867963--9/4/2008--UNITED_AMERICAN_HEALTHCARE

related topics

{regulation, government, change}

{cost, contract, operation}

{system, service, information}

{control, financial, internal}

{personnel, key, retain}

{interest, director, officer}

{product, liability, claim}

{tax, income, asset}

{debt, indebtedness, cash}

{cost, regulation, environmental}

{condition, economic, financial}

LEGISLATIVE OR REGULATORY ACTIONS, ECONOMIC CONDITIONS OR OTHER FACTORS THAT ADVERSELY AFFECT THOSE OPERATIONS COULD MATERIALLY REDUCE OUR REVENUES AND PROFITS. REDUCTIONS IN FUNDING FOR GOVERNMENT HEALTHCARE PROGRAMS COULD SUBSTANTIALLY REDUCE OUR PROFITABILITY. CMS'S RISK ADJUSTMENT PAYMENT SYSTEM AND BUDGET NEUTRALITY FACTORS MAKE OUR REVENUE AND PROFITABILITY DIFFICULT TO PREDICT AND COULD RESULT IN MATERIAL RETROACTIVE ADJUSTMENTS TO OUR RESULTS OF OPERATIONS. IF WE ARE UNABLE TO ESTIMATE INCURRED BUT NOT REPORTED MEDICAL BENEFITS EXPENSE ACCURATELY, THAT COULD AFFECT OUR REPORTED FINANCIAL RESULTS. OUR RECORDS MAY CONTAIN INACCURATE INFORMATION REGARDING THE RISK ADJUSTMENT SCORES OF OUR MEMBERS, WHICH COULD CAUSE US TO OVERSTATE OR UNDERSTATE OUR REVENUE. THE COMPETITIVE BIDDING PROCESS MAY ADVERSELY AFFECT OUR PROFITABILITY. WE DERIVE ALL OF OUR MEDICARE REVENUES FROM OUR SNP OPERATIONS, AND LEGISLATIVE OR REGULATORY ACTIONS, ECONOMIC CONDITIONS OR OTHER FACTORS THAT ADVERSELY AFFECT THOSE OPERATIONS COULD MATERIALLY REDUCE OUR REVENUES AND PROFITS. FINANCIAL ACCOUNTING FOR THE MEDICARE PART D BENEFITS IS COMPLEX AND REQUIRES DIFFICULT ESTIMATES AND ASSUMPTIONS. IF STATE REGULATORS DO NOT APPROVE PAYMENTS BY OUR HEALTH PLAN TO US, OUR BUSINESS AND GROWTH STRATEGY COULD BE MATERIALLY IMPAIRED OR WE COULD BE REQUIRED TO INCUR INDEBTEDNESS TO FUND THESE STRATEGIES. WE ARE REQUIRED TO COMPLY WITH LAWS GOVERNING THE TRANSMISSION, SECURITY AND PRIVACY OF HEALTH INFORMATION THAT REQUIRE SIGNIFICANT COMPLIANCE COSTS, AND ANY FAILURE TO COMPLY WITH THESE LAWS COULD RESULT IN MATERIAL CRIMINAL AND CIVIL PENALTIES. IF OUR MEDICARE CONTRACT IS NOT EXTENDED OR IS TERMINATED, OUR BUSINESS WOULD BE MATERIALLY IMPAIRED. BECAUSE OUR PREMIUMS ARE ESTABLISHED BY CONTRACT AND CANNOT BE MODIFIED DURING THE CONTRACT TERM, OUR PROFITABILITY WILL LIKELY BE REDUCED OR WE COULD CEASE TO BE PROFITABLE IF WE ARE UNABLE TO MANAGE OUR MEDICAL EXPENSES EFFECTIVELY. COMPETITION IN OUR MEDICARE ADVANTAGE SERVICE AREA MAY LIMIT OUR ABILITY TO MAINTAIN OR ATTRACT MEMBERS, WHICH COULD ADVERSELY AFFECT OUR RESULTS OF OPERATIONS. A FAILURE TO INCREASE OUR SNP MEMBERSHIP COULD ADVERSELY AFFECT OUR RESULTS OF OPERATIONS. A DISRUPTION IN OUR HEALTHCARE PROVIDER NETWORKS COULD HAVE AN ADVERSE EFFECT ON OUR OPERATIONS AND PROFITABILITY. WE RELY ON THE ACCURACY OF LISTS PROVIDED BY CMS REGARDING THE ELIGIBILITY OF A PERSON TO PARTICIPATE IN OUR PLAN, AND ANY INACCURACIES IN THOSE LISTS COULD CAUSE CMS TO RECOUP PREMIUM PAYMENTS FROM US WITH RESPECT TO MEMBERS WHO ARE NOT OURS, WHICH COULD REDUCE OUR REVENUE AND PROFITABILITY. OUTSOURCED SERVICE PROVIDERS MAY MAKE MISTAKES AND SUBJECT US TO FINANCIAL LOSS OR LEGAL LIABILITY. NEGATIVE PUBLICITY REGARDING THE MANAGED HEALTHCARE INDUSTRY GENERALLY OR THE COMPANY IN PARTICULAR COULD ADVERSELY AFFECT OUR RESULTS OF OPERATIONS OR BUSINESS. WE ARE DEPENDENT UPON OUR EXECUTIVE OFFICERS, AND THE LOSS OF ANY ONE OR MORE OF THEM AND THEIR MANAGED CARE EXPERTISE COULD ADVERSELY AFFECT OUR BUSINESS. VIOLATION OF THE LAWS AND REGULATIONS APPLICABLE TO US COULD EXPOSE US TO LIABILITY, REDUCE OUR REVENUE AND PROFITABILITY OR OTHERWISE ADVERSELY AFFECT OUR OPERATIONS AND OPERATING RESULTS. CLAIMS RELATING TO MEDICAL MALPRACTICE AND OTHER LITIGATION COULD CAUSE US TO INCUR SIGNIFICANT EXPENSES. IF WE ARE UNABLE OR FAIL TO PROPERLY MAINTAIN EFFECTIVE AND SECURE MANAGEMENT INFORMATION SYSTEMS, SUCCESSFULLY UPDATE OR EXPAND PROCESSING CAPABILITY OR DEVELOP NEW CAPABILITIES TO MEET OUR BUSINESS NEEDS, THAT COULD RESULT IN OPERATIONAL DISRUPTIONS AND OTHER ADVERSE CONSEQUENCES. IF WE ARE UNABLE TO MAINTAIN EFFECTIVE INTERNAL CONTROLS OVER FINANCIAL REPORTING, INVESTORS COULD LOSE CONFIDENCE IN THE RELIABILITY OF OUR FINANCIAL STATEMENTS, WHICH COULD RESULT IN A DECLINE IN THE PRICE OF OUR COMMON STOCK.

Full 10-K form ▸

867963--9/4/2008--UNITED_AMERICAN_HEALTHCARE_CORP