Income Taxes (Tables)

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Income tax provision (benefit)

Provision for income taxes consisted of the following for the years ended December 31:

	2018			2017
Current
Federal	$	21,058,703		$	19,219,251
State		9,646,172			5,336,885
		30,704,875			24,556,136
Deferred
Federal		(5,954,666	)		(18,718,113	)
State		(2,390,569	)		(1,951,238	)
		(8,345,235	)		(20,669,351	)
Total provision for income taxes	$	22,359,640		$	3,886,785

Deferred tax assets (liabilities)

	2018			2017
Deferred tax assets (liabilities)
State taxes	$	1,886,010		$	1,001,754
Stock options		1,660,664			1,784,524
Accrued payroll and related cost		238,633			185,130
Accrued hospital pool deficit		168,413			282,913
Allowance for bad debts		1,124,917			-
Investment in other entities		884,922			(1,437,061	)
Net operating loss carryforward		6,414,256			7,069,776
Property and equipment		(1,286,087	)		(1,286,452	)
Acquired intangible assets		(24,084,892	)		(28,626,943	)
Risk Pool Receivable		(2,434,573	)		-
Other		(792,781	)		(504,307	)
Net deferred tax liabilities before valuation allowance		(16,220,518	)		(21,530,666	)
Valuation allowance		(3,395,417	)		(3,385,932	)
Net deferred tax liabilities	$	(19,615,935	)	$	(24,916,598	)

Provision for income taxes

The provision for income taxes differs from the amount computed by applying the federal income tax rate as follows for the years ended December 31:

	2018			2017
Tax provision at U.S. Federal statutory rates		21.0	%		35.0	%
State income taxes net of federal benefit		6.7			4.4
Non-deductible permanent items		1.3			(9.7	)
Non-taxable entities		(0.7	)		(1.9	)
Stock-based compensation		(1.8	)		0.9
Change in valuation allowance					(2.9	)
Entity Conversion		0.5			-
Change in rate		-			(19.4	)
Other		0.1			1.4
Effective income tax rate		27.1	%		7.8	%