Cost of revenue includes salaries and related benefits, services provided by third parties and our providers, and other expenses associated with the development of American CareSource Holdings’ ancillary health programs. Cost of revenue increased from $2,352,552 for the six months ended June 30, 2005 to $4,215,309 for the six months ended June 30, 2006 or 79%. The increase in these costs primarily reflects an increase in amounts expected to be paid to providers for service as a result of our increase in revenue.
Selling, general and administrative expense remained increased by $397,600 to $1,335,490 for the six months ended June 30, 2006 as compared to $937,890 for the six months ended June 30, 2005. These costs consist primarily of salaries, related benefits and travel costs, commissions and management fees, sales materials, other marketing related expenses, costs of corporate operations, finance and accounting, human resources and other general operating expenses of American CareSource Holdings. The majority of the cost increase is related to the increased cost of operating as a public Company, which includes the cost of expensing stock options, and the increased commissions and management fees associated with our higher sales.
Amortization and depreciation expense was $158,347 a decrease of $2,079 in the quarter ended June 30, 2006 compared to $160,426 in six months ended June 30, 2005. These expenses include $106,791 of amortization of intangibles that includes $42,758 in amortization of certain software development costs and $64,033 in amortization of the capitalized value of provider contracts that were acquired as part of the acquisition of American CareSource assets by Patient Infosystems.
The on-going value of these acquired contracts are re-evaluated each quarter to test for any potential impairment to this asset. As of June 30, 2006, the Company’s analysis of its goodwill and related intangibles did not indicate any impairment.
It is anticipated that American CareSource Holdings will need to invest heavily in the sales and marketing process in future periods, and intends to do so as funds are available. To the extent that American CareSource Holdings has limited funds available for sales and marketing, or cannot leverage its marketing partnerships adequately, it will likely be unable to invest in the necessary marketing activities to generate substantially greater sales.
Other Income/Expense is comprised of financing costs, interest expenses and other expenses. The totals are as follows:
Interest income was $20,604 for the six months ended June 30, 2006 compared to expense of $42,180 for the six months ended June 30, 2005, due to the decrease in the line of credit and the invested cash balance. The increase in debt issuance cost is associated with the amortization cost of warrants and expenses related to the guarantees of the Company’s Wells Fargo Line of credit.
Taxes
American CareSource Holdings had no tax benefit in the six months ended June 30, 2006 or the six months ended June 30, 2005 due, in part, to recording a full valuation allowance to reduce its deferred tax assets. American CareSource Holdings’ deferred tax assets consist primarily of the tax benefit associated with its net operating loss carry forwards. At this time, management is continuing to record a full valuation allowance to reduce deferred tax benefit.
Management of American CareSource Holdings has evaluated the available evidence about future taxable income and other possible sources of realization of deferred tax assets. The valuation allowance reduces deferred tax assets to zero, which represents management’s best estimate of the amount of such deferred tax assets that more likely than not will be realized.
Loss
American CareSource Holdings reported a net loss of $(524,206) for the six months ended June 30, 2006 as compared to $(1,197,249) for the six months ended June 30, 2005. On a per share basis, the Company lost $0.04 per share for the six months ending June 30, 2006 and $0.10 per share for the six months ended June 30, 2005.
Liquidity and Capital Resources
As of June 30, 2006, American CareSource Holdings had a working capital surplus of $4,846,445 as compared to working capital deficit of ($223,122) at December 31, 2005. Since its inception, American CareSource Holdings has not generated positive cash flow from operations and has relied on external sources for its operational, working capital and capital expenditures needs.
Since the acquisition by Patient Infosystems in December 2003, American CareSource Holdings received funding of $3,201,288 from Patient Infosystems in the form of equity contributions and loans. The balance due to Patient Infosystems was $325,792 and $336,277 as of June 30, 2006 and December 31, 2005, respectively. The loan is due and payable on February 1, 2007.
American CareSource Holdings has a credit agreement in place with Wells Fargo Bank, NA providing for a $5,000,000 line of credit. The agreement is guaranteed by John Pappajohn, Derace Schafer, directors of American CareSource Holdings, and Matt Kinley, an employee of a company owned by Mr. Pappajohn. The line of credit bears interest at the bank’s prime index rate which is 8.25% as of June 30, 2006. The line of credit requires interest to be paid currently with the principal due on the expiration of the credit facility on March 31, 2007. The Company currently has no borrowing against the line of credit.
In March 2006 the Company completed a private placement of its common stock. The offering raised approximately $10.0 million at a price of $5.00 per share. In connection with such private placement, American CareSource relied upon the exemption from registration provided under Section 4(2) of the Securities Act and Rule 506 of Regulation D promulgated thereunder. The net proceeds from the transaction was approximately $9.1 million. Additionally, American CareSource Holdings granted the accredited investors certain registration rights pursuant to a registration rights agreement, in connection with this transaction. The registration rights agreement required the Company to file a registration statement following the final closing of the private placement covering the resale of all shares included therein, as well as the shares underlying the placement agent’s warrants. A registration statement registering such shares for resale was filed on April 7, 2006. On May 11, 2006, the Securities and Exchange Commission declared effective this registration statement.
