false--12-31Q2201900011965011121P3YP1Y0.010.0117500000017500000098924501101014406852616648735049811000002400000000.010.015000000500000000P4YP1Y1366319413663194 0001196501 2019-01-01 2019-06-30 0001196501 2019-07-31 0001196501 2019-06-30 0001196501 2018-12-31 0001196501 2019-04-01 2019-06-30 0001196501 2018-04-01 2018-06-30 0001196501 2018-01-01 2018-06-30 0001196501 us-gaap:CommonStockIncludingAdditionalPaidInCapitalMember 2019-01-01 2019-06-30 0001196501 us-gaap:CommonStockIncludingAdditionalPaidInCapitalMember 2017-12-31 0001196501 us-gaap:CommonStockMember 2017-12-31 0001196501 us-gaap:CommonStockIncludingAdditionalPaidInCapitalMember 2019-04-01 2019-06-30 0001196501 us-gaap:CommonStockMember 2018-04-01 2018-06-30 0001196501 2018-06-30 0001196501 us-gaap:TreasuryStockMember 2019-01-01 2019-06-30 0001196501 us-gaap:CommonStockMember 2018-01-01 2018-06-30 0001196501 us-gaap:TreasuryStockMember 2018-12-31 0001196501 us-gaap:TreasuryStockMember 2018-03-31 0001196501 us-gaap:RetainedEarningsMember 2018-12-31 0001196501 us-gaap:CommonStockIncludingAdditionalPaidInCapitalMember 2019-03-31 0001196501 us-gaap:TreasuryStockMember 2019-03-31 0001196501 us-gaap:RetainedEarningsMember 2019-01-01 2019-06-30 0001196501 us-gaap:TreasuryStockMember 2018-06-30 0001196501 us-gaap:RetainedEarningsMember 2018-01-01 0001196501 us-gaap:RetainedEarningsMember 2018-06-30 0001196501 us-gaap:CommonStockMember 2019-06-30 0001196501 us-gaap:CommonStockIncludingAdditionalPaidInCapitalMember 2018-04-01 2018-06-30 0001196501 us-gaap:CommonStockMember 2018-03-31 0001196501 us-gaap:RetainedEarningsMember 2019-06-30 0001196501 us-gaap:CommonStockIncludingAdditionalPaidInCapitalMember 2018-01-01 2018-06-30 0001196501 us-gaap:CommonStockMember 2018-06-30 0001196501 us-gaap:TreasuryStockMember 2017-12-31 0001196501 us-gaap:CommonStockMember 2018-12-31 0001196501 us-gaap:TreasuryStockMember 2018-01-01 2018-06-30 0001196501 us-gaap:CommonStockIncludingAdditionalPaidInCapitalMember 2018-06-30 0001196501 us-gaap:CommonStockMember 2019-04-01 2019-06-30 0001196501 us-gaap:CommonStockMember 2019-01-01 2019-06-30 0001196501 us-gaap:TreasuryStockMember 2019-04-01 2019-06-30 0001196501 us-gaap:RetainedEarningsMember 2019-04-01 2019-06-30 0001196501 us-gaap:RetainedEarningsMember 2018-03-31 0001196501 us-gaap:TreasuryStockMember 2018-04-01 2018-06-30 0001196501 us-gaap:TreasuryStockMember 2019-06-30 0001196501 us-gaap:CommonStockMember 2019-03-31 0001196501 us-gaap:CommonStockIncludingAdditionalPaidInCapitalMember 2018-12-31 0001196501 us-gaap:RetainedEarningsMember 2017-12-31 0001196501 us-gaap:CommonStockIncludingAdditionalPaidInCapitalMember 2019-06-30 0001196501 us-gaap:RetainedEarningsMember 2018-04-01 2018-06-30 0001196501 us-gaap:RetainedEarningsMember 2019-03-31 0001196501 us-gaap:RetainedEarningsMember 2018-01-01 2018-06-30 0001196501 us-gaap:CommonStockIncludingAdditionalPaidInCapitalMember 2018-03-31 0001196501 2017-12-31 0001196501 us-gaap:AccountingStandardsUpdate201602Member 2019-01-01 0001196501 hmsy:SalesChannelFederalMember 2019-01-01 2019-06-30 0001196501 hmsy:SalesChannelFederalMember 2018-04-01 2018-06-30 0001196501 hmsy:SalesChannelFederalMember 2019-04-01 2019-06-30 0001196501 hmsy:SalesChannelFederalMember 2018-01-01 2018-06-30 0001196501 hmsy:SalesChannelStateMember 2019-04-01 2019-06-30 0001196501 hmsy:SalesChannelCommercialMember 2018-04-01 2018-06-30 0001196501 hmsy:SalesChannelStateMember 2019-01-01 2019-06-30 0001196501 hmsy:SalesChannelCommercialMember 2018-01-01 2018-06-30 0001196501 hmsy:SalesChannelStateMember 2018-04-01 2018-06-30 0001196501 hmsy:SalesChannelCommercialMember 2019-04-01 2019-06-30 0001196501 hmsy:SalesChannelCommercialMember 2019-01-01 2019-06-30 0001196501 hmsy:SalesChannelStateMember 2018-01-01 2018-06-30 0001196501 hmsy:TotalPopulationManagementMember 2019-01-01 2019-06-30 0001196501 hmsy:CoordinationOfBenefitsMember 2019-04-01 2019-06-30 0001196501 hmsy:TotalPopulationManagementMember 2018-01-01 2018-06-30 0001196501 hmsy:CoordinationOfBenefitsMember 2019-01-01 2019-06-30 0001196501 hmsy:CoordinationOfBenefitsMember 2018-04-01 2018-06-30 0001196501 hmsy:PaymentIntegrityMember 2018-01-01 2018-06-30 0001196501 hmsy:PaymentIntegrityMember 2019-01-01 2019-06-30 0001196501 hmsy:TotalPopulationManagementMember 2019-04-01 2019-06-30 0001196501 hmsy:TotalPopulationManagementMember 2018-04-01 2018-06-30 0001196501 hmsy:PaymentIntegrityMember 2018-04-01 2018-06-30 0001196501 hmsy:PaymentIntegrityMember 2019-04-01 2019-06-30 0001196501 hmsy:CoordinationOfBenefitsMember 2018-01-01 2018-06-30 0001196501 us-gaap:AccountingStandardsUpdate201409Member 2018-01-01 0001196501 srt:MinimumMember 2019-06-30 0001196501 srt:MinimumMember 2019-01-01 2019-06-30 0001196501 srt:MaximumMember 2019-01-01 2019-06-30 0001196501 2018-01-01 2018-12-31 0001196501 us-gaap:CustomerRelationshipsMember 2018-12-31 0001196501 us-gaap:CustomerRelationshipsMember 2018-01-01 2018-12-31 0001196501 us-gaap:IntellectualPropertyMember 2018-12-31 0001196501 us-gaap:TradeNamesMember 2018-01-01 2018-12-31 0001196501 hmsy:RestrictiveCovenantMember 2018-12-31 0001196501 us-gaap:IntellectualPropertyMember 2018-01-01 2018-12-31 0001196501 us-gaap:TradeNamesMember 2018-12-31 0001196501 hmsy:RestrictiveCovenantMember 2018-01-01 2018-12-31 0001196501 us-gaap:CustomerRelationshipsMember 2019-06-30 0001196501 hmsy:RestrictiveCovenantMember 2019-06-30 0001196501 us-gaap:TradeNamesMember 2019-06-30 0001196501 us-gaap:IntellectualPropertyMember 2019-06-30 0001196501 hmsy:RestrictiveCovenantMember 2019-01-01 2019-06-30 0001196501 us-gaap:IntellectualPropertyMember 2019-01-01 2019-06-30 0001196501 us-gaap:CustomerRelationshipsMember 2019-01-01 2019-06-30 0001196501 us-gaap:TradeNamesMember 2019-01-01 2019-06-30 0001196501 hmsy:OriginalRACContractMember 2019-04-01 2019-06-30 0001196501 2018-01-01 2018-03-31 0001196501 hmsy:RAC4ContractMember 2019-01-01 2019-06-30 0001196501 hmsy:OriginalRACContractMember 2019-01-01 2019-06-30 0001196501 hmsy:CommercialContractsMember 2019-01-01 2019-06-30 0001196501 hmsy:OriginalRACContractMember 2019-06-30 0001196501 hmsy:OriginalRACContractMember 2018-12-31 0001196501 hmsy:RAC4ContractMember 2018-12-31 0001196501 hmsy:CommercialContractsMember 2019-06-30 0001196501 hmsy:RAC4ContractMember 2019-06-30 0001196501 hmsy:CommercialContractsMember 2018-12-31 0001196501 srt:MaximumMember us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember us-gaap:LondonInterbankOfferedRateLIBORMember 2017-12-01 2017-12-31 0001196501 us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember us-gaap:LondonInterbankOfferedRateLIBORMember 2017-12-01 2017-12-31 0001196501 hmsy:CreditAgreementMember 2017-12-31 0001196501 us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember 2017-12-01 2017-12-31 0001196501 srt:MinimumMember us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember 2017-12-01 2017-12-31 0001196501 us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember 2019-01-01 2019-06-30 0001196501 srt:MaximumMember hmsy:FromAndAfterJanuary2020Member us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember 2017-12-01 2017-12-31 0001196501 us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember us-gaap:FederalFundsEffectiveSwapRateMember 2017-12-01 2017-12-31 0001196501 srt:MaximumMember us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember 2017-12-01 2017-12-31 0001196501 srt:MinimumMember us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember us-gaap:LondonInterbankOfferedRateLIBORMember 2017-12-01 2017-12-31 0001196501 us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember 2019-06-30 0001196501 us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember 2018-01-01 2018-06-30 0001196501 us-gaap:LetterOfCreditMember hmsy:CreditAgreementMember 2017-12-31 0001196501 srt:MaximumMember hmsy:ThroughDecember2019Member us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember 2017-12-01 2017-12-31 0001196501 us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember 2018-12-31 0001196501 srt:MinimumMember us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember hmsy:OneMonthLIBORRateMember 2017-12-01 2017-12-31 0001196501 srt:MaximumMember us-gaap:RevolvingCreditFacilityMember hmsy:CreditAgreementMember hmsy:OneMonthLIBORRateMember 2017-12-01 2017-12-31 0001196501 hmsy:SwinglineLoansMember hmsy:CreditAgreementMember 2017-12-31 0001196501 hmsy:CreditAgreementMember 2017-12-01 2017-12-31 0001196501 us-gaap:LetterOfCreditMember hmsy:CreditAgreementMember 2017-12-01 2017-12-31 0001196501 us-gaap:RevolvingCreditFacilityMember 2018-01-01 2018-06-30 0001196501 us-gaap:RevolvingCreditFacilityMember 2019-01-01 2019-06-30 0001196501 us-gaap:RevolvingCreditFacilityMember 2018-04-01 2018-06-30 0001196501 us-gaap:RevolvingCreditFacilityMember 2019-04-01 2019-06-30 0001196501 us-gaap:EmployeeStockOptionMember 2019-04-01 2019-06-30 0001196501 us-gaap:EmployeeStockOptionMember 2018-01-01 2018-06-30 0001196501 us-gaap:RestrictedStockMember 2018-04-01 2018-06-30 0001196501 us-gaap:RestrictedStockMember 2019-01-01 2019-06-30 0001196501 us-gaap:RestrictedStockMember 2018-01-01 2018-06-30 0001196501 us-gaap:EmployeeStockOptionMember 2019-01-01 2019-06-30 0001196501 us-gaap:RestrictedStockMember 2019-04-01 2019-06-30 0001196501 us-gaap:EmployeeStockOptionMember 2018-04-01 2018-06-30 0001196501 us-gaap:SellingGeneralAndAdministrativeExpensesMember 2019-01-01 2019-06-30 0001196501 us-gaap:CostOfSalesMember 2019-01-01 2019-06-30 0001196501 us-gaap:CostOfSalesMember 2018-04-01 2018-06-30 0001196501 us-gaap:CostOfSalesMember 2019-04-01 2019-06-30 0001196501 us-gaap:SellingGeneralAndAdministrativeExpensesMember 2018-04-01 2018-06-30 0001196501 us-gaap:CostOfSalesMember 2018-01-01 2018-06-30 0001196501 us-gaap:SellingGeneralAndAdministrativeExpensesMember 2019-04-01 2019-06-30 0001196501 us-gaap:SellingGeneralAndAdministrativeExpensesMember 2018-01-01 2018-06-30 0001196501 us-gaap:RestrictedStockUnitsRSUMember 2018-04-01 2018-06-30 0001196501 us-gaap:RestrictedStockUnitsRSUMember 2019-01-01 2019-06-30 0001196501 us-gaap:RestrictedStockUnitsRSUMember 2019-06-30 0001196501 us-gaap:RestrictedStockUnitsRSUMember 2019-04-01 2019-06-30 0001196501 us-gaap:RestrictedStockUnitsRSUMember 2018-01-01 2018-06-30 0001196501 us-gaap:RestrictedStockUnitsRSUMember 2018-12-31 0001196501 us-gaap:EmployeeStockOptionMember hmsy:BlackScholesModelMember 2018-01-01 2018-06-30 0001196501 us-gaap:EmployeeStockOptionMember hmsy:BlackScholesModelMember 2019-01-01 2019-06-30 0001196501 srt:MaximumMember 2019-06-30 0001196501 2017-11-03 2017-11-03 0001196501 hmsy:DismissedMember hmsy:BreachofContractMember 2012-07-01 2012-07-31 0001196501 hmsy:BreachofImpliedCovenantMember 2012-07-01 2012-07-31 0001196501 hmsy:BreachofContractMember 2012-07-01 2012-07-31 0001196501 us-gaap:SubsequentEventMember 2019-07-24 2019-07-24 0001196501 hmsy:InstaMedHoldingsInc.Member us-gaap:SubsequentEventMember 2019-07-24 2019-07-24 iso4217:USD hmsy:cause_of_action xbrli:pure iso4217:USD xbrli:shares hmsy:Segment xbrli:shares


UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended June 30, 2019
or
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from to
Commission File Number: 000-50194
HMSLOGOREGISTRATION2COLORRGB.JPG
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)
(214) 453-3000
(Registrant’s telephone number, including area code)
Not applicable
(Former name, former address and former fiscal year, if changed since last report)
Securities registered pursuant to Section 12(b) of the Act:
Title of each class
Trading Symbol
Name of each exchange on which registered
Common Stock $0.01 par value
HMSY
The Nasdaq Stock Market LLC
Nasdaq Global Select Market
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes   No ☐
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).  Yes   No ☐
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer
Accelerated filer
Non-accelerated filer
Smaller reporting company
 
 
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes   No 

As of July 31, 2019, there were approximately 87,353,476 shares of the registrant’s common stock outstanding.




