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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549

FORM 8-K
CURRENT REPORT
Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): February 20, 2009

HMS Holdings Corp.

(Exact Name of Registrant as Specified in Charter)

New York 0-50194 11-3656261

(State or Other Jurisdiction (Commission (IRS Employer
of Incorporation File Number) Identification No.)

401 Park Avenue South, New York, New York 10016

(Address of Principal Executive Offices, Zip Code)

Registrant’s telephone number, including area code: (212) 725-7965

Not applicable.

(Former Name or Former Address, if Changed Since Last Report)

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of
the following provisions (see General Instruction A.2. below):
o Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
o Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
o Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
o Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))
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TABLE OF CONTENTS

Item 2.02. Result of Operations and Financial Condition

Item 7.01 Regulation FD Disclosure

Item 9.01. Financial Statements and Exhibits

Signatures

Exhibit Index

Exhibit 99.1 Press Release dated February 20, 2009

Exhibit 99.2 Slide presentation from February 20, 2009 earnings conference call

Exhibit 99.3 Income Statement Presentation Reconciliation Analysis

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Section 2 — Financial Information

Item 2.02 Results of Operations and Financial Condition.

On February 20, 2009, HMS Holdings Corp. (the “Company”) issued a press release announcing its financial results for the fourth quarter
and full year 2008. A copy of the press release is furnished as Exhibit 99.1. As announced in the press release on February 20, 2008, the
Company will host its fourth quarter and full year 2008 earnings conference call on February 20, 2009 at 9 am ET. A slide presentation and
Income Statement Presentation Reconciliation Analysis of which are furnished as Exhibit 99.2 and Exhibit 99.3 respectively hereto. These
exhibits are incorporated herein by reference.
In accordance with general instruction B-2 to Form 8-K, the information (including Exhibits 99.1 and 99.2 furnished herewith) in this report is
“furnished” pursuant to item 2.02 and shall not be deemed to be “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as
amended (the “Exchange Act”), or otherwise subject to the liability of that section, and shall not be incorporated by reference into any
registration statement or other document filed under the Securities Act of 1933, as amended, or the Exchange Act, except as shall be expressly
set forth by specific reference in such filing.

Section 7 — Regulation FD

Item 7.01 Regulation FD Disclosure.

The press release referenced in Item 2.02 is furnished pursuant to Item 7.01 as Exhibit 99.1. The slide presentation of the conference call
referenced in Item 2.02 is furnished pursuant to Item 7.01 as Exhibit 99.2 hereto. The Income Statement Presentation Reconciliation Analysis
referenced in Item 2.02 is furnished pursuant to Item 7.01 as Exhibit 99.3 hereto.

The filing of this current report on Form 8-K is not an admission as to the materiality of any information in this report that is required to be
disclosed solely by Regulation FD.

Section 9 — Financial Statements and Exhibits

Item 9.01 Financial Statements and Exhibits.

(c) Exhibits:
This exhibit is furnished pursuant to Items 2.02 and 7.01 hereof and should not be deemed to be “filed” under the Exchange Act.

Exh ibit No. Exh ibit De scription

99.1 Press Release dated February 20, 2009

99.2 Slide presentation from February 20, 2009 earnings conference call

99.3 Income Statement Presentation Reconciliation Analysis

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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by
the undersigned thereunto duly authorized.

Date: February 20, 2009

HMS HOLDINGS CORP.

By: /s/ Walter D. Hosp

Walter D. Hosp
Chief Financial Officer
(Principal Financial Officer and Accounting Officer)
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Table of Contents

INDEX TO EXHIBITS

Exh ibit No. De scription

99.1 Press Release dated February 20, 2009

99.2 Slide presentation from February 20, 2009 earnings conference call

99.3 Income Statement Presentation Reconciliation Analysis

Exhibit 99.1

(HMS LOGO)

Contacts: Christine Rogers Saenz (investor relations) Francesca Marraro (media relations)
(212) 857-5986 (212) 857-5442
csaenz@hms.com fmarraro@hms.com

