIES

CONSOLIDATED STATEMENT OF SHAREHOLDERS’ EQUITY

(in thousands, except share amounts)

(unaudited)

 

 

    Common Stock           Treasury Stock    
                             
    # of Shares Issued   Par Value   Capital in Excess
of Par Value
  Retained Earnings   # of Shares   Amount   Total
Shareholders'
Equity
Balance at December 31, 2015     95,263,461     $ 952     $ 330,290     $ 288,474       11,273,746     $ (95,014 )   $ 524,702  
Net income     -       -       -       4,560       -       -       4,560  
Stock-based compensation expense     -       -       4,240       -       -       -       4,240  
Exercise of stock options     9,975       -       26       -       -       -       26  
Vesting of restricted stock units, net of shares withheld for employee tax     132,718       2       (1,004 )     -       -       -       (1,002 )
Excess tax benefit from exercise of stock options     -       -       10       -       -       -       10  
Tax shortfall due to exercise of stock options and vesting of restricted stock units     -       -       (436 )     -       -       -       (436 )
Deferred tax asset reversal for unexercised stock options     -       -       (216 )     -       -       -       (216 )
                                                         
Balance at March 31, 2016     95,406,154     $ 954     $ 332,910     $ 293,034       11,273,746     $ (95,014 )   $ 531,884  

 

 

 

See accompanying notes to the unaudited consolidated financial statements.

 

6  

 

HMS HOLDINGS CORP. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

(in thousands)

(unaudited)

 

    Three Months Ended
March 31,
    2016   2015
Operating activities:                
Net income   $ 4,560     $ 3,522  
Adjustments to reconcile net income to net cash provided by (used in) operating activities:                
Depreciation and amortization of property and equipment     6,577       8,163  
Amortization of intangible assets     5,043       5,077  
Amortization of deferred financing costs     521       521  
Stock-based compensation expense     4,240       3,245  
Excess tax benefit from exercised stock options     (10 )     (1,448 )
Deferred income taxes     1,308       (226 )
Loss on disposal of fixed assets     10       10  
Changes in operating assets and liabilities:                
Accounts receivable     3,350       (9,344 )
Prepaid expenses     (2,362 )     (983 )
Prepaid income taxes     -       2,049  
Other current assets     328       51  
Other assets     51       (147 )
Income taxes payable     (3,589 )     -  
Accounts payable, accrued expenses and other liabilities     (16,963 )     (10,772 )
Estimated liability for appeals     (2,465 )     187  
Net cash provided by (used in) operating activities     599       (95 )
Investing activities:                
Purchases of land, property and equipment     (570 )     (2,513 )
Investment in capitalized software     (1,185 )     (721 )
Net cash used in investing activities     (1,755 )     (3,234 )
Financing activities:                
Proceeds from exercise of stock options     26       3,273  
Excess tax benefit from exercised stock options     10       1,448  
Payments of tax withholdings on behalf of employees for net-share settlement for stock-based compensation     (1,002 )     (596 )
Payments on capital lease obligations     (37 )     (366 )
Net cash provided by (used in) financing activities     (1,003 )     3,759  
Net increase (decrease) in cash and cash equivalents     (2,159 )     430  
Cash and Cash Equivalents                
Cash and cash equivalents at beginning of year     145,610       133,116  
Cash and cash equivalents at end of year   $ 143,451     $ 133,546  
                 
Supplemental disclosure of cash flow information:                
Cash paid for income taxes   $ 5,052     $ 656  
Cash paid for interest   $ 1,446     $ 2,826  
                 
Supplemental disclosure of non-cash activities:                
Accrued property and equipment purchases   $ 122     $ 959  

 

See accompanying notes to the unaudited consolidated financial statements.

 

7  

 

HMS HOLDINGS CORP. AND SUBSIDIARIES

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS

For the Three Months Ended March 31, 2016 and 2015

(unaudited)

 

1. Basis of Presentation

 

HMS Holdings Corp, (the “Company” or “HMS”) provides coordination of benefits services to government and private healthcare payers and sponsors to ensure that the responsible party pays healthcare claims. Additionally, the Company’s payment integrity services ensure that healthcare claims billed are accurate and appropriate. Together these various services help customers recover amounts from liable third parties; prevent future improper payments; reduce fraud, waste and abuse; and ensure regulatory compliance.

 

The consolidated financial statements and notes herein are unaudited. Accordingly, they do not include all of the information and notes required by United States Generally Accepted Accounting Principles (“U.S. GAAP”) for complete financial statements. These statements include all adjustments (consisting of normal recurring accruals) that management considers necessary to present a fair statement of the Company’s results of operations, financial position and cash flows. The results reported in these consolidated financial statements should not be regarded as necessarily indicative of results that may be expected for the entire year. It is suggested that these consolidated financial statements be read in conjunction with the Company’s consolidated financial statements as of and for the year ended December 31, 2015 which were filed with the U.S. Securities and Exchange Commission (“SEC”) on February 29, 2016 as part of the Company’s Annual Report on Form 10-K for the year ended December 31, 2015 (“2015 Form 10-K”).

 

The preparation of the Company’s unaudited consolidated financial statements requires management to make certain estimates and assumptions that affect the reported amounts of assets and liabilities, primarily accounts receivable, intangible assets, accrued expenses, estimated allowance for appeals, estimated liability for appeals, the disclosure of contingent liabilities at the date of the unaudited consolidated financial statements and the reported amounts of revenue and expenses during the reporting periods. The Company’s actual results could differ from those estimates.

 

These unaudited consolidated financial statements include HMS accounts and transactions and those of the Company’s wholly owned subsidiaries. All significant intercompany balances and transactions have been eliminated in consolidation.

 

Certain reclassifications were made to prior period amounts to conform to the current period presentation.

 

HMS is managed and operated as one business, with a single management team that reports to the Chief Executive Officer. HMS does not operate separate lines of business with respect to any of the Company’s product lines.

 

2. Summary of Significant Accounting Policies

 

There have been no material changes to the Company’s significant accounting policies that are referenced in the 2015 Form 10-K.

 

Recently Adopted Accounting Pronouncements

 

The Company adopted Accounting Standards Updated (“ASU”) ASU 2015-03, “ Simplifying the Presentation of Debt Issuance Costs ” and ASU 2015-15, “ Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of-Credit Arrangements ” (“ASU 2015-15”). The Company made a policy election to continue recording the deferred costs as an asset, as allowed for revolving credit agreements. As the Company only has a line-of-credit arrangement, the adoption of the ASU’s had no change in the Company’s accounting for debt issuance costs related to such line of credit and had no impact on the Company’s consolidated financial statements.

 

Recently Issued Accounting Pronouncements

 

In addition to the recently issued accounting pronouncements disclosed in the 2015 Form 10-K, the following guidance has been issued since the annual filing. There have been no changes in the Company’s anticipated adoption of the previously disclosed pronouncements, except as noted above.

 

In March 2016, the FASB issued ASU 2016-08, Revenue from Contracts with Customers (Topic 606) – Principal versus Agent Considerations (Reporting Revenue Gross versus Net) (“ASU 2016-08”). ASU 2016-08 requires the Company to recognize revenue in the gross amount of consideration to which it expects to be entitled in exchange for those goods or services it transfers to a customer. It also requires the agent to recognize revenue in the amount of any fee or commission to which it expects to be entitled in exchange for arranging the specified goods or services to be provided to the customer. ASU 2016-08 is effective for annual reporting periods beginning after December 15, 2017 and for interim reporting periods within such annual periods. The Company is currently evaluating the impact of adopting this guidance.

 

8  

 

In March 2016, as part of its Simplification Initiative, the FASB issued ASU No. 2016-09 , Compensation—Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accountin g, (“ASU 2016-09”) which finalizes Proposed ASU No. 2015-270 of the same name, and seeks to reduce complexity in accounting standards. The areas for simplification in ASU No. 2016-09, involve several aspects of the accounting for share-based payment transactions, including (1) accounting for income taxes, (2) classification of excess tax benefits on the statement of cash flow, (3) forfeitures, (4) minimum statutory tax withholding requirements, (5) classification of employee taxes paid on the statement of cash flows when an employer withholds shares for tax withholding purposes, (6) the practical expedient for estimating the expected term, and (7) intrinsic value. Application is effective for annual periods beginning after December 15, 2016, and for interim periods within those annual periods. The Company is currently evaluating the impact of adopting this guidance.

 

In March 2016, the FASB issued ASU No. 2016-10, Revenue from Contracts with Customers (Topic 606): Identifying Performance Obligations and Licensing , which finalizes Proposed ASU No. 2015-250 of the same name, and suggests guidance for stakeholders on identifying performance obligations and licenses in customer contracts. The amendments in ASU No. 2016-10 impact entities with transactions that include contracts with customers to transfer goods or services (that are an output of the entity’s ordinary activities) in exchange for consideration, and they require entities to recognize revenue by following certain steps, including: (1) identifying the contract(s) with a customer; (2) identifying the performance obligations in a contract; (3) determining the transaction price; (4) allocating the transaction price to the performance obligations in the contract; and (5) recognizing revenue when, or as, the entity satisfies a performance obligation. The amendments are effective for annual reporting periods beginning after December 15, 2017, and for interim periods within those annual periods. The Company is currently evaluating the impact of adopting this guidance.

 

In May 2016, the FASB issued ASU No. 2016-12 , Revenue From Contracts With Customers (Topic 606): Narrow-Scope Improvements and Practical Expedients (“ASU 2016-12”). The amendments clarify the assessment of the likelihood that revenue will be collected from a contract, the guidance for presenting sales taxes and similar taxes, and the timing for measuring customer payments that are not in cash. The amendments provide a practical expedient for recognizing revenue from contracts that have been modified prior to the transition period to the new standard. ASU 2016-12 also states that a contract should be considered complete if all, or substantially all, of its revenue has been collected prior to making the transition to the new standard. In addition, the update clarifies the disclosure requirements for retrospective application of the standard. The amendments are effective for annual reporting periods beginning after December 15, 2017 and for interim reporting periods within such annual periods. The Company is currently evaluating the impact of adopting this guidance.

 

3. Accounts Receivable and Allowance for Doubtful Accounts:

 

The Company’s accounts receivable, net, consist of the following as of March 31, 2016 and December 31, 2015 (in thousands) :

 

    March 31,
 2016
  December 31,
2015
Accounts receivable   $ 170,953     $ 173,995  
Allowance for doubtful accounts     (5,157 )     (4,849 )
Accounts receivable, net   $ 165,796     $ 169,146  

 

A summary of the activity in the allowance for doubtful accounts is as follows (in thousands) :

 

    Three Months Ended
March 31,
    2016   2015
Balance--beginning of period   $ 4,849     $ 1,898  
Provision--allowance for doubtful accounts     3,646       -  
Charge-offs     (3,152 )     (420 )
Recoveries     (186 )     -  
Balance--end of period   $ 5,157     $ 1,478  

 

The Company’s accounts receivable are net of the estimated liability for appeals, which is presented in Note 7.

 

9  

 

4. Intangible Assets

 

Intangible assets consisted of the following as of March 31, 2016 and December 31, 2015 ( in thousands ):

 

    Gross Carrying
Amount
  Accumulated
Amortization
  Net Carrying
Amount
  Useful Life
(in years)
March 31, 2016                                    
Customer relationships   $ 101,806     $ (61,087 )   $ 40,719       5 - 10    
Restrictive covenants     16,800       (14,419 )     2,381       3 - 7    
Trade name     17,000       (10,835 )     6,165       3 - 5    
Total   $ 135,606     $ (86,341 )   $ 49,265              
                                     
December 31, 2015                                    
Customer relationships   $ 101,806     $ (57,497 )   $ 44,309       5 - 10    
Restrictive covenants     16,800       (13,580 )     3,220       3 - 7    
Trade name     17,000       (10,221 )     6,779       3 - 5    
Total   $ 135,606     $ (81,298 )   $ 54,308              

 

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

 

Year ending December 31,    
Remainder of 2016   $ 14,891  
2017     16,613  
2018     15,992  
2019     1,582  
2020     187  
Thereafter     -  

 

For the three months ended March 31, 2016 and 2015, amortization expense related to intangible assets was $5.0 million and $5.1 million, respectively.

 

5. Accounts Payable, Accrued Expenses and Other Liabilities

 

Accounts payable, accrued expenses and other liabilities as of March 31, 2016 and December 31, 2015 consisted of the following (in thousands) :

 

    March 31,
2016
  December 31,
2015
                 
Accounts payable, trade   $ 7,199     $ 7,790  
Accrued compensation and other     10,335       21,948  
Accrued operating expenses     16,868       21,923  
Total accounts payable, accrued expenses and other liabilities   $ 34,402     $ 51,661  

 

6. Income Taxes

 

The Company’s effective tax rate increased to 42.0% for the three months ended March 31, 2016 from 41.7% for the three months ended March 31, 2015, primarily due to changes in interest on prior state unrecognized tax benefits and permanent differences.

 

During the three months ended March 31, 2016, the Company utilized an immaterial amount in tax deductions arising from stock-based compensation.

