Advanzeon Solutions, Inc. - Quarter Report: 2012 September (Form 10-Q)
Table of Contents
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 10-Q
Quarterly report pursuant to Section 13 or 15(d) of
the Securities Exchange Act of 1934
For the quarterly period ended September 30, 2012
Commission File Number 1-9927
COMPREHENSIVE CARE CORPORATION
(Exact name of registrant as specified in its charter)
Delaware | 95-2594724 | |
(State or other jurisdiction of incorporation or organization) |
(IRS Employer Identification No.) |
3405 W. Dr. Martin Luther King Jr. Blvd, Suite 101, Tampa, FL 33607
(Address of principal executive offices and zip code)
(813) 288-4808
(Registrants telephone number, including area code)
(Former name, former address and former fiscal year, if changed since last report)
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 (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes x No ¨
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (Section 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). Yes x No ¨
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.
Large Accelerated Filer | ¨ | Accelerated Filer | ¨ | |||
Non-Accelerated Filer | ¨ | Smaller reporting company | x |
Indicate by check mark whether the Registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ¨ No x
As of November 9, 2012, there were 59,251,836 shares of the registrants common stock, $0.01 par value, outstanding.
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
PART I FINANCIAL INFORMATION
ITEM 1. CONSOLIDATED FINANCIAL STATEMENTS
(Dollars in thousands)
September 30, | December 31, | |||||||
2012 | 2011 | |||||||
(unaudited) | ||||||||
ASSETS |
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Current assets: |
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Cash |
$ | 1,589 | $ | 832 | ||||
Accounts receivable, net of allowance of $11 and $0, respectively |
1,314 | 834 | ||||||
Other |
388 | 699 | ||||||
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3,291 | 2,365 | |||||||
Property and equipment, net |
212 | 392 | ||||||
Goodwill |
12,150 | 12,150 | ||||||
Other intangible assets, net of accumulated amortization of $1,560 in 2011 |
| 28 | ||||||
Other |
321 | 381 | ||||||
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$ | 15,974 | $ | 15,316 | |||||
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LIABILITIES AND STOCKHOLDERS EQUITY DEFICIENCY |
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Current liabilities: |
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Notes payable: |
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Related parties |
$ | 2,000 | $ | 2,090 | ||||
Other |
2,207 | 580 | ||||||
Current portion of long-term debt: |
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Related parties |
1,000 | | ||||||
Other |
3,499 | 2,467 | ||||||
Accounts payable |
1,081 | 1,323 | ||||||
Accrued claims payable |
12,800 | 14,036 | ||||||
Other accrued expenses |
6,378 | 7,399 | ||||||
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28,965 | 27,895 | |||||||
Long-term liabilities: |
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Long-term debt, net of current portion: |
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Related parties |
| 1,000 | ||||||
Other |
385 | 2,903 | ||||||
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Total liabilities |
29,350 | 31,798 | ||||||
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Stockholders equity deficiency: |
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Preferred stock, $50 par value: |
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Series C Convertible; 14,400 shares authorized; 10,434 shares issued and outstanding |
522 | 522 | ||||||
Series D Convertible; 7,000 shares authorized; 250 shares issued and outstanding in 2012; none vested |
| | ||||||
Other series; 974,260 shares authorized; none issued |
| | ||||||
Common stock, $0.01 par value; authorized shares: 500,000,000 and 200,000,000; issued and outstanding 59,251,836 |
592 | 592 | ||||||
Additional paid-in capital |
25,838 | 25,455 | ||||||
Deficit |
(40,328 | ) | (43,051 | ) | ||||
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Total stockholders equity deficiency |
(13,376 | ) | (16,482 | ) | ||||
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$ | 15,974 | $ | 15,316 | |||||
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See accompanying notes to consolidated financial statements.
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)
(Dollars in thousands, except per share amounts)
Three Months Ended | Nine Months Ended | |||||||||||||||
September 30, | September 30, | |||||||||||||||
2012 | 2011 | 2012 | 2011 | |||||||||||||
Revenues: |
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Managed care revenues |
$ | 16,753 | $ | 17,200 | $ | 52,767 | $ | 54,039 | ||||||||
Costs and expenses: |
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Costs of revenues |
13,060 | 17,121 | 43,469 | 52,444 | ||||||||||||
General and administrative |
2,043 | 1,979 | 4,784 | 6,122 | ||||||||||||
Depreciation and amortization |
53 | 207 | 209 | 641 | ||||||||||||
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15,156 | 19,307 | 48,462 | 59,207 | |||||||||||||
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Operating income (loss) |
1,597 | (2,107 | ) | 4,305 | (5,168 | ) | ||||||||||
Other income (expense): |
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Interest expense, including $156, $127, $476 and $371, respectively, to related parties, and amortization of debt discount of $49, $176, $319 and $586, respectively |
(437 | ) | (444 | ) | (1,465 | ) | (1,346 | ) | ||||||||
Other non-operating income, net |
6 | | 18 | 107 | ||||||||||||
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Income (loss) before income taxes |
1,166 | (2,551 | ) | 2,858 | (6,407 | ) | ||||||||||
Income taxes |
129 | (1 | ) | 134 | 72 | |||||||||||
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Net income (loss) |
$ | 1,037 | $ | (2,550 | ) | $ | 2,724 | $ | (6,479 | ) | ||||||
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Net income (loss) attributable to common stockholders |
$ | 1,037 | $ | (2,550 | ) | $ | 2,724 | $ | (6,479 | ) | ||||||
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Earnings (loss) per common share: |
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Basic |
$ | 0.02 | $ | (0.04 | ) | $ | 0.05 | $ | (0.12 | ) | ||||||
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Diluted |
$ | 0.01 | n/a | $ | 0.04 | n/a | ||||||||||
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Weighted average common shares outstanding: |
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Basic |
59,252 | 58,379 | 59,252 | 56,283 | ||||||||||||
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Diluted |
90,524 | n/a | 90,034 | n/a | ||||||||||||
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See accompanying notes to consolidated financial statements.
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited)
(Dollars in thousands)
Nine Months Ended | ||||||||
September 30, | ||||||||
2012 | 2011 | |||||||
Net cash provided by (used in) operating activities |
$ | 990 | $ | (2,335 | ) | |||
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Cash flows from investing activities: |
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Additions to property and equipment |
(2 | ) | (35 | ) | ||||
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Cash flows from financing activities: |
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Net proceeds from sale of common stock |
| 1,018 | ||||||
Proceeds from borrowings: |
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Related parties |
| 200 | ||||||
Other |
125 | 1,800 | ||||||
Debt issuance costs |
(8 | ) | (108 | ) | ||||
Repayment of debt: |
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Related parties |
(90 | ) | (100 | ) | ||||
Other |
(258 | ) | (230 | ) | ||||
Cancelation of common stock |
| (125 | ) | |||||
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Net cash (used in) provided by financing activities |
(231 | ) | 2,455 | |||||
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Net increase in cash |
757 | 85 | ||||||
Cash at beginning of period |
832 | 563 | ||||||
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Cash at end of period |
$ | 1,589 | $ | 648 | ||||
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Supplemental disclosures of cash flow information: |
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Cash paid during the period for interest, including related party interest of $12 and $12, respectively |
520 | 289 | ||||||
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Income taxes |
82 | 56 | ||||||
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Property acquired under capital leases |
| 37 | ||||||
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Conversion of Series C preferred to common stock |
| 198 | ||||||
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Common stock and warrants issued for outside services |
| 293 | ||||||
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See accompanying notes to consolidated financial statements.
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
NOTE 1 DESCRIPTION OF THE COMPANYS BUSINESS AND BASIS OF PRESENTATION
The accompanying unaudited interim condensed consolidated financial statements for Comprehensive Care Corporation (referred to herein as the Company, or CompCare) and its subsidiaries have been prepared in accordance with the Securities and Exchange Commission (SEC) rules for interim financial information and do not include all information and notes required for complete financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included. Interim results for the current period are not necessarily indicative of the results that may be expected for the entire fiscal year. The accompanying financial information should be read in conjunction with the consolidated financial statements and the notes thereto in our most recent annual report on Form 10-K. Certain minor reclassifications of prior period amounts have been made to conform to the current period presentation.
Our consolidated financial statements include the accounts of the Company and our wholly-owned subsidiaries, Comprehensive Behavioral Care, Inc. (CBC) and Core Corporate Consulting Group, Inc. (Core), each with their respective subsidiaries (collectively referred to herein as we, us or our). Through CBC, we provide managed care services in the behavioral health, substance abuse, and psychotropic pharmacy management fields for commercial, Medicare, Medicaid and Childrens Health Insurance Program (CHIP) members on behalf of health plans. We also provide behavioral pharmaceutical management services for two health plans in Puerto Rico. Our managed care operations include at-risk behavioral health contracts, at-risk pharmacy management contracts, and administrative service agreements. The customer base for our services includes both private and governmental entities. Our services are provided by unrelated vendors on a subcontract basis.
