Table of Contents
UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

____________________________

__________________________
FORM 10-K

(Mark One)

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the fiscal year endedDecember 31, 2016

2019

OR

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from ___to _____

Commission File Number001-31932

_______________________

__________________________
CATASYS, INC.

(Exact name of registrant as specified in its charter)

_______________________

__________________________

Delaware

88-0464853

Delaware

88-0464853
(State or other jurisdiction of incorporation)

(I.R.S. Employer Identification Number)

11601 Wilshire Boulevard,


2120 Colorado Ave., Suite 1100

Los Angeles, California 90025

230

Santa Monica, CA 90404
(Address of principal executive offices, including zip code)


(310) 444-4300

(Registrant’s telephone number, including area code)


Securities registered pursuant to Section 12(b) of the Act:

None

Act:


Title of Each ClassTrading SymbolName of Each Exchange on Which Registered
Common Stock, par value $0.0001 per shareCATSThe NASDAQ Stock Exchange

Securities registered pursuant to Section 12(g) of the Act:

Common Stock, Par Value $0.0001 Per Share

(Title of Class)

Act:

Not Applicable
Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.

Yes☐

Yes
No

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act.

Yes☐

No ☑

Yes
No

Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.

Yes☑

Yes
No


Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Website, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).

Yes☑

Yes
No

Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein, and will not be contained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of the Form 10-K or any amendment to this Form 10-K. ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, or a non-accelerated filer, or a smaller reporting company or an emerging growth company. See definitions of “large accelerated filer”, “accelerated filer,” “large accelerated filer,’’“smaller reporting company” and “smaller reporting“emerging growth company” in Rule 12b-2 of the Exchange Act. (Check one):

Large accelerated filer

Accelerated filer

Accelerated filer☐

Non-accelerated filer

Smaller reporting company ☑

[Do not check if a smaller

reporting company]

Emerging growth company ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).

Yes☐

Yes ☐
No

As of June 30, 2016,28, 2019, the last business day of the registrant’s second fiscal quarter, the aggregate market value of the common stock held by non-affiliates of the registrant (without admitting that any person whose shares are not included in such calculation is an affiliate) was $3,986,460$140,851,867 based on the $0.65$19.22 closing bidsales price of the common stock on the OTCQBThe NASDAQ Capital Market on that date.

As of February 24, 2017,March 6, 2020, there were 55,288,45816,726,964 shares of the registrant’s common stock outstanding.

DOCUMENTS INCORPORATED BY REFERENCE

None.


Portions of the 2020 definitive Proxy Statement are incorporated by reference into Part III of this Form 10-K.




Table of Contents

CATASYS, INC.

Form 10-K Annual Report

For The Fiscal Year Ended December 31, 2016

TABLE OF CONTENTS

PART I

1

Item 1.

Business

Risk Factors

7

18

18

18

19

19

20

20

27

27

27

27

28

29

29

33

38

40

42

43

43

Item 16.Form 10-K Summary27

In this Annual Report on Form 10-K, except as otherwise stated or the context otherwise requires, the terms “the Company,” “our Company,” “we,” “us” or “our” refer to Catasys, Inc., our variable interest entities, and our wholly-owned subsidiaries. Our common stock, par value $0.0001 per share, is referred to as “common stock.”




PART I

Forward-Looking Statements

ThisAnnual Report on Form 10-K contains forward-looking statements that involve risks and uncertainties. Our actual results may differ materially from those discussed due to factors such as, among others, limited operating history, difficulty in developing, exploiting and protecting proprietary technologies, intense competition and substantial regulation in the healthcare industry. Additional information concerning factors that could cause or contribute to such differences can be found in the following discussion, as well as in Item 1A.Risk Factors1A. “Risk Factors” and Item 7.7.Management’s Discussion and Analysis of Financial Condition and Results of Operations.Operations.We encourage you to read those descriptions carefully. We caution you not to place undue reliance on the forward-looking statements contained in this report. These statements, like all statements in this report, speak only as of the date of this report (unless an earlier date is indicated) and we undertake no obligation to update or revise the statements except as required by law. Such forward-looking statements are not guarantees of future performance and actual results will likely differ, perhaps materially, from those suggested by such forward-looking statements.

ITEM 1. BUSINESS

Overview

Catasys, Inc. was incorporated in the State of Delaware on September 29, 2003. Unless the context requires otherwise, the words “Catasys,” “we,” “Company,” “us” and “our” refer to Catasys, Inc.
Catasys was founded with a passion for engaging with and helping improve the health and save lives of anyone impacted by behavioral health conditions. We provideare a leading Artificial Intelligence (“AI”) and technology-enabled healthcare company and harness proprietary big data predictive analytics, artificial intelligence and telehealth, combined with human interaction, to deliver improved member health and cost savings to health plans. We identify, engage and treat health plan members with unaddressed behavioral health conditions that worsen medical comorbidities.
We apply advanced data analytics based specializedand predictive modeling to identify members with untreated behavioral health managementconditions, whether diagnosed or not, and integratedcoexisting medical conditions that may be impacted through treatment services toin the OnTrak program. We then uniquely engage health plans through ourplan members who do not typically seek behavioral healthcare by leveraging proprietary enrollment capabilities built on deep insights into the drivers of care avoidance. Our technology enabled OnTrak solution. Our OnTrak solution is designed to improvean integrated suite of services that includes evidence-based psychosocial and medical interventions delivered either in-person or via telehealth, nurse-led care coaching and local community support. We believe that the program is currently improving member health and, at the same time, lowerdemonstrating reduced medical utilization, driving a reduction in total health plan costs for enrolled members.
We have contracted with leading national and regional health plans to the insurer for underserved populations wheremake OnTrak available to eligible members in twenty eight states.

Our Market
The true impact of behavioral health is often under-identified by organizations that provide healthcare benefits. Individuals with unaddressed behavioral health conditions are causing or exacerbating co-existingthat worsen chronic medical conditions. The program utilizes proprietary analytics, member engagementcomorbidities cost health plans and patient centric treatment that integrates evidence-based medical and psychosocial interventions along withemployers a disproportionate amount of the total healthcare costs.
According to the U.S. Census Bureau in 2017, there were over 295 million lives in the U.S. covered by various private managed care coaching in a 52-week outpatient program. Our initial focus was members with substance use disorders, but we have expanded our solution to assist members with anxiety and depression. We currently operate our OnTrak solutions in Florida, Georgia, Illinois, Kansas, Kentucky, Louisiana, Massachusetts, Missouri, New Jersey, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia and Wisconsin. We provide services to commercial (employer funded), managed Medicare Advantage,programs, including Preferred Provider Organizations, Health Maintenance Organizations, self-insured employers and managed Medicare/Medicaid programs.  Each year, based on our analysis, approximately 1.9% of commercial plan members will have a substance dependence diagnosis, and duel eligible (Medicarethat figure may be lesser or greater for specific payors depending on the health plan demographics and Medicaid) populations. 

We have not been profitable since being incorporatedlocation.  A smaller, high-cost subset of this population drives the majority of the claims costs for the overall substance dependent population.  One in 2003 and may continue to incur operating losses for at leastfive adults in the next twelve months. AsUnited States of December 31, 2016, these conditions raised substantial doubt as to our ability to continue as a going concern.

We believe that our business and operations as outlined aboveAmerica are in substantial compliance with applicable laws and regulations. However,impacted by one of the healthcare industry is highly regulated, and the criteria are often vague and subject to change and interpretation by various federal and state legislatures, courts, enforcement and regulatory authorities. Our future prospects are subject to the legal, regulatory, commercial and scientific risks outlined below and in Item 1.A “Risk Factors.”

following behavioral health issues:

1

Substance Dependence

abuse. Scientific research indicates that not only can drugs interfere with normal brain functioning,   but they can also have long-lasting effects that persist even after the drug is no longer being used. Data indicates that at some point, changes may occur in the brain that can turn drug and alcohol abuse into substance dependence—a chronic, relapsing, and sometimes fatal disease. Those dependent on drugs may suffer from compulsive drug craving and usage and be unable to stop drug use or remain drug abstinent without effective treatment. Professional medical treatment may be necessary to end this physiologically-based compulsive behavior.

Substance dependence is a worldwide problem with prevalence rates continuing to rise despite the efforts by national and local health authorities to curtail its growth. Substance dependence disorders affect many people and have wide-ranging social consequences. In 2015, an estimated 20.8 million adults in the United States (U.S.) met the criteria for substance dependence, according to the National Survey of Drug Use and Health. 


We believe the best results in treating substance dependence can be achieved in programs such as our OnTrak solution that integrate psychosocial and medical treatment modalities and provide longer term support on an out-patient basis.

Anxiety Disorders

Disorders. According to the National Institute of Mental Health, anxiety disorders are the most common mental illness in the U.S., affecting an estimated 18%19.1% of adults or approximately 43 million people ageaged 18 years or older. People with anxiety disorders are:

Three to five times more likely to go to the doctor; and

Six times more likely to be hospitalized for psychiatric disorders.

Mood Disorders

Depression. In 2013,2016, an estimated 15.710.3 million U.S. adults aged 18 or older, or approximately 6.7%4.3% of all U.S. adults, had at least one major depressive episode in the past year, according to the National Institute of Mental Health. Patients with substance dependence and mood disorders were ranked four out of the top 10 reasons leading to readmission rates for Medicaid patients.

Our Market

The true impact of behavioral health is often under-identified by organizations that provide healthcare benefits. The reality is that individuals with behavioral health conditions:

are prevalent in any organization;

cost health plans and employers a disproportionate amount of money;

have higher rates of absenteeism and lower rates of productivity; and

have co-morbid medical conditions which incur increased costs for the treatment of these conditions compared to a non-substance dependent population.

When considering behavioral health-related costs, many organizations have historically only looked at direct treatment costs–usually behavioral claims. The reality is that individuals with behavioral health conditions generally have overall poorer health and lower compliance, which leads to more expensive treatment for related, and even seemingly unrelated, co-occurring medical conditions. In fact, forFor the members we seek to engage our solutions,solution, costs associated with behavioral health treatment arerepresent a small portion of their overall healthcare claims.

According toclaims, while the U.S. Census Bureau in 2014, there were over 283 million lives inmedical costs are significant.


Our Solution
Our OnTrak solution includes the U.S. covered by various private managed care programs, including Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), self-insured employersidentification, engagement and managed Medicare/Medicaid programs.  Each year, based on our analysis, approximately 1.9%treatment of commercialhealth plan members will have awith unaddressed behavioral health conditions that worsen medical comorbidities. We specifically focus on members with anxiety, depression and/or substance dependence diagnosis,use disorder(s). We apply claims-based analytics and predictive modeling to first identify health plan members with medical costs that figure may be lesserimpacted through behavioral health treatment with the OnTrak program. These members may or greater for specific payors depending onmay not be diagnosed with a behavioral condition. We then conduct multichannel outreach to eligible members. Enrolled members receive nurse-led care coaching, the health plan demographicsopportunity to participate in telehealth or face-to-face evidence-based psychosocial and location.  A smaller, high-cost subset of this population drives the majority of the claims costs for the overall substance dependent population.  For commercial members with substance dependence and a total annual claims cost of at least $7,500, the average annual per member claims cost is $30,000, compared with an average of $3,250 for a commercial non-substance dependent member, according to our research. 


Our Customers

Our customers provide health insurance to individuals or groups (Contracted Membership). We contract with our customers to provide our OnTrak solution to the customers’ Contracted Membership generally in specific lines of business (e.g., commercial, Medicare, Medicaid, etc.) and/or specific states or other geographical areas and for specific indications, such as substance use disorders and, more recently, anxiety and depression. We refer to the Contracted Membership to whom we are providing the OnTrak solution as Covered Lives. Generally, we receive data relating to the Covered Lives on a regular basis from our customers. We use that data to identify members who meet our contractual eligibility requirements (Eligible Members) and we attempt to engage and enroll those members in our OnTrak solution. Our Eligible Members can fluctuate significantly from month to month due to fluctuations in our customers’ Contracted Membership and changes in eligibility due to changes in claims or eligibility data provided to us by our customers. Based on our analysis of the data provided to us by our customers, approximately 0.045% of the adult Contracted Membership in a commercial line of business is anticipated to be eligible for our OnTrak solution. Based on our analysis, Medicare and Medicaid lines of business average approximately 2.5 times the number of Eligible Members for our OnTrak solution as the same number of Covered Lives in a commercial line of business. Further, our preliminary data analysis shows that adding anxiety and depression indications to our Covered Lives is anticipated to increase our pool of Eligible Members substantially. Based on the latest data provided by one of our customers that has contracted for us to provide OnTrak for anxiety, adding the anxiety and depression indications are anticipated to increase the number of Eligible Members by approximately four times over substance use disorders alone. There are fluctuations in the number of Eligible Members across customers and geographies. Our analysis to date is based on limited data,pharmacological treatment and in some cases, like anxiety and depression, very limited data. There can be no assurance that the data we have analyzed to date will be predictive of the future or that the portion of Covered Lives that are eligible for our programs will not change in the future. In addition, the percentage of Eligible Members in any lines of Covered Lives may fluctuate substantially from period to period.

Our Solution: OnTrak

OnTrak

Our OnTrak solution combines evidence-based medical and psychosocial treatments with elements of population health management and ongoing member support to help health plans treat members with substance dependence, anxiety and depression and to improve member health and lower the overall health plan costs of these members.in-market Community Care Coordinator support. We believe the benefits of our OnTrak solution include improved clinical outcomes and decreased costs for the payor, andas well as improved quality of life and productivity for the member.

Although the healthcare services industry is competitive, we believe OnTrak is the only solution of its kind. The OnTrak solution was developed by behavioral health experts with years of clinical experience. This experience has helped to form key areas of expertise that we believe sets our solution apart from other solutions, including member engagement, working directly with the member treatment team and a more fully integrated treatment offering.

Our OnTrak solution includes the following components: identification of impactable members, member engagement, enrollment/referral, provider network, outpatient medical treatment, outpatient psychosocial treatment, care coaching, monitoring and reporting, and our proprietary web-based clinical information platform (eOnTrak).

We assist health plans to identify those members who incur significant costs and may be appropriate for enrollment into OnTrak. We then engage and enroll targeted members into our program through direct mailings and telephonic outreach, and referral through health plan sources. After enrollment, our contracted network of providers provide treatments utilizing integrated medical and psychosocial treatment modalities, including our proprietary OnTrak therapy modules for anxiety, depression and substance use disorders to help members develop improved coping skills and a recovery support network. Throughout the treatment process, our care coaches work directly with members to keep them engaged in treatment by proactively supporting members to enhance motivation, minimize lapses and enable lifestyle modifications consistent with the recovery goals. Periodically, we will provide outcomes reporting to payors on clinical and financial metrics to our customersa periodic basis to demonstrate the extentvalue of the program’s value.

Clinical and financial outcomes from the OnTrak solution have been promising with OnTrak enrolled members achieving an average gross cost reduction of more than 50% for the year after enrollment compared to the 12 months prior to enrollment. In addition, to date, approximately 80% of members who have remained eligible have been retained in the program.


OnTrak

Our proprietary OnTrak solution is designed to improve treatment outcomes and lower the utilization of medical and behavioral health plan services by high utilization and high risk enrollees. Our OnTrak solution includes medical and psychosocial interventions; a proprietary web based clinical information platform and database, psychosocial programs and integrated care coaching services.

Another important aspect of the Catasys solution is that the solution is flexible and can be altered in a modular way to enable us to partner with payors to meet their needs. As a service delivery model, the OnTrak solution can be modified to cover particular populations and provide for varying levels of service. In this way, OnTrak can work with payors to identify, engage and treat a broader spectrum of patients in a way that is consistent with payors’ business needs.

Our value proposition to our customers includes that the OnTrak solution is designed for the following benefits:

A specific program aimed at addressing high-cost conditions by improving patient health and thereby reducing overall healthcare costs can benefit health plans;

Increased worker productivity by reducing workplace absenteeism, compensation claims and job related injuries;

Decreased emergency room and inpatient utilization;

Decreased readmission rates; and

Healthcare cost savings (including medical, behavioral and pharmaceutical).

Our Strategy

Our business strategy is to provide a quality integrated medicaldeliver proven, repeatable clinical and behavioral programfinancial outcomes to help health plans and other organizations treat and manage health plan members whose behavioral health conditions are exacerbating co-existing medical conditions resulting in increased in-patient medical costs. Our initial focus wasfor their members with unaddressed behavioral conditions that worsen medical comorbidities. We do this by identifying, engaging and treating these members through our OnTrak solution. Our OnTrak solution to date has focused on substance use disorder, and we have expanded our solution into anxiety disorders and depression.

Key elements of our business strategy include:

Demonstrating the potential for improved clinical outcomes and reduced cost associated with using our OnTrak solution with key managed care and other third-party payors;

Educating third-party payors on the disproportionately high cost of their substance dependent population;

Providing our OnTrak solution to third-party payors for reimbursement on a case rate, fee for service, or monthly fee basis; and

Generating outcomes data from our OnTrak solution to demonstrate cost reductions and utilization of this outcomes data to facilitate broader adoption.

As an early entrant into offering integrated medical and behavioral programs for substance dependence, we believe we will be well positioned to address increasing market demand. We believe our OnTrak solution will help fill the gap that exists today: a lack of programs that focus on smaller populations with disproportionately higher costs driven by behavioral health conditions that improve patient care while controlling overall treatment costs.


Our Operations

Healthcare Services

Our OnTrak solution combines care coaching, innovative psychosocial and medical treatment delivered through a proprietary provider network and psychosocial treatments with elements of traditional disease management, case management, and ongoing memberin-market support from Community Care Coordinators. The solution is designed to help organizationspayors treat and manage populations struggling with substance dependence,use disorder, depression, and anxiety to improve their health and thereby decrease their overall health care costs.

As of February 24, 2017, we have contracts with six health plans, two of which have merged and are in the process of integrating operations. We are enrolling patients under five of these contracts.

We are currently marketing our OnTrak solution to managed care health planspayors on a case rate, monthly fee, or fee for service basis, which involves educating third party payorsthem on the disproportionately high cost of their substance dependent population with unaddressed behavioral health conditions that exacerbate medical comorbidities, and demonstrating the potential for improved clinical outcomes and reduced cost associated with using our program.

Competition

Healthcare Services

Our OnTrak solution to date has focused primarily on substance dependence, anxiety and depression, and is marketed to health plans and other insurance payers. While we believe our products and services are unique, we operate in highly competitive markets. We compete with other healthcare management service organizations, care management and disease management companies, including managed behavioral health organizations (MBHOs) that manage behavioral health benefits, perform utilization reviews, provide case management and patient coaching, and pay their network of providers for behavioral health services delivered. Most of our competitors are significantly larger and have greater financial, marketing and other resources than us. We compete with companies such as Hummingbird, One Health Solutions, and Health Integrated that offer coaching, social media, and in the case of Health Integrated, more comprehensive products to address the costs of members with substance dependence and other behavioral health conditions. One Health Solutions, a behavioral change technology and social networking site for people in recovery, has conducted a pilot with a national health plan that purported to show a reduction in in-patient readmissions for substance dependence treatment and has reported a pilot with a large managed behavioral health organization that has exceeded expectations on duration and frequency of participant engagement. There are several companies that seek to utilize digital approaches to treat behavioral health conditions or use data analytics and digital technologies to identify health plan members with behavior health conditions and try to match them to treatment providers. Some ofreduce these companies also utilize care coaches or on-line therapists to enhance their digital models. A small number of these have secured reimbursement for their products or services from health plans. We believe these providers are serving a different segment of the market and do not provide an end-to-end integrated solution with financial outcomes. We believe our product is the most comprehensive one to focus exclusively on engaging and treating high cost members whose anxiety, depression, or substance use disorders are exacerbating co-existing medical conditions through our network of providers using specially designed treatment regimens.

