SUPPLEMENTAL CASH FLOW & OTHER DATA

9 Months Ended

Sep. 30, 2020

Supplemental Cash Flow Elements [Abstract]

SUPPLEMENTAL CASH FLOW AND OTHER DATA

Supplemental cash flow and other data for the three and nine months ended September 30, 2020 and 2019 was as follows:


	Three Months Ended September 30,						Nine Months Ended September 30,
	2020		2019		2020		2019
Depreciation expense	$	62	$	59	$	186	$	175
Amortization expense	27		23		77		72
Depreciation and amortization expense	$	89	$	82	$	263	$	247

Interest expense	$	(42)	$	(45)	$	(126)	$	(136)
Interest income	—		1		2		3
Interest expense, net	$	(42)	$	(44)	$	(124)	$	(133)

Interest paid	$	33	$	58	$	136	$	149
Income taxes paid	$	148	$	65	$	168	$	148

Accounts payable associated with capital expenditures	$	55	$	24	$	55	$	24

Dividends payable	$	76	$	72	$	76	$	72

Businesses acquired:
Fair value of assets acquired	$	126	$	—	$	377	$	61
Fair value of liabilities assumed	(9)		—		(29)		—
Fair value of net assets acquired	117		—		348		61
Merger consideration receivable/payable	2		—		2		(5)
Cash paid for business acquisitions	119		—		350		56
Less: Cash acquired	18		—		21		—
Business acquisitions, net of cash acquired	$	101	$	—	$	329	$	56

Leases:




Leased assets obtained in exchange for new operating lease liabilities	$	40	$	38	$	119	$	116
Leased assets obtained in exchange for new finance lease liabilities	$	—	$	1	$	—	$	1

In March 2020, in response to the COVID-19 pandemic, the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act") was signed into law. The CARES Act provides numerous tax provisions and other stimulus measures, including temporary changes regarding the prior and future utilization of net operating losses, temporary changes to the prior and future limitations on interest deductions, temporary suspension of certain payment requirements for the employer portion of social security taxes, technical corrections from prior tax legislation for tax depreciation of certain qualified improvement property, and the creation of certain payroll tax credits associated with the retention of employees. The CARES Act also includes a number of benefits that are applicable to the Company and other healthcare providers including, but not limited to, the appropriation of $100 billion to health care providers for related expenses or lost revenues that are attributable to the COVID-19 pandemic.

In April 2020 and August 2020, the Company received approximately $65 million and $73 million, respectively, of funds that were distributed to healthcare providers for related expenses or lost revenues that are attributable to the COVID-19 pandemic under the CARES Act. In October 2020, the Company announced that it plans to return the entire $138 million of funds received.

The Company accounts for the receipt of the funds under a gain contingency model. Accordingly, such amounts are recognized when the funds are received and the Company has determined that it has satisfied the associated terms and conditions. During the three months ended June 30, 2020, based on the terms and conditions that were in effect at such time, the Company concluded that it had satisfied such terms and conditions for the $65 million of funds that were received in April 2020 and, therefore, the Company recognized such amount in other operating expense (income), net during the second quarter. During the three months ended September 30, 2020, the Company reversed the $65 million of funds that had previously been recognized in other operating expense (income), net. As of September 30, 2020, no amounts are recorded in the Company's year-to-date consolidated statement of operations and the entire $138 million of funds that the Company intends to return are recorded in accounts payable and accrued expenses on the Company’s consolidated balance sheet. For the nine months ended September 30, 2020, net cash provided by operating activities included the $138 million that the Company received from the funds that were distributed to healthcare providers under the CARES Act.