NOTE 2 NOTES PAYABLE
In September 2012, we committed to an installment plan to pay $76,000 plus interest at 10% to pay outstanding claims due a provider. The payments begin with a $16,000 principal payment in November 2012 followed by twelve $5,000 payments of principal plus interest ending in November 2013.
In July 2012, a 14%, $100,000 convertible promissory note matured and was renewed on the same terms until October 31, 2012, at which time the note was again renewed. The new note utilizes the same terms as the previous note and has a maturity date of January 31, 2013.
In August 2012, a zero coupon promissory note in the amount of $230,000 matured and was replaced by a new note of similar terms with a face value of $230,000 and a maturity date of November 30, 2012.
NOTE 3 LONG-TERM DEBT
In August 2012, in exchange for cash proceeds of $25,000, we issued a $25,000 convertible promissory note to an investor. The note bears interest at the rate of 12% per annum payable quarterly and has a term of two years. At maturity, any or all of the principal plus the accrued but unpaid interest may be converted at the investors option into our common stock at a conversion price of $0.25 per share. At any time prior to the maturity date of the note, the investor may elect to convert the outstanding balance, or any portion thereof, of the note plus any accrued but unpaid interest into shares of the Companys common stock at $0.25 per share. In conjunction with the note issuance, the investor received a warrant with a two year term that may be used to purchase 100,000 shares of our common stock at an exercise price of $0.25 per share. The warrant was vested in full at issuance.
NOTE 4 CONTINGENCIES
Economic conditions and related risks, concentrations and uncertainties:
The United States and other parts of the world have been experiencing a severe and widespread recession accompanied by, among other things, instability in the financial markets and reduced credit availability, which are likely to continue to have far-reaching effects on economic activity for an indeterminate period. The effects and probable duration of these conditions on our ability to obtain continued support from our major stockholders and other lenders, success in our marketing efforts, and ultimately, profitable operations and positive cash flows, cannot be estimated at this time.
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
We occasionally carry cash and equivalents on deposit with financial institutions in excess of federally-insured limits, and the risk of losses related to such concentrations may be increasing as a result of recent economic developments discussed in the foregoing paragraph. The extent of a loss to be sustained as a result of uninsured deposits in the event of a future failure of a financial institution, if any, however, is not subject to estimation at this time.
Going concern uncertainty:
At September 30, 2012, we had a working capital deficiency of approximately $25.7 million and a stockholders equity deficiency of approximately $13.4 million resulting from a history of operating losses. Approximately $2.9 million of debt was past due and in default. As a result of these conditions, and the aforementioned economic conditions and related risks, our ability to continue as a going concern will be dependent upon the success of managements plans, as set forth in the following paragraph, and is subject to significant uncertainty. Management has determined that these conditions have not contributed to any impairment of the Companys goodwill at this time, and the accompanying consolidated financial statements do not include any adjustments that may result from the outcome of this uncertainty, except for the consideration afforded this matter in determining the valuation allowance for deferred tax assets from net operating loss carryforwards (Note 7).
Need for Additional Financing
Our existing capital may not be sufficient to meet our cash needs. Additionally, the possible expiration of our major Puerto Rico contract at December 31, 2012, as discussed in the next paragraph, may reduce our operating cash inflows. Although we cannot provide any assurance in this respect, we believe that subject to the general economic conditions, risks and uncertainties discussed in the preceding paragraphs, with (a) our existing customer contracts, plus the addition of new contracts we believe we are close to obtaining through our marketing efforts, and the launch of new pharmacy management programs, and (b) the expected continuing financial support from our major stockholders and bondholders, that we will be able to sustain our current operations for the remainder of the current calendar year. However, no commitments have been made by any major stockholders and bondholders, and we do not currently maintain a line of credit or other financing arrangement with any financial institution. We have not made any arrangements to obtain any additional financing, but are actively looking at various alternative sources of financing if operations cannot support our ongoing plan. Nevertheless, there also can be no assurance that we will be able to find such financing in amounts or on terms acceptable to us, if at all, or that we will be able to achieve the expected profitable operations and positive operating cash flows for the remainder of the current calendar year. Accordingly, our ability to achieve our business objectives and continue as a going concern is dependent upon the success of the foregoing plans to obtain sufficient debt or equity financing, and, ultimately, to achieve profitable operations and positive cash flows from operations during the next year.
Concentration, major customer contract:
We currently provide mental health, substance abuse, and pharmacy prescription drugs management services to approximately 212,000 members of a health plan in Puerto Rico on an at-risk basis. The contract accounted for 79.1%, or $41.8 million, and 66.1%, or $35.7 million of our revenues for the nine months ended September 30, 2012 and 2011, respectively. We are in the process of submitting a proposal to extend our contract with this customer beyond its December 31, 2012 expiration date. If the contract term is not extended, the loss of this customer as of December 31, 2012, without replacement by new business, would adversely affect our future financial results and jeopardize our ability to continue as a going concern.
In April 2012 we resolved a contract interpretation dispute with this major customer to remove from our responsibility a charge of $2.2 million of pharmacy drug costs originally charged to us by the customers pharmacy benefit manager, from the contracts inception to April 2012. The contract resolution reduced our pharmacy cost by $2.2 million during the three months ended June 30, 2012. It is anticipated that a similar adjustment may be forthcoming for the months of April through September 2012. However, management is not presently able to estimate the amount of such an adjustment.
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
Legal matters:
From time to time, we may be involved in litigation relating to claims arising out of our operations in the normal course of business. Aside from the litigation described below, as of the date of this report, we are not currently involved in any legal proceeding that we believe would have a material adverse effect on our business, financial condition or operating results.
(1) | We are subject to a pending judgment of damages to a former director of approximately $1.9 million including an award for reimbursement of legal fees and payment of interest. The judgment and award are under appeal, and oral arguments have been scheduled for February 2013. |
(2) | A subsidiary was subject to a suit for trademark infringement, among other things, in connection with its proposal to obtain a managed behavioral healthcare services contract in Puerto Rico. The complaint sought monetary damages in the amount of $600,000 and certain injunctive relief. In October 2012, we paid the complainant $25,000 to settle and discharge the suit. |
(3) | In addition, we and a former customer are being sued for damages of approximately $1.7 million for allegedly unpaid claims for behavioral health professional services rendered in 2007 and 2008. We filed a counterclaim for breach of a settlement agreement that we believe previously resolved many of the claims that are the subject of the complaint, which we believe is without merit and are vigorously opposing. |
During the six months ended June 30, 2012, we re-evaluated the adequacy of our provision for possible litigation settlements and legal defense costs and made adjustments to reduce the provision by the amount of approximately $1.6 million, which resulted in an equal reduction of our general and administrative expense. The reduction is primarily due to the Company obtaining an offsetting judgment against an individual that also has pending judgments against us described in item (1) above. With regard to this matter, we obtained a letter of credit in 2011 for approximately $1.9 million to collateralize two surety bonds that permit our appeal of these judgments against us. During the three months ended September 30, 2012, we increased our legal provision for this matter by approximately $0.2 million to reflect more recently available information, resulting in a corresponding increase in our general and administrative expense. Management believes that our legal provision is adequate for the estimated probable minimum losses, including legal defense costs, to be incurred from the litigation described above.
Other:
In connection with a customer agreement for us to provide mental health, substance abuse and pharmacy prescription drugs management services in Puerto Rico, we maintain a letter of credit from a bank in the amount of $4.0 million to assure the customer of our compliance with our obligations under the agreement. Under such agreement, the customer may draw on all or part of the letter of credit under certain defined circumstances. Collateral for the letter of credit was provided by a major stockholder of the Company. If the client draws upon the letter of credit, we may become liable to our major stockholder for the amount of collateral accessed by the bank to fulfill its obligations under the letter of credit.
NOTE 5 FAIR VALUE OF FINANCIAL INSTRUMENTS
The carrying amounts of cash, accounts receivable and accounts payable approximate their estimated fair value due to the short-term nature of these instruments. Since our other financial liabilities are not traded in an open market, we generally use a present value technique, which is a level 3 input, as defined in generally accepted accounting principles, to measure the estimated fair value of these financial instruments, except for valuing stock options and warrants. The rate used for discounting expected cash flows is a risk-free rate adjusted for systematic and unsystematic risk.
