FORM 10-Q
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 10-Q
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QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE QUARTERLY PERIOD ENDED DECEMBER 31, 2008 |
OR
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o |
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TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934 |
For the transition period from
to
Commission File Number 001-12115
CONTINUCARE CORPORATION
(Exact Name of Registrant as Specified in Its Charter)
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Florida
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59-2716023 |
(State or Other Jurisdiction of
Incorporation or Organization)
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(IRS Employer Identification No.) |
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7200 Corporate Center Drive |
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Suite 600 |
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Miami, Florida
(Address of Principal Executive Offices)
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33126
(Zip Code) |
(305) 500-2000
(Registrants Telephone Number, Including Area Code)
Securities registered pursuant to Section 12(b) of the Act:
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Title of Each Class
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Name of Each Exchange On Which Registered |
COMMON STOCK
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NEW YORK STOCK EXCHANGE |
$.0001 PAR VALUE
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ALTERNEXT US |
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by
Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months, and (2)
has been subject to such filing requirements for the past 90 days. Yes x No o
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a
non-accelerated filer, or a smaller reporting company. See the definitions of large accelerated
filer, accelerated filer, and smaller reporting company in Rule 12b-2 of the Exchange Act.
(Check one):
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Large accelerated filer o
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Accelerated filer x
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Non-accelerated filer o
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Smaller reporting company o |
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(Do not check if a smaller reporting company) |
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Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the
Exchange Act). Yes o No x
At January 30, 2009, the Registrant had 59,808,481 shares of $0.0001 par value common stock
outstanding.
CONTINUCARE CORPORATION
INDEX
2
PART I FINANCIAL INFORMATION
ITEM 1. FINANCIAL STATEMENTS
CONTINUCARE CORPORATION
CONDENSED CONSOLIDATED BALANCE SHEETS
(Unaudited)
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December 31, |
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June 30, |
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2008 |
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2008 |
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ASSETS |
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Current assets: |
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Cash and cash equivalents |
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$ |
7,982,960 |
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$ |
9,905,740 |
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Due from HMOs, net of a liability for incurred
but not reported medical claims of
approximately $20,678,000 and $23,900,000 at
December 31, 2008 and June 30, 2008,
respectively |
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13,045,227 |
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15,325,783 |
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Prepaid expenses and other current assets |
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1,226,717 |
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708,841 |
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Deferred income tax assets |
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381,774 |
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413,932 |
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Total current assets |
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22,636,678 |
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26,354,296 |
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Certificates of deposit, restricted |
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1,287,542 |
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1,274,147 |
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Property and equipment, net |
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8,965,893 |
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8,363,427 |
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Goodwill |
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73,204,582 |
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73,204,582 |
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Intangible assets, net of accumulated amortization
of approximately $2,787,000 and $2,168,000 at
December 31, 2008 and June 30, 2008, respectively |
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5,873,000 |
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6,492,333 |
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Deferred income tax assets |
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2,647,794 |
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2,574,472 |
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Other assets, net |
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285,114 |
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227,047 |
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Total assets |
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$ |
114,900,603 |
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$ |
118,490,304 |
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LIABILITIES AND SHAREHOLDERS EQUITY |
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Current liabilities: |
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Accounts payable |
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$ |
442,030 |
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$ |
402,718 |
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Accrued expenses and other current liabilities |
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3,134,475 |
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4,458,119 |
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Income taxes payable |
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97,095 |
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1,198,722 |
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Total current liabilities |
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3,673,600 |
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6,059,559 |
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Deferred income tax liabilities |
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6,224,588 |
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6,256,205 |
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Other liabilities |
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964,586 |
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948,263 |
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Total liabilities |
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10,862,774 |
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13,264,027 |
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Commitments and contingencies |
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Shareholders equity: |
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Common stock, $0.0001 par value: 100,000,000
shares authorized; 60,945,781 shares issued and
outstanding at December 31, 2008 and 64,796,303
shares issued and outstanding at June 30, 2008 |
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6,095 |
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6,480 |
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Additional paid-in capital |
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107,170,845 |
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114,514,853 |
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Accumulated deficit |
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(3,139,111 |
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(9,295,056 |
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Total shareholders equity |
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104,037,829 |
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105,226,277 |
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Total liabilities and shareholders equity |
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$ |
114,900,603 |
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$ |
118,490,304 |
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THE ACCOMPANYING NOTES ARE AN INTEGRAL PART
OF THESE CONSOLIDATED FINANCIAL STATEMENTS
3
CONTINUCARE CORPORATION
CONDENSED CONSOLIDATED STATEMENTS OF INCOME (Unaudited)
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Three Months Ended |
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December 31, |
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2008 |
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2007 |
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Revenue |
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$ |
65,539,894 |
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$ |
61,485,447 |
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Operating expenses: |
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Medical services: |
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Medical claims |
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45,148,703 |
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43,847,320 |
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Other direct costs |
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7,144,073 |
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6,940,714 |
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Total medical services |
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52,292,776 |
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50,788,034 |
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Administrative payroll and employee benefits |
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3,120,450 |
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2,689,879 |
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General and administrative |
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4,193,438 |
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4,156,778 |
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Total operating expenses |
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59,606,664 |
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57,634,691 |
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Income from operations |
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5,933,230 |
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3,850,756 |
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Other income (expense): |
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Interest income |
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47,688 |
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201,390 |
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Interest expense |
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(5,055 |
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(4,536 |
) |
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Income before income tax provision |
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5,975,863 |
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4,047,610 |
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Income tax provision |
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2,316,053 |
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1,535,925 |
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Net income |
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$ |
3,659,810 |
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$ |
2,511,685 |
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Net income per common share: |
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Basic |
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$ |
.06 |
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$ |
.04 |
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Diluted |
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$ |
.06 |
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$ |
.04 |
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Weighted average common shares outstanding: |
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Basic |
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61,813,969 |
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69,816,147 |
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Diluted |
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62,912,031 |
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70,970,949 |
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THE ACCOMPANYING NOTES ARE AN INTEGRAL PART
OF THESE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
4
CONTINUCARE CORPORATION
CONDENSED CONSOLIDATED STATEMENTS OF INCOME (Unaudited)
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Six Months Ended |
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December 31, |
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2008 |
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2007 |
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Revenue |
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$ |
130,604,529 |
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$ |
122,408,109 |
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Operating expenses: |
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Medical services: |
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Medical claims |
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92,465,994 |
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88,724,515 |
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Other direct costs |
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14,301,926 |
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13,533,793 |
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Total medical services |
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106,767,920 |
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102,258,308 |
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Administrative payroll and employee benefits |
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5,854,007 |
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5,423,114 |
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General and administrative |
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8,046,759 |
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7,931,108 |
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Total operating expenses |
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120,668,686 |
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115,612,530 |
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Income from operations |
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9,935,843 |
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6,795,579 |
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Other income (expense): |
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Interest income |
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123,791 |
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360,503 |
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Interest expense |
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(8,097 |
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(11,954 |
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Income before income tax provision |
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10,051,537 |
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7,144,128 |
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Income tax provision |
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3,895,592 |
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2,710,947 |
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Net income |
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$ |
6,155,945 |
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$ |
4,433,181 |
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Net income per common share: |
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Basic |
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$ |
.10 |
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$ |
.06 |
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Diluted |
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$ |
.10 |
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$ |
.06 |
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Weighted average common shares outstanding: |
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Basic |
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63,136,805 |
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69,928,201 |
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Diluted |
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64,255,154 |
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71,102,303 |
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THE ACCOMPANYING NOTES ARE AN INTEGRAL PART
OF THESE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
5
CONTINUCARE CORPORATION
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited)
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Six Months Ended |
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December 31, |
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2008 |
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2007 |
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CASH FLOWS FROM OPERATING ACTIVITIES |
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Net income |
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$ |
6,155,945 |
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$ |
4,433,181 |
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Adjustments to reconcile net income to net cash provided by operating activities: |
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Depreciation and amortization |
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1,085,838 |
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1,239,607 |
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Loss on disposal of fixed assets |
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22,434 |
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Provision for bad debts |
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181,081 |
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Compensation expense related to issuance of stock options |
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578,337 |
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637,303 |
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Deferred tax expense |
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(72,781 |
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(212,891 |
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Changes in operating assets and liabilities: |
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Due from HMOs, net |
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2,280,556 |
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4,599,115 |
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Prepaid expenses and other current assets |
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(517,876 |
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101,846 |
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Other assets, net |
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(89,677 |
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(19,002 |
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Accounts payable |
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39,312 |
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(327,033 |
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Accrued expenses and other current liabilities |
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(1,359,200 |
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(981,567 |
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Income taxes payable |
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(1,101,627 |
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523,837 |
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Net cash provided by operating activities |
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7,021,261 |
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10,175,477 |
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CASH FLOWS FROM INVESTING ACTIVITIES |
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Purchase of certificates of deposit |
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(13,395 |
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(90,219 |
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Purchase of property and equipment |
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(956,128 |
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(603,965 |
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Net cash used in investing activities |
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(969,523 |
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(694,184 |
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CASH FLOWS FROM FINANCING ACTIVITIES |
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Repayment on long-term debt |
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(6,083 |
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Principal repayments under capital lease obligations |
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(51,788 |
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(17,522 |
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Proceeds from exercise of stock options |
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10,625 |
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64,375 |
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Payment of fees related to issuance of stock |
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(45,000 |
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Repurchase and retirement of common stock |
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(7,933,355 |
) |
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(1,459,157 |
) |
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Net cash used in financing activities |
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(7,974,518 |
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(1,463,387 |
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Net (decrease) increase in cash and cash equivalents |
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(1,922,780 |
) |
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8,017,906 |
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Cash and cash equivalents at beginning of period |
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9,905,740 |
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7,262,247 |
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Cash and cash equivalents at end of period |
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$ |
7,982,960 |
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$ |
15,280,153 |
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SUPPLEMENTAL DISCLOSURE OF NONCASH INVESTING AND FINANCING ACTIVITIES: |
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Purchase of property and equipment with proceeds of capital lease obligations |
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$ |
103,667 |
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$ |
38,922 |
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SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION: |
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Cash paid for taxes |
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$ |
5,070,000 |
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$ |
2,400,000 |
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Cash paid for interest |
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$ |
8,097 |
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$ |
11,954 |
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THE ACCOMPANYING NOTES ARE AN INTEGRAL PART
OF THESE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
6
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
DECEMBER 31, 2008
(UNAUDITED)
NOTE 1 UNAUDITED INTERIM INFORMATION
The accompanying unaudited condensed consolidated financial statements of Continucare Corporation
(Continucare or the Company) have been prepared in accordance with accounting principles
generally accepted in the United States for interim financial information and with the instructions
to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the
information and footnotes required by accounting principles generally accepted in the United States
for complete financial statements. In the opinion of management, all adjustments (consisting of
normal recurring accruals) considered necessary for a fair presentation have been included.
