HMS (HMSY) 10-Q 6 Jun 17 2017 Q1 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	3 Months Ended
	Mar. 31, 2017	May 31, 2017
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)		83,909,845
Document Type	10-Q
Document Period End Date	Mar. 31, 2017
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	Q1
Amendment Flag	false

Consolidated Balance Sheets (Cu

Consolidated Balance Sheets (Current Period Unaudited) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Current assets:
Cash and cash equivalents	$ 168,289	$ 175,999
Accounts receivable, net of allowance of $9,985 and $10,772, at March 31, 2017 and December 31, 2016, respectively	166,604	173,582
Prepaid expenses	16,376	13,699
Income tax receivable	4,088	3,354
Other current assets	568	1,001
Total current assets	355,925	367,635
Property and equipment, net	93,176	92,167
Goodwill	379,716	379,716
Intangible assets, net	33,470	37,797
Deferred financing costs, net	2,269	2,790
Other assets	2,566	2,650
Total assets	867,122	882,755
Current liabilities:
Accounts payable, accrued expenses and other liabilities	38,593	59,402
Estimated liability for appeals	31,544	30,755
Total current liabilities	70,137	90,157
Long-term liabilities:
Revolving credit facility	197,796	197,796
Net deferred tax liabilities	22,965	22,717
Deferred rent	5,265	5,427
Other liabilities	10,127	10,048
Total long-term liabilities	236,153	235,988
Total liabilities	306,290	326,145
Commitments and contingencies (Note 10)
Shareholders' equity:
Preferred stock -- $0.01 par value; 5,000,000 shares authorized; none issued	0	0
Common stock -- $0.01 par value; 175,000,000 shares authorized; 96,299,517 shares issued and 83,885,439 shares outstanding at March 31, 2017; 95,966,852 shares issued and 83,552,774 shares outstanding at December 31, 2016	959	959
Capital in excess of par value	347,805	345,025
Retained earnings	327,552	326,110
Treasury stock, at cost: 12,414,078 shares at March 31, 2017 and December 31, 2016	(115,484)	(115,484)
Total shareholders' equity	560,832	556,610
Total liabilities and shareholders' equity	$ 867,122	$ 882,755

Consolidated Balance Sheets (C3

Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Accounts receivable, allowance for doubtful accounts	$ 9,985	$ 10,772
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)	96,299,517	95,966,852
Common stock, shares outstanding (in shares)	83,885,439	83,552,774
Treasury cost, shares (in shares)	12,414,078	12,414,078

Consolidated Statements of Inco

Consolidated Statements of Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Revenue	$ 113,733	$ 119,758
Cost of services:
Compensation	48,920	46,401
Data processing	9,783	9,624
Occupancy	3,547	3,627
Direct project expenses	10,443	14,483
Other operating expenses	7,203	5,776
Amortization of acquisition related software and intangible assets	6,286	7,013
Total cost of services	86,182	86,924
Selling, general and administrative expenses	23,608	22,925
Total operating expenses	109,790	109,849
Operating income	3,943	9,909
Interest expense	(2,286)	(2,091)
Interest income	155	47
Income before income taxes	1,812	7,865
Income taxes	370	3,305
Net income	$ 1,442	$ 4,560
Basic income per common share:
Net income per common share -- basic (in dollars per share)	$ 0.02	$ 0.05
Diluted income per common share:
Net income per common share -- diluted (in dollars per share)	$ 0.02	$ 0.05
Weighted average shares:
Basic (in shares)	83,617	84,033
Diluted (in shares)	85,580	84,479

Consolidated Statement of Share

Consolidated Statement of Shareholders' Equity (Unaudited) - 3 months ended Mar. 31, 2017 - USD ($) $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Treasury Stock [Member]	Total
Balance (in shares) at Dec. 31, 2016	95,966,852			12,414,078
Balance at Dec. 31, 2016	$ 959	$ 345,025	$ 326,110	$ (115,484)	$ 556,610
Net income			1,442		1,442
Stock-based compensation expense		5,386			$ 5,386
Exercise of stock options (in shares)	677				677
Exercise of stock options		2			$ 2
Vesting of restricted stock units, net of shares withheld for employee tax (in shares)	331,988
Vesting of restricted stock units, net of shares withheld for employee tax		(2,608)			(2,608)
Balance (in shares) at Mar. 31, 2017	96,299,517			12,414,078
Balance at Mar. 31, 2017	$ 959	$ 347,805	$ 327,552	$ (115,484)	$ 560,832