In addition, managed care companies may seek to provide similar specialty healthcare services directly to their members, rather than by contracting with us for such services.  Behavioral health conditions, including substance dependence, are typically managed for insurance companies by internal divisions or third-parties (MBHOs) frequently under capitated arrangements.  Under such arrangements, MBHOs are paid a fixed monthly fee and must pay providers for provided services, which gives such entities an incentive to decrease cost and utilization of services by members.  We compete to differentiate our integrated program for high utilizing substance dependence members, which seeks to increase treatment and impact the overall health care costs of the members, from the population utilization management programs that MBHOs offer to manage a health benefit.

We believe that our ability to offer customers an outcomes based comprehensive and integrated solution, including the utilization of innovative medical and psychosocial treatments and engagement methodologies, and our network of treatment providers, will enable us to compete effectively.  However, there can be no assurance that we will not encounter more effective competition in the future, which would limit our ability to maintain or increase our business.

Once we contract with a third-party payor, we implement our program in conjunction with the third party payor and then commence outreach to eligible members to enroll them in our OnTrak solution. In this enrollment process, we compete against numerous other providers of behavioral health treatment programs, facilities and providers for those members that elect to receive treatment for their behavioral health conditions (see Treatment Programs below). We believe we provide members with a lower cost and more comprehensive solutions, but members may choose to receive care from other providers. To the extent a member selects a different provider that is part of a health plan network of providers, the cost of such treatment may be paid in whole or in part by our health plan customer.

costs.


Employees

Treatment Programs

There are over 14,000 facilities reporting to the SAMHSA that provide substance dependence treatment. Well-known examples of residential treatment programs include the Betty Ford Center®, Caron Foundation®, Hazelden® and Sierra Tucson®. In addition, individual physicians may provide substance dependence treatment in the course of their practices. Many of these traditional treatment programs have established name recognition.

Trademarks

We rely on a combination of trademark, trade secret and copyright laws and contractual restrictions to protect the proprietary aspects of our technology. Our branded trade names on which we rely include the following:

OnTrak™; and

eOnTrak™.

We require that, as a condition of their employment, employees assign to us their interests in inventions, original works of authorship, copyrights and similar intellectual property rights conceived or developed by them during their employment with us.

Financial Information about Segments

We manage and report our operations through one business segment: Healthcare Services. This segment includes the OnTrak solution marketed to health plans and other third party payors.

Employees

As of February 24, 2017,December 31, 2019, we employed 88395 full-time employees. We are not a party to any labor agreements and none of our employees are represented by a labor union.


Corporate Information

2

We were incorporated in the State of Delaware on September 29, 2003. Our principal executive offices are located at 11601 Wilshire Blvd,2120 Colorado Ave., Suite 1100, Los Angeles, California 90025,230, Santa Monica, CA 90404, and our telephone number is (310) 444-4300.

Our corporate website address iswww.catasys.com,the contents of which are not incorporated herein. Our Annual Report on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K, and amendments to reports filed pursuant to Sections 13(a) and 15(d) of the Securities Exchange Act of 1934, as amended, are available free of charge on our website as soon as reasonably practicable after we electronically file such material with, or furnish it to, the Securities and Exchange Commission.Commission ("SEC"). The Securities and Exchange Commission maintains an internet site that contains our public filings with the Securities and Exchange Commission and other information regarding our company, atwww.sec.gov. These reports and other information concerning our company may also be accessed at the Securities and Exchange Commission’s Public Reference Room at 100 F Street, NE, Washington, DC 20549. The public may obtain information on the operation of the Public Reference Room by calling the Securities and Exchange Commission at 1-800-SEC-0330. The contents of these websites are not incorporated into this Annual Report. Further, our references to the URLs for these websites are intended to be inactive textual reference only.


ITEM 1A.RISK FACTORS

You should

In evaluating us and our common stock, we urge you to carefully consider the risks and evaluate all of theother information in this report, includingAnnual Report on Form 10-K. Any of the risk factors listed below. Risksrisks discussed in this Annual Report on Form 10-K, as well as additional risks and uncertainties in addition to those we describe below, that may not be presentlycurrently known to us or that we currently believe aredeem immaterial, may also harm our business and operating resultscould materially and financial condition, as well as adversely affect the valueour results of an investment in our Company.operations or financial condition. If any of these risks occur, our business, results of operations and financial condition could be harmed, the price of our common stock could decline, and future events and circumstances could differ significantly from those anticipated in the forward-looking statements contained in this Annual Report on Form 10-K.


Risks related to our business

We have a limited operating history, expect to continue to incur substantial operating losses and may be unable to obtain additional financing, causing our independentregistered public accounting firm to express substantial doubt about our ability to continue as a going concern.

financing.

We have been unprofitable since our inception in 2003 and expect to incur substantial additional operating losses and negative cash flow from operations for at least the next twelve months. As of December 31, 2016, these conditions raised substantial doubt as to our ability to continue as a going concern. At December 31, 2016,2019, cash and cash equivalents was approximately $851,000$13.6 million and accumulated deficit was approximately $280$331 million. During the twelve monthsyear ended December 31, 2016,2019, our cash and cash equivalents used by operating activities was $5.7($16.9) million. AlthoughAdditionally, we had working capital of $6.3 million. We expect our current cash resources to cover expenses through at least the next twelve months, however, delays in cash collections, revenue, or unforeseen expenditures could impact this estimate.
Historically, we have taken actionsseen and continue to see net losses, net loss from operations, negative cash flow from operating activities, and historical working capital deficits as we continue through a period of rapid growth. The accompanying financial statements do not reflect any adjustments that might result if we were unable to continue as a going concern. We have alleviated substantial doubt by both entering into contracts for additional revenue-generating health plan customers and expanding our OnTrak program within existing health plan customers. To support this increased demand for services, we invested and will continue to invest in additional headcount needed to support the anticipated growth.  Additional management plans include increasing the outreach pool as well as improving our current enrollment rate.  We will continue to explore ways to increase margins on both existing and new members. 
We have a growing customer base and believe we are able to fully scale our revenueoperations to service the contracts and future enrollment providing leverage in these investments that will generate positive cash flow in the near future. We believe we will have enough capital to cover expenses through the foreseeable future and we are seekingwill continue to obtainmonitor liquidity. If we add more health plans than budgeted, increase the size of the outreach pool by more than we anticipate, decide to invest in new products or seek out additional growth opportunities, we would consider financing there can be no assurancethese options with either a debt or equity financing.
Wemayneed additional funding, and we cannot guarantee that we will be successfulfind adequate sources of capital in the future.
We have incurred negative cash flows from operations since inception and have expended, and expect to continue to expend, substantial funds to grow our efforts.business. We may require additional funds before we achieve positive cash flows and we may never become cash flow positive.
If we raise additional funds by issuing equity securities, such financing will result in further dilution to our stockholders. Any equity securities issued also may provide for rights, preferences or privileges senior to those of holders of our common stock. If
3

we raise funds by issuing debt securities, these debt securities would have rights, preferences and privileges senior to those of holders of our common stock, and the terms of the debt securities issued could impose significant restrictions on our operations in addition to those referenced above.
We do not know whether additional financing will be successful in raising necessary fundsavailable on commercially acceptable terms, or at all, andall. If adequate funds are not available or are not available on commercially acceptable terms, we may not be ableneed to offset our operating losses by sufficient reductions in expenses and increases in revenue. If this occurs, we may be unablecontinue to meet our cash obligations as they become due and we may be required to further delaydownsize, curtail program development efforts or reduce operating expenses and curtailhalt our operations which would have a material adverse effect on us.

altogether.

We may fail to successfully manage and grow our business, which could adversely affect our results of operations, financial condition and business.

Continued expansion could put significant strain on our management, operational and financial resources. The need to comply with the rules and regulations of the SEC will continue to place significant demands on our financial and accounting staff, financial, accounting and information systems, and our internal controls and procedures, any of which may not be adequate to support our anticipated growth. The need to comply with the state and federal healthcare, security and privacy regulation will continue to place significant demands on our staff and our policies and procedures, any of which may not be adequate to support our anticipated growth. We may not be able to effectively hire, train, retain, motivate and manage required personnel. Our failure to manage growth effectively could limit our ability to satisfy our reporting obligations, or achieve our marketing, commercialization and financial goals.

Wewill need additional funding, may be unable to successfully execute on our growth initiatives, business strategies or operating plans.
We are continually executing a number of growth initiatives, strategies and operating plans designed to enhance our business. The anticipated benefits from these efforts are based on several assumptions that may prove to be inaccurate. Moreover, we may not be able to successfully complete these growth initiatives, strategies and operating plans and realize all of the benefits, including growth targets and cost savings, that we expect to achieve or it may be more costly to do so than we anticipate. A variety of risks could cause us not to realize some or all of the expected benefits. These risks include, among others, delays in the anticipated timing of activities related to such growth initiatives, strategies and operating plans, increased difficulty and cost in implementing these efforts, including difficulties in complying with new regulatory requirements and the incurrence of other unexpected costs associated with operating the business. Moreover, our continued implementation of these programs may disrupt our operations and performance. As a result, we cannot guaranteeassure you that we will find adequate sourcesrealize these benefits. If, for any reason, the benefits we realize are less than our estimates or the implementation of capital in the future.

We have incurred negative cash flows from operations since inceptionthese growth initiatives, strategies and have expended, and expect to continue to expend, substantial funds to grow our business. As of February 24, 2017, we estimate that our existing cash and cash equivalents will be sufficient to fund our operating expenses and capital requirements through March 31, 2017. Actual cash fees collected and expenses incurred may significantly impact this estimate. We will require additional funds before we achieve positive cash flows and we may never become cash flow positive.

If we raise additional funds by issuing equity securities, such financing will result in further dilution to our stockholders. Any equity securities issued also may provide for rights, preferences or privileges senior to those of holders of our common stock. If we raise funds by issuing debt securities, these debt securities would have rights, preferences and privileges senior to those of holders of our common stock, and the terms of the debt securities issued could impose significant restrictions on our operations.


We do not know whether additional financing will be available on commercially acceptable terms, or at all. If adequate funds are not available or are not available on commercially acceptable terms, we may need to continue to downsize, curtail program development efforts or haltplans adversely affect our operations altogether.

or cost more or take longer to effectuate than we expect, or if our assumptions prove inaccurate, our business, financial condition and results of operations may be materially adversely affected.

Our programs may not be as effective as we believe them to be, which could limit ourpotentialrevenue growth.

Our belief in the efficacy of our OnTrak solution is based on a limited experience with a relatively small number of patients. Such results may not be statistically significant, have not been subjected to close scientific scrutiny, and may not be indicative of the long-term future performance of treatment with our programs. If the initially indicated results cannot be successfully replicated or maintained over time, utilization of our programs could decline substantially. There are no standardized methods for measuring efficacy of programs such as ours. Even if we believe our solutions are effective, our customers could determine they are not utilizing different outcomes measures. In addition, even if our customers determine our programssolutions are effective they may discontinue them because they determine that the aggregate cost savings are not sufficient or that our solutionsprograms do not have a high enough return on investment. Our success is dependent on our ability to enroll third-party payor members in our OnTrak solutions. Large scale outreach and enrollment efforts have not been conducted and only for limited time periods and we may not be able to achieve the anticipated enrollment rates.

Our OnTraksolutionmay not become widely accepted, which could limit our growth.

Our ability to achieve further marketplace acceptance for our OnTrak solution may beis dependent on our ability to contract with a sufficient number of third party payors and to demonstrate financial and clinical outcomes from thoseour agreements. If we are unable to secure sufficient contracts to achieve recognition or acceptance of our OnTrak solution or if our program does not demonstrate the expected level of clinical improvement and cost savings, it is unlikely that we will be able to achieve widespread market acceptance.

Disappointing results for ourSolutionssolutionsor failure to attain our publicly disclosedmilestonescould adversely affect market acceptance and have a material adverse effect on our stock price.

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Disappointing results, later-than-expected press release announcements or termination of evaluations, pilot programs or commercial OnTrak solutions could have a material adverse effect on the commercial acceptance of our solutions, our stock price and on our results of operations. In addition, announcements regarding results, or anticipation of results, may increase volatility in our stock price. In addition to numerous upcoming milestones, from time to time we provide financial guidance and other forecasts to the market. While we believe that the assumptions underlying projections and forecasts we make publicly available are reasonable, projections and forecasts are inherently subject to numerous risks and uncertainties. Any failure to achieve milestones, or to do so in a timely manner, or to achieve publicly announced guidance and forecasts, could have a material adverse effect on our results of operations and the price of our common stock.


We face business disruption and related risks resulting from the recent outbreak of the novel coronavirus 2019 (COVID-19), which could have a material adverse effect on our business and results of operations.

Our business could be disrupted and materially adversely affected by the recent outbreak of COVID-19. As a result of measures imposed by the governments in affected regions, businesses and schools have been suspended due to quarantines intended to contain this outbreak and many people have been forced to work from home in those areas. The spread of COVID-19 from China to other countries has resulted in the Director General of the World Health Organization declaring the outbreak of COVID-19 as a Public Health Emergency of International Concern (PHEIC), based on the advice of the Emergency Committee under the International Health Regulations (2005), and the Centers for Disease Control and Prevention in the U.S. issued a warning on February 25, 2020 regarding the likely spread of COVID-19 to the U.S. While the COVID-19 outbreak is still in very early stages, international stock markets have begun to reflect the uncertainty associated with the slow-down in the Chinese economy and the reduced levels of international travel experienced since the beginning of January and the significant decline in the Dow Industrial Average at the end of February 2020 was largely attributed to the effects of COVID-19. We are still assessing our business operations and system supports and the impact COVID-19 may have on our results and financial condition, but there can be no assurance that this analysis will enable us to avoid part or all of any impact from the spread of COVID-019 or its consequences, including downturns in business sentiment generally or in our sector in particular.
Our industry is highly competitive, and we may not be able to compete successfully.

The healthcare business in general, and the behavioral health treatment business in particular, are highly competitive. While we believe our products and services are unique, we operate in highly competitive markets. We compete with other healthcare management service organizations, care management and disease management companies, including Managed Behavioral Healthcare Organizations (MBHOs), other specialty healthcare and managed care companies, and healthcare technology companies that are offering treatment and support of behavioral health on-line and on mobile devices.  Most of our competitors are significantly larger and have greater financial, marketing and other resources than us. We believe that our ability to offer customers a comprehensive and integrated behavioral health solution, including the utilization of our analytical models and innovative member engagement methodologies, will enable us to compete effectively. However, there can be no assurance that we will not encounter more effective competition in the future, that we will have financial resources to continue to improve our offerings or that we will be successful improving them, which would limit our ability to maintain or increase our business.

Our competitors may develop and introduce new processes and products that are equal or superior to our programs in treating behavioral health conditions. Accordingly, we may be adversely affected by any new processes and products developed by our competitors.


A substantial percentage of ourrevenuesare attributable tofourlarge customers, any or all of which mayterminate our servicesat any time.
Four customers account for an aggregate of 85% and 76% of our revenue for the years ended December 31, 2019 and 2018, respectively, and four customers represented an aggregate of 89% and 88% of our accounts receivable as of December 31, 2019 and 2018, respectively. We expect that revenues from a limited number of customers will continue for the foreseeable future. Sales to these customers are made pursuant to agreements with flexible termination provisions, generally entitling the customer to terminate with or without cause on limited notice to us. We may not be able to keep our key customers, or these customers may decrease their enrollment levels. Any substantial decrease or delay in revenues relating to one or more of our key customers would harm our financial results. If revenues relating to current key customers cease or are reduced, we may not obtain sufficient enrollments from other customers necessary to offset any such losses or reductions.

We depend on key personnel, the loss of which could impact the ability to manage our business.

We are highly dependent on our senior management and key operating and technical personnel. The loss of the services of any member of our senior management and key operating and technical personnel could have a material adverse effect on our
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business, operating results and financial condition. We also rely on consultants and advisors to assist us in formulating our strategy. All of our consultants and advisors are either self-employed or employed by other organizations, and they may have conflicts of interest or other commitments, such as consulting or advisory contracts with other organizations, that may affect their ability to contribute to us.

We will need to hire additional employees in order to achieve our objectives. There is currently intense competition for skilled executives and employees with relevant expertise, and this competition is likely to continue. The inability to attract and retain sufficient personnel could adversely affect our business, operating results and financial condition.

Our success depends largely upon the continued services of our key executive officers. These executive officers are at-will employees and therefore they may terminate employment with us at any time with no advance notice. We also rely on our leadership team in the areas of research and development, marketing, services and general and administrative functions. From time to time, there may be changes in our executive management team resulting from the hiring or departure of executives, which could disrupt our business. The replacement of one or more of our executive officers or other key employees would likely involve significant time and costs and may significantly delay or prevent the achievement of our business objectives.
To continue to execute our growth strategy, we also must attract and retain highly skilled personnel. Competition is intense for qualified professionals. We may not be successful in continuing to attract and retain qualified personnel. We have from time to time in the past experienced, and we expect to continue to experience in the future, difficulty in hiring and retaining highly skilled personnel with appropriate qualifications. The pool of qualified personnel with experience working in the healthcare market is limited overall. In addition, many of the companies with which we compete for experienced personnel have greater resources than we have.
In addition, in making employment decisions, particularly in high-technology industries, job candidates often consider the value of the stock options or other equity instruments they are to receive in connection with their employment. Volatility in the price of our stock may, therefore, adversely affect our ability to attract or retain highly skilled personnel. Further, the requirement to expense stock options and other equity instruments may discourage us from granting the size or type of stock option or equity awards that job candidates require to join our company. Failure to attract new personnel or failure to retain and motivate our current personnel, could have a material adverse effect on our business, financial condition and results of operations.
We are dependent on our ability to recruit, retain and develop a very large and diverse workforce. We must transform our culture in order to successfully grow our business.
Our products and services and our operations require a large number of employees. A significant number of employees have joined us in recent years as we continue to grow and expand our business. Our success is dependent on our ability to transform our culture, align our talent with our business needs, engage our employees and inspire our employees to be open to change, to innovate and to maintain member- and client-focus when delivering our services. Our business would be adversely affected if we fail to adequately plan for succession of our executives and senior management; or if we fail to effectively recruit, integrate, retain and develop key talent and/or align our talent with our business needs, in light of the current rapidly changing environment. While we have succession plans in place and we have employment arrangements with a limited number of key executives, these do not guarantee that the services of these or suitable successor executives will continue to be available to us.
We may be subject to future litigation, which could result in substantial liabilities that may exceed our insurance coverage.