Operating results for the three and six-month periods ended December 31, 2008 are not necessarily
indicative of the results that may be reported for the remainder of the fiscal year ending June 30,
2009 or future periods. Except as otherwise indicated by the context, the terms the Company or
Continucare mean Continucare Corporation and its consolidated subsidiaries. All references to a
fiscal year refer to the Companys fiscal year which ends June 30. As used herein, Fiscal 2009
refers to the fiscal year ending June 30, 2009, Fiscal 2008 refers to the fiscal year ended June
30, 2008, and Fiscal 2007 refers to the fiscal year ended June 30, 2007.
The balance sheet at June 30, 2008 has been derived from the audited financial statements at that
date but does not include all of the information and footnotes required by accounting principles
generally accepted in the United States for complete financial statements.
For further information, refer to the consolidated financial statements and footnotes thereto
included in the Companys Annual Report on Form 10-K for Fiscal 2008. These interim condensed
consolidated financial statements should be read in conjunction with the consolidated financial
statements and notes to consolidated financial statements included in that report.
Certain reclassifications have been made to the prior year amounts to conform to the current year
presentation.
NOTE 2 GENERAL
The Company is a provider of primary care physician services on an outpatient basis in Florida.
The Company provides medical services to patients through employee physicians, advanced registered
nurse practioners and physicians assistants. Additionally, the Company provides practice
management services to independent physician affiliates (IPAs). Substantially all of the
Companys revenue is derived from managed care agreements with three health maintenance
organizations, Humana Medical Plans, Inc. (Humana), Vista Healthplan of South Florida, Inc. and
its affiliated companies including Summit Health Plan, Inc. (Vista) and Wellcare Health Plans,
Inc. and its affiliated companies (Wellcare) (collectively, the HMOs). The Company was
incorporated in 1996 as the successor to a Florida corporation formed earlier in 1996.
NOTE 3 ACQUISITION
Effective October 1, 2006, the Company completed its acquisition (the Acquisition) of Miami Dade
Health Centers, Inc. and its affiliated companies (collectively, the MDHC Companies). In
connection with the completion of the Acquisition and in consideration for the assets acquired
pursuant to the Acquisition, the Company paid the MDHC Companies approximately $6.7 million in
cash, issued to the MDHC Companies 19.7 million shares of the Companys common stock and assumed or
repaid certain indebtedness and liabilities of the MDHC Companies.
The purchase price, including acquisition costs, of approximately $66.2 million has been allocated
to the estimated fair value of acquired tangible assets of $13.9 million, identifiable intangible
assets of $8.7 million and assumed liabilities of $15.3 million as of October 1, 2006, resulting in
goodwill totaling $58.9 million. This purchase price allocation includes certain adjustments
recorded during the three-month period ended September 30, 2007 that resulted in a decrease in
goodwill of approximately $0.5 million. These adjustments primarily related to Medicare risk
adjustment payments relating to the operations of the MDHC Companies for periods prior to
completion of our acquisition. The identifiable intangible assets of $8.7 million consist of
estimated fair values of $1.6 million assigned to the trade name, $6.2 million to customer
relationships and $0.9 million to a noncompete agreement.
7
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
DECEMBER 31, 2008
(UNAUDITED)
The trade name was determined to have an
estimated useful life of six years and the customer relationships and
noncompete agreements were each determined to have an estimated useful life of eight and five
years, respectively. The fair values of the customer relationships and other identifiable
intangible assets are amortized over their estimated lives using the straight-line method. The
customer relationships are non-contractual. The fair value of the identifiable intangible assets
was determined, with the assistance of an outside valuation firm, based on standard valuation
techniques. The Acquisition consideration of $66.2 million includes the estimated fair value of
Continucares common stock issued to the MDHC Companies of $58.5 million, cash paid to the
principal owners of $5.7 million at the closing of the Acquisition, cash paid to the principal
owners of $1.0 million in October 2007, and acquisition costs of approximately $1.0 million.
NOTE 4 RECENT ACCOUNTING PRONOUNCEMENTS
In December 2007, the FASB issued SFAS No. 141 (revised 2007), Business Combinations (SFAS No.
141R). SFAS No. 141R expands the definition of a business combination and requires the fair value
of the purchase price of an acquisition, including the issuance of equity securities, to be
determined on the acquisition date. SFAS No. 141R also requires that all assets, liabilities,
contingent consideration, and contingencies of an acquired business be recorded at fair value at
the acquisition date. In addition, SFAS No. 141R requires that acquisition costs generally be
expensed as incurred, restructuring costs generally be expensed in periods subsequent to the
acquisition date and changes in accounting for deferred income tax asset valuation allowances and
acquired income tax uncertainties after the measurement period impact income tax expense. SFAS No.
141R is effective for the Companys fiscal years beginning on or after December 15, 2008, with
early adoption prohibited. The effect of SFAS No. 141R on the Companys financial statements will
be dependent on the nature and terms of any business combination consummated by the Company on or
after July 1, 2009.
In December 2007, the FASB issued SFAS No. 160, Noncontrolling Interests in Consolidated Financial
Statements, an Amendment of ARB No. 51 (SFAS No. 160). SFAS No. 160 requires minority interests
to be recharacterized as noncontrolling interests and reported as a component of equity. In
addition, SFAS No. 160 requires that purchases or sales of equity interests that do not result in a
change in control be accounted for as equity transactions and, upon a loss of control, requires the
interests sold, as well as any interests retained, to be recorded at fair value with any gain or
loss recognized in earnings. SFAS No. 160 is effective for fiscal years beginning on or after
December 15, 2008, with early adoption prohibited. No material impact on the Companys financial
statements is expected from the adoption of this standard.
In March 2008, the FASB issued SFAS No. 161, Disclosures about Derivatives and Hedging
Activities, which enhances the requirements under SFAS No. 133, Accounting for Derivatives and
Hedging Activities. SFAS No. 161 requires enhanced disclosures about an entitys derivatives and
hedging activities and how they affect an entitys financial position, financial performance, and
cash flows. This Statement will be effective for fiscal years and interim periods beginning after
November 15, 2008. No material impact on the Companys financial statements is expected from the
adoption of this standard.
NOTE 5 SHARE-BASED PAYMENT
The Company accounts for share-based compensation expense under SFAS No. 123(R), Share-Based
Payment, which is a revision of SFAS No. 123 (SFAS 123(R)), using the modified prospective
transition method.