Consolidated Statements of Cash

Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Operating activities:
Net income	$ 1,442	$ 4,560
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization of property and equipment	6,235	6,577
Amortization of intangible assets	4,327	5,043
Amortization of deferred financing costs	521	521
Stock-based compensation expense	5,386	4,240
Deferred income taxes	248	1,308
Loss on disposal of assets		10
Changes in operating assets and liabilities:
Accounts receivable	6,978	3,350
Prepaid expenses	(2,677)	(2,362)
Other current assets	433	328
Other assets	84	51
Income taxes receivable / (payable)	(734)	(3,589)
Accounts payable, accrued expenses and other liabilities	(19,646)	(16,963)
Estimated liability for appeals	789	(2,465)
Net cash provided by operating activities	3,386	609
Investing activities:
Purchases of land, property and equipment	(6,282)	(570)
Investment in capitalized software	(2,206)	(1,185)
Net cash used in investing activities	(8,488)	(1,755)
Financing activities:
Proceeds from Stock Options Exercised	2	26
Payments of tax withholdings on behalf of employees for net-share settlement for stock-based compensation	(2,608)	(1,002)
Payments on capital lease obligations	(2)	(37)
Net cash used in financing activities	(2,608)	(1,013)
Net decrease in cash and cash equivalents	(7,710)	(2,159)
Cash and cash equivalents at beginning of year	175,999	145,610
Cash and cash equivalents at end of period	168,289	143,451
Supplemental disclosure of cash flow information:
Cash paid for income taxes	734	5,052
Cash paid for interest	1,686	1,446
Supplemental disclosure of non-cash activities:
Change in balance of accrued property and equipment purchases	$ (1,244)	$ 122

Note 1 - Business and Summary o

Note 1 - Business and Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Organization, Consolidation, Basis of Presentation, Business Description and Accounting Policies [Text Block]	1. Business and Summary of Significant Accounting Policies (a) Business HMS is a leading provider of cost containment solutions in the U.S. healthcare marketplace. Using innovative technology as well as extensive data services and powerful analytics, the Company delivers coordination of benefits, payment integrity, and health management and engagement solutions through its operating subsidiaries to help healthcare payers improve performance and outcomes. The Company is managed and operates as one The consolidated financial statements and notes herein are unaudited. Accordingly, they do not not may December 31, 2016 2016 10 December 31, 2016 not 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. (b) Summary of Significant Accounting Policies There have been no 2016 10 Recently Adopted Accounting Pronouncements In March 2016, No. 2016 09, Compensation – Stock Compensation (Topic 718 2016 09” no 2016 09 December 15, 2016, fourth 2016 January 1, 2016, 2016. no January 1, 2016, $0.01 three March 31, 2016. $0.1 three March 31, 2016. no In November 2015, 2015 17, Income Taxes (Topic 740 2015 17” 2015 17 2015 17, December 15, 2016, fourth 2016. $7.5 December 31, 2016. Recently Issued Accounting Pronouncements In May 2014, 2014 09, Revenue from Contracts with Customers 606 2014 09” 2014 09 December 15, 2017, not January 1, 2018. two third 2017. In February 2016, 2016 02, Leases (Topic 842 2016 02” 2016 02 2016 02 December 15, 2018 not In August 2016, No. 2016 15, Statements of Cash Flows (Topic 230 2016 15” . not eight December 15, 2017, In January 2017, No. 2017 01, Business Combinations (Topic 805 2017 01” 2017 01 December 15, 2017, In January 2017, No. 2017 04, Goodwill and Other (Topic 350 2017 04” 2 2 1 2 not December 15, 2019. January 1, 2017. In May 2017, No. 2017 09, Compensation – Stock Compensation (Topic 718 2017 09” 2017 09 1 2 3 December 15, 2017. not Other new pronouncements issued but not March 31, 2017, not

Note 2 - Accounts Receivable an

Note 2 - Accounts Receivable and Allowance for Doubtful Accounts	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Accounts Receivable and Allowance for Doubtful Accounts [Text Block]	2. The Company’s accounts receivable, net, consisted of the following (in thousands) March 31, December 31, Accounts receivable $ 176,589 $ 184,354 Allowance (9,985 ) (10,772 ) Accounts receivable, net $ 166,604 $ 173,582 A summary of the activity in the allowance was as follows (in thousands) March 31, Balance--beginning of period $ 10,772 Provision 4,038 Charge-offs (4,825 ) Recoveries - Balance--end of period $ 9,985