HMS HOLDINGS CORP. AND SUBSIDIARIES
QUARTERLY REPORT ON FORM 10-Q
FOR THE THREE AND SIX MONTHS ENDED JUNE 30, 2019
INDEX
 
 
Page
 
 
 
1
 
 
 
 
 
6
 
 
 
 
6
 
 
 
 
7
 
 
 
 
8
 
 
 
 
9
 
 
 
 
10
 
 
 
27
 
 
 
37
 
 
 
37
 
 
 
 
 
 
38
 
 
 
38
 
 
 
39
 
 
 
41




Glossary
Throughout this Quarterly Report on Form 10-Q, the Company may use certain abbreviations, acronyms and terms which are described below:
ACA
Patient Protections and Affordable Care Act, as amended by the Health Care and Education
Reconciliation Act
ACO
Accountable Care Organization
ADR
Additional Documentation Request
ASC
Accounting Standards Codification
ASO
Administrative Service Only
ASU
Accounting Standards Update
CHIP
Children's Health Insurance Program
CMS
Centers for Medicare & Medicaid Services
CMS NHE
CMS National Health Expenditures
COB
Coordination of benefits
COSO
Committee of Sponsoring Organizations of the Treadway Commission
Credit Agreement
The Amended and Restated Credit Agreement dated as of May 3, 2013, as amended by Amendment  No. 1 to Amended and Restated Credit Agreement dated as of March 8, 2017, and as further amended by Amendment No. 2 to Amended and Restated Credit Agreement, dated as of December 19, 2017, by and among HMS Holdings Corp. the Guarantors party thereto, the Lenders party thereto and Citibank, N.A. as Administrative Agent
DSO
Days sales outstanding
ERISA
Employment Retirement Income Security Act of 1974
Exchange Act
Securities Exchange Act of 1934, as amended
FASB
Financial Accounting Standards Board
Form 10-Q
HMS Holdings Corp. Quarterly Report on Form 10-Q for the quarterly period ended June 30, 2019
HIPAA
Health Insurance Portability and Accountability Act of 1996
HITECH
Health Information Technology for Economic and Clinical Health Act
IRC
Internal Revenue Code
IRS
U.S. Internal Revenue Service
LIBO Rate
London Interbank Offered Rate (or any successor rate determined in accordance with the Credit Agreement)
MCO
Managed Care Organization
PBM
Pharmacy Benefit Manager
PHI
Protected health information
PHM
Population Health Management
PI
Payment Integrity
PMPM
Per Member Per Month
PMPY
Per Member Per Year
R&D Credit
U.S. Research and Experimentation Tax Credit pursuant to IRC Section 41

1



RAC
Recovery Audit Contractor
RFP
Request for proposal
ROU
Right-of-use
SEC
U.S. Securities and Exchange Commission
Securities Act
Securities Act of 1933, as amended
Section 199 Deduction
U.S. Production Activities Deduction pursuant to IRC Section 199
SG&A
Selling, general and administrative
TPL
Third-party liability
U.S. GAAP
United States Generally Accepted Accounting Principles
2006 Stock Plan
HMS Holdings Corp. Fourth Amended and Restated 2006 Stock Plan, as amended by Amendment No. 1 to the HMS Holdings Corp. Fourth Amended and Restated 2006 Stock Plan dated as of February 16, 2017
2016 Omnibus Plan
HMS Holdings Corp. 2016 Omnibus Incentive Plan
2017 Tax Act
Tax Cuts and Jobs Act of 2017
2018 Form 10-K
HMS Holdings Corp. Annual Report on Form 10-K for the year ended December 31, 2018
2019 Omnibus Plan
HMS Holdings Corp. 2019 Omnibus Incentive Plan
401(k) Plan
HMS Holdings Corp. 401(k) Plan

2



For purposes of this Form 10-Q, the terms “HMS,” “Company,” “we,” “us,” and “our” refer to HMS Holdings Corp. and its consolidated subsidiaries unless the context clearly indicates otherwise. 
Cautionary Note Regarding Forward-Looking Statements
Included in this Form 10-Q are “forward-looking statements” within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. From time to time, we also provide forward-looking statements in other materials we release to the public, as well as oral forward-looking statements. Such statements relate to our current expectations, projections and assumptions about our business, the economy and future events or conditions. They do not relate strictly to historical or current facts.
We have tried to identify forward-looking statements by using words such as “aim,” “anticipate,” “believe,” “estimate,” “expect,” “forecast,” “future,” “intend,” “likely,” “may,” “outlook,” “plan,” “potential,” “project,” “seek,” “strategy,” “target,” “trend,” “will,” “would,” “could,” “should,” and similar expressions and references to guidance, although some forward-looking statements may be expressed differently. These statements include, among other things, information concerning our future growth, business strategy, strategic or operational initiatives, our future operating or financial performance, our ability to invest in and utilize our data and analytics capabilities to expand our solutions and services, the benefits and synergies to be obtained from completed and future acquisitions, the future performance of companies we have acquired, our future expenses, interest rates and tax rates, our ability to meet our future liquidity requirements, the impact of changes to U.S. healthcare legislation or healthcare spending affecting Medicare, Medicaid or other publicly funded or subsidized health programs, and other statements regarding our possible future actions, business plans, objectives and prospects.
Forward-looking statements are not guarantees and involve risks, uncertainties and assumptions that are difficult to predict. Actual results may differ materially from past results and from those indicated by such forward-looking statements if known or unknown risks or uncertainties materialize, or if underlying assumptions prove inaccurate. These risks and uncertainties include, among other things:
our ability to execute our business plans or growth strategy;
our ability to innovate, develop or implement new or enhanced solutions or services;
the nature of investment and acquisition opportunities we are pursuing, and the successful execution of such investments and acquisitions;
our ability to successfully integrate acquired businesses and realize synergies;
significant competition for our solutions and services;
variations in our results of operations;
our ability to accurately forecast the revenue under our contracts and solutions;
our ability to protect our systems from damage, interruption or breach, and to maintain effective information and technology systems and networks;
our ability to protect our intellectual property rights, proprietary technology, information processes and know-how;
our failure to maintain a high level of customer retention or the unexpected reduction in scope or termination of key contracts with major customers;
customer dissatisfaction or our non-compliance with contractual provisions or regulatory requirements;
our failure to meet performance standards triggering significant costs or liabilities under our contracts;

3



our inability to manage our relationships with data sources and suppliers;
our reliance on subcontractors and other third party providers and parties to perform services;
our ability to continue to secure contracts and favorable contract terms through the competitive bidding process;
pending or threatened litigation;
unfavorable outcomes in legal proceedings;
our success in attracting and retaining qualified employees and members of our management team;
our ability to generate sufficient cash to cover our interest and principal payments under our credit facility;
unexpected changes in tax laws, regulations or guidance and unexpected changes in our effective tax rate;
unanticipated increases in the number or amount of claims for which we are self-insured;
accounting changes or revisions;
changes in the U.S. healthcare environment or healthcare financing system, including regulatory, budgetary or political actions that affect healthcare spending or the practices and operations of healthcare organizations;
our failure to comply with applicable laws and regulations governing individual privacy and information security or to protect such information from theft and misuse;
our ability to comply with current and future legal and regulatory requirements;
negative results of government or customer reviews, audits or investigations;
state or federal limitations related to outsourcing of certain government programs or functions;
restrictions on bidding or performing certain work due to perceived conflicts of interests;
the market price of our common stock and lack of dividend payments; and
anti-takeover provisions in our corporate governance documents.
These and other risks are discussed in this Form 10-Q and under the headings “Business,” “Risk Factors,” “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and “Quantitative and Qualitative Disclosures About Market Risk” of our 2018 Form 10-K, and in other documents we file with the SEC.
Any forward-looking statements made by us in this Form 10-Q speak only as of the date on which they are made. We undertake no obligation to publicly update forward-looking statements, whether as a result of new information, future events or otherwise, except as may be required by law. We caution readers not to place undue reliance upon any of these forward-looking statements. You are advised, however, to consult any further disclosures we make on related subjects in our reports and other filings with the SEC.
Market and Industry Data
This Form 10-Q may include market, industry and government data and forecasts that have been obtained from publicly available information, various industry publications, other published industry sources and our own internal data and estimates. We have not independently verified third-party information and cannot make any representation as to the accuracy or completeness of such information. None of the reports and other materials of third-party sources referred to in this Form 10-Q were prepared for use in, or in connection with, this Form 10-Q.
Trademarks and Trade Names

4



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

5



PART I — FINANCIAL INFORMATION

Item 1. Financial Statements
HMS HOLDINGS CORP. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(in thousands, except share and per share amounts)
 
June 30,
2019
 
December 31,
2018
Assets
(unaudited)
 
 
Current assets:
 
 
 
Cash and cash equivalents
$
268,677

 
$
178,946

Accounts receivable, net of allowance of $12,808 and $13,683, at June 30, 2019 and December 31, 2018, respectively
199,932

 
206,772

Prepaid expenses
20,348

 
19,970

Income tax receivable
9,431

 
18,817

Deferred financing costs, net
564

 
564

Other current assets
225

 
240

Total current assets
499,177

 
425,309

Property and equipment, net
86,607

 
94,435

Goodwill
487,617

 
487,617

Intangible assets, net
62,463

 
67,140

Operating lease right-of-use assets
18,940



Deferred financing costs, net
1,391

 
1,673

Other assets
3,544

 
2,344

Total assets
$
1,159,739

 
$
1,078,518


 
 
 
Liabilities and Shareholders' Equity
 
 
 
Current liabilities:
 
 
 
Accounts payable, accrued expenses and other liabilities
$
71,330

 
$
74,902

Estimated liability for appeals
2,948

 
21,723

Total current liabilities
74,278

 
96,625

Long-term liabilities:
 
 
 
Revolving credit facility
240,000

 
240,000

Operating lease liabilities
17,245



Net deferred tax liabilities
23,073

 
18,485

Other liabilities
7,173

 
10,012

Total long-term liabilities
287,491

 
268,497

Total liabilities
361,769

 
365,122

Commitments and contingencies


 


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;101,014,406 shares issued and 87,350,498 shares outstanding at June 30, 2019; 98,924,501 shares issued and 85,261,664 shares outstanding at December 31, 2018
1,010

 
989

Capital in excess of par value
461,559

 
425,748

Retained earnings
470,977

 
422,235

Treasury stock, at cost: 13,663,194 shares at June 30, 2019 and December 31, 2018
(135,576
)
 
(135,576
)
Total shareholders' equity
797,970

 
713,396

Total liabilities and shareholders' equity
$
1,159,739

 
$
1,078,518

See accompanying Notes to the unaudited Consolidated Financial Statements.

6



HMS HOLDINGS CORP. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF INCOME
(in thousands, except per share amounts)
(unaudited)
 
Three Months Ended
June 30,
 
Six Months Ended
June 30,
 
2019
 
2018
 
2019
 
2018
Revenue
$
168,182

 
$
146,791

 
$
316,135

 
$
288,216

Cost of services:


 
 
 
 
 
 
Compensation
58,322

 
55,188

 
115,775

 
111,267

Direct project and other operating expenses
20,742

 
17,959

 
40,941

 
34,607

Information technology
12,316

 
14,240

 
25,420

 
26,503

Occupancy
4,052

 
4,014

 
8,131

 
8,397

Amortization of acquisition related software and intangible assets
4,166

 
9,621

 
8,332

 
17,753

Total cost of services
99,598

 
101,022

 
198,599

 
198,527

Selling, general and administrative expenses
28,036

 
26,532

 
57,282

 
58,530

Settlement expense

 
20,000

 

 
20,000

Total operating expenses
127,634

 
147,554

 
255,881

 
277,057

Operating income/(loss)
40,548

 
(763
)
 
60,254

 
11,159

Interest expense
(2,853
)
 
(3,034
)
 
(5,702
)
 
(5,682
)
Interest income
966

 
188

 
2,080

 
308

Income/(loss) before income taxes
38,661

 
(3,609
)
 
56,632

 
5,785

Income taxes
9,561

 
(242
)
 
7,890

 
2,761

Net income/(loss)
$
29,100

 
$
(3,367
)
 
$
48,742

 
$
3,024

 


 
 
 
 
 
 
Basic income per common share:


 
 
 
 
 
 
Net income/(loss) per common share -- basic
$
0.34

 
$
(0.04
)
 
$
0.56

 
$
0.04

Diluted income per common share:


 
 
 
 
 
 
Net income/(loss) per common share -- diluted
$
0.33

 
$
(0.04
)
 
$
0.55

 
$
0.04

Weighted average shares:


 
 
 
 
 
 
Basic
85,956

 
83,231

 
86,524

 
83,222

Diluted
87,858

 
83,231

 
88,843

 
84,837

See accompanying Notes to the unaudited Consolidated Financial Statements.

7



HMS HOLDINGS CORP. AND SUBSIDIARIES
CONSOLIDATED STATEMENT OF SHAREHOLDERS’ EQUITY
(in thousands, except share amounts)
(unaudited)
 
Three Months Ended
June 30,
 
Six Months Ended
June 30,
 
2019
 
2018
 
2019
 
2018
Common Stock and paid-in capital
 
 
 
 
 
 
 
Balance, beginning of period
$
454,087

 
$
376,737

 
$
426,737

 
$
369,686

Exercise of stock options
3,859

 
2,246

 
26,998

 
2,390

Stock-based compensation expense
4,802

 
4,714

 
15,781

 
14,208

Vesting of restricted stock units, net of shares withheld for employee tax
(179
)
 
(97
)
 
(6,947
)
 
(2,684
)
Balance, end of period
462,569

 
383,600

 
462,569

 
383,600

Retained earnings
 
 
 
 


 


Balance, beginning of period
441,877

 
373,982

 
422,235

 
366,164

Net income/(loss)
29,100

 
(3,367
)
 
48,742

 
3,024

Cumulative effect of accounting changes



 

 
1,427

Balance, end of period
470,977

 
370,615

 
470,977

 
370,615

Treasury stock
 
 
 
 


 


Balance, beginning of period
(135,576
)
 
(135,576
)
 
(135,576
)
 
(129,621
)
Purchase of treasury stock



 

 
(5,955
)
Balance, end of period
(135,576
)
 
(135,576
)
 
(135,576
)
 
(135,576
)
Total shareholders' equity
$
797,970

 
$
618,639

 
$
797,970

 
$
618,639

 
 
 
 
 


 


Shares issued
 
 
 
 


 


Balance, beginning of period
100,745,077

 
96,876,154

 
98,924,501

 
96,536,251

Exercise of stock options
242,723

 
141,991

 
1,686,408

 
151,034

Vesting of restricted stock units, net of shares withheld for employee tax
26,606

 
32,963

 
403,497

 
363,823

Balance, end of period
101,014,406

 
97,051,108

 
101,014,406

 
97,051,108

 
 
 
 
 


 


Treasury Stock
 
 
 
 


 


Balance, beginning of period
13,663,194

 
13,663,194

 
13,663,194

 
13,279,393

Purchase of treasury stock



 

 
383,801

Balance, end of period
13,663,194

 
13,663,194

 
13,663,194

 
13,663,194

See accompanying Notes to the unaudited Consolidated Financial Statements.

8



HMS HOLDINGS CORP. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(in thousands)
(unaudited)
 
Six Months Ended
June 30,
 
2019
 
2018
Operating activities:
 
 
 
Net income
$
48,742

 
$
3,024

Adjustments to reconcile net income to net cash provided by operating activities:
 
 
 
Depreciation and amortization of property, equipment and software
15,989

 
16,758

Amortization of intangible assets
4,677

 
12,774

Amortization of deferred financing costs
282

 
282

Stock-based compensation expense
15,781

 
14,208

Deferred income taxes
4,588

 
(3,900
)
Noncash lease expense
2,366



Release of estimated liability for appeals, net
(10,478
)

(8,436
)
Changes in operating assets and liabilities:
 
 
 
Accounts receivable
(2,062
)
 
(3,654
)
Prepaid expenses
(378
)
 
63

Other current assets
15

 
570

Other assets
(1,200
)
 
(29
)
Income taxes receivable
9,386

 
(5,324
)
Accounts payable, accrued expenses and other liabilities
(7,235
)
 
(2,546
)
Operating lease liabilities
(2,952
)


Estimated liability for appeals
605

 
(99
)
Net cash provided by operating activities
78,126

 
23,691

Investing activities:
 
 
 
Purchases of property and equipment
(945
)
 
(2,455
)
Investment in capitalized software
(7,465
)
 
(10,173
)
Net cash used in investing activities
(8,410
)
 
(12,628
)
Financing activities:
 
 
 
Proceeds from exercise of stock options
26,998

 
2,390

Payments of tax withholdings on behalf of employees for net-share settlements
(6,947
)
 
(2,684
)
Payments on capital lease obligations
(36
)


Purchases of treasury stock


(5,955
)
Net cash provided by/(used in) financing activities
20,015

 
(6,249
)
Net increase in cash and cash equivalents
89,731

 
4,814

Cash and Cash Equivalents
 
 
 
Cash and cash equivalents at beginning of year
178,946

 
83,313

Cash and cash equivalents at end of period
$
268,677

 
$
88,127

 
 
 
 
Supplemental disclosure of cash flow information:
 
 
 
Cash (refunds received)/paid for income taxes, net of refunds
$
(6,509
)
 
$
11,472

Cash paid for interest
$
5,524

 
$
4,916

 
 
 
 
Supplemental disclosure of non-cash activities:
 
 
 
Change in balance of accrued property and equipment purchases
$
250

 
$
1,082

See accompanying Notes to the unaudited Consolidated Financial Statements.

9



HMS HOLDINGS CORP. AND SUBSIDIARIES
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
FOR THE THREE AND SIX MONTHS ENDED JUNE 30, 2019 and 2018
(unaudited)
1.     Business and Summary of Significant Accounting Policies
(a) Business
The terms “HMS,” “Company,” “we,” “us,” and “our” refer to HMS Holdings Corp. and its consolidated subsidiaries unless the context clearly indicates otherwise. HMS is an industry-leading provider of cost containment solutions in the healthcare marketplace. We use healthcare data technology, analytics and engagement solutions, to deliver coordination of benefits, payment integrity and population health management solutions to help payers reduce costs, improve healthcare outcomes and enhance member experiences. We provide coordination of benefits services to government and commercial healthcare payers to ensure that the correct party pays the claim, and our payment integrity services promote accuracy by fighting fraud, waste and abuse. Our population health management solutions consist of population risk analytics and care management and consumer engagement services that provide risk-bearing organizations with reliable intelligence across their member populations to identify risks and improve patient engagement and outcomes. Together these various services help move the healthcare system forward for our customers. We currently operate as one business segment with a single management team that reports to the Chief Executive Officer.
The Consolidated Financial Statements and accompanying Notes in this Form 10-Q are unaudited. Accordingly, they do not include all of the information and notes required by generally accepted accounting principles (“U.S. GAAP”) for complete financial statements. These statements include all adjustments (which include only normal recurring adjustments, except as disclosed) 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 unaudited 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 unaudited Consolidated Financial Statements be read in conjunction with the Company’s consolidated financial statements and notes thereto as of and for the year ended December 31, 2018, which were filed with the SEC as part of the Company’s Annual Report on Form 10-K for the year ended December 31, 2018 (“2018 Form 10-K”). The consolidated balance sheet as of December 31, 2018 included herein was derived from audited financial statements, but does not include all disclosures required by U.S. GAAP.
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, fixed assets, accrued expenses, 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.