The Company calculates the fair value for employee stock options using a Black-Scholes option
pricing model at the time the stock options are granted and that amount is amortized over the
vesting period of the stock options, which is generally up to four years. The fair value for
employee stock options granted during the three-month periods ended December 31, 2008 and 2007 was
calculated based on the following assumptions: risk-free interest rate ranging from 0.75% to 1.76%
and 3.01% to 3.49%, respectively; dividend yield of 0%; volatility factor of the expected market
price of the Companys common stock of 59.3% and 59.0%, respectively; and weighted-average expected
life of the options ranging from 3 to 6 years depending on the vesting provisions of each option.
The fair value for employee stock options granted during the six-month periods ended December 31,
2008 and 2007 was calculated based on the following assumptions: risk-free interest rate ranging
from 0.75% to 3.09% and 3.01% to
8
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
DECEMBER 31, 2008
(UNAUDITED)
4.22%, respectively; dividend yield of 0%; volatility factor of
the expected market price of the Companys common stock of 58.1% and
59.5%, respectively; and weighted-average expected life of the options ranging from 3 to 6 years
depending on the vesting provisions of each option. The expected life of the options is based on
the historical exercise behavior of the Companys employees. The expected volatility factor is
based on the historical volatility of the market price of the Companys common stock as adjusted
for certain events that management deemed to be non-recurring and non-indicative of future events.
For each of the three-month periods ended December 31, 2008 and 2007, the Company recognized
share-based compensation expense of $0.3 million. For each of the six-month periods ended December
31, 2008 and 2007, the Company recognized share-based compensation expense of $0.6 million. For
the three and six-month periods ended December 31, 2008 and 2007, the Company had no excess tax
benefits resulting from the exercise of stock options.
NOTE 6 DEBT
The Company has in place a credit facility that provides for a revolving loan to the Company of
$5.0 million (the Credit Facility) with a maturity date of December 31, 2009. The Credit
Facility has a variable interest rate at a per annum rate equal to the sum of 2.5% and the 30-day
Dealer Commercial Paper Rate (0.54% at December 31, 2008). The Credit Facility includes covenants
requiring the Company and its subsidiaries, on a consolidated basis, to maintain a tangible net
worth of $12 million and a debt coverage ratio of 1.25 to 1. Substantially all assets of the
Company serve as collateral for the Credit Facility.
In connection with the Acquisition, the Company entered into two term loan facilities funded out of
lines of credit (the Term Loans) with maximum loan amounts of $4.8 million and $1.0 million,
respectively. Each of the Term Loans requires mandatory monthly payments that reduce the lines of
credit under the Term Loans. Subject to the terms and conditions of the Term Loans, any prepayments
made to the Term Loans may be re-borrowed on a revolving basis so long as the line of credit
applicable to such Term Loan, as reduced by the mandatory monthly payment, is not exceeded. As of
December 31, 2008, the total maximum amount available for borrowing under the two Term Loans was
approximately $4.7 million. The $4.8 million and $1.0 million Term Loans mature on October 31,
2011 and October 31, 2010, respectively. Each of the Term Loans (i) has variable interest rates at
a per annum rate equal to the sum of 2.4% and the One-Month LIBOR (0.44% at December 31, 2008),
(ii) requires the Company and its subsidiaries, on a consolidated basis, to maintain a tangible net
worth of $12 million and a debt coverage ratio of 1.25 to 1 and (iii) are secured by substantially
all of the assets of the Company and its subsidiaries.
At December 31, 2008, there was no outstanding principal balance on the Credit Facility or the Term
Loans.
NOTE 7 EARNINGS PER SHARE
A reconciliation of the denominator of the basic and diluted earnings per share computation is as
follows:
9
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
DECEMBER 31, 2008
(UNAUDITED)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended |
|
|
Six Months Ended |
|
|
|
December 31, |
|
|
December 31, |
|
|
|
2008 |
|
|
2007 |
|
|
2008 |
|
|
2007 |
|
|
Basic weighted average number
of shares outstanding |
|
|
61,813,969 |
|
|
|
69,816,147 |
|
|
|
63,136,805 |
|
|
|
69,928,201 |
|
Dilutive effect of stock options |
|
|
1,098,062 |
|
|
|
1,154,802 |
|
|
|
1,118,349 |
|
|
|
1,174,102 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Dilutive weighted average
number of shares outstanding |
|
|
62,912,031 |
|
|
|
70,970,949 |
|
|
|
64,255,154 |
|
|
|
71,102,303 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Not included in calculation of
diluted earnings per share as
impact is antidilutive: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Stock options outstanding |
|
|
3,798,250 |
|
|
|
2,115,500 |
|
|
|
3,798,250 |
|
|
|
2,115,500 |
|
Warrants |
|
|
|
|
|
|
760,000 |
|
|
|
|
|
|
|
760,000 |
|
NOTE 8 INCOME TAXES
The Company accounts for income taxes under FASB Statement No. 109, Accounting for Income Taxes
(SFAS 109). Deferred income tax assets and liabilities are determined based upon differences
between the financial reporting and tax bases of assets and liabilities and are measured using the
enacted tax rates and laws that will be in effect when the differences are expected to reverse.
The Company recorded an income tax provision of $2.3 million and $1.5 million for the three-month
periods ended December 31, 2008 and 2007, respectively, and $3.9 million and $2.7 million for the
six-month periods ended December 31, 2008 and 2007, respectively.
Effective July 1, 2007, the Company adopted the provisions of Interpretation 48 (FIN 48),
Accounting for Uncertainty in Income Taxes An Interpretation of FASB Statement No. 109. The
implementation of FIN 48 had no impact on our liability for unrecognized tax benefits which was
approximately $0.8 million at December 31, 2008 and July 1, 2007 and is included in other
liabilities on the condensed consolidated balance sheet. The total amount of unrecognized tax
benefits that if recognized would affect the effective tax rate is $0.9 million, which includes
accrued interest and penalties of approximately $47,000 at December 31, 2008 and June 30, 2008. The
Company recognizes interest accrued related to unrecognized tax benefits in interest expense and
penalties in operating expense. The Company does not currently anticipate that the total amount of
unrecognized tax benefits will significantly increase or decrease by the end of Fiscal 2009. The
Company is no longer subject to tax examinations by tax authorities for fiscal years ended on or
prior to June 30, 2004.
NOTE 9 RELATED PARTY TRANSACTIONS
As a result of the Acquisition, the Company became a party to two lease agreements for office space
owned by Dr. Luis Cruz and Jose M. Garcia, principal owners of the MDHC Companies. Dr. Cruz is a
director of the Company and Mr. Garcia was an officer of the Company through January 15, 2009. The Company terminated one of
the lease agreements effective September 30, 2007. Expenses related to these leases were
approximately $0.1 million for each of the three-month periods ended December 31, 2008 and 2007,
and $0.2 million for each of the six-month periods ended December 31, 2008 and 2007.
Effective November 1, 2007, the Company entered into agreements with Centers of Medical Excellence,
Inc., an entity owned by Dr. Cruz pursuant to which this entity will act as one of the Companys
independent physician affiliates in connection with the provision of primary care health services
to a limited number of Medicare Advantage members enrolled in plans sponsored by CarePlus Health
Plans, Inc. The arrangement is on substantially similar terms to those between the Company and its
other independent physician affiliates under at risk arrangements where the Company provides
medical utilization services and pays a primary care capitation fee to the provider. Under this
arrangement, CarePlus pays the Company a global per member capitation fee and the Company in turn
pays a monthly primary care capitation fee to Centers of Medical Excellence based on the number of
CarePlus Medicare Advantage members who have selected Centers of Medical Excellence as their
primary care provider. Centers of Medical Excellence is also eligible to receive a bonus from the
Company if they operate in cumulative surplus. For the six-month period ended December 31, 2008,
the Company sustained an operating loss of $0.2 million under this arrangement.
On September 19, 2008, the Company purchased an aggregate of 400,000 shares of its common stock
from certain family trusts of Dr. Cruz. Dr. Cruz does not have a beneficial ownership in the
shares of common stock held by these family trusts. Continucare paid $2.14 per share for the
shares for an aggregate purchase price of $856,000. The per share purchase price paid by
Continucare represented a 10% discount from the closing price of Continucares common stock on
September 19, 2008.
10
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
DECEMBER 31, 2008
(UNAUDITED)
On September 19, 2008, the Company purchased an aggregate of 600,000 shares of its common stock
from Mr. Garcia. Continucare paid $2.14 per share for the shares for an aggregate purchase price
of $1,284,000. The per share purchase price paid by Continucare represented a 10% discount from
the closing price of Continucares common stock on September 19, 2008.