Note 3 - Intangible Assets and

Note 3 - Intangible Assets and Goodwill	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Goodwill and Intangible Assets Disclosure [Text Block]	3. Intangible assets consisted of the following ( in thousands, except for useful life Gross Accumulated Net Carrying Useful Life March 31, 2017 Customer relationships $ 103,090 $ (75,549 ) $ 27,541 5 - 10 Trade name 15,936 (11,969 ) 3,967 3 - 5 Intellectual Property 2,100 (245 ) 1,855 3 - 7 Restrictive covenants 133 (26 ) 107 3 - 5 Total $ 121,259 $ (87,789 ) $ 33,470 December 31, 2016 Customer relationships $ 103,090 $ (71,914 ) $ 31,176 5 - 10 Trade name 15,936 (11,393 ) 4,543 3 - 5 Intellectual Property 2,100 (140 ) 1,960 3 - 7 Restrictive covenants 133 (15 ) 118 3 - 5 Total $ 121,259 $ (83,462 ) $ 37,797 Amortization expense of intangible assets is expected to approximate the following (in thousands): Year ending December 31, Remainder of 2017 $ 12,979 2018 16,685 2019 2,245 2020 791 2021 463 Thereafter 307 For the three March 31, 2017 2016 $4.3 $5.0

Note 4 - Accounts Payable, Accr

Note 4 - Accounts Payable, Accrued Expenses and Other Liabilities	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Accounts Payable, Accrued Liabilities, and Other Liabilities Disclosure, Current [Text Block]	4. Accounts payable, accrued expenses and other liabilities consisted of the following (in thousands) March 31, December 31, Accounts payable, trade $ 9,399 $ 13,847 Accrued compensation and other 11,686 28,507 Accrued operating expenses 17,508 17,048 Total accounts payable, accrued expenses and other liabilities $ 38,593 $ 59,402

Note 5 - Income Taxes

Note 5 - Income Taxes	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Income Tax Disclosure [Text Block]	5. The Company’s effective tax rate decreased to 20.4% three March 31, 2017 42.0% three March 31, 2016. three March 31, 2017, 36.8%. Included in Other Liabilities on the Consolidated Balance Sheets, are the total amount of unrecognized tax benefits of approximately $7.6 $7.4 March 31, 2017 December 31, 2016, $0.7 $0.6 March 31, 2017 December 31, 2016, three March 31, 2017 2016 $0.1 $0.2 may $1.0 twelve HMS files income tax returns with the U.S. Federal government and various state and local jurisdictions. HMS is no 2012. 2013 2014

Note 6 - Estimated Liability fo

Note 6 - Estimated Liability for Appeals	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Estimated Liability and Allowance for Appeals [Text Block]	6. 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 RAC contract with the CMS, held by the Company’s 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 A summary of the activity in the Estimated liability for appeals was as follows (in thousands) March 31, Balance--beginning of period $ 11,126 Provision - Appeals found in providers favor (521 ) Balance--end of period $ 10,605 The above chart represents the CMS estimated reserve liability only. The liability for appeals is an offset to revenue to the Company’s unaudited Consolidated Statements of Income. The total liability for appeals balance of $31.5 $30.8 March 31, 2017 December 31, 2016, $17.9 $17.3 $10.6 $11.1

Note 7 - Credit Agreement

Note 7 - Credit Agreement	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Debt Disclosure [Text Block]	7. During the years ended December 31, 2016 2015, no $197.8 May 2018. The Credit Agreement provides for an initial $500 one not $75 not $25 no 2.5:1.0. 100% The Credit Agreement requires the Company to comply with certain principal financial covenants and other covenants, including a maximum consolidated leverage ratio at 3.25:1.00 3.00:1.00. The interest rates applicable to the revolving credit facility are, at the Company’s option, either: a) the LIBOR multiplied by the statutory reserve rate plus an interest margin ranging from 1.50% 2.25% b) a base rate (which is equal to the greatest of (i) Citibank’s prime rate, (ii) the federal funds effective rate plus 0.50% one 1.00% 0.50% 1.25% HMS pays an unused commitment fee on the revolving credit facility during the term of the Credit Agreement ranging from 0.375% 0.50% Interest expense and the commitment fees on the unused portion of the Company’s revolving credit facility were as follows ( in thousands Three Months Ended 2017 2016 Interest expense $ 1,374 $ 1,178 Commitment fees $ 378 $ 378 As of March 31, 2016 December 31, 2016, $2.3 $2.8 three March 31, 2017 2016, $0.5 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 not As part of the Company’s contractual agreement with a customer, HMS has an outstanding irrevocable letter of credit for $3.0 May 1, 2017, April 26, 2018. As previously disclosed, on March 8, 2017, No. 1 90 180 December 31, 2016. As of March 31, 2017,

Note 8 - Earnings Per Share

Note 8 - Earnings Per Share	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Earnings Per Share [Text Block]	8. 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 2017 2016 Net income $ 1,442 $ 4,560 Weighted average common shares outstanding-basic 83,617 84,033 Plus: net effect of dilutive stock options and restricted stock units 1,963 446 Weighted average common shares outstanding-diluted 85,580 84,479 Net income per common share-basic $ 0.02 $ 0.05 Net income per common share-diluted $ 0.02 $ 0.05 For the three March 31, 2017 2016, 2,106,397 4,321,528 not three March 31, 2017 2016, 42,056 99,461 not