HMS HOLDINGS CORP. ANNOUNCES Q4 AND FULL YEAR 2008 RESULTS

AND MANAGEMENT TRANSITION; RAISES 2009 EPS GUIDANCE TO $1.00
William C. Lucia to become CEO; Robert M. Holster continues as Chairman
NEW YORK, N.Y., February 20, 2009—HMS Holdings Corp. (NASDAQ: HMSY) today announced financial results for its fourth quarter and
full year ended December 31, 2008.
Revenue for the fourth quarter of 2008 increased 26% to $52.4 million, compared with $41.7 million for the same period a year ago. HMSY
reported net income of $7.1 million or $0.26 per diluted common share for the fourth quarter of 2008, compared to net income of $4.0 million or
$0.15 per diluted common share during the fourth quarter of the prior year.
For the full year 2008, the Company reported revenue of $184.5 million, a 26% increase over 2007 revenue of $146.7 million. Also for the full
year, the Company reported net income of $21.4 million or $0.80 per diluted common share, versus net income of $15.0 million or $0.57 per
diluted common share in the prior year. Earnings per diluted common share increased 73% and 40% for the fourth quarter and full year,
respectively.
The Company raised 2009 guidance to $218 million in revenue and $1.00 in fully diluted earnings per share.
The Company also announced that current President and Chief Operating Officer William C. Lucia will become Chief Executive Officer on
March 1, 2009. Current Chairman and CEO Robert M. Holster will continue as Chairman.
“HMS is reporting another year of record revenue growth and profitability, and expects continuing strong performance given the expansion of
the government healthcare programs we serve,” said Holster. “So we believe it is the right time to initiate a management transition for which
the Company has been preparing for several years. Within weeks of returning to HMS in 2001, I asked Bill Lucia to take responsibility for our
government healthcare cost containment division. In the years since, his strategic vision, capacity for product innovation and extraordinary
attention to client service has led to an almost ten-fold increase in the size of that business, which had become by late 2005 HMS’s sole
focus.”
Lucia added, “Bob and I and our Board of Directors are confident that HMS has the management structure, product pipeline and technology in
place to drive the company forward. We will continue to focus on delivering consistent, predictable growth to our investors.”
Lucia, 51, joined HMS in 1996 after more than a decade of senior management experience in the insurance industry. He was appointed
President of the Company’s Health Management Systems, Inc subsidiary in 2001 and was appointed President and Chief Operating Officer of
the parent company in May 2005.
Holster, 62, rejoined HMS in April of 2001 as President and Chief Operating Officer. He was appointed Chief Executive Officer in May 2005 and
elected Chairman in April 2006. He will continue to serve as Chairman until March of 2011. In addition to his duties as Chairman, he will be
assisting the Company with corporate development, legal and regulatory affairs, and investor relations.
HMS will be hosting its fourth quarter 2008 conference call and webcast with the investment community on Friday, February 20, 2009 at 9:00
am Eastern Time. The conference call number is US/Canada: (866) 394-8630 Int’l/Local Dial-In: (706) 758-0082 Conference ID: 82192441. A slide
presentation will accompany the conference call and may be accessed through our website at
http://www.hmsholdings.com/news/quarterly_reports.asp.
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A conference call replay will be available beginning February 20, 2009 10:00 AM ET through February 27, 2009 11:59 PM ET. To listen to the
replay of the call, dial: US/Canada: (800) 642-1687 Int’l/Local Dial-In: (706) 645-9291 Conference ID: 82192441 or visit our website at
http://www.hmsholdings.com/news/quarterly_reports.asp.
The HMS Holdings Corp. Form 10-K for the year ended December 31, 2008 will be filed and available on our website www.hmsholdings.com on
or about March 12, 2009, and will contain additional information about our results of operations for the fiscal year-to-date. This press release
and the interim financial statements herein will be available at www.hmsholdings.com for at least a 12-month period. Shareholders and
interested investors are welcome to contact Investor Relations at 212-857-5986..

About HMS Holdings Corp.

HMS Holdings Corp. is the leader in coordination of benefits and program integrity services for government healthcare programs. The
company’s clients include health and human services programs in more than 40 states, 90 managed care plans, the Centers for Medicare and
Medicaid Services (CMS), and Veterans Administration facilities. HMS helps ensure that healthcare claims are paid correctly and by the
responsible party. As a result of the company’s services, government healthcare programs recover over $1 billion annually, and avoid billions
of dollars more in erroneous payments. HMS is headquartered in New York and operates offices nationwide.