A portion of the proceeds from the March 2006 transaction was used to re-pay the full balance of the Wells Fargo Bank, N.A. credit line. The outstanding principal retired by American CareSource Holdings was $3,650,000. The remainder of the proceeds will be used to fund working capital and other general corporate purposes. Although American CareSource Holdings paid in full all obligations outstanding under its credit agreement with Wells Fargo Bank, N.A, the line of credit remains fully available to American CareSource Holdings if needed. If there are any future drawings under the line of credit, American
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CareSource Holdings believes it will be able to satisfy its cash requirements based on its current customer base and anticipated timing of new accounts, its existing service agreements, and available capital. Therefore, American CareSource Holdings does not anticipate the need to raise additional funds through 2006.
Inflation
Inflation did not have a significant impact on American CareSource Holdings’ costs during the quarters and six months ended June 30, 2006 and June 30, 2005. American CareSource Holdings continues to monitor the impact of inflation in order to minimize its effects through pricing strategies, productivity improvements and cost reductions.
Critical Accounting Policies
Critical accounting policies are those that require application of management’s most difficult, subjective or complex judgments, often as a result of the need to make estimates about the effect of matters that are inherently uncertain and may change in subsequent periods.
American CareSource Holdings’ significant accounting policies are described in Note 1 to the Financial Statements. Not all of these significant accounting policies require management to make difficult, subjective or complex judgments or estimates. However, the following accounting policies are deemed to be critical by American CareSource Holdings’ management.
Use of Estimates. In preparing the financial statements, American CareSource Holdings uses estimates in determining the economic useful lives and possible impairments of its assets, provisions for doubtful accounts, tax valuation allowances and various other recorded or disclosed amounts. Estimates require management to use its judgment. While American CareSource Holdings believes that its estimates for these matters are reasonable, if the actual amount is significantly different than the estimated amount, its assets, liabilities or results of operations may be overstated or understated.
Intangible Assets. The value of American CareSource Holdings’ intangible assets was derived from the allocation of the purchase price from the December 31, 2003 acquisition of the assets of American CareSource Corporation by Patient Infosystems. The allocation of purchase price was based on an independent appraisal of the acquired assets. The amounts assigned to each asset are being amortized on a straight line basis over the expected life of the asset, 5 years for software and 15 years for the provider contracts. The provider contracts do not have a specified contract period. Our experience to date demonstrates attrition of less than 2% per year, implying a greater than twenty year life, however we believe that 15 years represents a more realistic estimate. Accordingly, American CareSource Holdings has elected to amortize the value of these contracts over 15 years. The on going value of these acquired contracts are re-evaluated each quarter using the discounted cashflow method to test for any potential impairment to this asset that would result from either reduced cash flows or a shorter than anticipated useful life. The contracts are accounted for as a pool of contracts. There will be no additions to the capitalized amounts that were established at the time of the acquisition, the cost of adding additional providers is considered an ongoing operating expense.
Impairment of Long-Lived Assets. American CareSource Holdings records impairment losses on long-lived assets used in operations when events and circumstances indicate that the assets might be impaired and the undiscounted future cash flows estimated to be generated by those assets are less than the carrying amount of those assets. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of the asset to future net cash flows expected to be generated by the asset. If the asset is considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the asset exceeds the fair value of the asset. If the actual value is significantly less than the estimated value, American CareSource Holdings assets may be overstated.
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Revenue recognition. American CareSource Holdings evaluates their service provider contracts using the indicators of EITF No. 99-19 “Reporting Gross Revenue as a Principal vs. Net as an Agent” (EITF 99-19) to determine whether American CareSource Holdings is acting as a principal or an agent in the fulfillment of services to be rendered.
Revenues are recorded gross when services by providers have been authorized and performed and collections from third party payors are reasonably assured. American CareSource Holdings acts as principal under EITF 99-19 when settling claims for service providers through their contracted service provider network for the following reasons:
| • | American CareSource Holdings negotiates a contract with the service provider and also negotiates contracts with payors. Neither the service provider nor the payor can look through the Company and claim directly against the other party. Both contracts with these parties are separate and each only contracts with the Company. Each party deals directly with the Company and does not deal with each other directly. |
| • | American CareSource Holdings determines through negotiations which payor will be included or excluded in the network to be offered to the service provider, based on price, access, etc. |
| • | American CareSource Holdings does not earn a fixed dollar amount per customer transaction regardless of the amount billed to customers or earn a stated percentage of the amount billed to its customers. |
| • | American CareSource Holdings is responsible to the service provider for processing the claim and managing the claim their adjustor processes. |
| • | American CareSource Holdings sets prices to be settled with payors and separately negotiates the prices to be settled with the service providers. |
| • | American CareSource Holdings may realize a positive or negative margin represented by the difference between the negotiated fees received from the payor and the negotiated amount paid to the service providers. |
| • | When claims are recorded gross, the payor’s payment to American CareSource Holdings is recorded as revenue and the American CareSource Holdings’ payment to the service provider is recorded as cost of revenue in the statement of operations. American CareSource Holdings does, however, record revenue on a net basis when an agency relationship exists. When American CareSource Holdings receives a fee for claims processing and there are no financial risks to American CareSource Holdings, then only the claims processing fee is recorded as revenue. |
| • | American CareSource Holdings does not have responsibility to collect co-payments to be made or co-insurance claims to be received. Accordingly, co-payments or co-insurance claims collected are not recorded as either revenue or cost of sales. |
Off-balance sheet arrangements
American CareSource Holdings does not have any material off-balance sheet arrangements at June 30, 2006 or June 30, 2005, or for the periods then ended.