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
The carrying amounts and estimated fair values of these financial instruments (all are liabilities) at September 30, 2012, are as follows (in thousands):
Carrying | Estimated | |||||||
Amount | Fair Value | |||||||
Promissory notes |
$ | 3,280 | $ | 3,246 | ||||
Zero-coupon promissory notes |
230 | 225 | ||||||
Debentures |
549 | 546 | ||||||
Senior promissory notes |
1,759 | 1,753 | ||||||
Long-term promissory note |
125 | 119 | ||||||
Less unamortized discount |
(133 | ) | | |||||
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Net liabilities |
$ | 5,810 | $ | 5,889 | ||||
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Due to the inherent nature of related party transactions, we have not attempted to estimate the fair value of liabilities payable to related parties of the Company. As such, promissory notes payable with a carrying value of $3,000,000 are excluded from the table above.
NOTE 6 EQUITY INSTRUMENTS
Our Series C preferred stock is currently convertible into common stock at the rate of approximately 316.28 common shares for each share of Series C preferred, adjustable for any dilutive issuances of common occurring in the future. Series C preferred shares vote with the common stockholders on an as-converted basis. The shares are nonparticipating except that dividends, when declared by our Board of Directors on the common stock, must be paid on the Series C stock on an as-converted basis before any dividends are paid on our common stock. The Series C is also cumulative with respect to dividends on common stock and junior series of preferred stock. Other significant rights and preferences of the Series C preferred include:
| the right to vote as a separate class to appoint five directors of the Company, and |
| liquidation preferences, whereby the Series C holders have a claim against our assets senior to the claim of the holders of our common stock in the event of our liquidation, dissolution or winding-up (the value of the liquidation preference is $250 per share, or approximately $2.6 million at September 30, 2012). |
We also have a class of convertible preferred stock, Series D, for which 7,000 shares are authorized and 250 shares were issued during the nine months ended and outstanding as of September 30, 2012. The shares, which were granted in January 2012, do not vest until the tenth anniversary of the grant date. Such shares were issued in exchange for the cancelation of 120 previously granted warrants to purchase Series D shares. Once vested, a Series D preferred share will be convertible at any time into 100,000 shares of common stock, subject to adjustment in the event of any common stock dividend, split, combination thereof or other similar recapitalization, without additional consideration. Prior to vesting and thereafter, each Series D convertible preferred share is entitled to all voting, dividend, liquidation and other rights accorded a share of Series D convertible preferred stock. As to dividends, the Series D stock is noncumulative. If a dividend is declared on the common stock, each share of Series D stock is entitled to receive a dividend equal to 50% of the dividend declared for the common stock as if the Series D stock had been converted. Despite their nonvested status, voting rights of each share nevertheless consist of the right to cast the number of votes equal to those of 500,000 shares of common stock. Unless otherwise required by applicable law, holders of shares of Series D have the right to vote together with holders of common stock as a single class on all matters submitted to a vote of our stockholders. At September 30, 2012, approximately $3.5 million of compensation expense remained to be recognized over the next 9.3 years related to the Series D shares.
STOCK INCENTIVE COMPENSATION PLANS
WARRANTS:
To Purchase Common Stock
We periodically issue warrants to purchase shares of our common stock for the services of employees and non-employee directors.
Due to employee and director resignations, we derecognized net compensation costs of approximately $23,000, related to warrants to purchase common stock during the nine months ended September 30, 2012. Total unrecognized compensation costs related to warrants as of September 30, 2012, was approximately $3,000 which is expected to be recognized over a weighted-average period of 15 months. The total fair value of warrants vested during the three and nine months ended September 30, 2012 was $9,610 and 15,318.
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
A summary of our warrant activity for the three and nine months ended September 30, 2012 and 2011 follows:
Warrants |
Shares | Weighted- Average Exercise Price |
Weighted- Average Remaining Contractual Term |
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Outstanding at January 1, 2012 |
41,057,583 | $ | 0.35 | 4.86 years | ||||||||
Granted |
25,000 | $ | 0.25 | |||||||||
Forfeited or expired |
(100,000 | ) | $ | 0.53 | ||||||||
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Outstanding at March 31, 2012 |
40,982,583 | $ | 0.35 | 4.61 years | ||||||||
Forfeited or expired |
(2,300,000 | ) | $ | 0.32 | ||||||||
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Outstanding at June 30, 2012 |
38,682,583 | $ | 0.35 | 4.58 years | ||||||||
Granted |
100,000 | $ | 0.25 | |||||||||
Forfeited or expired |
(2,075,000 | ) | $ | 0.63 | ||||||||
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Outstanding at September 30, 2012 |
36,707,583 | $ | 0.33 | 4.43 years | ||||||||
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Exercisable at September 30, 2012* |
36,640,583 | $ | 0.33 | 4.43 years | ||||||||
Outstanding at January 1, 2011 |
27,209,750 | $ | 0.38 | 4.25 years | ||||||||
Granted |
1,291,500 | $ | 0.89 | |||||||||
Reclassified |
500,000 | $ | 0.55 | |||||||||
Forfeited, expired, or cancelled |
(650,000 | ) | $ | 0.51 | ||||||||
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Outstanding at March 31, 2011 |
28,351,250 | $ | 0.40 | 4.05 years | ||||||||
Granted |
433,000 | $ | 0.25 | |||||||||
Forfeited or expired |
(1,000,000 | ) | $ | 1.00 | ||||||||
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Outstanding at June 30, 2011 |
27,784,250 | $ | 0.37 | 3.77 years | ||||||||
Granted |
3,373,333 | $ | 0.44 | |||||||||
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Outstanding at September 30, 2011 |
31,157,583 | $ | 0.38 | 3.57 years | ||||||||
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Exercisable at September 30, 2011* |
29,357,583 | $ | 0.35 | 3.56 years |
* | No aggregate intrinsic value. |
OPTIONS:
From time-to-time, we grant stock options as compensation for services to our employees, non-employee directors and certain consultants (grantees) allowing grantees to purchase our common stock pursuant to stockholder-approved stock option plans. We currently have three active incentive qualified option plans, the 1995 Incentive Plan, the 2002 Incentive Plan and the 2009 Equity Compensation Plan (collectively, the Plans), that provide for the granting of stock options, stock appreciation rights, limited stock appreciation rights, restricted preferred stock, and common stock grants to grantees. Grants issued under the Plans may qualify as incentive stock options (ISOs) under Section 422A of the Internal Revenue Code of 1986, as amended. Options for ISOs may be granted for terms of up to ten years. The vesting of options issued under the 1995 and 2002 plans generally occurs after six months for one-half of the options and after 12 months for the remaining options. For the 2009 Equity Compensation Plan, the vesting period is determined by the Compensation and Stock Option Committee. The exercise price for ISOs must equal or exceed the fair market value of the underlying shares on the date of grant. The Plans also provide for the full vesting of all outstanding options under certain change of control events. The maximum number of common shares authorized for issuance under the Plans is 52,000,000. As of September 30, 2012, there were a total of 44,616,000 shares available for grant and 6,353,000 options outstanding, 5,769,100 of which were exercisable, under the Plans.
In addition, under our Non-employee Directors Stock Option Plan, we are authorized to issue non-qualified stock options to our non-employee directors for up to 1,000,000 common shares. Each non-qualified stock option is exercisable at a price equal to the average of the closing bid and asked prices of the common stock in the over-the-
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counter market for the most recent preceding day there was a sale of the stock prior to the grant date. Grants of options vest in accordance with vesting schedules established by our Board of Directors Compensation and Stock Option Committee. Upon joining our Board of Directors, directors receive an initial grant of 25,000 options. Annually, directors are granted 15,000 options on the date of our annual meeting. As of September 30, 2012, there were 796,668 shares available for option grants and 105,000 options outstanding under the non-qualified directors plan, 65,000 of which were exercisable.
As of September 30, 2012, we also had 1,500,000 options outstanding and exercisable. These options were issued outside the option plans described above.