###
This press release includes presentations of earnings before interest, taxes, depreciation and amortization (EBITDA) and adjusted EBITDA.
Adjusted EBITDA represents EBITDA adjusted for share-based compensation expense. EBITDA is a measure commonly used by the capital
markets to value enterprises. Interest, taxes, depreciation and amortization can vary significantly between companies due in part to
differences in accounting policies, tax strategies, levels of indebtedness and interest rates. Excluding these items provides insight into the
underlying results of operations and facilitates comparisons between HMSY and other companies. EBITDA is also a useful measure of the
Company’s ability to service debt and is one of the measures used for determining debt covenant compliance. In addition, because of the
varying methodologies for determining share-based compensation expense, and the subjective assumptions involved in those
determinations, we believe excluding share-based compensation expense from EBITDA enhances the ability of management and investors to
compare our core operating results over multiple periods with those of other companies. Management believes EBITDA and adjusted
EBITDA information is useful to investors for these reasons. Both EBITDA and adjusted EBITDA are non-GAAP financial measures and
should not be viewed as an alternative to GAAP measures of performance. Management believes the most directly comparable GAAP
financial measure is net income and has provided a reconciliation of EBITDA and adjusted EBITDA to net income in this press release.
Certain statements in this press release constitute “forward-looking statements” within the meaning of the Private Securities Litigation
Reform Act of 1995 (the “Reform Act”). Such forward-looking statements involve known and unknown risks, uncertainties, and other
factors that may cause the actual results, performance, or achievements of HMSY, or industry results, to be materially different from any
future results, performance, or achievements expressed or implied by such forward-looking statements. The important factors that could
cause actual results to differ materially from those indicated by such forward-looking statements include, but are not limited to: (i) the
information being of a preliminary nature and therefore subject to further adjustment; (ii) the uncertainties of litigation; (iii) HMSY’s
dependence on significant customers; (iv) changing conditions in the healthcare industry which could simplify the reimbursement process
and adversely affect HMSY’s business; (v) government regulatory and political pressures which could reduce the rate of growth of
healthcare expenditures and/or discourage the assertion of claims for reimbursement against and delay the ultimate receipt of payment
from third party payors; (vi) competitive actions by other companies, including the development by competitors of new or superior services
or products or the entry into the market of new competitors; (vii) all the risks inherent in the development, introduction, and
implementation of new products and services; and (viii) other risk factors described from time to time in HMSY’s filings with the SEC,
including HMSY’s Form 10-K for the year ended December 31, 2007. HMSY assumes no responsibility to update the forward-looking
statements contained in this release as a result of new information, future events or otherwise. When/if used in this release, the words
“focus”, “believe”, “confident”, “anticipate”, “expected”, “strong”, “potential”, and similar expressions are intended to identify forward-
looking statements, and the above described risks inherent therein.
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HMS HOLDINGS CORP. AND SUBSIDIARIES

Consolidated Statements of Income
(In Thousands, Except Per Share Amounts)
(unaudited)

Th re e m on ths e n de d De c. 31, Ye ar e n de d De c. 31,

2008 2007 2008 2007
Revenue $ 52,404 $ 41,668 $ 184,495 $ 146,651

Cost of services:
Compensation 15,577 12,900 60,571 46,185
Data processing 2,977 2,675 10,999 9,298
Occupancy 2,793 2,720 10,079 8,431
Direct project costs 8,680 6,405 28,429 22,774
Other operating costs 2,861 1,953 10,831 6,540
Amortization of acquisition related software and intangibles 1,185 1,162 4,714 4,642
Total cost of services 34,073 27,815 125,623 97,870

Selling, general & administrative expenses 6,903 6,296 22,142 20,500

Total operating expenses 40,976 34,111 147,765 118,370
Operating income 11,428 7,557 36,730 28,281

Interest expense (356) (464) (1,491) (2,207)

Interest income 200 93 719 475
Income before income taxes 11,272 7,186 35,958 26,549
Income taxes 4,214 3,150 14,583 11,593

Net Income $ 7,058 $ 4,036 $ 21,375 $ 14,956

Net income per common share:

Basic $ 0.28 $ 0.17 $ 0.85 $ 0.63
Diluted $ 0.26 $ 0.15 $ 0.80 $ 0.57

Weighted average shares:

Basic 25,292 24,471 25,048 23,904
Diluted 26,934 26,646 26,816 26,249
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HMS HOLDINGS CORP. AND SUBSIDIARIES

Consolidated Balance Sheets
(In Thousands, Except Share and Per Share Amounts)
(unaudited)