All significant medical treatments and procedures, including treatment utilizing our programs, involve the risk of serious injury or death. While we have not been the subject of any such claims, our business entails an inherent risk of claims for personal injuries and substantial damage awards. We cannot control whether individual physicians and therapists will apply the appropriate standard of care in determining how to treat their patients. While our agreements typically require physicians to indemnify us for their negligence, there can be no assurance they will be willing and financially able to do so if claims are made. In addition, our license agreements require us to indemnify physicians, hospitals or their affiliates for losses resulting from our negligence.

We currently have insurance coverage for personal injury claims, directors’ and officers’ liability insurance coverage, and errors and omissions insurance. We may not be able to maintain adequate liability insurance at acceptable costs or on favorable terms. We expect that liability insurance will be more difficult to obtain and that premiums will increase over time and as the volume of patients treated with our programs increases. In the event of litigation, we may sustain significant damages or settlement expense (regardless of a claim's merit), litigation expense and significant harm to our reputation.

If third-party payors fail to provide coverage and adequate payment rates for oursolutions, our revenue and prospects for profitability will be harmed.

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Our future revenue growth will depend in part upon our ability to contract with health plans and other insurance payors for our OnTrak solutions. To date, we have not received a significant amount of revenue from our OnTrak solutions from health plans and other insurance payors, and acceptance of our OnTrak solutions is critical to the future prospects of our business. In addition, insurance payors are increasingly attempting to contain healthcare costs, and may not cover or provide adequate payment for our programs. Adequate insurance reimbursement might not be available to enable us to realize an appropriate return on investment in research and product development, and the lack of such reimbursement could have a material adverse effect on our operations and could adversely affect our revenues and earnings.

We may not be able to achieve promised savings for our OnTrakcontracts, which could result in pricing levels insufficient to cover our costs or ensure profitability.

We anticipate that many

Many of our OnTrak contracts will beare based upon anticipated or guaranteed levels of savings for our customers and achieving other operational metrics resulting in incentive fees based on savings. If we are unable to meet or exceed promised savings, achieve agreed upon operational metrics, or favorably resolve contract billing and interpretation issues with our customers, we may be required to refund from the amount of fees paid to us any difference between savings that were guaranteed and the savings, if any, which were actually achieved; or we may fail to earn incentive fees based on savings. Accordingly, during or at the end of the contract terms, we may be required to refund some or all of the fees paid for our services. This exposes us to significant risk that contracts negotiated and entered into may ultimately be unprofitable. In addition, managed care operations are at risk for costs incurred to provide agreed upon services under our solution. Therefore, failure to anticipate or control costs could have a materially adverse effect on our business.


Our ability to utilizeuse our net operating losses to offset future taxable income may be subject to certain limitations.

Our net operating loss carryforwards may be limited.

As of December 31, 2016, we had net operating loss carryforwards (NOLs) of approximately $222 million for federal income tax purposes that("NOLs") will begin to expire in 2024.2023. These NOLs may be used to offset future taxable income, to the extent we generate any taxable income, and thereby reduce or eliminate our future federal income taxes otherwise payable. Section 382 of the Internal Revenue Code imposes limitations on a corporation's ability to utilize NOLs if it experiences an ownership change as defined in Section 382. In general terms, an ownership change may result from transactions increasing the ownership of certain stockholders in the stock of a corporation by more than 50% over a three-year period. In the event that an ownership change has occurred, or were to occur, utilization of our NOLs would be subject to an annual limitation under Section 382 determined by multiplying the value of our stock at the time of the ownership change by the applicable long-term tax-exempt rate as defined in the Internal Revenue Code. Any unused annual limitation may be carried over to later years. We may be found to have experienced an ownership change under Section 382 as a result of events in the past or the issuance of shares of common stock, or a combination thereof. If so, the use of our NOLs, or a portion thereof, against our future taxable income may be subject to an annual limitation under Section 382, which may result in expiration of a portion of our NOLs before utilization.


In order to protect the Company’s significant NOLs, we filed an Amended and Restated Certificate of Incorporation of the Company containing an amendment (the “Protective Amendment”) with the Delaware Secretary of State on October 28, 2019. The Protective Amendment was approved by the Company’s stockholders by written consent dated September 24, 2019.
The Protective Amendment is designed to assist in protecting the long-term value of our accumulated NOLs by limiting certain transfers of our common stock. The Protective Amendment’s transfer restrictions generally restrict any direct or indirect transfers of common stock if the effect would be to increase the direct or indirect ownership of the common stock by any person from less than 4.99% to 4.99% or more of the common stock, or increase the percentage of the common stock owned directly or indirectly by a person owning or deemed to own 4.99% or more of the common stock. Any direct or indirect transfer attempted in violation of the Protective Amendment will be void as of the date of the prohibited transfer as to the purported transferee.
The Protective Amendment also requires any person attempting to become a holder of 4.99% or more of our common stock to seek the approval of our Board. This may have an unintended “anti-takeover” effect because our Board may be able to prevent any future takeover. Similarly, any limits on the amount of stock that a shareholder may own could have the effect of making it more difficult for shareholders to replace current management. Additionally, because the Protective Amendment may have the effect of restricting a shareholder’s ability to dispose of or acquire our common stock, the liquidity and market value of our common stock might suffer.
The Protective Amendment is not binding with respect to shares of common stock issued prior to its adoption unless the holder of such shares has voted in favor of the Protective Amendment and the resulting transfer restriction is noted conspicuously on the certificate representing such shares, or, in the case of uncertificated shares, the registered owners are notified of the Protective Amendment, or such registered owner has actual knowledge of the Protective Amendment. Therefore, even after the effectiveness of the Protective Amendment, we cannot assure you that we will not experience an ownership change as defined in Section 382, including as a result of a waiver or modification by our Board as permitted by the Protective Amendment.

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Risks related to our intellectual property

Confidentiality agreements with employees,treating physiciansand others may not adequately prevent disclosure of trade secrets and other proprietary information.

In order to protect our proprietary technology and processes, we rely in part on confidentiality provisions in our agreements with employees, treating physicians, and others. These agreements may not effectively prevent disclosure of confidential information and may not provide an adequate remedy in the event of unauthorized disclosure of confidential information. In addition, others may independently discover trade secrets and proprietary information. Costly and time-consuming litigation could be necessary to enforce and determine the scope of our proprietary rights, and failure to obtain or maintain trade secret protection could adversely affect our competitive business position.

We may be subject to claims that we infringe the intellectual property rights of others, and unfavorable outcomes could harm our business.

Our future operations may be subject to claims, and potential litigation, arising from our alleged infringement of patents, trade secrets, trademarks or copyrights owned by other third parties. Within the healthcare, drug and bio-technology industry, many companies actively pursue infringement claims and litigation, which makes the entry of competitive products more difficult. We may experience claims or litigation initiated by existing, better-funded competitors and by other third parties. Court-ordered injunctions may prevent us from continuing to market existing products or from bringing new products to market and the outcome of litigation and any resulting loss of revenues and expenses of litigation may substantially affect our ability to meet our expenses and continue operations.

Risks related to ourhealthcareindustry

Recent changes in insurance and health care laws have created uncertainty in the health care industry.

The Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act, each enacted in March 2010, generally known as the Health Care Reform Law, significantly expanded health insurance coverage to uninsured Americans and changed the way health care is financed by both governmental and private payers.Thepayers. Following the 2016 federal elections, which resulted in the election of the Republican presidential nominee and Republican majorities in both houses of Congress, is likely to promptthere were renewed legislative efforts to significantly modify or repeal the Health Care Reform Law is likelyand certain executive policy changes designed to modify its impact, howincluding the executive branch implementsenactment of the law,Tax Cuts and may impact howJobs Act in December 2017 which repealed the federal government responds to lawsuits challengingpenalties under the Health Care Reform Law.Law for uninsured persons. We cannot predict what further reform proposals, if any, will be adopted, when they may be adopted, or what impact they may have on our business. There may also be other risks and uncertainties associated with the Health Care Reform Law. If we fail to comply or are unable to effectively manage such risks and uncertainties, our financial condition and results of operations could be adversely affected.


Our policies and procedures may not fully comply with complex and increasing regulation by state and federal authorities, which could negatively impact our business operations.

The healthcare industry is highly regulated and continues to undergo significant changes as third-party payors, such as Medicare and Medicaid, traditional indemnity insurers, managed care organizations and other private payors, increase efforts to control cost, utilization and delivery of healthcare services. Healthcare companies are subject to extensive and complex federal, state and local laws, regulations and judicial decisions. Our failure or the failure of our treating physicians, to comply with applicable healthcare laws and regulations may result in the imposition of civil or criminal sanctions that we cannot afford, or require redesign or withdrawal of our programs from the market.

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We or our healthcare professionals may bebecome subject to regulatory, enforcement and investigative proceedings,medical liability claims, which could adversely affectcause us to incur significant expenses and may require us to pay significant damages if not covered by insurance.
Our business entails the risk of medical liability claims against both our financial condition or operations.

We or one or moreproviders and us. Although we carry insurance covering medical malpractice claims in amounts that we believe are appropriate in light of the risks attendant to our healthcare professionals could become the subject of regulatory, enforcement, or other investigations or proceedings, and our relationships, business, structure, and interpretations of applicable laws and regulations may be challenged. The defense of any such challengesuccessful medical liability claims could result in substantial costdamage awards that exceed the limits of our insurance coverage. We carry professional liability insurance for ourselves, and we separately carry a diversion of management’s time and attention.general insurance policy, which covers medical malpractice claims. In addition, any such challengeprofessional liability insurance is expensive and insurance premiums may increase significantly in the future, particularly as we expand our services. As a result, adequate professional liability insurance may not be available to us in the future at acceptable costs or at all.

Any claims made against us that are not fully covered by insurance could require significant changesbe costly to how we conductdefend against, result in substantial damage awards against us and divert the attention of our businessmanagement and our providers from our operations, which could have a material adverse effect on our business, regardless of whether the challenge ultimately is successful. If determination is made that we or one or more of our healthcare professionals has failed to comply with any applicable laws or regulations, our business, financial condition and results of operations could beoperations. In addition, any claims may adversely affected.

affect our business or reputation.

Our business practices may be found to constitute illegal fee-splitting or corporate practice of medicine, which may lead to penalties and adversely affect our business.

Many states, including California where our principal executive offices are located, have laws that prohibit business corporations, such as us, from practicing medicine, exercising control over medical judgments or decisions of physicians or other health care professionals (such as nurses or nurse practitioners), or engaging in certain business arrangements with physicians or other health care professionals, such as employment of physicians and other health care professionals or fee-splitting. The state laws and regulations and administrative and judicial decisions that enumerate the specific corporate practice and fee-splitting rules vary considerably from state to state and are enforced by both the courts and government agencies, each with broad discretion. Courts, government agencies or other parties, including physicians, may assert that we are engaged in the unlawful corporate practice of medicine, fee-splitting, or payment for referrals by providing administrative and other services in connection with our treatment programs. As a result of such allegations, we could be subject to civil and criminal penalties, our contracts could be found invalid and unenforceable, in whole or in part, or we could be required to restructure our contractual arrangements. If so, we may be unable to restructure our contractual arrangements on favorable terms, which would adversely affect our business and operations.

Our business practices may be found to violate anti-kickback, physician self-referral or false claims laws, which may lead to penalties and adversely affect our business.

The healthcare industry is subject to extensive federal and state regulation with respect to kickbacks, physician self-referral arrangements, false claims and other fraud and abuse issues.

The federal anti-kickback law (the “Anti-Kickback Law”) prohibits, among other things, knowingly and willfully offering, paying, soliciting, receiving, or providing remuneration, directly or indirectly, in exchange for or to induce either the referral of an individual, or the furnishing, arranging for, or recommending of an item or service that is reimbursable, in whole or in part, by a federal health care program. “Remuneration” is broadly defined to include anything of value, such as, for example, cash payments, gifts or gift certificates, discounts, or the furnishing of services, supplies, or equipment. The Anti-Kickback Law is broad, and it prohibits many arrangements and practices that are lawful in businesses outside of the health care industry.


Recognizing the breadth of the Anti-Kickback Law and the fact that it may technically prohibit many innocuous or beneficial arrangements within the health care industry, the Office of Inspector General (“OIG”) has issued a series of regulations, known as the “safe harbors.” Compliance with all requirements of a safe harbor immunizes the parties to the business arrangement from prosecution under the Anti-Kickback Law. The failure of a business arrangement to fit within a safe harbor does not necessarily mean that the arrangement is illegal or that the OIG will pursue prosecution. Still, in the absence of an applicable safe harbor, a violation of the Anti-Kickback Law may occur even if only one purpose of an arrangement is to induce referrals. The penalties for violating the Anti-Kickback Law can be severe. These sanctions include criminal and civil penalties, imprisonment, and possible exclusion from the federal health care programs. Many states have adopted laws similar to the Anti-Kickback Law, and some apply to items and services reimbursable by any payor, including private insurers.

In addition, the federal ban on physician self-referrals, commonly known as the Stark Law, prohibits, subject to certain exceptions, physician referrals of Medicare patients to an entity providing certain “designated health services” if the physician or an immediate family member of the physician has any financial relationship with the entity. A “financial relationship” is created
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by an investment interest or a compensation arrangement. Penalties for violating the Stark Law include the return of funds received for all prohibited referrals, fines, civil monetary penalties, and possible exclusion from the federal health care programs. In addition to the Stark Law, many states have their own self-referral bans, which may extend to all self-referrals, regardless of the payor.

The federal False Claims Act imposes liability on any person or entity that, among other things, knowingly presents, or causes to be presented, a false or fraudulent claim for payment to the federal government. Under the False Claims Act, a person acts knowingly if he has actual knowledge of the information or acts in deliberate ignorance or in reckless disregard of the truth or falsity of the information. Specific intent to defraud is not required. Violations of other laws, such as the Anti-Kickback Law or the FDA prohibitions against promotion of off-label uses of drugs, can lead to liability under the federal False Claims Act. The qui tam provisions of the False Claims Act allow a private individual to bring an action on behalf of the federal government and to share in any amounts paid by the defendant to the government in connection with the action. The number of filings of qui tam actions has increased significantly in recent years. When an entity is determined to have violated the False Claims Act, it may be required to pay up to three times the actual damages sustained by the government, plus civil penalties of between $5,500 and $11,000 for each false claim. Conduct that violates the False Claims Act may also lead to exclusion from the federal health care programs. Given the number of claims likely to be at issue, potential damages under the False Claims Act for even a single inappropriate billing arrangement could be significant. In addition, various states have enacted similar laws modeled after the False Claims Act that apply to items and services reimbursed under Medicaid and other state health care programs, and, in several states, such laws apply to claims submitted to all payors.

On May 20, 2009, the Federal Enforcement and Recovery Act of 2009, or FERA, became law, and it significantly amended the federal False Claims Act. Among other things, FERA eliminated the requirement that a claim must be presented to the federal government. As a result, False Claims Act liability extends to any false or fraudulent claim for government money, regardless of whether the claim is submitted to the government directly, or whether the government has physical custody of the money. FERA also specifically imposed False Claims Act liability if an entity “knowingly and improperly avoids or decreases an obligation to pay or transmit money or property to the Government.” As a result, the knowing and improper failure to return an overpayment can serve as the basis for a False Claims Act action. In March 2010, Congress passed the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, collectively the ACA, which also made sweeping changes to the federal False Claims Act. The ACA also established that Medicare and Medicaid overpayments must be reported and returned within 60 days of identification or when any corresponding cost report is due.

Finally, the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations created the crimes of health care fraud and false statements relating to health care matters. The health care fraud statute prohibits knowingly and willfully executing a scheme to defraud any health care benefit program, including a private insurer. The false statements statute prohibits knowingly and willfully falsifying, concealing, or covering up a material fact or making any materially false, fictitious, or fraudulent statement in connection with the delivery of or payment for health care benefits, items, or services. A violation of this statute is a felony and may result in fines, imprisonment, or exclusion from the federal health care programs.


Federal or state authorities may claim that our fee arrangements, our agreements and relationships with contractors, hospitals and physicians, or other activities violate fraud and abuse laws and regulations. If our business practices are found to violate any of these laws or regulations, we may be unable to continue with our relationships or implement our business plans, which would have an adverse effect on our business and results of operations. Further, defending our business practices could be time consuming and expensive, and an adverse finding could result in substantial penalties or require us to restructure our operations, which we may not be able to do successfully.

Our business practices may be subject to state regulatory and licensurelicensure requirements.

Our business practices may be regulated by state regulatory agencies that generally have discretion to issue regulations and interpret and enforce laws and rules. These regulations can vary significantly from jurisdiction to jurisdiction, and the interpretation of existing laws and rules also may change periodically. Some of our business and related activities may be subject to state health care-related regulations and requirements, including managed health care, utilization review (UR) or third-party administrator-related regulations and licensure requirements. These regulations differ from state to state, and may contain network, contracting, and financial and reporting requirements, as well as specific standards for delivery of services, payment of claims, and adequacy of health care professional networks. If a determination is made that we have failed to comply with any applicable state laws or regulations, our business, financial condition and results of operations could be adversely affected.

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If our providers or experts are characterized as employees, we would be subject to employment and withholding liabilities.
We structure our relationships with our providers and experts in a manner that we believe results in an independent contractor relationship, not an employee relationship. An independent contractor is generally distinguished from an employee by his or her degree of autonomy and independence in providing services. A high degree of autonomy and independence is generally indicative of a contractor relationship, while a high degree of control is generally indicative of an employment relationship. Although we believe that our providers and experts are properly characterized as independent contractors, tax or other regulatory authorities may in the future challenge our characterization of these relationships. If such regulatory authorities or state, federal or foreign courts were to determine that our providers or experts are employees, and not independent contractors, we would be required to withhold income taxes, to withhold and pay social security, Medicare and similar taxes and to pay unemployment and other related payroll taxes. We would also be liable for unpaid past taxes and subject to penalties. As a result, any determination that our providers or experts are our employees could have a material adverse effect on our business, financial condition and results of operations.
We may be subject to healthcare anti-fraud initiatives, which may lead to penalties and adversely affect our business.

State and federal government agencies are devoting increased attention and resources to anti-fraud initiatives against healthcare providers and the entities and individuals with whom they do business, and such agencies may define fraud expansively to include our business practices, including the receipt of fees in connection with a healthcare business that is found to violate any of the complex regulations described above. While to our knowledge we have not been the subject of any anti-fraud investigations, if such a claim were made, defending our business practices could be time consuming and expensive and an adverse finding could result in substantial penalties or require us to restructure our operations, which we may not be able to do successfully.

Our use and disclosure of patient information is subject to privacy and security regulations, which may result in increased costs.