 

As of March 31, 2016 and 2015, the total amount of unrecognized tax benefits was approximately $1.9 million and $1.4 million, respectively (net of the federal benefit for state issues) that, if recognized, would favorably affect the Company’s future effective tax rate. As of March 31, 2016 and 2015, the accrued liability for interest expense and penalties related to unrecognized tax benefits was $0.6 million and $0.3 million, respectively. HMS includes interest expense and penalties in the provision for income taxes in the unaudited Consolidated Statements of Income. The amount of interest expense (net of federal and state income tax benefits) and penalties in the unaudited Consolidated Statements of Income for the three months ended March 31, 2016 and 2015 was $0.2 million and an immaterial amount, respectively. The Company believes it is reasonably possible that the amount of unrecognized tax benefits may decrease, by $1.6 million during 2016, due to the expiration of the statute of limitations in various state jurisdictions.

 

10  

 

HMS files income tax returns with the U.S. Federal government and various state and local jurisdictions. HMS is no longer subject to U.S. Federal income tax examinations for years before 2012. HMS operates in a number of state and local jurisdictions, most of which have never audited the Company’s records. Accordingly, HMS is subject to state and local income tax examinations based upon the various statutes of limitations in each jurisdiction. HMS is currently being examined by the Internal Revenue Service and the State of New York.

 

7. Estimated Liability for Appeals and Estimated Allowance for Appeals

 

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.

 

Under the Company’s Medicare Recovery Audit Contractor (“RAC”) contract with the Centers for Medicare & Medicaid Services (“CMS”), (held by its wholly owned subsidiary HealthDataInsights, Inc.) and certain contracts for commercial health plan customers, HMS recognizes revenue when claims are sent to the customer for offset against future claims payments. Providers and health plan customers have the right to appeal a claim and may pursue additional appeals if the initial appeal is found in favor of the customer. HMS accrues an estimated liability for appeals based on the amount of revenue that is subject to appeals, closures or other adjustments and which HMS estimate are probable of being returned to providers following a successful appeal. The Company’s estimates are based on the Company’s historical experience with appeals. The estimated liability for appeals represents the Company’s estimate of the potential amount of repayments related to appeals of claims, closures and other adjustments for which revenue was previously collected.

 

A summary of the activity in the estimated liability for appeals and estimated allowance for appeals is as follows (in thousands) :

 

    Three Months Ended
March 31,
    2016   2015
Balance--beginning of period (1)   $ 39,692     $ 41,623  
Provision     998       2,321  
Appeals found in providers favor     (4,729 )     (1,485 )
Balance--end of period (2)   $ 35,961     $ 42,459  

 

(1) For the three months ended December 31, 2015 and 2014 included within the estimated allowance for appeals found in favor of providers, $6,614 million and $4,824 million, respectively was activity associated with the Medicare RAC contract.

 

(2) For the three months ended March 31, 2016 and 2015 included within the estimated allowance for appeals found in favor of providers, $5,348 million and $5,473 million, respectively was activity associated with the Medicare RAC contract.

 


 

8. Credit Agreement

 

In May 2013, HMS entered into a $500 million five-year, amended and restated revolving credit agreement (“Credit Agreement”) with certain financial institutions and Citibank, N.A. as Administrative Agent . No principal payments were made against the Company’s revolving credit facility during the three months ended March 31, 2016 and 2015. The $197.8 million principal balance of the Company’s revolving credit facility is due in May 2018.

 

The Credit Agreement provides for an initial $500 million revolving credit facility, and, under specified circumstances, the revolving credit facility can be increased or one or more incremental term loan facilities can be added, provided that the incremental credit facilities do not exceed in the aggregate the sum of (a) $75 million plus (b) an additional amount not less than $25 million, so long as the Company’s total secured leverage ratio, calculated giving pro forma effect to the requested incremental borrowing and other customary and appropriate pro forma adjustment events, including any permitted acquisitions, is no greater than 2.5:1.0. The amount available to borrow is based on certain borrowing base calculations found in the Company’s Credit Agreement. The Credit Agreement is collateralized by the Company’s assets.

 

11  

 

The Credit Agreement contains certain customary representations and warranties, affirmative and negative covenants and events of default. The Credit Agreement requires HMS to comply, on a quarterly basis, with certain principal financial covenants, including a maximum consolidated leverage ratio of 3.25:1.00 and a minimum interest coverage ratio of 3.00:1.00. As of March 31, 2016, HMS was in compliance with all of the terms of the Credit Agreement.

 

The interest rates applicable to the revolving credit facility are, at the Company’s option, either (i) the LIBOR multiplied by the statutory reserve rate plus an interest margin ranging from 1.50% to 2.25% based on HMS’s consolidated leverage ratio, or (ii) a base rate (which is equal to the greatest of (a) Citibank’s prime rate, (b) the federal funds effective rate plus 0.50% and (iii) the one-month LIBOR plus 1.00% plus an interest margin ranging from 0.50% to 1.25% based on the Company’s consolidated leverage ratio). The applicable interest rate was 2.36% at March 31, 2016. HMS pays an unused commitment fee on the revolving credit facility during the term of the Credit Agreement ranging from 0.375% to 0.50% per annum based on the Company’s consolidated leverage ratio.

 

HMS’s obligations under the Credit Agreement may be accelerated upon the occurrence of an event of default, which includes customary events of default including, without limitation, payment defaults, failures to perform affirmative covenants, failure to refrain from actions or omissions prohibited by negative covenants, the inaccuracy of representations or warranties, cross-defaults, bankruptcy and insolvency related defaults, defaults relating to judgments, defaults due to certain ERISA related events and a change of control default.

 

The interest expense and the commitment fees on the unused portion of the Company’s revolving credit facility are as follows (in thousands) :

 

    Three Months Ended
March 31,
    2016   2015
Interest expense   $ 1,178     $ 1,027  
Commitment fees   $ 378     $ 372  

 

As of March 31, 2016 and December 31, 2015, the unamortized balance of deferred origination fees and debt issue costs were $4.4 million and $4.9 million, respectively. For both the three month periods ended March 31, 2016 and 2015, HMS amortized $0.5 million of interest expense related to the Company’s deferred origination fees and debt issue costs.

 

Although HMS expects that operating cash flows will continue to be a primary source of liquidity for the Company’s operating needs, the revolving credit facility may be used for general corporate purposes, including acquisitions, if necessary.

 

As part of the Company’s contractual agreement with a customer, HMS has an outstanding irrevocable letter of credit for $3.0 million, which HMS established against the revolving credit facility. The expiration date of the letter of credit is June 30, 2016.

 

9. Earnings Per Share

 

Basic income per share is calculated by dividing net income by the weighted average number of common shares outstanding during the period. Diluted income per share is calculated by dividing net income by the weighted average number of common shares and dilutive common share equivalents outstanding during the period. The Company’s dilutive common share equivalents consist of stock options and restricted stock awards and units.

 

The following table reconciles the basic to diluted weighted average common shares outstanding using the treasury stock method (in thousands, except per share amounts) :

 

    Three Months Ended
March 31,
    2016   2015
Net income   $ 4,560     $ 3,522  
                 
Weighted average common shares outstanding-basic     84,033       88,246  
Plus: net effect of dilutive stock options     85       181  
Plus: net effect of dilutive restricted stock awards and units     361       197  
Weighted average common shares outstanding-diluted     84,479       88,624  
Net income per common share-basic   $ 0.05     $ 0.04  
Net income per common share-diluted   $ 0.05     $ 0.04  

 

For the three months ended March 31, 2016 and 2015, 4,321,528 and 2,940,897 stock options, respectively, were not included in the diluted earnings per share calculation because the effect would have been anti-dilutive.

 

12  

 

10. Stock-Based Compensation

 

Total stock-based compensation expense in the Company’s unaudited Consolidated Statements of Income related to the Company’s long-term incentive award plans was as follows (in thousands) :

 

    Three Months Ended
March 31,
    2016   2015
Cost of services-compensation   $ 1,931     $ 1,341  
Selling, general and administrative     2,309       1,904  
Total   $ 4,240     $ 3,245  

 

Stock Options

 

The Company’s stock option activity for the three months ended March 31, 2016 (in thousands, except for weighted average exercise price and weighted average remaining contractual term) :

 

    Shares   Weighted
Average
Exercise
Price
  Weighted
Average
Remaining
Contractual
Terms
  Aggregate
Intrinsic
Value
Outstanding at December 31, 2015     5,030     $ 17.37                  
Granted     983       13.90                  
Exercised     (10 )     2.85                  
Forfeitures     (27 )     18.88                  
Expired     (69 )     24.63                  
Outstanding at March 31, 2016     5,907       16.73       5.21       6,503  
                                 
Expected to vest at March 31, 2016     3,830       15.77       6.21       2,508  
Exercisable at March 31, 2016     1,990     $ 18.59       3.23     $ 3,944  

 

For awards subject to service-based vesting conditions, HMS recognizes stock-based compensation expense, net of estimated forfeitures, equal to the grant date fair value of stock options on a straight-line basis over the requisite service period, which is generally the vesting term. For awards subject to both performance and service-based vesting conditions, HMS recognizes stock-based compensation expense using the straight-line recognition method when it is probable that the performance condition will be achieved. Forfeitures are estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates.

 

The fair value of each option grant with service-based vesting conditions was estimated using a Black-Scholes option-pricing valuation model. The performance share awards granted in 2016 and 2015 are market condition awards as attainment is based on the performance of the Company’s common stock for the relevant performance period. These awards were valued on the date of grant using a Monte Carlo simulation model.

 

Expected volatilities are calculated based on the historical volatility of the Company’s common stock. Management monitors stock option exercises and employee termination patterns to estimate forfeiture rates within the valuation model. Separate groups of employees that have similar historical exercise behavior are considered separately for valuation purposes. The expected holding period of options represents the period of time that options granted are expected to be outstanding. The expected terms of options granted are based on the Company’s historical experience for similar types of stock option awards. The risk-free interest rate is based on U.S. Treasury Notes.

 

13  

 

The weighted average grant-date fair value per share of the stock options granted during the three months ended March 31, 2016 and 2015 was $5.45 and $5.89, respectively. HMS estimated the fair value of each stock option grant on the date of grant using a Black-Scholes option-pricing model and the weighted-average assumptions set forth in the following table:

 

    Three Months Ended
March 31,
    2016   2015
Expected dividend yield     0%       0%  
Risk-free interest rate     1.20%       1.44%  
Expected volatility     43.89%       38.29%  
Expected life (in years)     4.90       4.88  

 

During the three months ended March 31, 2016 and 2015, HMS issued 0.01 million shares and 0.4 million shares, respectively, of the Company’s common stock upon the exercise of outstanding stock options and received proceeds of $0.03 million and $3.3 million, respectively.

 

For the three months ended March 31, 2016 and 2015, stock-based compensation expense for stock options was $2.0 million and $1.4 million, respectively.

 

Excess tax benefit from the exercise of stock options for the three months ended March 31, 2016 was $0.01 million and for the year ended December 31, 2015 was $1.6 million, respectively.

 

The total intrinsic value of options exercised (the difference in the market price of the Company’s common stock on the exercise date and the price paid by the optionees to exercise the options) for the three months ended March 31, 2016 and 2015 was approximately $0.1 million and $5.4 million, respectively.

 

As of March 31, 2016, there was approximately $17.6 million of total unrecognized compensation cost, adjusted for estimated forfeitures, related to stock options outstanding, which is expected to be recognized over a weighted average period of 1.47 years.

 

Restricted Stock Units

 

HMS non-employee members of the Company’s Board of Directors and certain employees have received restricted stock units under the Fourth Amended and Restated 2006 Stock Plan (the “2006 Stock Plan”). The fair value of restricted stock units is estimated based on the closing sale price of the Company’s common stock on the NASDAQ Global Select Market on the date of issuance. The total number of restricted stock units expected to vest is adjusted by estimated forfeiture rates.

 

For the three months ended March 31, 2016, HMS granted 562,645 restricted stock units with an aggregate fair market value of $7.8 million.

 

For the three months ended March 31, 2016 and 2015, stock-based compensation expense for restricted stock units was $2.2 million and $1.8 million, respectively.

 

As of March 31, 2016, 1,348,340 restricted stock units remained unvested and there was approximately $18.7 million of unamortized compensation cost related to these restricted stock units, which is expected to be recognized over the remaining weighted-average vesting period of 1.51 years.