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Pending Accounting Pronouncements
In December 2004, the FASB issued SFAS No. 153, “Exchanges of Nonmonetary Assets-an amendment of APB Opinion No. 29” (“SFAS No. 153”), addressing the measurement of exchanges of nonmonetary assets. SFAS No. 153 eliminates the exception from fair value measurement for nonmonetary exchanges of similar production assets in APB Opinion No. 29 “Accounting for Nonmonetary Exchanges,” and replaces it with an exception for exchanges that do not have commercial substance. SFAS No. 153 is effective for nonmonetary asset exchanges occurring in fiscal periods beginning after June 15, 2005 with earlier application permitted. American CareSource Holdings does not expect adoption of the provisions of SFAS No. 153 to have material impact on the consolidated financial statement, results of operations or liquidity of American CareSource Holdings.
In June 2006, the FASB issued Interpretation No. 48 (“FIN48”), Accounting for Uncertainty in Income Taxes – an interpretation of FASB Statement No. 109, to clarify certain aspects of accounting for uncertain tax positions, including issues related to the recognition and measurement of those tax positions. This interpretation is effective for fiscal years beginning after December 15, 2006. The Company is in the process of evaluating the impact of this interpretation and believes that any entry will not have a material effect on the Company’s consolidated financial position or results of operations.
Item 3. Controls and Procedures
Evaluation of Disclosure Controls and Procedures. Our management, with the participation of our Chief Executive Officer, Chief Financial Officer, and Principal Accounting Officer, has evaluated the effectiveness of our disclosure controls and procedures as of June 30, 2006. Based upon this evaluation, our Chief Executive Officer, Chief Financial Officer, and Principal Accounting Officer concluded that our disclosure controls and procedures (as defined in Rules 130-15(e) and 15(d)-15(e) under the Securites and Exchange Act of 1934) are effective for the recording, processing, summarizing and reporting the information that American CareSource Holdings is required to disclose in the reports it files under the Securities Exchange Act of 1934, within the time periods specified in the SEC’s rules and forms.
Changes in Internal Controls. There were no significant changes in American CareSource Holdings’ internal controls or in other factors that could significantly affect these controls subsequent to the date of their evaluation, including any corrective actions with regard to significant deficiencies and material weaknesses.
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RISK FACTORS
You should carefully consider each of the following risk factors and all of the other information in this report. The following risks relate principally to American CareSource Holdings’ business. If any of the following risks actually occur, the business, financial condition or results of operations of American CareSource Holdings could be materially adversely affected. As a result, the market price of shares of American CareSource Holdings common stock could decline significantly.
American CareSource Holdings has a history of losses, has never been profitable and will likely continue to lose money for the foreseeable future.
American CareSource Holdings has incurred net losses in each year since its inception in December 2003 and has an accumulated deficit of approximately $5.8 million as of June 30, 2006. Its predecessor never achieved profitability either. American CareSource Holdings will require significant growth in either claims volume for existing contracts, new contracts or both in order to generate sufficient operational margin to become profitable. No assurances can be given that American CareSource Holdings will be able to generate additional revenues or ever operate profitably in the future. American CareSource Holdings prospects must be considered in light of the numerous risks, expenses, delays and difficulties frequently encountered in an industry characterized by intense competition, as well as the risks inherent in the development of new programs and the commercialization of new services particularly given its failure to date to operate profitably.
American CareSource Holdings has faced working capital shortfalls and may need to identify additional sources of capital within 12 months to maintain its operations.
American CareSource Holdings has never earned profits. Based on American CareSource Holdings’ current plans, and as a result of the March 2006 private placement, the Company believes that it has sufficient funds to meet its operating expenses and capital requirements through 2006. If the Company is unable reach profitability within the year, it will need to raise additional funds to continue is operations following that period. No assurance can be given that American CareSource Holdings will be able to obtain financing, or successfully sell assets or stock, or, even if such transactions are possible, that they will be on terms reasonable to American CareSource Holdings or that such transactions will enable American CareSource Holdings to satisfy its cash requirements. If American CareSource Holdings does not obtain additional funds, American CareSource Holdings will likely be required to eliminate programs, delay development of its products, alter its business plans, or in the extreme situation, cease operations.
American CareSource Holdings is dependent on payments from third party payors who may reduce rates of reimbursement.
The profitability of American CareSource Holdings will depend on payments provided by third-party payors. Competition for patients, efforts by traditional third-party payors to contain or reduce healthcare costs and the increasing influence of managed care payors such as health maintenance organizations in recent years have resulted in reduced rates of reimbursement. If these trends continue, they could adversely affect American CareSource Holdings’ results of operations unless American CareSource Holdings can implement measures to offset the loss of revenues and decreased profitability. In addition, changes in reimbursement policies of private and governmental third-party payors, including policies relating to the Medicare and Medicaid programs, could reduce the amounts reimbursed to these customers for American CareSource Holdings’ services and consequently, the amount these customers would be willing to pay for the services.