A summary of our option activity for the three and nine months ended September 30, 2012 and 2011 follows:
Options |
Shares | Weighted- Average Exercise Price |
Weighted- Average Remaining Contractual Term |
|||||||||
Outstanding at January 1, 2012 |
8,795,400 | $ | 0.33 | 7.74 years | ||||||||
Forfeited or expired |
(40,000 | ) | $ | 0.38 | ||||||||
|
|
|||||||||||
Outstanding at March 31, 2012 |
8,755,400 | $ | 0.33 | 7.49 years | ||||||||
Forfeited or expired |
(119,500 | ) | $ | 0.35 | ||||||||
|
|
|||||||||||
Outstanding at June 30, 2012 |
8,635,900 | $ | 0.33 | 7.24 years | ||||||||
Forfeited or expired |
(677,900 | ) | $ | 0.29 | ||||||||
|
|
|||||||||||
Outstanding at September 30, 2012 |
7,958,000 | $ | 0.33 | 6.85 years | ||||||||
|
|
|||||||||||
Exercisable at September 30, 2012* |
7,334,100 | $ | 0.34 | 6.75 years | ||||||||
Outstanding at January 1, 2011 |
2,611,100 | $ | 0.50 | 8.09 years | ||||||||
Granted |
25,000 | $ | 0.23 | 9.82 years | ||||||||
Forfeited or expired |
(464,750 | ) | $ | 0.30 | ||||||||
|
|
|||||||||||
Outstanding at March 31, 2011 |
2,171,350 | $ | 0.54 | 7.77 years | ||||||||
Forfeited or expired |
(116,500 | ) | $ | 0.38 | ||||||||
|
|
|||||||||||
Outstanding at June 30, 2011 |
2,054,850 | $ | 0.55 | 7.47 years | ||||||||
Forfeited or expired |
(126,450 | ) | $ | 0.55 | ||||||||
|
|
|||||||||||
Outstanding at September 30, 2011 |
1,928,400 | $ | 0.55 | 7.22 years | ||||||||
|
|
|||||||||||
Exercisable at September 30, 2011* |
1,019,300 | $ | 0.69 | 6.40 years |
* | No aggregate intrinsic value. |
Total recognized compensation costs during the three and nine months ended September 30, 2012 were approximately $32,000 and $200,000, respectively. As of September 30, 2012, there was approximately $68,000 of unrecognized compensation cost related to options expected to be recognized over a weighted-average period of 10 months. We might have recognized approximately $1,000 and $35,000 of tax benefits attributable to stock-based compensation expense recorded during the three and nine months ended September 30, 2012. However, this potential benefit was fully offset by our valuation allowance due to the aforementioned significant uncertainty of future realization. The total fair value of options vested during the three and nine months ended September 30, 2012, was $0 and $11,148, respectively.
NOTE 7 INCOME TAXES
We are subject to the income tax jurisdictions of the U.S., Puerto Rico, as well as multiple state tax jurisdictions. Our provisions for income taxes for the three and nine months ended September 30, 2012 and 2011 were attributable to Puerto Rico and certain states. The estimated effective income tax rates for the three and nine months ended September 30, 2012 were 11.1% and 4.7%, respectively. Our income before income taxes for the three and nine months ended September 30, 2012 was attributable to the net profit of a subsidiary in Puerto Rico, which is currently not subject to the U.S. federal tax jurisdiction. For the nine months ended September 30, 2012, our subsidiary in Puerto Rico utilized approximately $1.2 million of deferred tax assets from net operating loss carryforwards. No further net operating loss carryforwards remain to be used in Puerto Rico in future years. At September 30, 2012, we have federal net operating loss carryforwards of approximately $38.4 million, the
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deductibility of $29.6 million of which is presently limited under Section 382 of the Internal Revenue Code. Approximately $361,000 of any net operating losses prior to the January 2009 ownership change (the earlier change) can be used to offset taxable income annually. In addition, we can offset our taxable income each year by approximately $274,000 of the net operating losses which incurred between the earlier change and the August 2011 ownership change. We estimate that 59% of the $29.6 million pre-change losses will expire and be unavailable to offset our future taxable income.
Management has evaluated our tax positions taken or to be taken on income tax returns that remain subject to examination (i.e., tax years 2008 and thereafter federally, earlier for certain other jurisdictions), and has concluded that there are no uncertain tax positions, as defined in generally accepted accounting principles, that require recognition or disclosure in the consolidated financial statements.
NOTE 8 PER SHARE DATA
For the periods presented, the following table sets forth the computation of basic and, where applicable,* diluted earnings per share attributable to common stockholders (dollars in thousands, except per share data):
Three Months Ended September 30, |
Nine Months Ended September 30, |
|||||||||||||||
2012 | 2011 | 2012 | 2011 | |||||||||||||
Numerator: |
||||||||||||||||
Net income (loss) attributable to common stockholders |
$ | 1,037 | $ | (2,550 | ) | $ | 2,724 | $ | (6,479 | ) | ||||||
Add: Impact of assumed conversions |
233 | | 696 | | ||||||||||||
|
|
|
|
|
|
|
|
|||||||||
Net income (loss) attributable to common stockholders after assumed conversions |
$ | 1,270 | $ | (2,550 | ) | $ | 3,420 | $ | (6,479 | ) | ||||||
Denominator: |
||||||||||||||||
Weighted average common shares basic |
59,252 | 58,379 | 59,252 | 56,283 | ||||||||||||
Effect of dilutive securities: |
||||||||||||||||
Series C convertible preferred stock |
3,300 | | 3,300 | | ||||||||||||
Series D convertible preferred stock |
7,206 | | 6,770 | | ||||||||||||
Stock options |
| | | | ||||||||||||
Warrants |
| | | | ||||||||||||
Convertible debts |
20,766 | | 20,712 | | ||||||||||||
|
|
|
|
|
|
|
|
|||||||||
Weighted average common shares diluted |
90,524 | 58,379 | 90,034 | 56,283 | ||||||||||||
|
|
|
|
|
|
|
|
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Earnings per share: |
||||||||||||||||
Basic |
$ | 0.02 | $ | (0.04 | ) | $ | 0.05 | $ | (0.12 | ) | ||||||
|
|
|
|
|
|
|
|
|||||||||
Diluted |
$ | 0.01 | n/a | $ | 0.04 | n/a | ||||||||||
|
|
|
|
* | No diluted per share data is presented for loss periods because to do so would be anti-dilutive. |
NOTE 9 SUBSEQUENT EVENTS
Other than the changes in our outstanding debt instruments described in Notes 2 and 3, no events were identified that in our opinion require accounting recognition or disclosure in these financial statements.
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ITEM 2. MANAGEMENTS DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
In addition to historical information, the following information contains forward-looking statements as defined under federal securities laws. Such statements include, but are not limited to, statements about the expected future overall performance of the healthcare market, our expected future financial resources and operating results, including increases in revenues, profitability, interest expense, and our expected growth and expansion, and our expectations regarding our ability to obtain new and maintain existing behavioral healthcare contracts and the profitability, if any, of such behavioral healthcare contracts. These statements are based on current estimates and predictions by management about the industry and markets in which we operate, the customers we serve and managements beliefs and assumptions. Forward-looking statements are not guarantees of future performance and involve certain known and unknown risks and uncertainties that could cause actual results to differ materially from those expressed or implied by such statements. Such risks and uncertainties include, but are not limited to, those related to changes in local, regional, and national economic and political conditions, the effect of governmental regulation, competitive market conditions, varying trends in member utilization, our ability to manage healthcare operating expenses, our ability to achieve expected results from new business, the profitability of our capitated contracts, cost of care, seasonality, our ability to obtain additional financing, and other risks detailed herein and from time to time in our filings with the SEC.
The following discussion should be read in conjunction with the accompanying condensed consolidated financial statements and notes thereto of CompCare and subsidiaries appearing elsewhere in this report.
OVERVIEW
The Company provides health care services and products through its primary operating subsidiaries, Comprehensive Behavioral Care, Inc. (CBC) and Core Corporate Consulting Group, Inc. (Core.)
Through CBC and its subsidiaries, we provide managed behavioral healthcare, substance abuse, and psychotropic pharmacy management services. We provide these services primarily to commercial, Medicare, Medicaid and Childrens Health Insurance Program (CHIP) health plans. Additionally, CBC provides pharmacy and analytic services for its health plan customers to integrate medical claims data and pharmacy data into actionable information so patient care can be coordinated cost effectively. Our managed care operations include at-risk behavioral health contracts, at-risk pharmacy management contracts, and administrative service agreements.
SOURCES OF REVENUE
Our revenue can be segregated into the following significant categories (dollars in thousands):
Three Months Ended | Nine Months Ended | |||||||||||||||
September 30, | September 30, | |||||||||||||||
2012 | 2011 | 2012 | 2011 | |||||||||||||
At-risk behavioral contracts |
$ | 5,984 | $ | 8,127 | $ | 20,950 | $ | 27,222 | ||||||||
Administrative services only contracts |
806 | 687 | 2,476 | 2,138 | ||||||||||||
At-risk pharmacy contracts |
9,963 | 8,386 | 29,341 | 24,679 | ||||||||||||
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$ | 16,753 | $ | 17,200 | $ | 52,767 | $ | 54,039 | |||||||||
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|
Our customer base primarily includes regional health plans that do not have their own behavioral network. We provide services primarily through a network of contracted providers that includes:
| psychiatrists; |
| psychologists; |
| therapists; |
| other licensed healthcare professionals; |
| psychiatric hospitals; |
| general medical facilities with psychiatric beds; |
| residential treatment centers; and |
| other treatment facilities. |
The services provided through our provider network include outpatient programs (such as counseling or therapy), intermediate care programs (such as intensive outpatient programs and partial hospitalization services), inpatient programs and crisis intervention services. We do not directly provide treatment or own any treatment facility.