 

14  

 

A summary of the status of the Company’s restricted stock units and of changes in restricted stock units outstanding under the 2006 Stock Plan for the three months ended March 31, 2016 is as follows (in thousands, except for weighted average grant date fair value per unit) :

 

    Number of
Units
  Weighted Average
Grant Date Fair
Value per Share
  Aggregate
Intrinsic
Value
Outstanding balance at December 31, 2016     1,154     $ 18.85          
Granted     563       13.94          
Vesting of restricted stock units, net of shares withheld for taxes     (133 )     19.23          
Shares withheld for taxes     (73 )     19.23          
Forfeitures     (22 )     18.68          
Outstanding balance at March 31, 2016     1,489     $ 16.92     $ 21,366  

 

11. Commitments and Contingencies

 

Kern Health Systems : In August 2011, in the Superior Court of the State of California, County of Los Angeles, Kern Health Systems (“KHS”) sought to recover in excess of $7.0 million exclusive of interest, attorneys’ fees and costs, against HMS’s wholly owned subsidiary Allied Management Group Special Investigation Unit, Inc. (“AMG”) and two of AMG’s former owners Dennis Demetre and Lori Lewis (collectively, the “Defendants”), jointly and severally, on causes of action for breach of contract, professional negligence, intentional misrepresentation, negligent misrepresentation and unfair business practices under the California Business and Professions Code. In June 2014, the jury issued its verdict in favor of all the Defendants on all causes of action except negligent misrepresentation. On that cause of action, due to an error in the special verdict form, the jury awarded damages to KHS in the sum of $1.38 million, while also finding that KHS failed to prove the required elements of the claim. However, the court denied the Defendants’ motion to vacate the jury’s verdict and resulting judgment. The court further awarded each side certain costs but denied AMG recovery of its attorneys’ fees sought in the sum of approximately $2.4 million. In August 2014, AMG filed a notice of appeal based on the award of damages to KHS on the negligent misrepresentation claim, and the denial of AMG’s request for attorneys’ fees. Following completion of briefing and oral argument on the appeal, on April 25, 2016, the California Court of Appeal reversed the judgment and remanded the matter to the trial court with directions to enter a new judgment in favor of the Defendants on all causes of action and to award the Defendants their reasonable attorneys’ fees. The decision is set to become final on May 25, 2016. Although there are risks and uncertainties related to any litigation, including appeals, HMS did not record an obligation as the Company believes it was probable that AMG would prevail on the appeal of this matter. Pending the appeal process, HMS was required to obtain a surety bond in the amount of 150% of the final judgment amount, or approximately $2.2 million, which was collateralized by a cash deposit and is reflected in other current assets on the Company’s Consolidated Balance Sheet as of March 31, 2016.  

 

Dennis Demetre and Lori Lewis : In July 2012, Dennis Demetre and Lori Lewis (the “Plaintiffs”), filed an action in the Supreme Court of the State of New York against HMS Holdings Corp., claiming an undetermined amount of damages alleging that various actions unlawfully deprived the Plaintiffs of the acquisition earn-out portion of the purchase price of 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 asserts a counterclaim for breach of contract arising out of the Plaintiffs’ failure to indemnify the Company for costs, including attorneys’ fees arising out of the Company’s defense of the Kern Health Systems matter described above. In January 2016, HMS moved for summary judgment on (i) its remaining counterclaim for breach of contract against the Plaintiffs and (ii) the Plaintiffs’ breach of contract causes of action against HMS. Oral argument on the motions for summary judgement is set for June 22, 2016. A trial date has not been set. HMS believes it has a meritorious defense and will continue to defend this matter vigorously. As such, HMS has not accrued for any loss contingencies related to this matter because no assessment can been made as to the likely outcome of this lawsuit or whether the outcome will be material to the Company.

 

Restrictive Covenants, Trade Secret, Contract and other Causes of Action in Texas and New York : HMS was the plaintiff in lawsuits filed in August 2014, entitled HMS Holdings Corp., et al. v. Public Consulting Group, Inc., James Gambino and Jason Ramos , in the District Court of Dallas County, Texas, and HMS Holdings Corp., et al. v. Matthew Arendt, Sean Curtin and Danielle Lange , in the New York State Supreme Court, Albany County. In July 2015, HMS filed a third related lawsuit, entitled HMS Holdings Corp., et al. v. Elena Moiseenko and Joseph Flora , in the New York State Supreme Court, Albany County. These suits allege that, in violation of their respective contractual, statutory and common law obligations to the Company, defendants PCG, Flora and former HMS employees Gambino, Ramos, Arendt, Curtin, Lange and Moiseenko unlawfully misappropriated HMS’s confidential, proprietary and trade secret information and committed other wrongdoing. The lawsuits seek damages and injunctive relief and assert causes of action including breach of contract, breach of fiduciary duty and misappropriation of trade secrets. HMS has sought injunctions in all three lawsuits.

 

15  

 

On April 27, 2016, the Company entered into settlement agreements with PCG and various individuals that fully resolve the matters in controversy in these lawsuits. Pursuant to terms of the settlement agreement between HMS and PCG, PCG agreed that for a period of seven years from the date of the settlement agreement, PCG will not develop, plan, market, provide, offer, advise with respect to, assist with, sell, or otherwise perform, directly or indirectly, any TPL services, including, but not limited to, coordination of benefits, credit balance audits and dependent eligibility audits. PCG further agreed to withdraw any pending TPL bids, bid protests or contract negotiations, which includes the withdrawal of its pending TPL bid with the New Jersey Department of Human Services. HMS and the New Jersey Department of Human Services have entered into an amendment to extend the current TPL contract through May 31, 2016. The settlements also result in the dismissal of all pending cases or appeals between the parties and includes full, mutual releases of PCG, HMS and their affiliates from any and all pending and future claims related to the lawsuits.

 

In addition, in August 2015, the New York State Office of Medicaid Inspector General (“OMIG”) awarded HMS the new Medicaid Third Party Liability Match and Recovery Services contract, which PCG challenged by filing a protest with the New York Office of the State Comptroller. In March 2016, OMIG denied PCG’s protest and HMS’s new contract was approved with an effective date of April 7, 2016.

 

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 and employment-related matters. 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.

 

12. Subsequent Events

 

In connection with the preparation of these unaudited Consolidated Financial Statements, an evaluation of subsequent events was performed through the date of issuance and there were no other events that have occurred that would require adjustments to the financial statements or disclosure.

16  

 

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

 

The following discussion and analysis of financial condition and results of operations should be read in conjunction with the other sections of this Quarterly Report on Form 10-Q and with our 2015 Form 10-K. In addition to historical consolidated financial information, the following discussion contains forward-looking statements that reflect our plans, estimates and beliefs. Our actual results could differ materially from those discussed in the forward-looking statements. Factors that could cause or contribute to these differences include those discussed below and elsewhere in this Quarterly Report on Form 10-Q, and in Part I, Item 1A. “Risk Factors” of our 2015 Form 10-K.

 

We operate in the U.S. healthcare insurance benefit cost containment marketplace. We provide coordination of benefits services to government and private healthcare payers and sponsors to ensure that the responsible party pays healthcare claims. Our payment integrity services ensure that healthcare claims billed are accurate and appropriate. Together, these various services help customers recover improper payments, including those from liable third parties; prevent future improper payments; reduce fraud, waste and abuse; and ensure regulatory compliance.

 

Our customers are state and federal healthcare agencies, including state Medicaid agencies, health plans, including Medicaid managed care, Medicare Advantage and group and individual health lines of business; government and private employers; and other healthcare payers and sponsors. As of March 31, 2016, we served 45 state Medicaid programs and the District of Columbia; and federal government health agencies, including CMS and the Veterans Health Administration (“VHA”). We also provided services to approximately 250 health plans and supported their multiple lines of business. We additionally served as a subcontractor to certain business outsourcing and technology firms.

 

The Company has grown both organically and through targeted asset and stock acquisitions. Initially, the Company provided coordination of benefits services to state Medicaid agencies, then expanded its business by providing similar services to managed care organizations when Medicaid began designating members to those plans. After launching payment integrity services in 2007, HMS grew its product suite and expanded its reach in the marketplace by acquiring IntegriGuard, LLC (2009), Verify Solutions, Inc. (2009), Chapman Kelly, Inc. (2010), HealthDataInsights, Inc. (“HDI”) (2011) and MedRecovery Management, LLC (2012).

 

Healthcare Environment

 

The Patient Protection and Affordable Care Act (the “ACA”) was signed into law in 2010. This legislation touched almost every sector of the healthcare system, and affords HMS a range of growth opportunities across a number of services. We are focused on three critical areas related to this legislation:

 

· Medicaid Expansion;
· Payment Integrity; and
· Employer-Sponsored Health Coverage.

 

Medicaid Expansion: States that expand their Medicaid programs in accordance with the ACA receive federal funding for the total cost of the expansion for a period of three years, and reduced funding thereafter. As of early 2016, approximately two-thirds of the states opted to expand their Medicaid programs as provided under the ACA. According to the CMS National Health Expenditures (“NHE”) Projections, the number of individuals enrolled in Medicaid and the Children’s Health Insurance Program (“CHIP”) is expected to increase from 77.9 million in 2016 to 84.6 million in 2024, with expenditures over the same period expected to increase from $585 billion to $915 billion. As a result, we anticipate continued demand for our cost containment services by states and the managed care organizations they contract with. We believe that our strong history of successful contracting with Medicaid agencies and Medicaid managed care organizations will enable us to continue providing value-added services to help control the escalating costs for this expanded population.

 

Payment Integrity: The ACA contained a number of provisions for combating fraud, waste and abuse throughout the healthcare system, including in Medicaid and Medicare. These initiatives include: (i) requiring state Medicaid agencies to contract with state Medicaid RACs and deploy programs modeled on the Medicare RAC Program administered by CMS, (ii) expanding the Medicare RAC Program to include Medicare Part C and D, (iii) establishing a national healthcare fraud, waste and abuse data collection program and (iv) increasing scrutiny of providers and suppliers who want to participate in Medicare, Medicaid and other federally-funded programs. The ACA further required that each state establish a Medicaid RAC program by January 1, 2012. In addition, the ACA allowed for significant increases in funding for these and other fraud, waste and abuse efforts. We continue to seek opportunities to expand our current partnerships with CMS, states and health plans and to provide innovative ideas to support their payment integrity initiatives.

 

Employer-Sponsored Health Coverage: The ACA largely preserves and builds upon the existing employer-sponsored health coverage model. Though not all employers will be required to provide healthcare coverage, large employers (i.e. those with 50 or more full time equivalents) will be penalized starting in 2016 if (i) they do not offer coverage (or if they offer coverage that does not meet certain requirements) and (ii) one or more of their full time employees receives a federal tax credit or cost sharing subsidy through a health insurance exchange. Employers will also be prohibited from imposing waiting periods for enrollment of more than 90 days. We expect that we will be able to offer a range of audit services to employers of all sizes, which will be valuable as these employers extend coverage to their employees.

 

17  

 

Customers

 

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

 

For example, our largest contract with CMS is through HDI, which after multiple contract modifications due to the delay in procurement of the new Medicare RAC contract awards, now provides for a term that expires on July 31, 2016 and requires HDI to continue to support the appeal process through January 31, 2018. In November 2015, CMS released a new RFP for recovery audit services that replaces the procurement activities begun in February 2013. In December 2015, CMS delayed the current procurement in order to gather requirements for recovery auditing work of health plans. In April 2016, CMS resumed the procurement and announced that proposals for the new Medicare RAC contracts are due May 24, 2016. The timing and outcome of the new Medicare RAC contract awards continue to remain uncertain and the prolonged delay of the new contract awards and their implementation may further impact the Company’s business.

 

In addition, in August 2014, CMS announced it would settle with hospitals willing to withdraw inpatient status claims currently pending in the RAC appeals process by offering to pay hospitals 68% for all eligible claims they had billed to Medicare. In June 2015, CMS notified HDI that based on the initial lists of finalized settlements, HDI owed CMS approximately $28.6 million due to adjustments in contingency fees pursuant to HDI’s contract with CMS. HDI previously advised CMS that it disagrees with CMS’ interpretation of the contract and that CMS does not have the contractual right, among other things, to require repayment of fees already paid. Due to errors and incomplete data in certain backup documentation initially provided by CMS regarding settled claims, HDI’s evaluation of the amount allegedly owed to CMS is not yet complete. HDI has provided CMS with data which it believes more accurately reflects the number of claims which were apparently settled. There has been no recent communication or further action by HDI or CMS as of the date of this filing. A portion of our reserve for estimated liability for appeals recorded as of December 31, 2015 may apply to this population, and there could be a material negative impact on our future revenue in future periods to the extent that (i) any final determination of amounts owed by HDI to CMS under the current Medicare RAC contract materially exceeds our accrued reserves for such appeals, (ii) HDI is required to return certain fees which have been paid or (iii) HDI’s ability to collect fees for audits already performed is affected.

 

Critical Accounting Policies

 

Since the date of our 2015 Form 10-K for the year ended December 31, 2015, there have been no material changes to our critical accounting policies. Refer to the items disclosed as our Critical Accounting Policies in Part II, Item 7. “Management’s Discussion and Analysis of Financial Condition and Results of Operations” of our 2015 Form 10-K.

 

SUMMARY OF OPERATING RESULTS

 

Selected Operating Performance and Other Significant Items for the Three Months Ended March 31, 2016

 

· Revenue increased $9.5 million, or 8.6% from the same quarter in 2015.
· Operating income increased $1.9 million, or 23.8% from the same quarter in 2015.
· Net income increased $1.1 million, or 31.4% from the same quarter in 2015.
· Diluted earnings per share increased $.01 or 25% from the same quarter in 2015.
· Shareholders’ equity increased $7.2 million since December 31, 2015.
· First quarter 2016 cash flow from operations was $0.6 million.

