Income Taxes

3 Months Ended

Mar. 31, 2013

Income Taxes [Abstract]

Income Taxes

7. Income Taxes

The following table summarizes the income tax expense and effective tax rate for the three months ended March 31, 2013 and 2012:

	Three Months Ended March 31,
	2013			2012
Current tax benefit	$	(18,021	)	$	(29,136	)
Deferred tax expense		32,209			30,372
Income tax expense	$	14,188		$	1,236
Effective tax rate		(0.2	%)		0.0	%

The income tax expense for the three months ended March 31, 2013 and 2012 consisted of a U.S. deferred income tax expense and foreign tax benefit. The U.S. income tax expense for the three months ended March 31, 2013 and 2012 related to indefinite lived intangible assets and for 2013 was reduced by a deferred income tax benefit from periodic amortization of nondeductible acquired intangible assets acquired in the MedEfficiency acquisition.