In providing administrative services to healthcare providers and operating our treatment programs, we may collect, use, disclose, maintain and transmit patient information in ways that will be subject to many of the numerous state, federal and international laws and regulations governing the collection, use, disclosure, storage, privacy and security of patient-identifiable health information, including the administrative simplification requirements of the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (HIPAA) and the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH). The HIPAA Privacy Rule restricts the use and disclosure of patient information (“Protected Health Information” or “PHI”), and requires safeguarding that information. The HIPAA Security Rule and HITECH establish elaborate requirements for safeguarding PHI transmitted or stored electronically. HIPAA applies to covered entities, which may include healthcare facilities and also includes health plans that will contract for the use of our programs and our services. HIPAA and HITECH require covered entities to bind contractors that use or disclose protected health information (or “Business Associates”) to compliance with certain aspects of the HIPAA Privacy Rule and all of the HIPAA Security Rule. In addition to contractual liability, Business Associates are also directly subject to regulation by the federal government. Direct liability means that we are subject to audit, investigation and enforcement by federal authorities. HITECH imposes new breach notification obligations requiring us to report breaches of “Unsecured Protected Health Information” or PHI that has not been encrypted or destroyed in accordance with federal standards. Business Associates must report such breaches so that their covered entity customers may in turn notify all affected patients, the federal government, and in some cases, local or national media outlets. We may be required to indemnify our covered entity customers for costs associated with breach notification and the mitigation of harm resulting from breaches that we cause. If we are providing management services that include electronic billing on behalf of a physician practice or facility that is a covered entity, we may be required to conduct those electronic transactions in accordance with the HIPAA regulations governing the form and format of those transactions. Services provided under our OnTrak solution not only require us to comply with HIPAA and HITECH but also Title 42 Part 2 of the Code of Federal Regulations (“Part 2”). Part 2 is a federal, criminal law that severely restricts our ability to use and disclose drug and alcohol treatment information obtained from federally-supported treatment facilities. Our operations must be carefully structured to avoid liability under this law. Our OnTrak solution qualifies as a federally funded treatment facility which requires us to disclose information on members only in compliance with Title 42.
In addition to the federal privacy regulations, there are a number of state laws governing the privacy and security of health and personal information. The penalties for violation of these laws vary widely and the area is rapidly evolving.

In 2018, California passed a privacy law (the “CCPA”), which gives consumers significant rights over the use of their personal information, including the right to object to the “sale” of their personal information.While certain information covered
11

by HIPAA is exempt from the applicability of the CCPA, the rights of consumers under the CCPA may restrict our ability to use personal information in connection with our business operations.The CCPA also provides a private right of action for security breaches.

In 2019, New York passed a law known as the SHIELD Act, which will, as of March 21, 2020, require companies to have robust data security programs in place. Other states, including Washington, have introduced significant privacy bills, and Congress is debating federal privacy legislation, which if passed, may restrict our business operations and require us to incur additional costs for compliance.

In addition, several foreign countries and governmental bodies, including the E.U., Brazil and Canada, have laws and regulations concerning the collection and use of personally identifiable information obtained from their residents, including identifiable health information, which are often more restrictive than those in the U.S. Laws and regulations in these jurisdictions apply broadly to the collection, use, storage, disclosure and security of personally identifiable information, including health information, identifying, or which may be used to identify, an individual, such as names, email addresses and, in some jurisdictions, Internet Protocol (IP) addresses, device identifiers and other data. Although we currently conduct business only in the United States of America, these laws and regulations could become applicable to us in the event we expand our operations into other countries. These and other obligations may be modified and interpreted in different ways by courts, and new laws and regulations may be enacted in the future.

Within the EEA, the General Data Protection Regulation ("GDPR") took full effect on May 25, 2018, superseding the 1995 European Union Data Protection Directive and becoming directly applicable across E.U. member states. The GDPR includes more stringent operational requirements for processors and controllers of personal data, for companies established in the EEA and those outside the EEA that collect and use personal data, including health information, imposes significant penalties for non-compliance and has broader extra-territorial effect. As the GDPR is a regulation rather than a directive, it applies throughout the EEA, but permits member states to enact supplemental requirements if they so choose. Noncompliance with the GDPR can trigger fines of up to the greater of €20 million or 4% of global annual revenues. Further, a Data Protection Act substantially implementing the GDPR was enacted in the U.K., effective in May 2018. It remains unclear, however, if the U.K.'s withdrawal from the E.U. will ultimately transpire and, if it does, how U.K. data protection laws or regulations will develop in the medium to longer term and how data transfers to and from the U.K. will be regulated. In addition, some countries are considering or have enacted legislation requiring local storage and processing of data that could increase the cost and complexity of delivering our services.

We believe that we have taken the steps required of us to comply with laws governing the privacy and security of personal information, including health information privacy and security laws and regulations, in all applicable jurisdictions, both state and federal. However, we may not be able to maintain compliance in all jurisdictions where we do business. Failure to maintain compliance, or changes in state or federal privacy and security laws could result in civil and/or criminal penalties and could have a material adverse effect on our business, including significant reputational damage associated with a breach. Under HITECH, we are subject to prosecution or administrative enforcement and increased civil and criminal penalties for non-compliance, including a four-tiered system of monetary penalties. We are also subject to enforcement by state attorneys general who were given authority to enforce HIPAA under HITECH, and who have authority to enforce state-specific data privacy and security laws. If regulations change, if we expand the territorial scope of our operations, or if it is determined that we are not in compliance with privacy regulations, we may be required to modify aspects of our program, which may adversely affect program results and our business or profitability. Under HITECH, we are subject to prosecution or administrative enforcement and increased civil and criminal penalties for non-compliance, including a new, four-tiered system of monetary penalties. We are also subject to enforcement by state attorneys general who were given authority to enforce HIPAA under HITECH.


Certain of our professional healthcare employees, such as nurses, must comply with individual licensing requirements.

All of our healthcare professionals who are subject to licensing requirements, such as our care coaches, are licensed in the state in which they provide professional services in person. While we believe our nurses provide coaching and not professional services, one or more states may require our healthcare professionals to obtain licensure if providing services telephonically across state lines to the state’s residents. Healthcare professionals who fail to comply with these licensure requirements could face fines or other penalties for practicing without a license, and we could be required to pay those fines on behalf of our healthcare professionals. If we are required to obtain licenses for our nurses in states where they provide telephonic coaching, it would significantly increase the cost of providing our product. In addition, new and evolving agency interpretations, federal or state legislation or regulations, or judicial decisions could lead to the implementation of out-of-state licensure requirements in additional states, and such changes would increase the cost of services and could have a material effect on our business.

Security breaches, loss of data and other disruptions could compromise sensitive information related to our business, prevent us from accessing critical information or expose us to liability, which could adversely affect our business and our reputation.

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In the ordinary course of our business, we collect and store sensitive data, including legally protected patient health information, personally identifiable information about our employees, intellectual property, and proprietary business information. We manage and maintain our applications and data utilizing an off-site co-location facility. These applications and data encompass a wide variety of business critical information including research and development information, commercial information and business and financial information.


The secure processing, storage, maintenance and transmission of this critical information is vital to our operations and business strategy, and we devote significant resources to protecting such information. Although we take measures to protect sensitive information from unauthorized access or disclosure, our information technology and infrastructure may be vulnerable to attacks by hackers, viruses, breaches or interruptions due to employee error or malfeasance, terrorist attacks, earthquakes, fire, flood, other natural disasters, power loss, computer systems failure, data network failure, Internet failure or lapses in compliance with privacy and security mandates. We may be subject to distributed denial of service (DDOS) attacks by hackers aimed at disrupting service to patients and customers. Our response to such DDOS attacks may be insufficient to protect our network and systems. In addition, there has been a continuing increase in the number of malicious software attacks in the technology industry, including malware and ransomware. Any such virus, breach or interruption could compromise our networks and the information stored there could be accessed by unauthorized parties, publicly disclosed, lost or stolen. We have measures in place that are designed to detect and respond to such security incidents and breaches of privacy and security mandates. Nonetheless, we cannot guarantee our backup systems, regular data backups, security protocols, network protection mechanisms and other procedures currently in place, or that may be in place in the future, will be adequate to prevent or remedy network and service interruption, system failure, damage to one or more of our systems, data loss, security breaches or other data security incidents. We might be required to expend significant capital and resources to protect against or address such incidents. Any such access, disclosure or other loss of information could result in legal claims or proceedings, liability under laws that protect the privacy of personal information such(such as HIPAA and state data security laws), government enforcement actions and regulatory penalties. We may also be required to indemnify our customers for costs associated with having their data on our system breached. Unauthorized access, loss or dissemination could also interrupt our operations, including our ability to bill our customers, provide customer support services, conduct research and development activities, process and prepare company financial information, manage various general and administrative aspects of our business and damage our reputation, or we may lose one or more of our customers, especially if they felt their data may be breached, any of which could adversely affect our business.

Risks related to our Note Agreement
The terms of our Note Agreement place restrictions on our operating and financial flexibility, and failure to comply with covenants or to satisfy certain conditions of the agreement may result in acceleration of our repayment obligations, which could significantly harm our liquidity, financial condition, operating results, business and prospects and cause the price of our securities to decline.

On September 24, 2019 (the “Closing Date”), we entered into a Note Agreement (the “Note Agreement”), by and among us, certain of our subsidiaries as guarantors, Goldman Sachs Specialty Lending Holdings, Inc. (with any other purchasers party thereto from time to time, collectively the “Holder”) and Goldman Sachs Specialty Lending Group, L.P., as collateral agent, in connection with the sale of up to $45.0 million aggregate principal amount of senior secured notes (the “Notes”). On the Closing Date, we issued an aggregate of $35.0 million in principal amount of Notes and, subject to the achievement of threshold trailing six month annualized revenue targets and certain other conditions, the Holder is obligated to purchase up to an additional $10.0 million in principal amount of Notes during the period from the Closing Date until September 24, 2021.

The Note Agreement contains customary covenants, including, among others, covenants that restrict the our ability to incur debt, grant liens, make certain investments and acquisitions, pay dividends, repurchase equity interests, repay certain debt, amend certain contracts, enter into affiliate transactions and asset sales or make certain equity issuances, and covenants that require the us to, among other things, provide annual, quarterly and monthly financial statements, together with related compliance certificates, maintain its property in good repair, maintain insurance and comply with applicable laws. The Note Agreement also includes covenants with respect to our maintenance of certain financial ratios, including a fixed charge coverage ratio, leverage ratio and consolidated liquidity as well as minimum levels of consolidated adjusted EBITDA and revenue.

The Note Agreement and the Notes could have important consequences for us and our stockholders. For example, the Notes require a balloon payment at maturity in September 2024, which may require us to dedicate a substantial portion of our uncommitted cash flow from operations to this future payment if we feel we cannot be successful in our ability to refinance in the future, thereby further reducing the availability of our cash flow to fund working capital, capital expenditures, and acquisitions, and for other general corporate purposes. In addition, our indebtedness could:

increase our vulnerability to adverse economic and competitive pressures in our industry;
13

place us at a competitive disadvantage compared to our competitors that have less debt;
limit our flexibility in planning for, or reacting to, changes in our business and our industry; and
limit our ability to borrow additional funds on terms that are acceptable to us or at all.

The Note Agreement contains restrictive covenants that will restrict our operational flexibility and require that we maintain specified financial ratios. If we cannot comply with these covenants, we may be in default under the Note Agreement.

The Note Agreement contains restrictions and limitations on our ability to engage in activities that may be in our long-term best interests. The Note Agreement contains affirmative and negative covenants that limit and restrict, among other things, our ability to:

incur additional debt;
sell assets;
issue equity securities;
pay dividends or repurchase equity securities;
incur liens or other encumbrances;
make certain restricted payments and investments;
acquire other businesses; and
merge or consolidate.

The Note Agreement contains a fixed charge coverage ratio covenant, a leverage ratio covenant and minimum revenue and liquidity covenants. Events beyond our control could affect our ability to meet these and other covenants under the Note Agreement. The Note Agreement also contains customary events of default, including, among others, payment default, bankruptcy events, cross-default, breaches of covenants and representations and warranties, change of control, judgment defaults and an ownership change within the meaning of Section 382 of the Code. Our failure to comply with our covenants and other obligations under the Note Agreement may result in an event of default thereunder. A default, if not cured or waived, may permit acceleration of the Notes. If the indebtedness represented by the Notes is accelerated, we cannot be certain that we will have sufficient funds available to pay the accelerated indebtedness (together with accrued interest and fees), or that we will have the ability to refinance the accelerated indebtedness on terms favorable to us or at all. This could have serious consequences to our financial condition, operating results, and business, and could cause us to become insolvent or enter bankruptcy proceedings, and shareholders may lose all or a portion of their investment because of the priority of the claims of our creditors on our assets.

If we are unable to generate or borrow sufficient cash to make payments on our indebtedness, our financial condition would be materially harmed, our business could fail, and shareholders may lose all of their investment.

Our ability to make scheduled payments on or to refinance our obligations will depend on our financial and operating performance, which will be affected by economic, financial, competitive, business, and other factors, some of which are beyond our control. We cannot assure you that our business will generate sufficient cash flow from operations to service our indebtedness or to fund our other liquidity needs. If we are unable to meet our debt obligations or fund our other liquidity needs, we may need to restructure or refinance all or a portion of our indebtedness on or before maturity or sell certain of our assets. We cannot assure you that we will be able to restructure or refinance any of our indebtedness on commercially reasonable terms, if at all, which could cause us to default on our debt obligations and impair our liquidity. Any refinancing of our indebtedness could be at higher interest rates and may require us to comply with more onerous covenants, which could further restrict our business operations.

Increases in interest rates could adversely affect our results from operations and financial condition.

The Notes bear interest at either a floating rate plus an applicable margin in the case of Notes subject to cash interest payments or a floating rate plus a slightly higher applicable margin in the case of Notes as to which current interest has been capitalized during the first twelve months following the Closing Date, at the Company’s option. The applicable margins are subject to stepdowns, in each case, following the achievement of certain financial ratios. As a result, an increase in prevailing interest rates would have an effect on the interest rates charged on the Notes, which rise and fall upon changes in interest rates. If prevailing interest rates or other factors result in higher interest rates, the increased interest expense would adversely affect our cash flow and our ability to service our indebtedness.
Risks related to our common stock

14

Our common stockhas limited trading volume,, and it is therefore susceptible tohighpricevolatility.

volatility.

Our common stock is quotedlisted on the OTCQBNASDAQ Capital Market under the symbol “CATS” and has at times experienced limited trading volume.volumes. As such, our common stock ismay be more susceptible to significant and sudden price changes than stocks that are widely followed by the investment community and actively traded on an exchange.traded. The liquidity of our common stock depends upon the presence in the marketplace of willing buyers and sellers. We cannot assure you that you will be able to find a buyer for your shares. In the future, if we successfully list the common stock on a securities exchange or obtain trading authorization, we will not be able to assure you that an organized public market for our securities will develop or that there will be any private demand for the common stock. We could also subsequently fail to satisfy the standards for continued national securities exchange trading,NASDAQ listing, such as standards having to do with a minimum share price, the minimum number of public shareholders or the aggregate market value of publicly held shares. Any holder of our securities should regard them as a long-term investment and should be prepared to bear the economic risk of an investment in our securities for an indefinite period.

Our common stock is considered a “penny stock” and may be difficult to sell.

Our common stock is subject to certain rules and regulations relating to “penny stock.” Penny stocks are generally equity securities with a price of less than $5.00 (other than securities registered on certain national securities exchanges, provided that current price and volume information with respect to transactions in such securities is provided by the exchange or system). The penny stock rules require a broker−dealer, prior to a transaction in a penny stock not otherwise exempt from the rules, to deliver a standardized risk disclosure document that provides information about penny stocks and the risks in the penny stock market. The broker−dealer must also provide the customer with current bid and offer quotations for the penny stock, the compensation of the broker−dealer and its salesperson in the transaction, and monthly account statements showing the market value of each penny stock held in the customer’s account. In addition, the penny stock rules generally require that prior to a transaction in a penny stock, the broker−dealer make a special written determination that the penny stock is a suitable investment for the purchaser and receive the purchaser’s written agreement to the transaction. These disclosure requirements may have the effect of reducing the level of trading activity in the secondary market for a stock that becomes subject to the penny stock rules. Since the Company’s securities are subject to the penny stock rules, investors in the Company may find it more difficult to sell their securities.

Failure to maintain effective internal controls could adversely affect our operating results and the market for our common stock.

Section 404 of the Sarbanes-Oxley Act of 2002 requires that we maintain internal control over financial reporting that meets applicable standards. As with many smaller companies with small staff, material weaknesses in our financial controls and procedures may be discovered. If we are unable, or are perceived as unable, to produce reliable financial reports due to internal control deficiencies, investors could lose confidence in our reported financial information and operating results, which could result in a negative market reaction and adversely affect our ability to raise capital.

Approximately 79%

More than 50% of ouroutstanding commonstock isbeneficially ownedby our chairman and chief executive officer, who has the ability to substantially influence the election of directors and other matters submitted to stockholders.

62,068,826

10,419,788 shares are beneficially held of record by Acuitas Group Holdings, LLC (“Acuitas”), whose sole managing member is our Chairman and Chief Executive Officer, which represents beneficial ownership of approximately 79%50% of our outstanding shares of common stock. As a result, he has and is expected to continue to have the ability to significantly influence the election of our Board of Directors and the outcome of all other matters submitted to our stockholders. His interest may not always coincide with our interests or the interests of other stockholders, and he may act in a manner that advances his best interests and not necessarily those of other stockholders. One consequence to this substantial influence or control is that it may be difficult for investors to remove management of our Company. It could also deter unsolicited takeovers, including transactions in which stockholders might otherwise receive a premium for their shares over then current market prices.


Our stock price may be subject to substantial volatility, and the value of our stockholders' investment may decline.

The price at which our common stock will trade may fluctuatetrades fluctuates as a result of a number of factors, including the number of shares available for sale in the market, quarterly variations in our operating results and actual or anticipated announcements of our OnTrak solution, announcements regarding new or discontinued OnTrak solution contracts, new products or services by us or competitors, regulatory investigations or determinations, acquisitions or strategic alliances by us or our competitors, recruitment or departures of key personnel, the gain or loss of significant customers, changes in the estimates of our operating performance, actual or threatened litigation, market conditions in our industry and the economy as a whole.

Numerous factors, including many over which we have no control, may have a significant impact on the market price of our common stock, including:

announcements of new products or services by us or our competitors;

current events affecting the political, economic and social situation in the United States;

trends in our industry and the markets in which we operate;

changes in financial estimates and recommendations by securities analysts;

acquisitions and financings by us or our competitors;

the gain or loss of a significant customer;

quarterly variations in operating results;

the operating and stock price performance of other companies that investors may consider to be comparable;

purchases or sales of blocks of our securities; and

issuances of stock.

● announcements of new products or services by us or our competitors;
● current events affecting the political, economic and social situation in the United States;
● trends in our industry and the markets in which we operate;
● changes in financial estimates and recommendations by securities analysts;
● acquisitions and financings by us or our competitors;
● the gain or loss of a significant customer;
● quarterly variations in operating results;
● the operating and stock price performance of other companies that investors may consider to be comparable;
● purchases or sales of blocks of our securities; and
● issuances of stock.
Furthermore, stockholders may initiate securities class action lawsuits if the market price of our stock drops significantly, which may cause us to incur substantial costs and could divert the time and attention of our management.

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Future sales of common stock by existing stockholders, or the perception that such sales may occur, could depress our stock price.

The market price of our common stock could decline as a result of sales by, or the perceived possibility of sales by, our existing stockholders. We have completed a number of private placements of our common stock and other securities over the last several years, and we have effective resale registration statements pursuant to which the purchasers can freely resell their shares into the market. In addition, mostMost of our outstanding shares are eligible for public resale pursuant to Rule 144 under the Securities Act of 1933, as amended. As of February 24, 2017,December 31, 2019, approximately 48.99.2 million shares of our common stock are held by our affiliates and may be sold pursuant to an effective registration statement or in accordance with the volume and other limitations of Rule 144 or pursuant to other exempt transactions. Future sales of common stock by significant stockholders, including those who acquired their shares in private placements or who are affiliates, or the perception that such sales may occur, could depress the price of our common stock.