 

18  

 

Three Months Ended March 31, 2016 Compared to Three Months Ended March 31, 2015

 

The following table sets forth, for the periods indicated, certain items in our unaudited Consolidated Statements of Income expressed as a percentage of revenue:

 

    Three Months Ended
March 31,
    2016   2015
Revenue     100 %     100 %
Cost of services:                
Compensation     38.7       39.9  
Data processing     8.0       9.1  
Occupancy     3.0       3.6  
Direct project expenses     12.1       9.5  
Other operating expenses     4.8       6.1  
Amortization of acquisition related software and intangible assets     5.9       6.4  
Total cost of services     72.5       74.6  
Selling, general and administrative expenses     19.1       18.1  
Total operating expenses     91.6       92.7  
Operating income     8.3       7.2  
Interest expense     (1.7 )     (1.8 )
Interest income     0.0       0.0  
Income before income taxes     6.6       5.4  
Income taxes     2.8       2.3  
Net income     3.8 %     3.1 %

 

Revenue

 

During the three months ended March 31, 2016, revenue was $119.8 million, an increase of $9.5 million, or 8.6% compared to $110.3 million for the three months ended March 31, 2015. This increase was primarily due to commercial health plan growth, including expansion of services to existing health plan customers, an increase in the number of new customer contract implementations and higher Medicare RAC revenue; offset by a decrease in state government revenue in part due to the significant decrease in lives due to the ACA expansion and its resulting impact on state revenues in 2014 and the first half of 2015.

 

Cost of Services

 

During the three months ended March 31, 2016, total cost of services as a percentage of revenue was 72.5% compared to 74.6% for the three months ended March 31, 2015. Total cost of services for the three months ended March 31, 2016 was $86.9 million, an increase of $4.5 million, or 5.5% compared to $82.4 million for the three months ended March 31, 2015. This change resulted primarily from increases in compensation and direct project expenses. Compensation expense is composed of salaries and wages, which include overtime, health benefits, stock option expense, performance awards, commissions, employer’s share of FICA and fringe benefits. Direct project expenses increased as a result of increases in subcontractor fees, data costs and chart fees.

 

Selling, General and Administrative Expense (“SG&A”)

 

During the three months ended March 31, 2016 SG&A expense as a percentage of revenue was 19.1% compared to 18.1% for the three months ended March 31, 2015.  SG&A expense for the three months ended March 31, 2016 was $22.9 million, an increase of $2.9 million, or 14.5% compared to $20.0 million for the three months ended March 31, 2015. This change resulted from a $1.5 million increase in compensation and stock-based compensation expense. SG&A expense also increased $3.5 million due to an increase in the provision for bad debt expense. The increase in SG&A expense was offset by a $2.1 million decrease in legal expense.

 

Operating Income

 

During the three months ended March 31, 2016 operating income was $9.9 million, an increase of $1.9 million, or 23.8%, compared to operating income of $8.0 million for the three months ended March 31, 2015.

 

19  

 

Interest Expense

 

During the three months ended March 31, 2016, interest expense was $2.1 million, an increase of $0.1 million, compared to $2.0 million for the three months ended March 31, 2015. Interest expense represents borrowings under our revolving credit facility, interest on debt, commitment fees, letter of credit fees and amortization of deferred financing costs.

 

Income Taxes

 

We recorded income tax expense of $3.3 million for the three months ended March 31, 2016, compared to income tax expense of $2.5 million for the three months ended March 31, 2015, an increase of $0.8 million. Income before taxes increased $1.9 million for the current quarter over income before taxes in the same period in the prior year, which caused an increase in our tax expense. Additionally, our effective tax rate increased to 42.0% for the three months ended March 31, 2016 compared to 41.7% for the three months ended March 31, 2015 primarily due to a change in interest on prior state unrecognized tax benefits and   permanent differences. The principal differences between our statutory rate and our effective rate are state taxes, interest related to prior year state unrecognized tax benefits, and permanent differences.

 

Net Income

 

During the three months ended March 31, 2016, net income was $4.6 million which represents an increase of $1.1 million compared to the three months ended March 31, 2015 of $3.5 million.

 

Off-Balance Sheet Arrangements

 

Other than our Letter of Credit, we do not have any off-balance sheet arrangements.

 

Liquidity and Capital Resources

 

We believe our ability to generate cash from operating activities is one of our fundamental financial strengths. The near-term outlook for our business remains strong, and we expect to generate substantial cash flows from operations throughout the remainder of 2016. As a result of our expected cash flows from operations, access to capital markets and availability of our revolving credit facility under the Credit Agreement, we believe we have significant flexibility to meet our financial commitments for the foreseeable future, which include:

 

· the working capital requirements of our operations;
· investments in our business;
· repurchases of treasury stock
· business development activities; and
· repayment of our revolving credit facility under our Credit Agreement.

 

(In thousands)   March 31,
 2016
  December 31,
2015
Cash and cash equivalents   $ 143,451     $ 145,610  
Working capital   $ 264,530     $ 247,916  
Available borrowings under credit facility   $ 169,929     $ 121,204  

 

A summary of our cash flows is as follows:

 

    Three Months Ended
March 31,
(In thousands)   2016   2015
Net cash provided by (used in) operating activities   $ 1,383     $ (95 )
Net cash used in investing activities     (1,877 )     (3,234 )
Net cash provided by (used in) financing activities     (1,665 )     3,759  
Net increase (decrease) in cash and cash equivalents   $ (2,159 )   $ 430  

 

Cash Flows from Operating Activities

 

Net cash provided by operating activities for the three months ended March 31, 2016 was $0.6 million, an increase of $0.7 million as compared to net cash used in operating activities of $0.1 million for the three months ended March 31, 2015. The increase in operating cash flow is primarily attributable to a reduction of accounts receivable, net and offset by payments made on accounts payable, accrued expenses and taxes. Additionally, the number of Days Sales Outstanding decreased from the prior year quarter by 11 days from 136 days for the three months ended March 31, 2015 to 125 days for the three months ended March 31, 2016 as a result of stronger collections.

 

20  

 

Cash Flows from Investing Activities

 

Net cash used in investing activities for the three months ended March 31, 2016 was $1.8 million, a $1.4 million decrease compared to net cash used in investing activities of $3.2 million for the three months ended March 31, 2015. The decrease primarily related to a $1.9 million decrease in purchases of property and equipment, partially offset by a $0.5 million increase in investment in capitalized software.

 

Cash Flows from Financing Activities

 

Net cash used in financing activities for the three months ended March 31, 2016 was $1.0 million, a $2.8 million decrease from net cash provided by financing activities of $3.8 million for the three months ended March 31, 2015. This decrease was primarily attributable to a $1.0 million reduction in payments of tax withholdings on behalf of employees for net-share settlement for stock-based compensation. The remaining decrease was due to fewer options exercised and thus less cash paid for stock and less taxes paid for stock exercised as compared to the same period in the prior year.

 

Contractual Obligations

 

There have been no material changes in our contractual obligations as presented in our 2015 Form 10-K.

 

Recently Issued Accounting Pronouncements

 

See “Recently Issued Accounting Pronouncements” in Note 2 of the unaudited Consolidated Financial Statements.

 

Item 3. Quantitative and Qualitative Disclosures About Market Risk

 

As of March 31, 2016, we were not a party to any derivative financial instruments. We conduct all of our business in U.S. currency and hence do not have direct foreign currency risk. We are exposed to changes in interest rates, primarily with respect to our revolving credit facility under our 2013 Credit Agreement. If the effective interest rate for all of our variable rate debt were to increase by 100 basis points (1%), our annual interest expense would increase by a maximum of $2.0 million based on our debt balances at March 31, 2016. Further, we currently invest substantially all of our excess cash in short-term investments, primarily money market accounts, where returns effectively reflect current interest rates. As a result market interest rate changes may impact our interest income or expense. The impact will depend on variables such as the magnitude of rate changes and the level of borrowings or excess cash balances. We do not consider this risk to be material. We manage such risk by continuing to evaluate the best investment rates available for short-term, high quality investments.

 

Item 4. Controls and Procedures

 

We maintain disclosure controls and procedures (as defined in Rule 13a-15(e) under the Securities Exchange Act of 1934 (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 our 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 March 31, 2016. 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 this Quarterly Report on Form 10-Q.

 

There have been no changes in our internal control over financial reporting identified in connection with the evaluation of our controls performed during the three months ended March 31, 2016 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

 

21  

 

PART II — OTHER INFORMATION

 

Item 1. Legal Proceedings

 

The information set forth under the caption “Commitments and Contingencies” in Note 11 included in Item 1. Notes to the Consolidated Financial Statements is incorporated by reference.

 

Item 1A. Risk Factors

 

In addition to the information set forth in this Quarterly Report on Form 10-Q, the risks that are discussed in the Company’s 2015 Form 10-K, under the headings “Part I, Item 1. Business,” “Part I, Item 1A. Risk Factors” and “Part II, Item 7A. Quantitative and Qualitative Disclosures About Market Risk,” should be carefully considered as such risks could materially affect the Company’s business, financial conditions or future results. There has been no material change in the Company’s risk factors from those described in the 2015 Form 10-K .

 

These risks are not the only risks facing the Company. Additional risks and uncertainties not currently known to the Company or that it currently deems to be immaterial also may have a material adverse effect on the Company’s business, financial condition or future results.

 

Item 6. Exhibits

 

Exhibit

Number

 

 

Description

3.1  

Amended and Restated Bylaws of HMS Holdings Corp., dated May 4, 2016. Incorporated by reference to Exhibit 3.2 to HMS Holdings Corp.’s Current Report on Form 8-K, file No. 000-50194, filed with the SEC on May 5, 2016.

     

10.1†*

 

Form of 2016 Executive and Senior Vice President Non-Qualified Stock Option Agreement under the 2006 Stock Plan.

     
10.2†*   Form of 2016 Executive and Senior Vice President Restricted Stock Unit Agreement under the 2006 Stock Plan.
     
31.1*   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.
     
31.2*   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.
     
32.1‡   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.
     
32.2‡   Section 1350 Certification of the Principal Financial Officer of HMS Holdings Corp., as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
     
101.INS*   XBRL Instance Document
     
101.SCH*   XBRL Taxonomy Extension Schema Document
     
101.CAL*   XBRL Taxonomy Extension Calculation Linkbase Document
     
101.DEF*   XBRL Taxonomy Extension Definition Linkbase Document
     
101.LAB*   XBRL Taxonomy Extension Label Linkbase Document
     
101.PRE*   XBRL Taxonomy Extension Presentation Linkbase Document

 

Indicates a management contract or compensatory plan, contract or arrangement
* Filed herewith
Furnished herewith

 

 

22  

 

SIGNATURES

 

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

 

Date: May 10, 2016   HMS HOLDINGS CORP.
         
         
      By: /s/ WILLIAM C. LUCIA
        William C. Lucia
        President and Chief Executive Officer and Duly
        Authorized Officer
        (Principal Executive Officer)
         
         
      By: /s/ JEFFREY S. SHERMAN
        Jeffrey S. Sherman
        Executive Vice President, Chief Financial Officer and Treasurer
       

(Principal Financial Officer)

 

 

 

 

 

 

 

23  

 

HMS Holdings Corp. and Subsidiaries

Exhibit Index

 

Exhibit

Number

  Description
     
3.1  

Amended and Restated Bylaws of HMS Holdings Corp., dated May 4, 2016. Incorporated by reference to Exhibit 3.2 to HMS Holdings Corp.’s Current Report on Form 8-K, file No. 000-50194, filed with the SEC on May 5, 2016.

     

10.1 †*

 

10.2 †*

 

31.1*

 

Form of 2016 Executive and Senior Vice President Non-Qualified Stock Option Agreement under the 2006 Stock Plan.

 

Form of 2016 Executive and Senior Vice President Restricted Stock Unit Agreement under the 2006 Stock Plan.

 

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.

     
31.2*   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.
     
32.1‡   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.
     
32.2‡   Section 1350 Certification of the Principal Financial Officer of HMS Holdings Corp., as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
     
101.INS*   XBRL Instance Document
     
101.SCH*   XBRL Taxonomy Extension Schema Document
     
101.CAL*   XBRL Taxonomy Extension Calculation Linkbase Document
     
101.DEF*   XBRL Taxonomy Extension Definition Linkbase Document
     
101.LAB*   XBRL Taxonomy Extension Label Linkbase Document
     
101.PRE*   XBRL Taxonomy Extension Presentation Linkbase Document

______________________

Indicates a management contract or compensatory plan, contract or arrangement
* Filed herewith
Furnished herewith

 

 

24


Exhibit 10.1

 

2016 Executive & SVP NQSO Agreement

<Participant Full Name>

 

Dear <Participant First Name> ,

 

Congratulations, HMS Holdings Corp. (the “ Company ”) has granted you a stock option grant under the Company’s Fourth Amended and Restated 2006 Stock Plan, as amended (the “ Plan ”). A stock option grant gives you the right to purchase a specific number of shares of the Company’s common stock at a fixed price, assuming that you satisfy conditions of the Plan and the implementing grant agreement. We would like you to have an opportunity to share in the success of the Company through this stock option grant under the Plan. The following represents a brief description of your grant. Additional details regarding your award are provided in the attached Nonqualified Stock Option Grant Agreement (the “ Grant Agreement ”) and in the Plan.