American CareSource Holdings has a limited number of customers, a few of which account for a substantial portion of its business.
American CareSource Holdings’ five largest customers account for approximately 92% of its revenues quarter ending June 30, 2005 and 98% of its revenue during the quarter ended June 30, 2006. Significant declines in the level of use of American CareSource Holdings services by one or more of these customers could have a material adverse effect on American CareSource Holdings’ business and results of operations.
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Additionally, an adverse change in the financial condition of any of these customers, including an adverse change as a result of a change in governmental or private reimbursement programs, could have a material adverse effect on its business. No assurance can be given that American CareSource Holdings will not lose additional substantial customers in the future.
American CareSource Holdings is dependent upon discounted rates made available by ancillary service providers which may be discontinued at any time.
American CareSource Holdings obtains revenue from cost savings that it is able to receive from the ancillary service providers and pass on to customers. Should the ancillary service providers not continue to provide a discount to American CareSource Holdings, American CareSource Holdings will be unable to recognize any gain from the sale of services to payors or networks. If American CareSource Holdings is unable to recognize these margins, it will be unable to continue its business as it is currently conducted.
American CareSource Holdings historically has not entered into any long-term contracts with any of its customers and failure to retain such customers could have a material adverse effect on American CareSource Holdings’ business and results of operations.
Generally, American CareSource Holdings does not have any long-term contracts with any of its customers. Currently, American CareSource Holdings only has one long-term contract with its customers that is set to extend beyond the next twelve months. In the aggregate, customer agreements that are set to expire within the next twelve months accounted for 60% of the revenues of American CareSource Holdings during the quarter ended June 30, 2006. There can be no assurance that customers will maintain their agreements with American CareSource Holdings or that customers will renew their contracts upon expiration, or on terms favorable to, American CareSource Holdings. Consequently, the failure to retain such customers could have a material adverse effect on American CareSource Holdings’ business and results of operations.
Changes in state and federal regulations could restrict American CareSource Holdings’ ability to conduct its business.
Numerous state and federal laws and regulations affect American CareSource Holdings’ business and operations. These laws and regulations include, but are not necessarily limited to:
| • | healthcare fraud and abuse laws and regulations, which prohibit illegal referral and other payments; |
| • | Employee Retirement Income Security Act of 1974 and related regulations, which regulate many healthcare plans; |
| • | mail pharmacy laws and regulations; |
| • | privacy and confidentiality laws and regulations; |
| • | consumer protection laws and regulations; |
| • | legislation imposing benefit plan design restrictions; |
| • | various licensure laws, such as managed care and third party administrator licensure laws; |
| • | drug pricing legislation; and |
| • | Medicare and Medicaid reimbursement regulations. |
American CareSource Holdings believes it is operating its business in substantial compliance with all existing legal requirements material to the operation of its business. There are, however, significant uncertainties regarding the application of many of these legal requirements to its business, and there cannot be any assurance that a regulatory agency charged with enforcement of any of these laws or regulations will not interpret them differently or, if there is an enforcement action, that American CareSource Holdings’ interpretation would prevail. In addition, there are numerous proposed healthcare laws and regulations at the federal and state levels, many of which could materially affect American CareSource Holdings’ ability to conduct its business or adversely affect its results of operations.
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If American CareSource Holdings fails to comply with the requirements of HIPAA, it could face sanctions and penalties.
HIPAA provides safeguards to ensure the integrity and confidentiality of such health information. Violation of the standards is punishable by fines and, in the case of wrongful disclosure of individually identifiable health information, imprisonment. Although American CareSource Holdings intends to comply with all applicable laws and regulations regarding medical information privacy, failure to do so could have an adverse effect on American CareSource Holdings’ business.
There are large competitors in the healthcare industry that could choose to compete against American CareSource Holdings, reducing American CareSource Holdings’ profit margins.
Traditional health insurance companies, preferred provider networks, and pharmacy benefit managers (“PBM’s”) are potential competitors of American CareSource Holdings. These companies include well-established companies which may have greater financial, marketing and technological resources than American CareSource Holdings, such as Merck-Medco, Express Scripts and Caremark Rx. Competition in the marketplace has caused many PBM’s to reduce the prices charged to clients for core services and share a larger portion of the formulary fees and related revenues received from drug manufacturers with clients. Increased price competition could reduce American CareSource Holdings’ profit margins and have a material adverse effect on its results of operations.
There are limited barriers to entry into the ancillary services market which could result in greater competition.
Although American CareSource Holdings is not aware of any organization or company that currently provides similar ancillary services management, there are limited barriers to entry into the ancillary services management market. Major benefit management companies and healthcare companies not presently offering ancillary services management may decide to enter the market. These companies may have greater financial, marketing and other resources than American CareSource Holdings. Competition from other companies may have a material adverse effect on American CareSource Holdings’ financial condition and results of operations.
American CareSource Holdings’ inability to react effectively to changes in the healthcare industry could adversely effect its operating results.