10



(b) Summary of Significant Accounting Policies
There have been no material changes to the Company’s significant accounting policies that are referenced in the 2018 Form 10-K other than as described below with respect to leases.
Recently Adopted Accounting Pronouncements
In February 2016, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2016-02, Leases (Topic 842) (“ASU 2016-02”). ASU 2016-02 requires most lessees to recognize a majority of the company’s leases on the balance sheet, which increases reported assets and liabilities. ASU 2016-02 was subsequently amended by ASU No. 2018-01, Land Easement Practical Expedient for Transition to Topic 842; ASU No. 2018-10, Codification Improvements to Topic 842, Leases; and ASU No. 2018-11, Targeted Improvements. The new standard establishes a right-of-use (“ROU”) model that requires a lessee to recognize a ROU asset and lease liability on the balance sheet for all leases with a term longer than 12 months. Leases are classified as finance or operating, with classification affecting the pattern and classification of expense recognition in the income statement. ASU 2016-02 is effective for annual reporting periods beginning after December 15, 2018 including interim periods within such annual reporting periods with early adoption permitted. The Company adopted this guidance on January 1, 2019, utilizing the optional transition method approach with an effective date of January 1, 2019. Consequently, financial information prior to the effective date was not updated and the disclosures required under the new standard are not provided for dates and periods prior to the effective date. There were no cumulative effect adjustments to retained earnings as part of adoption. The Company elected the available practical expedients, including the practical expedient to not separate lease and non-lease components of its leases and the short-term lease practical expedient. The Company’s internal control framework did not materially change, but existing internal controls were modified due to certain changes to business processes and systems to support the new leasing standard as necessary. As the Company previously disclosed, the standard had a material impact on its consolidated balance sheets, the most significant impact being the recognition of approximately $21.3 million of ROU assets and $26.3 million lease liabilities on the effective date, but there was no impact on its consolidated income statements. The Company continues to expect that any impact from its adoption of the new standard will be immaterial to its net income and its internal control framework for future periods.
In June 2018, the FASB issued ASU No. 2018-07, Compensation – Stock Compensation (Topic 718) – Improvements to Nonemployee Share-Based Payment Accounting, (“ASU 2018-07”). ASU 2018-07 requires entities to apply similar accounting for share-based payment transactions with non-employees as with share-based payment transactions with employees. ASU 2018-07 is effective for public entities for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. The Company adopted this guidance on January 1, 2019. The adoption of this guidance did not have a material effect on the Company’s consolidated financial statements.
Recently Issued Accounting Pronouncements Not Yet Adopted
In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments – Credit Losses (“ASU 2016-13”). ASU 2016-13 introduces the current expected credit losses methodology for estimating allowances for credit losses. ASU 2016-13 applies to all financial instruments carried at amortized cost and off-balance-sheet credit exposures not accounted for as insurance, including loan commitments, standby letters of credit, and financial guarantees. The new accounting standard does not apply to trading assets, loans held for sale, financial assets for which the fair value option

11



has been elected, or loans and receivables between entities under common control. ASU 2016-13 is effective for public entities for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. Early adoption is permitted. The Company continues to evaluate whether the adoption of this guidance will have any impact on the Company’s financial statements but does not expect that this guidance will have a material impact on the Company’s financial position, results of operations or internal control framework.
In August 2018, the FASB issued ASU 2018-15, Intangibles - Goodwill and Other - Internal Use Software (Subtopic 350-40): Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract ("ASU 2018-15"). The standard aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal use software. ASU 2018-15 is effective for public business entities for fiscal years beginning after December 15, 2019, and interim periods within those fiscal years. Early adoption is permitted, including adoption in any interim period for which financial statements have not been
issued. Entities can choose to adopt the new guidance prospectively to eligible costs incurred on or after the date this guidance is first applied or retrospectively. This guidance is not expected to have a material impact on the Company’s financial position, results of operations or internal control framework.

2.     Revenue Recognition
The Company’s revenue disaggregated by solution for the three and six months ended June 30, 2019 and 2018 was as follows (in thousands):
 
Three Months Ended
Six Months Ended
 
June 30, 2019
 
June 30, 2018
June 30, 2019
 
June 30, 2018
Coordination of Benefits
$
105,094

 
$
100,755

$
210,945

 
$
192,507

Payment Integrity
49,121

 
31,192

76,847

 
69,833

Population Health Management
13,967

 
14,844

28,343

 
25,876

Total
$
168,182

 
$
146,791

$
316,135

 
$
288,216


Coordination of benefits revenue is derived from contracts with state governments and Medicaid managed care plans that can span years with the option to renew. Types of service contracts could include: (a) the identification of erroneously paid claims; (b) the delivery of verified commercial insurance coverage information; (c) the identification of paid claims where another third party is liable; and (d) the identification and enrollment of Medicaid members who have access to employer insurance. Most of these types of service contracts contain multiple promises, all of which are not distinct within the context of the contract. Therefore, the promises represent a single, distinct performance obligation for the types of services we offer. Revenue derived from these performance obligations is largely based on variable consideration where, based on the number of claims or amount of findings the Company identified, a contingent or fixed transaction price/recovery percentage is allocated to each distinct performance obligation. The Company utilizes the expected value method to estimate the variable consideration related to the transaction price for its service contracts. Key inputs and assumptions in determining variable consideration include identified pricing and expected recoveries and/or savings. The expected recoveries and/or savings are based on historical experience of information received from our customers. Revenue is primarily recognized at a point in time when our customers realize economic benefits from our services when

12



our services are completed. However, we have a limited number of fixed fee arrangements where revenue is recognized over time as performance obligations are satisfied within one to three years. Generally, coordination of benefit contract payment terms are not standardized within the respective contract; however, payment is typically due on demand and there is a clear and distinct history of customers making consistent payments.
Analytical services revenue consists of revenue for our payment integrity services and population health management solutions. 
Payment integrity services revenue is derived from contracts with federal and state governments, commercial health plans and other at-risk entities that can span years with the option to renew. Types of service contracts could include: (a) services designed to ensure that healthcare payments are accurate and appropriate; and (b) the identification of over/under payments or inaccurate charges based on a review of medical records. Most of these types of service contracts contain multiple promises, all of which are not distinct within the context of the contract. Therefore, the promises represent a single, distinct performance obligation for the types of services we offer. Revenue derived from these performance obligations is largely based on variable consideration where, based on the amount of recovery findings the Company identifies, a contingent or fixed transaction price/recovery percentage is allocated to each distinct performance obligation. The Company utilizes the expected value method to estimate the variable consideration related to the transaction price for its service contracts. Key inputs and assumptions in determining variable consideration include identified pricing and expected recoveries and/or savings. The expected recoveries and/or savings are based on historical experience of information received from our customers. Revenue is primarily recognized at a point in time when our customers realize economic benefits from our services when our services are completed. However, we have a limited number of fixed fee arrangements where revenue is recognized over time as performance obligations are satisfied within one to three years. Generally, payment integrity contract payment terms are not standardized within the respective contract; however, invoice payment is typically due on demand and there is a clear and distinct history of customers making consistent payments.
Population health management revenue is derived from contracts with health plans and other risk-bearing entities that can span years with the option to renew. Types of service contracts could include: (a) programs designed to improve member engagement; and (b) outreach services designed to improve clinical outcomes. Most of these types of service contracts contain multiple promises, all of which are not distinct within the context of the contract. Therefore, the promises represent a single, distinct performance obligation for the types of services we offer. Revenue derived from these services is largely based on consideration associated with prices per order/transfer and PMPM/PMPY fees. The Company believes the output method is a reasonable measure of progress for the satisfaction of our performance obligations, which are satisfied over time, as it provides a faithful depiction of (1) our performance toward complete satisfaction of the performance obligation under the contract and (2) the value transferred to the customer of the services performed under the contract. The Company has elected the right to invoice practical expedient for recognition of revenue related to its performance obligations when the amount we have the right to invoice the customer corresponds directly with the value to the customer. Additionally, certain population health management contracts have distinct performance obligations related to software license and implementation fees which have historically been recognized as revenue ratably over the life of the contract. Lastly, we have a limited number of fixed fee arrangements where revenue is recognized over time as performance obligations are satisfied within one to three years. Upon adoption of ASC 606, revenue for software licenses is recognized at the beginning of the license

13



period when control is transferred as the license is installed and revenue for implementation fees is recognized when control is transferred over time as the implementation is being performed. As the performance obligation is deemed to have been satisfied and control transferred to our customers for software licenses and implementation fees on or before December 31, 2017, the Company recorded a decrease to deferred revenue and an increase to opening retained earnings of $1.1 million, net of tax, as of January 1, 2018 for the cumulative adoption of ASC 606. Generally, population health management contract payment terms are stated within the contract and are due within an explicitly stated time period (e.g., 30, 45, 60 days) from the date of invoice. A portion of the payment received may relate to future performance obligations and will result in an increase to deferred revenue until the obligation has been met.
In connection with coordination of benefits and certain payment integrity services, lockboxes and their associated bank accounts are setup to support recoveries and remittances. Generally, these bank accounts are for the benefit of the Company’s customers.  Customer cash held in Company bank accounts for the benefit of the customer was approximately $4.9 million as of June 30, 2019.  This amount is included in cash and cash equivalents and other current liabilities on the accompanying consolidated balance sheet.  
The Company’s revenue disaggregated by market for the three and six months ended June 30, 2019 and 2018 was as follows (in thousands):
 
Three Months Ended
Six Months Ended
 
June 30, 2019
 
June 30, 2018
June 30, 2019
 
June 30, 2018
Commercial
$
79,044

 
$
80,493

$
155,303

 
$
152,278

State
65,180

 
58,815

126,922

 
113,435

Federal
23,958

 
7,483

33,910

 
22,503

Total
$
168,182

 
$
146,791

$
316,135

 
$
288,216


A portion of the Company’s services are deferred and revenue is recognized at a later time. Deferred revenue was approximately $5.9 million and $5.6 million as of June 30, 2019 and December 31, 2018, respectively, and is included in Accounts payable, accrued expenses and other liabilities in the Consolidated Balance Sheets. Approximately $2.8 million of the December 31, 2018 balance was recognized in revenue during the quarter ended June 30, 2019.
Contract modifications are routine in nature and often done to account for changes in the contract specifications or requirements. In most instances, contract modifications are for services that are not distinct, and, therefore, modifications are accounted for as part of the existing contract. The Company has elected to use the practical expedient to expense the incremental costs of obtaining a contract if the amortization period of the asset that the Company would have otherwise recognized is one year or less.

3.     Accounts Receivable and Accounts Receivable Allowance
The Company’s accounts receivable, net, consisted of the following (in thousands):

14



 
June 30,
2019
 
December 31,
2018
Accounts receivable
$
212,740

 
$
220,455

Allowance
(12,808
)
 
(13,683
)
Accounts receivable, net
$
199,932

 
$
206,772


We record an accounts receivable allowance based on historical patterns of billing adjustments, length of operating and collection cycle and customer negotiations, behaviors and payment patterns. Changes in these estimates are recorded to revenue in the period of change. The following is a summary of the activity in the accounts receivable allowance (in thousands)
 
June 30,
2019
 
December 31,
2018
Balance--beginning of period
$
13,683

 
$
14,799

Provision
7,717

 
20,453

Charge-offs
(8,592
)
 
(21,569
)
Balance--end of period
$
12,808

 
$
13,683



4.     Intangible Assets and Goodwill
Intangible assets consisted of the following (in thousands, except for weighted average amortization period):
 
Gross Carrying Amount
 
Accumulated
Amortization
 
Net Carrying Amount
 
Weighted Average Amortization Period in Years
June 30, 2019
 
 
 
 
 
 
 
Customer relationships
$
68,290

 
$
(18,936
)
 
$
49,354

 
12.5
Intellectual property
21,700

 
(8,606
)
 
13,094

 
3.7
Trade names
136

 
(128
)
 
8

 
0.2
Restrictive covenants
133

 
(126
)
 
7

 
0.2
Total
$
90,259

 
$
(27,796
)
 
$
62,463

 
 
 
Gross Carrying Amount
 
Accumulated
Amortization
 
Net Carrying Amount
 
Weighted Average Amortization Period in Years
December 31, 2018
 
 
 
 
 
 
 
Customer relationships
$
156,790

 
$
(104,740
)
 
$
52,050

 
12.8
Intellectual property
21,700

 
(6,670
)
 
15,030

 
4.1
Trade names
16,246

 
(16,215
)
 
31

 
0.7
Restrictive covenants
263

 
(234
)
 
29

 
0.7
Total
$
194,999

 
$
(127,859
)
 
$
67,140

 
 

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

15



Year ending December 31,
Amortization

2019 (excluding the six months ended June 30, 2019)
$
4,568

2020
7,613

2021
7,197

2022
7,197

2023
4,822

Thereafter
31,066

Total
$
62,463


For the three months ended June 30, 2019 and 2018, amortization expense related to intangible assets was $2.3 million and $6.7 million, respectively. For the six months ended June 30, 2019 and 2018, amortization expense related to intangible assets was $4.7 million and $12.8 million, respectively.
There was no change in the carrying amount of goodwill for the six months ended June 30, 2019.

5.     Accounts Payable, Accrued Expenses and Other Liabilities
Accounts payable, accrued expenses and other liabilities consisted of the following (in thousands):
 
June 30,
2019
 
December 31,
2018
Accounts payable, trade
$
11,774

 
$
12,394

Accrued compensation and other
26,735

 
42,833

Accrued operating expenses
26,301

 
19,675

Current portion of lease liabilities
6,520



Total accounts payable, accrued expenses and other liabilities
$
71,330

 
$
74,902



6.     Income Taxes
The Company’s effective tax rate decreased to 13.9% for the six months ended June 30, 2019 from 47.7% for the six months ended June 30, 2018. The effective tax rate for the six months ended June 30, 2019 includes discrete tax benefits related to net equity compensation deductions offset by interest on uncertain tax benefits. For the six months ended June 30, 2019, the differences between the federal statutory rate and our effective tax rate are tax expense items related to state taxes, equity compensation impacts, unrecognized tax benefits, including interest, officer compensation deduction limits, research and development tax credits, and other permanent differences.
Included in Other liabilities on the Consolidated Balance Sheets, are the total amount of unrecognized tax benefits (net of the federal benefit for state issues) of approximately $5.3 million and $4.8 million, as of June 30, 2019 and December 31, 2018, respectively, that, if recognized, would favorably affect the Company’s future effective tax rate. Also included in Other liabilities on the Consolidated Balance Sheets, are accrued liabilities for interest expense and penalties related to unrecognized tax benefits of $1.0 million and $0.7 million as of June 30, 2019 and December 31, 2018, respectively. HMS includes interest expense and penalties in the provision for income taxes

16



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 six months ended June 30, 2019 and 2018 was $0.3 million and $0.3 million, respectively. The Company believes it is reasonably possible that the amount of unrecognized tax benefits may decrease by $1.8 million over the next twelve months, due to the expiration of the statute of limitations in federal and various state jurisdictions.
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 2013. HMS operates in a number of state and local jurisdictions. Accordingly, HMS is subject to state and local income tax examinations based on the various statutes of limitations in each jurisdiction.

7.     Estimated Liability For Appeals
Under the Company’s contracts with certain commercial health plan customers and its Medicare Recovery Audit Contractor (“RAC”) contract with the Centers for Medicare & Medicaid Services (“CMS”) (included within the Company’s payment integrity services revenue), providers have the right to appeal HMS claim findings and to pursue additional appeals if the initial appeal is found in favor of HMS’s customer. The appeal process established under the Medicare RAC contracts with CMS includes five levels of appeals, and resolution of appeals can take substantial time to resolve. HMS records (a) a liability for findings which have been previously adjudicated in favor of providers and (b) an estimated liability based on the amount of revenue that is subject to appeals and which are probable of being adjudicated in favor of providers following their successful appeal. The Company’s estimate is based on the Company’s historical experience. To the extent the amount to be returned to providers following a successful appeal exceeds or is less than the amount recorded, revenue in the applicable period would be reduced or increased by such amount. Any future changes or modifications to the Company's Medicare RAC contract or commercial health plan customer contracts may force the Company to apply different assumptions, which could materially affect both the Company’s revenue and estimated liability for appeals in future periods.
The following roll-forward summarizes the activity in Estimated liability for appeals (in thousands):
 
Original
RAC contract
 
RAC 4
contract
 
Commercial contracts
 
Total
Balance at December 31, 2018
$
19,380

 
$
20

 
$
2,323

 
$
21,723

Provision


604

 
5,135

 
5,739

Appeals found in providers favor


(309
)
 
(4,825
)
 
(5,134
)
Release of liability
(19,380
)
 

 

 
(19,380
)
Balance at June 30, 2019
$

 
$
315

 
$
2,633

 
$
2,948


The Company’s original Medicare RAC contract with CMS expired on January 31, 2018. As a result of the original contract expiration, which historically had net settlement terms, the Company’s contractual obligation with respect to any appeals resolved in favor of providers subsequent to the expiration date ceased, and the Company released its estimated liability and increased revenue by $8.4 million during the first quarter of 2018. The Company has determined, based on communications, that there is no further contractual obligation to CMS with respect to the original Medicare RAC contract as of June 30, 2019. Accordingly, the Company released its remaining

17



estimated liability of $19.4 million and net receivables. As a result of the release, there was a $10.5 million increase to the Company's revenue for the three months ended June 30, 2019.