 

Stock Option Grant Summary:

 

Date of Grant March 2, 2016
Option Shares <Number of Shares Granted>
Exercise Price per Share $_____
Exercisability One-sixth of the Option Shares on each of the first, second and third anniversaries of the Date of Grant, with the remainder becoming exercisable as provided in Exhibit A to the Grant Agreement.  Each of those dates is an “ Exercisability Date .”
Term Expiration Date __________, ____

 

· You have been granted a nonqualified stock option to purchase shares of the Company’s common stock (“ Shares ”). The total number of Shares under your grant is in the chart above under “ Option Shares ” and the price per share is under “ Exercise Price per Share .”

 

· The potential value of your stock option grant increases if the price of the Company’s stock increases, but you also have to continue to provide services to the Company (except as the Grant Agreement provides) to actually receive such value. Of course, the value of the stock may go up and down over time.

 

· You can’t exercise the stock option (actually purchase Shares) until it becomes exercisable. Your stock option becomes exercisable as provided in the chart above under “ Exercisability ,” assuming you remain an employee or a member of the Board of Directors of the Company and subject to the terms in the Grant Agreement.

 

· Whether or not you decide to exercise your stock option and purchase the stock is your decision, and you have until the stock option expires (which will be no later than the seventh anniversary of the “ Date of Grant but can end earlier in various situations) to make that decision.

 

· Once you have purchased the Shares, you will own them and may decide whether to hold the stock, sell the stock or give the stock to someone as a gift.

 

You can access the Merrill Lynch portal, including updates and additional information at: https://www29.benefits.ml.com/login/login.aspx. Please email ir@hms.com with any questions.

 

 

HMS Holdings Corp.

Nonqualified Stock Option Grant Agreement for

Executives and Senior Vice Presidents

 

 

HMS Holdings Corp. (the “ Company ”) has granted you an option (the “ Option ”) under the HMS Holdings Corp. Fourth Amended and Restated 2006 Stock Plan (as it may be amended from time to time) (the “ Plan ”). The Option lets you purchase a specified number (the “ Option Shares ”) of shares of the Company’s common stock (“ Shares ”), at a specified price per Share (the “ Exercise Price ”).

 

The individualized communication you received (the “ Cover Letter ”) provides the details for your Option. It specifies the number of Option Shares, the Exercise Price, the Date of Grant, the schedule for Exercisability, and the latest date the Option will expire (the “ Term Expiration Date ”).

 

The Option is subject in all respects to the applicable provisions of the Plan. This grant agreement (the “ Grant Agreement ”) does not cover all of the rules that apply to the Option under the Plan; please refer to the Plan document. Capitalized terms are defined either further below in this Grant Agreement or in the Plan.

 

 

 

 

 

 

 

 

The Plan document is available on the Merrill Lynch website. The Prospectus for the Plan, the Company’s Registration Statement on Form S-8, the Company’s Annual Report on Form 10-K, and other filings the Company makes with the Securities and Exchange Commission are available for your review under the Investor Relations tab on the Company’s web site (http://investor.hms.com/financials.cfm). You may also obtain paper copies of these documents upon request to the Company’s Investor Relations department (ir@hms.com).

 

Neither the Company nor anyone else is making any representations or promises regarding the duration of your service, exercisability of the Option, the value of the Company's stock or of this Option, or the Company's prospects. The Company is not providing any advice regarding tax consequences to you or regarding your decisions regarding the Option; you agree to rely only upon your own personal advisors.

 

No one may sell, transfer, or distribute the Option or the securities that may be purchased upon exercising the Option without an effective registration statement relating thereto or an opinion of counsel satisfactory to the Company or other information and representations satisfactory to it that such registration is not required.

 

  Page 2

 

In addition to the Plan’s terms and restrictions, the following terms and restrictions apply:

 

Option Exercisability    While your Option remains in effect under the Option Expiration section below, you may exercise any exercisable portions of the Option (and buy the Option Shares) under the timing rules of this section, provided that you may not exercise the Option for fewer than 100 full Shares at any particular time unless fewer than 100 remain unexercised.
           
      The Option will become exercisable according to the schedule provided in the Cover Letter to this Grant Agreement assuming that through each Exercisability Date, (i) if you received the Option in your capacity as an employee of the Company, you remain an employee or (ii) if you received the Option in your capacity as a member of the Company’s Board of Directors (the “ Board ”), you remain a member of the Company’s Board.  Any fractional shares will be carried forward to the following Exercisability Date, unless the Compensation Committee (the “ Committee ”) selects a different treatment.  For purposes of this Grant Agreement, employment with the Company will include employment with any Affiliate whose employees are then eligible to receive awards under the Plan.  Unless the Committee determines otherwise, if an entity employing you ceases to be an Affiliate, your employment with the Company will be treated as ended even though you continue to be employed by that entity.
           
      Exercisability will accelerate fully on your disability or death, including with respect to the Performance Option Shares (as defined in Exhibit A to the Grant Agreement).  For this purpose, “ disability ” means permanent and total disability as defined by Section 22(e)(3) of the Internal Revenue Code of 1986.  Exercisability will continue and increase (until fully exercisable) over the two (2) years following your date of Retirement.  “ Retirement ” for this purpose means cessation of service on or after attaining age 60 and completing five (5) years of service with the Company.
           
Change in Control    If a Change in Control occurs, your Option will be treated as provided in Section 11 of the Plan if, within twenty-four (24) months following the Change in Control, your employment or service ends on a termination without cause (as determined by the Committee or the Board), provided also that the Option will remain outstanding for twelve (12) months following such termination but not beyond the Term Expiration Date.
           
Option Expiration   The Option will expire no later than the close of business on the Term Expiration Date.  Unexercisable portions of the Option expire immediately when you cease to be employed (unless you are concurrently remaining or becoming a member of the Board, or, for a Board member, concurrently remaining or becoming an employee of the Company).   If the Company terminates your employment or service for cause, the Option will immediately expire without regard to whether it is then exercisable.
           
      Exercisable portions of the Option remain exercisable until the first to occur of the following (the “ Final Exercise Date ”), each as defined further in the Plan or the Grant Agreement:  
           
      •  Three (3) months (measured to the corresponding date in the month) after your employment (or directorship) ends if you resign or if the Company terminates your employment or service without cause (as determined under the Plan), except as provided above under Change in Control;
      For death or Disability, the first anniversary of the date employment or service ends; 

 

  Page 3

 

      •  For Retirement, the end of the second year following your date of Retirement; or 
      •  The Term Expiration Date.
           
      The Committee can override the expiration provisions of this Grant Agreement.
           
Method of Exercise and Payment for Shares   Subject to this Grant Agreement and the Plan, you may exercise the Option only by providing a written notice (or notice through another previously approved method, which could include a voice- or web-based or e-mail system) to the Corporate Secretary of the Company or to whomever the Committee designates, received on or before the date the Option expires.  Each such notice must satisfy whatever then-current procedures apply to that Option and must contain such representations (statements from you about your situation) as the Company requires.  You must, at the same time, pay the Exercise Price using one or more of the following methods:
           
  Cash/Check   cash or check in the amount of the Exercise Price payable to the order of the Company;
           
  Cashless   an approved cashless exercise method, including directing the Company 
         
  Exercise   to send the stock certificates (or other acceptable evidence of ownership) to be issued under the Option to a licensed broker acceptable to the Company as your agent in exchange for the broker’s tendering to the Company cash (or acceptable cash equivalents) equal to the Exercise Price and, if you so elect, any required tax withholdings;
           
  Net Exercise   by delivery of a notice of “net exercise” to or as directed by the Company, as a result of which you will receive (i) the number of shares underlying the portion of the Option being exercised less (ii) such number of shares as is equal to (x) the aggregate Exercise Price for the portion of the Option being exercised divided by (y) the Fair Market Value on the date of exercise;
           
  Stock   if permitted by the Committee, by delivery of Shares owned by you, valued at their Fair Market Value, provided (i) applicable law then permits such method of payment, (ii) you owned such Shares, if acquired directly from the Company, for such minimum period of time, if any, as the Committee may establish in its discretion, and (iii) the Shares are not subject to any repurchase, forfeiture, unfulfilled vesting, or other similar restrictions; or 
           
        any combination of the above permitted forms for payment.
           
Withholding   Issuing the Option Shares is contingent on satisfaction of all obligations with respect to required tax or other required withholdings (for example, in the United States, any applicable Federal, state, and local taxes).  The Company may take any action permitted under Section 14(c) of the Plan to satisfy such obligation, including satisfying the tax obligations by (i) reducing the number of Option Shares to be issued to you in connection with any exercise of such Option by the number of Option Shares (valued at their Fair Market Value on the date of exercise) that would equal all taxes required to be withheld (at their minimum withholding levels), (ii) accepting payment of the withholdings directly from you or from a broker in connection with a Cashless Exercise of the Option, or (iii) taking any other action under Section 14(c) of the Plan.  If a fractional share remains after deduction for required withholding, the Company will pay you the value of the fraction in cash.
           

 

  Page 4

 

Compliance with Law   You may not exercise the Option if the Company’s issuing stock upon such exercise would violate any applicable Federal or state securities laws or other laws or regulations.  You may not sell or otherwise dispose of the Option Shares in violation of applicable law.  As part of this prohibition, you may not use the Cashless Exercise methods if the Company’s insider trading policy then prohibits you from selling to the market.
           
Additional Conditions to Exercise   The Company may postpone issuing and delivering any Option Shares for so long as the Company determines to be advisable to satisfy the following:
           
        its completing or amending any securities registration or qualification of the Option Shares or its or your satisfying any exemption from registration under any Federal or state law, rule, or regulation;
           
        its receiving proof it considers satisfactory that a person seeking to exercise the Option after your death is entitled to do so;
           
        your complying with any requests for representations under the Plan; and/or
           
        your complying with any Federal, state, or local tax withholding obligations.
           
Additional Representations from You   If you exercise the Option at a time when the Company does not have a current registration statement (generally on Form S-8) under the Securities Act of 1933 (the “Act”) that covers issuances of shares to you, you must comply with the following before the Company will issue the Option Shares to you.  You must —
           
        represent to the Company, in a manner satisfactory to the Company’s counsel, that you are acquiring the Option Shares for your own account and not with a view to reselling or distributing the Option Shares; and
           
        agree that you will not sell, transfer, or otherwise dispose of the Option Shares unless:
           
          a registration statement under the Act is effective at the time of disposition with respect to the Option Shares you propose to sell, transfer, or otherwise dispose of; or
           
          the Company has received an opinion of counsel or other information and representations it considers satisfactory to the effect that, because of Rule 144 under the Act or otherwise, no registration under the Act is required.
           
No Effect on Employment or Other Relationship   Nothing in this Grant Agreement restricts the Company’s rights or those of any of its Affiliates to terminate your employment or other relationship at any time and for any or no reason.  The termination of employment or other relationship, whether by the Company or any of its Affiliates or otherwise, and regardless of the reason for such termination, has the consequences provided for under the Plan and any applicable employment or severance agreement or plan.
           
Not a Shareholder   You understand and agree that the Company will not consider you a shareholder for any purpose with respect to any of the Option Shares until you have exercised the Option, paid for the shares, and received evidence of ownership.
           

 

  Page 5

 

No Effect on Running Business   You understand and agree that the existence of the Option will not affect in any way the right or power of the Company or its shareholders to make or authorize any adjustments, recapitalizations, reorganizations, or other changes in the Company’s capital structure or its business, or any merger or consolidation of the Company, or any issuance of bonds, debentures, preferred or other stock, with preference ahead of or convertible into, or otherwise affecting the Company’s common stock or the rights thereof, or the dissolution or liquidation of the Company, or any sale or transfer of all or any part of its assets or business, or any other corporate act or proceeding, whether or not of a similar character to those described above.
           
           
Governing Law   The laws of the State of Texas will govern all matters relating to the Option, without regard to the principles of conflict of laws.
           
Restrictive Covenants Clawback   If the Board or the Committee determines, in its sole discretion, that you violated or are violating any of the Restrictive Covenants set forth below under the section titled “ Restrictive Covenants ,” the Option will immediately terminate without regard to whether it has then become exercisable or “vested” in whole or in part.  In addition, the Board or the Committee may, in its sole discretion, require from you payment or transfer to the Company of the Gain from the Option, where the “ Gain ” consists of the greatest of (i) the value of the Option Shares on the date, within the Recovery Measurement Period, on which you exercised the Option with respect to such Option Shares, (ii) the value of the Option Shares received upon exercise during the Recovery Measurement Period, as determined on the date of the request by the Committee to pay or transfer, (iii) the gross (before tax) proceeds you received from any sale of the Option Shares during the Recovery Measurement Period, and (iv) if transferred without sale during the Recovery Measurement Period, the value of the Option Shares when so transferred.  The Board or the Committee may determine the recoupment method in its sole discretion for any portion of the Option transferred (where permitted) before being exercised.  The “ Recovery Measurement Period ” means the twelve (12) months before the date of the determination of violation.  The provisions in this section are essential economic conditions to the Company’s grant of the Option to you. By acknowledging receipt of the grant of the Option hereunder, you agree that the Company may deduct from any amounts it owes you from time to time (such as any severance or other payments owed following a termination of employment, as well as any other amounts owed to you by the Company, as permitted by applicable law) to the extent of any amounts you owe the Company under this Restrictive Covenants Clawback section.
           