On October 23, 2008, the Company entered into a joint venture with Dr. Jacob Nudel, a director of
the Company, that will seek to establish special purpose medical provider networks. As of December
31, 2008, the Company had made capital contributions of approximately $80,000 to the joint venture.
On
January 15, 2009, the Company purchased an aggregate of 1,100,000
shares of its common stock from Mr. Garcia. Continucare paid $1.71
per share for the shares for an aggregate purchase price of
$1,881,000. The per share purchase price paid by Continucare was the
closing price of Continucares common stock on January 15,
2009.
NOTE 10 CONTINGENCIES
The Company is involved in legal proceedings incidental to its business that arise from time to
time in the ordinary course of business including, but not limited to, claims related to the
alleged malpractice of employed and contracted medical professionals, workers compensation claims
and other employee-related matters, and minor disputes with equipment lessors and other vendors.
The Company has recorded an accrual for claims related to legal proceedings, which includes amounts
for insurance deductibles and projected exposure, based on managements estimate of the ultimate
outcome of such claims. The Company does not believe that the ultimate resolution of these matters
will have a material adverse effect on the Companys business, results of operations, financial
condition, or cash flows.
However, the results of these matters cannot be predicted with certainty, and an unfavorable
resolution of one or more of these matters could have a material adverse effect on the Companys
business, results of operations, financial condition, cash flow, and prospects.
11
ITEM 2. MANAGEMENTS DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
Unless otherwise indicated or the context otherwise requires, all references in this Quarterly
Report on Form 10-Q to we, us, our, Continucare or the Company refers to Continucare
Corporation and its consolidated subsidiaries. All references to the MDHC Companies refer to
Miami Dade Health Centers, Inc. and its affiliated companies.
The following discussion and analysis should be read in conjunction with the unaudited
condensed consolidated financial statements and notes thereto appearing elsewhere in this Quarterly
Report on Form 10-Q.
General
We are a provider of primary care physician services. Through our network of 18 medical
centers, we provide primary care medical services on an outpatient basis. We also provide practice
management services to independent physician affiliates (IPAs) at 21 medical offices. All of our
medical centers and IPAs are located in Miami-Dade, Broward and Hillsborough Counties, Florida.
Substantially all of our revenues are derived from managed care agreements with three health
maintenance organizations (HMOs), Humana Medical Plans, Inc. (Humana), Vista Healthplan of
South Florida, Inc. and its affiliated companies including Summit Health Plan, Inc. (Vista) and
Wellcare Health Plans, Inc. and its affiliated companies (Wellcare). Our managed care agreements
with these HMOs are primarily risk agreements under which we receive for our services a monthly
capitated fee with respect to the patients assigned to us. The capitated fee is a percentage of
the premium that the HMOs receive with respect to those patients. In return, we assume full
financial responsibility for the provision of all necessary medical care to our patients even for
services we do not provide directly. For the six-month period ended December 31, 2008,
approximately 89% and 8% of our revenue was generated by providing services to Medicare-eligible
and Medicaid-eligible members, respectively, under such risk arrangements. As of December 31,
2008, we provided services to or for approximately 25,800 patients on a risk basis and
approximately 8,600 patients on a limited or non-risk basis. Additionally, we also provided
services to over 2,500 patients as of December 31, 2008 on a non-risk fee-for-service basis.
Medicare and Medicaid Considerations
Substantially all of our revenue is generated by providing services to Medicare-eligible
members and Medicaid-eligible members. The federal government and state governments, including
Florida, from time to time explore ways to reduce medical care costs through Medicare and Medicaid
reform, specifically, and through health care reform generally. Any changes that would limit,
reduce or delay receipt of Medicare or Medicaid funding or mandate increased benefit levels or any
developments that would disqualify us from receiving Medicare or Medicaid funding could have a
material adverse effect on our business, results of operations, prospects, financial results,
financial condition and cash flows. Due to the diverse range of medical care related proposals put
forth and the uncertainty of any proposals adoption, we cannot predict what impact any Medicare
reform proposal ultimately adopted may have on our business, financial position or results of
operations.
On January 1, 2006, the Medicare Prescription Drug Plan created by the Medicare Modernization
Act became effective. As a result, our HMO affiliates have established or expanded prescription
drug benefit plans for their Medicare Advantage members. Under the terms of our risk arrangements,
we are financially responsible for a substantial portion of the cost of the prescription drugs our
patients receive, and, in exchange, our HMO affiliates have agreed to provide us with an additional
per member capitated fee related to prescription drug coverage. However, there can be no assurance
that the additional fee that we receive will be sufficient to reimburse us for the additional costs
that we may incur under the Medicare Prescription Drug Plan.
In addition, the premiums our HMO affiliates receive from the Centers for Medicare and
Medicaid Services (CMS) for their Medicare Prescription Drug Plans is subject to periodic
adjustment, positive or negative, based upon the application of risk corridors that compare their
plans revenues targeted in their bids to actual prescription drug costs. Variances exceeding
certain thresholds may result in CMS making additional payments to the HMOs or require the HMOs to
refund to CMS a portion of the payments they received. Our contracted HMO
12
affiliates estimate and periodically adjust premium revenues related to the risk corridor payment
adjustment, and a portion of the HMOs estimated premium revenue adjustment is allocated to us. As
a result, the revenues recognized under our risk arrangements with our HMO affiliates are net of
the portion of the estimated risk corridor adjustment allocated to us. The portion of any such
risk corridor adjustment that the HMOs allocate to us may not directly correlate to the historical
utilization patterns of our patients or the costs that we may incur in future periods. Our HMO
affiliates allocated to us adjustments related to their risk corridor payments which had the effect
of reducing our operating income by approximately $0.3 million and $0.8 million, respectively,
during the three-month periods ended December 31, 2008 and 2007, and $1.0 million and $1.8 million,
respectively, during the six-month periods ended December 31, 2008 and 2007.
The Medicare Prescription Drug Plan has also been subject to significant public criticism and
controversy, and members of Congress have discussed possible changes to the program as well as ways
to reduce the programs cost to the federal government. We cannot predict what impact, if any,
these developments may have on the Medicare Prescription Drug Plan or on our future financial
results.
Critical Accounting Policies and Estimates
Our significant accounting policies are described in Note 2 to the consolidated financial
statements included in our Annual Report on Form 10-K for Fiscal 2008. Included within these
policies are certain policies which contain critical accounting estimates and, therefore, have been
deemed to be critical accounting policies. Critical accounting estimates are those which require
management to make assumptions about matters that were uncertain at the time the estimate was made
and for which the use of different estimates, which reasonably could have been used, or changes in
the accounting estimates that are reasonably likely to occur from period to period, could have a
material impact on the presentation of our financial condition, changes in financial condition or
results of operations.
We base our estimates and assumptions on historical experience, knowledge of current events
and anticipated future events, and we continuously evaluate and update our estimates and
assumptions. However, our estimates and assumptions may ultimately prove to be incorrect or
incomplete and our actual results may differ materially. We believe the following critical
accounting policies involve the most significant judgments and estimates used in the preparation of
our consolidated financial statements.
Revenue Recognition
Under our risk contracts with HMOs, we receive a percentage of premium or other capitated fee
for each patient that chooses one of our physicians as their primary care physician. Revenue under
these agreements is generally recorded in the period we assume responsibility to provide services
at the rates then in effect as determined by the respective contract. As part of the Medicare
Advantage program, CMS periodically recomputes the premiums to be paid to the HMOs based on updated
health status of participants and updated demographic factors. We record any adjustments to this
revenue at the time that the information necessary to make the determination of the adjustment is
received from the HMO.
Under our risk agreements, we assume responsibility for the cost of all medical services
provided to the patient, even those we do not provide directly, in exchange for a percentage of
premium or other capitated fee. To the extent that patients require more frequent or expensive
care, our revenue under a contract may be insufficient to cover the costs of care provided. When
it is probable that expected future health care costs and maintenance costs under a contract or
group of existing contracts will exceed anticipated capitated revenue on those contracts, we
recognize losses on our prepaid health care services with HMOs. No contracts were considered loss
contracts at December 31, 2008 because we have the right to terminate unprofitable physicians and
close unprofitable centers under our managed care contracts.
13
Under our limited risk and non-risk contracts with HMOs, we receive a capitation fee based on
the number of patients for which we are providing services on a monthly basis. The capitation fee
is recorded as revenue in the period in which services are provided as determined by the respective
contract.