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We typically enter into contracts on an annual basis to provide managed behavioral healthcare, substance abuse, and psychotropic pharmacy management services to our customers members. Our arrangements with our clients fall into two broad categories:
| At-risk arrangements under which our clients pay us a fixed fee per member in exchange for our assumption of the financial risk of providing services; and |
| ASO arrangements where we manage behavioral healthcare programs or perform various managed care services, such as clinical care management, provider network development, and claims processing without assuming financial risk for member behavioral healthcare costs. |
We also cover psychotropic pharmacy management services, where we receive an additional per-member per-month amount. We manage psychotropic pharmacy services through the collection and analysis of pharmacy claims data which is provided by the health plans pharmacy benefit manager (PBM), whose primary functions are claims adjudication and drug cost negotiation. Through data analysis and usage evaluation against clinically sound, evidence-based criteria, we are able to identify ineffective, inappropriate and costly drug utilization. Our approach is to address these issues in a collaborative manner with the primary care physicians and psychiatrists through the provision of useful information based on our analysis. Our goal is to produce positive outcomes for patients while controlling pharmacy costs.
Under at-risk arrangements, the number of covered members as reported to us by our clients determines the amount of premiums we receive, which is independent of the cost of services rendered to members. The amount of premiums we receive for each member is fixed by our contract at the beginning of our contract term. Under certain circumstances these premiums may be subsequently adjusted up or down, or the contract terminated, generally at the commencement of each renewal period.
Our largest expense is the cost of behavioral health services and pharmacy drugs that we provide, which is based primarily on our arrangements with healthcare providers. Since we are subject to increases in healthcare operating expenses based on an increase in the number and frequency of our members seeking behavioral care services, our profitability depends on our ability to predict and effectively manage healthcare operating expenses in relation to the fixed premiums we receive under at-risk arrangements. Providing services on an at-risk basis exposes us to the risk that our contracts may ultimately be unprofitable if we are unable to control or otherwise anticipate healthcare costs. Accrued claims payable and claims expense are our most critical accounting estimates. See Critical Accounting Policies and Estimates below.
We manage programs through which services are provided to recipients in 23 states, the District of Columbia and Puerto Rico. Our objective is to provide easily accessible, high quality behavioral healthcare and pharmacy services and to manage costs through measures such as the monitoring of hospital inpatient admissions and the review of authorizations for various types of outpatient therapy. Our goal is to combine access to quality behavioral healthcare services with effective management controls in order to ensure the most cost-effective use of healthcare resources.
Our programs and services include:
| management of prescription drugs on an at-risk basis for health plans; |
| fully integrated behavioral healthcare and psychotropic pharmacy management services; |
| analytic services for medical and pharmacy claims for medical integration of behavioral and medical care coordination; |
| case management/utilization review services; |
| administrative services management; |
| preferred provider network development; |
| management and physician advisor reviews; and |
| overall care management services. |
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We also manage physician-prescribed psychotropic medications for two Medicare health plans in Puerto Rico. Members are generally given a prescription from their primary care physician or psychiatrist. We are at-risk for the psychotropic drug costs and manage that appropriate medications are being utilized by the prescribing physician.
RECENT DEVELOPMENTS
Senior Promissory Note Renegotiation
During the nine months ended September 30, 2012, we renewed approximately 99% of our 10% senior promissory notes in the amount of approximately $1.8 million that had come due on April 15, 2012. The new notes will mature April 15, 2013 and bear interest at 14%.
Major Contract
We are in the process of submitting a proposal to extend our contract with our major health plan customer in Puerto Rico. We have provided mental health, substance abuse, and pharmacy prescription drugs management services to approximately 212,000 members of the plan on an at-risk basis since September 2010. The contract, which is set to expire on December 31, 2012, accounted for 79.1%, or $41.8 million, and 66.1%, or $35.7 million, of our revenues for the nine months ended September 30, 2012 and 2011. If the contract is not extended, the loss of this customer as of December 31, 2012, without replacement by new business, would adversely affect our future financial results and jeopardize our ability to continue as a going concern.
In April 2012, we resolved a contract interpretation dispute with this major customer to remove from our responsibility a charge of $2.2 million of pharmacy drug costs originally charged to us by the customers pharmacy benefit manager. The contract dispute resolution removes the cost of drugs prescribed for non-mental health conditions charged to us from the contracts inception to April 2012. The effect of the contract dispute resolution was to reduce our pharmacy cost by $2.2 million for the three months ended June 30, 2012. It is anticipated that a similar adjustment may be forthcoming for the months of April through September 2012. However, management is not presently able to estimate the amount of such an adjustment.
Contract Terminations
In August 2012, we received a letter from a customer terminating its contract with us effective October 31, 2012. Under the contract we provided behavioral healthcare services on an ASO basis to approximately 194,000 Medicare, Medicaid, and commercial members. The contract accounted for 2.5% or $1.3 million, and 2.2%, or $1.2 million, of our revenues for the nine months ended September 30, 2012 and 2011, respectively.
In June 2012, we received a letter from our Louisiana client informing us that our contract to provide at-risk behavioral healthcare services to approximately 52,000 of its Medicare members would be terminated effective July 31, 2012. The contract accounted for 4.3% or $2.3 million, and 4.7%, or $2.5 million, of our revenues for the nine months ended September 30, 2012 and 2011, respectively. As this contract resulted in an operating loss during 2012, its elimination is likely to improve our overall operating results.
Expense Reduction Initiative
In May 2012, we announced that we had implemented cost-saving measures beginning in the first quarter of this year to reduce our general and administrative expenses and increase our operating income. The measures included salary reductions for mid-level staff and senior management, as well as the layoff of 26 employees, among others.
RESULTS OF OPERATIONS
Three months ended September 30, 2012 vs. 2011
Revenues: Total managed care revenues decreased 2.6%, or approximately $0.4 million, for the three months ended September 30, 2012 compared to the three months ended September 30, 2011. We experienced various increases and decreases in the categories of such revenues as described below.
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At-risk behavioral health contracts: Operating revenues from at-risk contracts decreased by 26.4%, or approximately $2.1 million, to $6.0 million for the three months ended September 30, 2012, compared to $8.1 million for the three months ended September 30, 2011. The decrease was primarily attributable to the loss of customers in Missouri, Texas and Wisconsin during the fourth quarter of 2011 and first quarter of 2012 that had accounted for $1.7 million of revenue for the three months ended September 30, 2011 and the loss of contracts in Louisiana and Michigan during the third quarter of 2012 that had accounted for $1.5 million of revenue for the three months ended September 30, 2011. This decrease was offset by approximately $1.1 million in additional revenues in 2012 from new and previously existing customers.
ASO contracts: Revenue from ASO contracts increased by 17.2%, or approximately $0.1 million, to $0.8 million for the three months ended September 30, 2012, due primarily to additional revenue from the expansion of business of previously existing ASO customers.
Pharmacy management contracts: Pharmacy revenue increased by 18.8%, or approximately $1.6 million, to $10.0 million for the three months ended September 30, 2012, from approximately $8.4 million for the three months ended September 30, 2011, attributable primarily to a 6.7% increase in membership and a 11% contract rate increase effective January 1, 2012 from our major customer in Puerto Rico.
Costs of revenues: Total costs of revenues decreased 23.7%, or approximately $4.1 million, in 2012 as compared to 2011 for reasons set forth in the following four paragraphs.
Claims costs, at-risk behavioral health contracts: Claims expense on at-risk contracts decreased by 22.1%, or approximately $1.4 million, to $4.8 million for the three months ended September 30, 2012, as compared to the three months ended September 30, 2011. The decrease was primarily attributable to a $3.2 million reduction of claims related to contracts lost in Michigan, Missouri and Louisiana during the fourth quarter of 2011 and 2012, which was offset by increases in claims of $1.0 million from new and existing business and the effect of a $0.5 million elimination in the third quarter of 2011 of unnecessary accruals related to lost or expired contracts. Claims costs as a percentage of at-risk revenues increased to 79.4% for the three months ended September 30, 2012, from 75.1% for the three months ended September 30, 2011, attributable to higher utilization.