      You acknowledge that you would not be receiving the Option described herein but for your agreement to comply with the Restrictive Covenants.  Likewise, you acknowledge that you would be unjustly enriched if you violate the Restrictive Covenants, while being able to retain some or all of the Option Shares or the gain associated with them.  Furthermore, you acknowledge and agree that the damages for your breach of the Restrictive Covenants are not subject to calculation and that the remedies set forth in this Restrictive Covenants Clawback section, therefore, will only reimburse the Company for a portion of the damage done.  For this reason, the Company shall be entitled to recover from you any and all damages the Company has suffered and, in addition, the Company will be entitled to injunctive relief.  The parties agree that the forfeiture of the Option and payments described in this section are expressly not the Company’s exclusive or sole remedy.   
           
      This remedy is in addition to any other remedies that the Company may have available in law or equity with respect to breaches of the Restrictive Covenants below.  It is also in addition to, and not in substitution for, any other clawback laws or policies that may be adopted from time to time, including any required by Federal law, such as under Section 304 of the Sarbanes-Oxley Act of 2002 or the Dodd-Frank Wall Street Reform and Consumer Protection Act.  
           

 

  Page 6

 

      Payment is due in cash or cash equivalents within ten (10) days after the Board or the Committee provides notice to you that it is enforcing this clawback.  Payment will be calculated on a gross basis, without reduction for taxes or commissions.  The Company may, but is not required to, accept retransfer of shares in lieu of cash payments.
           
Restrictive Covenants   In consideration of the terms of this Option and your access to Proprietary Information (as defined below), you agree to the following Restrictive Covenants: 
           
  Proprietary Information and Developments    You have or will be given access to and provided with sensitive, confidential, proprietary and/or trade secret information (collectively, “ Proprietary Information ”) in the course of your employment. Examples of Proprietary Information include inventions, new product or marketing plans, business strategies and plans, merger and acquisition targets, financial and pricing information, software of the Company in various stages of development, including computer programs in source code and binary code form, software designs, specifications, programming aids (including “library subroutines” and productivity tools), programming languages, interfaces, visual displays, technical documentation, user manuals, data files and databases of the Company, analytical models, customer/client lists and information, and supplier and vendor lists and information. You agree not to disclose or use Proprietary Information, either during or after your employment with the Company, except as necessary to perform your duties or as the Company may consent in writing.  In addition, you agree that you will make full and prompt disclosure to the Company of all inventions, creations, improvements, ideas, discoveries, trade secrets, secret processes, technology, methods, developments, software and works of authorship or other creative works, whether patentable or not, that are created, made, conceived or reduced to practice by you or under your direction or jointly with others during you employment by the Company, whether or not during normal working hours or on the premises of the Company  (collectively, “ Developments ”). 
           
  Non-competition and Non-solicitation   You agree that while the Company employs you and for a period of twelve (12) months after your employment ends for any reason, you will not directly or indirectly (whether as an owner, partner, officer, employee, director, investor, lender, consultant, independent contractor or otherwise) do any of the following: 
           
        (i)         Compete.   In the geographical area where the Company does business or, at the time your employment ends, plans to do business, you will not engage or assist others in engaging in any business or enterprise that competes with the Company’s business, including any business or enterprise that develops, designs, produces, manufactures, markets, licenses, sells, renders, or provides any product or service that competes with any product or service actually or planned to be developed, designed, produced, manufactured, marketed, licensed, sold, rendered, or provided by the Company while you are or were employed by the Company; provided that your passive ownership of not more than 1% of the outstanding stock of a publicly-held company will not, by itself, violate this provision.  For purposes of this Grant Agreement, you agree that the Company does business throughout and plans to do business throughout the United States;
           

 

  Page 7

 

        (ii)       Solicit Clients, Customers, or Accounts .  You will not, either alone or in association with others, actually or attempt to solicit, divert, or take away the business or patronage of any of the Company’s clients, customers, or accounts, or prospective clients, customers, or accounts, that the Company contacted, solicited, or served while you were employed by the Company or about which you have Proprietary Information, provided that this provision does not prevent you from soliciting clients, customers, or accounts (if you are not using Proprietary Information to do so) for purposes that are not in actual or potential competition with the Company; 
           
        (iii)       Solicit Company Employees and Independent Contractors .  You will not, either alone or in association with others, actually or attempt to (x) solicit, recruit or induce any Company employee or independent contractor who was employed or engaged by the Company at any time during the twelve (12) month period preceding the end of your employment, and who, at any time during the same twelve (12) month period, had knowledge of Proprietary Information and/or made Developments, to leave the Company’s service to engage in any business or enterprise that competes with the Company’s business or (y) solicit, recruit or engage as an employee or independent contractor in any business or enterprise that competes with the Company’s business any individual whom the Company employed or engaged at any time during the twelve (12) month period preceding the end of your employment, and who, at any time during the same twelve (12) month period, had knowledge of Proprietary Information and/or made Developments, except for an individual whose employment or other service relationship with the Company ended at least six (6) months before the date of your action; and/or 
           
        (iv)      Disclose or Utilize Product Development.   You will not, either alone or in association with others, disclose to, or utilize for the benefit of, any entity other than the Company, any systems or product development ideas, concepts, or strategies that you or others in communication with you explored, generated, initiated, or discussed for potential implementation during your employment with the Company, even if the Company has not implemented such ideas, concepts, or strategies by the time your employment with the Company ends.
           
        For the purposes of subsection (ii) “ Solicit Clients, Customers, or Accounts” , the terms “customer,” “client,” or “account” as applied to governmental agencies will mean the agency or department for which any of the products or services of the Company are sold or performed during the applicable period, any related program office, and any agency, department, or office that succeeds to the functions of any agency, department, or office to which the Company then provides or within the preceding twelve (12) months provided goods or services (to the extent that the successor replaces part or all of the customer or client to which the Company provided goods or services).
           

 

  Page 8

 

  General   To the extent you and the Company agree at any time to enter into separate agreements containing restrictive covenants with different or inconsistent terms than those contained herein, you and the Company acknowledge and agree that such different or inconsistent terms shall not in any way affect or have relevance to the Restrictive Covenants contained herein, and that the terms of these Restrictive Covenants do not supersede or amend any others currently in place, or any such future terms, unless otherwise specified by the Company in writing.  By accepting this Option grant, you agree the provisions of this Restrictive Covenants section (and the related Restrictive Covenants Clawback section) are reasonable and necessary to protect the legitimate interests of the Company. 
           
Notices     Any notice you give to the Company must follow the procedures then in effect.  If no other procedures apply, you must send your notice in writing by hand or by mail to the office of the Company’s Corporate Secretary (or to the Chair of the Committee if you are then serving as the sole Corporate Secretary).  If mailed, you should address it to the Company’s Corporate Secretary (or the Chair of the Committee) at the Company’s then corporate headquarters, unless the Company directs optionees to send notices to another corporate department or to a third party administrator or specifies another method of transmitting notice.  The Company and the Committee will address any notices to you using its standard electronic communications methods or at your office or home address as reflected on the Company’s personnel or other business records.  You and the Company may change the address for notice by like notice to the other, and the Company can also change the address for notice by general announcements to optionees. 
           
Amendment     Subject to any required action by the Committee or the shareholders of the Company, the Company may cancel the Option and provide a new award in its place, provided that the award so replaced will satisfy all of the requirements of the Plan as of the date such new award is made and no such action will adversely affect the Option to the extent then exercisable.
           
Plan Governs     Wherever a conflict may arise between the terms of this Grant Agreement and the terms of the Plan, the terms of the Plan will control.  The Committee may adjust the number of Option Shares and the Exercise Price and other terms of the Option from time to time as the Plan provides.  

 

 

 

 

 

 

  Page 9

 

 

Exhibit A

 

The exercisability of 50% of the Shares covered by the Option (the “ Performance Option Shares ”) is subject to the following conditions:

 

A.    Service Condition

 

The Performance Option Shares will become exercisable according to the applicable schedule described in Paragraph C below, provided you remain employed by the Company as of each applicable exercisability date set forth below.

 

B.    Performance Conditions

 

1.     The Company’s average closing price per Share as reported on the NASDAQ Global Select Market during at least one measurement period (as described below) must be at least 25% higher than the Exercise Price per Share specified in the Stock Option Grant Summary.

 

2.     The measurement period will consist of the applicable trading days in any consecutive thirty (30) calendar day period preceding the first, second and/or third anniversaries of the Date of Grant.

 

3.     On each anniversary of the Date of Grant (or as promptly as practicable thereafter), the Company will calculate the average closing price for the applicable measurement periods preceding such date in order to determine if the performance condition has been satisfied.

 

C. Exercisability

 

1.     Performance Condition Achieved prior to First Anniversary of the Date of Grant . If the performance condition is achieved prior to the first anniversary of the Date of Grant, the Performance Option Shares will become exercisable in equal installments pursuant to the following schedule:

 

Exercisability Date Proportion of Performance Option Shares Exercisable as of the Exercisability Date

1 st anniversary of Date of Grant

2 nd anniversary of Date of Grant

3 rd anniversary of Date of Grant

One-third of the Performance Option Shares

One-third of the Performance Option Shares

One-third of the Performance Option Shares

 

2.     Performance Condition Achieved after First Anniversary but before Second Anniversary of the Date of Grant . If the performance condition is achieved after the first anniversary but before the second anniversary of the Date of Grant, the Performance Option Shares will become exercisable pursuant to the following schedule:

 

Exercisability Date Proportion of Performance Option Shares Exercisable as of the Exercisability Date

1 st anniversary of Date of Grant

2 nd anniversary of Date of Grant

3 rd anniversary of Date of Grant

-0-

Two-thirds of the Performance Option Shares

One-third of the Performance Option Shares

 

3.     Performance Condition Achieved after Second Anniversary but before Third Anniversary of the Date of Grant . If the performance condition is achieved after the second anniversary but before the third anniversary of the Date of Grant, the Performance Option Shares will become fully exercisable as of such third anniversary pursuant to the following schedule:

 

  Page 10

 

Exercisability Date Proportion of Performance Option Shares Exercisable as of the Exercisability Date

1 st anniversary of Date of Grant

2 nd anniversary of Date of Grant

3 rd anniversary of Date of Grant

-0-

-0-

100% of the Performance Option Shares

 

4.     Performance Condition Not Achieved before the Third Anniversary of the Date of Grant. Except in the event of death, Disability or a Change of Control prior to the third anniversary of the Date of Grant (in which case the terms set forth in the Grant Agreement will apply and, for the avoidance of doubt, the performance condition will no longer be applicable), if the performance condition is not achieved by the third anniversary of the Date of Grant, no portion of the Performance Option Shares will become exercisable and the Performance Option Shares shall be forfeited.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page 11

 

 

Exhibit 10.2

 

2016 Executive & SVP RSU Agreement

<Participant Full Name>

 

Dear <Participant First Name> ,

 

Congratulations, HMS Holdings Corp. (the “ Company ”) has granted you restricted stock units (“ RSUs ”) under the Company’s Fourth Amended and Restated 2006 Stock Plan, as amended (the “ Plan ”). An RSU entitles you to receive a share of the Company’s common stock at a future date, assuming that you satisfy conditions of the Plan and the implementing grant agreement. We would like you to have an opportunity to share in the success of the Company through these RSUs under the Plan. The following represents a brief description of your grant. Additional details regarding your award are provided in the attached Restricted Stock Unit Grant Agreement (the “ Grant Agreement ”) and in the Plan.

 

Restricted Stock Unit Grant Summary:

 

Date of Grant March 2, 2016
RSU Shares <Number of Shares Granted>
Vesting One-sixth of the RSU Shares shall vest on the first, second and third anniversaries of the Date of Grant, with the remainder vesting as provided in Exhibit A to the Grant Agreement.  Each of those dates is a “ Vesting Date .”

 

· You have been granted RSUs for shares of the Company’s common stock (“ Shares ”) for the total number of Shares specified under “ RSU Shares ” in the chart above.

 

· The potential value of your RSUs increases if the price of the Company’s stock increases, but you also have to continue to provide services to the Company (except as the Grant Agreement provides) to actually receive such value. Of course, the value of the stock may go up and down over time.

 

· You will not receive the Shares represented by the RSUs unless and until the RSUs vest. Your RSUs vest as provided in the chart above under “ Vesting ,” assuming you remain an employee or a member of the Board of Directors of the Company and subject to the terms in the Grant Agreement.

 

· Once you have received the Shares, you will own them and may decide whether to hold the stock, sell the stock or give the stock to someone as a gift.

 

You can access the Merrill Lynch portal, including updates and additional information at: https://www29.benefits.ml.com/login/login.aspx. Please email ir@hms.com with any questions.

 

 

 

HMS Holdings Corp.