In recent years, the healthcare industry has undergone significant change driven by various efforts to reduce costs, including potential national healthcare reform, trends toward managed care, cuts in Medicare reimbursements, and horizontal and vertical consolidation within the healthcare industry. Proposed changes to the U.S. healthcare system may increase governmental involvement in healthcare and ancillary health services, and otherwise change the way payors, networks and providers conduct business. Healthcare organizations may react to these proposals and the uncertainty surrounding them by reducing or delaying purchases of cost control mechanisms and related services that American CareSource Holdings provides. Other legislative or market-driven changes in the healthcare system that American CareSource Holdings cannot anticipate could also materially adversely affect American CareSource Holdings’ business. American CareSource Holdings’ inability to react effectively to these and other changes in the healthcare industry could adversely affect its operating results. American CareSource Holdings cannot predict whether any healthcare reform efforts will be enacted and what effect any such reforms may have on American CareSource Holdings or its customers. The inability of American CareSource Holdings to react effectively to changes in the healthcare industry may result in a material adverse effect on its business.
The continued services and leadership of American CareSource Holdings’ senior management is critical to its ability to maintain growth and any loss of key personnel could adversely affect its business.
The future of the business of American CareSource Holdings depends to a significant degree on the skills and efforts of its senior executives, in particular, Wayne Schellhammer, its Chief Executive Officer and David Boone, its Chief Operating Officer and Chief Financial Officer. If American CareSource Holdings
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loses the services of any of its senior executives, and especially if any of its executives joins a competitor or forms a competing company, American CareSource Holdings’ business and financial performance could be seriously harmed. American CareSource Holdings has employment agreements with Mr. Schellhammer and Mr. Boone. Mr. Schellhammer’s initial term under his employment agreement expired October 10, 2005, but was automatically renewed for a successive one year term. Mr. Boone’s initial term under his employment agreement expired April 30, 2006, but automatically renewed for a successive one year term. If, for any reason, we lose any of our executive officers’ skills, knowledge of the industry, contacts and expertise, it could result in a setback to the American CareSource Holdings operating plan.
American CareSource Holdings will incur additional costs as an independent public company and may be unable to operate profitably as a stand-alone company.
American CareSource Holdings will incur significant additional costs as a newly separate and independent public company. These costs include, among other things, additional legal and accounting costs incurred as a result of becoming a public company. Furthermore, American CareSource Holdings will need to put in place the financial, administrative and managerial structure necessary to operate as an independent public company, or the development of such structure may require a significant amount of management’s time and other resources including financial resources, which could hinder American CareSource Holdings’ ability to operate profitably.
American CareSource Holdings may be unsuccessful in the successful hiring and retention of skilled personnel.
The future growth of American CareSource Holdings’ business depends on successful hiring and retention of skilled personnel, and American CareSource Holdings may be unable to hire and retain the skilled personnel it needs to succeed. Qualified personnel are in great demand throughout the healthcare industry. The failure of American CareSource Holdings to attract and retain sufficient skilled personnel may limit the rate at which its business can grow, which will harm its financial performance.
The interruption of data processing capabilities and telecommunications will negatively impact American CareSource Holdings’ operating results.
The business of American CareSource Holdings is dependent upon its ability to store, retrieve, process and manage data and to maintain and upgrade its data processing capabilities. Interruption of data processing capabilities for any extended length of time, loss of stored data, programming errors, other computer problems or interruptions of telephone service could have a material adverse effect on its business.
Any inability to adequately protect its intellectual property could harm American CareSource Holdings’ competitive position.
American CareSource Holdings considers its methodologies, processes and know-how to be proprietary. American CareSource Holdings seeks to protect its proprietary information through confidentiality agreements with its employees. American CareSource Holdings’ policy is to have employees enter into confidentiality agreements containing provisions prohibiting the disclosure of confidential information to anyone outside of American CareSource Holdings, requiring employees to acknowledge, and, if requested, assist in confirming American CareSource Holdings’ ownership of new ideas, developments, discoveries or inventions conceived during employment, and requiring assignment to American CareSource Holdings of proprietary rights to such matters that are related to American CareSource Holdings’ business. There can be no assurance that the steps taken by American CareSource Holdings to protect its intellectual property will be successful. If American CareSource Holdings does not adequately protect its intellectual property, competitors may be able to use its technologies and erode or negate its competitive advantage.
Fluctuations in the number and types of claims processed could make it more difficult to predict American CareSource Holdings’ revenues from quarter to quarter.
Monthly fluctuations in the number of claims American CareSource Holdings processes and the types of claims they process will impact the quarterly and annual results of the Company. American CareSource
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Holdings’ discount rate varies by type of service provided and the overall mix of these claims will impact profitability. Consequently, it will be difficult to predict the revenue for American CareSource Holdings from one quarter to another quarter.
Future sales of American CareSource Holdings common stock, or the perception that these sales may occur, could depress the price of American CareSource Holdings’ common stock.