Note 9 - Stock-based Compensati

Note 9 - Stock-based Compensation	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Disclosure of Compensation Related Costs, Share-based Payments [Text Block]	9. (a) Stock-Based Compensation Expense Total stock-based compensation expense in the Company’s Consolidated Statements of Income related to the Company’s long-term incentive award plans was as follows (in thousands) Three Months Ended 2017 2016 Cost of services-compensation $ 2,040 $ 1,931 Selling, general and administrative 3,346 2,309 Total $ 5,386 $ 4,240 (b) Stock Options Stock-based compensation expense related to stock options was approximately $2.1 $2.0 three March 31, 2017 2016, Presented below is a summary of stock option activity for the three March 31, 2017 ( in thousands except for weighted average exercise price and weighted average remaining contractual terms Number Weighted Weighted Aggregate Outstanding balance at December 31, 2016 5,191 $ 17.35 Granted - - Exercised 1 2.71 Forfeitures (52 ) 18.88 Expired (16 ) 24.87 Outstanding balance at March 31, 2017 5,124 17.32 4.76 $ 20,130 Expected to vest at March 31, 2017 1,540 15.01 5.52 8,431 Exercisable at March 31, 2017 2,920 $ 18.99 4.21 $ 8,231 The weighted-average grant date fair value per share of the stock options granted during the three March 31, 2016 $5.45. No three March 31, 2017. Three Months 2017 2016 Expected dividend yield ― ― Risk-free interest rate ― 1.20 % Expected volatility ― 43.89 % Expected life (years) ― 4.9 During the three March 31, 2017 2016, 677 9,975 $1,836 $26,425, three March 31, 2017 2016 $10,903 $100,815, As of March 31, 2017, $10.2 1.11 Excess tax benefit from the exercise of stock options for the three March 31, 2017 2016 $0.4 $0.01 (c) Restricted Stock Units Stock-based compensation expense related to restricted stock units was $3.3 $2.2 three March 31, 2017 2016, Presented below is a summary of restricted stock units activity for the three March 31, 2017 (in thousands, except for weighted average grant date fair value per unit): Number of Weighted Average Outstanding balance at December 31, 2016 1,413 $ 16.44 Granted 4 20.33 Vesting of restricted stock units, net of units withheld for taxes (332 ) 16.27 Units withheld for taxes (140 ) 16.27 Forfeitures (28 ) 17.99 Outstanding balance at March 31, 2017 917 $ 16.51 As of March 31, 2017, 761,178 $10.4 1.11

Note 10 - Commitments and Conti

Note 10 - Commitments and Contingencies	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	10. Dennis Demetre and Lori Lewis July 2012, second two one Kern Health Systems v. AMG, Dennis Demetre and Lori Lewis , . September 2014 not June 2016, . In January 2016, not June 22, 2016. not not Shareholder Proceedings March 3, 2017, Danahar v. HMS Holdings Corp., et al March 2, 2017 2016 10 10 December 31, 2015 10 January 1, 2016 September 30, 2016 May 19, 2017, not From time to time, HMS may not may may may 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 not .

Note 11 - Subsequent Events

Note 11 - Subsequent Events	3 Months Ended
	Mar. 31, 2017
Notes to Financial Statements
Subsequent Events [Text Block]	11. (a) Eliza Holding Acquisition As previously disclosed, on April 17, 2017, $172.0 75% 25% (b) Annual Grants to Employees On April 26, 2017, $16.6 three three 10 In connection with the preparation of these unaudited Consolidated Financial Statements, an evaluation of subsequent events was performed through the date of issuance and, other than the events above, there were no

Significant Accounting Policies

Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2017
Accounting Policies [Abstract]
New Accounting Pronouncements, Policy [Policy Text Block]	Recently Adopted Accounting Pronouncements In March 2016, No. 2016 09, Compensation – Stock Compensation (Topic 718 2016 09” no 2016 09 December 15, 2016, fourth 2016 January 1, 2016, 2016. no January 1, 2016, $0.01 three March 31, 2016. $0.1 three March 31, 2016. no In November 2015, 2015 17, Income Taxes (Topic 740 2015 17” 2015 17 2015 17, December 15, 2016, fourth 2016. $7.5 December 31, 2016. Recently Issued Accounting Pronouncements In May 2014, 2014 09, Revenue from Contracts with Customers 606 2014 09” 2014 09 December 15, 2017, not January 1, 2018. two third 2017. In February 2016, 2016 02, Leases (Topic 842 2016 02” 2016 02 2016 02 December 15, 2018 not In August 2016, No. 2016 15, Statements of Cash Flows (Topic 230 2016 15” . not eight December 15, 2017, In January 2017, No. 2017 01, Business Combinations (Topic 805 2017 01” 2017 01 December 15, 2017, In January 2017, No. 2017 04, Goodwill and Other (Topic 350 2017 04” 2 2 1 2 not December 15, 2019. January 1, 2017. In May 2017, No. 2017 09, Compensation – Stock Compensation (Topic 718 2017 09” 2017 09 1 2 3 December 15, 2017. not Other new pronouncements issued but not March 31, 2017, not