De ce m be r 31, De ce m be r 31,
2008 2007
Assets
Current Assets:
Cash and cash equivalents $ 49,216 $ 21,275
Accounts receivable, net of allowance of $664 and $662 at December 31, 2008 and 2007,
respectively 45,155 39,704
Prepaid expenses and other current assets, including deferred tax assets of $1,696 and $657 at
December 31, 2008 and 2007 respectively 5,541 3,970
Total current assets 99,912 64,949

Property and equipment, net 17,757 16,496

Goodwill, net 82,342 80,242
Deferred income taxes, net 2,040 3,111
Intangible assets, net 19,823 22,495
Other assets 639 807
Total assets $ 222,513 $ 188,100
Liabilities and Shareholders’ Equity
Current Liabilities:
Accounts payable, accrued expenses and other liabilities $ 22,859 $ 21,539
Current portion of long term-debt 6,300 6,300
Total current liabilities 29,159 27,839

Long-term liabilities:
Long-term debt 11,025 17,325
Other liabilities 3,967 4,187
Total long-term liabilities 14,992 21,512
Total liabilities 44,151 49,351

Shareholders’ Equity:
Preferred Stock — $. 01 par value; 5,000,000 shares authorized; none issued — —
Common Stock — $ .01 par value; 45,000,000 shares authorized;
27,174,875 shares issued and 25,512,029 shares outstanding at December 31, 2008;
26,409,035 shares issued and 24,746,189 shares outstanding at December 31, 2007; 272 264
Capital in excess of par value 146,145 127,887
Retained earnings 41,562 20,187
Treasury stock, at cost; 1,662,846 shares at December 31, 2008 and December 31, 2007 (9,397) (9,397)
Accumulated other comprehensive loss (220) (192)
Total Shareholders’ Equity 178,362 138,749
Total liabilities and shareholders’ equity $ 222,513 $ 188,100
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HMS HOLDINGS CORP. AND SUBSIDIARIES

Consolidated Statements of Cash Flows
For the Years ended December 31, 2008 and 2007
(in Thousands)
(unaudited)

Ye ar e n de d De ce m be r 31,
2008 2007
Operating activities:
Net income $ 21,375 $ 14,956
Adjustments to reconcile net income to net cash provided by operating activities:
Loss on disposal of fixed assets 90 370
Depreciation and amortization 11,967 10,558
Share-based compensation expense 3,498 2,173
Decrease in deferred tax asset 32 3,445
Changes in assets and liabilities:
Increase in accounts receivable (4,531) (8,197)
Increase in prepaid expenses and other current assets (504) (1,185)
Increase in other assets (21) (171)
Increase (decrease) in accounts payable, accrued expenses and other liabilities (1,037) 4,649
Net cash provided by operating activities 30,869 26,598

Investing activities:
Purchases of property and equipment (5,988) (8,594)
Acquisition of PrudentRx (4,496) —
Acquisition of Permedion — (627)
Acquisition of BSPA — (15,000)
Investment in capitalized software (912) (606)
Net cash used in investing activities (11,396) (24,827)

Financing activities:
Proceeds from exercise of stock options 4,226 6,577
Repayment of long-term debt (6,300) (7,875)
Tax benefit of disqualifying dispositions 10,542 8,275
Net cash provided by financing activities 8,468 6,977

Net increase in cash and cash equivalents 27,941 8,748

Cash and cash equivalents at beginning of year 21,275 12,527

Cash and cash equivalents at end of year $ 49,216 $ 21,275

Supplemental disclosure of cash flow information:

Cash paid for income taxes $ 3,823 $ 56
Cash paid for interest $ 1,299 $ 1,945

Supplemental disclosure of noncash investing activities:

Tenant improvement allowance $ 208 $ 1,635

Accrued property and equipment purchases $ 1,898 $ —

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HMS HOLDINGS CORP. AND SUBSIDIARIES

Reconciliation of net income to EBITDA and adjusted EBITDA
(In thousands, except share and per share amounts)
(unaudited)

As summarized in the following table, earnings before interest, taxes, depreciation and amortization, and share-based compensation expense
(adjusted EBITDA) was $15.7 million for the fourth quarter of 2008, an increase of 41% over the same period a year ago.