Payments under both our risk contracts and our non-risk contracts (for both the Medicare
Advantage program as well as Medicaid) are also subject to reconciliation based upon historical
patient enrollment data. We record any adjustments to this revenue at the time that the
information necessary to make the determination of the adjustment is received from the HMO or the
applicable governmental body.
Medical Claims Expense Recognition
The cost of health care services provided or contracted for is accrued in the period in which
the services are provided. This cost includes our estimate of the related liability for medical
claims incurred in the period but not yet reported, or IBNR. IBNR represents a material portion of
our medical claims liability which is presented in the balance sheet net of amounts due from HMOs.
Changes in this estimate can materially affect, either favorably or unfavorably, our results of
operations and overall financial position.
We develop our estimate of IBNR primarily based on historical claims incurred per member per
month. We adjust our estimate if we have unusually high or low utilization or if benefit changes
provided under the HMO plans are expected to significantly increase or reduce our claims exposure.
We also adjust our estimate for differences between the estimated claims expense recorded in prior
months to actual claims expense as claims are paid by the HMO and reported to us. We use an
actuarial analysis as an additional tool to further corroborate our estimate of IBNR.
Based on our analysis, as of December 31, 2008, we recorded a liability of approximately $20.7
million for IBNR. The liability for IBNR decreased by $3.2 million or 13.5% to $20.7 million as of
December 31, 2008 from $23.9 million as of June 30, 2008 and decreased by $1.4 million or 6.0% to
$22.2 million as of December 31, 2007 from $23.6 million as of June 30, 2007. These decreases in
the liability for IBNR were primarily due to favorable variances between estimated claims expense
recorded in prior months and actual claims paid by the HMOs. Also, we experienced improved
utilization outcomes during the three-month period ended December 31, 2008 resulting in a decrease
in our estimate of incurred but not yet reported medical claims as of December 31, 2008.
Consideration of Impairment Related to Goodwill and Other Intangible Assets
Our balance sheet includes intangible assets, including goodwill and other separately
identifiable intangible assets, of approximately $79.1 million, which represented approximately 69%
of our total assets at December 31, 2008. The most significant component of the intangible assets
consists of the intangible assets recorded in connection with the acquisition (the Acquisition)
of Miami Dade Health Centers, Inc. and its affiliated companies (collectively, the MDHC
Companies). The purchase price, including acquisition costs, of approximately $66.2 million was
allocated to the estimated fair value of acquired tangible assets of $13.9 million, identifiable
intangible assets of $8.7 million and assumed liabilities of $15.3 million, resulting in goodwill
totaling $58.9 million.
Under Statement of Financial Accounting Standards No. 142, Goodwill and Other Intangible
Assets, goodwill and intangible assets with indefinite useful lives are no longer amortized, but
are reviewed for impairment on an annual basis or more frequently if certain indicators of
impairment arise. Intangible assets with definite useful lives are amortized over their respective
useful lives to their estimated residual values and also reviewed for impairment annually, or more
frequently if certain indicators of impairment arise. Indicators of an impairment include, among
other things, a significant adverse change in legal factors or the business climate, the loss of a
key HMO contract, an adverse action by a regulator, unanticipated competition, and the loss of key
personnel or allocation of goodwill to a portion of business that is to be sold.
Because we operate in a single segment of business, we have determined that we have a single
reporting unit and we perform our impairment test for goodwill on an enterprise level. In
performing the impairment test, we compare the total current market value of all of our outstanding
common stock, to the current carrying value of our
14
total net assets, including goodwill and intangible assets. Depending on the market value of
our common stock at the time that an impairment test is required, there is a risk that a portion of
our intangible assets would be considered impaired and must be written-off during that period. We
completed our annual impairment test as of May 1, 2008 and determined that no impairment existed.
In addition, no indicators of impairment were noted and accordingly, no impairment charges were
required for the three and six-month periods ended December 31, 2008. Should we later determine
that an indicator of impairment exists, we would be required to perform an additional impairment
test.
Realization of Deferred Income Tax Assets
We account for income taxes in accordance with SFAS No. 109, Accounting for Income Taxes
(SFAS 109) which requires that deferred income tax assets and liabilities be recognized using
enacted tax rates for the effect of temporary differences between the book and tax bases of
recorded assets and liabilities. SFAS No. 109 also requires that deferred income tax assets be
reduced by a valuation allowance if it is more likely than not that some portion or all of the
deferred income tax asset will not be realized.
As part of the process of preparing our consolidated financial statements, we estimate our
income taxes based on our actual current tax exposure together with assessing temporary differences
resulting from differing treatment of items for tax and accounting purposes. We also recognize as
deferred income tax assets the future tax benefits from net operating loss carryforwards. We
evaluate the realizability of these deferred income tax assets by assessing their valuation
allowances and by adjusting the amount of such allowances, if necessary. Among the factors used to
assess the likelihood of realization are our projections of future taxable income streams, the
expected timing of the reversals of existing temporary differences, and the impact of tax planning
strategies that could be implemented to avoid the potential loss of future tax benefits. However,
changes in tax codes, statutory tax rates or future taxable income levels could materially impact
our valuation of tax accruals and assets and could cause our provision for income taxes to vary
significantly from period to period. At December 31, 2008, we had deferred income tax liabilities
in excess of deferred income tax assets of approximately $3.2 million.
Stock-Based Payment
We use the modified prospective transition method under SFAS 123(R). SFAS 123(R) requires us
to recognize compensation costs in our financial statements related to our share-based payment
transactions with employees and directors. SFAS 123(R) requires us to calculate this cost based on
the grant date fair value of the equity instrument. As a result of adopting SFAS No. 123(R), we
recognized share-based compensation expense of $0.3 million for each of the three-month periods
ended December 31, 2008 and 2007 and $0.6 million for each of the six-month periods ended December
31, 2008 and 2007. For the three and six-month periods ended December 31, 2008 and 2007, the
Company had no excess tax benefits resulting from the exercise of stock options.
Consistent with our practices prior to adopting SFAS 123(R), we have elected to calculate the
fair value of our employee stock options using the Black-Scholes option pricing model. Using this
model we calculated the fair value for employee stock options granted during the three-month
periods ended December 31, 2008 and 2007 based on the following assumptions: risk-free interest
rate ranging from 0.75% to 1.76% and 3.01% to 3.49%, respectively; dividend yield of 0%;
weighted-average volatility factor of the expected market price of our common stock of 59.3% and
59.0%, respectively, and weighted-average expected life of the options ranging from 3 to 6 years
depending on the vesting provisions of each option. The fair value for employee stock options
granted during the six-month periods ended December 31, 2008 and 2007 based on the following
assumptions: risk-free interest rate ranging from 0.75% to 3.09% and 3.01% to 4.22%, respectively;
dividend yield of 0%; weighted-average volatility factor of the expected market price of our common
stock of 58.1% and 59.5%, respectively, and weighted-average expected life of the options ranging
from 3 to 6 years depending on the vesting provisions of each option. The expected life of the
options is based on the historical exercise behavior of our employees. The expected volatility
factor is based on the historical volatility of the market price of our common stock as adjusted
for certain events that management deemed to be non-recurring and non-indicative of future events.
15
SFAS 123(R) does not require the use of any particular option valuation model. Because our
stock options have characteristics significantly different from traded options and because changes
in the subjective input assumptions can materially affect the fair value estimate, in managements
opinion, it is possible that existing models
may not necessarily provide a reliable measure of the fair value of our employee stock options. We
selected the Black-Scholes model based on our prior experience with it, its wide use by issuers
comparable to us, and our review of alternate option valuation models.
The effect of applying the fair value method of accounting for stock options on reported net
income for any period may not be representative of the effects for future periods because our
outstanding options typically vest over a period of several years and additional awards may be made
in future periods.
RESULTS OF OPERATIONS
COMPARISON OF THE THREE-MONTH PERIOD ENDED DECEMBER 31, 2008 TO THE THREE- MONTH PERIOD ENDED
DECEMBER 31, 2007
Revenue
Revenue increased by $4.0 million, or 6.6%, to $65.5 million for the three-month period ended
December 31, 2008 from $61.5 million for the three-month period ended December 31, 2007 due
primarily to increases in our Medicare revenue.