Restricted Stock Unit Grant Agreement for

Executives and Senior Vice Presidents

 

 

HMS Holdings Corp. (the “ Company ”) has granted you restricted stock units (the “ RSUs ”) under the HMS Holdings Corp. Fourth Amended and Restated 2006 Stock Plan (as it may be amended from time to time) (the “ Plan ”). Each RSU lets you receive a share (an “ RSU Share ”) of the Company’s common stock, upon satisfaction of the conditions to receipt.

 

The individualized communication you received (the “ Cover Letter ”) provides the details for your RSUs. It specifies the number of RSU Shares, the Date of Grant, and the schedule for Vesting, with the related vesting dates (“ Vesting Dates ”).

 

The RSUs are subject in all respects to the applicable provisions of the Plan. This grant agreement (the “ Grant Agreement ”) does not cover all of the rules that apply to the RSUs under the Plan; please refer to the Plan document. Capitalized terms are defined either further below in this Grant Agreement or in the Plan.

 

 

 

 

 

 

 

The Plan document is available on the Merrill Lynch website. The Prospectus for the Plan, the Company’s Registration Statement on Form S-8, the Company’s Annual Report on Form 10-K, and other filings the Company makes with the Securities and Exchange Commission are available for your review under the Investor Relations tab on the Company’s web site (http://investor.hms.com/financials.cfm). You may also obtain paper copies of these documents upon request to the Company’s Investor Relations department (ir@hms.com).

 

Neither the Company nor anyone else is making any representations or promises regarding the duration of your service, vesting of the RSUs, the value of the Company's stock or of these RSUs, or the Company's prospects. The Company is not providing any advice regarding tax consequences to you or regarding your decisions regarding the RSUs; you agree to rely only upon your own personal advisors.

 

No one may sell, transfer, or distribute the RSUs or the securities that may be received under them without an effective registration statement relating thereto or an opinion of counsel satisfactory to the Company or other information and representations satisfactory to it that such registration is not required.

 

  Page 2

 

In addition to the Plan’s terms and restrictions, the following terms and restrictions apply:

 

Vesting Schedule    Your RSUs become nonforfeitable (“ Vested ”) as provided in the Cover Letter to this Grant Agreement, assuming that through each Vesting Date, (i) if you received the RSUs in your capacity as an employee of the Company, you continue in service as an employee or (ii) if you received the RSUs in your capacity as a member of the Company’s Board of Directors (the “Board”), you continue in service as a member of the Company’s Board.  Any fractional shares will be carried forward to the following Vesting Date, unless the Compensation Committee (the “Committee”) selects a different treatment.  For purposes of this Grant Agreement, employment with the Company will include employment with any Affiliate whose employees are then eligible to receive awards under the Plan.  Unless the Committee determines otherwise, if an entity employing you ceases to be an Affiliate, your employment with the Company will be treated as ended even though you continue to be employed by that entity.
           
      Vesting will accelerate fully on your disability or death, including with respect to the Performance RSUs (as defined in Exhibit A to the Grant Agreement).  For this purpose, “ disability ” means permanent and total disability as defined by Section 22(e)(3) of the Internal Revenue Code of 1986 (the “ Code ”).
           
      If your employment or service ends as a result of Retirement, you will be treated as continuing in service for vesting purposes until the earlier to occur of (x) the second anniversary of your Retirement and (y) the last of the applicable Vesting Dates.  “ Retirement ” for this purpose means cessation of employment or service on or after attaining age 60 and completing five (5) years of service with the Company.
           
Change in Control   If a Change in Control occurs, your RSUs will be treated as provided in Section 11 of the Plan if, within twenty-four (24) months following the Change in Control, your employment or service ends on (i) a termination without cause (as determined by the Committee or the Board) or (ii) Retirement.
           
Termination for Cause   If the Company terminates your employment or service for cause, the RSUs will immediately terminate without regard to whether they are then Vested in whole or in part.
           
Distribution Date   Subject to any overriding provisions in the Plan, you will receive a distribution of the shares of common stock of the Company (“ Shares ”) equivalent to your Vested RSU Shares as soon as practicable following the date(s) on which they become Vested (with the actual date being the " Distribution Date ”) and, in any event, no later than thirty (30) days following an applicable Vesting Date, unless the Committee determines that you may make a timely deferral election to defer distribution to a later date and you have made such an election (in which case the deferred date will be the “ Distribution Date ”).
           
      Vesting that accelerates after a Change in Control will only accelerate the Distribution Date if and to the extent permitted under Section 409A of the Code.
           
Restrictions and Forfeiture   You may not sell, assign, pledge, encumber, or otherwise transfer any interest (“Transfer”) in the RSU Shares until the RSU Shares are distributed to you. Any attempted Transfer that precedes the Distribution Date is invalid.
           

 

  Page 3

 

      Unless the Committee determines otherwise or the Grant Agreement provides otherwise, if your employment or service with the Company terminates for any reason before your RSUs are Vested, then you will forfeit the unvested RSUs (and the Shares to which they relate) to the extent that the RSUs do not otherwise vest as a result of the termination, pursuant to the rules in the Vesting Schedule section above.  The forfeited RSUs will then immediately revert to the Company.  You will receive no payment for the RSUs if you forfeit them.
           
Taxes and Withholding   The RSUs provide tax deferral, meaning that the RSU Shares are not taxable until you actually receive the RSU Shares on or around the Distribution Date.    You will then owe taxes at ordinary income tax rates as of the Distribution Date at the Shares' value.  If you are an employee of the Company, you may owe FICA and HI (Social Security and Medicare) taxes before the Distribution Date.
           
      Issuing the Shares under the RSUs is contingent on satisfaction of all obligations with respect to required tax or other required withholdings (for example, in the United States, any applicable Federal, state, and local taxes).  The Company may take any action permitted under Section 14(c) of the Plan to satisfy such obligation, including satisfying the tax obligations by (i) reducing the number of RSU Shares to be issued to you by that number of RSU Shares (valued at their Fair Market Value on the date of distribution) that would equal all taxes required to be withheld (at their minimum withholding levels), (ii) accepting payment of the withholdings directly from you or from a broker in connection with a sale of the RSU Shares, or (iii) taking any other action under Section 14(c) of the Plan.  If a fractional share remains after deduction for required withholding, the Company will pay you the value of the fraction in cash.
           
Compliance with Law   The Company will not issue the RSU Shares if doing so would violate any applicable Federal or state securities laws or other laws or regulations.  You may not sell or otherwise dispose of the RSU Shares in violation of applicable law.
           
Additional Conditions to Receipt   The Company may postpone issuing and delivering any RSU Shares for so long as the Company determines to be advisable to satisfy the following:
           
        its completing or amending any securities registration or qualification of the RSU Shares or its or your satisfying any exemption from registration under any Federal or state law, rule, or regulation;
           
        its receiving proof it considers satisfactory that a person seeking to receive the RSU Shares after your death is entitled to do so;
           
        your complying with any requests for representations under the Plan; and/or
           
        your complying with any Federal, state, or local tax withholding obligations.
           
Additional Representations from You   If the vesting provisions of the RSUs are satisfied and you are entitled to receive RSU Shares at a time when the Company does not have a current registration statement (generally on Form S-8) under the Securities Act of 1933 (the “Act”) that covers issuances of shares to you, you must comply with the following before the Company will issue the RSU Shares to you.  You must —
           
        represent to the Company, in a manner satisfactory to the Company’s counsel, that you are acquiring the RSU Shares for your own account and not with a view to reselling or distributing the RSU Shares; and
           

 

  Page 4

 

        agree that you will not sell, transfer, or otherwise dispose of the RSU Shares unless:
           
          a registration statement under the Act is effective at the time of disposition with respect to the RSU Shares you propose to sell, transfer, or otherwise dispose of; or
           
          the Company has received an opinion of counsel or other information and representations it considers satisfactory to the effect that, because of Rule 144 under the Act or otherwise, no registration under the Act is required.
           
No Effect on Employment or Other Relationship   Nothing in this Grant Agreement restricts the Company’s rights or those of any of its Affiliates to terminate your employment or other relationship at any time and for any or no reason.  The termination of employment or other relationship, whether by the Company or any of its Affiliates or otherwise, and regardless of the reason for such termination, has the consequences provided for under the Plan and any applicable employment or severance agreement or plan.
           
Limited Status   You understand and agree that the Company will not consider you a shareholder for any purpose with respect to the RSU Shares, unless and until the RSU Shares have been issued to you on the Distribution Date.  You will not receive dividends with respect to the RSUs, but the Company will credit additional whole or fractional RSUs to this grant equal to the result of dividing (i) the product of the total number of RSUs credited to you under this grant on the record date for such dividend (and not yet distributed in Shares) and the per share amount of such dividend by (ii) the Fair Market Value of one Share on the date such dividend is paid by the Company to shareholders.  The additional RSUs will be or become Vested to the same extent as the RSUs that resulted in the crediting of such additional units and may be paid out in cash or Shares under the timing rules provided in Section 8(e) of the Plan. 
           
Voting   You may not vote the RSUs.  You may not vote the RSU Shares unless and until the Shares are distributed to you.
           
No Effect on Running Business   You understand and agree that the existence of the RSUs will not affect in any way the right or power of the Company or its shareholders to make or authorize any adjustments, recapitalizations, reorganizations, or other changes in the Company’s capital structure or its business, or any merger or consolidation of the Company, or any issuance of bonds, debentures, preferred or other stock, with preference ahead of or convertible into, or otherwise affecting the Company’s common stock or the rights thereof, or the dissolution or liquidation of the Company, or any sale or transfer of all or any part of its assets or business, or any other corporate act or proceeding, whether or not of a similar character to those described above.
           
Section 409A of the Code    The RSUs are intended to comply with the requirements of Section 409A and must be construed consistently with that section.  Notwithstanding anything in the Plan or this Grant Agreement to the contrary, if the RSUs Vest in connection with your “separation from service” within the meaning of Section 409A, as determined by the Company), and if (x) you are then a “specified employee” within the meaning of Section 409A at the time of such separation from service (as determined by the Company, by which determination you agree you are bound) and (y) the distribution of RSU Shares under such RSUs will result in the imposition of additional tax under Section 409A if distributed to you within the six (6) month period following your separation from service, then the distribution under such accelerated RSUs will not be made until the earlier of (i) the date six (6) months and one (1) day following the date of your separation from service or (ii) the 10th day after your date of death.  Neither the Company nor you shall have the right to accelerate or defer the delivery of any such RSU Shares or benefits except to the extent specifically permitted or required by Section 409A.  In no event may the Company or you defer the delivery of the RSU Shares beyond the date specified in the Distribution Date section, unless such deferral complies in all respects with Treasury Regulation Section 1.409A-2(b) related to subsequent changes in the time or form of payment of nonqualified deferred compensation arrangements, or any successor regulation.  In any event, the Company makes no representations or warranty and shall have no liability to you or any other person, if any provisions of or distributions under this Grant Agreement are determined to constitute deferred compensation subject to Section 409A but not to satisfy the conditions of that section.
           

 

  Page 5

 

Unsecured Creditor   The RSUs create a contractual obligation on the part of the Company to make a distribution of the RSU Shares at the time provided for in this Grant Agreement.  Neither you nor any other party claiming an interest in deferred compensation hereunder shall have any interest whatsoever in any specific assets of the Company.  Your right to receive distributions hereunder is that of an unsecured general creditor of Company.
           
Governing Law   The laws of the State of Texas will govern all matters relating to the RSUs, without regard to the principles of conflict of laws.
           
Restrictive Covenants Clawback   If the Board or the Committee determines, in its sole discretion, that you violated or are violating any of the Restrictive Covenants set forth below under the section titled “ Restrictive Covenants ,” the RSUs will immediately terminate without regard to whether they are then Vested in whole or in part.  In addition, the Board or the Committee may, in its sole discretion, require from you payment or transfer to the Company of the Gain from the RSUs, where the “ Gain ” consists of the greatest of (i) the value of the RSU Shares on the applicable Distribution Date on which you received them within the Recovery Measurement Period, (ii) the value of the RSU Shares received during the Recovery Measurement Period, as determined on the date of the request by the Committee to pay or transfer, (iii) the gross (before tax) proceeds you received from any sale of the RSU Shares during the Recovery Measurement Period, and (iv) if transferred without sale during the Recovery Measurement Period, the value of the RSU Shares when so transferred.  The “ Recovery Measurement Period ” means the twelve (12) months before the date of the determination of violation.  The provisions in this section are essential economic conditions to the Company’s grant of RSUs to you. By receiving the grant of RSUs hereunder, you agree that the Company may deduct from any amounts it owes you from time to time (such as any severance or other payments owed following a termination of employment, as well as any other amounts owed to you by the Company, as permitted by applicable law) to the extent of any amounts you owe the Company under this Restrictive Covenants Clawback section.
           

 

  Page 6

 

      You acknowledge that you would not be receiving the RSUs described herein but for your agreement to comply with the Restrictive Covenants.  Likewise, you acknowledge that you would be unjustly enriched if you violate the Restrictive Covenants, while being able to retain some or all of the RSUs or the gain associated with them.  Furthermore, you acknowledge and agree that the damages for your breach of the Restrictive Covenants are not subject to calculation and that the remedies set forth in this Restrictive Covenants Clawback section, therefore, will only reimburse the Company for a portion of the damage done.  For this reason, the Company shall be entitled to recover from you any and all damages the Company has suffered and, in addition, the Company will be entitled to injunctive relief.  The parties agree that the forfeiture of the RSUs and payments described in this section are expressly not the Company’s exclusive or sole remedy.   
           