Note 2 - Accounts Receivable 19

Note 2 - Accounts Receivable and Allowance for Doubtful Accounts (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Accounts, Notes, Loans and Financing Receivable [Table Text Block]	March 31, December 31, Accounts receivable $ 176,589 $ 184,354 Allowance (9,985 ) (10,772 ) Accounts receivable, net $ 166,604 $ 173,582
Movement in Valuation Allowances and Reserves Roll Forward [Table Text Block]	March 31, Balance--beginning of period $ 10,772 Provision 4,038 Charge-offs (4,825 ) Recoveries - Balance--end of period $ 9,985

Note 3 - Intangible Assets an20

Note 3 - Intangible Assets and Goodwill (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Finite-Lived Intangible Assets [Table Text Block]	Gross Accumulated Net Carrying Useful Life March 31, 2017 Customer relationships $ 103,090 $ (75,549 ) $ 27,541 5 - 10 Trade name 15,936 (11,969 ) 3,967 3 - 5 Intellectual Property 2,100 (245 ) 1,855 3 - 7 Restrictive covenants 133 (26 ) 107 3 - 5 Total $ 121,259 $ (87,789 ) $ 33,470 December 31, 2016 Customer relationships $ 103,090 $ (71,914 ) $ 31,176 5 - 10 Trade name 15,936 (11,393 ) 4,543 3 - 5 Intellectual Property 2,100 (140 ) 1,960 3 - 7 Restrictive covenants 133 (15 ) 118 3 - 5 Total $ 121,259 $ (83,462 ) $ 37,797
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]	Year ending December 31, Remainder of 2017 $ 12,979 2018 16,685 2019 2,245 2020 791 2021 463 Thereafter 307

Note 4 - Accounts Payable, Ac21

Note 4 - Accounts Payable, Accrued Expenses and Other Liabilities (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Accounts Payable and Accrued Liabilities [Table Text Block]	March 31, December 31, Accounts payable, trade $ 9,399 $ 13,847 Accrued compensation and other 11,686 28,507 Accrued operating expenses 17,508 17,048 Total accounts payable, accrued expenses and other liabilities $ 38,593 $ 59,402

Note 6 - Estimated Liability 22

Note 6 - Estimated Liability for Appeals (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Valuation and Qualifying Accounts Disclosure [Table Text Block]	March 31, Balance--beginning of period $ 11,126 Provision - Appeals found in providers favor (521 ) Balance--end of period $ 10,605

Note 7 - Credit Agreement (Tabl

Note 7 - Credit Agreement (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Interest Expense and Commitment Fees on Debt Instrument [Table Text Block]	Three Months Ended 2017 2016 Interest expense $ 1,374 $ 1,178 Commitment fees $ 378 $ 378

Note 8 - Earnings Per Share (Ta

Note 8 - Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2017
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended 2017 2016 Net income $ 1,442 $ 4,560 Weighted average common shares outstanding-basic 83,617 84,033 Plus: net effect of dilutive stock options and restricted stock units 1,963 446 Weighted average common shares outstanding-diluted 85,580 84,479 Net income per common share-basic $ 0.02 $ 0.05 Net income per common share-diluted $ 0.02 $ 0.05

Note 9 - Stock-based Compensa25

Note 9 - Stock-based Compensation (Tables)	3 Months Ended
	Mar. 31, 2017
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 2017 2016 Cost of services-compensation $ 2,040 $ 1,931 Selling, general and administrative 3,346 2,309 Total $ 5,386 $ 4,240
Share-based Compensation, Stock Options, Activity [Table Text Block]	Number Weighted Weighted Aggregate Outstanding balance at December 31, 2016 5,191 $ 17.35 Granted - - Exercised 1 2.71 Forfeitures (52 ) 18.88 Expired (16 ) 24.87 Outstanding balance at March 31, 2017 5,124 17.32 4.76 $ 20,130 Expected to vest at March 31, 2017 1,540 15.01 5.52 8,431 Exercisable at March 31, 2017 2,920 $ 18.99 4.21 $ 8,231
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	Three Months 2017 2016 Expected dividend yield ― ― Risk-free interest rate ― 1.20 % Expected volatility ― 43.89 % Expected life (years) ― 4.9
Schedule of Share-based Compensation, Restricted Stock Units Award Activity [Table Text Block]	Number of Weighted Average Outstanding balance at December 31, 2016 1,413 $ 16.44 Granted 4 20.33 Vesting of restricted stock units, net of units withheld for taxes (332 ) 16.27 Units withheld for taxes (140 ) 16.27 Forfeitures (28 ) 17.99 Outstanding balance at March 31, 2017 917 $ 16.51