Pharmacy drug costs: Pharmacy costs decreased by 20.1%, or approximately $1.7 million, to $6.9 million for the three months ended September 30, 2012, as compared to $8.6 million for the three months ended September 30, 2011. The decrease is primarily attributable to the recent availability of a generic form of a highly prescribed name-brand medication. Pharmacy costs as a percentage of pharmacy revenue decreased from 103.0% for the three months ended September 30, 2011, to 69.3% for the three months ended September 30, 2012, due to an increase in the contract rate for our major Puerto Rico customer effective January 1, 2012 and the aforementioned decrease in the cost of the highly prescribed drug.
Contract loss allowance: During the three months ended September 30, 2012, we reversed $0.1 million of an excess contract loss allowance that we had established at December 31, 2011 for our Louisiana contract. The allowance was no longer needed due to the early termination of the contract.
Other healthcare operating costs: Other healthcare costs, which consist of the costs of care administration, such as salaries, employee benefits and external medical case review fees, decreased 35.8%, or approximately $0.9 million, due primarily to salary reductions and cost savings from employee headcount reductions that began during the three months ended June 30, 2012. Total healthcare costs as a percentage of total operating revenue decreased to 9.1% for the three months ended September 30, 2012, compared to 13.8% for the three months ended September 30, 2011.
General and administrative expense: General and administrative expense increased slightly by 3.2%, or approximately $64,000, for the three months ended September 30, 2012, as compared to the three months ended September 30, 2011. A $0.4 million increase in legal expense attributable primarily to an adjustment of a legal provision in the amount of $0.2 million was partially offset by a decrease of approximately $0.3 million in salaries and benefits due to the Companys expense reduction initiative. As a percentage of total operating revenue, general and administrative expense increased to 12.1% for the three months ended September 30, 2012, compared to 11.5% for the three months ended September 30, 2011.
Interest expense: Interest expense, excluding amortization of debt discount, increased by approximately 44.8%, or approximately $120,000, for the three months ended September 30, 2012, as compared to the three months ended September 30, 2011 due to an increase in the weighted average amount of debt outstanding to approximately $8.5 million for the three months ended September 30, 2012, from $6.3 million for the comparable prior period, and an increase in the average effective interest rate, excluding amortization of debt discount, for the three months ended September 30, 2012, to approximately 18.3% from 17.1% for the same period in 2011.
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Income taxes: Our provisions for income taxes for the quarters ended September 30, 2012 and 2011 were attributable to Puerto Rico and certain states. Our effective income tax rate for the three months ended September 30, 2012 was 11.1% as compared to 0% for the three months ended September 30, 2011. During the current quarter, our subsidiary in Puerto Rico utilized approximately $0.1 million of deferred tax assets from net operating loss carryforwards, as compared to none in the comparable period of the prior year.
Nine months ended September 30, 2012 vs. 2011
Revenues: Total managed care revenues decreased 2.4%, or approximately $1.3 million, for the nine months ended September 30, 2012 compared to the nine months ended September 30, 2011. We experienced increases and decreases in the various categories of such revenues as follows.
At-risk behavioral health contracts: Operating revenues from at-risk contracts decreased by 23.0%, or approximately $6.3 million, to $20.9 million for the nine months ended September 30, 2012, compared to $27.2 million for the nine months ended September 30, 2011. The decrease was primarily attributable to the loss of customers in Missouri, Texas and Wisconsin during the fourth quarter of 2011 that accounted for $8.0 million of revenue for the nine months ended September 30, 2011 and to the loss of contracts in Louisiana and Michigan during the third quarter of 2012 that had accounted for $1.4 million of revenue for the three months ended September 20, 2011. The decrease was offset by approximately $3.2 million in additional revenues from new and previously existing customers.
ASO contracts: Revenue from ASO contracts increased by 15.8%, or approximately $0.3 million, to $2.5 million for the nine months ended September 30, 2012, due primarily to additional revenue from the expansion of business of previously existing ASO customers.
Pharmacy management contracts: Pharmacy revenue increased by 18.9%, or approximately $4.6 million, to $29.3 million for the nine months ended September 30, 2012, from approximately $24.7 million for the nine months ended September 30, 2011, attributable primarily to a 7.2% increase in membership and a 11% contract rate increase effective January 1, 2012 from our major customer in Puerto Rico.
Costs of revenues: Total costs of revenues decreased approximately 17.1%, or $9.0 million, in 2012 as compared to 2011 for reasons set forth in the following four paragraphs.
Claims costs, at-risk behavioral health contracts: Claims expense on at-risk contracts decreased by 22.4%, or approximately $4.6 million, to $15.9 million for the nine months ended September 30, 2012 as compared to the nine months ended September 30, 2011. The decrease was primarily attributable to a reduction of claims related to contracts lost in Missouri, Texas, and Wisconsin during the fourth quarter of 2011 described above as compared to $6.7 million of claims costs for these contracts for the comparable period. The claims costs decrease was offset by increases of $1.4 million and $1.0 million resulting from the expansion of existing contracts and the addition of new at-risk business, respectively. Claims costs as a percentage of at-risk revenues increased to 75.7% for the nine months ended September 30, 2012, from 75.0% for the nine months ended September 30, 2011, attributable to higher utilization.
Pharmacy drug costs: Pharmacy costs decreased by 11.1%, or approximately $2.8 million, to $22.7 million for the nine months ended September 30, 2012 as compared to $25.5 million for the nine months ended September 30, 2011. The decrease is attributable to a $2.2 million resolution of a contract interpretation dispute relating to the removal of non-psychotropic drugs charged to us by the health plans pharmacy benefit manager and the effect of the lesser cost of a recently available generic version of a popular drug. The decrease was offset by higher drug costs attributable to greater drug utilization accompanying a 7.2% increase in membership. Pharmacy costs as a percentage of pharmacy revenue decreased from 103.6% for the nine months ended September 30, 2011 to 77.4% for the nine months ended September 30, 2012, due to an increase in the contract rate effective January 1, 2012 for our major customer in Puerto Rico, the previously mentioned $2.2 million adjustment, and the aforementioned decrease in the cost of the highly prescribed drug.
Contract loss allowance: During the nine months ended September 30, 2012, we reversed $450,000 of an excess contract loss allowance that we had established at December 31, 2011 for our Louisiana contract. The allowance was no longer needed due to the early termination of the contract.
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Other healthcare operating costs: Other healthcare costs, which consist of the costs of care administration, such as salaries, employee benefits and external medical case review fees, decreased $1.1 million to $5.3 million for the nine month period ended September 30, 2012, as compared to $6.4 million for the nine month period ended September 30, 2011. The decrease is primarily attributable to salary reductions and cost savings from employee reductions in 2012. Total healthcare costs as a percentage of total operating revenue decreased to 10.1% for the nine months ended September 30, 2012 compared to 11.9% for the nine months ended September 30, 2011.
General and administrative expense: General and administrative expense decreased by 21.9%, or approximately $1.3 million, to $4.8 million for the nine months ended September 30, 2012, as compared to the nine months ended September 30, 2011. The decrease was primarily attributable to a reduction in legal expense due to adjustments of an estimated legal settlement provision, as well as a cost savings from employee reductions in 2012. As a percentage of total operating revenue, general and administrative expense decreased to 9.0% for the nine months ended September 30, 2012, compared to 11.3% for the nine months ended September 30, 2011, attributable to the aforementioned.
Interest expense: Interest expense, excluding amortization of debt discount, increased by approximately 47.3%, or approximately $368,000, for the nine months ended September 30, 2012, as compared to the nine months ended September 30, 2011 due to an increase in the weighted average amount of debt outstanding to approximately $9.3 million for the nine months ended September 30, 2012, from $5.9 million for the comparable prior period net of a decline in the average effective interest rate, excluding amortization of debt discount, for the nine months ended September 30, 2012, to approximately 16.5% from 17.1% for the same period in 2011, which was the result of adding $3.5 million in debt at 14% during the third quarter of 2011.
Income taxes: Our provisions for income taxes for the nine months ended September 30, 2012 and 2011 were attributable to Puerto Rico and certain states. Our effective income tax rate for the nine months ended September 30, 2012 was 4.7%. Our subsidiary in Puerto Rico utilized approximately $1.2 million of deferred tax assets from net operating loss carryforwards for the nine months ended September 30, 2012.
CRITICAL ACCOUNTING POLICIES AND ESTIMATES
Preparation of our consolidated financial statements requires us to make significant estimates and judgments to develop the amounts reflected and disclosed in the consolidated financial statements. On an on-going basis, we evaluate the appropriateness of our estimates and we maintain a thorough process to review the application of our accounting policies. We base our estimates on historical experience and on various other assumptions that we believe to be reasonable under the circumstances. Actual results may differ from these estimates under different assumptions or conditions.
We believe our accounting policies specific to our revenue recognition, accrued claims payable, premium deficiencies and claims expense, goodwill, and income taxes are critical to the preparation of our consolidated financial statements.