The most significant component of our revenue is the revenue we generate from Medicare
patients under risk arrangements which increased by $4.5 million, or 8.4%, during the three-month
period ended December 31, 2008. During the three-month period ended December 31, 2008, revenue
generated by our Medicare risk arrangements increased approximately 7.4% on a per patient per month
basis and Medicare patient months increased by approximately 1.0% over the comparable period of
Fiscal 2008. The increase in the per member per month Medicare revenue was primarily due to a rate
increase in the Medicare premiums and an increase in premiums resulting from the Medicare risk
adjustment program. In addition, during the three-month periods ended December 31, 2008 and 2007,
one of our HMO affiliates increased the percentage of Medicare premium we received under our risk
contract for the twelve-month periods ended December 31, 2008 and 2007. These favorable
adjustments resulted in an increase in revenue and operating profits of approximately $0.9 million
and $0.7 million, respectively, for each of the three-month periods ended December 31, 2008 and
2007. We do not expect to receive a similar premium adjustment in future periods. Based on
information received from our HMO affiliates and CMS, we believe that our Medicare premiums on a
per patient per month basis will increase by approximately 8% effective January 1, 2009 without
taking into account any adjustments resulting from changes in our Medicare risk adjustment scores.
There is, however, no assurance that our Medicare premiums will increase by this amount, if at all,
or that the effect of any CMS risk adjustment will not result in a negative adjustment or that the
effect of any adverse changes in our Medicare risk adjustment scores will not exceed any premium
increases. The increase in Medicare revenue was partially offset by a $1.1 million decrease in
revenue generated by our Medicaid patients due primarily to a decrease in Medicaid patient months.
Under the Medicare risk adjustment program, the health status and demographic factors of
Medicare Advantage participants are taken into account in determining premiums paid for each
participant. CMS periodically recomputes the premiums to be paid to the HMOs based on the updated
health status and demographic factors of the Medicare Advantage participants. In addition, the
premiums paid to the HMOs for their Medicare Prescription Drug Plan are subject to periodic
adjustment based upon CMSs risk corridor adjustment methodology. The net effect of these premium
adjustments included in revenue for the three-month periods ended December 31, 2008 and 2007 were
favorable retroactive Medicare adjustments of $18,000 and unfavorable retroactive Medicare
adjustments of $0.4 million, respectively. Future Medicare risk adjustments may result in
reductions of revenue depending on the future health status and demographic factors of our patients
as well as the application of CMSs risk corridor methodology to the HMOs Medicare Prescription
Drug Programs.
Revenue generated by our managed care entities under contracts with Humana, Vista and Wellcare
accounted for approximately 71%, 18% and 9%, respectively, of our total revenue for the three-month
period ended December 31, 2008. Revenue generated by our managed care entities under contracts
with Humana, Vista and Wellcare accounted for approximately 72%, 20% and 8%, respectively, of our
total revenue for the three-month period ended December 31, 2007.
16
Operating Expenses
Medical services expenses are comprised of medical claims expense and other direct costs
related to the provision of medical services to our patients. Because our risk contracts with HMOs
provide that we are financially responsible for the cost of substantially all medical services
provided to our patients under those contracts, our medical claims expense includes the costs of
prescription drugs our patients receive as well as medical services provided to patients under our
risk contracts by providers other than us. Other direct costs consist primarily of salaries, taxes
and benefits of our health professionals providing primary care services including a portion of our
stock-based compensation expense, medical malpractice insurance costs, capitation payments to our
IPA physicians and fees paid to independent contractors providing medical services to our patients.
Medical services expenses for the three-month period ended December 31, 2008 increased by $1.5
million, or 3.0%, to $52.3 million from $50.8 million for the three-month period ended December 31,
2007. Medical claims expense, which is the largest component of medical services expense,
increased by $1.3 million, or 3.0%, to $45.1 million for the three-month period ended December 31,
2008 from $43.8 million for the three-month period ended December 31, 2007 primarily due to an
increase in Medicare claims expense of $2.4 million, or 6.2%. The increase in Medicare claims
expense resulted from a 5.2% increase on a per patient per month basis in medical claims expenses
related to our Medicare patients and an increase of 1.0% in Medicare patient months. The increase
in Medicare per patient per month medical claims expense is primarily attributable to enhanced
benefits offered by our HMO affiliates and inflationary trends in the health care industry. The
increase in Medicare claims expense was partially offset by a decrease in Medicaid claims expense
of $0.9 million due primarily to a decrease in Medicaid patient months.
As a percentage of revenue, medical services expenses decreased to 79.8% of revenue for the
three-month period ended December 31, 2008 as compared to 82.6% for the three-month period ended
December 31, 2007. Our claims loss ratio (medical claims expense as a percentage of revenue)
decreased to 68.9% for the three-month ended December 31, 2008 from 71.3% for the three-month
period ended December 31, 2007. This decrease was primarily due to an increase in Medicare revenue
at a greater rate than the increase in Medicare claims expense on a per patient per month basis.
HMOs, however, are under continuous competitive pressure to offer enhanced, and possibly more
expensive, benefits to their Medicare Advantage members. The premiums CMS pays to HMOs for
Medicare Advantage members are generally not increased as a result of those benefit enhancements.
This could increase our claims loss ratio in future periods, which could reduce our profitability
and cash flows.
Other direct costs increased by $0.2 million, or 2.9%, to $7.1 million for the three-month
period ended December 31, 2008 from $6.9 million for the three-month period ended December 31,
2007. As a percentage of revenue, other direct costs decreased to 10.9% for the three-month period
ended December 31, 2008 from 11.3% for the three-month period ended December 31, 2007. The
increase in the amount of other direct costs was primarily due to an increase in payroll expense
and related benefits for physicians and medical support personnel at our medical centers and an
increase in capitation payments to our IPAs.
Administrative payroll and employee benefits expense increased by $0.4 million, or 16.0%, to
$3.1 million for the three-month period ended December 31, 2008 from $2.7 million for the
three-month period ended December 31, 2007. As a percentage of revenue, administrative payroll and
employee benefits expense increased to 4.8% for the three-month period ended December 31, 2008 from
4.4% for the three-month period ended December 31, 2007. The increase in administrative payroll
and employee benefits expense was primarily due to increases in vacation benefit accruals.
General and administrative expenses remained relatively unchanged at $4.2 million for the
three-month periods ended December 31, 2008 and 2007. As a percentage of revenue, general and
administrative expenses decreased to 6.4% for the three-month period ended December 31, 2008 from
6.8% for the three-month period ended December 31, 2007.
17
Income from Operations
Income from operations for the three-month period ended December 31, 2008 increased by $2.0
million, or 54.1%, to $5.9 million from $3.9 million for the three-month period ended December 31,
2007.
Taxes
An income tax provision of $2.3 million and $1.5 million was recorded for the three-month
periods ended December 31, 2008 and 2007, respectively. The effective income tax rates were 38.8%
and 37.9% for the three-month periods ended December 31, 2008 and 2007, respectively. The increase
in the effective tax rate was primarily due to an increase in the statutory federal income tax rate
resulting from an increase in taxable income.
Net Income
Net income for the three-month period ended December 31, 2008 increased by $1.2 million, or
45.7%, to $3.7 million from $2.5 million for the three-month period ended December 31, 2007.
COMPARISON OF THE SIX-MONTH PERIOD ENDED DECEMBER 31, 2008 TO THE SIX-MONTH PERIOD ENDED DECEMBER
31, 2007
Revenue
Revenue increased by $8.2 million, or 6.7%, to $130.6 million for the six-month period ended
December 31, 2008 from $122.4 million for the six-month period ended December 31, 2007 due
primarily to increases in our Medicare revenue.
The most significant component of our revenue is the revenue we generate from Medicare
patients under risk arrangements which increased by $8.8 million, or 8.2%, during the six-month
period ended December 31, 2008. During the six-month period ended December 31, 2008, revenue
generated by our Medicare risk arrangements increased approximately 7.9% on a per patient per month
basis and Medicare patient months increased by approximately 0.2% over the comparable period of
Fiscal 2008. The increase in the per patient per month Medicare revenue was primarily due to a
rate increase in the Medicare premiums and an increase in premiums resulting from the Medicare risk
adjustment program. Included in revenue for the six-month periods ended December 31, 2008 and 2007
were favorable retroactive Medicare adjustments of $0.6 million and unfavorable retroactive
Medicare adjustments of $1.0 million, respectively, related to Medicare premiums and risk corridor
adjustments. Future Medicare risk adjustments may result in reductions of revenue depending on the
future health status and demographic factors of our patients as well as the application of CMSs
risk corridor methodology to the HMOs Medicare Prescription Drug Programs. The increase in
Medicare revenue was partially offset by a $1.1 million decrease in revenue generated by our
Medicaid patients due primarily to a decrease in Medicaid patient months.
During the six-month period ended December 31, 2007, we received payments and recorded amounts
due from our HMO affiliates of approximately $0.5 million related primarily to Medicare risk
adjustments relating to the operations of the MDHC Companies for periods prior to completion of the
Acquisition. While these transactions ordinarily are reflected in our results of operations, since
they related to periods prior to our acquisition of the MDHC Companies, they were instead recorded
as purchase accounting adjustments which decreased the amount of goodwill we recorded for the
Acquisition.