Note 1 - Business and Summary26

Note 1 - Business and Summary of Significant Accounting Policies (Details Textual) $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)
Number of Businesses	1
Increase to Net Cash From Operations and Net Cash Used in Financing [Member] | Quarter Ended March 31, 2016 [Member] | Accounting Standards Update 2016-09 [Member]
Prior Period Reclassification Adjustment	$ 10
Decrease to Total Current Assets and Total Long-term Liabilities [Member] | Year Ended December 31, 2016 [Member]
Prior Period Reclassification Adjustment	$ 7,500

Note 2 - Accounts Receivable 27

Note 2 - Accounts Receivable and Allowance for Doubtful Accounts - Summary of Accounts Receivable (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Accounts receivable	$ 176,589	$ 184,354
Allowance for doubtful accounts	(9,985)	(10,772)
Accounts receivable, net	$ 166,604	$ 173,582

Note 2 - Accounts Receivable 28

Note 2 - Accounts Receivable and Allowance for Doubtful Accounts - Activity in Allowance for Doubtful Accounts (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)
Balance--beginning of period	$ 10,772
Provision	4,038
Charge-offs	(4,825)
Recoveries
Balance--end of period	$ 9,985

Note 3 - Intangible Assets an29

Note 3 - Intangible Assets and Goodwill (Details Textual) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Amortization of Intangible Assets	$ 4,327	$ 5,043

Note 3 - Intangible Assets an30

Note 3 - Intangible Assets and Goodwill - Summary of Intangible Assets (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2017	Dec. 31, 2016
Net Carrying Amount	$ 33,470	$ 37,797
Gross Value	121,259	121,259
Accumulated Amortization	(87,789)	(83,462)
Customer Relationships [Member]
Net Carrying Amount	27,541	31,176
Gross Value	103,090	103,090
Accumulated Amortization	$ (75,549)	$ (71,914)
Customer Relationships [Member] | Minimum [Member]
Useful Life (Year)	5 years	5 years
Customer Relationships [Member] | Maximum [Member]
Useful Life (Year)	10 years	10 years
Trade Names [Member]
Net Carrying Amount	$ 3,967	$ 4,543
Gross Value	15,936	15,936
Accumulated Amortization	$ (11,969)	$ (11,393)
Trade Names [Member] | Minimum [Member]
Useful Life (Year)	3 years	3 years
Trade Names [Member] | Maximum [Member]
Useful Life (Year)	5 years	5 years
Intellectual Property [Member]
Net Carrying Amount	$ 1,855	$ 1,960
Gross Value	2,100	2,100
Accumulated Amortization	$ (245)	$ (140)
Intellectual Property [Member] | Minimum [Member]
Useful Life (Year)	3 years	3 years
Intellectual Property [Member] | Maximum [Member]
Useful Life (Year)	7 years	7 years
Restrictive Covenant [Member]
Net Carrying Amount	$ 107	$ 118
Gross Value	133	133
Accumulated Amortization	$ (26)	$ (15)
Restrictive Covenant [Member] | Minimum [Member]
Useful Life (Year)	3 years	3 years
Restrictive Covenant [Member] | Maximum [Member]
Useful Life (Year)	5 years	5 years

Note 3 - Intangible Assets an31

Note 3 - Intangible Assets and Goodwill - Estimated Amortization Expense of Intangible Assets (Details) $ in Thousands	Mar. 31, 2017USD ($)
Remainder of 2017	$ 12,979
2,018	16,685
2,019	2,245
2,020	791
2,021	463
Thereafter	$ 307

Note 4 - Accounts Payable, Ac32

Note 4 - Accounts Payable, Accrued Expenses and Other Liabilities - Summary of Accounts Payable, Accrued Expenses and Other Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Accounts payable, trade	$ 9,399	$ 13,847
Accrued compensation and other	11,686	28,507
Accrued operating expenses	17,508	17,048
Total accounts payable, accrued expenses and other liabilities	$ 38,593	$ 59,402