Sales of substantial amounts of American CareSource Holdings common stock, or the perception in the public that such sales may occur, could cause the market price of American CareSource Holdings common stock to decline. This could also impair the ability of American CareSource Holdings to raise additional capital through the sale of equity securities. As of July 25, 2006, American CareSource Holdings has 14,472,248 shares of common stock outstanding. At July 25, 2006, there are outstanding warrants to purchase 1,897,502 shares of common stock and 2,249,329 shares are available for grant (1,809,442 shares have been granted and 1,675,222 options are outstanding as of July 25, 2006) under the American CareSource Holdings, Inc. 2005 Stock Option Plan. If all of the outstanding warrants are exercised and all options available under the American CareSource Holdings, Inc. 2005 Stock Option Plan are issued and exercised, there will be approximately 18,517,540 shares of common stock outstanding. Accordingly, American CareSource Holdings stockholders could experience significant dilution. In addition, American CareSource Holdings will file a registration statement that will register for resale substantially all of its restricted securities, the effect of which could have a depressive effect on the market price of the common stock.
Some of our existing stockholders can exert control over us and may not make decisions that further the best interests of all stockholders.
As of July 25, 2006, our officers, directors and principal stockholders (greater that 5% stockholders) together control beneficially approximately 45.9% of our outstanding common stock. As a result, these stockholders, if they act individually or together, may exert a significant degree of influence over our management and affairs and over matters requiring stockholder approval, including the election of directors and approval of significant corporate transactions. Furthermore, the interests of this concentration of ownership may not always coincide with our interests or the interests of other stockholders and accordingly, they could cause us to enter into transactions or agreements which we would not otherwise consider. In addition, this concentration of ownership may delay or prevent a merger or acquisition resulting in a change in control of us and might affect the market price of our common stock, even when such a change in control may be in the best interest of all stockholders.
Our common stock qualifies as a “penny stock” under Securities and Exchange Commission rules which may make it more difficult for our stockholders to resell their shares of our common stock.
American CareSource Holdings’ common stock trades on the OTC Bulletin Board. As a result, the holders of American CareSource Holdings common stock may find it more difficult to obtain accurate quotations concerning the market value of the stock. Stockholders also may experience greater difficulties in attempting to sell the stock than if it were listed on a stock exchange or quoted on the Nasdaq National Market or the Nasdaq Small-Cap Market. Because our common stock does not trade on a stock exchange or on the Nasdaq National Market or the Nasdaq Small-Cap Market, and the market price of the common stock is, at times, less than $5.00 per share, the common stock qualifies as a “penny stock.” SEC Rule 15g-9 under the Securities Exchange Act, of 1934, as amended (the “Exchange Act”) imposes additional sales practice requirements on broker-dealers that recommend the purchase or sale of penny stocks to persons other than those who qualify as an “established customer” or an “accredited investor.” This includes the requirement that a broker-dealer must make a determination on the appropriateness of investments in penny stocks for the customer and must make special disclosures to the customer concerning the risks of penny stocks. Application of the penny stock rules to our common stock could adversely affect the market liquidity of the shares, which in turn may affect the ability of holders of our common stock to resell the stock.
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PART II. OTHER INFORMATION
Item 1. Legal Proceedings.
On March 1, 2006, Dayton Area Health Plan and CareSource Management Group, Co. Inc. (collectively “DAHP”), wrote a letter to American CareSource Holdings informing American CareSource Holdings that it believed American CareSource Holdings is infringing on the designation “CARESOURCE”. DAHP represented to the United States Patent and Trademark Office that it first used the “CARESOURCE” designation on August 25, 2000. American Caresource Holdings, which is the successor-in-interest to Physician’s Referral Network and Patient Infosystems had used the designation “AMERICAN CARESOURCE,” “CARESOURCE,” and other similar designations in connection with its ancillary care business since May 9, 1996. Accordingly, American Caresource Holdings, demanded that DAHP, cease and desist from all use of the “CARESOURCE” designation and related designations, and abandon its registrations of such mark and related marks. No assurance can be given that American CareSource Holdings will prevail or that it will not be required to cease use of the name itself or that it will not incur costs or expenses in connection with the action.
On April 24, 2006, Ancillary Care Management, Inc. (“ACM”) wrote a letter to American CareSource Holdings informing American CareSource Holdings that it believed that American CareSource Holdings’ wholly owned subsidiary Ancillary Care Services is infringing on ACM’s registered mark “ANCILLARY CARE MANAGEMENT”. ACM has asked American CareSource Holdings and Ancillary Care Services to cease and desist the use of the designations ANCILLARY CARE SERVICES, ANCILLARY CARE or any other designations similar to ANCILLARY CARE MANAGEMENT. American CareSource Holdings believes that the claim is without merit and that its use is valid. However, no assurance can be given that American CareSource Holdings will prevail or that it will not be required to cease use of the name itself or that it will not incur costs or expenses in connection with the action.
Item 5. Other Information.
American CareSource Holdings filed a registration statement on Form S-8 covering the 2,249,329 shares of its Employee Stock Option Plan on April 7, 2006. Additionally, on May 11, 2006 the Securities and Exchange Commission declared effective American CareSource Holding’s registration statement on Form SB-2 covering the resale of 4,292,280 shares of common stock from time to time by certain selling stockholders listed therein. Of such shares, (i) 1,859,310 shares were issued pursuant to the distribution by dividend of American CareSource Holdings’ common stock by Patient Infosystems to investors in its October 2005 private offering; (ii) 273,618 shares were issued pursuant to the distribution by dividend of shares of American CareSource Holdings’ common stock by Patient Infosystems as payment of dividends in the October 2005 dividend distribution of Patient Infosystems’ common stock to its Series C and Series D preferred stockholders of Patient Infosystems; and (iii) 2,159,352 shares were issued by American CareSource Holdings in its March 2006 private placement. Of the above amounts, 313,470 shares are issuable upon exercise of certain common stock purchase warrants issued as compensation to Laidlaw & Company (UK) Ltd. for acting as the placement agent in connection with the March 2006 private placement.