Revenue generated by our managed care entities under contracts with Humana, Vista and Wellcare
accounted for approximately 72%, 17% and 9%, respectively, of our total revenue for the six-month
period ended December 31, 2008. Revenue generated by our managed care entities under contracts
with Humana, Vista and Wellcare accounted for approximately 72%, 20% and 8%, respectively, of our
total revenue for the six-month period ended December 31, 2007.
18
Operating Expenses
Medical services expenses for the six-month period ended December 31, 2008 increased by $4.5
million, or 4.4%, to $106.8 million from $102.3 million for the six-month period ended December 31,
2007. Medical claims expense, which is the largest component of medical services expense,
increased by $3.8 million, or 4.2%, to $92.5 million for the six-month period ended December 31,
2008 from $88.7 million for the six-month period ended December 31, 2007 primarily due to an
increase in Medicare claims expense of $4.7 million, or 6.0%. The increase in Medicare claims
expense resulted from a 5.8% increase in medical claims expense on a per patient per month basis
and a 0.2% increase in Medicare patient months. The increase in Medicare per patient per month
medical claims expense is primarily attributable to enhanced benefits offered by our HMO affiliates
and inflationary trends in the health care industry. The increase in Medicare claims expense was
partially offset by a decrease in Medicaid claims expense of $0.8 million due primarily to a
decrease in Medicaid patient months.
As a percentage of revenue, medical services expenses decreased to 81.7% of revenue for the
six-month period ended December 31, 2008 as compared to 83.5% for the six-month period ended
December 31, 2007. Our claims loss ratio (medical claims expense as a percentage of revenue)
decreased to 70.8% for the six-month ended December 31, 2008 from 72.5% for the six-month period
ended December 31, 2007. This decrease was primarily due to an increase in revenue at a greater
rate than the increase in both our medical services expenses and our medical claims expense.
Other direct costs increased by $0.8 million, or 5.7%, to $14.3 million for the six-month
period ended December 31, 2008 from $13.5 million for the six-month period ended December 31, 2007.
As a percentage of revenue, other direct costs decreased to 11.0% for the six-month period ended
December 31, 2008 from 11.1% for the six-month period ended December 31, 2007. The increase in the
amount of other direct costs was primarily due to an increase in payroll expense and related
benefits for physicians and medical support personnel at our medical centers.
Administrative payroll and employee benefits expense increased by $0.5 million, or 7.9%, to
$5.9 million for the six-month period ended December 31, 2008 from $5.4 million for the six-month
period ended December 31, 2007. As a percentage of revenue, administrative payroll and employee
benefits expense increased to 4.5% for the six-month period ended December 31, 2008 from 4.4% for
the six-month period ended December 31, 2007. The increase in administrative payroll and employee
benefits expense was primarily due to increases in vacation benefit accruals.
General and administrative expenses remained relatively unchanged at $8.0 million and $7.9
million for the six-month periods ended December 31, 2008 and 2007, respectively. As a percentage
of revenue, general and administrative expenses decreased to 6.2% for the six-month period ended
December 31, 2008 from 6.5% for the six-month period ended December 31, 2007.
Income from Operations
Income from operations for the six-month period ended December 31, 2008 increased by $3.1
million, or 46.2%, to $9.9 million from $6.8 million for the six-month period ended December 31,
2007.
Taxes
An income tax provision of $3.9 million and $2.7 million was recorded for the six-month
periods ended December 31, 2008 and 2007, respectively. The effective income tax rates were 38.8%
and 37.9% for the six-month periods ended December 31, 2008 and 2007, respectively. The increase
in the effective tax rate was primarily due to an increase in the statutory federal income tax rate
resulting from an increase in taxable income.
19
Net Income
Net income for the six-month period ended December 31, 2008 increased by $1.8 million, or
38.9%, to $6.2 million from $4.4 million for the six-month period ended December 31, 2007.
LIQUIDITY AND CAPITAL RESOURCES
At December 31, 2008, working capital was $19.0 million, a decrease of $1.3 million from $20.3
million at June 30, 2008. Cash and cash equivalents decreased by $1.9 million to $8.0 million at
December 31, 2008 compared to $9.9 million at June 30, 2008. The decreases in cash and cash
equivalents and working capital were primarily due to cash used to repurchase our common stock of
$7.9 million and cash used for the purchase of property and equipment of $1.0 million, partially
offset by cash provided by operating activities of $7.0 million during the six-month period ended
December 31, 2008.
Net cash of $7.0 million was provided by operating activities for the six-month period ended
December 31, 2008 compared to $10.2 million for the six-month period ended December 31, 2007. This
$3.2 million decrease in cash provided by operating activities was primarily due to a net decrease
in amounts due from HMOs of $2.3 million and a net decrease in income taxes payable of $1.6
million.
Net cash of $1.0 million was used for investing activities for the six-month period ended
December 31, 2008 compared to $0.7 million for the six-month period ended December 31, 2007. The
$0.3 million increase in net cash used for investing activities primarily related to an increase in
cash used for the purchase of property and equipment.
Net cash of approximately $8.0 million was used for financing activities for the six-month
period ended December 31, 2008 compared to $1.5 million for the six-month period ended December 31,
2007. The $6.5 million increase in cash used for financing activities for the six-month period
ended December 31, 2008 was primarily due to a $6.5 million net increase in cash used for the
repurchase of common stock.
Pursuant to the terms under our managed care agreements with certain of our HMO affiliates, we
posted irrevocable standby letters of credit amounting to $1.1 million to secure our payment
obligations to those HMOs. We are required to maintain these letters of credit throughout the term
of the managed care agreements.
In November 2008, our Board of Directors increased our previously announced program to
authorize the repurchase of an additional 2,500,000 shares of our common stock bringing the total
number of shares of common stock authorized for repurchase under the program to 12,500,000 shares.
Any such repurchases will be made from time to time at the discretion of our management in the open
market or in privately negotiated transactions subject to market conditions and other factors. We
anticipate that any such repurchases of shares will be funded through cash from operations. During
the three and six-month periods ended December 31, 2008, we repurchased 2,169,972 shares and
3,856,772 shares of our common stock, respectively, for approximately $4.2 million and $7.9
million, respectively. During the period from January 1, 2009 through January 30, 2009, we
repurchased 1,137,300 shares of our common stock for approximately $1.9 million. As of January 30,
2009, we had repurchased 11,482,072 shares of our common stock for approximately $24.3 million.
We believe that we will be able to fund our capital commitments and our anticipated operating
cash requirements for the foreseeable future and satisfy any remaining obligations from our working
capital, anticipated cash flows from operations, our Credit Facility, and our Term Loans. At
December 31, 2008, approximately $9.7 million was available for future borrowing under the Term
Loans and the Credit Facility.
