Other Accrued Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2015	Dec. 31, 2014
Accrued Liabilities, Current [Abstract]
Accrued professional liabilities	$ 12,606	$ 11,983
Contingent purchase price payable	28,700	12,213
Current income taxes payable	12,634	0
Refunds payable	41,302	17,752
Other	35,321	26,038
Total other accrued liabilities	$ 130,563	$ 67,986