Revenue recognition. The majority of our managed care activities are performed under at-risk arrangements pursuant to terms of agreements primarily with health plans to provide contracted behavioral healthcare and pharmacy management services to subscribing members. Revenue under these agreements is earned continuously over time regardless of services actually provided and, therefore, is recognized monthly based on the number of qualified members. The information regarding qualified members is supplied by our clients, and we review member eligibility records and other reported information to verify its accuracy and determine the amount of revenue to be recognized. The remaining balance of our revenues is earned and recognized as services are delivered on a non-risk basis.
We also manage the psychotropic drug benefit under certain behavioral health contracts for certain health plans subscribing members and are responsible for the cost of drugs dispensed. In accordance with the contracts, the health plans pharmacy benefit manager (PBM) performs drug price negotiation and claims adjudication. As such, payment for our pharmacy management services is withheld until a monthly or quarterly comparison of our total premium to total drug cost is made, at which time we receive or pay the difference. Accordingly, similar to our other at-risk arrangements, pharmacy drug management revenue is earned at a contracted rate per eligible member and recognized monthly.
Accrued claims payable. Claims expense, a major component of cost of care, is recognized in the period in which an eligible plan member actually receives services and includes incurred but not reported (IBNR) claims. We contract with various healthcare providers including hospitals, physician groups and other licensed behavioral healthcare
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professionals either on a discounted fee-for-service or a per-case basis. We determine that a member has received services when we receive a claim within the contracted timeframe with all required billing elements correctly completed by the service provider. We then determine whether the member is eligible to receive the service, the service provided is medically necessary and is covered by the benefit plans certificate of coverage, and the service is authorized by one of our employees, if required. If all of these requirements are met, the claim is entered into our claims system for payment.
The accrued claims payable liability represents the estimated ultimate net amounts owed for all behavioral healthcare services provided through the respective balance sheet dates, including estimated amounts for claims IBNR. We have used the same methodology and assumptions for estimating the IBNR portion of the accrued claims liability for the last two years.
Our unpaid claims liability is estimated using an actuarial paid completion factor methodology and other statistical analyses. These estimates are subject to the effects of trends in utilization and other factors. Any significant increase in member utilization that falls outside of our estimates would increase claims expense and could adversely affect our ability to achieve and sustain improvements in profitability and positive cash flow. Although considerable variability is inherent in such estimates, we believe that our unpaid claims liability is adequate.
Whenever we believe it is probable that a future loss will be incurred under a managed care contract based on an expected premium deficiency and we are unable to cancel our obligation or renegotiate the contract, we record a loss in the amount of the expected future losses. We perform our loss accrual analysis on a contract-by-contract basis by taking into consideration various factors such as future contractual revenue, estimated future healthcare and maintenance costs, and each contracts specific terms related to future revenue increases as compared to expected increases in healthcare costs. The estimated future healthcare and maintenance costs are based on historical trends and expected future cost increases. Our analysis at September 30, 2012 did not identify any loss contracts.
Accrued claims payable consists primarily of amounts established for reported claims and IBNR claims, which are unpaid through the respective balance sheet dates. Our policy is to record managements best estimate of IBNR. The IBNR liability is estimated monthly using an actuarial paid completion factor methodology and is continually reviewed and adjusted, if necessary, to reflect any change in the estimated liability as more information becomes available. In deriving an initial range of estimates, we use an industry accepted actuarial model that incorporates past claims payment experience, enrollment data and key assumptions such as trends in healthcare costs and seasonality. Authorization data, utilization statistics, calculated completion percentages and qualitative factors are then combined with the initial range to form the basis of managements best estimate of the accrued claims payable balance. However, estimating IBNR claims involves a significant amount of judgment by our management. The following are the principal factors that would have an impact on our future operations and financial condition:
| Changes in the number of employee plan members due to economic factors; |
| Other changes in utilization patterns; |
| Changes in healthcare costs; |
| Changes in claims submission timeframes by providers; |
| Success in renegotiating contracts with healthcare providers; |
| Occurrence of catastrophes; |
| Changes in benefit plan design; and |
| The impact of present or future state and federal regulations. |
The accrued claims payable ranges were between $12.7 and $12.9 million at September 30, 2012 and between $13.9 and $14.1 million at December 31, 2011. Based on the information available, we determined our best estimate of the accrued claims liability to be $12.9 million at September 30, 2012 and $14.0 million at December 31, 2011. Our accrued claims liability at September 30, 2012 and December 31, 2011 includes approximately $10.6 million and $7.3 million, respectively, of submitted and approved but unpaid claims, $2.2 million and $6.2 million for IBNR claims, respectively, and $0 and $0.5 million, respectively, of contract loss allowance. A 5% increase in assumed healthcare cost trends from those used in our calculations of IBNR at September 30, 2012 could increase our claims expense by approximately $108,000. Actual claims incurred could differ from estimated claims accrued.
Goodwill. We periodically evaluate the amount of our recorded goodwill by performing impairment tests that compare the carrying amount to an estimated fair value, based on level 3 inputs as defined in generally accepted accounting principles. Management considers both the income and market approaches in the fair value estimation. In estimating the fair value under the income approach, management makes its best assumptions regarding future cash flows and applies a discount rate to the cash flows to yield a present, fair value of equity. The market approach is
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based primarily on reference to transactions including our common stock and the quoted market prices of our common stock. However, actual results may differ significantly from managements assumptions, resulting in a potentially adverse impact to our consolidated financial statements. As of September 30, 2012, there had been no significant changes in the conditions affecting goodwill since our last detailed goodwill evaluation at December 31, 2011. The resolution of certain matters during the fourth quarter, such as the possible expiration of our major customer contract in Puerto Rico, without replacement by new business, could have a significant detrimental impact on the recorded amount of goodwill at December 31, 2012.
Income taxes. Computing our provision for income taxes involves significant judgment and estimates particularly in relation to the realization of deferred tax assets from net operating loss carryforwards, uncertain income tax positions, and in estimating the probable annual effective income tax rates for interim financial reporting periods.
We are particularly vulnerable to additional changes in control in the near term due to probable future equity dilution or possible takeover resulting in further loss of our ability to utilize the remaining carryforwards pursuant to Section 382. In addition, as of September 30, 2012, the Company continues to be in a deficit position. Based on this evidence, and the uncertainty as to our ability to continue as a going concern and current economic conditions discussed under LIQUIDITY AND CAPITAL RESOURCES below, we determined that based on our judgment, we cannot conclude at this time that it is more likely than not that the Companys deferred tax assets (which relate primarily to the federal net operating losses) will be realizable within the carryforward period. Accordingly, the Company continues to maintain an effective 100% valuation allowance against the balance of these deferred tax assets at this time. Our judgments regarding future taxable income may change in the future due to many factors, including changes in operating results from changing economic or market conditions, or changes in tax laws, operating results or other factors.
RECENT ACCOUNTING PRONOUNCEMENTS
No recent accounting pronouncements have been issued that are not yet effective and have not been early adopted that we believe will have a significant effect on our consolidated financial statements in future periods.
SEASONALITY OF BUSINESS
Historically, we have experienced increased member utilization during the months of March, April and May and consistently low utilization by members during the months of June, July, and August. Such variations in member utilization affect our costs of care incurred during these months, having a generally positive impact on our operations during June through August and a negative impact from March through May.
LIQUIDITY AND CAPITAL RESOURCES
At September 30, 2012, we had a working capital deficiency of approximately $25.7 million and a stockholders equity deficiency of approximately $13.4 million net of a deficit of approximately $40.3 million resulting from a history of operating losses. Approximately $2.9 million of debt was past due and, therefore, in default. As a result of these conditions, and the economic conditions and related risks discussed in the second paragraph, below, our ability to continue as a going concern will be dependent upon the success of managements plans, as set forth in the following paragraphs, and is subject to significant uncertainty. In their report on our most recent audited financial statements as of and for the year ended December 31, 2011, our independent auditors expressed substantial doubt as to our ability to continue as a going concern. Except for its consideration in establishing our valuation allowance for deferred tax assets, the accompanying consolidated financial statements do not include any adjustments that may result from the outcome of this uncertainty.
The United States and other parts of the world have been experiencing a severe and widespread recession accompanied by, among other things, instability in the financial markets and reduced credit availability, which are likely to continue to have far-reaching effects on economic activity for an indeterminate period. The effects and probable duration of these conditions on our ability to obtain continued support from our major stockholders and other lenders, success in our marketing efforts, and ultimately, profitable operations and positive cash flows, cannot be estimated at this time.