Future issuances of common stock and hedging activities may depress the trading price of our common stock.

Any future issuance of equity securities, including the issuance of shares upon direct registration, the conversion of our 12% Original Issue Discount Convertible Debenture (the “Convertible Debenture”) or our 8% Senior Convertible Debenture (the “December 2016 Convertible Debenture”), upon satisfaction of our obligations, compensation of vendors, exercise of outstanding warrants, or effectuation of a reverse stock split, could dilute the interests of our existing stockholders, and could substantially decrease the trading price of our common stock. As of February 24, 2017,of March 6, 2020, we have outstanding options to purchase approximately 1,462,960approximately 3,964,118 shares of our common stock and warrants to purchase approximately 9,519,1821,539,926 shares of our common stock at prices ranging from $0.30$1.80 to $3,200.00$105.60 per share.share. We may issue equity securities in the future for a number of reasons, including to finance our operations and business strategy, in connection with acquisitions, to adjust our ratio of debt to equity, to satisfy our obligations upon the exercise of outstanding warrants or options or for other reasons.

There may be future sales or other dilution of our equity, which may adversely affect the market price of our common stock.

In the future, we may need to raise additional funds through public or private financing, which might include sales of equity securities. The issuance of any additional shares of common stock or securities convertible into, exchangeable for, or that represent the right to receive common stock or the exercise of such securities could be substantially dilutive to holders of shares of our common stock. Holders of shares of our common stock have no preemptive rights that entitle holders to purchase their pro rata share of any offering of shares of any class or series. The market price of our common stock could decline as a result of sales of shares of our common stock made after this offering or the perception that such sales could occur. Because our decision to issue securities in any future offering will depend on market conditions and other factors beyond our control, we cannot predict or estimate the amount, timing or nature of our future offerings. Thus, our stockholders bear the risk of our future offerings reducing the market price of our common stock and diluting their interests in our Company.

Provisions in our certificate of incorporation and Delaware law could discourage a change in control, or an acquisition of us by a third party, even if the acquisition would be favorable to you.

Our amended and restated certificate of incorporation and the Delaware General Corporation Law contain provisions (including the Section 382 Ownership Limit) that may have the effect of making more difficult or delaying attempts by others to obtain control of our Company, even when these attempts may be in the best interests of stockholders. For example,In addition, our amended and restated certificate of incorporation authorizes our Board of Directors, without stockholder approval, to issue one or more series of preferred stock, which could have voting and conversion rights that adversely affect or dilute the voting power of the holders of common stock. Delaware law also imposes conditions on certain business combination transactions with “interested stockholders.” These provisions and others that could be adopted in the future could deter unsolicited takeovers or delay or prevent changes in our control or management, including transactions in which stockholders might otherwise receive a premium for their shares over then current market prices. These provisions may also limit the ability of stockholders to approve transactions that they may deem to be in their best interests.

We do not expect to pay dividends in the foreseeable future.

We have paid no cash dividends on our common stock to date, and we intend to retain our future earnings, if any, to fund the continued development and growth of our business. As a result, we do not expect to pay any cash dividends in the foreseeable future. Further, any payment of cash dividends will also depend on our financial condition, results of operations, capital requirements and other factors, including contractual restrictions to which we may be subject, and will be at the discretion of our Board of Directors.

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A number fewof our outstanding warrants contain anti-dilution provisions that, if triggered, could cause substantial dilution to our then-existing stockholders and adversely affect our stock price.

A numberfew of our outstanding warrants contain anti-dilution provisions. As a result, if we, in the future, issue or grant any rights to purchase any of our common stock or other securities convertible into our common stock for a per share price less than the exercise price of our warrants, the exercise price, or in the case of some of our warrants the exercise price and number of shares of common stock, will be reduced. If our available funds and cash generated from operations are insufficient to satisfy our liquidity requirements in the future, then we may need to raise substantial additional funds in the future to support our working capital requirements and for other purposes. If shares of our common stock or securities exercisable for our common stock are issued in consideration of such funds at an effective per share price lower than our existing warrants, then the anti-dilution provisions would be triggered, thus possibly causing substantial dilution to our then-existing shareholders if such warrants are exercised. Such anti-dilution provisions may also make it more difficult for us to obtain financing.


The exercise of our outstanding warrants may result in a dilution of our current stockholders' voting power and an increase in the number of shares eligible for future resale in the public market,,which may negatively impact the market price of our stock.

The exercise of some or all of our outstanding warrants could significantly dilute the ownership interests of our existing stockholders. As of February 24, 2017,March 6, 2020, we had outstanding warrants to purchase an aggregate of 9,519,1821,539,926 shares of common stock at exercise prices ranging from $0.30$1.80 to $3.00$18.71 per share. To the extent warrants are exercised, additional shares of common stock will be issued, and such issuance may dilute existing stockholders and increase the number of shares eligible for resale in the public market.

In addition to the dilutive effects described above, the exercise of those warrants would lead to a potential increase in the number of shares eligible for resale in the public market. Sales of substantial numbers of such shares in the public market could adversely affect the market price of our shares.

Certain of our outstanding warrants contain anti-dilution provisions that, if triggered, could cause dilution to our then-existing stockholders and adversely affect our stock price.
Certain of our outstanding warrants, including those warrants issued in connection with the Note Agreement, contain anti-dilution provisions. As a result, if we, in the future, issue or grant any rights to purchase any of our common stock or other securities convertible into our common stock for a per share price less than the exercise price of our warrants, the exercise price, or in the case of some of our warrants the exercise price and number of shares of common stock, will be reduced. If our available funds and cash generated from operations are insufficient to satisfy our liquidity requirements in the future, then we may need to raise substantial additional funds in the future to support our working capital requirements and for other purposes. If shares of our common stock or securities exercisable for our common stock are issued in consideration of such funds at an effective per share price lower than our existing warrants, then the anti-dilution provisions would be triggered, thus possibly causing dilution to our then-existing shareholders if such warrants are exercised. Such anti-dilution provisions may also make it more difficult for us to obtain financing.
ITEM1B.      1B. UNRESOLVED STAFF COMMENTS

Not Applicable.

ITEM 2.      PROPERTIES

Information concerning our principal facilities, all of which were leased at December 31, 2016, is set forth below:

Location

Use

Approximate
Area in
Square Feet

11601 Wilshire Blvd., Suite 1100
Los Angeles, California 90025

Principal executive and administrative offices

9,120

2. PROPERTIES

Our principal executive and administrative offices are located in Los Angeles, California, and consists of leasedofficeleased office space totaling approximately 9,120 square feet, which will expire in April 2019. Our base rent is approximately $31,000 per month, subject to annual adjustments, with aggregate minimum lease commitments at February 24, 2017, totaling approximately $800,000.

Santa Monica, California.

We believe that the current office space is adequate to meet our needs.

ITEM 3. LEGAL PROCEEDINGS

None.

From time to time, we are subject to various legal proceedings that arise in the normal course of our business activities. As of the date of this Annual Report on Form 10-K, we are not a party to any litigation the outcome of which, if determined adversely to us, would individually or in the aggregate be reasonably expected to have a material adverse effect on our results of operations or financial position.
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ITEM4. MINE SAFETY AND DISCLOSURE

Not Applicable.



PART II

II


ITEM 5.

MARKET FOR REGISTRANT’S COMMON EQUITY AND RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES

Market Information

Our common stock is quoted on the OTCQB under the symbol “CATS.” The last reported bid price for our common stock on the OTCQB on February 24, 2017 was $1.13 per share.

The table below sets forth the high and low bid prices for our common stock as reported on the OTCQB

ITEM 5. MARKET FOR REGISTRANT’S COMMON EQUITY AND RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES
UnregisteredSales ofSecurities
All sales of unregistered securities during the periods indicated. The quotations below as provided by OTC Markets Group, Inc., reflect inter-dealer prices and do not include retail markup, markdown or commissions. In addition, these quotations may not necessarily represent actual transactions.

  

Bid Price

 

2016

 

High

  

Low

 

4th Quarter

 $1.28  $0.79 

3rd Quarter

  1.55   0.60 

2nd Quarter

  0.88   0.33 

1st Quarter

  0.58   0.25 

  

Bid Price

 

2015

 

High

  

Low

 

4th Quarter

 $0.79  $0.29 

3rd Quarter

  1.69   0.61 

2nd Quarter

  2.10   0.95 

1st Quarter

  2.45   1.72 

Stockholders

As of February 24, 2017, thereyear ended December 31, 2019 were approximately 69 stockholders of record of our 55,288,458 outstanding shares of common stock.

Dividends

We have never declared or paid dividends on our common stock and we do not anticipate paying any cash dividends on our common stockpreviously disclosed in the foreseeable future. Payment of cash dividends, if any, in the future will be at the discretion of our board of directors and will depend on applicable law and then-existing conditions, including our financial condition, operating results, contractual restrictions, capital requirements, business prospects and other factors our board of directors may deem relevant. We currently intend to retain all available funds and any future earnings to fund the development and growth of our business.

Information about our Equity Compensation Plans

Information regarding our equity compensation plans is incorporated by reference to Item 10, “Directors, Executive Officers and Corporate Governance” of Part III of this Annuala Quarterly Report on Form 10-K.

UnregisteredSales ofSecurities

Nothing to Report.

10-Q or Current Report on Form 8-K.

Issuer Purchase of Equity Securities

None.


None.

ITEM 6.SELECTED FINANCIAL DATA

Not applicable.

ITEM 7.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

ITEM 7. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
Forward-Looking Statements

This Annual Report on Form 10-K contains forward-lookingstatements that involve risks and uncertainties. Our actual results may differ materially from those discussed due to factors such as, among others, limited operating history, difficulty in developing, exploiting and protecting proprietary technologies, intense competition and substantial regulation in the healthcare industry. Additional information concerningfactors that could cause or contribute to such differences can be found in the following discussion, as well asin Item 1.A.1.A. -“Risk Factors.Factors.

OVERVIEW

General

We provideharness proprietary big data predictive analytics, artificial intelligence and telehealth, combined with human interaction, to deliver improved member health and cost savings to health plans. We identify, engage and treat health plan members with unaddressed behavioral health conditions that worsen medical comorbidities. Our mission is to help improve the health and save the lives of as many people as possible.
We apply advanced data analytics based specializedand predictive modeling to identify members with untreated behavioral health managementconditions, whether diagnosed or not, and integratedcoexisting medical conditions that may be impacted through treatment services toin the OnTrak program. We then uniquely engage health plans through ourplan members who do not typically seek behavioral healthcare by leveraging proprietary enrollment capabilities built on deep insights into the drivers of care avoidance. Our technology enabled OnTrak solution. Our OnTrak solution is designed to improvean integrated suite of services that includes evidence-based psychosocial and medical interventions delivered either in-person or via telehealth, nurse-led care coaching and local community support. We believe that the program is currently improving member health and, at the same time, lowerdriving a reduction in total health plan costs after completion of the OnTrak program.
We operate as one segment and we have contracted with leading national and regional health plans to make OnTrak available to eligible members in 28 states.

Metrics
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The following table sets forth our key metrics that we use to evaluate our business, measure our performance, identify trends affecting our business, formulate financial projections and make strategic decisions (in thousands):
Revenues. Our revenues are mostly generated from fees charged to members in our OnTrak program. Our contracts are generally designed to provide cash fees to us on a monthly basis, an upfront case rate, or fee for service based on enrolled members. The Company’s performance obligation is satisfied over the insurer for underserved populations where12 month period of the OnTrak program.
Effective outreach pool. Effective Outreach Pool are individuals insured by our health plan customers who have been identified through our advanced data analytics and predictive modeling with untreated behavioral health conditions are causingthat may be impacted through treatment in the OnTrak program.
Cash flow from operations. Our current business activities result in an outflow of cash flow from operations as we invest strategically into our business to help continue the growth of our operations.

Year Ended December 31,
2019  2018  Change% Change
Revenue$35,095  $15,177  $19,918  131 %
Effective outreach pool108,000  41,000  67,000  163 %
Cash flow from operations$(16,901) $(8,574) $(8,327) (97)%
Key Components of Our Results of Operations
Revenue

Revenue from contracts with customers is recognized when, or exacerbating co-existing medical conditions. Theas, we satisfy our performance obligations by transferring the promised goods or services to the customers. Revenue from a performance obligation satisfied over time is recognized by measuring our progress in satisfying the performance obligation in a manner that depicts the transfer of the goods or services to the customer. Revenue from customers enrolled in our program utilizes proprietary analytics,is recognized over the term of the program, which is typically twelve months.

Cost of Revenue

Cost of healthcare services consists primarily of salaries related to our care coaches, member engagement and patient centric treatment that integrates evidence-based medical and psychosocial interventions along with care coaching in a 52-week outpatient program. Our initial focus was members with substance use disorders, but we have expanded our solution to assist members with anxiety and depression. We currently operate our OnTrak solutions in Florida, Georgia, Illinois, Kansas, Kentucky, Louisiana, Massachusetts, Missouri, New Jersey, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia and Wisconsin. We provide services to commercial (employer funded), managed Medicare Advantage, and managed Medicaid and duel eligible (Medicare and Medicaid) populations. 

Our Strategy

Our business strategy is to provide a quality integrated medical and behavioral solution to help health plansspecialists and other organizations treatstaff directly involved in member care, healthcare provider claims payments, and manage health plan members who’s behavioral health conditionsfees charged by our third party administrators for processing these claims. Salaries and fees charged by our third-party administrators for processing claims are exacerbating co-existing medical conditions resultingexpensed when incurred and healthcare provider claims payments are recognized in increased in-patient medical costs. We initially focused on members with substance use disordersthe period in which an eligible member receives services.


Operating Expenses

Our operating expenses consists our sales and we have expandedmarketing, research and development and general and administrative expenses. Sales and marketing expenses consist primarily of personnel and related expenses for our solution into anxiety disorderssales and depression. We intend to grow our business through increased adoption by health plansmarketing staff, including salaries, benefits, bonuses, stock-based compensation and commissions; costs of marketing and promotional events, corporate communications, online marketing, product marketing and other payorsbrand-building activities. Research and development expenses consist primarily of personnel and related expenses for our OnTraksolutions.

Key elementsresearch and development staff, including salaries, benefits, bonuses and stock-based compensation; the cost of our business strategy include:

Demonstrating the potential for improved clinical outcomes and reduced cost associated with using our OnTrak solution with key managed care and other third-party payors;

Educating third-party payors on the disproportionately high cost of their substance dependent population;

Providing our OnTrak solution to third-party payors for reimbursement on a case rate, fee for service, or monthly fee basis; and

Generating outcomes data from our OnTrak solution to demonstrate improved health and cost reductions, and utilize outcomes data to facilitate broader adoption.

As an early entrant into offering outcomes based, integrated engagementcertain third-party service providers. Research and treatment programsdevelopment costs are expensed as incurred. General and administrative expenses consist primarily of personnel and related expenses for anxiety, depressionadministrative, legal, finance and substance use disorders, we believe we will be well positioned to address increasing market demand. We believe our OnTrak solution will help fill the gap that exists today: a lack of programs that focus on identifying, engaginghuman resource staff, including salaries, benefits, bonuses and treating smaller populations with disproportionately high costs driven by behavioral health conditions to improve their health and reduce overall health care costs.


Reporting Segment

We manage and report our operations through one business segment: healthcare services. The healthcare services segment includes the OnTrak solutions marketed to health plansstock-based compensation; professional fees; insurance premiums; and other third party payors.

Summary financial information forcorporate expenses.


Interest Expense

Interest expense consists primarily of interest expense from our reportable segment is as follows:

note agreements, accretion of debt discount and amortization of debt issuance costs.

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Other Expenses

Other expenses consists primarily of debt termination costs, write-off of deferred debt issuance costs associated with the loan payoff and employee severance costs.
Results of Operations

The table below and the discussion that follows summarize our results of operations and certain selected operating statistics for each of the last two fiscal years ended December 31, 2016periods indicated (in thousands):
Year Ended December 31,
20192018
Revenue$35,095  $15,177  
Cost of revenue20,408  11,119  
Gross profit14,687  4,058  
Operating expenses34,701  17,684  
Operating loss(20,014) (13,626) 
Other income (expense)(2,538) 40  
Interest expense(3,047) (570) 
Change in fair value of warrant liability(60) (56) 
Net loss$(25,659) $(14,212) 
Revenue
The mix of our revenues between commercial and 2015:

  

Twelve Months Ended

 

(In thousands, except per share amounts)

 

December 31,

 
  

2016

  

2015

 

Revenues

        

Healthcare services revenues

 $7,075  $2,705 
         

Operating expenses

        

Cost of healthcare services

  4,670   2,433 

General and administrative

  8,838   9,049 

Depreciation and amortization

  141   122 

Total operating expenses

  13,649   11,604 
         

Loss from operations

  (6,574)  (8,899)
         

Interest and other income

  106   64 

Interest expense

  (5,354)  (2,590)

Loss on impairment of intangible assets

  -   (88)

Loss on exchange of warrants

  -   (4,410)

Loss on debt extinguishment

  (2,424)  (195)

Change in fair value of warrant liability

  2,093   11,665 

Change in fair value of derivative liability

  (5,774)  (2,761)

Loss from operations before provision for income taxes

  (17,927)  (7,214)

Provision for income taxes

  9   9 

Net loss

 $(17,936) $(7,223)
         
         

Basic and diluted net loss per share:

 $(0.33) $(0.18)
         

Basic weighted number of shares outstanding

  55,074   40,372 

Year ended December 31, 2016government insured members remained consistent year over year. The following table sets forth our sources of revenue for each of the periods indicated (in thousands, except percentages):

Year Ended December 31,
20192018
Commercial revenue$21,753  $9,495  
Percentage of commercial revenue to total revenue62 %63 %
Government revenue$13,342  $5,682  
Percentage of government revenue to total revenue38 %37 %
Total revenue$35,095  $15,177  
Revenue increased $19.9 million, or 131% in 2019 when compared to 2018. Enrolled members increased 4,043, or 137% in 2019 when compared to 2018. The increase is attributable to the continued expansion of our OnTrak program with year ended December 31, 2015

Summaryour existing health plan customers.

Cost of Consolidated Operating Results

Loss from operations before provision for income taxes for the twelve months ended December 31, 2016 was $17.9Revenue, Gross Profit and Gross Margin


Year Ended December 31,
(in thousands)2019  2018  Change% Change
Cost of revenue$20,408  $11,119  $9,289  84 %
Gross profit$14,687  $4,058  $10,629  262 %
Gross profit margin41.8 %26.7 %
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Cost of revenue increased $9.3 million, or 84%, in 2019 as compared with $7.2 million for the twelve months ended December 31, 2015.to 2018. The increase in loss from operationscost of revenue was primarily due to the decrease$6.1 million in the changehigher employee-related costs due to higher headcount and $2.5 million in fair value of warrants of $9.6 million, the increase in the change in fair value of derivative liability of $3.0 million, an increase in interest expense of $2.8 million, the increase in the loss on debt extinguishment of $2.2 million, offset by the decrease in the loss from operations of $2.3 million, and a decrease in the loss on the exchange of warrants of $4.4 million.