Note 5 - Income Taxes (Details

Note 5 - Income Taxes (Details Textual) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016	Dec. 31, 2016
Effective Income Tax Rate Reconciliation, Percent	20.40%	42.00%
Unrecognized Tax Benefits			$ 7.4
Unrecognized Tax Benefits that Would Impact Effective Tax Rate	$ 0.7		$ 0.6
Unrecognized Tax Benefits, Income Tax Penalties and Interest Expense	0.1	$ 0.2
Decrease in Unrecognized Tax Benefits is Reasonably Possible	$ 1

Note 6 - Estimated Liability 34

Note 6 - Estimated Liability for Appeals (Details Textual) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Estimated Liability for Appeals	$ 31,544	$ 30,755
Estimated Liability for Appeals, Amount Adjudicated	17,900	17,300
Estimated Liability for Appeals, Amount Probable of Being Returned	$ 10,600	$ 11,100

Note 6 - Estimated Liability 35

Note 6 - Estimated Liability for Appeals - Summary of Estimated Liability and Allowance for Appeals (Details) - Estimated Liability for Appeals and Estimated Allowance for Appeals [Member] $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)
Balance--beginning of period	$ 11,126
Provision
Appeals found in providers favor	(521)
Balance--end of period	$ 10,605

Note 7 - Credit Agreement (Deta

Note 7 - Credit Agreement (Details Textual) $ in Thousands	1 Months Ended	3 Months Ended		12 Months Ended
	May 31, 2013USD ($)	Mar. 31, 2017USD ($)	Mar. 31, 2016USD ($)	Dec. 31, 2016USD ($)	Dec. 31, 2015USD ($)
Long-term Line of Credit, Noncurrent		$ 197,796		$ 197,796
Amortization of Debt Issuance Costs		521	$ 521
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%
Revolving Credit Facility [Member] | The 2013 Credit Agreement [Member]
Repayments of Long-term Lines of Credit				0	$ 0
Long-term Line of Credit, Noncurrent		197,800
Line of Credit Facility, Maximum Borrowing Capacity	$ 500,000
Line of Credit Facility, Amount of Incremental Credit Facilities Under Specified Circumstances	$ 75,000
Debt Issuance Costs, Net			2,300	$ 2,800
Amortization of Debt Issuance Costs		500	$ 500
Letters of Credit Outstanding, Amount		$ 3,000
Revolving Credit Facility [Member] | The 2013 Credit Agreement [Member] | Federal Funds Effective Swap Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	0.50%
Revolving Credit Facility [Member] | The 2013 Credit Agreement [Member] | One-month LIBOR Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	1.00%
Revolving Credit Facility [Member] | The 2013 Credit Agreement [Member] | Minimum [Member]
Line of Credit Facility, Additional Amount of Incremental Credit Facilities Under Specified Circumstances	$ 25,000
Debt Instrument, Covenant, Interest Coverage Ratio	3
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage	0.375%
Revolving Credit Facility [Member] | The 2013 Credit Agreement [Member] | Minimum [Member] | One-month LIBOR Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	0.50%
Revolving Credit Facility [Member] | The 2013 Credit Agreement [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%
Revolving Credit Facility [Member] | The 2013 Credit Agreement [Member] | Maximum [Member] | One-month LIBOR Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	1.25%

Note 7 - Credit Agreement - Sum

Note 7 - Credit Agreement - 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
	Mar. 31, 2017	Mar. 31, 2016
Interest expense	$ 1,374	$ 1,178
Commitment fees	$ 378	$ 378

Note 8 - Earnings Per Share (De

Note 8 - Earnings Per Share (Details Textual) - shares	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Employee Stock Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	2,106,397	4,321,528
Restricted Stock Units (RSUs) [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	42,056	99,461

Note 8 - Earnings Per Share - S

Note 8 - Earnings Per Share - Summary of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Net income	$ 1,442	$ 4,560
Basic (in shares)	83,617	84,033
Plus: net effect of dilutive stock options and restricted stock units (in shares)	1,963	446
Weighted average common shares outstanding-diluted (in shares)	85,580	84,479
Net income per common share -- basic (in dollars per share)	$ 0.02	$ 0.05
Net income per common share -- diluted (in dollars per share)	$ 0.02	$ 0.05