Reconciliation of net income to EBITDA and adjusted EBITDA

Th re e Mon ths En de d Ye ar En de d
De ce m be r 31, De ce m be r 31,
2008 2007 2008 2007
Net Income $ 7,058 $ 4,036 $ 21,375 $ 14,956

Net interest (income) expense 156 371 772 1,732

Income taxes 4,214 3,150 14,583 11,593
Depreciation and amortization, net of deferred financing costs, included
in net interest expense (income) 3,087 2,796 11,766 10,210

Earnings before interest, taxes, depreciation and amortization

(EBITDA) 14,515 10,353 48,496 38,491
Share-based compensation expense 1,147 753 3,498 2,173
Adjusted EBITDA $ 15,662 $ 11,106 $ 51,994 $ 40,664

Exhibit 99.2

F YQ4 2008 I nves t or Ca l l Fe br ua r y 20, 2009 Ro b e r t Ho l s t e r , Ch a i r m a n and CE O Bi l l Lu c i a , Pr e s i de nt and COO W a l t e r Ho s p , S VP a n d CF O

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3 S a f e Ha r b o r S t a t e m e n t Ce r t a i n s t a t e m e n t s i n t h i s p r e s e n t a t i o n c o n s t i t u t e " f o r wa r d - l o o k i n g s t a t e m e n t s " wi t h i n t h e m e a n i n g o f t h e P r i v a t e S e c u r i t i e s L i t i g a t i o n Re f o r m Ac t o f 1 9 9 5 ( t h e " Re f o r m Ac t " ) . S u c h f o r wa r d - l o o k i n g s t a t e m e n t s i n v o l v e k n o wn a n d u n k n o wn r i s k s , u n c e r t a i n t i e s , a n d o t h e r f a c t o r s t h a t m a y c a u s e t h e a c t u a l r e s u l t s , p e r f o r m a n c e , o r a c h i e v e m e n t s o f HM S Y, o r i n d u s t r y r e s u l t s , t o b e m a t e r i a l l y d i f f e r e n t f r o m a n y f u t u r e r e s u l t s , p e r f o r m a n c e , o r a c h i e v e m e n t s e x p r e s s e d o r i m p l i e d b y s u c h f o r wa r d - l o o k i n g s t a t e m e n t s . T h e i m p o r t a n t f a c t o r s t h a t c o u l d c a u s e a c t u a l r e s u l t s t o d i f f e r m a t e r i a l l y f r o m t h o s e i n d i c a t e d b y s u c h f o r wa r d - l o o k i n g

s t a t e m e n t s i n c l u d e , b u t a r e n o t l i m i t e d t o ( i ) t h e i n f o r m a t i o n b e i n g o f a p r e l i m i n a r y n a t u r e a n d t h e r e f o r e s u b j e c t t o f u r t h e r a d j u s t m e n t ; ( i i ) t h e u n c e r t a i n t i e s o f l i t i g a t i o n ; ( i i i ) HM S Y's d e p e n d e n c e o n s i g n i f i c a n t c u s t o m e r s ; ( i v ) c h a n g i n g c o n d i t i o n s i n t h e h e a l t h c a r e i n d u s t r y wh i c h c o u l d s i m p l i f y t h e r e i m b u r s e m e n t p r o c e s s a n d a d v e r s e l y a f f e c t HM S Y's b u s i n e s s ; ( v ) g o v e r n m e n t r e g u l a t o r y a n d p o l i t i c a l p r e s s u r e s wh i c h c o u l d r e d u c e t h e r a t e o f g r o wt h o f h e a l t h c a r e e x p e n d i t u r e s a n d / o r d i s c o u r a g e t h e a s s e r t i o n o f c l a i m s f o r r e i m b u r s e m e n t a g a i n s t a n d d e l a y t h e u l t i m a t e r e c e i p t o f p a y m e n t f r o m t h i r d p a r t y p a y o r s ; ( v i ) c o m p e t i t i v e a c t i o n s b y o t h e r c o m p a n i e s ,
i n c l u d i n g t h e d e v e l o p m e n t b y c o m p e t i t o r s o f n e w o r s u p e r i o r s e r v i c e s o r p r o d u c t s o r t h e e n t r y i n t o t h e m a r k e t o f n e w c o m p e t i t o r s ; ( v i i ) a l l t h e r i s k s i n h e r e n t i n t h e d e v e l o p m e n t , i n t r o d u c t i o n , a n d i m p l e m e n t a t i o n o f n e w p r o d u c t s a n d s e r v i c e s ; a n d ( v i i i ) o t h e r r i s k f a c t o r s d e s c r i b e d f r o m t i m e t o t i m e i n HM S Y's f i l i n g s wi t h t h e S E C, i n c l u d i n g HM S Y's F o r m 1 0 - K f o r t h e y e a r e n d e d De c e m b e r 3 1 , 2 0 0 7 . HM S Y a s s u m e s n o r e s p o n s i b i l i t y t o u p d a t e t h e f o r wa r d - l o o k i n g s t a t e m e n t s c o n t a i n e d i n t h i s r e l e a s e a s a r e s u l t o f n e w i n f o r m a t i o n , f u t u r e e v e n t s o r o t h e r wi s e . W h e n / i f u s e d i n t h i s p r e s e n t a t i o n , t h e wo r d s " f o c u s , " " b e l i e v e , " " c o n f i d e n t , " " a n t i c i p a t e , " " e x p e c t e d , "
" s t r o n g , " " p o t e n t i a l , " a n d s i m i l a r e x p r e s s i o n s a r e i n t e n d e d t o i d e n t i f y f o r wa r d - l o o k i n g s t a t e m e n t s , a n d t h e a b o v e d e s c r i b e d r i s k s i n h e r e n t t h e r e i n .
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5 Di s c u s s i o n Ou t l i n e F YQ4 2008 Fi na nc i a l Pe r f or m a nc e M anagem ent Tr a n s i t i o n Op e r a t i o n a l Hi g h l i g h t s 2009 M acr o En v i r o n m e n t St r a t e gi c Op p o r t u n i t y 2009 Gu i d a n c e Q& A

