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Income Taxes | 12 Months Ended
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Dec. 31, 2011
Income Taxes [Abstract] |
Income Taxes | 11. Income Taxes: The components of the income tax provision are as follows (in thousands):
|  | December 31, |
|  | 2011 |  |  | 2010 |  |  | 2009 |
Federal: |  |  |  |  |  |  |  |  |  |  |  |
Current |  | $ | 113,290 |  |  | $ | 73,756 |  |  | $ | 93,590 |
Deferred |  |  | 7,486 |  |  |  | 22,814 |  |  |  | 6,391 |
|  |  | 120,776 |  |  |  | 96,570 |  |  |  | 99,981 |
State: |  |  |  |  |  |  |  |  |  |  |  |
Current |  |  | 13,895 |  |  |  | 10,330 |  |  |  | 11,315 |
Deferred |  |  | 577 |  |  |  | 1,561 |  |  |  | 600 |
|  |  | 14,472 |  |  |  | 11,891 |  |  |  | 11,915 |
Total |  | $ | 135,248 |  |  | $ | 108,461 |  |  | $ | 111,896 |
The Company files its tax return on a consolidated basis with its subsidiaries. The remaining affiliated professional contractors file tax returns on an individual basis. The effective tax rate was 38.29%, 34.86% and 38.89% for the years ended December 31, 2011, 2010 and 2009, respectively. The net decrease in the Company's effective income tax rate for the year ended December 31, 2010 was primarily related to the $10.9 million reduction in its income tax provision resulting from a resolution of certain matters that were under review with taxing authorities. The differences between the effective rate and the United States federal income tax statutory rate are as follows:
|  | December 31, |
|  | 2011 |  |  | 2010 |  |  | 2009 |
Tax at statutory rate |  |  | 35.00 | % |  |  | 35.00 | % |  |  | 35.00 | %
State income tax, net of federal benefit |  |  | 2.66 |  |  |  | 2.42 |  |  |  | 2.69 |
Non-deductible expenses |  |  | 0.32 |  |  |  | 0.35 |  |  |  | 0.40 |
Change in accrual estimates relating to uncertain tax positions |  |  | 0.44 |  |  |  | (2.81 | ) |  |  | 0.82 |
Other, net |  |  | (0.13 | ) |  |  | (0.10 | ) |  |  | (0.02 | )
Income tax provision |  |  | 38.29 | % |  |  | 34.86 | % |  |  | 38.89 | %
The significant components of deferred income tax assets and liabilities are as follows (in thousands):
|  | December 31, 2011 |  |  | December 31, 2010 |
|  | Total |  |  | Current |  |  | Non- Current |  |  | Total |  |  | Current |  |  | Non- Current |
Allowance for uncollectible accounts |  | $ | 47,459 |  |  | $ | 47,459 |  |  | $ | — |  |  | $ | 34,254 |  |  | $ | 34,254 |  |  | $ | — |
Net operating loss carryforward |  |  | 3,533 |  |  |  | 3,533 |  |  |  | — |  |  |  | 7,799 |  |  |  | 7,799 |  |  |  | — |
Reserves and accruals |  |  | 40,807 |  |  |  | 36,828 |  |  |  | 3,979 |  |  |  | 37,045 |  |  |  | 33,378 |  |  |  | 3,667 |
Other |  |  | 483 |  |  |  | 483 |  |  |  | — |  |  |  | 488 |  |  |  | 488 |  |  |  | — |
Stock-based compensation |  |  | 18,657 |  |  |  | 10,586 |  |  |  | 8,071 |  |  |  | 18,316 |  |  |  | 8,700 |  |  |  | 9,616 |
Total deferred tax assets |  |  | 110,939 |  |  |  | 98,889 |  |  |  | 12,050 |  |  |  | 97,902 |  |  |  | 84,619 |  |  |  | 13,283 |
Accrual to cash adjustment |  |  | (28,575 | ) |  |  | (28,575 | ) |  |  | — |  |  |  | (24,040 | ) |  |  | (24,040 | ) |  |  | — |
Property and equipment |  |  | (128 | ) |  |  | — |  |  |  | (128 | ) |  |  | (965 | ) |  |  | — |  |  |  | (965 | )
Amortization |  |  | (105,753 | ) |  |  | — |  |  |  | (105,753 | ) |  |  | (86,384 | ) |  |  | — |  |  |  | (86,384 | )
Total deferred tax liabilities |  |  | (134,456 | ) |  |  | (28,575 | ) |  |  | (105,881 | ) |  |  | (111,389 | ) |  |  | (24,040 | ) |  |  | (87,349 | )
Net deferred tax (liability) asset |  | $ | (23,517 | ) |  | $ | 70,314 |  |  | $ | (93,831 | ) |  | $ | (13,487 | ) |  | $ | 60,579 |  |  | $ | (74,066 | )
The income tax benefit related to the exercise of stock options, the purchase of shares under the Company's non-qualified employee stock purchase plan and the vesting of restricted stock in excess of amounts recorded as equity compensation expense reduces taxes currently payable and is credited to additional paid-in capital. Such amounts totaled approximately $7.1 million, $3.0 million, and $6.9 million for the years ended December 31, 2011, 2010 and 2009, respectively. The Company has net operating loss carryforwards for federal and state tax purposes totaling approximately $9.4 million, $20.7 million, and $8.0 million at December 31, 2011, 2010 and 2009, respectively, expiring at various times commencing in 2014. The decrease in net operating loss carryforwards of $11.3 million in 2011 and the increase of $12.7 million in 2010 are primarily due to timing differences related to the recognition of income for tax purposes associated with physician practice acquisitions. As of December 31, 2011, 2010 and 2009, the Company's liability for uncertain tax positions, excluding accrued interest and penalties, was $16.2 million, $22.3 million and $49.4 million, respectively. The Company had approximately $13.2 million of uncertain tax positions that, if recognized, would favorably impact its effective tax rate at December 31, 2011. The following table summarizes the activity related to the Company's liability for uncertain tax positions for the years ended December 31, 2011, 2010 and 2009 (in thousands):