      This remedy is in addition to any other remedies that the Company may have available in law or equity with respect to breaches of the Restrictive Covenants below.  It is also in addition to, and not in substitution for, any other clawback laws or policies that may be adopted from time to time, including any required by Federal law, such as under Section 304 of the Sarbanes-Oxley Act of 2002 or the Dodd-Frank Wall Street Reform and Consumer Protection Act.  
           
      Payment is due in cash or cash equivalents within ten (10) days after the Board or the Committee provides notice to you that it is enforcing this clawback.  Payment will be calculated on a gross basis, without reduction for taxes or commissions.  The Company may, but is not required to, accept retransfer of shares in lieu of cash payments.
           
Restrictive Covenants   In consideration of the terms of this RSU award and your access to Proprietary Information (as defined below), you agree to the following Restrictive Covenants:
           
  Proprietary Information and Developments   You have or will be given access to and provided with sensitive, confidential, proprietary and/or trade secret information (collectively, “ Proprietary Information ”) in the course of your employment. Examples of Proprietary Information include inventions, new product or marketing plans, business strategies and plans, merger and acquisition targets, financial and pricing information, software of the Company in various stages of development, including computer programs in source code and binary code form, software designs, specifications, programming aids (including “library subroutines” and productivity tools), programming languages, interfaces, visual displays, technical documentation, user manuals, data files and databases of the Company, analytical models, customer/client lists and information, and supplier and vendor lists and information. You agree not to disclose or use Proprietary Information, either during or after your employment with the Company, except as necessary to perform your duties or as the Company may consent in writing.  In addition, you agree that you will make full and prompt disclosure to the Company of all inventions, creations, improvements, ideas, discoveries, trade secrets, secret processes, technology, methods, developments, software and works of authorship or other creative works, whether patentable or not, that are created, made, conceived or reduced to practice by you or under your direction or jointly with others during you employment by the Company, whether or not during normal working hours or on the premises of the Company  (collectively, “ Developments ”).
           

 

  Page 7

 

  Non-competition and Non-solicitation   You agree that while the Company employs you and for a period of twelve (12) months after your employment ends for any reason, you will not directly or indirectly (whether as an owner, partner, officer, employee, director, investor, lender, consultant, independent contractor or otherwise) do any of the following: 
           
        (i)     Compete.   In the geographical area where the Company does business or, at the time your employment ends, plans to do business, you will not engage or assist others in engaging in any business or enterprise that competes with the Company’s business, including any business or enterprise that develops, designs, produces, manufactures, markets, licenses, sells, renders, or provides any product or service that competes with any product or service actually or planned to be developed, designed, produced, manufactured, marketed, licensed, sold, rendered, or provided by the Company while you are or were employed by the Company; provided that your passive ownership of not more than 1% of the outstanding stock of a publicly-held company will not, by itself, violate this provision.  For purposes of this Grant Agreement, you agree that the Company does business throughout and plans to do business throughout the United States;
           
        (ii)     Solicit Clients, Customers, or Accounts .  You will not, either alone or in association with others, actually or attempt to solicit, divert, or take away the business or patronage of any of the Company’s clients, customers, or accounts, or prospective clients, customers, or accounts, that the Company contacted, solicited, or served while you were employed by the Company or about which you have Proprietary Information, provided that this provision does not prevent you from soliciting clients, customers, or accounts (if you are not using Proprietary Information to do so) for purposes that are not in actual or potential competition with the Company; 
           
        (iii)     Solicit Company Employees and Independent Contractors .  You will not, either alone or in association with others, actually or attempt to (x) solicit, recruit or induce any Company employee or independent contractor who was employed or engaged by the Company at any time during the twelve (12) month period preceding the end of your employment, and who, at any time during the same twelve (12) month period, had knowledge of Proprietary Information and/or made Developments, to leave the Company’s service to engage in any business or enterprise that competes with the Company’s business or (y) solicit, recruit or engage as an employee or independent contractor in any business or enterprise that competes with the Company’s business any individual whom the Company employed or engaged at any time during the twelve (12) month period preceding the end of your employment, and who, at any time during the same twelve (12) month period, had knowledge of Proprietary Information and/or made Developments, except for an individual whose employment or other service relationship with the Company ended at least six (6) months before the date of your action; and/or 
           
        (iv)     Disclose or Utilize Product Development.   You will not, either alone or in association with others, disclose to, or utilize for the benefit of, any entity other than the Company, any systems or product development ideas, concepts, or strategies that you or others in communication with you explored, generated, initiated, or discussed for potential implementation during your employment with the Company, even if the Company has not implemented such ideas, concepts, or strategies by the time your employment with the Company ends.
           

 

  Page 8

 

        For the purposes of subsection (ii) “ Solicit Clients, Customers, or Accounts” , the terms “customer,” “client,” or “account” as applied to governmental agencies will mean the agency or department for which any of the products or services of the Company are sold or performed during the applicable period, any related program office, and any agency, department, or office that succeeds to the functions of any agency, department, or office to which the Company then provides or within the preceding twelve (12) months provided goods or services (to the extent that the successor replaces part or all of the customer or client to which the Company provided goods or services).
           
  General   To the extent you and the Company agree at any time to enter into separate agreements containing restrictive covenants with different or inconsistent terms than those contained herein, you and the Company acknowledge and agree that such different or inconsistent terms shall not in any way affect or have relevance to the Restrictive Covenants contained herein, and that the terms of these Restrictive Covenants do not supersede or amend any others currently in place, or any such future terms, unless otherwise specified by the Company in writing.  By accepting this RSU award, you agree the provisions of this Restrictive Covenants section (and the related Restrictive Covenants Clawback section) are reasonable and necessary to protect the legitimate interests of the Company. 
           
Notices   Any notice you give to the Company must follow the procedures then in effect.  If no other procedures apply, you must send your notice in writing by hand or by mail to the office of the Company’s Corporate Secretary (or to the Chair of the Committee if you are then serving as the sole Corporate Secretary).  If mailed, you should address it to the Company’s Corporate Secretary (or the Chair of the Committee) at the Company’s then corporate headquarters, unless the Company directs Plan participants to send notices to another corporate department or to a third party administrator or specifies another method of transmitting notice.  The Company and the Committee will address any notices to you using its standard electronic communications methods or at your office or home address as reflected on the Company’s personnel or other business records.  You and the Company may change the address for notice by like notice to the other, and the Company can also change the address for notice by general announcements to Plan participants. 
           
Amendment   Subject to any required action by the Committee or the shareholders of the Company, the Company may cancel the RSUs and provide a new award in its place, provided that the award so replaced will satisfy all of the requirements of the Plan as of the date such new award is made and no such action will adversely affect the RSUs to the extent then Vested.
           
Plan Governs   Wherever a conflict may arise between the terms of this Grant Agreement and the terms of the Plan, the terms of the Plan will control.  The Committee may adjust the number of RSU Shares and other terms of the RSUs from time to time as the Plan provides.  

 

 

  Page 9

 

Exhibit A

 

The vesting of 50% of the RSUs (the “ Performance RSUs ”) is subject to the following conditions:

 

A.    Service Condition

 

The Performance RSUs will vest according to the applicable schedule described in Paragraph C below, provided you remain employed by the Company as of each applicable vesting date set forth below.

 

B.    Performance Conditions

 

1.     The Company’s average closing price per Share as reported on the NASDAQ Global Select Market during at least one measurement period (as described below) must be at least 25% higher than the closing price per Share as reported on the NASDAQ Global Select Market on the Date of Grant.

 

2.     The measurement period will consist of the applicable trading days in any consecutive thirty (30) calendar day period preceding the first, second and/or third anniversaries of the Date of Grant.

 

3.     On each anniversary of the Date of Grant (or as promptly as practicable thereafter), the Company will calculate the average closing price for the applicable measurement periods preceding such date in order to determine if the performance condition has been satisfied.

 

C.    Vesting

 

1.     Performance Condition Achieved prior to First Anniversary of the Date of Grant . If the performance condition is achieved prior to the first anniversary of the Date of Grant, the Performance RSUs will vest in equal installments pursuant to the following schedule:

 

Vesting Date Proportion of Performance RSUs that will vest as of the Vesting Date

1 st anniversary of Date of Grant

2 nd anniversary of Date of Grant

3 rd anniversary of Date of Grant

One-third of the Performance RSUs

One-third of the Performance RSUs

One-third of the Performance RSUs

 

2.     Performance Condition Achieved after First Anniversary but before Second Anniversary of the Date of Grant . If the performance condition is achieved after the first anniversary but before the second anniversary of the Date of Grant, the Performance RSUs will vest pursuant to the following schedule:

 

Vesting Date Proportion of Performance RSUs that will vest as of the Vesting Date

1 st anniversary of Date of Grant

2 nd anniversary of Date of Grant

3 rd anniversary of Date of Grant

- 0 -

Two-thirds of the Performance RSUs

One-third of the Performance RSUs

 

3.     Performance Condition Achieved after Second Anniversary but before Third Anniversary of the Date of Grant . If the performance condition is achieved after the second anniversary but before the third anniversary of the Date of Grant, the Performance RSUs will become fully vested as of such third anniversary pursuant to the following schedule:

 

  Page 10

 

Vesting Date Proportion of Performance RSUs that will vest as of the Vesting Date

1 st anniversary of Date of Grant

2 nd anniversary of Date of Grant

3 rd anniversary of Date of Grant

- 0 -

- 0 -

100% of the Performance RSUs

 

4.       Performance Condition Not Achieved before the Third Anniversary of the Date of Grant. Except in the event of death, Disability or a Change of Control prior to the third anniversary of the Date of Grant (in which case the terms set forth in the Grant Agreement will apply and, for the avoidance of doubt, the performance condition will no longer be applicable), if the performance condition is not achieved by the third anniversary of the Date of Grant, no portion of the Performance RSUs will vest and the Performance RSUs shall be forfeited.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page 11

 

 

 

 

Exhibit 31.1

Certification

 

I, William C. Lucia, certify that:

 

1. I have reviewed this Quarterly Report on Form 10-Q of HMS Holdings Corp.;

 

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

 

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

 

4. The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

 

(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

 

(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, 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;

 

(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

 

(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

 

5. The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

 

(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

 

(b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

 

 

Date:     May 10, 2016 /s/ WILLIAM C. LUCIA
  William C. Lucia
  Chief Executive Officer
  (Principal Executive Officer)

 

 

 

Exhibit 31.2

 

Certification

 

I, Jeffrey S. Sherman, certify that:

 

1. I have reviewed this Quarterly Report on Form 10-Q of HMS Holdings Corp.;

 

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

 

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

 

4. The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

 

(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

 

(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, 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;

 

(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

 

(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

 

5. The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

 

(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

 

(b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

 

 

Date:     May 10, 2016 /s/ JEFFREY S. SHERMAN
  Jeffrey S. Sherman
  Chief Financial Officer
  (Principal Financial Officer)

 

 

Exhibit 32.1

 

Certification Pursuant To 18 U.S.C. Section 1350 As Adopted Pursuant To Section 906 of the Sarbanes-Oxley Act of 2002

 

In connection with the Quarterly Report of HMS Holdings Corp. (the “ Company ”) on Form 10-Q for the period ended March 31, 2016 as filed with the Securities and Exchange Commission (the “ Report ”), I, William C. Lucia, Chief Executive Officer of the Company, certify, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

 

(1) the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

 

(2) the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

 

 

  /s/ WILLIAM C. LUCIA
  William C. Lucia
  Chief Executive Officer
  (Principal Executive Officer)
   
   
  May 10, 2016

 

A signed original of this written statement required by Section 906 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request. This written statement accompanies the Form 10-Q to which it relates, is not deemed filed with the Securities and Exchange Commission, and will not be incorporated by reference into any filing of the Company under the Securities Act of 1933 or the Securities Exchange Act of 1934, irrespective of any general incorporation language contained in such filing.

 

 

 

Exhibit 32.2

 

Certification Pursuant To 18 U.S.C. Section 1350 As Adopted Pursuant To Section 906 of the Sarbanes-Oxley Act of 2002

 

In connection with the Quarterly Report of HMS Holdings Corp. (the “ Company ”) on Form 10-Q for the period ended March 31, 2016 as filed with the Securities and Exchange Commission (the “ Report ”), I, Jeffrey S. Sherman, Chief Financial Officer of the Company, certify, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

 

(1) the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

 

(2) the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

 

 

  /s/ JEFFREY S. SHERMAN
  Jeffrey S. Sherman
  Chief Financial Officer
  (Principal Financial Officer)
   
   
  May 10, 2016

 

A signed original of this written statement required by Section 906 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request. This written statement accompanies the Form 10-Q to which it relates, is not deemed filed with the Securities and Exchange Commission, and will not be incorporated by reference into any filing of the Company under the Securities Act of 1933 or the Securities Exchange Act of 1934, irrespective of any general incorporation language contained in such filing.