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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) | 9 Months Ended
--- | ---
Sep. 30, 2018 | Sep. 30, 2017
Cash flows from operating activities |  |
Net income | $ 62,208,688 | $ 24,913,613
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Depreciation and amortization | 14,819,627 | 14,407,113
Loss on disposal of property and equipment | 41,782 | 0
Share-based compensation | 1,238,708 | 963,699
Unrealized loss (gain) from investment in equity securities | 10,218 | (79,527)
Change in fair value of derivative instrument | 0 | 278,886
Loss from equity method investments | 2,573,219 | 28,936
Deferred tax | 7,135,408 | (5,730,758)
Changes in operating assets and liabilities, net of acquisition amounts: |  |
Receivables, net | (38,366,867) | 263,132
Prepaid expenses and other current assets | (590,602) | (736,525)
Other assets | (26,931) | (131,983)
Accounts payable and accrued expenses | 31,701,367 | (1,897,636)
Incentives payable | (16,500,000) | (7,939,317)
Medical liabilities | (30,466,895) | (752,876)
Income taxes payable | (1,912,842) | 12,733,179
Net cash provided by operating activities | 31,864,880 | 36,319,936
Cash flows from investing activities |  |
Purchases of marketable securities | (9,013) | (5,283)
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) | (400,000)
Dividends received from equity method investments | 207,410 | 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 | (867,732) | (1,627,760)
Net cash used in investing activities | (20,248,175) | (5,808,043)
Cash flows from financing activities |  |
Repayment of bank loan | (375,485) | 0
Dividends paid | (16,725,799) | (9,490,632)
Change in noncontrolling interest capital | 27,300 | 0
Borrowings on line of credit | 8,000,000 | 0
Payment of capital lease obligations | (73,775) | (78,343)
Proceeds from sale of common stock of VIE | 200,000 | 0
Proceeds from the exercise of stock options and warrants | 3,574,046 | 425,025
Net cash used in financing activities | (5,373,713) | (9,143,950)
Net increase in cash, cash equivalents and restricted cash | 6,242,992 | 21,367,943
Cash, cash equivalents and restricted cash, beginning of period | 118,500,095 | 54,925,712
Cash, cash equivalents and restricted cash, end of period | 124,743,087 | 76,293,655
Supplementary disclosures of cash flow information: |  |
Cash paid for income taxes | 18,032,590 | 9,489,563
Cash paid for interest | 287,332 | 1,748
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
Conversion of loan receivable to investment in Accountable Health Care, IPA | 5,000,000 | 0
Reclassification of dividends payable to accounts payable and accrued expenses | 432,113 | 0
Reclassification of APS noncontrolling interest to equity | 443,184 | 0
Reclassification of stock options exercised to liability for unissued common shares | 0 | 425,025
Reclassification of fiduciary cash to payable | 1,416,972 | 51,525
Reconciliation of cash, cash equivalents, and restricted cash |  |
Cash and cash equivalents | 119,779,499 | 76,293,655
Restricted cash - long-term - letters of credit | 745,412 | 0
Restricted cash - short-term - distributions to former NMM shareholders | 4,218,176 | 0
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows | $ 124,743,087 | $ 76,293,655

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