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7 Co n s o l i d a t e d St a t e m e nt s of I ncom e ( $ i n t hous ands )

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Co n s o l i d a t e d St a t e m e nt s of I ncom e ( $ i n t hous ands ) 9

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11 Co n d e n s e d Ba l a n c e She e t s ( $ i n t hous ands )

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13 Co n d e n s e d St a t e m e nt s of Ca s h Fl ow ( $ i n t hous ands )
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15 E BI T DA Re c o n c i l i a t i o n ( $ i n t hous ands )
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17 Bi l l Lu c i a Bi o Spe nt 15+ year s as i ns ur ance i ndus t r y execut i ve J oi ned HM S i n 1996 as Ge n e r a l M anager of Pr ovi de r E DI di vi s i on Na m e d Pr e s i de nt of HM S , I nc. i n 2001 La u n c h e d M CO b u s i n e s s i n 2004 Ap p o i n t e d Pr e s i de nt of HM S Ho l d i n g s i n 2005
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19 On g o i n g Bo b Ho l s t e r Ro l e Ch a i r m a n unt i l M ar ch 2011 Co n t i n u i n g f ocus on: Co r p o r a t e devel opm ent Le g a l and r egul at or y af f ai r s I nves t or com m uni t y r el at i ons
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21 HM S L e a d e r s h i p
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23 Hi g h l i g h t s : Bu s i n e s s De v e l o p m e n t St a t e Co m m e r c i a l Fe de r a l Ne w Ca l i f o r n i a * Ne w Yo r k * W as hi ngt on, DC M i n n e s o t a Ae t n a Ci t r u s He a l t h Se nt a r a He a l t h Ro y a l He a l t h Ve t e r a n s Ad m i n i s t r a t i o n Um b r e l l a Co n t r a c t Ex p a n s i o n s / Ex t e n s i o n s Ge o r g i a Ok l a h o m a Al a b a m a Pe nns yl va ni a Am e r i h e a l t h : Sout h Ca r o l i n a Ca r e 1 s t : Ar i z o n a Ve t e r a n s : Co m m e r c i a l Cl a i m s Re c o v e r y * r epr ocur em ent