Revenues

During the twelve months ended December 31, 2016, we have launched OnTrak in several new populations, which has resulted in a significant increase in the number of patients enrolled in our solutions compared with the same period in 2015. For the twelve months ended December 31, 2016, enrollment increased by more than 57% over the same period in 2015. Recognized revenue increased by $4.4 million, or 162%, for the year ended December 31, 2016, compared with the same period in 2015. We reserve a portion, and in some cases all, of the fees we receive related to enrolled members, as the fees are subject to performance guarantees or are received as case rates in advance at the time of enrollment. Fees deferred for performance guarantees are recognized when those guarantees are satisfied and fees received in advance are recognized ratably over the period of enrollment. Deferred revenue decreased by $158,000 since December 31, 2015.

Operating Expenses

Cost of Healthcare Services

Cost of healthcare services consists primarily of salaries related to our care coaches, healthcare provider claims payments to our network of physicians and psychologists, and fees charged by our third party administrators for processing these claims.

We expect our cost of revenues to increase as our revenue increases, but expect our gross margin to increase over time as we optimize the efficiency of our operations and continue to scale our business.
Operating Expenses

Year Ended December 31,
(in thousands)2019  2018  Change% Change
Operating expense$34,701  $17,684  $17,017  96 %
Operating loss$(20,014) $(13,626) $(6,388) 47 %
Operating loss margin(57.0)%(89.8)%
Total operating expense increased $17.0 million, or 96%, in 2019 as compared to 2018. The increase of $2.2 million in cost of healthcare services for the year ended December 31, 2016 compared with the same period in 2015, relates primarily to the increase in members being treated, the addition of care coaches, outreach staff, community care coordinators and other staff to manage the increasing number of enrolled members. In addition, we hire staff in preparation for anticipated future customer contracts and corresponding increases in members eligible for OnTrak. The costs for such staff are included in Cost of Healthcare Services during training and ramp-up periods.

General and Administrative Expenses

Total general and administrative expense decreased by $211,000 for the year ended December 31, 2016, compared with the same period in 2015. The decreaseoperating expenses was primarily due to decreases in share-based compensation expense$7.5 million of higher employee-related costs due to higher headcount, $8.2 million of higher vendor related costs to support our growing operations and $1.5 million related to stock options issueda severance payment made to a former employee.

We expect our board of directors during the first quarter of 2015, investor relations, and costs for legal services.

Depreciation and Amortization

Depreciation and amortization was immaterialoperating expenses to increase for the years ended December 31, 2016 and 2015.

Interest Expense

Interest expense for the year ended December 31, 2016 increased by $2.8 million compared with the sameforeseeable future as we continue to grow our business, but expect our operating expenses to decrease as a percentage of revenue over time. Our operating expenses may fluctuate as a percentage of our total revenue from period in 2015. The expense is directly relatedto period due to the multiple financings that were done during 2016timing and 2015.

Loss on Exchangeextent of Warrant

our operating and strategic initiates.


Other Expenses

Year Ended December 31,
(in thousands)2019  2018  Change% Change
Other expense$5,645  $586  $5,059  863 %
Other expense increased $5.1 million, or 863%, in 2019 as compared to 2018. The loss of $4.4 million on the exchange of warrants related to the exchange of 21,277,220 warrants for 21,277,220 shares of common stock during 2015. Thereincrease in other expenses was no such warrant exchange during 2016.

Loss on Debt Extinguishment

The loss of $2.4 million on the debt extinguishment related to exchange of the August 2016 promissory notes for the December 2016 8% senior convertible debentures. There was no such debt extinguishment during 2015.

Change in Fair Value of Warrant Liabilities

We have issued warrants to purchase common stock in February 2012, April 2015, July 2015, August 2016, and December 2016. The warrants are being accounted for as liabilities in accordance with FASB accounting rules,primarily due to anti-dilution provisionsa $2.5 million increase in some warrants that protect the holders from declines ininterest expenses for our stock price, which is considered outside our control.  The warrants are marked-to-market each reporting period, using the Black-Scholes pricing model, until they are completely settled or expire.


The decrease in the change in fair value of warrants of $9.6notes and $2.6 million for the twelve months ended December 31, 2016 primarily related to the exchangetermination of warrants during 2015.

We will continue to mark-to-market the warrants each quarter until they are completely settled or expire.

Change in fair value of derivative liability

The increase in the change in fair value of derivative liabilities was $3.0 million for the twelve months ended December 31, 2016 compared with the same period in 2015. The derivative liability was the result of the issuance of the July 2015 convertible debenture.

We will continue to mark-to-market the derivative liability each quarter until they are completely settled.

existing notes.


Liquidity and Capital Resources

Liquidity

Cash and Going Concern

As of February 24, 2017, we had a balance of approximately $585,000 cash on hand. We had working capital deficit of approximately $20.7equivalents was $13.6 million as of December 31, 2016.2019.  We had working capital of approximately $6.3 million as of December 31, 2019. We have incurred significant net losses and negative operating cash flows since our inception. We expect to continue to incur negative cash flows and net losses for the next twelve months. Our current cash burn rate is approximately $450,000 per month. We expect our current cash resources and contracted bridge loans to cover our operationsexpenses through March 31, 2017;at least the next twelve months, however, delays in cash collections, revenue, or unforeseen expenditures could impact this estimate. We are

In September 2019, the Company entered into a Note Agreement dated September 24, 2019 (the “Note Agreement”) with certain subsidiaries of the Company party thereto as guarantors, Goldman Sachs Specialty Lending Holdings, Inc. and any other purchasers party thereto from time to time (collectively, the “Holders”). Under the Note Agreement, the Company initially issued $35.0 million aggregate principal amount of senior secured notes (the "2024 Notes"), which bear interest at either a floating rate plus an applicable margin in needthe case of additional capital, however, there is no assurance that additional capital can be timely raised2024 Notes subject to cash interest payments or a floating rate plus a slightly higher applicable margin in an amount which is sufficient for us or on terms favorable to us and our stockholders, if at all. If we do not obtain additional capital, there is significant doubtthe case of 2024 Notes as to whether we can continuewhich current interest has been capitalized during the period ending September 24, 2020. The Company has elected for the $35 million in aggregate principal amount of 2024 Notes issued on the date of the Note Agreement that such interest shall be payable in cash. The Holder is obligated to operate as a going concernpurchase up to an additional $10.0 million in principal amount of 2024 Notes during the period from the date of the Note Agreement until the second anniversary thereof. The entire principal amount of the 2024 Notes is due and whether we will need to curtailpayable on the fifth anniversary of the Note Agreement unless earlier
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redeemed upon the occurrence of certain mandatory prepayment events, including with the proceeds of equity or cease operations or seek bankruptcy relief. If we discontinue operations, we may not have sufficient funds to pay any amounts to our stockholders.

debt issuances, 50% of excess cash flow, asset sales and the amount by which total debt exceeds an applicable leverage multiple.

Our ability to fund our ongoing operations and continue as a going concern is dependent on increasing the number of members that are eligible for our solutions by signing new contracts, identifying more eligible membersenroll in existing contracts, and generating fees from existing and new contracts and the success of management’s plan to increase revenue and continue to control expenses.OnTrak program. We currently operate our OnTrak solutions in eighteentwenty seven states. We provide services to commercial (employer funded), managed Medicare Advantage, and managed Medicaid and duel eligible (Medicare and Medicaid) populations. We
Historically, we have generated feesseen and continue to see net losses, net loss from our launched programsoperations, negative cash flow from operating activities, and expect to increase enrollment and fees throughout 2017. However, there can be no assurance that we will generate such fees or that new programs will launchhistorical working capital deficits as we expect.We are in needcontinue through a period of additional capital, however, there is no assurance that additional capital can be timely raised in an amount which is sufficient for us or on terms favorable to us and our stockholders, if at all. If werapid growth. The accompanying financial statements do not obtain additional capital, there is a significant doubt asreflect any adjustments that might result if we were unable to whether we can continue to operate as a going concernconcern. We have alleviated substantial doubt by both entering into contracts for additional revenue-generating health plan customers and expanding our OnTrak program within existing health plan customers. To support this increased demand for services, we invested and will continue to invest in additional headcount needed to support the anticipated growth. 
We have a growing customer base and believe we are able to fully scale our operations to service the contracts and future enrollment providing leverage in these investments that will generate positive cash flow by in the near future. We believe we will have enough capital to cover expenses through the foreseeable future and we will needcontinue to curtail or cease operationsmonitor liquidity. If we add more health plans than budgeted, increase the size of the outreach pool by more than we anticipate, decide to invest in new products or seek bankruptcy relief. Ifout additional growth opportunities, we discontinue operations, we may not have sufficient funds to pay any amounts towould consider financing these options with either a debt or equity financing.
The following table sets forth a summary of our stockholders.

Cash Flows

cash flows for the periods indicated (in thousands):


Year Ended December 31,
2019  2018  
Net cash used in operating activities$(16,901) $(8,574) 
Net cash provided by investing activities$—  $62  
Net cash provided by financing activities$27,349  $7,303  
We used $5.7$16.9 million of cash from operating activities during the year ended December 31, 20162019 compared with $5.2$8.6 million during the same period in 2015.2018. The increase in cash used in operating activities reflectsprimarily relates to the increase in members being treated, the addition of care coaches, outreach specialists, community care coordinators and other staff to manage the increasing number of enrolled members, and the addition of staffinvestments in preparation for anticipated future increases in members eligible for OnTrak. Significant non-cash adjustmentsdata science, IT and software development to operating activities for the year ended December 31, 2016 included an amortization of debt discountsupport growth and issuance costs of $4.7 million, a loss on debt extinguishment of $2.4 million, share-based compensation of $697,000, and a $5.8 million fair value adjustment on derivative liability, offset by a fair value adjustment on warrant liability of $2.1 million.                 

drive efficiency.

Capital expenditures for the year ended December 31, 20162019 and 2018 were not material.Wesignificant. We anticipate that capital expenditures will increase in the future as we replace our computer systems that are reaching the end of their useful lives, upgrade equipment to support our increased number of enrolled members, and enhance the reliability and security of our systems. These future capital expenditure requirements will depend upon many factors, including obsolescence or failure of our systems, progress with expanding the adoption of our solutions, our marketing efforts, the necessity of, and time and costs involved in obtaining, regulatory approvals, competing technological and market developments, and our ability to establish collaborative arrangements, effective commercialization, marketing activities and other arrangements.

Our net cash provided by financing activities was $5.8$27.3 million for the year ended December 31, 2016,2019, compared with net cash provided by financing activities of $5.5$7.3 million for the year ended December 31, 2015.2018. Cash provided by financing activities for the year ended December 31, 2016 primarily2019 consisted of the netgross proceeds from the issuance of debt in the 8% senior convertible debenture.

amount of $44 million, proceeds from option exercises of $1.9 million, warrant exercises of $1.1 million, partially offset by loan repayment of $16.9 million, debt issuance costs of $2.8 million and debt termination costs of $2.0 million.

As discusseda result of the above we currently expendour cash at a rateand cash equivalents as of approximately $450,000 per month. We also anticipate cash inflow to increase during 2017 as we continue to service our executed contracts and sign new contracts. December 31, 2019 is $13.6 million.
We expect our current cash resources to cover our operations through March 31, 2017;at least the next twelve months, however, delays in cash collections, revenue, or unforeseen expenditures could impact this estimate. We are in need
Contractual Obligations
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Our principal commitments consist of obligations for us or on terms favorable to usoutstanding debt, leases for our office space, contractual commitments for professional service projects and third-party consulting firms. The following table summarizes our stockholders, ifcontractual obligations at all. If we do not obtain additional capital, there is a significant doubt as to whether we can continue to operate as a going concern, and we will need to curtail or cease operations or seek bankruptcy relief. If we discontinue operations, we may not have sufficient funds to pay any amounts to our stockholders.

December 31, 2019 (in thousands):


Total  Less than a year  1-3 Years3-5 YearsMore than 5 Years
Long-term debt obligations$36,502  $—  $—  $36,502  $—  
Lease obligations$3,184  $737  $1,475  $972  $—  
Other contractual obligations$377  $309  $68  $—  $—  

Off-Balance Sheet Arrangements

As of December 31, 2016,2019, we had no off-balance sheet arrangements.

Critical Accounting Policy and Estimates

The discussion and analysis of our financial condition and results of operations is based upon our financial statements, which have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”). U.S. GAAP requires management to make estimates, judgments and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses, and the disclosure of contingent assets and liabilities. We base our estimates on experience and on various other assumptions that we believe to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that may not be readily apparent from other sources. On an on-going basis, we evaluate the appropriateness of our estimates and we maintain a thorough process to review the application of our accounting policies. Our actual results may differ from these estimates.

We consider our critical accounting estimates to be those that (1) involve significant judgments and uncertainties, (2) require estimates that are more difficult for management to determine, and (3) may produce materially different results when using different assumptions. We have discussed these critical accounting estimates, the basis for their underlying assumptions and estimates, and the nature of our related disclosures herein with the audit committee of our Board of Directors. We believe our accounting policies related to revenue recognition and share-based compensation expense the estimation of the fair value of warrant liabilities, and the estimation of the fair value of our derivative liabilities involve our most significant judgments and estimates that are material to our consolidated financial statements. They are discussed further below.

Share-based

Revenue Recognition
Revenue from contracts with customers is recognized when, or as, we satisfy our performance obligations by transferring the promised goods or services to the customers. A good or service is transferred to a customer when, or as, the customer obtains control of that good or service. A performance obligation may be satisfied over time or at a point in time. Revenue from a performance obligation satisfied over time is recognized by measuring our progress in satisfying the performance obligation in a manner that depicts the transfer of the goods or services to the customer. Revenue from a performance obligation satisfied at a point in time is recognized at the point in time that we determine the customer obtains control over the promised good or service. The amount of revenue recognized reflects the consideration we expect to be entitled to in exchange for those promised goods or services (i.e., the “transaction price”). In determining the transaction price, we consider multiple factors, including the effects of variable consideration. Variable consideration is included in the transaction price only to the extent it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainties with respect to the amount are resolved. In determining when to include variable consideration in the transaction price, we consider the range of possible outcomes, the predictive value of our past experiences, the time period of when uncertainties expect to be resolved and the amount of consideration that is susceptible to factors outside of our influence, such as the judgment and actions of third parties.
Catasys contracts are generally designed to provide cash fees to us on a monthly basis, an upfront case rate, or fee for service based on enrolled members. The Company’s performance obligation is satisfied over time as the OnTrak service is provided continuously throughout the service period. The Company recognizes revenue evenly over the service period using a time-based measure because the Company is providing a continuous service to the customer. Contracts with minimum performance guarantees or price concessions include variable consideration and are subject to the revenue constraint. The Company uses an
23

expected value method to estimate variable consideration for minimum performance guarantees and price concessions. The Company has constrained revenue for expected price concessions during the year ended December 31, 2019.
Cost of Revenue
Cost of revenue consists primarily of salaries related to our care coaches, outreach specialists and other staff directly involved in member care, healthcare provider claims payments, and fees charged by our third party administrators for processing these claims. Salaries and fees charged by our third party administrators for processing claims are expensed when incurred and healthcare provider claims payments are recognized in the period in which an eligible member receives services.
Cashand CashEquivalents
The Company considers all highly liquid investments with an original maturity of three months or less to be cash equivalents. Financial instruments that potentially subject us to a concentration of credit risk consist of cash and cash equivalents. Cash is deposited with what we believe are highly credited, quality financial institutions. The deposited cash may exceed Federal Deposit Insurance Corporation (“FDIC”) insured limits. The Company cannot provide assurance that we will not experience losses on these deposits.
Commissions
We defer commissions paid to our sales force and engagement specialists as these amounts are incremental costs of obtaining a contract with a customer and are recoverable from future revenue that gave rise to the commissions. Commissions for initial contracts and member enrollments are deferred on the consolidated balance sheets and amortized on a straight-line basis over a period of benefit that has been determined to be six years and one year, respectively.
Share-Based Compensation
Stock Options – Employees and Directors
We measure and recognize compensation expense

for all share-based payment awards made to employees and directors based on estimated fair values on the date of grant. We estimate the fair value of share-based payment awards using the Black-Scholes option-pricing model. The value of the portion of the award that is ultimately expected to vest is recognized as expense over the requisite service periods in the consolidated statements of operations. We recognize forfeitures when they occur.

Stock Options and Warrants – Non-employees
We account for the issuance of stock, stock options and warrants for services from non-employees based on an estimate ofby estimating the fair value of stock options and warrants issued using the Black-Scholes pricing model. This model’s calculations includeincorporate the exercise price, the market price of shares on grant date, the weighted average assumptions for risk-free interest rates,rate, expected life of the option or warrant, expected volatility of our stock and expected dividend yield.

dividends.

The amountsFor options and warrants issued as compensation to non-employees for services that are fully vested and non-forfeitable at the time of issuance, the estimated value is recorded in equity and expensed when the financial statements for share-based compensationservices are performed and benefit is received. For unvested shares, the change in fair value during the period is recognized in expense could vary significantly if we were to use different assumptions. For example,using the assumptions we have made for the expected volatility of our stock price have been based on the historical volatility of our stock, measured over a period generally commensurate with the expected term. If we were to use a different volatility than the actual volatility of our stock price, there may be a significant variance in the amounts of share-based expense from the amounts reported. The weighted average expected option term for the twelve months ended December 31, 2016 and 2015 reflects the application of the simplified method set out in SEC Staff Accounting Bulletin No. 107, which defines the life as the average of the contractual term of the options and the weighted averagegraded vesting period for all option tranches.

method.

From time to time, we retainhave retained terminated employees as part-time consultants upon their resignationdeparture from the Company.company. Because the employees continue to provide services to us, their options continue to vest in accordance with the terms set forth under their original grants.terms. Due to the change in classification of the option awards, the options are considered modified at the date of termination. The modifications are treated as exchanges of the original awards in return for the issuance of new awards. At the date of termination, the unvested options are no longer accounted for as employee awards andunder FASB’s accounting rules for share-based expense but are instead accounted for as new non-employee awards. The accounting for the portion of the total grants that have already vested and have been previously expensed as equity awards is not changed. There were no employees moved to consulting status for the twelve monthsyears ended December 31, 2016.There was one employee moved to consulting status2019 and 2018, respectively.
Income Taxes
We account for income taxes using the twelve months ended December 31, 2015. The employee was 100% vested at the date of termination so no entry was recorded, and the employee is no long a consultant as of December 31, 2016.

Warrant Liabilities

We have issued warrants to purchase common stock in February 2012, April 2015, July 2015, August 2016, and December 2016. The warrants are being accounted for as liabilitiesliability method in accordance with FASB accounting rules,Accounting Standards Committee (“ASC”) 740 “Income Taxes”. To date, no current income tax liability has been recorded due to anti-dilution provisionsour accumulated net losses. Deferred tax assets

24

and liabilities are recognized for temporary differences between the financial statement carrying amounts of assets and liabilities and the amounts that are reported in some warrants that protect the holders from declines in our stock price, which is considered outside our control.  The warrantstax returns. Deferred tax assets and liabilities are marked-to-market each reporting period, using the Black-Scholes pricing model, until they are completely settled or expire.

