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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) | 6 Months Ended
--- | ---
Jun. 30, 2018 | Jun. 30, 2017
Cash flows from operating activities |  |
Net income | $ 23,583,248 | $ 13,089,250
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Depreciation and amortization | 9,976,590 | 9,642,330
Loss on disposal of property and equipment | 41,782 | 0
Share-based compensation | 1,036,326 | 642,466
Unrealized loss from investment in equity securities | 16,060 | 0
Change in fair value of derivative instrument | 0 | (127,779)
Income from equity method investments | (1,641,837) | (1,432,160)
Deferred tax | 706,813 | (4,419,701)
Changes in operating assets and liabilities: |  |
Receivables, net | (2,824,511) | 14,775,701
Prepaid expenses and other current assets | (3,495,683) | (975,914)
Other assets | (95,258) | (86,452)
Accounts payable and accrued expenses | (692,000) | (1,808,721)
Dividends payable | 617,210 | 0
Incentives payable | (16,395,926) | (8,021,645)
Medical liabilities | 2,881,017 | (437,795)
Income taxes payable | (298,439) | 3,861,749
Net cash provided by operating activities | 13,415,392 | 24,701,329
Cash flows from investing activities |  |
Purchases of marketable securities | (3,932) | (1,301)
Repayments from related parties – loans receivable | 0 | 200,000
Advances to related parties - loans receivable | (2,500,000) | (5,000,000)
Purchase of investments – joint venture | (16,673,840) | 0
Dividends received from equity method investments | 0 | 1,000,000
Purchase of investment in a privately held entity | (405,000) | 0
Proceeds on sale of investments - cost method | 0 | 25,000
Purchases of property and equipment | (682,712) | (943,395)
Net cash used in investing activities | (20,265,484) | (4,719,696)
Cash flows from financing activities |  |
Repayment of bank loan | (257,374) | 0
Dividends paid | (12,000,000) | (9,490,632)
Change in noncontrolling interest capital | 27,500 | 0
Borrowings on line of credit | 8,000,000 | 0
Payment of capital lease obligations | (48,999) | (54,555)
Proceeds from sale of common stock of VIE | 200,000 | 0
Proceeds from the exercise of stock options and warrants | 2,347,329 | 425,025
Net cash used in financing activities | (1,731,544) | (9,120,162)
Net (decrease) increase in cash, cash equivalents and restricted cash | (8,581,636) | 10,861,471
Cash, cash equivalents and restricted cash, beginning of period | 118,500,095 | 54,925,712
Cash, cash equivalents and restricted cash, end of period | 109,918,459 | 65,787,183
Supplementary disclosures of cash flow information: |  |
Cash paid for income taxes | 11,612,590 | 9,195,024
Cash paid for interest | 144,544 | 1,386
Supplemental disclosures of non-cash investing and financing activities |  |
Cashless exercise of stock options | 47 | 0
Deferred tax liability adjustment to goodwill | 1,110,456 | 0
Cumulative effect adjustment for ASC 606 included in accounts receivable | 11,600,000 | 0
Cumulative effect adjustment for ASC 606 included in deferred tax liabilities | 3,246,098 | 0
Purchase price adjustment for acceleration of vested stock options | 868,000 | 0
Reclassification of stock options exercised to liability for unissued common shares | 0 | 425,025
Reclassification of fiduciary cash to payable | 722,934 | 2,911
Reconciliation of cash, cash equivalents, and restricted cash |  |
Cash and cash equivalents | 101,132,237 | 65,787,183
Restricted cash - long-term - letters of credit | 745,352 | 0
Restricted cash - short-term - distributions to former NMM shareholders | 8,040,870 | 0
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows | $ 118,500,095 | $ 54,925,712

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- Definition Cash outflow in the form of capital distributions and dividends to common shareholders, preferred shareholders and noncontrolling interests. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3291-108585 + Details
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