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Need for Additional Financing
Our existing capital may not be sufficient to meet our cash needs. Additionally, the possible expiration of our major Puerto Rico contract at December 31, 2012 may reduce our operating cash inflows. Although we cannot provide any assurance in this respect, we believe that subject to the general economic conditions, risks and uncertainties discussed in the preceding paragraphs, with (a) our existing customer contracts, plus the addition of new contracts we believe we are close to obtaining through our marketing efforts, and the launch of new pharmacy management programs, and (b) the expected continuing financial support from our major stockholders and bondholders, that we will be able to sustain our current operations for the remainder of the current calendar year. However, no commitments have been made by any major stockholders and bondholders, and we do not currently maintain a line of credit or term loan with any commercial bank or other financial institution. We have not made any arrangements to obtain such additional financing, but are actively looking at various alternative sources of financing if operations cannot support our ongoing plan. Nevertheless, there also can be no assurance that we will be able to find such financing in amounts or on terms acceptable to us, if at all, or that we will be able to achieve the expected profitable operations and positive operating cash flows for the remainder of the current calendar year. Accordingly, our ability to achieve our business objectives and continue as a going concern is dependent upon the success of the foregoing plans to obtain sufficient debt or equity financing, and, ultimately, to achieve profitable operations and positive cash flows from operations during the next year.
Our primary internal source of liquidity on an on-going basis is from operations and consists of the monthly capitation payments we receive from our clients for providing managed care services. Based on historical experience, there is a high degree of certainty with respect to the reliability and timing of these payments from continuing contracts. However, the expiration or termination of existing contracts, whether expected or not, or the commencement of new contracts may cause our operational cash flow to vary significantly.
Our external sources of liquid funds consist primarily of borrowings and the use of equity instruments. Our ability to continue to borrow funds on an unsecured basis is unknown, as well as our ability to sell shares of our common stock in private placement offerings. With the exception of contracted maturities of debt, there are no other known future liquidity demands due to commitments or events. We do not have any off-balance sheet financing arrangements. The duration of our borrowings has typically ranged from one week to three years, with stated interest rates ranging from 7% to 24%. Certain of the loans have contained features such as the ability to convert all or a portion of the loan into our common stock, or have had a detachable warrant for the purchase of our common stock issued in conjunction with the loan, or both.
As evident in our statement of cash flows, during the nine months ended September 30, 2012, our cash balance increased by $757,000 due primarily to managing our cash outflows relating to our cost of care and from our cost reduction initiatives. We also obtained additional debt financing in the amount of $125,000 and repaid existing debt, including capitalized leases, in the amount of $348,000.
ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
While we currently have market risk sensitive instruments, we have no significant exposure to changing interest rates, as the interest rates on our short-term debt are fixed. Additionally, we do not use derivative financial instruments for investment or trading purposes.
ITEM 4. CONTROLS AND PROCEDURES
(a) | Evaluation of Disclosure Controls and Procedures |
Our management, with the participation of our Chief Executive Officer and Chief Financial Officer, evaluated the effectiveness of our disclosure controls and procedures as of the end of the period covered by this report. Based upon this evaluation, our Chief Executive Officer along with the Chief Financial Officer concluded that our disclosure controls and procedures as of the end of the period covered by this report are functioning effectively to provide reasonable assurance that the information required to be disclosed by the Company in reports filed under the Exchange Act is (1) recorded, processed, summarized and reported within the time periods specified in the SECs rules and forms, and (2) accumulated and communicated to the Companys management, including the Chief Executive Officer and Chief Financial Officer, as appropriate to allow timely decisions regarding disclosure.
(b) | Change in Internal Control over Financial Reporting |
No change in our internal control over financial reporting occurred during our most recent fiscal quarter that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.
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In the ordinary conduct of our business, we are subject to periodic lawsuits and claims. Although we cannot predict with certainty the ultimate resolution of lawsuits and claims asserted against us, we do not believe that any currently pending legal proceedings to which we are a party could have a material adverse effect on our business, or our future results of operations, cash flows or financial condition except as described below:
(1) | We initiated an action against Jerry Katzman, a former director, in July 2009 alleging that Mr. Katzman fraudulently induced us to enter into an employment agreement and, alternatively, that Mr. Katzman breached that alleged employment agreement and was rightfully terminated. In September 2010, the matter proceeded to a trial by jury. The jury found that Mr. Katzman did not fraudulently induce CompCare to enter into the contract. The jury also found that Mr. Katzman was not entitled to damages. On defendants motion to amend the verdict due to inconsistency, the trial court set aside the jury verdict and awarded Mr. Katzman damages of approximately $1.3 million. In February 2011, the Company filed a Notice of Appeal, posted a collateralized appeal bond for approximately $1.3 million, and filed a motion for reconsideration. Oral arguments on the appeal have been scheduled for February 2013. |
In addition, in July 2011, the District Court awarded Mr. Katzman approximately $582,000 as reimbursement of his legal fees and costs, and payment of prejudgment interest on the damage award of $1.3 million. In response, the Company in August 2011 filed a Notice of Appeal, posted a collateralized appeal bond for approximately $582,000, and filed a motion for reconsideration. Oral arguments on the appeal have been scheduled for February 2013.
(2) | On September 21, 2010, a complaint entitled InfoMC, Inc. v. Comprehensive Behavioral Care, Inc. and CompCare de Puerto Rico, Inc. was filed against us alleging, among other things, that the Company improperly used InfoMC, Inc.s trademarks in connection with CompCare de Puerto Rico Inc.s proposal to obtain a managed behavioral healthcare services contract in Puerto Rico. The complaint asserted claims for federal trademark infringement, false advertising, unfair competition, conversion, promissory estoppel and unjust enrichment. The plaintiff sought monetary damages in the amount of $600,000 and certain injunctive relief. In October 2012, we paid the plaintiff $25,000 to settle and discharge the suit. |
(3) | On January 5, 2011, a complaint entitled Community Hospitals of Indiana, Inc. vs. Comprehensive Behavioral Care, Inc. and MDwise, Inc. was filed against us. The complaint claims damages of approximately $1.7 million from us and MDwise, Inc., a former client, for allegedly unpaid claims for behavioral health professional services rendered between 2007 and 2008. The complaint alleges, among other things, breach of contract and unjust enrichment, and requests recovery of alleged losses despite the absence of a contract between us and complainant. We believe the suit against the Company is without merit and are vigorously opposing the litigation. |
Management believes that the Company has made adequate provision for any estimated probable losses, including legal defense costs, from the litigation described above. Management also believes that the resolution of these matters will not have a material adverse effect on the Companys future financial condition or results of operations.
The risk factors included in our Annual Report on Form 10-K for the year ended December 31, 2011 have not materially changed.
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ITEM 2. UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS
During the period August 10, 2012 through November 9, 2012, we neither sold nor issued our common shares or securities convertible into common stock in private placements not involving a public offering.
ITEM 3. DEFAULTS UPON SENIOR SECURITIES
A 24% convertible promissory note in the amount of $2 million issued to a related party, a major stockholder, was not repaid on its maturity date of June 4, 2011, and is currently in default. As of September 30, 2012, interest of approximately $1.1 million was also due and in default on this promissory note.
ITEM 4. MINE SAFETY DISCLOSURES
Not applicable.
Not applicable.
EXHIBIT |
DESCRIPTION | |
31.1 | Certification of Chief Executive Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 | |
31.2 | Certification of Chief Financial Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 | |
32.1 | Certification of Chief Executive Officer pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 | |
32.2 | Certification of Chief Financial Officer pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 | |
101 | The following materials from Comprehensive Care Corporations Quarterly Report on Form 10-Q for the quarter ended September 30, 2012, formatted in eXtensible Business Reporting Language (XBRL): (i) Consolidated Balance Sheets, (ii) Consolidated Statements of Operations, (iii) Consolidated Statements of Cash Flows, and (iv) Notes to Consolidated Financial Statements. Pursuant to Rule 406T of Regulation S-T, the Interactive Data Files on Exhibit 101 hereto are deemed not filed or part of a registration statement or prospectus for purposes of Sections 11 or 12 of the Securities Act of 1933, as amended, are deemed not filed for purposes of Section 18 of the Securities and Exchange Act of 1934, as amended, and otherwise are not subject to liability under those sections. |
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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.
COMPREHENSIVE CARE CORPORATION | ||||||
November 14, 2012 | ||||||
By | /s/ CLARK A. MARCUS | |||||
Clark A. Marcus | ||||||
Chief Executive Officer and Chairman | ||||||
(Principal Executive Officer) | ||||||
By | /s/ ROBERT J. LANDIS | |||||
Robert J. Landis | ||||||
Chief Financial Officer and Chief Accounting Officer | ||||||
(Principal Financial and Accounting Officer) |
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