EXHIBIT 32.1

                  CERTIFICATION OF PRINCIPAL EXECUTIVE OFFICER
                       PURSUANT TO 18 U.S.C. SECTION 1350

In connection with the accompanying Annual Report on Form 10-K of HMS Holdings
Corp. for the year ended December 31, 2003, I, William F. Miller III, Chairman
and Chief Executive Officer of HMS Holdings Corp., hereby certify pursuant to 18
U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley
Act of 2002, to the best of my knowledge and belief, that:

                                    (1) such Annual Report on Form 10-K for the
                                    year ended December 31, 2003, fully complies
                                    with the requirements of section 13(a) or
                                    15(d) of the Securities Exchange Act of
                                    1934; and

                                    (2) the information contained in such Annual
                                    Report on Form 10-K for the year ended
                                    December 31, 2003, fairly presents, in all
                                    material respects, the financial condition
                                    and results of operations of HMS Holdings
                                    Corp.

                       /S/ WILLIAM F. MILLER III
                       ------------------------------------
                       WILLIAM F. MILLER III
                       Chairman and Chief Executive Officer

March 26, 2004

A signed copy of this written statement required by Section 906 has been
provided to HMS Holdings, Inc. and will be retained by HMS Holdings, Inc. and
furnished to the Securities and Exchange Commission or its staff upon request.