The warrant liabilities were calculated using the Black-Scholes model based upon the following assumptions:

  

December 31,

2016

  

December 31,

2015

 

Expected volatility

  104.31

%

  133.19%

Risk-free interest rate

  1.20%-1.93

%

  0.65-1.76%

Weighted average expected lives in years

  2.25-4.99   0.99-4.29 

Expected dividend

  0

%

  0%

For the year ended December 31, 2016, we recorded on a net gain of $2.1 million, compared withbasis; however, our net deferred tax assets have been fully reserved by a net gain of $11.7 million for the same period in 2015, relatedvaluation allowance due to the revaluationuncertainty of our warrant liabilities.

We will continueability to mark the warrantsrealize future taxable income and to market value each reporting period, using the Black-Scholes pricing model until they are completely settled or expire.

recover our net deferred tax assets.

Derivative Liabilities

In July 2015, we entered into a $3.55 million 12% Original Issue Discount Convertible Debenture due January 18, 2016 with Acuitas (the “July 2015 Convertible Debenture”). The conversion price of the July 2015 Convertible Debenture was $1.90 per share, subject to adjustments, including for issuances of common stock and common stock equivalents below the then current conversion price.  In October 2015, we entered into an amendment of the July 2015 Convertible Debenture which extended the maturity date of the July 2015 Convertible Debenture from January 18, 2016 to January 18, 2017. In addition, the conversion price of the July 2015 Convertible Debenture was subsequently adjusted to $0.30 per share. The July 2015 Convertible Debenture is unsecured, bears interest at a rate of 12% per annum payable in cash or shares of common stock, subject to certain conditions, at our option, and is subject to mandatory prepayment upon the consummation of certain future financings. The derivative liability associated with the July 2015 Convertible Debenture was calculated using the Black-Scholes model based upon the following assumptions:

  

December 31,

2016

  

December 31,

2015

 

Expected volatility

  104.31

%

  133.19%

Risk-free interest rate

  0.44

%

  0.23%

Weighted average expected lives in years

  0.05   1.05 

Expected dividend

  0

%

  0%

The expected volatility assumption for the twelve months ended December 31, 2016 was based on the historical volatility of our stock, measured over a period generally commensurate with the expected term. The weighted average expected lives in years for 2016 reflect the application of the simplified method set out in Security and Exchange Commission (SEC) Staff Accounting Bulletin (SAB) 107 (and as amended by SAB 110), which defines the life as the average of the contractual term of the options and the weighted average vesting period for all option tranches. We use historical data to estimate the rate of forfeitures assumption for awards granted to employees.

For the twelve months ended December 31, 2016 and 2015, we recognized a loss of $5.8 million and $2.8 million, respectively, related to the revaluation of our derivative liability.

Recently Issued or Newly Adopted Accounting Pronouncements

In April 2016, the FASB issued Accounting Standards Update (“ASU”) 2016-10,Revenue from Contracts with Customers (Topic 606), which amends certain aspects

For additional information regarding recent accounting pronouncements adopted and under evaluation, refer to Note 2 of the Board’s new revenue standard, ASU 2014-09, Revenue from Contracts with Customers. The standard should be adopted concurrently with adoption of ASU 2014-09, which is effective for annual and interim periods beginning after December 15, 2017. Early adoption is permitted. The Company has not yet selected a transition method nor has it determined the effect of the standardNotes to Consolidated Financial Statements included in this Annual Report on its ongoing financial reporting.

In March 2016, the FASB issued ASU 2016-09, Compensation — Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting(“ASU 2016-09”), which outlines new provisions intended to simplify various aspects related to accounting for share-based payments and their presentation in the financial statements. The standard is effective for the Company for fiscal years beginning after December 15, 2016, and interim periods within those annual periods. Early adoption is permitted. The adoption of ASU 2016-09 did not have a material effect on our consolidated financial positon or results of operations.

In February 2015, the FASB issued ASU,Consolidation (Topic 810): Amendments to the Consolidation Analysis (“ASU 2015-02”). ASU 2015-02 modifies existing consolidation guidance for reporting organizations that are required to evaluate whether they should consolidate certain legal entities. ASU 2015-02 is effective for fiscal years and interim periods within those years beginning after December 15, 2015, and requires either a retrospective or a modified retrospective approach to adoptions. Early adoption is permitted. The adoption of ASU 2015-02 did not have a material effect on our consolidated financial position or results of operations.

In August 2014, the FASB issued FASB ASU 2014-15,Presentation of Financial Statements—Going Concern (Subtopic 205-40): Disclosure of Uncertainties about an Entity’s Ability to Continue as a Going Concern(“ASU 2014-15”).ASU 2014-15 changes the disclosure of uncertainties about an entity’s ability to continue as a going concern. Under U.S. GAAP, continuation of a reporting entity as a going concern is presumed as the basis for preparing financial statements unless and until the entity’s liquidation becomes imminent. Even if an entity’s liquidation is not imminent, there may be conditions or events that raise substantial doubt about the entity’s ability to continue as a going concern. Because there is no guidance in U.S. GAAP about management’s responsibility to evaluate whether there is substantial doubt about an entity’s ability to continue as a going concern or to provide related note disclosures, there is diversity in practice whether, when, and how an entity discloses the relevant conditions and events in its financial statements. As a result, these changes require an entity’s management to evaluate whether there are conditions or events, considered in the aggregate, that raise substantial doubt about the entity’s ability to continue as a going concern within one year after the date that financial statements are issued. Substantial doubt is defined as an indication that it is probable that an entity will be unable to meet its obligations as they become due within one year after the date that financial statements are issued. If management has concluded that substantial doubt exists, then the following disclosures should be made in the financial statements: (i) principal conditions or events that raised the substantial doubt, (ii) management’s evaluation of the significance of those conditions or events in relation to the entity’s ability to meet its obligations, (iii) management’s plans that alleviated the initial substantial doubt or, if substantial doubt was not alleviated, management’s plans that are intended to at least mitigate the conditions or events that raise substantial doubt, and (iv) if the latter in (iii) is disclosed, an explicit statement that there is substantial doubt about the entity’s ability to continue as a going concern. ASU 2014-15 is effective for periods beginning after December 15, 2016. The adoption of ASU 2014-15 did not have a material effect on our consolidated financial position or results of operations.

Form 10-K.

Effects of Inflation

Our most liquid assets are cash and cash equivalents. Because of their liquidity, these assets are not directly affected by inflation. Because we intend to retain and continue to use our equipment, furniture, and fixtures and leasehold improvements, we believe that the incremental inflation related to replacement costs of such items will not materially affect our operations. However, the rate of inflation affects our expenses, such as those for employee compensation and contract services, which could increase our level of expenses and the rate at which we use our resources.

ITEM 7A.

QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

ITEM 7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
Not applicable.

ITEM 8.

FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA

ITEM 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA
Our consolidated financial statements and related financial information required to be filed hereunder are indexed under Item 15 of this report and are incorporated herein by reference.

ITEM 9.

CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE

None.

ITEM 9. CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE
Not applicable.

ITEM 9A.

CONTROLS AND PROCEDURES

ITEM 9A. CONTROLS AND PROCEDURES
Evaluation ofDisclosure Controls and Procedures

We have evaluated, with the participation of our principal executive officer and our principal financial officer, the effectiveness of our disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) as of the end of the period covered by this Annual Report on Form 10-K. Based on this evaluation, our principal executive officer and our principal financial officer have concluded that our disclosure controls and procedures were effective to ensure that information required to be disclosed by us in the reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported, within the time periods specified in the SEC’s rules and forms, and is accumulated and communicated to our management, including our principal executive and principal financial officers, or persons performing similar functions, as appropriate to allow timely decisions regarding required disclosure.

Changes in Internal Control

There were no changes in our internal controls over financial reporting during the fourth quarter of our year ended December 31, 2016,2019, that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

Management's Annual Report on Internal Controloverover Financial Reporting

Our management is responsible for establishing and maintaining adequate internal control over financial reporting (as defined in Rule 13a-15(f) and 15d-15(f) under the Exchange Act) and for assessing the effectiveness of our internal control over financial reporting. Our internal control system is designed to provide reasonable assurance to our management and Board of Directors regarding the preparation and fair presentation of published financial statements in accordance with United States generally accepted accounting principles (GAAP).


Our internal control over financial reporting is supported by written policies and procedures that:

pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of our assets;

provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with GAAP and that our receipts and expenditures are being made only in accordance with authorizations of our management and our Board of Directors; and

provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of our assets that could have a material effect on our financial statements.

pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of our assets;
provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with GAAP and that our receipts and expenditures are being made only in accordance with authorizations of our management and our Board of Directors; and
25

provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of our assets that could have a material effect on our financial statements.
Our management assessed the effectiveness of our internal control over financial reporting as of December 31, 2016,2019, using the criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission in Internal Control-Integrated Framework.Framework (2013). Management's assessment included an evaluation of the design of our internal control over financial reporting and testing of the operational effectiveness of our internal control over financial reporting.  Based upon this assessment, our management believes that, as of December 31, 2016,2019, our internal control over financial reporting was effective based on those criteria.

Because of its inherent limitations, a system of internal control over financial reporting can provide only reasonable assurance and may not prevent or detect misstatements. In addition, projections of any evaluation of effectiveness to future periods are subject to the risks that controls may become inadequate because of changes in conditions and that the degree of compliance with the policies or procedures may deteriorate.

The effectiveness of the Company's internal control over financial reporting as of December 31, 2019 has been audited by EisnerAmper LLP, the Company's independent registered certified public accounting firm. Their report, which is set forth in Part II, Item 8, Financial Statements, of this Annual Report on Form 10-K, expresses an unqualified opinion of the effectiveness of the Company's internal control over financial reporting as of December 31, 2019.

ITEM 9B.OTHER INFORMATION

       In January 2017, we entered into a Subscription Agreement (the “Subscription Agreement”) with Acuitas, pursuant to which the Company will receive aggregate gross proceeds of $1,300,000 (the “Loan Amount”) in consideration of the issuance of (i) an 8% Series B Convertible Debenture due March 31, 2017 (the “January 2017 Convertible Debenture”) and (ii) five-year warrants to purchase shares of the Company’s common stock in an amount equal to one hundred percent (100%) of the initial number of shares of common stock issuable upon the conversion of the January 2017 Convertible Debenture, at an exercise price of $0.85 per share (the “January 2017 Warrants”). The Loan Amount is payable in tranches through March 2017. In addition, any warrants issued in conjunction with the December 2016 Convertible Debenture currently outstanding with Acuitas have been increased by an additional 25% warrant coverage, exercisable for an aggregate of 827,293 shares of the Company’s common stock.

       The January 2017 Warrants include, among other things, price protection provisions pursuant to which, subject to certain exempt issuances, the then exercise price of the January 2017 Warrants will be adjusted if the Company issues shares of common stock at a price that is less than the then exercise price of the January 2017 Warrants. Such price protection provisions will remain in effect until the earliest of (i) the termination date of the January 2017 Warrants, (ii) such time as the January 2017 Warrants are exercised or (iii) contemporaneously with the listing of the Company’s shares of common stock on a registered national securities exchange.

       In connection with the Subscription Agreement described above, the number of Shamus Warrants were increased from 75% to 100% warrant coverage, exercisable for an aggregate of 352,941 shares of the Company’s common stock.

2017 Stock Incentive Plan

On February 27, 2017, the Board of Directors and our stockholders approved the adoption of the 2017 Stock Incentive Plan (the “2017 Plan”). The 2017 Plan allows the Company, under the direction of the Board of Directors or a committee thereof, to make grants of stock options, restricted and unrestricted stock and other stock-based awards to employees, including the Company’s executive officers, consultants and directors. The 2017 Plan allows for the issuance of up to 14,000,000 additional shares of Common Stock pursuant to new awards granted under the 2017 Plan and up to approximately 1,500,000 shares of Common Stock that are represented by options outstanding under the 2010 Plan (defined below) that are forfeited, expire or are cancelled without delivery of shares of Common Stock or which result in the forfeiture of shares of Common Stock back to the Company.This description is qualified in its entirety by reference to the actual terms of the 2017 Plan, a copy of which is attached as Exhibit B to the Company’s preliminary Information Statement on Schedule 14C, filed with the Securities and Exchange Commission on February 28, 2017.


None.

PART III


ITEM 10.

DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE

ITEM 10. DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE
The following table lists our executive officers and directors serving at February 24, 2017. Our executive officers are elected annually by our Board of Directors and serve at the discretion of the Board of Directors. Each current director is serving a term that will expire at the Company's next annual meeting. There are no family relationships among any of our directors or executive officers.

Name

 

Age

 

Position

 

Officer/ Director Since

Terren S. Peizer

 

57

 

Director, Chairman of the Board and Chief Executive Officer

 

2003

       

Richard A. Anderson

 

47

 

Director, President and Chief Operating Officer

 

2003

       

Susan E. Etzel

 

43

 

Chief Financial Officer

 

2011

       

Richard A. Berman

 

72

 

Director, Chairman of the Audit Committee, and Member of the Compensation Committee 

 

2014

       

David E. Smith

 

70

 

Director, and Member of the Nominations and Corporate Governance Committee 

 

2014

       

Marvin Igelman

 

54

 

Director, Chairman of the Nominations and Corporate Governance Committee, Member of the Compensation Committee, and Member of the Audit Committee 

 

2014

       

Steve Gorlin

 

79

 

Director, and Member of the Nominations and Corporate Governance Committee

 

2014

Terren S. Peizeris the founder of our Company and an entrepreneur, investor, and financier with a particular interest in healthcare, having founded and successfully commercialized several healthcare companies. He has served as its Chief Executive Officer and Chairman of the Board of Directors since the Company’s inception in 2004. Mr. Peizer is also the founder, Chairman and CEO NeurMedix, Inc., a biotechnology company with a focus on inflammatory, neurological and neuro-degenerative diseases. In addition to his roles with Catasys and NeurMedix, Mr. Peizer is Chairman of Acuitas Group Holdings, LLC, his personal investment vehicle, and holding company that is the owner of all of his portfolio company interests. Through Acuitas, Mr. Peizer owns Crede Capital Group, LLC an industry leader in investing in micro and small capitalization equities, having invested over $1.2 billion directly into portfolio companies. Mr. Peizer has been the largest beneficial shareholder of, and has held various senior executive positions with, several other publicly-traded growth companies, including having served as Chairman of Cray, Inc. a supercomputer company. Mr. Peizer has a background in venture capital, investing, mergers and acquisitions, corporate finance, and previously held senior executive positions with the investment banking firms Goldman Sachs, First Boston, and Drexel Burnham Lambert. He received his B.S.E. in Finance from The Wharton School of Finance and Commerce. 

We believe Mr. Peizers’s qualifications to serve on our board of directors include his role as an investor and executive positions in several private and public companies, including numerous companies in the healthcare field. He has extensive knowledge and experience in the financial and healthcare industries, and provides extensive insight and experience with capital markets and publicly traded companies at all stages of development.

Richard A. Andersonhas served as a director since July 2003 and as a member of our management team since April 2005. He has been our President and Chief Operating Officer since July 2008; in this role he has been primarily responsible for the creation and leadership of our OnTrak solution. He has more than twenty-five years of experience in business development, strategic planning, operations, finance and management, with more than 15 years of that in the healthcare field. Prior to joining the Company, he held senior level financial and operational positions in healthcare and financial companies, and served as a director in PriceWaterhouseCoopers LLP’s business assurance and transaction support practices. He received a B.A. in Business Economics from University of California, Santa Barbara.


We believe Mr. Anderson’s qualifications to serve on the board of directors include his business and healthcare experience, including a diversified background as an executive and in operational roles in both public and private companies. His leadership of our product creation gives him a breadth of knowledge and valuable understanding of our business, operations and customers.

SusanE.Etzel has served as the Company’s Chief Financial Officer since July 2011 and prior to that was the Company’s Corporate Controller since February 2011. Prior to joining the Company, she acted as the Controller of Clearant, Inc., a developer of a universal pathogen inactivation technology, from July 2005 until February 2011. Prior to joining the Clearant she held a senior level auditor position at Arthur Anderson LLP. She received a Bachelor of Business Economics with an emphasis in Accounting from the University of California, Santa Barbara.

Richard A. Bermanis the interim dean of the USF Patel College of Global Sustainability, visiting social entrepreneurship professor in the Muma College of Business, and a professor in the institute of innovation and discovery. As a recognized global leader, Mr. Berman has held positions in health care, education, politics and management.  He has worked with several foreign governments, the United Nations, the U.S. Department of Health and Welfare, the FDA, and as a cabinet level official for the state of New York.  He has also worked with McKinsey & Co, NYU Medical Center, Westchester Medical, Korn-Ferry International, Howe-Lewis International and numerous startup companies. In 1995, Mr. Berman was selected by Manhattanville College to serve as its tenth President. Mr. Berman is credited with the turnaround of the College, where he served until 2009.  Mr. Berman serves on the board of several organizations and is an elected member of the National Academy of Medicine of the National Academy of Sciences (Formerly known as the Institute of Medicine). Mr. Berman received his BBA, MBA, and MPH from the University of Michigan and holds honorary doctorates from Manhattanville College and New York Medical College.

We believe Mr. Berman’s qualifications to serve on our board of directors include his extensive experience as an executive in several healthcare firms.  In addition, as a board member of a health plan we believe he has an understanding of our customer base and current developments and strategies in the health insurance industry.

David E. Smith is the President, Chief Executive Officer and Chief Investment Officer of the Trading Advisor. Mr. Smith was the founder and Chief Executive Officer of Coast Asset Management. Mr. Smith has worked in various capacities in the securities industry, including as Vice President of Security Pacific Bank , and Oppenheimer and Company as a bond arbitrageur, and he is also a successful investor in small cap growth companies. Mr. Smith has an MBA from the University of California at Berkeley.

We believe Mr. Smith’s qualifications to serve on our board of directors include his extensive background in the banking and securities industries, as well as his experience in corporate governance and management.

Marvin Igelman is the Chief Executive Officer of Breaking Data Corporation, formally known as Sprylogics International Inc. (TSX: BKD), a leader in the semantic search technology sector. Previously, he was Chief Executive Officer of Unomobi, Inc. a mobile advertising and messaging platform that was acquired in February 2010 by Poynt Corporation and was previously on the Board of Directors of Jamba Juice (NASDAQ: JMBA). Mr. Igelman was also founder, President and Chief Executive Officer of Brandera Inc., which operated Portfolios.com, a leading online business-to-business site for the Graphic Arts and creative community, and has served as a business development consultant for numerous technology companies, and established a number of other successful ventures. Mr. Igelman has a Bachelor of Laws from Osgoode Hall Law School.

We believe Mr. Igelman’s qualifications to serve on our board of directors include his extensive business development experience, and his current and past executive experience in numerous private and publicly traded companies.