On May 23, 2006, David A. George was elected to serve on the American CareSource Holdings, Inc. Board of Directors. Mr. George serves as the chairman of the Compensation Committee and serves as a member of the Corporate Governance Committee. Also on May 23, 2006, American CareSource Holdings Board of Directors adopted a charter for its Governances and Nomination Committee and Compensation Committee.
On June 14, 2006, the Company entered into a new lease for 9,349 square feet of office space that will commence on September 1, 2006. The Company plans to use the new space as its primary office space and will vacate its existing office space.
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Item 6. Exhibits.
Exhibit # | Description of Exhibits |
3.1(2) | Certificate of Incorporation |
3.2(2) | By-Laws |
3.3(4) | Amendment to the Certificate of Incorporation, dated May 25, 2005. |
3.4(4) | Amendment to the Certificate of Incorporation, dated June 2, 2005. |
3.5(7) | Amendment to the Certificate of Incorporation, dated November 14, 2005. |
3.6(10) | Certificate of Incorporation of Ancillary Care Services – Group Health, Inc. |
3.7(10) | Certificate of Incorporation of Ancillary Care Services – Medicare, Inc. |
3.8(10) | Certificate of Incorporation of Ancillary Care Services – Worker’s Compensation, Inc. |
3.9(10) | Certificate of Incorporation of Ancillary Care Services, Inc. |
4.1(2) | 2005 Stock Option Plan. |
4.2(3) | Specimen Stock Certificate. |
10.01(3) | Employment Agreement, dated October 11, 2004 between the American CareSource Holdings and Wayne A. Schellhammer. |
10.02(3) | Employment Agreement, dated May 1, 2005, between the American CareSource Holdings and David Boone. |
10.03(2) | Commercial Lease, dated July 1, 1998, between Today Tristar, L.P. and American CareSource Corporation, as amended. |
10.04(2) | Lease, dated July 1, 2002, between Madison Square Park, LLC and American CareSource Corporation. |
10.05(2) | Credit Agreement, dated December 1, 2004, between Well Fargos Bank, National Association and American CareSource Holdings, Inc. |
10.06(2) | Security Agreement, dated December 1, 2004, between Well Fargo Bank, National Association and American CareSource Holdings, Inc. |
10.07(2) | First Addendum to Credit Agreement dated February 2, 2005 between Well Fargo Bank, National Association and American CareSource Holdings, Inc. |
10.08(3) | Guaranty, dated January 26, 2005, by and between Wells Fargo Bank, National Association, American CareSource Holdings, Inc. and Derace L. Schaffer. |
10.09(3) | Guaranty, dated January 26, 2005, by and between Wells Fargo Bank, National Association, American Caresource Holdings, Inc. and John Pappajohn. |
10.10(3) | Stock Purchase Warrant, dated January 27, 2005, by and between American CareSource Holdings, Inc. and Derace L. Schaffer. |
10.11(8) | Corrected Stock Purchase Warrant, dated January 27, 2005, by and between American CareSource Holdings, Inc. and John Pappajohn. |
10.12(3) | Transitional Services Agreement, by and between Patient Infosystems, Inc. and American CareSource Holdings, Inc. |
10.13(6) | Second Addendum to Credit Agreement dated August 9, 2005 between Wells Fargo Bank, National Association and American CareSource Holdings, Inc. |
10.14(5) | Consent to Second Addendum to Credit Agreement, Ratification of Guaranty and Waiver of Claims, dated August 9, 2005 from John Pappajohn. |
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10.15(5) | Consent to Second Addendum to Credit Agreement, Ratification of Guaranty and Waiver of Claims, dated August 9, 2005 from Derace L. Schaffer. |
10.16(5) | Consent to Second Addendum to Credit Agreement, Ratification of Guaranty and Waiver of Claims, dated August 9, 2005 from Matthew P. Kinley. |
10.17(5) | Guaranty, dated August 9, 2005, by and among Wells Fargo Bank, National Association, American Caresource Holdings, Inc. and John Pappajohn. |
10.18(5) | Guaranty, dated August 9, 2005, by and among Wells Fargo Bank, National Association, American CareSource Holdings, Inc. and Derace L. Schaffer. |
10.19(5) | Guaranty, dated August 9, 2005, by and among Wells Fargo Bank, National Association, American CareSource Holdings, Inc. and Matthew P. Kinley. |
10.20(5) | Guarantors’ Letter, dated August 9, 2005 by and among Wells Fargo Bank, National Association, John Pappajohn, Derace L. Schaffer and Matthew P. Kinley. |
10.21(5) | Creditor Agreement, dated August 26, 2005 among American CareSource Holdings, Inc., John Pappajohn, Derace L. Schaffer and Matthew P. Kinley. |
10.22(5) | Stock Purchase Warrant, dated August 15, 2005, by and among American CareSource Holdings, Inc. and John Pappajohn. |
10.23(5) | Stock Purchase Warrant, dated August 15, 2005, by and among American Caresource Holdings, Inc. and Derace L. Schaffer. |
10.24(5) | Stock Purchase Warrant, dated August 15, 2005, by and among American Caresource Holdings, Inc. and Matthew P. Kinley. |