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25 Hi g h l i g h t s : Pr ogr a m I nt egr i t y Sa l e s Pr ovi de r Au d i t s Cl i n i c a l Re v i e ws Pha r m a c y Au d i t s Go v e r n m e n t Ca l i f o r n i a I daho Ne v a d a Ne w Yo r k Ne w J e r s e y I ndi ana Co m m e r c i a l Ae t n a M edi cai d Ro y a l He a l t h Ci t r u s He a l t h W el l car e
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27 27 2009 M acr o En v i r o n m e n t Un e m p l o y m e n t and uni ns ur ed i ncr eas i ng Fe de r a l s t i m ul us expands M edi cai d and S CHI P Ag g r e s s i v e f ocus on cos t cont ai nm ent and paym ent accur acy W or s eni ng st at e def i ci t s f uel s dem and f or cos t cont ai nm ent
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29 Ho w W e Ta p t he Op p o r t u n i t y 29 Ri d e M edi cai d g r o wt h wa v e Ca p t u r e m or e M edi cai d l i ves I nt r oduce new pr oduct s and s er vi ces Up s e l l t o exi s t i ng cus t om er s 29
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31 31 EP S $ 0 . 2 1 2009 Gu i d a n c e EP S $ 0 . 5 7 EP S $ 0 . 8 0 EP S $ 1 . 0 0
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3 3 Ap p e n d i x : E BI T DA E BI T DA i s d e f i n e d a s e a r n i n g s b e f o r e i n t e r e s t , t a x e s , d e p r e c i a t i o n a n d a m o r t i z a t i o n a n d a d j u s t e d E BI T DA r e p r e s e n t s E BI T DA a d j u s t e d f or s h a r e b a s e d c o m p e n s a t i o n e x p e n s e . E BI T DA i s a m e a s u r e c o m m o n l y us ed by t he capi t al m ar ket s t o val ue ent er pr i s es . I nt er es t , t axes , depr eci at i on and am or t i zat i on can v a r y s i g n i f i c a n t l y b e t we e n c o m p a n i e s d u e i n p a r t t o d i f f e r e n c e s i n a c c o u n t i n g p o l i c i e s , t a x s t r a t e g i e s , l e v e l s o f i n d e b t e d n e s s a n d i n t e r e s t r a t e s . Ex c l u d i n g t hes e i t em s pr ovi des i ns i ght i nt o t he under l yi ng r es ul t s of oper at i ons a n d f a c i l i t a t e s c o m p a r i s o n s b e t we e n HM S Y a n d o t h e r c o m p a n i e s . E BI T DA i s a l s o a u s e f u l m e a s u r e o f t h e c o m p a n y 's
abi l i t y t o s er vi ce debt and i s one of t he m eas ur es us ed f or det er m i ni ng debt covenant com pl i ance. I n addi t i on, becaus e of t he var yi ng m et hodol ogi es f or det er m i ni ng s t ock- bas ed com pens at i on expens e, and t he s ubj ect i ve a s s u m p t i o n s i n v o l v e d i n t h o s e d e t e r m i n a t i o n s , we bel i eve excl udi ng s t ock- bas ed com pens at i on expens e f r o m E BI T DA e n h a n c e s t h e a b i l i t y o f m a n a g e m e n t a n d i n v e s t o r s t o c o m p a r e o u r c o r e o p e r a t i n g r e s u l t s o v e r m u l t i p l e p e r i o d s wi t h t h o s e o f o t h e r c o m p a n i e s . M anagem ent bel i eves E BI T DA a n d a d j u s t e d E BI T DA i n f o r m a t i o n i s u s e f u l t o i n v e s t o r s f o r t h e s e r e a s o n s . Bo t h E BI T DA a n d a d j u s t e d E BI T DA a r e n o n - GAAP f i n a n c i a l m e a s u r e s a n d s houl d not be
v i e we d a s a n a l t e r n a t i v e t o GAAP m e a s u r e s o f p e r f o r m a n c e . M a n a g e m e n t b e l i e v e s t h e m o s t d i r e c t l y c o m p a r a b l e GAAP f i n a n c i a l m e a s u r e i s n e t i n c o m e and h a s p r o v i d e d a r e c o n c i l i a t i o n o f E BI T DA a n d a d j u s t e d E BI T DA t o n e t i ncom e i n t hi s pr es ent at i on.

Exhibit 99.3

HMS Holdings Inc.

New Income Statement Presentation Format Reconciliation
as of December 31, 2008

2008 2007 2006

Pre viously As Pre viously As Pre viously As
Re porte d Adj’s Re vise d Re porte d Adj’s Re vise d Re porte d Adj’s Re vise d
Re ve n u e 184,495 — 184,495 146,651 — 146,651 87,940 — 87,940

O pe ratin g Expe n se s:

Cost of Services

Compensation 73,783 (13,212) 60,571 57,137 (10,952) 46,185 38,547 (7,970) 30,577
Data P rocessing 12,039 (1,040) 10,999 10,026 (728) 9,298 6,812 (264) 6,548
Occupancy 11,010 (931) 10,079 9,411 (980) 8,431 6,322 (1,105) 5,217
Direct P roject
Cost 28,429 — 28,429 22,774 — 22,774 13,849 — 13,849
Other Operating
Cost 17,790 (6,959) 10,831 14,380 (7,840) 6,540 8,165 (3,637) 4,528
Amort of
Intangibles 4,714 — 4,714 4,642 — 4,642 6,420 — 6,420
T otal Cost of
Services 147,765 (22,142) 125,623 118,370 (20,500) 97,870 80,115 (12,976) 67,139

Selling General &

Admin Expenses — 22,142 22,142 — 20,500 20,500 — 12,976 12,976

T otal Operating
Expenses 147,765 — 147,765 118,370 — 118,370 80,115 — 80,115

O pe ratin g In com e 36,730 — 36,730 28,281 — 28,281 7,825 — 7,825

SGA as a % to
Rev 12.00% 13.98% 14.76%

Cost of Ser as a
% to Rev 68.09% 66.74% 76.35%

SGA as a % to
T otal Exp’s 14.98% 17.32% 16.20%

Cost of Rev as a
% to T otal
Exp’s 85.02% 82.68% 83.80%

Operating Inc as
a % to Rev 19.91% 19.28% 8.90%

% of Revenue
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2008 2007 2006

Pre viously As Pre viously As Pre viously As
Re porte d Adj’s Re vise d Re porte d Adj’s Re vise d Re porte d Adj’s Re vise d
O pe ratin g Expe n se s:

Compensation 40.0% 7.2% 32.8% 39.0% 7.5% 31.5% 43.8% 9.1% 34.8%
Data P rocessing 6.5% 0.6% 6.0% 6.8% 0.5% 6.3% 7.7% 0.3% 7.4%
Occupancy 6.0% 0.5% 5.5% 6.4% 0.7% 5.7% 7.2% 1.3% 5.9%
Direct P roject
Cost 15.4% 0.0% 15.4% 15.5% 0.0% 15.5% 15.7% 0.0% 15.7%
Other Operating
Cost 9.6% 3.8% 5.9% 9.8% 5.3% 4.5% 9.3% 4.1% 5.1%
Amort of
Intangibles 2.6% 0.0% 2.6% 3.2% 0.0% 3.2% 7.3% 0.0% 7.3%
T otal Cost of
Services 80.1% 12.0% 68.1% 80.7% 14.0% 66.7% 91.1% 14.8% 76.3%

Selling General &

Admin Expenses 0.0% -12.0% 12.0% 0.0% -14.0% 14.0% 0.0% -14.8% 14.8%

T otal Operating
Expenses 80.1% 0.0% 80.1% 80.7% 0.0% 80.7% 91.1% 0.0% 91.1%

O pe ratin g In com e 19.9% 0.0% 19.9% 19.3% 0.0% 19.3% 8.9% 0.0% 8.9%

% of Total Expense

2008 2007 2006

Pre viously As Pre viously As Pre viously As
Re porte d Adj’s Re vise d Re porte d Adj’s Re vise d Re porte d Adj’s Re vise d
O pe ratin g Expe n se s:

Compensation 49.9% 8.9% 41.0% 48.3% 9.3% 39.0% 48.1% 9.9% 38.2%
Data P rocessing 8.1% 0.7% 7.4% 8.5% 0.6% 7.9% 8.5% 0.3% 8.2%
Occupancy 7.5% 0.6% 6.8% 8.0% 0.8% 7.1% 7.9% 1.4% 6.5%
Direct P roject
Cost 19.2% 0.0% 19.2% 19.2% 0.0% 19.2% 17.3% 0.0% 17.3%
Other Operating
Cost 12.0% 4.7% 7.3% 12.1% 6.6% 5.5% 10.2% 4.5% 5.7%
Amort of
Intangibles 3.2% 0.0% 3.2% 3.9% 0.0% 3.9% 8.0% 0.0% 8.0%
T otal Cost of
Services 100.0% 15.0% 85.0% 100.0% 17.3% 82.7% 100.0% 16.2% 83.8%

Selling General &

Admin Expenses 0.0% -15.0% 15.0% 0.0% -17.3% 17.3% 0.0% -16.2% 16.2%

T otal Operating
Expenses 100.0% 0.0% 100.0% 100.0% 0.0% 100.0% 100.0% 0.0% 100.0%

O pe ratin g In com e 24.9% 0.0% 24.9% 23.9% 0.0% 23.9% 9.8% 0.0% 9.8%