20
FORWARD-LOOKING STATEMENTS
Our business, financial condition, results of operations, cash flows and prospects, and the
prevailing market price and performance of our common stock, may be adversely affected by a number
of factors, including the matters discussed below. Certain statements and information set forth in
this Quarterly Report on Form 10-Q, as well as other written or oral statements made from time to
time by us or by our authorized executive officers on our behalf,
constitute forward-looking statements within the meaning of the Federal Private Securities
Litigation Reform Act of 1995. We intend for our forward-looking statements to be covered by the
safe harbor provisions for forward-looking statements contained in the Private Securities
Litigation Reform Act of 1995, and we set forth this statement and these risk factors in order to
comply with such safe harbor provisions. You should note that our forward-looking statements speak
only as of the date of this report or when made and we undertake no duty or obligation to update or
revise our forward-looking statements, whether as a result of new information, future events or
otherwise. Although we believe that the expectations, plans, intentions and projections reflected
in our forward-looking statements are reasonable, such statements are subject to risks,
uncertainties and other factors that may cause our actual results, performance or achievements to
be materially different from any future results, performance or achievements expressed or implied
by the forward-looking statements. The risks, uncertainties and other factors that our shareholders
and prospective investors should consider include, but are not limited to, the following:
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Our operations are dependent on three health maintenance organizations; |
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Under our most important contracts we are responsible for the cost of medical
services to our patients in return for a capitated fee; |
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If we are unable to manage medical benefits expense effectively, our profitability
will likely be reduced; |
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A failure to estimate incurred but not reported benefits expense accurately will
affect our profitability; |
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We compete with many health care providers for patients and HMO affiliations; |
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We may not be able to successfully recruit or retain existing relationships with
qualified physicians and medical professionals; |
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Our business exposes us to the risk of medical malpractice lawsuits; |
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Our revenues will be affected by the Medicare Risk Adjustment program; |
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We presently operate only in Florida; |
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Failure to maintain effective internal controls in accordance with Section 404 of
the Sarbanes-Oxley Act could have a material adverse effect on our business and stock
price; |
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A significant portion of our voting power is concentrated; |
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We are dependent on our executive officers and other key employees; |
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We depend on the management information systems of our affiliated HMOs; |
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We depend on our information processing systems; |
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Volatility of our stock price could adversely affect you; |
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The Internal Revenue Service may disagree with the parties description of the
federal income tax consequences; |
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Goodwill and other intangible assets represent a substantial portion of our total
assets; |
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Competition for acquisition targets and acquisition financing and other factors may
impede our ability to acquire other businesses and may inhibit our growth; |
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Our acquisitions could result in integration difficulties, unexpected expenses,
diversion of managements attention and other negative consequences; |
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We are subject to government regulation; |
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The health care industry is subject to continued scrutiny; |
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Our insurance coverage may not be adequate, and rising insurance premiums could
negatively affect our profitability; |
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Deficit spending and economic downturns could negatively impact our results of
operations; |
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Many factors that increase health care costs are largely beyond our ability to
control; |
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Health care reform initiatives, particularly changes to the Medicare system, could
adversely affect our operations; and |
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Medicare premiums have generally risen more slowly than the cost of providing health
care services. |
We assume no responsibility to update our forward-looking statements as a result of new
information, future events or otherwise. Additional information concerning these and other risks
and uncertainties is contained in our filings with the Securities and Exchange Commission,
including the section entitled Risk Factors in our Annual Report on Form 10-K for Fiscal 2008 and
in Item 1A of Part II of this Quarterly Report Form 10-Q.
21
ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
At December 31, 2008, we held certificates of deposit and cash equivalent investments in high
grade, short-term securities, which are not typically subject to material market risk. At December
31, 2008, we had capital lease obligations outstanding at fixed rates. For loans with fixed
interest rates, a hypothetical 10% change in interest rates would have no material impact on our
future earnings and cash flows related to these instruments and would have an immaterial impact on
the fair value of these instruments. Our Term Loans and Credit Facility have variable interest
rates and are interest rate sensitive, however, we had no amount outstanding under these facilities
at December 31, 2008. We have no material risk associated with foreign currency exchange rates or
commodity prices.
ITEM 4. CONTROLS AND PROCEDURES
Evaluation of Disclosure Controls and Procedures
Our management, with the participation of our Chief Executive Officer and Chief Financial
Officer, has evaluated the effectiveness of our disclosure controls and procedures (as defined in
Exchange Act Rules 13a-15(e) or Rule 15d-15(e)) as of the end of the period covered by this report.
Based on that evaluation, our Chief Executive Officer and Chief Financial Officer have concluded
that, as of December 31, 2008, our disclosure controls and procedures were effective to ensure that
information required to be disclosed by us in the reports that we file or submit under the Exchange
Act (i) is recorded, processed, summarized and reported, within the time periods specified in the
SECs rules and forms and (ii) is accumulated and communicated to our management, including our
Chief Executive Officer and Chief Financial Officer, as appropriate to allow timely decisions
regarding required disclosure.
Our Chief Executive Officers and Chief Financial Officers conclusions regarding the
effectiveness of our disclosure controls and procedures should be considered in light of the
following limitations on the effectiveness of our disclosure controls and procedures, some of which
pertain to most, if not all, business enterprises, and some of which arise as a result of the
nature of our business. Our management, including our Chief Executive Officer and our Chief
Financial Officer, does not expect that our disclosure controls and procedures will prevent all
errors or improper conduct. A control system, no matter how well conceived and operated, can
provide only reasonable, but not absolute, assurance that the objectives of the control system will
be met. Further, the design of a control system must reflect the fact that there are resource
constraints, and the benefits of controls must be considered relative to their costs. Because of
the inherent limitations in all control systems, no evaluation of controls can provide absolute
assurance that all control issues and instances of improper conduct, if any, will be detected.
These inherent limitations include the realities that judgments in decision-making can be faulty
and that breakdowns can occur because of simple error or mistake. Additionally, controls can be
circumvented by the individual acts of some persons, by collusion of two or more people or by
management override of the controls. Further, the design of any control system is based, in part,
upon assumptions about the likelihood of future events, and there can be no assurance that any
control system design will succeed in achieving its stated goals under all potential future
conditions. Additionally, over time, controls may become inadequate because of changes in
conditions or the degree of compliance with the policies or procedures may deteriorate. Because of
the inherent limitations in a cost-effective control system, misstatements due to error or fraud
may occur and not be detected. In addition, we depend on our HMO affiliates for certain financial
and other information that we receive concerning the revenue and expenses that we earn and incur.
Because our HMO affiliates generate that information for us, we have less control over the manner
in which that information is generated.
Changes in Internal Control over Financial Reporting
In connection with its evaluation of the effectiveness of our internal control over financial
reporting, our management did not identify any changes in our internal control over financial
reporting that occurred during our most recent fiscal quarter that has materially affected, or is
reasonably likely to materially affect, our internal control over financial reporting.
22
Section 302 Certifications
Provided with this report are certifications of our Chief Executive Officer and Chief
Financial Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 and the SECs
implementing regulations. This Item 4 contains the information concerning the evaluations referred
to in those certifications, and you should read this information in conjunction with those
certifications for a more complete understanding of the topics presented.
PART II OTHER INFORMATION
ITEM 1. LEGAL PROCEEDINGS
See Note 10 of our Condensed Consolidated Financial Statements.
ITEM 1A. RISK FACTORS
There have been no material changes to the risk factors previously disclosed in our Annual
Report on Form 10-K for Fiscal 2008 and in other reports filed from time to time with the SEC since
the date we filed our Annual Report on Form 10-K. Readers are urged to carefully review our risk
factors since they may cause our results to differ from the forward-looking statements made in
this report or otherwise made by or on our behalf. Those risk factors are not the only ones we
face. Additional risks not presently known to us or other factors not perceived by us to present
significant risks to our business at this time also may impair our business operation.
ITEM 2. UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS
In November 2008, we increased our previously announced stock repurchase program to authorize
the repurchase of an additional 2,500,000 shares of common stock bringing the total number of
shares of common stock authorized for repurchase under the program to 12,500,000 shares. Any such
repurchases will be made from time to time at the discretion of our management in the open market
or in privately negotiated transactions subject to market conditions and other factors. We
anticipate that any such repurchases of shares will be funded through cash from operations. The
stock repurchase program was originally approved by the Board of Directors in February 2005. There
is no expiration date specified for this program. The following table provides information with
respect to our stock repurchases during the second quarter of Fiscal 2009:
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Total Number of |
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Maximum Number of |
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Shares Purchased as |
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Shares that May Yet |
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Total Number of |
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Average Price Paid |
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Part of Publicly |
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Be Purchased Under |
Period |
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Shares Purchased |
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per Share |
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Announced Plan |
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the Plan |
October 1 to October 31, 2008 |
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883,225 |
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$ |
2.23 |
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883,225 |
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3,441,975 |
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November 1 to November 30, 2008 |
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1,093,247 |
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$ |
1.70 |
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1,093,247 |
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2,348,728 |
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December 1 to December 31, 2008 |
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193,500 |
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$ |
1.79 |
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193,500 |
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2,155,228 |
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Totals |
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2,169,972 |
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$ |
1.92 |
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2,169,972 |
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ITEM 3. DEFAULTS UPON SENIOR SECURITIES
None.
ITEM 4. SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS
None.
ITEM 5. OTHER INFORMATION
None.
23
ITEM 6. EXHIBITS
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Exhibits |
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31.1 |
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Section 302 Certification of the Chief Executive Officer. |
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31.2 |
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Section 302 Certification of the Chief Financial Officer. |
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32.1 |
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Certification Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant
to Section 906 of the Sarbanes-Oxley Act of 2002. |
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32.2 |
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Certification Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant
to Section 906 of the Sarbanes-Oxley Act of 2002. |
24
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, the
registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly
authorized.
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CONTINUCARE CORPORATION
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Dated: February 5, 2009 |
By: |
/s/ Richard C. Pfenniger, Jr.
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Richard C. Pfenniger, Jr. |
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Chairman of the Board, Chief Executive
Officer and President |
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By: |
/s/ Fernando L. Fernandez
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Fernando L. Fernandez |
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Senior Vice President -- Finance, Chief Financial Officer, Treasurer and Secretary |
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25