8.     Credit Agreement
In December 2017, the Company entered into an amendment to its Amended and Restated Credit Agreement, as amended (the “Credit Agreement”) which, among other things, extended the maturity of its then existing $500 million revolving credit facility by five years to December 2022 (the “Amended Revolving Facility”). The availability of funds under the Amended Revolving Facility includes sublimits for (a) up to $50 million for the issuance of letters of credit and (b) up to $25 million for swingline loans. In addition, the Company may increase the commitments under the Amended Revolving Facility and/or add one or more incremental term loan facilities, provided that such incremental facilities do not exceed in the aggregate the sum of (i) the greater of $120 million and 100% of Consolidated EBITDA (as defined in the Credit Agreement) and (ii) an additional amount so long as our first lien leverage ratio (as defined in the Credit Agreement) on a pro forma basis is not greater than 3.00:1.00, subject to obtaining commitments from lenders therefore and meeting certain other conditions.
As of June 30, 2019 and December 31, 2018, the outstanding principal balance due on the Amended Revolving Facility was $240 million. No principal payments were made against the Amended Revolving Facility during the six months ended June 30, 2019.
Borrowings under the Amended Revolving Facility bear interest at a rate equal to, at the Company’s election (except with respect to swingline borrowings, which will accrue interest based only at the base rate), either:
a base rate determined by reference to the greatest of (a) the prime or base commercial lending rate of the administrative agent as in effect on the relevant date, (b) the federal funds effective rate plus 0.50% and (c) the one-month London Interbank Offered Rate (or any successor rate determined in accordance with the Credit Agreement) (“LIBO Rate”) plus 1.00%, plus an interest margin ranging from 0.50% to 1.00% based on the Company’s consolidated leverage ratio for the applicable period; or
an adjusted LIBO Rate, equal to the LIBO Rate for the applicable interest period multiplied by the statutory reserve rate (equal to (x) one divided by (y) one minus the aggregate of the maximum reserve percentage (including any marginal, special, emergency or supplemental reserves) established by the Board of Governors of the Federal Reserve System of the United States), plus an interest margin ranging from 1.50% to 2.00% based on the Company’s consolidated leverage ratio for the applicable period.
In addition to paying interest on the outstanding principal, the Company is required to pay unused commitment fees on the Amended Revolving Facility during the term of the Credit Agreement ranging from 0.375% to 0.250% per annum based on the Company’s consolidated leverage ratio and letter of credit fees equal to 0.125% per annum on the aggregate face amount of each letter of credit, as well as customary agency fees. As part of a contractual agreement with a customer, the Company has an outstanding irrevocable letter of credit for $6.5 million, which is issued against its revolving credit facility and expires June 30, 2020.
The Amended Revolving Facility is secured, subject to certain customary carve-outs and exceptions, by a first priority lien and security interest in substantially all tangible and intangible

18



assets of the Company and certain subsidiaries of the Company. The Amended Revolving Facility contains certain restrictive covenants, which affect, among other things, the ability of the Company and its subsidiaries to incur indebtedness, create liens, make investments, sell or otherwise dispose of assets, engage in mergers or consolidations with other entities, and pay dividends or repurchase stock. The Company is also required to comply, on a quarterly basis, with two financial covenants: (i) a minimum interest coverage ratio of 3:00:1:00, and (ii) a maximum consolidated leverage ratio of 4.75:1.00 through December 2019 and 4.25:1.00 from and after January 2020. The consolidated leverage ratio is subject to a step-up to 5.25:1.00 for four full consecutive fiscal quarters following a permitted acquisition or similar investment. As of June 30, 2019, the Company was in compliance with all terms of the Credit Agreement.
Interest expense and the commitment fees on the unused portion of the Company’s Amended Revolving Facility were as follows (in thousands):
 
Three Months Ended
June 30,
Six Months Ended
June 30,
 
2019
 
2018
2019
 
2018
Interest expense
$
2,524

 
$
2,627

$
5,050

 
$
4,697

Commitment fees
160

 
239

316

 
477


As of June 30, 2019 and December 31, 2018, the unamortized balance of deferred origination fees and debt issuance costs was $2.0 million and $2.2 million, respectively. For the six month periods ended June 30, 2019 and 2018, HMS amortized $0.3 million and $0.3 million, respectively, of interest expense related to the Company’s deferred origination fees and debt issue costs.

9.     Earnings Per Share
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
June 30,
Six Months Ended
June 30,
 
2019
 
2018
2019
 
2018
Net income/(loss)
$
29,100

 
$
(3,367
)
$
48,742

 
$
3,024

 
 
 
 
 
 
 
Weighted average common shares outstanding-basic
85,956

 
83,231

86,524

 
83,222

Plus: net effect of dilutive stock options and restricted stock units
1,902

 

2,319

 
1,615

Weighted average common shares outstanding-diluted
87,858

 
83,231

88,843

 
84,837

Net income/(loss) per common share -- basic
$
0.34

 
$
(0.04
)
$
0.56

 
$
0.04

Net income/(loss) per common share -- diluted
$
0.33

 
$
(0.04
)
$
0.55

 
$
0.04


For the three months ended June 30, 2019, 588,379 stock options and restricted stock units representing 227,604 shares of the Company's common stock were not included in the diluted earnings per share calculation because the effect would have been anti-dilutive. For the three months ended June 30, 2018, the Company incurred a net loss. As a result, there was no difference

19



between the Company's basic and diluted earnings per share and 2,552,862 stock options and restricted stock units representing 626,341 shares of the Company's common stock were excluded from consideration in the calculation of diluted net loss per share because the effect would have been anti-dilutive.
For the six months ended June 30, 2019 and 2018, (i) 394,886 and 2,738,783 stock options, respectively, and (ii) restricted stock units representing 151,279 and 106,501 shares of common stock, respectively, were not included in the diluted earnings per share calculation because the effect would have been anti-dilutive.

10.     Stock-Based Compensation
(a) Long-Term Incentive Award Plans
The Company grants stock options and restricted stock units to HMS employees and non-employee directors of the Company under the HMS Holdings Corp. 2019 Omnibus Incentive Plan (the “2019 Omnibus Plan”), as approved by the Company’s shareholders on May 22, 2019. The 2019 Omnibus Plan replaces and supersedes the HMS Holdings Corp. 2016 Omnibus Incentive Plan. Awards granted under the 2019 Omnibus Plan generally vest over one to four years. Subject to certain exceptions, the exercise price of stock options granted under the 2019 Omnibus Plan may not be less than the fair market value of a share of stock on the grant date, which is determined based on the closing price of the Company’s common stock reported on the Nasdaq Global Select Market on that date, and the term of a stock option may not exceed ten years.
(b) Stock-Based Compensation Expense
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
June 30,
Six Months Ended
June 30,
 
2019
 
2018
2019
 
2018
Cost of services-compensation
$
2,720

 
$
1,673

$
6,843

 
$
4,236

Selling, general and administrative
2,082

 
3,041

8,938

 
9,972

Total
$
4,802

 
$
4,714

$
15,781

 
$
14,208


(c) Stock Options
For the three months ended June 30, 2019 and 2018, stock-based compensation expense related to stock options was approximately $2.0 million and $2.1 million, respectively. For the six months ended June 30, 2019 and 2018, stock-based compensation expense related to stock options was approximately $6.8 million and $6.1 million, respectively.
Presented below is a summary of stock option activity for the six months ended June 30, 2019 (in thousands, except for weighted average exercise price and weighted average remaining contractual terms):

20



 
Number of Options
 
Weighted
Average
Exercise
Price
 
Weighted
Average-
Remaining
Contractual
Terms
 
Aggregate
Intrinsic
Value
Outstanding balance at December 31, 2018
4,402

 
$
17.07

 
 
 
 
Granted
622

 
38.72

 
 
 
 
Exercised
(1,686
)
 
16.01

 
 
 
 
Forfeitures
(140
)
 
19.31

 
 
 
 
Expired




 
 
 
Outstanding balance at June 30, 2019
3,198

 
$
21.79

 
6.86
 
$
37,514

Expected to vest at June 30, 2019
1,045

 
$
28.12

 
8.98
 
$
7,507

Exercisable at June 30, 2019
1,728

 
$
16.91

 
5.13
 
$
26,745


During the three months ended June 30, 2019 and 2018, the Company received proceeds of $3.9 million and $2.2 million, respectively, for the issuance of 242,723 and 87,230 shares of common stock upon the exercise of outstanding stock options, respectively. The total intrinsic value of stock options exercised during the three months ended June 30, 2019 and 2018 was $3.7 million and $0.8 million, respectively. During the six months ended June 30, 2019 and 2018, the Company received proceeds of $27.0 million and $2.4 million, respectively, for the issuance of 1,686,408 and 151,034 shares of common stock upon the exercise of outstanding stock options, respectively. The total intrinsic value of stock options exercised during the six months ended June 30, 2019 and 2018 was $29.4 million and $0.8 million, respectively.
As of June 30, 2019, there was approximately $6.4 million of total unrecognized compensation cost related to stock options outstanding, which is expected to be recognized over a weighted average period of 1.3 years.
The weighted-average grant date fair value per share of the stock options granted during the six months ended June 30, 2019 and 2018 was $13.82 and $7.52, respectively. HMS estimated the fair value of each stock option grant on the date of grant using a Black-Scholes option pricing model and weighted–average assumptions set forth in the following table:
 
Six Months Ended
June 30,
 
2019
 
2018
Expected dividend yield
0
%
 
0
%
Risk-free interest rate
2.5
%
 
2.7
%
Expected volatility
40.9
%
 
42.4
%
Expected life (years)
6.35

 
6.00


The total tax benefits recognized on stock-based compensation related to stock options for the six months ended June 30, 2019 and 2018 was $12.4 million and $2.5 million, respectively. 
(d) Restricted Stock Units
For the three months ended June 30, 2019 and 2018, stock-based compensation expense related to restricted stock units was approximately $2.8 million and $2.6 million, respectively. For the six

21



months ended June 30, 2019 and 2018, stock-based compensation expense related to restricted stock units was approximately $8.9 million and $8.1 million, respectively.
Presented below is a summary of restricted stock units activity for the six months ended June 30, 2019 (in thousands, except for weighted average grant date fair value per unit):
 
Number of
Units
 
Weighted Average
Grant Date Fair
Value per Unit
Outstanding balance at December 31, 2018
1,488

 
$
17.60

Granted
460

 
34.10

Vesting of restricted stock units, net of units withheld for taxes
(403
)
 
16.49

Units withheld for taxes
(200
)
 
16.49

Forfeitures
(82
)
 
18.92

Outstanding balance at June 30, 2019
1,263

 
$
25.74



For the three months ended June 30, 2019 and 2018, HMS granted 51,546 and 62,259 restricted stock units, respectively, with an aggregate fair market value of $1.6 million and $0.9 million, respectively. For the six months ended June 30, 2019 and 2018, HMS granted 459,985 and 761,083 restricted stock units, respectively, with an aggregate fair market value of $15.7 million and $12.7 million, respectively.
As of June 30, 2019, 1,003,051 restricted stock units remained unvested and there was approximately $14.3 million of unrecognized compensation cost related to restricted stock units, which is expected to be recognized over a weighted average vesting period of 1.38 years.

11.     Leases
The Company determines if an arrangement is a lease at inception. Operating leases are reported on the Company’s consolidated balance sheet within Operating lease right-of-use assets, Operating lease liabilities and Accounts payable, accrued expenses and other liabilities. Finance leases are reported on the Company’s consolidated balance sheets within Other assets, Other liabilities and Accounts payable, accrued expenses and other liabilities. 
Operating lease ROU assets and operating lease liabilities are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. As most of the Company’s leases do not provide an implicit rate, we use the Company’s incremental borrowing rate based on the information available at the lease’s commencement date in determining the present value of future payments. The operating lease ROU asset also includes any lease payments made and excludes lease incentives and initial direct costs incurred. The lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. For certain real estate and equipment leases, the Company has lease agreements with lease and non-lease components, which are generally accounted for as a single component.
The Company primarily leases real estate, information technology equipment and data centers on terms that expire on various dates through 2026, some of which include options to extend the lease

22



for up to 10 years. We evaluate whether to include the option period in the calculation of the ROU asset and lease liability on a lease-by-lease basis. 
As of June 30, 2019, all operating and finance leases that create significant rights and obligations for the Company have commenced. 
The components of lease expense for the three and six months ended June 30, 2019 were as follows (in thousands):
 
Three Months Ended
June 30, 2019
 
Six Months Ended
June 30, 2019
 
 
 
 
Operating lease cost
$
1,658

 
$
3,314

 
 
 
 
Finance lease cost:
 
 
 
Amortization of right-of-use assets
$
30

 
$
38

Interest on lease liabilities
$
4

 
$
5

Total finance lease cost
$
34

 
$
43


Supplemental cash flow and other information related to leases for the six months ended June 30, 2019 were as follows (in thousands):
 
Six Months Ended
June 30, 2019
 
 
Cash paid for amounts included in measurement of lease liabilities:
 
Operating cash flows from operating leases
$
3,700

Operating cash flows from finance leases
$
4

Financing cash flows from finance leases
$
36

Right-of-use assets obtained in exchange for new lease liabilities:
 
Operating leases
$
163

Finance leases
$
331



23



Supplemental balance sheet information related to leases as of June 30, 2019 consisted of the following (in thousands):
 
June 30, 2019
Operating Leases
 
Operating lease right-of-use assets
$
18,940

 
 
Other current liabilities
$
6,301

Operating lease liabilities
$
17,245

Total operating lease liabilities
$
23,546

 
 
Finance Leases
 
Other Assets
$
656

 
 
Other current liabilities
$
219

Other long-term liabilities
$
440

Total finance leases liabilities
$
659


As of June 30, 2019, the weighted-average remaining lease term for operating and finance leases was 4.5 years and 3 years, respectively. As of June 30, 2019, the weighted-average discount rates were 5.7% and 5.0% for operating and finance leases, respectively.
Sublease income for the six months ended June 30, 2019 and 2018 was $1.1 million and $0.8 million, respectively. 
Maturities of lease liabilities were as follows (in thousands):
Year ended December 31,
Operating Leases
 
Finance Leases
2019 (excluding the six months ended June 30, 2019)
$
3,728

 
$
123

2020
7,308

 
245

2021
5,605

 
245

2022
3,313

 
91

2023
3,073



Thereafter
3,578



Total lease payments
26,605

 
704

Less: Imputed interest
3,059

 
45

Total lease obligation
$
23,546

 
$
659



12.    Commitments and Contingencies

In July 2012, Dennis Demetre and Lori Lewis (the “Plaintiffs”), filed an action in the Supreme Court of the State of New York against HMS Holdings Corp., claiming an undetermined amount of damages alleging that various actions by HMS unlawfully deprived the Plaintiffs of the acquisition earn-out portion of the purchase price for Allied Management Group Special Investigation Unit, Inc. (“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

24



two causes of action for breach of contract and one cause of action for breach of implied covenant of good faith and fair dealing. HMS asserted a counterclaim against Plaintiffs for breach of contract based on contractual indemnification costs, including attorneys’ fees arising out of the Company’s defense of AMG in Kern Health Systems v. AMG, Dennis Demetre and Lori Lewis (the “California Action”), which are recoverable under the SPA. In June 2016, Kern Health Systems and AMG entered into a settlement agreement that resolved all claims in the California Action. In July 2017, the Court issued a decision on the Company’s motion for partial summary judgment and granted the motion in part, dismissing one of Plaintiffs’ breach of contract causes of action against HMS. On November 3, 2017, following a jury trial, a verdict was returned in favor of the Plaintiffs on a breach of contract claim, and the jury awarded $60 million in damages to the Plaintiffs. On March 14, 2018, the Court held a hearing on the Company’s post-trial motion for an order granting it judgment notwithstanding the verdict or, alternatively, setting aside the jury’s award of damages. On June 27, 2018, prior to the Court issuing a decision on the motion, the Company entered into a Settlement Agreement (the “Settlement Agreement”) with the Plaintiffs, John Alfred Lewis and Christopher Brandon Lewis. Pursuant to the terms of the Settlement Agreement, the Company paid $20 million to resolve all matters in controversy pertaining to the lawsuit. On July 5, 2018, the Court entered an order to discontinue the lawsuit pursuant to the Stipulation of Discontinuance with Prejudice filed by the parties.
In February 2018, the Company received a Civil Investigative Demand (“CID”) from the Texas Attorney General, purporting to investigate possible unspecified violations of the Texas Medicaid Fraud Prevention Act. In March 2018, the Company provided certain documents and information in response to the CID. HMS has not received any further requests for information in connection with this CID.
In September 2018, a former employee filed an action in the New York County Supreme Court entitled Christopher Frey v. Health Management Systems, Inc. alleging retaliation under New York law. The complaint seeks recovery of an unspecified amount of monetary damages, including back pay and other compensatory and equitable relief. The Company has moved to dismiss the complaint. On May 2, 2019, the Court held a hearing on the Company’s motion to dismiss. The Company continues to believe that this claim is without merit and intends to vigorously defend this matter.
From time to time, HMS may be subject to investigations, legal proceedings and other disputes arising in the ordinary course of the Company’s business, including but not limited to regulatory audits, billing and contractual disputes, employment-related matters and post-closing disputes related to acquisitions. Due to the Company’s contractual relationships, including those with federal and state government entities, HMS’s operations, billing and business practices are subject to scrutiny and audit by those entities and other multiple agencies and levels of government, as well as to frequent transitions and changes in the personnel responsible for oversight of the Company’s contractual performance. HMS may have contractual disputes with its customers arising from differing interpretations of contractual provisions that define the Company’s rights, obligations, scope of work or terms of payment, and with associated claims of liability for inaccurate or improper billing for reimbursement of contract fees, or for sanctions or damages for alleged performance deficiencies. Resolution of such disputes may involve litigation or may require that HMS accept some amount of loss or liability in order to avoid customer abrasion, negative marketplace perceptions and other disadvantageous results that could affect the Company’s business, financial condition, results of operations and cash flows.

25



HMS records accruals for outstanding legal matters when it believes it is probable that a loss will be incurred and the amount can be reasonably estimated. The Company evaluates, on a quarterly basis, developments in legal matters that could affect the amount of any accrual and developments that would make a loss contingency both probable and reasonably estimable. If a loss contingency is not both probable and estimable, HMS does not establish an accrued liability.

13.     Subsequent Events
As of June 30, 2019, the Company held common stock of InstaMed Holdings, Inc. On July 24, 2019, JP Morgan Chase & Co acquired one hundred percent of InstaMed Holdings, Inc., resulting in the sale of the Company's investment. As a result, the Company received proceeds of $9.8 million for the sale of the investment in the subsequent period.


26



Item 2.
Management’s Discussion and Analysis of Financial Condition and Results of Operations
The following Management’s Discussion and Analysis is intended to help the reader understand the results of operations and financial condition of HMS. You should read this discussion and analysis in conjunction with the other sections of this Form 10-Q, including the Cautionary Note Regarding Forward-Looking Statements appearing prior to Part I and the unaudited Consolidated Financial Statements and accompanying Notes included in Part I, Item 1. The historical results set forth in Items 1 and 2 of Part I of this Form 10-Q should not be taken as necessarily indicative of our future operations or financial results.

Business Overview
HMS provides a broad range of cost containment solutions to help healthcare payers and at-risk providers reduce costs, improve health outcomes and enhance member experiences. Using industry-leading technology, analytics and engagement solutions, we deliver coordination of benefits, payment integrity and population health management solutions through our operating subsidiaries to move the healthcare system forward for our customers. We are managed and operate as one business segment with a single management team that reports to the Chief Executive Officer.
OURCUSTOMERSA03.GIF
We serve state Medicaid programs, commercial health plans, federal government health agencies, government and private employers, CHIPs and other healthcare payers. We also serve as a subcontractor for certain business outsourcing and technology firms. As of June 30, 2019, our customer base included the following:
over 40 state Medicaid programs;
approximately 350 health plans, including 22 of the top 25 health plans nationally (based on membership) in support of their multiple lines of business, including Medicaid managed care, Medicare Advantage and group and individual health;
over 160 private employers;
CMS, the Centers for Disease Control and Prevention, and the Department of Veterans Affairs; and
PBMs, third-party administrators and other risk-bearing entities, including independent practice associations, hospital systems, ACOs and specialty care organizations.

Critical Accounting Policies and Estimates
Since the date of our 2018 Form 10-K, there have been no material changes to our critical accounting policies other than with respect to leases as described in Notes 1 and 11 to the unaudited Consolidated Financial Statements in Part I, Item 1 of this Form 10-Q. With respect to our accounting

27



policies other than those for leases, refer to the discussion in our 2018 Form 10-K under “Critical Accounting Policies and Estimates” in Part II, Item 7 and “Business and Summary of Significant Accounting Policies” in Note 1 to the Consolidated Financial Statements under Part II, Item 8.
RESULTS

As of and for the three months ended June 30, 2019 and June 30, 2018
Revenue of $168.2 million increased $21.4 million, or 14.6% over the same quarter in 2018; and
Operating income of $40.6 million increased by $41.3 million as compared to operating loss of $0.7 million in the same quarter of the prior year.

Comparison of Three Months Ended June 30, 2019 to June 30, 2018
 
 
Three Months Ended
 
 
 
 
dollars in millions
 
June 30,
 
$ Change
 
% Change
 
 
2019
 
2018
 
2019 vs 2018
Revenue
 
$
168.2

 
$
146.8

 
$
21.4

 
14.6
 %
Cost of services:
 


 


 


 


Compensation
 
58.3

 
55.2

 
3.1

 
5.6

Direct project and other operating expenses
 
20.7

 
17.9

 
2.8

 
15.6

Information technology
 
12.3

 
14.2

 
(1.9
)
 
(13.4
)
Occupancy
 
4.1

 
4.0

 
0.1

 
2.5

Amortization of acquisition related software and intangible assets
 
4.2

 
9.7

 
(5.5
)
 
(56.7
)
Total cost of services
 
99.6

 
101.0

 
(1.4
)
 
(1.4
)
Selling, general and administrative expenses
 
28.0

 
26.5

 
1.5

 
5.7

Settlement expense
 

 
20.0

 
(20.0
)
 
(100.0
)
Total operating expenses
 
127.6

 
147.5

 
(19.9
)
 
(13.5
)
Operating income/(loss)
 
40.6

 
(0.7
)
 
41.3

 
5,900.0

Interest expense
 
(2.9
)
 
(3.1
)
 
0.2

 
6.5

Interest income
 
1.0

 
0.2

 
0.8

 
400.0

Income/(loss) before income taxes
 
38.7

 
(3.6
)
 
42.3

 
1,175.0

Income taxes
 
9.6

 
(0.2
)
 
9.8

 
4,900.0

Net income/(loss)
 
$
29.1

 
$
(3.4
)
 
$
32.5

 
955.9
 %

28




Revenue (in millions)
  CHART-39B8F91FF7FA86FA58CA01.JPG
Three Months Ended June 302019 vs. 2018
During the three months ended June 30, 2019, revenue was $168.2 million, an increase of $21.4 million or 14.6% compared to revenue of $146.8 million for the prior year quarter.
By solution, which consists of coordination of benefits and analytical services, and included in analytical services are our payment integrity and population health management solutions:
o
Coordination of benefits revenue increased $4.3 million or 4.3% which was attributable to incremental services and yield increases provided to existing customers in our cost avoidance and post payment recovery business.  
o
Payment integrity revenue increased $17.9 million or 57.4% primarily due to $10.5 million increase in revenue from the Company's release of its remaining estimated liability and net receivables relating to the original Medicare RAC contract during the second quarter of 2019. The Company has determined that there is no further contractual obligation to CMS with respect to the original Medicare RAC contract as of June 30, 2019.
o
Population health management revenue decreased $0.8 million or 5.4%.
By market:
o
Commercial health plan market revenue decreased $1.5 million or 1.9%, which was primarily attributable to the decrease in Population health management revenue.
o
Federal government market revenue increased $16.5 million or 220.0% compared to the prior year quarter primarily due to the $10.5 million original Medicare RAC reserve release described above.
o
State government market revenue increased by $6.4 million or 10.9%, which was attributable to expanded scopes and yield improvements.

29



Total Cost of Services (in millions)
CHART-278673D1F36AE5244D1A01.JPG
Three Months Ended June 302019 vs. 2018
During the three months ended June 30, 2019, total cost of services was $99.6 million, a decrease of $(1.4) million or 1.4% compared to $101.0 million for the prior year quarter.
Compensation expense increased by $3.1 million primarily due to a reduction in capitalized software related projects, an increase in variable compensation costs and an increase stock compensation expense.
Direct project and other operating costs increased by $2.8 million due to increased labor and services utilized to support revenue generating activities.
Information technology expense decreased by $1.9 million due to a decrease in software maintenance and license costs and amortization of internally developed software assets.
Amortization of acquisition related software and intangible assets decreased by $5.5 million due to certain intangible assets becoming fully amortized in prior periods.
Selling, General and Administrative expenses (in millions)

CHART-ECC3C1CE8A84DF98B9AA01.JPG



30



Three Months Ended June 302019 vs. 2018
During the three months ended June 30, 2019, SG&A expense was $28.0 million, an increase of $1.5 million or 5.7% compared to $26.5 million for the prior year quarter.
Compensation expense in 2019 decreased by $1.1 million primarily due to a decrease in stock compensation expense,which resulted from a reduction in stock options vesting for SG&A related retirement eligible employees.
Professional and consulting fees increased $1.2 million compared to the prior year as the Company leveraged additional external resources and expertise for certain activities during the second quarter of 2019.

Income Taxes
Three Months Ended June 302019 vs. 2018
The Company’s effective tax rate increased to 24.7% for the three months ended June 30, 2019 compared to 6.7% for the three months ended June 30, 2018. The effective tax rate for the three months ended June 30, 2019 includes discrete tax benefits related to net equity compensation deductions offset by interest on uncertain tax benefits. Excluding the above mentioned discrete tax items, our effective tax rate would approximate 26.4% for the three months ended June 30, 2019. For the three months ended June 30, 2019, the differences between the federal statutory rate and our effective tax rate are tax expense items related to state taxes, equity compensation impacts, unrecognized tax benefits, including interest, officer compensation deduction limits, research and development tax credits, and other permanent differences.

As of and for the six months ended June 30, 2019 and June 30, 2018
Revenue of $316.1 million increased $27.9 million, or 9.7% over the same period in 2018; and
Operating income of $60.2 million increased by $49.0 million as compared to operating income of $11.2 million in the same period in 2018.




















31









Comparison of Six Months Ended June 30, 2019 to June 30, 2018
 
 
Six Months Ended
 
 
 
 
dollars in millions
 
June 30,
 
$ Change
 
% Change
 
 
2019
 
2018
 
2019 vs 2018
Revenue
 
$
316.1

 
$
288.2

 
$
27.9

 
9.7
 %
Cost of services:
 


 


 


 


Compensation
 
115.8

 
111.3

 
4.5

 
4.0

Direct project and other operating expenses
 
40.9

 
34.5

 
6.4

 
18.6

Information technology
 
25.4

 
26.5

 
(1.1
)
 
(4.2
)
Occupancy
 
8.1

 
8.4

 
(0.3
)
 
(3.6
)
Amortization of acquisition related software and intangible assets
 
8.4

 
17.8

 
(9.4
)
 
(52.8
)
Total cost of services
 
198.6

 
198.5

 
0.1

 
0.1

Selling, general and administrative expenses
 
57.3

 
58.5

 
(1.2
)
 
(2.1
)
Settlement expense
 

 
20.0

 
(20.0
)
 
(100.0
)
Total operating expenses
 
255.9

 
277.0

 
(21.1
)
 
(7.6
)
Operating income
 
60.2

 
11.2

 
49.0

 
437.5

Interest expense
 
(5.7
)
 
(5.7
)
 

 

Interest income
 
2.1

 
0.3

 
1.8

 
600.0

Income before income taxes
 
56.6

 
5.8

 
50.8

 
875.9

Income taxes
 
7.9

 
2.8

 
5.1

 
182.1

Net income
 
$
48.7

 
$
3.0

 
$
45.7

 
1,523.3
 %

32




Revenue (in millions)
  CHART-28723D44F8AF176874FA01.JPG
Six Months Ended June 302019 vs. 2018
During the six months ended June 30, 2019, revenue was $316.1 million, an increase of $27.9 million or 9.7% compared to revenue of $288.2 million for the prior year period.
By solution, which consists of coordination of benefits and analytical services, and included in analytical services are our payment integrity and population health management solutions:
o
Coordination of benefits revenue increased $18.5 million or 9.6% which was attributable to incremental services and yield increases provided to existing customers in our cost avoidance and post payment recovery business.  
o
Payment integrity revenue increased $7.0 million or 10.0% primarily due to a $9.5 million increase in Medicare RAC revenue, which included a $2.1 million increase in revenue from the release of the Company's remaining estimated liability and net receivables relating to the original Medicare RAC contract as described above.
o
Population health management revenue increased $2.4 million or 9.3% due to year over year growth in the Eliza business.
By market:
o
Commercial health plan market revenue increased $3.0 million or 2.0%, which was primarily attributable to year over year growth in the Eliza business and incremental services and yield increases provided to existing customers in our cost avoidance business.
o
Federal government market revenue increased $11.4 million or 50.7% compared to the prior year due to a $9.5 million increase in Medicare RAC revenue, which included an incremental increase in revenue of $2.1 million related to the original Medicare RAC contract as described above.
o
State government market revenue increased by $13.5 million or 11.9%, which was attributable to expanded scopes and yield improvements.

33



Total Cost of Services (in millions)
CHART-4F6312E20C6EA2DD993A01.JPG
Six Months Ended June 302019 vs. 2018
During the six months ended June 30, 2019, total cost of services was $198.6 million, an increase of $0.1 million or 0.1% compared to $198.5 million for the prior year period.
Compensation expense increased by $4.5 million primarily due to a reduction in capitalized software related projects, an increase in stock compensation expense due to stock option vestings for COS related retirement eligible employees.
Direct project and other operating costs increased by $6.4 million due to increased labor and services utilized to support revenue generating activities.
Information technology expense decreased by $1.1 million primarily due a reduction in third party data costs and hosting services.
Amortization of acquisition related software and intangible assets decreased by $9.4 million primarily related to certain intangible assets becoming fully amortized in prior periods, including certain customer relationships, trade names and software related intangibles.
Selling, General and Administrative expenses (in millions)

CHART-2411BA8D6B6BD20CF12.JPG

34




Six Months Ended June 302019 vs. 2018
During the six months ended June 30, 2019, SG&A expense was $57.3 million, a decrease of $1.2 million or 2.1% compared to $58.5 million for the prior year period.
Compensation expense in 2019 decreased by $3.0 million primarily as a result of a decrease in salaries and benefits, as well as stock compensation expense due to a reduction in stock options vesting for SG&A related retirement eligible employees.
Professional and consulting fees increased $1.7 million compared to the prior year as the Company leveraged additional external resources and expertise for certain activities during 2019 .
Income Taxes
Six Months Ended June 302019 vs. 2018
The Company’s effective tax rate decreased to 13.9% for the six months ended June 30, 2019 compared to 47.7% for the six months ended June 30, 2018. The effective tax rate for the six months ended June 30, 2019 includes discrete tax benefits related to net equity compensation deductions offset by interest on uncertain tax benefits. Excluding the above mentioned discrete tax items, our effective tax rate would approximate 26.6% for the six months ended June 30, 2019. For the six months ended June 30, 2019, the differences between the federal statutory rate and our effective tax rate are tax expense items related to state taxes, equity compensation impacts, unrecognized tax benefits, including interest, officer compensation deduction limits, research and development tax credits, and other permanent differences.


Off-Balance Sheet Arrangements
We do not have any off-balance sheet arrangements.

Liquidity and Capital Resources
The following tables should be read in conjunction with the unaudited Consolidated Financial Statements and Notes thereto in Part I, Item 1 of this Form 10-Q.
Our cash and cash equivalents, working capital and available borrowings under our revolving credit facility (based upon the borrowing base and financial covenants in our Credit Agreement) were as follows (in thousands):
 
June 30, 2019
 
December 31, 2018
Cash and cash equivalents
$
268,677

 
$
178,946

Working capital
$
424,899

 
$
328,684

Available borrowings under credit facility
$
253,500

 
$
253,500

The following is a summary of our cash flows (in thousands):

35



 
Six Months Ended June 30,
2019
 
2018
Net cash provided by operating activities
$
78,126

 
$
23,691

Net cash used in investing activities
(8,410
)
 
(12,628
)
Net cash provided by/(used in) financing activities
20,015

 
(6,249
)
Net increase in cash and cash equivalents
$
89,731

 
$
4,814

Our principal source of cash has been our cash flow from operations and our $500 million five-year revolving credit facility. Other sources of cash include proceeds from the exercise of stock options and tax benefits associated with stock option exercises. The primary uses of cash include, but are not limited to, acquisitions, capital investments, compensation expenses, data processing, direct project and other operating costs, SG&A expenses and other expenses.
We believe that expected cash flows from operations, available cash and cash equivalents, and funds available under our revolving credit facility will be sufficient to meet our liquidity requirements for the following year, which include:
the working capital requirements of our operations;
investments in our business;
business development activities; and
repurchases of common stock.
Any projections of future earnings and cash flows are subject to substantial uncertainty. We may need to access debt and equity markets in the future if unforeseen costs or opportunities arise, to meet working capital requirements, fund acquisitions or repay our indebtedness under the Credit Agreement. If we need to obtain new debt or equity financing in the future, the terms and availability of such financing may be impacted by economic and financial market conditions as well as our financial condition and results of operations at the time we seek additional financing.
Cash Flows from Operating Activities
Net cash provided by operating activities for the six months ended June 30, 2019 was $78.1 million, a $54.4 million increase compared to net cash provided by operating activities of $23.7 million for the six months ended June 30, 2018. The increase was primarily related to a $45.7 million increase in net income and a $7.2 million increase resulting from changes in operating assets and liabilities reconciling items. These increases were partially offset by a $2.0 million change in the Estimated liability for appeals balance due to a reserve release.
Cash Flows from Investing Activities
Net cash used in investing activities for the six months ended June 30, 2019 was $8.4 million, a $4.2 million decrease compared to net cash used in investing activities of $12.6 million for the six months ended June 30, 2018. The decrease was related to reductions in purchases of property and equipment and investment in capitalized software.
Cash Flows from Financing Activities
Net cash provided by financing activities for the six months ended June 30, 2019 was $20.0 million, a $26.2 million increase compared to net cash used in financing activities of $6.2 million for the six months ended June 30, 2018. The increase was primarily related to a $20.3 million increase in

36



proceeds from the exercise of stock options, net of payments of tax withholdings, and a $6.0 million decrease in repurchases of common stock.
Contractual Obligations
There have been no material changes outside the ordinary course of business in our contractual obligations as presented in our 2018 Form 10-K.
Recently Issued Accounting Pronouncements
The information set forth under the caption “Recently Issued Accounting Pronouncements Not Yet Adopted” in Note 1 to the unaudited Consolidated Financial Statements in Part I, Item 1 is incorporated herein by reference.

Item 3.    Quantitative and Qualitative Disclosures About Market Risk
There have been no material changes to the market risks discussed in Item 7A to Part II of our 2018 Form 10-K.

Item 4.    Controls and Procedures
We are responsible for maintaining disclosure controls and procedures (as defined in Rule 13a-15(e) under the Exchange Act) that are designed to ensure that information required to be disclosed in our reports filed under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms and that such information is accumulated and communicated to our management, including our Chief Executive Officer and 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 June 30, 2019. Based on that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures were effective to provide reasonable assurance that their objectives were met as of the end of the period covered by this Form 10-Q.
There have been no changes in the Company's internal control over financial reporting identified in connection with the evaluation of our controls performed during the three months ended June 30, 2019, that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

37



PART II — OTHER INFORMATION

Item 1.    Legal Proceedings
The information set forth under the caption “Commitments and Contingencies” in Note12 to the unaudited Consolidated Financial Statements of this Form 10-Q is incorporated herein by reference.

Item 1A.    Risk Factors
In addition to the information set forth in this Form 10-Q, the risks that are discussed in our 2018 Form 10-K, under the headings “Business” of Part I, Item 1, “Risk Factors” of Part I, Item 1A, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” of Part II, Item 7 and “Quantitative and Qualitative Disclosures About Market Risk” of Part II, Item 7A, should be carefully considered as such risks could materially affect the Company’s business, financial condition or future results. There has been no material change in the Company’s risk factors from those described in our 2018 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.

38



Item 6.    Exhibits
The exhibits may include agreements to which the Company is a party or has a beneficial interest. The agreements have been filed to provide investors with information regarding their respective terms. The agreements are not intended to provide any other actual information about the Company or its business or operations. In particular, the assertions embodied in any representations, warranties, and covenants contained in the agreements may be subject to qualifications with respect to knowledge and materiality different from those applicable to investors and may be qualified by information in disclosure schedules not included with the exhibits. These disclosure schedules may contain information that modifies, qualifies and creates exceptions to the representations, warranties and covenants set forth in the agreements. Moreover, certain representations, warranties, and covenants in the agreements may have been used for the purpose of allocating risk between parties, rather than establishing matters as facts. In addition, information concerning the subject matter of the representations, warranties and covenants may have changed after the date of the respective agreement, which subsequent information may or may not be fully reflected in the Company’s public disclosures. Accordingly, investors should not rely on the representations, warranties and covenants in the agreements as characterizations of the actual state of facts about the Company or its business or operations on the date hereof.
Where an exhibit is filed by incorporation by reference to a previously filed registration statement or report, such registration statement or report is identified after the description of the exhibit.

39



Exhibit
Number
 
Description
 
 
 
3.1
 
 
 
 
3.2
 
 
 
 
10.1
 
 
 
 
10.2
 
 
 
 
10.3
 
 
 
 
10.4
 
 
 
 
10.5
 
 
 
 
31.1
 
 
 
 
31.2
 
 
 
 
32.1
 
 
 
 
32.2
 
101.INS
 
XBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document
101.SCH
 
Inline XBRL Taxonomy Extension Schema Document
101.CAL
 
Inline XBRL Taxonomy Extension Calculation Linkbase Document
101.DEF
 
Inline XBRL Taxonomy Extension Definition Linkbase Document
101.LAB
 
Inline XBRL Taxonomy Extension Label Linkbase Document
101.PRE
 
Inline XBRL Taxonomy Extension Presentation Linkbase Document
__________________________________
Indicates a management contract or compensatory plan, contract or arrangement
*
The certifications attached hereto as Exhibit 32.1 and Exhibit 32.2 are furnished with this Form 10-Q and shall not be deemed “filed” by the Company for purposes of Section 18 of the Exchange Act

40



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:
August 5, 2019
 
HMS HOLDINGS CORP.
 
 
 
 
 
 
 
 
By:
/s/ William C. Lucia
 
 
 
 
William C. Lucia
President and Chief Executive Officer
(Principal Executive Officer)
 
 
 
 
 
 
 
 
By:
/s/ Jeffrey S. Sherman
 
 
 
 
Jeffrey S. Sherman
Executive Vice President, Chief Financial Officer and Treasurer
(Principal Financial Officer)

41
Exhibit 10.2
2019 NQSO Award Notice and Agreement


NONQUALIFIED STOCK OPTION AWARD NOTICE

HMS Holdings Corp.
2019 Omnibus Incentive Plan

Dear <Participant Name>,

Congratulations, HMS Holdings Corp. (the “Company”) has granted you a stock option award under the Company’s 2019 Omnibus Incentive Plan, as it may be amended from time to time (the “Plan”). A stock option 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 the terms and conditions of the Plan and the attached implementing Nonqualified Stock Option Award Agreement (the “Award Agreement”). We would like you to have an opportunity to share in the success of the Company through this stock option award under the Plan. The following represents a brief description of your individual award.

Stock Option Award Summary:     

Date of Grant
<Date of Grant>
Option Shares
<Number of Shares Covered by the Option Granted>
Option Exercise Price per Share
$<Exercise Price per Share>
Exercisability
[One-fourth/One-third] of the Option Shares shall vest and become exercisable on each of the first, second[, third and fourth/and third] anniversaries of the Date of Grant. Each of those dates is an “Exercisability Date.”
Option Expiration Date
<Date of tenth anniversary of the Date of Grant>
Participant Management-Level
<Management level of Participant at Date of Grant>

You have been granted a nonqualified stock option (the “Option”) to purchase shares of the Company’s common stock (“Shares”). The total number of Shares covered by the Option granted to you is in the chart above under “Option Shares” and the price per share is under “Option Exercise Price per Share.”
The potential value of your stock option award 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 Award Agreement provides) to actually receive such value. Of course, the value of the stock may go up and down over time.
You cannot exercise the 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 through each Exercisability Date and subject to the terms in the Award Agreement.
Additional details regarding your stock option award are provided in the Plan and the Award Agreement.
Whether or not you decide to exercise your stock option and purchase the Shares is your decision, and you have until the stock option expires (which will be no later than the tenth 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 website, including updates and additional information at: https://www29.benefits.ml.com/login/login.aspx. Please email EquityAdministration@hms.com with any questions regarding the Merrill Lynch website.

Page 2




NONQUALIFIED STOCK OPTION AWARD AGREEMENT
FOR EMPLOYEES

HMS Holdings Corp.
2019 Omnibus Incentive Plan
 
HMS Holdings Corp. (the “Company”) has granted you, the individual named in the attached Nonqualified Stock Option Award Notice (the “Award Notice”), an option (the “Option”) to purchase from the Company a specific number of shares of the Company’s common stock (“Shares”) at a specified price per Share (the “Option Exercise Price”) under the HMS Holdings Corp. 2019 Omnibus Incentive Plan (as it may be amended from time to time) (the “Plan”), the terms of which are incorporated by reference herein in their entirety. The Option is subject in all respects to the applicable provisions of the Plan, the Award Notice and this Nonqualified Stock Option Award Agreement (the “Award Agreement”). Any term used in this Award Agreement that is not specifically defined herein or in the Award Notice shall have the meaning specified in the Plan.

Please refer to the attached Award Notice for individualized details regarding your stock Option award, including the Date of Grant, the total number of Shares covered by the Option granted to you (the “Option Shares”), the Option Exercise Price per Share, the schedule for Exercisability and applicable Exercisability Dates, and the latest date the Option will expire (the “Option Expiration Date”).







The Plan document and the Prospectus for the Plan are available on the Merrill Lynch website. 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, without charge, upon request to the Company’s Corporate Secretary, 5615 High Point Drive, Irving, Texas 75038, telephone: 972-916-2380.

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 Shares or of this Option, or the Company's prospects. The Company is not providing any advice regarding tax consequences to you or 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 3



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

Option
While the Option remains in effect under the Option Expiration section below,
Exercisability
you may exercise any exercisable portions of the Option (and buy the Option Shares) under the timing rules of this section.
    
The Option will become vested and exercisable according to the schedule provided in the Award Notice assuming that you remain an employee of the Company or a member of the Company’s Board of Directors (the “Board”) through each Exercisability Date. For purposes of this Award Agreement, employment with the Company will include employment with any Affiliate whose employees are then eligible to receive awards under the Plan. Unless the Compensation Committee (the “Committee”) of the Board 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.

Unless otherwise specified in your employment or separation agreement, if your employment or service ends as a result of your disability or death, the Option will become vested and fully exercisable on your termination of employment. For this purpose, “disability” means permanent and total disability as defined by Section 22(e)(3) of the Internal Revenue Code.

If your employment or service ends as a result of Retirement, you will be treated as continuing in service for vesting purposes and the vested portion of the Option shall remain exercisable until the earlier to occur of (i) the second anniversary of your Retirement and (ii) the Option Expiration Date (the “Retirement Period”). Unless determined by the Committee otherwise, any portion of the Option outstanding but not yet vested on the last day of the Retirement Period shall be forfeited. “Retirement” for the purpose of this Award Agreement means cessation of service on or after attaining age 60 and completing five years of service with the Company.

Change in
In addition to any terms under your employment or separation agreement, if
Control
applicable, in the event a Change in Control occurs, the Option will be treated as provided in Section 11 of the Plan (and, if applicable, your employment or separation agreement) if within 24 months following the Change in Control, your employment or service ends on (i) a termination without Gross Misconduct or (ii) a resignation for good reason as specified under your employment agreement, if applicable, provided also that the Option will remain outstanding for twelve months following such termination but not beyond the Option Expiration Date.

Option Expiration
The Option will expire no later than the close of business on the Option Expiration Date. Unless otherwise specified in your employment or separation agreement, this Award Agreement, or the Committee determines otherwise, 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 Gross Misconduct, the Option will immediately expire without regard to whether it is then exercisable. “Gross Misconduct” for purposes of this Award Agreement: (i) shall have the same meaning as “cause” in your employment or separation agreement if you have an employment or separation agreement with the Company and cause is defined in such agreement; or (ii) if you do not have an

Page 4



employment or separation agreement or your agreement does not define cause, “gross misconduct” shall mean the occurrence of one of the following events: (A) your conviction or plea of guilty or nolo contendere to any felony (or to a felony charge reduced to a misdemeanor) or with respect to your employment to any misdemeanor (other than a traffic violation), (B) theft or embezzlement of assets of the Company or an Affiliate, or (C) violation of the terms of any non-competition, non-disclosure or similar agreement with respect to the Company or any Affiliate to which the Plan participant is a party, including the terms of Appendix A.

Unless otherwise specified in your employment or separation agreement, 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 this Award Agreement:

Three 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 Gross Misconduct, except as provided above under the Change in Control section;
For death or disability, the first anniversary of the date employment or service ends;
For Retirement, the second anniversary of your Retirement; or
The Option Expiration Date.

The Committee can override the expiration provisions of this Award Agreement as provided in Section 6(b) of the Plan (including without limitation as a result of a legal prohibition on exercise or an applicable “black-out period” or “lock-up” agreement).

Method of
Subject to this Award Agreement and the Plan, you may exercise the Option only
Exercise and
by providing a written notice (or notice through another previously approved
Payment for
method, which could include a voice- or web-based, other electronic, or e-mail
Shares
system) to the Corporate Secretary of the Company or the Corporate Secretary’s designee, 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 Option Exercise Price using one or more of the following methods:

Cash/Check
by cash or check in the amount of the Option Exercise Price payable to the order of the Company;

Cashless    through an approved cashless exercise method, including directing
Exercise     the Company 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 Option Exercise Price and, if you so elect, any required tax     withholdings;


Page 5



Net Exercise
by delivery of a notice of “net exercise” to us 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 Option 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 that you already own having a Fair Market Value equal to the Option Exercise Price on the date of exercise, provided that (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
The issuance of 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, as permitted by the Committee, 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, except as otherwise permitted by the Committee or the Board), (ii) accepting payment of the withholdings directly from you or from a broker in connection with a Cashless Exercise of the Option (as set forth above under Cashless Exercise), or (iii) taking any other action under Section 14(c) of the Plan.

Compliance
You may not exercise the Option if the Company’s issuing stock upon such
with Law
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
The Company may postpone issuing and delivering any Option Shares for so
Conditions
long as the Company determines to be advisable to satisfy the following:
to Exercise        
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.


Page 6



Additional
If you exercise the Option at a time when the Company does not have a current
Representations
registration statement (generally on Form S-8) under the Securities Act of 1933
from You
(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
Nothing in this Award Agreement restricts the Company’s rights or those of any
Employment
of its Affiliates to terminate your employment or other relationship at any time and
or Other
for any or no reason. The termination of employment or other relationship,
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 (i) no dividends or Dividend Equivalents will be paid on the Option and (ii) the Company will not consider you a shareholder for any purpose (including, without limitation, the right to vote or receive dividends on the shares) with respect to any of the Option Shares until you have exercised the Option, paid for the shares, and received evidence of ownership.

No Effect on
You understand and agree that the existence of the Option will not affect in any
Running Business
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 Shares 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 Delaware will govern all matters relating to the Option, without regard to the principles of conflict of laws, except as otherwise specified herein or in an appendix attached hereto.

Clawbacks
    The Committee may cancel this Option if you have engaged in or are engaging in activity that is in conflict with or adverse to the interest of the Company while employed by or providing services to the Company or any subsidiary, including fraud or conduct contributing to any financial restatements or irregularities. The Committee may cause you to forfeit any compensation, gain or other value realized thereafter on the vesting or exercise of the Option or the sale of Shares

Page 7



acquired under the Option, and must promptly repay such amounts to the Company. You agree that the Committee may require you to promptly repay to the Company any amount in excess of what you should have received under the terms of the Option for any reason (including without limitation by reason of a financial restatement, mistake in calculations or other administrative error). Furthermore, to the extent required by applicable law (including, without limitation, Section 304 of the Sarbanes-Oxley Act and Section 954 of the Dodd-Frank Wall Street Reform and Consumer Protection Act) and/or the rules and regulations of NASDAQ or any other securities exchange or inter-dealer quotation service on which the Shares are listed or quoted, or if so required pursuant to a written policy adopted by the Company, the Option shall be subject (including on a retroactive basis) to clawback, forfeiture or similar requirements.

Restrictive
Attached to this Award Agreement is Appendix A regarding your applicable
Covenants
    “Restrictive Covenants” (as defined therein). Your confirmation of receipt of this Option provides your consent to the Restrictive Covenants and to the additional clawback rules set forth in Appendix A.

Notices
Unless the Company specifies another method of transmitting notice, any notice to the Company under this Award Agreement must be sent in writing, by hand or by mail, to the office of the Company’s Corporate Secretary at the Company’s then corporate headquarters. The Company will address any notices to you using its standard electronic communications methods, or to your current office or home address, as reflected in 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 may also change the address for notice by general announcements to the Plan participants.

Amendment
The Committee may amend the Option without your consent provided that it concludes such amendment is not materially adverse to you, is required for compliance with Section 409A, or is permitted under Section 12 of the Plan.

Plan Governs
Wherever a conflict may arise between the terms of this Award Agreement and the terms of the Plan, the terms of the Plan will control. The Committee may adjust the number of Option Shares, the Option Exercise Price, and other terms of the Option from time to time as the Plan provides.

Electronic
You, by your electronic execution of this Award Agreement, agree to the terms
Execution of
and conditions contained herein, including the terms set forth in Appendix A,
Award Agreement
and further agree to execute any documents requested by the Company required to effect the issuance of stock to you in connection with your exercise of the Option.


  
Appendix A

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. Nothing in the Award Agreement or this Appendix A otherwise prohibits you from reporting possible violations of state or federal law or regulation to any government agency, regulator, or legal authority, or making other disclosures that are protected under the whistleblower provisions of state or federal law or regulation.  You are not required to notify the Company that you have made any such reports or disclosures; provided, however, that nothing herein authorizes the disclosure of information you obtained through a communication that was subject to the attorney-client privilege, unless disclosure of the information would otherwise be permitted by an applicable law or rule.  Further, pursuant to the Defend Trade Secrets Act: “An individual shall not be held criminally or civilly liable under any Federal or State trade secret law for the disclosure of a trade secret as defined in the Economic Espionage Act that (A) is made (i) in confidence to a Federal, State, or local government official, either directly or indirectly, or to an attorney; and (ii) solely for the purpose of reporting or investigating a suspected violation of law; or (B) is made in a complaint or other document filed in a lawsuit or other proceeding, if such filing is made under seal.  An individual who files a lawsuit for retaliation by an employer for reporting a suspected violation of law may disclose the trade secret to the attorney of the individual and use the trade secret information in the court proceeding, if the individual (A) files any document containing the trade secret under seal; and (B) does not disclose the trade secret, except pursuant to court order.”

Non-solicitation (all employees)

As an employee of the Company, you agree that while the Company employs you and for a period of twelve 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)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;

(ii)Solicit or Hire 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 to leave the Company’s service or (y) solicit, recruit, hire or engage as an employee or independent contractor any individual whom the Company employed or engaged at any time while you were employed by the Company, except for an individual whose employment or other service relationship with the Company ended at least six months before the date of your action; and/or

(iii)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 (i) “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 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).

Non-competition (executive vice presidents, senior vice presidents, vice presidents and directors)

Vice Presidents and above
As an executive vice president, senior vice president or vice president, you agree that while the Company employs you and for a period of twelve 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), 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 Appendix A, you agree that the Company does business throughout and plans to do business throughout the United States.

Director-level employees
As a director, you agree that while the Company employs you and for a period of six 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), 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 Appendix A, you agree that the Company does business throughout and plans to do business throughout the United States.

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 the Option reflected in the Award Agreement, you agree the provisions of this Restrictive Covenants section (and the related Restrictive Covenants Clawback section below) are reasonable and necessary to protect the legitimate interests of the Company.

The laws of the State of Texas will govern all matters relating to Appendix A 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 above in this Appendix A, the Option will immediately terminate without regard to whether it has already 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 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 it. 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 above. It is also in addition to, and not in substitution for, the clawback provisions in the Award Agreement to which this Appendix A is attached.

Payment is due in cash or cash equivalents within ten 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.


Page 8
Exhibit 10.3
2019 NQSO Award Notice and Agreement
Non-Employee Director Form


NONQUALIFIED STOCK OPTION AWARD NOTICE

HMS Holdings Corp.
2019 Omnibus Incentive Plan

Dear <Participant Name>,            

Congratulations, HMS Holdings Corp. (the “Company”) has granted you a stock option award under the Company’s 2019 Omnibus Incentive Plan, as it may be amended from time to time (the “Plan”). A stock option 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 the terms and conditions of the Plan and the attached implementing Nonqualified Stock Option Award Agreement (the “Award Agreement”). We would like you to have an opportunity to share in the success of the Company through this stock option award under the Plan. The following represents a brief description of your individual award.

Stock Option Award Summary:

Date of Grant
<Date of Grant>
Option Shares
<Number of Shares Covered by the Option Granted>
Option Exercise Price per Share
$<Exercise Price per Share>
Exercisability
______________________. Each of those dates is an “Exercisability Date”.
Option Expiration Date
<Date of tenth anniversary of the Date of Grant>

You have been granted a nonqualified stock option (the “Option”) to purchase shares of the Company’s common stock (“Shares”). The total number of Shares covered by the Option granted to you is in the chart above under “Option Shares” and the price per share is under “Option Exercise Price per Share.”
The potential value of your stock option award 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 Award Agreement provides) to actually receive such value. Of course, the value of the stock may go up and down over time.
You cannot exercise the Option (actually purchase Shares) until it becomes exercisable. Your stock option becomes exercisable as provided in the chart above under “Exercisability,” assuming you remain a member of the Board of Directors of the Company or an employee of the Company through each Exercisability Date and subject to the terms in the Award Agreement.
Additional details regarding your stock option award are provided in the Plan and the Award Agreement.
Whether or not you decide to exercise your stock option and purchase the Shares is your decision, and you have until the stock option expires (which will be no later than the tenth 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 website, including updates and additional information at: https://www29.benefits.ml.com/login/login.aspx. Please email EquityAdministration@hms.com with any questions regarding the Merrill Lynch website.





NONQUALIFIED STOCK OPTION AWARD AGREEMENT
FOR NON-EMPLOYEE DIRECTORS

HMS Holdings Corp.
2019 Omnibus Incentive Plan
 
HMS Holdings Corp. (the “Company”) has granted you, the individual named in the attached Nonqualified Stock Option Award Notice (the “Award Notice”), an option (the “Option”) to purchase from the Company a specific number of shares of the Company’s common stock (“Shares”) at a specified price per Share (the “Option Exercise Price”) under the HMS Holdings Corp. 2019 Omnibus Incentive Plan (as it may be amended from time to time) (the “Plan”), the terms of which are incorporated by reference herein in their entirety. The Option is subject in all respects to the applicable provisions of the Plan, the Award Notice and this Nonqualified Stock Option Award Agreement (the “Award Agreement”). Any term used in this Award Agreement that is not specifically defined herein or in the Award Notice shall have the meaning specified in the Plan.

Please refer to the attached Award Notice for individualized details regarding your stock Option award, including the Date of Grant, the total number of Shares covered by the Option granted to you (the “Option Shares”), the Option Exercise Price per Share, the schedule for Exercisability and applicable Exercisability Dates, and the latest date the Option will expire (the “Option Expiration Date”).







The Plan document and the Prospectus for the Plan are available on the Merrill Lynch website. 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, without charge, upon request to the Company’s Corporate Secretary, 5615 High Point Drive, Irving, Texas 75038, telephone: 972-916-2380.

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 Shares or of this Option, or the Company's prospects. The Company is not providing any advice regarding tax consequences to you or 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
While the Option remains in effect under the Option Expiration section below,
Exercisability
you may exercise any exercisable portions of the Option (and buy the Option Shares) under the timing rules of this section.
    
The Option will become vested and exercisable according to the schedule provided in the Award Notice assuming that you remain a member of the Company’s Board of Directors (the “Board”) or an employee of the Company through each Exercisability Date, as designated by the Compensation Committee (the “Committee”) of the Board.

Unless otherwise determined by the Committee, if your service with the Board ends as a result of your disability or death, the Option will become vested and fully exercisable on your termination of service. For this purpose, “disability” means permanent and total disability as defined by Section 22(e)(3) of the Internal Revenue Code.

If your service ends as a result of Retirement, you will be treated as continuing in service for vesting purposes and the portion of the Option that was exercisable on the date of Retirement shall remain exercisable until the earlier to occur of (i) the second anniversary of your Retirement and (ii) the Option Expiration Date. “Retirement” for the purpose of this Award Agreement means cessation of service on or after attaining age 60 and completing five years of service with the Company.

Change in Control
In the event a Change in Control occurs, the Option will be treated as provided in Section 11 of the Plan if within 24 months following the Change in Control, your service ends on a termination without Gross Misconduct, provided also that the Option will remain outstanding for twelve months following such termination but not beyond the Option Expiration Date.
    
Option Expiration
The Option will expire no later than the close of business on the Option Expiration Date. Unless the Committee determines otherwise, unexercisable portions of the Option expire immediately when you cease to be a Director (unless you are concurrently remaining or becoming an employee, or, for an employee, concurrently remaining or becoming a member of the Board). If the Company terminates your service for Gross Misconduct, the Option will immediately expire without regard to whether it is then exercisable. “Gross Misconduct” for purposes of this Award Agreement shall mean the occurrence of one of the following events: (A) your conviction or plea of guilty or nolo contendere to any felony (or to a felony charge reduced to a misdemeanor), (B) theft or embezzlement of assets of the Company or an Affiliate, or (C) violation of the terms of any non-competition, non-disclosure, confidentiality or similar obligation or agreement with respect to the Company or any Affiliate to which the Plan participant is a party.  

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 this Award Agreement:

Three months (measured to the corresponding date in the month) after your employment (or directorship) ends if you resign or if the Company terminates

Page 3



your employment or service without Gross Misconduct, except as provided above under the Change in Control section;
For death or disability, the first anniversary of the date your service ends;
For Retirement, the second anniversary of your Retirement; or
The Option Expiration Date.

The Committee can override the expiration provisions of this Award Agreement as provided in Section 6(b) of the Plan (including without limitation as a result of a legal prohibition on exercise or an applicable “black-out period” or “lock-up” agreement).

Method of
Subject to this Award Agreement and the Plan, you may exercise the Option only
Exercise and
by providing a written notice (or notice through another previously approved
Payment for
method, which could include a voice- or web-based, other electronic, or e-mail
Shares
system) to the Corporate Secretary of the Company or the Corporate Secretary’s designee, 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 Option Exercise Price using one or more of the following methods:

Cash/Check
by cash or check in the amount of the Option Exercise Price payable to the order of the Company;

Cashless    through an approved cashless exercise method, including directing
Exercise     the Company 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 Option Exercise Price and, if you so elect, any required tax     withholdings;

Net Exercise
by delivery of a notice of “net exercise” to us 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 Option 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 that you already own having a Fair Market Value equal to the Option Exercise Price on the date of exercise, provided that (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
The issuance of the Option Shares is contingent on satisfaction of all obligations with respect to required tax or other required withholdings (for example, in the

Page 4



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, as permitted by the Committee, 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, except as otherwise permitted by the Committee or the Board), (ii) accepting payment of the withholdings directly from you or from a broker in connection with a Cashless Exercise of the Option (as set forth above under Cashless Exercise), or (iii) taking any other action under Section 14(c) of the Plan.

Compliance
You may not exercise the Option if the Company’s issuing stock upon such
with Law
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
The Company may postpone issuing and delivering any Option Shares for so
Conditions
long as the Company determines to be advisable to satisfy the following:
to Exercise        
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
If you exercise the Option at a time when the Company does not have a current
Representations
registration statement (generally on Form S-8) under the Securities Act of 1933
from You
(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

Page 5



effect that, because of Rule 144 under the Act or otherwise, no registration under the Act is required.

No Effect on
Nothing in this Award Agreement restricts the Company’s rights or those of any
Employment
of its Affiliates to terminate your employment or other relationship at any time or
Other
and for any or no reason. The termination of employment or other relationship,
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 (i) no dividends or Dividend Equivalents will be paid on the Option and (ii) the Company will not consider you a shareholder for any purpose (including, without limitation, the right to vote or receive dividends on the shares) with respect to any of the Option Shares until you have exercised the Option, paid for the shares, and received evidence of ownership.

No Effect on
You understand and agree that the existence of the Option will not affect in any
Running Business
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 Shares 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 Delaware will govern all matters relating to the Option, without regard to the principles of conflict of laws.

Clawbacks
    The Committee may cancel this Option if you have engaged in or are engaging in activity that is in conflict with or adverse to the interest of the Company while employed by or providing services to the Company or any subsidiary, including fraud or conduct contributing to any financial restatements or irregularities. The Committee may cause you to forfeit any compensation, gain or other value realized thereafter on the vesting or exercise of the Option or the sale of Shares acquired under the Option, and must promptly repay such amounts to the Company. You agree that the Committee may require you to promptly repay to the Company any amount in excess of what you should have received under the terms of the Option for any reason (including without limitation by reason of a financial restatement, mistake in calculations or other administrative error). Furthermore, to the extent required by applicable law (including, without limitation, Section 304 of the Sarbanes-Oxley Act and Section 954 of the Dodd-Frank Wall Street Reform and Consumer Protection Act) and/or the rules and regulations of NASDAQ or any other securities exchange or inter-dealer quotation service on which the Shares are listed or quoted, or if so required pursuant to a written policy adopted by the Company, the Option shall be subject (including on a retroactive basis) to clawback, forfeiture or similar requirements.

Notices
Unless the Company specifies another method of transmitting notice, any notice to the Company under this Award Agreement must be sent in writing, by hand or by mail, to the office of the Company’s Corporate Secretary at the Company’s then corporate headquarters. The Company will address any notices to you using its standard electronic communications methods, or to your current office or home address, as reflected in the Company’s personnel or other business r

Page 6



ecords. You and the Company may change the address for notice by like notice to the other, and the Company may also change the address for notice by general announcements to the Plan participants.

Amendment
The Committee may amend the Option without your consent provided that it concludes such amendment is not materially adverse to you, is required for compliance with Section 409A, or is permitted under Section 12 of the Plan.

Plan Governs
Wherever a conflict may arise between the terms of this Award Agreement and the terms of the Plan, the terms of the Plan will control. The Committee may adjust the number of Option Shares, the Option Exercise Price, and other terms of the Option from time to time as the Plan provides.

Electronic
You, by your electronic execution of this Award Agreement, agree to the terms
Execution of
and conditions contained herein and further agree to execute any documents
Award Agreement
requested by the Company required to effect the issuance of stock to you in connection with your exercise of the Option.
    



Page 7
Exhibit 10.4
2019 NQSO Award Notice and Agreement


NONQUALIFIED STOCK OPTION AWARD NOTICE

HMS Holdings Corp.
2019 Omnibus Incentive Plan

Dear <Participant Name>,

Congratulations, HMS Holdings Corp. (the “Company”) has granted you a stock option award under the Company’s 2019 Omnibus Incentive Plan, as it may be amended from time to time (the “Plan”). A stock option 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 the terms and conditions of the Plan and the attached implementing Nonqualified Stock Option Award Agreement (the “Award Agreement”). We would like you to have an opportunity to share in the success of the Company through this stock option award under the Plan. The following represents a brief description of your individual award.

Stock Option Award Summary:     

Date of Grant
<Date of Grant>
Option Shares
<Number of Shares Covered by the Option Granted>
Option Exercise Price per Share
$<Exercise Price per Share>
Exercisability
[One-fourth/One-third] of the Option Shares shall vest and become exercisable on each of the first, second[, third and fourth/and third] anniversaries of the Date of Grant. Each of those dates is an “Exercisability Date.”
Option Expiration Date
<Date of tenth anniversary of the Date of Grant>
Participant Management-Level
<Management level of Participant at Date of Grant>

You have been granted a nonqualified stock option (the “Option”) to purchase shares of the Company’s common stock (“Shares”). The total number of Shares covered by the Option granted to you is in the chart above under “Option Shares” and the price per share is under “Option Exercise Price per Share.”
The potential value of your stock option award 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 Award Agreement provides) to actually receive such value. Of course, the value of the stock may go up and down over time.
You cannot exercise the 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 through each Exercisability Date and subject to the terms in the Award Agreement.
Additional details regarding your stock option award are provided in the Plan and the Award Agreement.
Whether or not you decide to exercise your stock option and purchase the Shares is your decision, and you have until the stock option expires (which will be no later than the tenth 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 website, including updates and additional information at: https://www29.benefits.ml.com/login/login.aspx. Please email EquityAdministration@hms.com with any questions regarding the Merrill Lynch website.

Page 2




NONQUALIFIED STOCK OPTION AWARD AGREEMENT
FOR EMPLOYEES

HMS Holdings Corp.
2019 Omnibus Incentive Plan
 
HMS Holdings Corp. (the “Company”) has granted you, the individual named in the attached Nonqualified Stock Option Award Notice (the “Award Notice”), an option (the “Option”) to purchase from the Company a specific number of shares of the Company’s common stock (“Shares”) at a specified price per Share (the “Option Exercise Price”) under the HMS Holdings Corp. 2019 Omnibus Incentive Plan (as it may be amended from time to time) (the “Plan”), the terms of which are incorporated by reference herein in their entirety. The Option is subject in all respects to the applicable provisions of the Plan, the Award Notice and this Nonqualified Stock Option Award Agreement (the “Award Agreement”). Any term used in this Award Agreement that is not specifically defined herein or in the Award Notice shall have the meaning specified in the Plan.

Please refer to the attached Award Notice for individualized details regarding your stock Option award, including the Date of Grant, the total number of Shares covered by the Option granted to you (the “Option Shares”), the Option Exercise Price per Share, the schedule for Exercisability and applicable Exercisability Dates, and the latest date the Option will expire (the “Option Expiration Date”).







The Plan document and the Prospectus for the Plan are available on the Merrill Lynch website. 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, without charge, upon request to the Company’s Corporate Secretary, 5615 High Point Drive, Irving, Texas 75038, telephone: 972-916-2380.

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 Shares or of this Option, or the Company's prospects. The Company is not providing any advice regarding tax consequences to you or 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 3



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

Option
While the Option remains in effect under the Option Expiration section below,
Exercisability
you may exercise any exercisable portions of the Option (and buy the Option Shares) under the timing rules of this section.
    
The Option will become vested and exercisable according to the schedule provided in the Award Notice assuming that you remain an employee of the Company or a member of the Company’s Board of Directors (the “Board”) through each Exercisability Date. For purposes of this Award Agreement, employment with the Company will include employment with any Affiliate whose employees are then eligible to receive awards under the Plan. Unless the Compensation Committee (the “Committee”) of the Board 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.

Unless otherwise specified in your employment or separation agreement, if your employment or service ends as a result of your disability or death, the Option will become vested and fully exercisable on your termination of employment. For this purpose, “disability” means permanent and total disability as defined by Section 22(e)(3) of the Internal Revenue Code.

If your employment or service ends as a result of Retirement, you will be treated as continuing in service for vesting purposes and the vested portion of the Option shall remain exercisable until the earlier to occur of (i) the second anniversary of your Retirement and (ii) the Option Expiration Date (the “Retirement Period”). Unless determined by the Committee otherwise, any portion of the Option outstanding but not yet vested on the last day of the Retirement Period shall be forfeited. “Retirement” for the purpose of this Award Agreement means cessation of service on or after attaining age 60 and completing five years of service with the Company.

Change in
In addition to any terms under your employment or separation agreement, if
Control
applicable, in the event a Change in Control occurs, the Option will be treated as provided in Section 11 of the Plan (and, if applicable, your employment or separation agreement) if within 24 months following the Change in Control, your employment or service ends on (i) a termination without Gross Misconduct or (ii) a resignation for good reason as specified under your employment agreement, if applicable, provided also that the Option will remain outstanding for twelve months following such termination but not beyond the Option Expiration Date.

Option Expiration
The Option will expire no later than the close of business on the Option Expiration Date. Unless otherwise specified in your employment or separation agreement, this Award Agreement, or the Committee determines otherwise, 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 Gross Misconduct, the Option will immediately expire without regard to whether it is then exercisable. “Gross Misconduct” for purposes of this Award Agreement: (i) shall have the same meaning as “cause” in your employment or separation agreement if you have an employment or separation agreement with the Company and cause is defined in such agreement; or (ii) if you do not have an

Page 4



employment or separation agreement or your agreement does not define cause, “gross misconduct” shall mean the occurrence of one of the following events: (A) your conviction or plea of guilty or nolo contendere to any felony (or to a felony charge reduced to a misdemeanor) or with respect to your employment to any misdemeanor (other than a traffic violation), (B) theft or embezzlement of assets of the Company or an Affiliate, or (C) violation of the terms of any non-competition, non-disclosure or similar agreement with respect to the Company or any Affiliate to which the Plan participant is a party, including the terms of Appendix A.

Unless otherwise specified in your employment or separation agreement, 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 this Award Agreement:

Three 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 Gross Misconduct, except as provided above under the Change in Control section;
For death or disability, the first anniversary of the date employment or service ends;
For Retirement, the second anniversary of your Retirement; or
The Option Expiration Date.

The Committee can override the expiration provisions of this Award Agreement as provided in Section 6(b) of the Plan (including without limitation as a result of a legal prohibition on exercise or an applicable “black-out period” or “lock-up” agreement).

Method of
Subject to this Award Agreement and the Plan, you may exercise the Option only
Exercise and
by providing a written notice (or notice through another previously approved
Payment for
method, which could include a voice- or web-based, other electronic, or e-mail
Shares
system) to the Corporate Secretary of the Company or the Corporate Secretary’s designee, 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 Option Exercise Price using one or more of the following methods:

Cash/Check
by cash or check in the amount of the Option Exercise Price payable to the order of the Company;

Cashless    through an approved cashless exercise method, including directing
Exercise     the Company 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 Option Exercise Price and, if you so elect, any required tax     withholdings;


Page 5



Net Exercise
by delivery of a notice of “net exercise” to us 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 Option 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 that you already own having a Fair Market Value equal to the Option Exercise Price on the date of exercise, provided that (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
The issuance of 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, as permitted by the Committee, 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, except as otherwise permitted by the Committee or the Board), (ii) accepting payment of the withholdings directly from you or from a broker in connection with a Cashless Exercise of the Option (as set forth above under Cashless Exercise), or (iii) taking any other action under Section 14(c) of the Plan.

Compliance
You may not exercise the Option if the Company’s issuing stock upon such
with Law
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
The Company may postpone issuing and delivering any Option Shares for so
Conditions
long as the Company determines to be advisable to satisfy the following:
to Exercise        
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.


Page 6



Additional
If you exercise the Option at a time when the Company does not have a current
Representations
registration statement (generally on Form S-8) under the Securities Act of 1933
from You
(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
Nothing in this Award Agreement restricts the Company’s rights or those of any
Employment
of its Affiliates to terminate your employment or other relationship at any time and
or Other
for any or no reason. The termination of employment or other relationship,
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 (i) no dividends or Dividend Equivalents will be paid on the Option and (ii) the Company will not consider you a shareholder for any purpose (including, without limitation, the right to vote or receive dividends on the shares) with respect to any of the Option Shares until you have exercised the Option, paid for the shares, and received evidence of ownership.

No Effect on
You understand and agree that the existence of the Option will not affect in any
Running Business
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 Shares 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 Delaware will govern all matters relating to the Option, without regard to the principles of conflict of laws, except as otherwise specified herein or in an appendix attached hereto.

Clawbacks
    The Committee may cancel this Option if you have engaged in or are engaging in activity that is in conflict with or adverse to the interest of the Company while employed by or providing services to the Company or any subsidiary, including fraud or conduct contributing to any financial restatements or irregularities. The Committee may cause you to forfeit any compensation, gain or other value realized thereafter on the vesting or exercise of the Option or the sale of Shares

Page 7



acquired under the Option, and must promptly repay such amounts to the Company. You agree that the Committee may require you to promptly repay to the Company any amount in excess of what you should have received under the terms of the Option for any reason (including without limitation by reason of a financial restatement, mistake in calculations or other administrative error). Furthermore, to the extent required by applicable law (including, without limitation, Section 304 of the Sarbanes-Oxley Act and Section 954 of the Dodd-Frank Wall Street Reform and Consumer Protection Act) and/or the rules and regulations of NASDAQ or any other securities exchange or inter-dealer quotation service on which the Shares are listed or quoted, or if so required pursuant to a written policy adopted by the Company, the Option shall be subject (including on a retroactive basis) to clawback, forfeiture or similar requirements.

Restrictive
Attached to this Award Agreement is Appendix A regarding your applicable
Covenants
    “Restrictive Covenants” (as defined therein). Your confirmation of receipt of this Option provides your consent to the Restrictive Covenants and to the additional clawback rules set forth in Appendix A.

Notices
Unless the Company specifies another method of transmitting notice, any notice to the Company under this Award Agreement must be sent in writing, by hand or by mail, to the office of the Company’s Corporate Secretary at the Company’s then corporate headquarters. The Company will address any notices to you using its standard electronic communications methods, or to your current office or home address, as reflected in 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 may also change the address for notice by general announcements to the Plan participants.

Amendment
The Committee may amend the Option without your consent provided that it concludes such amendment is not materially adverse to you, is required for compliance with Section 409A, or is permitted under Section 12 of the Plan.

Plan Governs
Wherever a conflict may arise between the terms of this Award Agreement and the terms of the Plan, the terms of the Plan will control. The Committee may adjust the number of Option Shares, the Option Exercise Price, and other terms of the Option from time to time as the Plan provides.

Electronic
You, by your electronic execution of this Award Agreement, agree to the terms
Execution of
and conditions contained herein, including the terms set forth in Appendix A,
Award Agreement
and further agree to execute any documents requested by the Company required to effect the issuance of stock to you in connection with your exercise of the Option.


  
Appendix A

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. Nothing in the Award Agreement or this Appendix A otherwise prohibits you from reporting possible violations of state or federal law or regulation to any government agency, regulator, or legal authority, or making other disclosures that are protected under the whistleblower provisions of state or federal law or regulation.  You are not required to notify the Company that you have made any such reports or disclosures; provided, however, that nothing herein authorizes the disclosure of information you obtained through a communication that was subject to the attorney-client privilege, unless disclosure of the information would otherwise be permitted by an applicable law or rule.  Further, pursuant to the Defend Trade Secrets Act: “An individual shall not be held criminally or civilly liable under any Federal or State trade secret law for the disclosure of a trade secret as defined in the Economic Espionage Act that (A) is made (i) in confidence to a Federal, State, or local government official, either directly or indirectly, or to an attorney; and (ii) solely for the purpose of reporting or investigating a suspected violation of law; or (B) is made in a complaint or other document filed in a lawsuit or other proceeding, if such filing is made under seal.  An individual who files a lawsuit for retaliation by an employer for reporting a suspected violation of law may disclose the trade secret to the attorney of the individual and use the trade secret information in the court proceeding, if the individual (A) files any document containing the trade secret under seal; and (B) does not disclose the trade secret, except pursuant to court order.”

Non-solicitation (all employees)

As an employee of the Company, you agree that while the Company employs you and for a period of twelve 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)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;

(ii)Solicit or Hire 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 to leave the Company’s service or (y) solicit, recruit, hire or engage as an employee or independent contractor any individual whom the Company employed or engaged at any time while you were employed by the Company, except for an individual whose employment or other service relationship with the Company ended at least six months before the date of your action; and/or

(iii)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 (i) “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 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).

Non-competition (executive vice presidents, senior vice presidents, vice presidents and directors)

Vice Presidents and above
As an executive vice president, senior vice president or vice president, you agree that while the Company employs you and for a period of twelve 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), 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 Appendix A, you agree that the Company does business throughout and plans to do business throughout the United States.

Director-level employees
As a director, you agree that while the Company employs you and for a period of six 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), 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 Appendix A, you agree that the Company does business throughout and plans to do business throughout the United States.

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 the Option reflected in the Award Agreement, you agree the provisions of this Restrictive Covenants section (and the related Restrictive Covenants Clawback section below) are reasonable and necessary to protect the legitimate interests of the Company.

The laws of the State of Texas will govern all matters relating to Appendix A 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 above in this Appendix A, the Option will immediately terminate without regard to whether it has already 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 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 it. 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 above. It is also in addition to, and not in substitution for, the clawback provisions in the Award Agreement to which this Appendix A is attached.

Payment is due in cash or cash equivalents within ten 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.


Page 8
Exhibit 10.5
2019 RSU Award Notice and Agreement
Non-Employee Director Form


RESTRICTED STOCK UNIT AWARD NOTICE

HMS Holdings Corp.
2019 Omnibus Incentive Plan

Dear <Participant Name>,            

Congratulations, HMS Holdings Corp. (the “Company”) has granted you restricted stock units (“RSUs”) under the Company’s 2019 Omnibus Incentive Plan, as it may be amended from time to time (the “Plan”). An RSU entitles you to receive a share of the Company’s common stock at a future date, assuming that you satisfy the terms and conditions of the Plan and the attached implementing Restricted Stock Unit Award Agreement (the “Award Agreement”). We would like you to have an opportunity to share in the success of the Company through this RSU award under the Plan. The following represents a brief description of your individual award.

Restricted Stock Unit Award Summary:

Date of Grant
<Date of Grant>
RSU Shares
<Number of Shares Covered by the RSUs Granted>
Vesting
________________________. 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 Award 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 a member of the Board of Directors of the Company or an employee of the Company through each Vesting Date and subject to the terms in the Award 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.
Additional details regarding your RSU award are provided in the Plan and the Award Agreement.

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





RESTRICTED STOCK UNIT AWARD AGREEMENT
FOR NON-EMPLOYEE DIRECTORS

HMS Holdings Corp.
2019 Omnibus Incentive Plan

HMS Holdings Corp. (the “Company”) has granted you, the individual named in the attached Restricted Stock Unit Award Notice (the “Award Notice”), restricted stock units (the “RSUs”) under the HMS Holdings Corp. 2019 Omnibus Incentive Plan (as it may be amended from time to time) (the “Plan”), the terms of which are incorporated by reference herein in their entirety. Each RSU lets you receive a share (an “RSU Share”) of the Company’s common stock (the “Shares”) and is subject in all respects to the applicable provisions of the Plan, the Award Notice and this Restricted Stock Unit Award Agreement (the “Award Agreement”). Any term used in this Award Agreement that is not specifically defined herein or in the Award Notice shall have the meaning specified in the Plan.

Please refer to the attached Award Notice for individualized details regarding your RSU award, including the Date of Grant, the total number of RSU Shares granted to you, and the schedule for Vesting and applicable vesting dates (the “Vesting Dates”).








The Plan document and the Prospectus for the Plan are available on the Merrill Lynch website. 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, without charge, upon request to the Company’s Corporate Secretary, 5615 High Point Drive, Irving, Texas 75038, telephone: 972-916-2380.

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 Shares or of these RSUs, or the Company's prospects. The Company is not providing any advice regarding tax consequences to you or 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
Your RSUs become nonforfeitable (“Vested”) as provided in the Award Notice,
Schedule assuming that you remain a member of the Company’s Board of Directors (the “Board”) or an employee of the Company through each Vesting Date, as designated by the Compensation Committee (the “Committee”) of the Board.

Unless otherwise determined by the Committee, if your service with the Board ends as a result of your disability, your RSUs will become fully vested. For this purpose “disability” means permanent and total disability as defined by Section 22(e)(3) of the Internal Revenue Code. Unless otherwise specified by the Committee, if your service ends as a result of your death, your RSUs will immediately vest in full upon your death.

If your service ends as a result of Retirement, you will be treated as continuing in service for vesting purposes until the earlier to occur of (i) the second anniversary of your Retirement and (ii) the last of the applicable Vesting Dates. “Retirement” for the purpose of this Award Agreement means cessation of service on or after attaining age 60 and completing five years of service with the Company.

Change in
In the event a Change in Control occurs, the RSUs will be treated as provided in
Control
Section 11 of the Plan if within 24 months following the Change in Control, your service ends on (i) a termination without Gross Misconduct or (ii) Retirement.
    
Termination due     If the Company terminates your employment or service for Gross Misconduct,
to Misconduct
the RSUs will immediately terminate without regard to whether they are then Vested in whole or in part. “Gross Misconduct” for purposes of this Award Agreement shall mean the occurrence of one of the following events: (A) your conviction or plea of guilty or nolo contendere to any felony (or to a felony charge reduced to a misdemeanor), (B) theft or embezzlement of assets of the Company or an Affiliate, or (C) violation of the terms of any non-competition, non-disclosure, confidentiality or similar obligation or agreement with respect to the Company or any Affiliate to which the Plan participant is a party.
    
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 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 Internal Revenue Code (“Section 409A”).

Restrictions        You may not sell, assign, pledge, encumber, or otherwise transfer any
and            interest (“Transfer”) in the RSUs or RSU Shares until the RSU Shares are Forfeiture         distributed to you. Any attempted Transfer that precedes the Distribution Date is                 invalid.


Page 3



Unless otherwise specified in your employment or separation agreement, this Award Agreement, or the Committee determines 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 in accordance with the rules in the Vesting 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
The RSUs provide tax deferral, meaning that the RSU Shares are not taxable
Withholding
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.

The issuance of 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, as permitted by the Committee, satisfying the tax obligations by (i) reducing the number of RSU Shares to be issued to you by that number of 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, except as otherwise permitted by the Committee or the Board), (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.

Compliance
The Company will not issue the RSU Shares if doing so would violate any
with Law
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
The Company may postpone issuing and delivering any RSU Shares for so
Conditions
long as the Company determines to be advisable to satisfy the following:
to Receipt
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
If the vesting provisions of the RSUs are satisfied and you are entitled to receive
Representations
RSU Shares at a time when the Company does not have a current registration
from You
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 —


Page 4



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

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
Nothing in this Award Agreement restricts the Company’s rights or those of any
Employment
of its Affiliates to terminate your employment or other relationship at any time and
or Other
    for any or no reason. The termination of employment or other relationship,
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 or for your account.

No Effect on
You understand and agree that the existence of the RSUs will not affect in any
Running Business
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 Shares 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
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 Award 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

Page 5



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 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 months and one 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 Award Agreement are determined to constitute deferred compensation subject to Section 409A but not to satisfy the conditions of that section.

Unsecured
The RSUs create a contractual obligation on the part of the Company to make
Creditor
a distribution of the RSU Shares at the time provided for in this Award 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 Delaware will govern all matters relating to the RSUs without regard to the principles of conflict of laws.

Clawbacks
    The Committee may cancel these RSUs if you have engaged in or are engaging in activity that is in conflict with or adverse to the interest of the Company while employed by or providing services to the Company or any subsidiary, including fraud or conduct contributing to any financial restatements or irregularities. The Committee may cause you to forfeit any compensation, gain or other value realized thereafter on the vesting or settlement of these RSUs or the sale of Shares acquired in respect of the RSUs, and must promptly repay such amounts to the Company. You agree that the Committee may require you to promptly repay to the Company any amount in excess of what you should have received under the terms of the RSUs for any reason (including without limitation by reason of a financial restatement, mistake in calculations or other administrative error). Furthermore, to the extent required by applicable law (including, without limitation, Section 304 of the Sarbanes-Oxley Act and Section 954 of the Dodd-Frank Wall Street Reform and Consumer Protection Act) and/or the rules and regulations of NASDAQ or any other securities exchange or inter-dealer quotation service on which the Shares are listed or quoted, or if so required pursuant to a written policy adopted by the Company, these RSUs shall be subject (including on a retroactive basis) to clawback, forfeiture or similar requirements.
    
Notices
Unless the Company specifies another method of transmitting notice, any notice to the Company under this Award Agreement must be sent in writing, by hand or by mail, to the office of the Company’s Corporate Secretary at the Company’s then corporate headquarters. The Company will address any notices to you u

Page 6



sing its standard electronic communications methods, or to your current office or home address, as reflected in 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 may also change the address for notice by general announcements to the Plan participants.

Amendment
The Committee may amend the RSUs without your consent provided that it concludes such amendment is not materially adverse to you, is required for compliance with Section 409A, or is permitted under Section 12 of the Plan.

Plan Governs
Wherever a conflict may arise between the terms of this Award 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.

Electronic
You, by your electronic execution of this Award Agreement, agree to the terms
Execution of
and conditions contained herein and further agree to execute any documents
Award Agreement
requested by the Company required to effect to effect the conversion of the RSUs into Shares.



Page 7



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:    August 5, 2019
/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:    August 5, 2019
/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 June 30, 2019 as filed with the Securities and Exchange Commission on the date hereof (the “Report”), I, William C. Lucia, Chief Executive Officer of the Company, hereby certify, to the best of my knowledge, 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, as amended; 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)
 
 
 
 
 
 
 
 
August 5, 2019
 





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 June 30, 2019 as filed with the Securities and Exchange Commission on the date hereof (the “Report”), I, Jeffrey S. Sherman, Chief Financial Officer of the Company, hereby certify, to the best of my knowledge, 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, as amended; 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)
 
 
 
 
 
 
 
 
August 5, 2019