|  | Years Ended December 31, |
|  | 2011 |  |  | 2010 |  |  | 2009 |
Balance at beginning of year |  | $ | 22,290 |  |  | $ | 49,416 |  |  | $ | 47,562 |
Increases related to prior year tax positions |  |  | 44 |  |  |  | 948 |  |  |  | — |
Decreases related to prior year tax positions |  |  | — |  |  |  | (9,569 | ) |  |  | (1,051 | )
Increases related to current year tax positions |  |  | 2,541 |  |  |  | 2,334 |  |  |  | 5,867 |
Decreases related to current year tax positions |  |  | (7,203 | ) |  |  | (19,035 | ) |  |  | — |
Settlements |  |  | 13 |  |  |  | (500 | ) |  |  | (2,191 | )
Decreases related to lapse of statutes of limitations |  |  | (1,520 | ) |  |  | (1,304 | ) |  |  | (771 | )
Balance at end of year |  | $ | 16,165 |  |  | $ | 22,290 |  |  | $ | 49,416 |
During the year ended December 31, 2011, the Company decreased its liability for uncertain tax positions by a total of $6.1 million, which is primarily related to reclassifications of certain temporary differences to deferred taxes payable. During the year ended December 31, 2010, the Company decreased its liability for uncertain tax positions by a total of $27.1 million, of which $19.0 million related to reclassifications of certain temporary differences to deferred taxes payable and $9.6 million related to the resolution of certain matters with taxing authorities. The Company includes interest and penalties related to income tax liabilities in income tax expense. The Company recognized $0.4 million, $1.7 million and $2.5 million, respectively, of interest and penalties related to income tax liabilities during the years ended December 31, 2011, 2010 and 2009. At December 31, 2011 and 2010, the Company's accrued liability for interest and penalties related to income tax liabilities totaled $8.7 million and $8.3 million, respectively. At December 31, 2011, accounts payable and accrued expenses and other liabilities as presented in the Company's Consolidated Balance Sheet include $3.2 million and $21.7 million, respectively, related to the Company's total liability for uncertain tax positions of $24.9 million. At December 31, 2010, accounts payable and accrued expenses and other liabilities as presented in the Company's Consolidated Balance Sheet include $10.9 million and $19.7 million, respectively, related to the Company's total liability for uncertain tax positions of $30.6 million. The Company's liability for uncertain tax positions could be reduced over the next 12 months by approximately $3.5 million, excluding accrued interest, due to changes in temporary differences and the expiration of statutes of limitation. Additionally, the Company anticipates that its liability for uncertain tax positions will be increased over the next 12 months by additional taxes of approximately $1.0 million. The Company is currently subject to U.S. Federal and various state income tax examinations for the tax years 2004 through 2010.

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- Definition The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32537-109319 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 109 -Paragraph 136, 172 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 109 -Paragraph 43, 44, 45, 46, 47, 48, 49 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 08 -Paragraph h -Article 4 Reference 5: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 3 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32559-109319 Reference 6: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 9 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32639-109319 Reference 7: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 15 -URI http://asc.fasb.org/extlink&oid=6907707&loc=d3e32718-109319 Reference 8: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.4-08.(h)) -URI http://asc.fasb.org/extlink&oid=6881521&loc=d3e23780-122690 + Details
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