10.25(9) | Third Addendum to the Credit Agreement, dated December 28, 2005, by and between Wells Fargo Bank, National Association and American CareSource Holdings, Inc. |
10.26(9) | Consent to Third Addendum to Credit Agreement, Ratification of Guaranty and Waiver of Claims, dated December 28, 2005 from John Pappajohn. |
10.27(9) | Guaranty, dated December 28, 2005, by and among Wells Fargo Bank, National Association, American CareSource Holdings, Inc. and John Pappajohn. |
10.28(10) | Form of Registration Rights Agreement used in March 2006 private placement. |
10.29(10) | Form of Subscription Agreement used in March 2006 private placement. |
10.30(10) | Amended and Restated Stock Purchase Warrant, dated March 30, 2006, by and between American CareSource Holdings, Inc. and John Pappajohn (amends Stock Purchase Warrant, dated January 27, 2005). |
10.31(10) | Amended and Restated Stock Purchase Warrant, dated March 29, 2006, by and between American CareSource Holdings, Inc. and Derace L. Schaffer (amends Stock Purchase Warrant, dated January 27, 2005). |
10.31(10) | Amended and Restated Stock Purchase Warrant, dated March 29, 2006, by and between American CareSource Holdings, Inc. and John Pappajohn (amends Stock Purchase Warrant, dated August 15, 2005). |
10.32(10) | Amended and Restated Stock Purchase Warrant, dated March 29, 2006, by and between American CareSource Holdings, Inc. and Derace L. Schaffer (amends Stock Purchase Warrant, dated August 15, 2005). |
10.33(10) | Amended and Restated Stock Purchase Warrant, dated March 30, 2006, by and between American CareSource Holdings, Inc. and Matthew P. Kinley (amends Stock Purchase Warrant, dated January 27, 2005). |
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10.34 | Lease dated June 14, 2006 between American CareSource Holding and TR LBJ Campus Partners, L.P. |
14.1(10) | Code of Ethics |
20.1 | Governance and Nomination Committee Charter |
20.2 | Audit Committee Charter |
20.3 | Compensation Committee Charter |
31.1 | Certification of the Chief Executive Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. |
31.2 | Certification of the Chief Financial Officer and Chief Operating Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. |
31.3 | Certification of the Principal Accounting Officer and Controller pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. |
32.1 | Certification pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. |
(1) | Previously filed with the Securities and Exchange Commission as an Exhibit to the Form SB-2 filed on February 14, 2005 and incorporated herein by reference. |
(2) | Previously filed with the Securities and Exchange Commission as an Exhibit to Amendment No. 1 to the Form SB-2 filed May 13, 2005 and incorporated herein by reference. |
(3) | Previously filed with the Securities and Exchange Commission as an Exhibit to Amendment No. 2 to the Form SB-2 filed June 15, 2005 and incorporated herein by reference. |
(4) | Previously filed with the Securities and Exchange Commission as an Exhibit to Amendment No. 5 to the Form SB-2 filed August 12, 2005 and incorporated herein by reference. |
(5) | Previously filed with the Securities and Exchange Commission as an Exhibit to Amendment No. 6 to the Form SB-2 filed September 14, 2005 and incorporated herein by reference. |
(6) | Previously filed with the Securities and Exchange Commission as an Exhibit to Amendment No. 7 to the Form SB-2 filed September 30, 2005 and incorporated herein by reference. |
(7) | Previously filed with the Securities and Exchange Commission as an Exhibit to Amendment No. 8 to the Form SB-2 filed November 18, 2005 and incorporated herein by reference. |
(8) | Previously filed with the Securities and Exchange Commission as an Exhibit to Amendment No. 9 to the Form SB-2 filed December 5, 2005 and incorporated herein by reference. |
(9) | Previously filed with the Securities and Exchange Commission as an Exhibit to the Form 8-K/A filed January 13, 2006 and incorporated herein by reference. |
(10) | Previously filed with the Securities and Exchange Commission as an Exhibit to the Form 10-KSB filed March 31, 2006 and incorporated herein by reference. |
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SIGNATURES
In accordance with the requirements of the Exchange Act of 1934, the registrant caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.
| | | | American CareSource Holdings, Inc. |
Date: | August 11, 2006 | | By: | /s/ Wayne A. Schellhammer |
| | | | Wayne A. Schellhammer Chief Executive Officer |
| | | | |
Date: | August 11, 2006 | | By: | /s/ David S. Boone |
| | | | David S. Boone Chief Operating Officer and Chief Financial Officer |
| | | | |
Date: | August 11, 2006 | | By: | /s/ Steven M. Phillips |
| | | | Steven M. Phillips Controller and Principal Accounting Officer |
| | | | |
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