Steve Gorlin is an entrepreneur who has founded numerous successful biotechnology and pharmaceutical companies over the last 40 years, including Hycor Biomedical, Inc. (acquired by Agilent), Theragenics Corporation (NYSE: TGX), CytRx Corporation (NASDAQ: CYTR), Medicis Pharmaceutical Corporation (sold to Valeant for approximately $2.6 billion), Entremed, Inc. (NASDAQ: ENMD), MRI Interventions (MRIC), DARA BioSciences, Inc. (NASDAQ: DARA), MiMedx (NASDAQ: MDXG), and Medivation, Inc. (NASDAQ: MDVN). Mr. Gorlin served many years on the Business Advisory Council to the Johns Hopkins School of Medicine and on theJohns Hopkins BioMedical Engineering Advisory Board and as well as on the Board of Andrews Institute. He is presently a member of the Research Institute Advisory Committee (RIAC) of Massachusetts General Hospital. Mr. Gorlin founded a number of non-medical related companies, including Perma-Fix, Inc., Pretty Good Privacy, Inc. (sold to Network Associates), Judicial Correction Services, Inc. (solt to Correctional Healthcare), and NTC China. He started the Touch Foundation, a nonprofit organization for the blind and was a principal financial contributor to the founding of Camp Kudzu for diabetic children. He presently serves as Vice Chairman of NantKwest (NASDAQ: NK), CEO of NantibodyFc, Executive Chairman of ViCapsys and Aperisys and serves on the Boards of Medovex, Inc. (MDVX), Catasys, Inc. and NTC China, Inc. 

We believe Mr. Gorlin’s qualifications to serve on our board of directors include his experience in the healthcare industry, his extensive business development experience, and his current and past executive experience in numerous private and publicly traded companies.

Section 16(a) beneficial ownership reporting compliance

Section 16(a) of the Securities Exchange Act of 1934, as amended (Exchange Act), requires our directors and executive officers, and persons who own more than 10% of our outstanding common stock, to file with the SEC, initial reports of ownership and reports of changes in ownership of our equity securities. Such persons areinformation required by SEC regulations to furnish us with copies of all such reports they file.

       To our knowledge, based solely on a review of the copies of such reports furnished to us regarding the filing of required reports, we believe that all Section 16(a) reports applicable to our directors, executive officers and greater-than-ten-percent beneficial owners with respect to fiscal 2016 were timely filed.

Code of Ethics

Our Board of Directors has adopted a code of ethics applicable to our chief executive officer, chief financial officer and persons performing similar functions.  Our code of ethics is listed hereto as Exhibit 14.1 and is accessible on our website athttp://www.catasys.com. Disclosure regarding any amendments to, or waivers from, provisions of the code of ethicsthis item will be included in a Current Report on Form 8-Kour Proxy Statement for the 2020 Annual Meeting of Stockholders to be filed with the SEC within four business120 days following the date of the amendment or waiver.

Independence of the Board of Directors

Our common stockfiscal year ended December 31, 2019, and is traded on the OTCQB. The Board of Directors has determined that two of the members of the Board of Directors qualify as “independent,” as definedincorporated herein by the listing standards of the NASDAQ. Consistent with these considerations, after review of all relevant transactions and relationships between each director, or any of his family members, and the Company, its senior management and its independent auditors, the Board has determined further that Messrs. Berman and Igelman are independent under the listing standards of NASDAQ. In making this determination, the Board of Directors considered that there were no new transactions or relationships between its current independent directors and the Company, its senior management and its independent auditors since last making this determination.

Committees of the Board of Directors

Audit committee

During 2016, the audit committee consisted of two directors, Messrs. Berman and Igelman. The Board of Directors has determined that each of the members of the audit committee were independent as defined by the NASDAQ rules, meet the applicable requirements for audit committee members, including Rule 10A-3(b) under the Exchange Act, and that Mr. Berman qualifies as an “audit committee financial expert” as defined by Item 401(h)(2) of Regulation S-K. The duties and responsibilities of the audit committee include (i) selecting, evaluating and, if appropriate, replacing our independent registered accounting firm, (ii) reviewing the plan and scope of audits, (iii) reviewing our significant accounting policies, any significant deficiencies in the design or operation of internal controls or material weakness therein and any significant changes in internal controls or in other factors that could significantly affect internal controls subsequent to the date of their evaluation and (iv) overseeing related auditing matters.

reference.

A copy of the audit committee’s written charter is publicly available through the “Investors-Governance” section of our website at www.catasys.com.

Nominations and governance committee

Our nominations and governance committee consists of one member who is independent as defined by the NASDAQ rules. During 2016, the committee consisted of two directors, Messrs. Smith, Igelman, and Gorlin, and did not hold any meetings. The committee nominates new directors and periodically oversees corporate governance matters.

The charter of the nominations and governance committee provides that the committee will consider board candidates recommended for consideration by our stockholders, provided the stockholders provide information regarding candidates as required by the charter or reasonably requested by us within the timeframe proscribed in Rule 14a-8 of Regulation 14A under the Exchange Act, and other applicable rules and regulations. Recommendation materials are required to be sent to the nominations and governance committee c/o Catasys, Inc., 11601 Wilshire Boulevard, Suite 1100, Los Angeles, California 90025. There are no specific minimum qualifications required to be met by a director nominee recommended for a position on the board of directors, nor are there any specific qualities or skills that are necessary for one or more of our directors to possess, other than as are necessary to meet any requirements under the rules and regulations applicable to us. The nominations and governance committee considers a potential candidate's experience, areas of expertise, and other factors relative to the overall composition of the board of directors.

The nominations and governance committee considers director candidates that are suggested by members of the board of directors, as well as management and stockholders. Although it has not been previously utilized, the committee may also retain a third-party executive search firm to identify candidates. The process for identifying and evaluating nominees for director, including nominees recommended by stockholders, involves reviewing potentially eligible candidates, conducting background and reference checks, interviews with the candidate and others (as schedules permit), meeting to consider and approve the candidate and, as appropriate, preparing and presenting to the full board of directors an analysis with respect to particular recommended candidates. The nominations and governance committee endeavors to identify director nominees who have the highest personal and professional integrity, have demonstrated exceptional ability and judgment, and, together with other director nominees and members, are expected to serve the long term interest of our stockholders and contribute to our overall corporate goals.

A copy of the nominations and governance committee’s written charter is publicly available through the “Investors-Governance” section of our website atwww.catasys.com.

Compensation committee

The compensation committee consists of up to three directors who are independent as defined by the NASDAQ rules. During 2016, the committee consisted of two directors, Messrs. Berman and Igelman, and did not hold any meetings. The compensation committee reviews and recommends to the board of directors for approval the compensation of our executive officers.

A copy of our compensation committee written charter is publicly available through the “Investors-Governance” section of our website atwww.catasys.com.


ITEM 11.

EXECUTIVE COMPENSATION

Summary Compensation Table

ITEM 11. EXECUTIVE COMPENSATION
The following table sets forthinformation required by this item will be included in our Proxy Statement for the total compensation paid during2020 Annual Meeting of Stockholders to be filed with the last two fiscal years ended December 31, 2016 and 2015 to (1) our Chief Executive Officer, and (2) our two next most highly compensated executive officers who earned more than $100,000 duringSEC within 120 days of the fiscal year ended December 31, 20162019, and were serving as executive officers as of such date.

            

All

     
            

Other

     
            

Compen-

     

Name and

       

Stock/Option

  

sation ($)

     

Principal Position

 

Year

 

Salary ($)

  

Award

  (2)  

Total ($)

 
                   
                   

Terren S. Peizer,

 

2016

  450,000 (1)  -   14,627   464,627 

Chairman and

 

2015

  450,000 (1)  -   18,899   468,899 

Chief Executive Officer

                  
                   

Richard A. Anderson,

 

2016

  386,548   -   28,473   415,021 

President and

 

2015

  379,077   -   28,231   407,308 

Chief Operating Officer

                  
                   

Susan Etzel,

 

2016

  170,000   -   -   170,000 

Chief Financial Officer

 

2015

  170,000   -   -   170,000 

(1)

Mr. Peizer deferred part of his salary for the 2016 and 2015 years.

(2)

Includes group life insurance premiums and medical benefits.

Narrative Disclosures to Summary Compensation Table

Executive employment agreements

Chief Executive Officer

We entered into a five-year employment agreement with our Chairman and Chief Executive Officer, Terren S. Peizer, effective as of September 29, 2003, which automatically renews after each five-year term. Mr. Peizer received an annual base salary of $450,000 in each of 2016 and 2015, part of which was deferred. Mr. Peizer is also eligible for an annual bonus targeted at 100% of his base salary based on goals and milestones established and reevaluated on an annual basisincorporated herein by mutual agreement between Mr. Peizer and the Board of Directors. Mr. Peizer did not receive any annual bonus during the fiscal years ended December 31, 2016 and 2015. His base salary and bonus target will be adjusted each year to not be less than the median compensation of similarly positioned CEO’s of similarly situated companies. Mr. Peizer receives executive benefits including group medical and dental insurance, term life insurance equal to 150% of his salary, accidental death and long-term disability insurance, grossed up for taxes. There were no equity awards granted to Mr. Peizer during 2016 or 2015. All unvested options vest immediately in the event of a change in control, termination without good cause or resignation with good reason. In the event that Mr. Peizer is terminated without good cause or resigns with good reason prior to the end of the term, he will receive a lump sum payment equal to the remainder of his base salary and targeted bonus for the year of termination, plus three years of additional salary, bonuses and benefits. If any of the provisions above result in an excise tax, we will make an additional “gross up” payment to eliminate the impact of the tax on Mr. Peizer.

reference.

President and Chief Operating Officer

We entered into a four-year employment agreement with our President and Chief Operating Officer, Richard A. Anderson, effective April 19, 2005, as amended on July 16, 2008. After the initial four-year term, the employment agreement automatically renews for additional three-year terms unless otherwise terminated. Mr. Anderson’s agreement renewed for an additional three-year term in April 2015. Mr. Anderson received an annual base salary of $386,548 in 2016 and $379,077 in 2015. Mr. Anderson is eligible for an annual bonus targeted at 50% of his base salary based on achieving certain milestones. Mr. Anderson did not receive any annual bonus during the fiscal years ended December 31, 2016 and 2015. Mr. Anderson’s compensation will be adjusted each year by an amount not less than the Consumer Price Index. Mr. Anderson received executive benefits, including group medical and dental insurance, term life insurance, accidental death and long-term disability insurance. There were no equity awards granted to Mr. Anderson in 2016 or 2015. All unvested options will vest immediately in the event of a change in control, termination without cause or resignation with good reason. In the event of termination without good cause or resignation with good reason prior to the end of the term, upon execution of a mutual general release, Mr. Anderson will receive a lump sum payment equal to one year of salary and bonus, and will receive continued medical benefits for one year unless he becomes eligible for coverage under another employer's plan. If he is terminated without cause or resigns with good reason within twelve months following a change in control, upon execution of a general release he will receive a lump sum payment equal to eighteen months salary, 150% of the targeted bonus, and will receive continued medical benefits for 18 months unless he becomes eligible for coverage under another employer's plan. 

Chief Financial Officer

We entered into a two-year employment agreement with Ms. Etzel effective January 1, 2013. Beginning January 1, 2015, Ms. Etzel is employed on an at-will basis. Ms. Etzel received an annual base salary of $170,000 in 2016 and $170,000 in 2015, and she may be eligible to an annual bonus, to be determined solely by the Company, contingent on achieving certain individual goals and milestones and the overall performance and profitability of the Company. Ms. Etzel did not receive any annual bonus during the years ended December 31, 2016 and 2015.

OUTSTANDING EQUITY AWARDS AT FISCAL YEAR-END

The following table sets forth all outstanding equity awards held by our named executive officers as of December 31, 2016.

  

Number of

  

Number of

      
  

Securities

  

Securities

      
  

Underlying

  

Underlying

      
  

Unexercised

  

Unexercised

  

Option

  
  

Options (#)

  

Options (#)

  

Exercise

 

Option

  

Exercisable

  

Unexer-

  

Price

 

Expiration

Name

 (1)  

cisable

  ($) 

Date

Terren S. Peizer

  1,150   -   123.20 

02/07/18

   1,350   -   123.20 

06/20/18

   2,398   -   193.60 

10/27/19

   148,500   -   17.60 

12/06/20

   153,398   -      
              

Richard A. Anderson

  733   -   112.00 

02/07/18

   862   -   112.00 

06/20/18

   1,245   -   176.00 

10/27/19

   148,500   -   16.00 

12/06/20

   151,340   -      
              

Susan Etzel

  1,625   -   8.00 

05/24/21

POTENTIAL PAYMENTS UPON TERMINATION OR CHANGE-IN-CONTROL

Potential payments upon termination

The following summarizes the payments that the named executive officers would have received if their employment had terminated on December 31, 2016.



If Mr. Peizer's employment had terminated due to disability, he would have received insurance and other fringe benefits for a period of one year thereafter, with a value equal to $10,000. If Mr. Peizer had been terminated without good cause or resigned for good reason, he would have received a lump sum payment of $2,731,000, based upon: (i) three years of additional salary at $450,000 per year; (ii) three years of additional bonus of $450,000 per year; and (iii) three years of fringe benefits, with a value equal to $31,000.

If Mr. Anderson had been or is terminated without good cause or resigned for good reason, he would have received a lump sum payment of $580,000 based upon one year's salary plus the full targeted bonus of 50% of base salary. In addition, medical benefits would continue for up to one year, with a value equal to $28,000.

Potential payments upon change in control

Upon a change in control, the unvested stock options of each of our named executive officers would have vested, with the values set forth above.

If Mr. Peizer had been terminated without good cause or resigned for good reason within twelve months following a change in control, he would have received a lump sum payment of $2,731,000, as described above, plus a tax gross up of $683,000.

If Mr. Anderson had been terminated without good cause or resigned for good reason within twelve months following a change in control, he would have received a lump sum payment of $870,000, based upon one-and-a-half year's salary plus one-and-a-half the full targeted bonus of 50% of base salary. In addition, medical benefits would continue for up to one-and-a-half years, with a value equal to $42,000.


DIRECTOR COMPENSATION

The following table provides information regarding compensation that was earned or paid to the individuals who served as non-employee directors during the year ended December 31, 2016. Except as set forth in the table, during 2016, directors did not earn nor receive cash compensation or compensation in the form of stock awards, option awards or any other form.

  

Option

     
  

awards ($)

     

Name

 

(1)

  

Total

 

Richard Berman

  167,500   167,500 

David Smith

  134,000   134,000 

Marvin Igelman

  134,000   134,000 

Steve Gorlin

  134,000   134,000 

Notes to director compensation table:

(1)

Amounts reflect the compensation expense recognized in the Company's financial statements in 2016 for non-employee director stock options granted in 2015, in accordance with FASB ASC Topic 718. As such, these amounts do not correspond to the compensation actually realized by each director for the period. See notesto consolidated financial statements included elsewhere in this Annual Report on Form 10-K for further information on the assumptions used to value stock options granted to non-employee directors.

Outstanding equity awards held by non-employee directors as of December 31, 2016, were as follows:

      

Aggregate

 
      

grant date

 
      

fair market value

 
  

Options

  

options

 
  

outstanding

  

outstanding

 

Richard Berman

  250,000  $502,500 

David Smith

  200,000   402,000 

Marvin Igelman

  200,000   402,000 

Steve Gorlin

  200,000   402,000 
   850,000  $1,708,500 

There were a total of 850,000 stock options outstanding as of December 31, 2016, with an aggregate grant date fair value of $1,708,500, the last of which vest in February 2017.  There were no options granted to non-employee directors during 2016.


EQUITY COMPENSATION PLAN INFORMATION

The following table provides certain aggregate information with respect to all of the Company’s equity compensation plans in effect as of December 31, 2016.

  

(a)

  

(b)

  

(c)

 

Plan Category

 

Number of securities to

be issued upon exercise

of outstanding options,

warrants and right

  

Weighted-average

exercise price of

outstanding options,

warrants and rights

  

Number of securities

remaining available for

future issuance under equity

compensation plans

(excluding securities

reflected in column (a))

 
             

Equity compensation plans approved by security holders (1)

  1,464,089  $6.49   303,674 
             

Equity compensation plans not approved by security holders

  -   -   - 
             
             

Total

  1,464,089  $6.49   303,674 

(1) We adopted our 2010 Stock Incentive Plan (the “2010 Plan”) in 2011. Under the 2010 Plan, we could grant incentive stock options, non-qualified stock option, restricted and unrestricted stock awards and other stock-based awards. As of December 31, 2016, 303,674 equity awards remained reserved for future issuance under the 2010 Plan.


ITEM 12.

SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER MATTERS

ITEM 12. SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER MATTERS
The following table sets forth certain information with respectrequired by this item will be included in our Proxy Statement for the 2020 Annual Meeting of Stockholders to the beneficial ownership of our common stock as of February 24, 2017 for (a) each stockholder known by us to own beneficially more than 5% of our common stock (b) our named executive officers, (c) each of our directors, and (d) all of our current directors and executive officers as a group. Beneficial ownership is determined in accordancebe filed with the rulesSEC within 120 days of the SECfiscal year ended December 31, 2019, and includes voting or investment power with respect to the securities. We deem shares of common stock that may be acquiredis incorporated herein by an individual or group within 60 days of February 24, 2017 pursuant to the exercise of options or warrants to be outstanding for the purpose of computing the percentage ownership of such individual or group, but are not deemed to be outstanding for the purpose of computing the percentage ownership of any other person shown in the table. Except as indicated in footnotes to this table, we believe that the stockholders named in this table have sole voting and investment power with respect to all shares of common stock shown to be beneficially owned by them based on information provided to us by these stockholders. Percentage of ownership is based on 55,288,458 shares of common stock outstanding on February 24, 2017.

          

Total

     
      

Shares

  

common

     
  

Common

  

beneficially

  

stock

  

Percent

 
  

stock

  

owned

  

beneficially

  

of

 

Name of beneficial owner (1)

 

owned (2)

  (3)  

owned

  

class (3)

 

Directors and Named Executive Officers:

                

Terren S. Peizer (4)

  38,358,250   23,710,576   62,068,826   78.6%

Richard A. Anderson (5)

  -   151,340   151,340   * 

Susan E. Etzel (6)

  -   1,625   1,625   * 

Richard A. Berman (7)

  -   250,000   250,000   * 

David E. Smith (8)

  10,066,496   2,499,979   12,566,475   21.7%

Marvin Igelman (9)

  -   200,000   200,000   * 

Steve Gorlin (10)

  450,000   200,000   650,000   * 
                 
                 

All directors and named executive officers as a group (7 persons)

  48,874,746   27,013,520   75,888,266   92.2%

* Less than 1%

(1)

Except as set forth below, the mailing address of all individuals listed is c/o Catasys, Inc., 11601 Wilshire Boulevard, Suite 1100, Los Angeles, California 90025.

(2)

The number of shares beneficially owned includes shares of common stock in which a person has sole or shared voting power and/or sole or shared investment power. Except as noted below, each person named reportedly has sole voting and investment powers with respect to the common stock beneficially owned by that person, subject to applicable community property and similar laws.

(3)

On February 24, 2017, there were 55,288,458 shares of common stock outstanding. Common stock not outstanding but which underlies options and rights (including warrants) vested as of or vesting within 60 days after February 24, 2017, is deemed to be outstanding for the purpose of computing the percentage of the common stock beneficially owned by each named person (and the directors and executive officers as a group), but is not deemed to be outstanding for any other purpose.

(4)

Consists of warrants to purchase 6,502,226 shares of common stock, options to purchase 153,398 shares of common stock, and convertible debentures to purchase 17,054,952 shares of common stock. 38,358,250 shares of common stock are held of record by Acuitas Group Holdings, LLC, a limited liability company 100% owned by Terren S. Peizer, and as such, Mr. Peizer may be deemed to beneficially own or control. