HMS (HMSY) 10-Q 9 Aug 16 2016 Q2 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	6 Months Ended
	Jun. 30, 2016	Aug. 04, 2016
Document Information [Line Items]
Entity Registrant Name	HMS HOLDINGS CORP
Entity Central Index Key	1,196,501
Trading Symbol	hmsy
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Well-known Seasoned Issuer	Yes
Entity Common Stock, Shares Outstanding (in shares)		84,441,859
Document Type	10-Q
Document Period End Date	Jun. 30, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q2
Amendment Flag	false

Consolidated Balance Sheets (Cu

Consolidated Balance Sheets (Current Period Unaudited) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 187,884	$ 145,610
Accounts receivable, net of allowance for doubtful accounts of $3,649 and $4,849, and estimated allowance for appeals of $6,483 and $6,614, at June 30, 2016 and December 31, 2015, respectively	152,339	169,146
Prepaid expenses	11,389	11,261
Deferred tax assets	5,285	7,460
Other current assets	399	3,051
Total current assets	357,296	336,528
Property and equipment, net	87,907	96,551
Goodwill	361,468	361,468
Intangible assets, net	44,222	54,308
Deferred financing costs, net	3,831	4,873
Other assets	4,649	4,329
Total assets	859,373	858,057
Current liabilities:
Accounts payable, accrued expenses and other liabilities	40,450	51,661
Estimated liability for appeals	30,586	33,078
Income taxes payable	700	3,873
Total current liabilities	71,736	88,612
Long-term liabilities:
Revolving credit facility	197,796	197,796
Deferred tax liabilities	33,899	38,421
Deferred rent	5,798	6,006
Other liabilities	3,017	2,520
Total long-term liabilities	240,510	244,743
Total liabilities	312,246	333,355
Commitments and contingencies (Note 11)
Shareholders' equity:
Preferred stock -- $0.01 par value; 5,000,000 shares authorized; none issued
Common stock -- $0.01 par value; 175,000,000 shares authorized; 95,711,773 shares issued and 84,438,027 shares outstanding at June 30, 2016; 95,263,461 shares issued and 83,989,715 shares outstanding at December 31, 2015	957	952
Capital in excess of par value	339,584	330,290
Retained earnings	301,600	288,474
Treasury stock, at cost: 11,273,746 shares at June 30, 2016 and December 31, 2015	(95,014)	(95,014)
Total shareholders' equity	547,127	524,702
Total liabilities and shareholders' equity	$ 859,373	$ 858,057

Consolidated Balance Sheets (C3

Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Accounts receivable, allowance for doubtful accounts	$ 3,649	$ 4,849
Accounts receivable, allowance for appeals	$ 6,483	$ 6,614
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	5,000,000	5,000,000
Preferred stock, shares issued (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	175,000,000	175,000,000
Common stock, shares issued (in shares)	95,711,773	95,263,461
Common stock, shares outstanding (in shares)	84,438,027	83,989,715
Treasury stock, shares (in shares)	11,273,746	11,273,746

Consolidated Statements of Inco

Consolidated Statements of Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Revenue	$ 123,550	$ 116,934	$ 243,313	$ 227,258
Cost of services:
Compensation	47,343	43,883	93,744	87,950
Data processing	9,104	10,438	18,728	20,483
Occupancy	3,631	3,806	7,258	7,813
Direct project expenses	11,473	13,572	25,955	24,050
Other operating expenses	6,407	7,153	12,184	13,891
Amortization of acquisition related software and intangible assets	7,013	7,047	14,026	14,094
Total cost of services	84,971	85,899	171,895	168,281
Selling, general and administrative expenses	22,227	19,283	45,157	39,244
Total operating expenses	107,198	105,182	217,052	207,525
Operating income	16,352	11,752	26,261	19,733
Interest expense	(2,100)	(1,940)	(4,191)	(3,894)
Interest income	60	12	107	23
Income before income taxes	14,312	9,824	22,177	15,862
Income taxes	5,746	4,406	9,051	6,922
Net income	$ 8,566	$ 5,418	$ 13,126	$ 8,940
Basic income per common share:
Net income per common share -- basic (in dollars per share)	$ 0.10	$ 0.06	$ 0.16	$ 0.10
Diluted income per common share:
Net income per common share -- diluted (in dollars per share)	$ 0.10	$ 0.06	$ 0.15	$ 0.10
Weighted average shares:
Basic (in shares)	84,073	88,523	84,104	88,385
Diluted (in shares)	84,528	88,908	84,923	88,771

Consolidated Statement of Share

Consolidated Statement of Shareholders' Equity (Unaudited) - 6 months ended Jun. 30, 2016 - USD ($) $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Treasury Stock [Member]	Total
Balance (in shares) at Dec. 31, 2015	95,263,461			11,273,746
Balance at Dec. 31, 2015	$ 952	$ 330,290	$ 288,474	$ (95,014)	$ 524,702
Net income			13,126		13,126
Stock-based compensation expense		8,645			$ 8,645
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period	298,692				298,692
Exercise of stock options	$ 3	1,193			$ 1,196
Vesting of restricted stock units, net of shares withheld for employee tax (in shares)	149,620
Vesting of restricted stock units, net of shares withheld for employee tax	$ 2	(1,069)			(1,067)
Adjustments to Additional Paid in Capital, Income Tax Benefit from Share-based Compensation		1,313			1,313
Tax shortfall due to exercise of stock options and vesting of restricted stock units		(465)			(465)
Deferred tax asset reversal for unexercised stock options		(323)			(323)
Balance (in shares) at Jun. 30, 2016	95,711,773			11,273,746
Balance at Jun. 30, 2016	$ 957	$ 339,584	$ 301,600	$ (95,014)	$ 547,127

Consolidated Statements of Cash

Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Operating activities:
Net income	$ 13,126	$ 8,940
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization of property and equipment	12,784	16,002
Amortization of intangible assets	10,086	10,154
Amortization of deferred financing costs	1,042	1,042
Stock-based compensation expense	8,645	7,068
Excess tax benefit from exercised stock options	(1,313)	(1,456)
Deferred income taxes	(3,135)	(3,483)
Loss on disposal of fixed assets	44	10
Changes in operating assets and liabilities:
Accounts receivable	16,807	(10,161)
Prepaid expenses	(128)	628
Prepaid income taxes		6,265
Other current assets	2,652	5
Other assets	(320)	(660)
Income taxes payable	(1,860)
Accounts payable, accrued expenses and other liabilities	(10,190)	(11,479)
Estimated liability for appeals	(2,492)	(2,785)
Net cash provided by operating activities	45,748	20,090
Investing activities:
Purchases of land, property and equipment	(2,122)	(5,022)
Investment in capitalized software	(2,752)	(1,340)
Net cash used in investing activities	(4,874)	(6,362)
Financing activities:
Proceeds from exercise of stock options	1,196	3,412
Excess tax benefit from exercised stock options	1,313	1,456
Payments of tax withholdings on behalf of employees for net-share settlement for stock-based compensation	(1,067)	(628)
Payments on capital lease obligations	(42)	(655)
Net cash provided by financing activities	1,400	3,585
Net increase in cash and cash equivalents	42,274	17,313
Cash and cash equivalents at beginning of year	145,610	133,116
Cash and cash equivalents at end of period	187,884	150,429
Supplemental disclosure of cash flow information:
Cash paid for income taxes	13,450	8,226
Cash paid for interest	3,016	3,868
Supplemental disclosure of non-cash activities:
Change in balance of accrued property and equipment purchases	$ (690)	$ 154

Note 1 - Basis of Presentation

Note 1 - Basis of Presentation	6 Months Ended
	Jun. 30, 2016
Notes to Financial Statements
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]	1. Basis of Presentation HMS Holdings Corp., through its subsidiaries (collectively, the “Company” or “HMS”) provides coordination of benefits services to government and private healthcare payers and sponsors to ensure that the responsible party pays healthcare claims. Additionally, the Company’s payment integrity services ensure that healthcare claims billed are accurate and appropriate. Together these various services help customers recover amounts from liable third parties; prevent future improper payments; reduce fraud, waste and abuse; and ensure regulatory compliance. The consolidated financial statements and notes herein are unaudited. Accordingly, they do not include all of the information and notes required by United States Generally Accepted Accounting Principles (“U.S. GAAP”) for complete financial statements. These statements include all adjustments (consisting of normal recurring accruals) that management considers necessary to present a fair statement of the Company’s results of operations, financial position and cash flows. The results reported in these consolidated financial statements should not be regarded as necessarily indicative of results that may be expected for the entire year. It is suggested that these consolidated financial statements be read in conjunction with the Company’s consolidated financial statements as of and for the year ended December 31, 2015 which were filed with the U.S. Securities and Exchange Commission (“SEC”) on February 29, 2016 as part of the Company’s Annual Report on Form 10-K for the year ended December 31, 2015 (“2015 Form 10-K”). The consolidated balance sheet as of December 31, 2015 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, accrued expenses, estimated allowance for appeals, estimated liability for appeals, the disclosure of contingent liabilities at the date of the unaudited consolidated financial statements and the reported amounts of revenue and expenses during the reporting periods. The Company’s actual results could differ from those estimates. These unaudited consolidated financial statements include HMS accounts and transactions and those of the Company’s wholly owned subsidiaries. All significant intercompany balances and transactions have been eliminated in consolidation. Certain reclassifications were made to prior period amounts to conform to the current period presentation. HMS is managed and operated as one business, with a single management team that reports to the Chief Executive Officer. HMS does not operate separate lines of business with respect to any of the Company’s product lines.

Note 2 - Summary of Significant

Note 2 - Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2016
Notes to Financial Statements
Significant Accounting Policies [Text Block]	2. Summary of Significant Accounting Policies There have been no material changes to the Company’s significant accounting policies that are referenced in the 2015 Form 10-K. Recently Adopted Accounting Pronouncements The Company adopted Accounting Standards Updated (“ASU”) No. 2015-03, “ Simplifying the Presentation of Debt Issuance Costs Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of-Credit Arrangements Recently Issued Accounting Pronouncements In addition to the recently issued accounting pronouncements disclosed in the 2015 Form 10-K, the following guidance has been issued since the annual filing. There have been no changes in the Company’s anticipated adoption of the previously disclosed pronouncements, except as noted above. In March 2016, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2016-08, Revenue from Contracts with Customers (Topic 606) – Principal versus Agent Considerations (Reporting Revenue Gross versus Net) In March 2016, as part of its Simplification Initiative, the FASB issued ASU No. 2016-09 , Compensation—Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accountin In March 2016, the FASB issued ASU No. 2016-10, Revenue from Contracts with Customers (Topic 606): Identifying Performance Obligations and Licensing In May 2016, the FASB issued ASU No. 2016-12 , Revenue From Contracts With Customers (Topic 606): Narrow- Scope Improvements and Practical Expedients

Note 3 - Accounts Receivable an

Note 3 - Accounts Receivable and Allowance for Doubtful Accounts	6 Months Ended
	Jun. 30, 2016
Notes to Financial Statements
Accounts Receivable and Allowance for Doubtful Accounts [Text Block]	3. Accounts Receivable and Allowance for Doubtful Accounts: The Company’s accounts receivable, net, consist of the following as of June 30, 2016 and December 31, 2015 (in thousands) June 30, December 31, Accounts receivable $ 155,988 $ 173,995 Allowance for doubtful accounts (3,649 ) (4,849 ) Accounts receivable, net $ 152,339 $ 169,146 A summary of the activity in the allowance for doubtful accounts is as follows (in thousands) Six Months Ended 2016 2015 Balance--beginning of period $ 4,849 $ 1,898 Provision--allowance for doubtful accounts 6,610 - Charge-offs (7,919 ) (420 ) Recoveries 109 - Balance--end of period $ 3,649 $ 1,478 The Company’s accounts receivable are net of the estimated liability for appeals, which is presented in Note 7.

Note 4 - Intangible Assets

Note 4 - Intangible Assets	6 Months Ended
	Jun. 30, 2016
Notes to Financial Statements
Goodwill and Intangible Assets Disclosure [Text Block]	4. Intangible Assets Intangible assets consisted of the following as of June 30, 2016 and December 31, 2015 ( in thousands, except for useful life Gross Carrying Amount Accumulated Net Carrying Amount Useful Life (years) June 30, 2016 Customer relationships $ 101,806 $ (64,674 ) $ 37,132 5 - 10 Restrictive covenants 16,800 (15,260 ) 1,540 3 - 7 Trade name 15,800 (10,250 ) 5,550 3 - 5 Total $ 134,406 $ (90,184 ) $ 44,222 Gross Carrying Amount Accumulated Net Carrying Amount Useful Life (years) December 31, 2015 Customer relationships $ 101,806 $ (57,497 ) $ 44,309 5 - 10 Restrictive covenants 16,800 (13,580 ) 3,220 3 - 7 Trade name 17,000 (10,221 ) 6,779 3 - 5 Total $ 135,606 $ (81,298 ) $ 54,308 Amortization expense of intangible assets is expected to approximate the following (in thousands): Year ending December 31, Remainder of 2016 $ 9,848 2017 16,613 2018 15,992 2019 1,582 2020 187 Thereafter - For the three and six months ended June 30, 2016 amortization expense related to intangible assets was $5.0 million and $10.1 million, respectively. For the three and six months ended June 30, 2015 amortization expense related to intangible assets was $5.1 million and $10.2 million, respectively.

Note 5 - Accounts Payable, Accr

Note 5 - Accounts Payable, Accrued Expenses and Other Liabilities	6 Months Ended
	Jun. 30, 2016
Notes to Financial Statements
Accounts Payable, Accrued Liabilities, and Other Liabilities Disclosure, Current [Text Block]	5. Accounts Payable, Accrued Expenses and Other Liabilities Accounts payable, accrued expenses and other liabilities as of June 30, 2016 and December 31, 2015 consisted of the following (in thousands) June 30, December 31, Accounts payable, trade $ 6,503 $ 7,790 Accrued compensation and other 16,993 21,948 Accrued operating expenses 16,954 21,923 Total accounts payable, accrued expenses and other liabilities $ 40,450 $ 51,661

Note 6 - Income Taxes

Note 6 - Income Taxes	6 Months Ended
	Jun. 30, 2016
Notes to Financial Statements
Income Tax Disclosure [Text Block]	6. Income Taxes The Company’s effective tax rate decreased to 40.1% for the three months ended June 30, 2016 from 44.8% for the three months ended June 30, 2015. The Company’s effective tax rate decreased to 40.8% for the six months ended June 30, 2016 from 43.6% for the six months ended June 30, 2015, primarily due to changes in state taxes and permanent differences. The principal differences between the statutory rate and our effective rate are changes in state taxes, interest on unrecognized tax benefits, and permanent items. During the three and six months ended June 30, 2016, the Company utilized $3.6 million in tax deductions arising from stock-based compensation, which resulted in an excess tax benefit of $1.3 million that was recorded to capital in excess of par value and an offsetting reduction to taxes payable. As of June 30, 2016 and December 31, 2015, the total amount of unrecognized tax benefits was approximately $1.9 million and $1.3 million, respectively (net of the federal benefit for state issues) that, if recognized, would favorably affect the Company’s future effective tax rate. As of June 30, 2016 and December 31, 2015, the accrued liability for interest expense and penalties related to unrecognized tax benefits was $0.7 million and $0.4 million, respectively. HMS includes interest expense and penalties in the provision for income taxes in the unaudited Consolidated Statements of Income. The amount of interest expense (net of federal and state income tax benefits) and penalties in the unaudited Consolidated Statements of Income for the six months ended June 30, 2016 and 2015 was $0.2 million and an immaterial amount, respectively. The Company believes it is reasonably possible that the amount of unrecognized tax benefits may decrease by $1.6 million during 2016, due to the expiration of the statute of limitations in various state jurisdictions. HMS files income tax returns with the U.S. Federal government and various state and local jurisdictions. HMS is no longer subject to U.S. Federal income tax examinations for years before 2012. HMS operates in a number of state and local jurisdictions, most of which have never audited the Company’s records. Accordingly, HMS is subject to state and local income tax examinations based upon the various statutes of limitations in each jurisdiction. HMS is currently being examined by the State of New York.

Note 7 - Estimated Liability fo

Note 7 - Estimated Liability for Appeals and Estimated Allowance for Appeals	6 Months Ended
	Jun. 30, 2016
Notes to Financial Statements
Estimated Liability and Allowance for Appeals [Text Block]	7. Estimated Liability for Appeals and Estimated Allowance for Appeals The Company provides services under contracts that contain various fee structures, including contingency fee and fixed fee arrangements. Revenue is recognized when a contract exists, services have been provided to the customer, the fee is fixed and determinable, and collectability is reasonably assured. In addition, the Company has contracts with the federal government which are generally cost-plus or time and material based. Revenue on cost-plus contracts is recognized based on costs incurred plus the negotiated fee earned. Revenue on time and materials contracts is recognized based on hours worked and expenses incurred. Under the Company’s Medicare Recovery Audit Contractor (“RAC”) contract with the Centers for Medicare & Medicaid Services (“CMS”), held by its wholly owned subsidiary HealthDataInsights, Inc. (“HDI”) and certain contracts for commercial health plan customers, HMS recognizes revenue when claims are sent to the customer for offset against future claims payments. Providers and health plan customers have the right to appeal a claim and may pursue additional appeals if the initial appeal is found in favor of the customer. HMS accrues an estimated liability for appeals based on the amount of revenue that is subject to appeals, closures or other adjustments and which HMS estimates are probable of being returned to providers following a successful appeal. The Company’s estimates are based on the Company’s historical experience with appeals. The estimated liability for appeals represents the Company’s estimate of the potential amount of repayments related to appeals of claims, closures and other adjustments for which revenue was previously collected. A summary of the activity in the estimated liability for appeals and estimated allowance for appeals is as follows (in thousands) Six Months Ended 2016 2015 Balance--beginning of period (1) $ 39,692 $ 41,623 Provision 3,500 5,333 Appeals found in providers favor (6,123 ) (6,999 ) Balance--end of period (2) $ 37,069 $ 39,957 (1) (2)

Note 8 - Credit Agreement

Note 8 - Credit Agreement	6 Months Ended
	Jun. 30, 2016
Notes to Financial Statements
Debt Disclosure [Text Block]	8. Credit Agreement In May 2013, HMS entered into a $500 million five-year, amended and restated revolving credit agreement (the “Credit Agreement”) with certain financial institutions and Citibank, N.A. as Administrative Agent (“Citibank”). The Credit Agreement is guaranteed by the Company’s material subsidiaries as designated by the Company from time to time or as required under the Credit Agreement (the “Guarantors”). No principal payments were made against the Company’s revolving credit facility during the six months ended June 30, 2016 and 2015. The $197.8 million principal balance of the Company’s revolving credit facility is due in May 2018. The Credit Agreement provides for an initial $500 million revolving credit facility, and, under specified circumstances, the revolving credit facility can be increased or one or more incremental term loan facilities can be added, provided that the incremental credit facilities do not exceed in the aggregate the sum of (a) $75 million plus (b) an additional amount not less than $25 million, so long as the Company’s total secured leverage ratio, calculated giving pro forma effect to the requested incremental borrowing and other customary and appropriate pro forma adjustment events, including any permitted acquisitions, is no greater than 2.5:1.0. The amount available to borrow is based on certain borrowing base calculations found in the Credit Agreement. The Credit Agreement is collateralized by all or substantially all of the Company’s and the Guarantors’ personal property assets. The Credit Agreement contains certain customary representations and warranties, affirmative and negative covenants and events of default. The Credit Agreement requires HMS to comply, on a quarterly basis, with certain principal financial covenants, including a maximum consolidated leverage ratio of 3.25:1.00 and a minimum interest coverage ratio of 3.00:1.00. As of June 30, 2016, HMS was in compliance with all of the terms of the Credit Agreement. The interest rates applicable to the revolving credit facility are, at the Company’s option, either (i) the LIBOR multiplied by the statutory reserve rate plus an interest margin ranging from 1.50% to 2.25% based on HMS’s consolidated leverage ratio, or (ii) a base rate (which is equal to the greatest of (a) Citibank’s prime rate, (b) the federal funds effective rate plus 0.50% and (iii) the one-month LIBOR plus 1.00% plus an interest margin ranging from 0.50% to 1.25% based on the Company’s consolidated leverage ratio). The applicable interest rate was 2.38% at June 30, 2016. HMS pays an unused commitment fee on the revolving credit facility during the term of the Credit Agreement ranging from 0.375% to 0.50% per annum based on the Company’s consolidated leverage ratio. The obligations of the Company and the Guarantors under the Credit Agreement may be accelerated upon the occurrence of an event of default, which includes customary events of default including, without limitation, payment defaults, failures to perform affirmative covenants, failures to refrain from actions or omissions prohibited by negative covenants, the inaccuracy of representations or warranties, cross-defaults, bankruptcy and insolvency related defaults, defaults relating to judgments, defaults due to certain ERISA related events and a change of control default. The interest expense and the commitment fees on the unused portion of the Company’s revolving credit facility are as follows (in thousands) Three Months Ended Six Months Ended 2016 2015 2016 2015 Interest expense $ 1,189 $ 1,014 $ 2,367 $ 2,040 Commitment fees $ 378 $ 376 $ 756 $ 748 As of June 30, 2016 and December 31, 2015, the unamortized balance of deferred origination fees and debt issuance costs were $3.8 million and $4.9 million, respectively, recorded in other assets on the Consolidated Balance Sheets. For both the three month periods ended June 30, 2016 and 2015, HMS amortized $0.5 million of interest expense related to the Company’s deferred origination fees and debt issue costs. For both the six month periods ended June 30, 2016 and 2015, HMS amortized $1.0 million of interest expense related to the Company’s deferred origination fees and debt issue costs. Although HMS expects that operating cash flows will continue to be a primary source of liquidity for the Company’s operating needs, the revolving credit facility may be used for general corporate purposes, including acquisitions, if necessary. As part of the Company’s contractual agreement with a customer, HMS has an outstanding irrevocable letter of credit for $3.0 million, which HMS established against the revolving credit facility. The expiration date of the letter of credit is June 30, 2017.

Note 9 - Earnings Per Share

Note 9 - Earnings Per Share	6 Months Ended
	Jun. 30, 2016
Notes to Financial Statements
Earnings Per Share [Text Block]	9. Earnings Per Share Basic income per share is calculated by dividing net income by the weighted average number of common shares outstanding during the period. Diluted income per share is calculated by dividing net income by the weighted average number of common shares and dilutive common share equivalents outstanding during the period. The Company’s dilutive common share equivalents consist of stock options and restricted stock units. The following table reconciles the basic to diluted weighted average common shares outstanding using the treasury stock method (in thousands, except per share amounts) Three Months Ended 2016 2015 Net income $ 8,566 $ 5,418 Weighted average common shares outstanding-basic 84,073 88,523 Plus: net effect of dilutive stock options 187 153 Plus: net effect of dilutive restricted stock units 268 232 Weighted average common shares outstanding-diluted 84,528 88,908 Net income per common share-basic $ 0.10 $ 0.06 Net income per common share-diluted $ 0.10 $ 0.06 For the three months ended June 30, 2016 and 2015, 3,207,146 and 2,576,385 stock options, respectively, 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, 2016 and 2015, 115,975 and 48,131 restricted stock units, respectively, were not included in the diluted earnings per share calculation because the effect would have been anti-dilutive. Six Months Ended 2016 2015 Net income $ 13,126 $ 8,940 Weighted average common shares outstanding-basic 84,104 88,385 Plus: net effect of dilutive stock options 411 167 Plus: net effect of dilutive restricted stock units 408 219 Weighted average common shares outstanding-diluted 84,923 88,771 Net income per common share-basic $ 0.16 $ 0.10 Net income per common share-diluted $ 0.15 $ 0.10 For the six months ended June 30, 2016 and 2015, 3,243,610 and 2,969,496 stock options, respectively, were not included in the diluted earnings per share calculation because the effect would have been anti-dilutive. For the six months ended June 30, 2016 and 2015, 134,946 and 127,185 restricted stock units, respectively, were not included in the diluted earnings per share calculation because the effect would have been anti-dilutive.

Note 10 - Stock-based Compensat

Note 10 - Stock-based Compensation	6 Months Ended
	Jun. 30, 2016
Notes to Financial Statements
Disclosure of Compensation Related Costs, Share-based Payments [Text Block]	10. Stock-Based Compensation Long-Term Incentive Award Plans The Company grants equity-based compensation awards, including options to purchase HMS common stock and restricted stock units, to HMS employees and non-employee directors under the 2016 Omnibus Incentive Plan (the “2016 Omnibus Plan”), which was approved by the Company’s shareholders on June 23, 2016. The 2016 Omnibus Plan replaced and superseded the Company’s Fourth Amended and Restated 2006 Stock Plan, as amended, and the HDI Holdings, Inc. Amended 2011 Stock Option and Stock Issuance Plan. 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 Six Months Ended 2016 2015 2016 2015 Cost of services-compensation $ 1,210 $ 1,580 $ 3,141 $ 2,922 Selling, general and administrative 3,195 2,243 5,504 4,146 Total $ 4,405 $ 3,823 $ 8,645 $ 7,068 Stock Options The Company’s stock option activity for the six months ended June 30, 2016 was as follows (in thousands, except for weighted average exercise price and weighted average remaining contractual term) Shares Weighted Average Exercise Price Weighted Average Remaining Contractual Terms Aggregate Intrinsic Value Outstanding at December 31, 2015 5,030 $ 17.37 Granted 1,029 13.90 Exercised (299 ) 4.01 Forfeitures (66 ) 17.67 Expired (98 ) 24.62 Outstanding at June 30, 2016 5,596 17.32 5.22 12,344 Expected to vest at June 30, 2016 3,791 15.75 5.97 10,094 Exercisable at June 30, 2016 1,718 $ 20.84 3.52 $ 2,041 For awards subject to service-based vesting conditions, HMS recognizes stock-based compensation expense, net of estimated forfeitures, equal to the grant date fair value of stock options on a straight-line basis over the requisite service period, which is generally the vesting term. For awards subject to both performance-based and service-based vesting conditions, HMS recognizes stock-based compensation expense using the straight-line recognition method when it is probable that the performance condition will be achieved. Forfeitures are estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. The fair value of each option grant with service-based vesting conditions was estimated using a Black-Scholes option- pricing valuation model. The awards subject to performance-based vesting conditions granted in 2016 and 2015 are market condition awards as attainment is based on the performance of the Company’s common stock for the relevant performance period. These awards were valued on the date of grant using a Monte Carlo simulation model. Expected volatilities are calculated based on the historical volatility of the Company’s common stock. Management monitors stock option exercises and employee termination patterns to estimate forfeiture rates within the valuation model. Separate groups of employees that have similar historical exercise behavior are considered separately for valuation purposes. The expected holding period of stock options represents the period of time that options granted are expected to be outstanding. The expected terms of stock options granted are based on the Company’s historical experience for similar types of stock option awards. The risk-free interest rate is based on U.S. Treasury Notes. The weighted average grant-date fair value per share of the stock options granted during the three months ended June 30, 2016 and 2015 was $5.45 and $6.23, respectively. HMS estimated the fair value of each stock option grant on the date of grant using a Black-Scholes option-pricing model and the weighted-average assumptions set forth in the following table: Six Months Ended 2016 2015 Expected dividend yield 0 % 0 % Risk-free interest rate 1.20 % 1.65 % Expected volatility 43.90 % 38.28 % Expected life (years) 4.90 4.89 During the three months ended June 30, 2016 and 2015, HMS issued 288,717 shares and 29,512 shares, respectively, of the Company’s common stock upon the exercise of outstanding stock options and received proceeds of $0.8 million and $0.1 million, respectively. For the three months ended June 30, 2016 and 2015, stock-based compensation expense for stock options was $2.1 million and $1.7 million, respectively. Excess tax benefit from the exercise of stock options for the three months ended June 30, 2016 and 2015 was $1.3 million and $7.0 thousand, respectively. The total intrinsic value of stock options exercised (the difference in the market price of the Company’s common stock on the exercise date and the price paid by the optionees to exercise the options) for the three months ended June 30, 2016 and 2015 was approximately $4.0 million and $0.3 million, respectively. During the six months ended June 30, 2016 and 2015, HMS issued 298,692 shares and 472,097 shares, respectively, of the Company’s common stock upon the exercise of outstanding stock options and received proceeds of $1.2 million and $3.4 million, respectively. For the six months ended June 30, 2016 and 2015, stock-based compensation expense for stock options was $4.1 million and $3.1 million, respectively. Excess tax benefit from the exercise of stock options for the six months ended June 30, 2016 and 2015 was $1.3 million and $1.5 million, respectively. The total intrinsic value of stock options exercised (the difference in the market price of the Company’s common stock on the exercise date and the price paid by the optionees to exercise the options) for the six months ended June 30, 2016 and 2015 was approximately $4.1 million and $5.7 million, respectively. As of June 30, 2016, there was approximately $15.6 million of total unrecognized compensation cost, adjusted for estimated forfeitures, related to stock options outstanding, which is expected to be recognized over a weighted average period of 1.25 years. Restricted Stock Units The Company’s restricted stock units activity for the six months ended June 30, 2016 was as follows (in thousands, except for weighted average grant date fair value per unit) Number of Weighted Average Aggregate Outstanding balance at December 31, 2015 1,154 $ 18.85 Granted 587 13.96 Vesting of restricted stock units, net of units withheld for taxes (150 ) 18.33 Units withheld for taxes (78 ) 18.33 Forfeitures (50 ) 17.39 Outstanding balance at June 30, 2016 1,463 $ 16.88 $ 25,757 For the three months ended June 30, 2016, HMS granted 24,447 restricted stock units with an aggregate fair market value of $0.4 million. For the three months ended June 30, 2015, HMS granted 70,187 restricted stock units with an aggregate fair market value of $1.2 million. For the three months ended June 30, 2016 and 2015, stock-based compensation expense for restricted stock units was $2.3 million and $2.2 million, respectively. For the six months ended June 30, 2016, HMS granted 587,092 restricted stock units with an aggregate fair market value of $8.2 million. For the six months ended June 30, 2015, HMS granted 659,684 restricted stock units with an aggregate fair market value of $11.1 million. For the six months ended June 30, 2016 and 2015, stock-based compensation expense for restricted stock units was $4.5 million and $4.0 million, respectively. As of June 30, 2016, 1,307,449 restricted stock units remained unvested and there was approximately $16.4 million of unamortized compensation cost related to these restricted stock units, which is expected to be recognized over the remaining weighted-average vesting period of 1.32 years.

Note 11 - Commitments and Conti

Note 11 - Commitments and Contingencies	6 Months Ended
	Jun. 30, 2016
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	11. Commitments and Contingencies Kern Health Systems Dennis Demetre and Lori Lewis Kern Health Systems Restrictive Covenants, Trade Secret, Contract and other Causes of Action in Texas and New York HMS Holdings Corp., et al. v. Public Consulting Group, Inc., James Gambino and Jason Ramos HMS Holdings Corp., et al. v. Matthew Arendt, Sean Curtin and Danielle Lange HMS Holdings Corp., et al. v. Elena Moiseenko and Joseph Flora The Company has entered into settlement agreements with the defendants that fully resolved the matters in controversy in these lawsuits. On April 27, 2016, HMS entered into settlement agreements with all defendants other than Flora. On May 4, 2016, the trial court in the Texas Action entered an Agreed Order of Dismissal with Prejudice regarding the lawsuit against defendants PCG, Gambino and Ramos, and the court in the New York Action entered an Order and Judgment on Consent Granting Permanent Injunction against defendants Arendt, Curtin and Lange. On June 24, 2016, HMS entered into a settlement agreement with Flora. On June 29, 2016, the court in the Second New York Action entered an Order and Judgment on Consent Granting Permanent Injunction against Flora. The terms of the settlements were not material to the Company’s financial condition or results of operations. From time to time, HMS may be subject to investigations, legal proceedings and other disputes arising in the ordinary course of the Company’s business, including but not limited to regulatory audits, billing and contractual disputes and employment-related matters. Due to the Company’s contractual relationships, including those with federal and state government entities, HMS’s operations, billing and business practices are subject to scrutiny and audit by those entities and other multiple agencies and levels of government, as well as to frequent transitions and changes in the personnel responsible for oversight of the Company’s contractual performance. HMS may have contractual disputes with its customers arising from differing interpretations of contractual provisions that define the Company’s rights, obligations, scope of work or terms of payment, and with associated claims of liability for inaccurate or improper billing for reimbursement of contract fees, or for sanctions or damages for alleged performance deficiencies. Resolution of such disputes may involve litigation or may require that HMS accept some amount of loss or liability in order to avoid customer abrasion, negative marketplace perceptions and other disadvantageous results that could affect the Company’s business, financial condition, results of operations and cash flows. HMS records accruals for outstanding legal matters when it believes it is probable that a loss will be incurred and the amount can be reasonably estimated. The Company evaluates, on a quarterly basis, developments in legal matters that could affect the amount of any accrual and developments that would make a loss contingency both probable and reasonably estimable. If a loss contingency is not both probable and estimable, HMS does not establish an accrued liability.

Note 12 - Subsequent Events

Note 12 - Subsequent Events	6 Months Ended
	Jun. 30, 2016
Notes to Financial Statements
Subsequent Events [Text Block]	12. Subsequent Events In connection with the preparation of these unaudited Consolidated Financial Statements, an evaluation of subsequent events was performed through the date of issuance and there were no other events that have occurred that would require adjustments to the financial statements or disclosure.

Significant Accounting Policies

Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2016
Accounting Policies [Abstract]
New Accounting Pronouncements, Policy [Policy Text Block]	Recently Adopted Accounting Pronouncements The Company adopted Accounting Standards Updated (“ASU”) No. 2015-03, “ Simplifying the Presentation of Debt Issuance Costs Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of-Credit Arrangements Recently Issued Accounting Pronouncements In addition to the recently issued accounting pronouncements disclosed in the 2015 Form 10-K, the following guidance has been issued since the annual filing. There have been no changes in the Company’s anticipated adoption of the previously disclosed pronouncements, except as noted above. In March 2016, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2016-08, Revenue from Contracts with Customers (Topic 606) – Principal versus Agent Considerations (Reporting Revenue Gross versus Net) In March 2016, as part of its Simplification Initiative, the FASB issued ASU No. 2016-09 , Compensation—Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accountin In March 2016, the FASB issued ASU No. 2016-10, Revenue from Contracts with Customers (Topic 606): Identifying Performance Obligations and Licensing In May 2016, the FASB issued ASU No. 2016-12 , Revenue From Contracts With Customers (Topic 606): Narrow- Scope Improvements and Practical Expedients

Note 3 - Accounts Receivable 20

Note 3 - Accounts Receivable and Allowance for Doubtful Accounts (Tables)	6 Months Ended
	Jun. 30, 2016
Notes Tables
Schedule of Accounts, Notes, Loans and Financing Receivable [Table Text Block]	June 30, December 31, Accounts receivable $ 155,988 $ 173,995 Allowance for doubtful accounts (3,649 ) (4,849 ) Accounts receivable, net $ 152,339 $ 169,146
Movement in Valuation Allowances and Reserves Roll Forward [Table Text Block]	Six Months Ended 2016 2015 Balance--beginning of period $ 4,849 $ 1,898 Provision--allowance for doubtful accounts 6,610 - Charge-offs (7,919 ) (420 ) Recoveries 109 - Balance--end of period $ 3,649 $ 1,478

Note 4 - Intangible Assets (Tab

Note 4 - Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2016
Notes Tables
Schedule of Finite-Lived Intangible Assets [Table Text Block]	Gross Carrying Amount Accumulated Net Carrying Amount Useful Life (years) June 30, 2016 Customer relationships $ 101,806 $ (64,674 ) $ 37,132 5 - 10 Restrictive covenants 16,800 (15,260 ) 1,540 3 - 7 Trade name 15,800 (10,250 ) 5,550 3 - 5 Total $ 134,406 $ (90,184 ) $ 44,222 Gross Carrying Amount Accumulated Net Carrying Amount Useful Life (years) December 31, 2015 Customer relationships $ 101,806 $ (57,497 ) $ 44,309 5 - 10 Restrictive covenants 16,800 (13,580 ) 3,220 3 - 7 Trade name 17,000 (10,221 ) 6,779 3 - 5 Total $ 135,606 $ (81,298 ) $ 54,308
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]	Year ending December 31, Remainder of 2016 $ 9,848 2017 16,613 2018 15,992 2019 1,582 2020 187 Thereafter -

Note 5 - Accounts Payable, Ac22

Note 5 - Accounts Payable, Accrued Expenses and Other Liabilities (Tables)	6 Months Ended
	Jun. 30, 2016
Notes Tables
Schedule of Accounts Payable and Accrued Liabilities [Table Text Block]	June 30, December 31, Accounts payable, trade $ 6,503 $ 7,790 Accrued compensation and other 16,993 21,948 Accrued operating expenses 16,954 21,923 Total accounts payable, accrued expenses and other liabilities $ 40,450 $ 51,661

Note 7 - Estimated Liability 23

Note 7 - Estimated Liability for Appeals and Estimated Allowance for Appeals (Tables)	6 Months Ended
	Jun. 30, 2016
Notes Tables
Valuation and Qualifying Accounts Disclosure [Table Text Block]	Six Months Ended 2016 2015 Balance--beginning of period (1) $ 39,692 $ 41,623 Provision 3,500 5,333 Appeals found in providers favor (6,123 ) (6,999 ) Balance--end of period (2) $ 37,069 $ 39,957

Note 8 - Credit Agreement (Tabl

Note 8 - Credit Agreement (Tables)	6 Months Ended
	Jun. 30, 2016
Notes Tables
Schedule of Interest Expense and Commitment Fees on Debt Instrument [Table Text Block]	Three Months Ended Six Months Ended 2016 2015 2016 2015 Interest expense $ 1,189 $ 1,014 $ 2,367 $ 2,040 Commitment fees $ 378 $ 376 $ 756 $ 748

Note 9 - Earnings Per Share (Ta

Note 9 - Earnings Per Share (Tables)	6 Months Ended
	Jun. 30, 2016
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended 2016 2015 Net income $ 8,566 $ 5,418 Weighted average common shares outstanding-basic 84,073 88,523 Plus: net effect of dilutive stock options 187 153 Plus: net effect of dilutive restricted stock units 268 232 Weighted average common shares outstanding-diluted 84,528 88,908 Net income per common share-basic $ 0.10 $ 0.06 Net income per common share-diluted $ 0.10 $ 0.06 Six Months Ended 2016 2015 Net income $ 13,126 $ 8,940 Weighted average common shares outstanding-basic 84,104 88,385 Plus: net effect of dilutive stock options 411 167 Plus: net effect of dilutive restricted stock units 408 219 Weighted average common shares outstanding-diluted 84,923 88,771 Net income per common share-basic $ 0.16 $ 0.10 Net income per common share-diluted $ 0.15 $ 0.10

Note 10 - Stock-based Compens26

Note 10 - Stock-based Compensation (Tables)	6 Months Ended
	Jun. 30, 2016
Notes Tables
Schedule of Compensation Cost for Share-based Payment Arrangements, Allocation of Share-based Compensation Costs by Plan [Table Text Block]	Three Months Ended Six Months Ended 2016 2015 2016 2015 Cost of services-compensation $ 1,210 $ 1,580 $ 3,141 $ 2,922 Selling, general and administrative 3,195 2,243 5,504 4,146 Total $ 4,405 $ 3,823 $ 8,645 $ 7,068
Schedule of Share-based Compensation, Stock Options, Activity [Table Text Block]	Shares Weighted Average Exercise Price Weighted Average Remaining Contractual Terms Aggregate Intrinsic Value Outstanding at December 31, 2015 5,030 $ 17.37 Granted 1,029 13.90 Exercised (299 ) 4.01 Forfeitures (66 ) 17.67 Expired (98 ) 24.62 Outstanding at June 30, 2016 5,596 17.32 5.22 12,344 Expected to vest at June 30, 2016 3,791 15.75 5.97 10,094 Exercisable at June 30, 2016 1,718 $ 20.84 3.52 $ 2,041
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	Six Months Ended 2016 2015 Expected dividend yield 0 % 0 % Risk-free interest rate 1.20 % 1.65 % Expected volatility 43.90 % 38.28 % Expected life (years) 4.90 4.89
Schedule of Share-based Compensation, Restricted Stock Units Award Activity [Table Text Block]	Number of Weighted Average Aggregate Outstanding balance at December 31, 2015 1,154 $ 18.85 Granted 587 13.96 Vesting of restricted stock units, net of units withheld for taxes (150 ) 18.33 Units withheld for taxes (78 ) 18.33 Forfeitures (50 ) 17.39 Outstanding balance at June 30, 2016 1,463 $ 16.88 $ 25,757

Note 1 - Basis of Presentation

Note 1 - Basis of Presentation (Details Textual)	Jun. 30, 2016
Number of Businesses	1

Note 3 - Summary of Accounts Re

Note 3 - Summary of Accounts Receivable (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015	Jun. 30, 2015	Dec. 31, 2014
Accounts receivable	$ 155,988	$ 173,995
Allowance for doubtful accounts	(3,649)	(4,849)	$ (1,478)	$ (1,898)
Accounts receivable, net	$ 152,339	$ 169,146

Note 3 - Summary of Allowance f

Note 3 - Summary of Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Balance--beginning of period	$ 4,849	$ 1,898
Provision--allowance for doubtful accounts	6,610
Charge-offs	(7,919)	(420)
Recoveries	109
Balance--end of period	$ 3,649	$ 1,478

Note 4 - Intangible Assets (Det

Note 4 - Intangible Assets (Details Textual) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Amortization of Intangible Assets	$ 5,000	$ 5,100	$ 10,086	$ 10,154

Note 4 - Summary of Intangible

Note 4 - Summary of Intangible Assets (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2016	Dec. 31, 2015
Customer Relationships [Member] | Minimum [Member]
Useful Life	5 years	5 years
Customer Relationships [Member] | Maximum [Member]
Useful Life	10 years	10 years
Customer Relationships [Member]
Intangible assets, gross	$ 101,806	$ 101,806
Less: Accumulated amortization	(64,674)	(57,497)
Intangible assets, net	$ 37,132	$ 44,309
Restrictive Covenant [Member] | Minimum [Member]
Useful Life	3 years	3 years
Restrictive Covenant [Member] | Maximum [Member]
Useful Life	7 years	7 years
Restrictive Covenant [Member]
Intangible assets, gross	$ 16,800	$ 16,800
Less: Accumulated amortization	(15,260)	(13,580)
Intangible assets, net	$ 1,540	$ 3,220
Trade Names [Member] | Minimum [Member]
Useful Life	3 years	3 years
Trade Names [Member] | Maximum [Member]
Useful Life	5 years	5 years
Trade Names [Member]
Intangible assets, gross	$ 15,800	$ 17,000
Less: Accumulated amortization	(10,250)	(10,221)
Intangible assets, net	5,550	6,779
Intangible assets, gross	134,406	135,606
Less: Accumulated amortization	(90,184)	(81,298)
Intangible assets, net	$ 44,222	$ 54,308

Note 4 - Estimated Amortization

Note 4 - Estimated Amortization Expense of Intangible Assets (Details) $ in Thousands	Jun. 30, 2016USD ($)
Remainder of 2016	$ 9,848
2,017	16,613
2,018	15,992
2,019	1,582
2,020	187
Thereafter

Note 5 - Summary of Accounts Pa

Note 5 - Summary of Accounts Payable, Accrued Expenses and Other Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Accounts payable, trade	$ 6,503	$ 7,790
Accrued compensation and other	16,993	21,948
Accrued operating expenses	16,954	21,923
Total accounts payable, accrued expenses and other liabilities	$ 40,450	$ 51,661

Note 6 - Income Taxes (Details

Note 6 - Income Taxes (Details Textual) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015	Dec. 31, 2015
Income Taxes [Member]
Unrecognized Tax Benefits, Income Tax Penalties and Interest Expense			$ 200
Employee Service Share-based Compensation, Tax Benefit Realized from Exercise of Stock Options	$ 3,600		$ 3,600
Effective Income Tax Rate Reconciliation, Percent	40.10%	44.80%	40.80%	43.60%
Adjustments to Additional Paid in Capital, Income Tax Benefit from Share-based Compensation	$ 1,300	$ 7	$ 1,313	$ 1,500
Unrecognized Tax Benefits that Would Impact Effective Tax Rate	1,900		1,900		$ 1,300
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued	700		700		$ 400
Decrease in Unrecognized Tax Benefits is Reasonably Possible	$ 1,600		$ 1,600

Note 7 - Estimated Liability 35

Note 7 - Estimated Liability for Appeals and Estimated Allowance for Appeals (Details Textual) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015	Jun. 30, 2015	Dec. 31, 2014
Portion Associated with Medicare RAC Contract [Member] | Estimated Liability for Appeals and Estimated Allowance for Appeals [Member]
Allowance for Appeals Related to Uncollected Accounts Receivable	$ 6,483	$ 6,614	$ 5,943	$ 4,824
Allowance for Appeals Related to Uncollected Accounts Receivable	$ 6,483	$ 6,614

Note 7 - Summary of Estimated L

Note 7 - Summary of Estimated Liability and Allowance for Appeals (Details) - Estimated Liability for Appeals and Estimated Allowance for Appeals [Member] - USD ($) $ in Thousands		6 Months Ended
		Jun. 30, 2016	Jun. 30, 2015
Balance--beginning of period	[1]	$ 39,692	$ 41,623
Provision		3,500	5,333
Appeals found in providers favor		(6,123)	(6,999)
Balance--end of period	[2]	$ 37,069	$ 39,957
[1]	As of December 31, 2015 and 2014, included within the estimated liability for appeals, $6,614 and $4,824, respectively, was activity associated with the Medicare RAC contract.
[2]	As of June 30, 2016 and 2015, included within the estimated liability for appeals, $6,483 and $5,943, respectively, was activity associated with the Medicare RAC contract.

Note 8 - Credit Agreement (Deta

Note 8 - Credit Agreement (Details Textual)	1 Months Ended	3 Months Ended		6 Months Ended
	May 31, 2013USD ($)	Jun. 30, 2016USD ($)	Jun. 30, 2015USD ($)	Jun. 30, 2016USD ($)	Jun. 30, 2015USD ($)	Dec. 31, 2015USD ($)
The 2013 Credit Agreement [Member] | Revolving Credit Facility [Member] | Minimum [Member] | One-month LIBOR Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	0.50%
The 2013 Credit Agreement [Member] | Revolving Credit Facility [Member] | Minimum [Member]
Line of Credit Facility, Additional Amount of Incremental Credit Facilities Under Specified Circumstances	$ 25,000,000
Debt Instrument, Covenant, Interest Coverage Ratio	3
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage	0.375%
The 2013 Credit Agreement [Member] | Revolving Credit Facility [Member] | Maximum [Member] | One-month LIBOR Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	1.25%
The 2013 Credit Agreement [Member] | Revolving Credit Facility [Member] | Maximum [Member]
Debt Instrument, Secured Leverage Ratio	2.5
Debt Instrument, Covenant, Consolidated Leverage Ratio	3.25
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage	0.50%
The 2013 Credit Agreement [Member] | Revolving Credit Facility [Member] | Federal Funds Effective Swap Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	0.50%
The 2013 Credit Agreement [Member] | Revolving Credit Facility [Member] | One-month LIBOR Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	1.00%
The 2013 Credit Agreement [Member] | Revolving Credit Facility [Member]
Repayments of Long-term Lines of Credit				$ 0	$ 0
Line of Credit Facility, Maximum Borrowing Capacity	$ 500,000,000
Debt Instrument, Term	5 years
Amortization of Debt Issuance Costs		$ 500,000	$ 500,000	$ 1,000,000	1,000,000
Long-term Line of Credit, Noncurrent	$ 197,800,000
Debt Instrument, Number of Incremental Term Loan Facilities Allowed	1
Line of Credit Facility, Amount of Incremental Credit Facilities Under Specified Circumstances	$ 75,000,000
Line of Credit Facility, Interest Rate at Period End		2.38%		2.38%
Debt Issuance Costs, Net		$ 3,800,000		$ 3,800,000		$ 4,900,000
Letters of Credit Outstanding, Amount		3,000,000		3,000,000
Revolving Credit Facility [Member] | Minimum [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate	1.50%
Revolving Credit Facility [Member] | Maximum [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument, Basis Spread on Variable Rate	2.25%
Amortization of Debt Issuance Costs				1,042,000	$ 1,042,000
Long-term Line of Credit, Noncurrent		$ 197,796,000		$ 197,796,000		$ 197,796,000

Note 8 - Summary of Interest Ex

Note 8 - Summary of Interest Expense and Commitment Fees on Unused Portion of Revolving Credit Facility (Details) - Revolving Credit Facility [Member] - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Interest expense	$ 1,189	$ 1,014	$ 2,367	$ 2,040
Commitment fees	$ 378	$ 376	$ 756	$ 748

Note 9 - Earnings Per Share (De

Note 9 - Earnings Per Share (Details Textual) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Employee Stock Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	3,207,146	2,576,385	3,243,610	2,969,496
Restricted Stock Units (RSUs) [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	115,975	48,131	134,946	127,185

Note 9 - Summary of Basic and D

Note 9 - Summary of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Employee Stock Option [Member]
Plus: net effect of dilutive securities (in shares)	187	153	411	167
Restricted Stock and Restricted Stock Units [Member]
Plus: net effect of dilutive securities (in shares)	268	232	408	219
Net income	$ 8,566	$ 5,418	$ 13,126	$ 8,940
Weighted average common shares outstanding-basic (in shares)	84,073	88,523	84,104	88,385
Weighted average common shares outstanding-diluted (in shares)	84,528	88,908	84,923	88,771
Net income per common share-basic (in dollars per share)	$ 0.10	$ 0.06	$ 0.16	$ 0.10
Net income per common share-diluted (in dollars per share)	$ 0.10	$ 0.06	$ 0.15	$ 0.10

Note 10 - Stock-based Compens41

Note 10 - Stock-based Compensation (Details Textual) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015	Dec. 31, 2015
Employee Stock Option [Member]
Allocated Share-based Compensation Expense	$ 2,100	$ 1,700	$ 4,100	$ 3,100
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition			1 year 91 days
Restricted Stock Units (RSUs) [Member] | 2006 Stock Plan [Member]
Allocated Share-based Compensation Expense	$ 2,300	$ 2,200	$ 4,500	$ 4,000
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition			1 year 116 days
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period	24,447	70,187	587,092	659,684
Stock Granted, Value, Share-based Compensation, Gross	$ 400	$ 1,200	$ 8,200	$ 11,100
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number	1,307,449		1,307,449
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Share-based Awards Other than Options	$ 16,400		$ 16,400
Restricted Stock Units (RSUs) [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period			587,000
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number	1,463,000		1,463,000		1,154,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value			$ 5.45	$ 6.23
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period	288,717	29,512	298,692	472,097
Proceeds from Stock Options Exercised	$ 800	$ 100	$ 1,196	$ 3,412
Allocated Share-based Compensation Expense	4,405	3,823	8,645	7,068
Adjustments to Additional Paid in Capital, Income Tax Benefit from Share-based Compensation	1,300	7	1,313	1,500
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period, Intrinsic Value	4,000	$ 300	4,100	$ 5,700
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Stock Options	$ 15,600		$ 15,600

Note 10 - Summary of Stock-base

Note 10 - Summary of Stock-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Cost of Sales [Member]
Allocated Share-based Compensation Expense	$ 1,210	$ 1,580	$ 3,141	$ 2,922
Selling, General and Administrative Expenses [Member]
Allocated Share-based Compensation Expense	3,195	2,243	5,504	4,146
Allocated Share-based Compensation Expense	$ 4,405	$ 3,823	$ 8,645	$ 7,068

Note 10 - Stock Option Activity

Note 10 - Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Beginning balance (in shares)			5,030,000
Beginning balance (in dollars per share)			$ 17.37
Granted (in shares)			1,029,000
Granted (in dollars per share)			$ 13.90
Exercised (in shares)	(288,717)	(29,512)	(298,692)	(472,097)
Exercised (in dollars per share)			$ 4.01
Forfeitures (in shares)			(66,000)
Forfeitures (in dollars per share)			$ 17.67
Expired (in shares)			(98,000)
Expired (in dollars per share)			$ 24.62
Ending balance (in shares)	5,596,000		5,596,000
Ending balance (in dollars per share)	$ 17.32		$ 17.32
Ending balance			5 years 80 days
Ending balance	$ 12,344		$ 12,344
Expected to vest (in shares)	3,791,000		3,791,000
Expected to vest (in dollars per share)	$ 15.75		$ 15.75
Expected to vest			5 years 354 days
Expected to vest	$ 10,094		$ 10,094
Exercisable (in shares)	1,718,000		1,718,000
Exercisable (in dollars per share)	$ 20.84		$ 20.84
Exercisable			3 years 189 days
Exercisable	$ 2,041		$ 2,041

Note 10 - Weighted-average Assu

Note 10 - Weighted-average Assumptions Used in Valuation of Stock Options (Details) - Employee Stock Option [Member]	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Expected dividend yield	0.00%	0.00%
Risk-free interest rate	1.20%	1.65%
Expected volatility	43.90%	38.28%
Expected life (years)	4 years 328 days	4 years 324 days

Note 10 - Summary of Status of

Note 10 - Summary of Status of Restricted Stock Units (Details) - Restricted Stock Units (RSUs) [Member] - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	6 Months Ended
	Jun. 30, 2016
Outstanding, beginning balance (in shares)	1,154
Outstanding, beginning balance (in dollars per share)	$ 18.85
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period	587
Granted (in dollars per share)	$ 13.96
Vesting of restricted stock units, net of units withheld for taxes (in shares)	(150)
Vesting of restricted stock units, net of units withheld for taxes (in dollars per share)	$ 18.33
Units withheld for taxes (in shares)	(78)
Units withheld for taxes (in dollars per share)	$ 18.33
Forfeitures (in shares)	(50)
Forfeitures (in dollars per share)	$ 17.39
Outstanding, ending balance (in shares)	1,463
Outstanding, ending balance (in dollars per share)	$ 16.88
Outstanding, ending balance	$ 25,757

Note 11 - Commitments and Con46

Note 11 - Commitments and Contingencies (Details Textual) - Subsidiaries [Member] - USD ($) $ in Thousands	Jun. 09, 2014	Aug. 31, 2011
Minimum [Member]
Loss Contingency, Damages Sought, Value		$ 7,000
Appeal Filed to Recover Attorney Fees and Costs [Member]
Loss Contingency, Damages Sought, Value	$ 2,400
Loss Contingency, Damages Awarded, Value	$ 1,380