Note 9 - Stock-based Compensa40

Note 9 - Stock-based Compensation (Details Textual) - USD ($)	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period, Intrinsic Value	$ 10,903	$ 100,815
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Stock Options	10,200,000
Allocated Share-based Compensation Expense	$ 5,386,000	$ 4,240,000
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition	1 year 40 days
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value		$ 5.45
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross	0
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period	677	9,975
Proceeds from Stock Options Exercised	$ 2,000	$ 26,000
Employee Stock Option [Member]
Adjustments to Additional Paid in Capital, Income Tax Benefit from Share-based Compensation	400,000	10,000
Allocated Share-based Compensation Expense	2,100,000	2,000,000
Proceeds from Stock Options Exercised	1,836	26,425
Restricted Stock Units (RSUs) [Member]
Allocated Share-based Compensation Expense	$ 3,300,000	$ 2,200,000
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number	761,178
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Share-based Awards Other than Options	$ 10,400,000
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition	1 year 40 days

Note 9 - Stock-based Compensa41

Note 9 - Stock-based Compensation - Summary of Stock-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Allocated Share-based Compensation Expense	$ 5,386	$ 4,240
Cost of Sales [Member]
Allocated Share-based Compensation Expense	2,040	1,931
Selling, General and Administrative Expenses [Member]
Allocated Share-based Compensation Expense	$ 3,346	$ 2,309

Note 9 - Stock-based Compensa42

Note 9 - Stock-based Compensation - Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Outstanding balance at December 31, 2016 (in shares)	5,191,000
Outstanding balance at December 31, 2016 (in dollars per share)	$ 17.35
Outstanding balance at March 31, 2017 (Year)	4 years 277 days
Outstanding balance at March 31, 2017	$ 20,130
Expected to vest at March 31, 2017 (in shares)	1,540,000
Expected to vest at March 31, 2017 (in dollars per share)	$ 15.01
Expected to vest at March 31, 2017 (Year)	5 years 189 days
Expected to vest at March 31, 2017	$ 8,431
Exercisable at March 31, 2017 (in shares)	2,920,000
Exercisable at March 31, 2017 (in dollars per share)	$ 18.99
Exercisable at March 31, 2017 (Year)	4 years 76 days
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross	0
Granted, Weighted Average Exercise Price (in dollars per share)
Exercised, Shares (in shares)	677	9,975
Exercised, Weighted Average Exercise Price (in dollars per share)	$ 2.71
Exercisable at March 31, 2017	$ 8,231
Forfeitures, Shares (in shares)	(52,000)
Forfeitures, Weighted Average Exercise Price (in dollars per share)	$ 18.88
Expired, Shares (in shares)	(16,000)
Expired, Weighted Average Exercise Price (in dollars per share)	$ 24.87
Outstanding balance at March 31, 2017 (in shares)	5,124,000
Outstanding balance at March 31, 2017 (in dollars per share)	$ 17.32

Note 9 - Stock-based Compensa43

Note 9 - Stock-based Compensation - Weighted Average Assumptions Used in Valuation of Stock Options (Details) - Employee Stock Option [Member]	3 Months Ended
	Mar. 31, 2016
Expected dividend yield
Risk-free interest rate	1.20%
Expected volatility	43.89%
Expected life (years) (Year)	4 years 328 days

Note 9 - Stock-based Compensa44

Note 9 - Stock-based Compensation - Summary of Restricted Stock Units (Details) - Restricted Stock Units (RSUs) [Member] shares in Thousands	3 Months Ended
	Mar. 31, 2017$ / sharesshares
Beginning balance, shares (in shares) | shares	1,413
Beginning balance, weighted average grant date fair value per unit (in dollars per share) | $ / shares	$ 16.44
Granted, shares (in shares) | shares	4
Granted, weighted average grant date fair value per unit (in dollars per share) | $ / shares	$ 20.33
Vesting of restricted stock units, net of units withheld for taxes, shares (in shares) | shares	(332)
Vesting of restricted stock units, net of units withheld for taxes, weighted average grant date fair value per unit (in dollars per share) | $ / shares	$ 16.27
Units withheld for taxes, shares (in shares) | shares	(140)
Units withheld for taxes, weighted average grant date fair value per unit (in dollars per share) | $ / shares	$ 16.27
Forfeitures, shares (in shares) | shares	(28)
Forfeitures, weighted average grant date fair value per unit (in dollars per share) | $ / shares	$ 17.99
Ending balance, shares (in shares) | shares	917
Ending balance, weighted average grant date fair value per unit (in dollars per share) | $ / shares	$ 16.51

Note 11 - Subsequent Events (De

Note 11 - Subsequent Events (Details Textual) - Subsequent Event [Member] - USD ($) $ in Millions	Apr. 26, 2017	Apr. 17, 2017
Share-based Compensation Arrangement by Share-based Payment Award, Options and Other than Options, Grants, Fair Value	$ 16.6
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period	3 years
Eliza Holding Group [Member]
Business Combination, Consideration Transferred		$ 172
Business Combination, Purchase Percent, Cash		75.00%
Business Combination, Purchase Percent, Revolving Credit Facility		25.00%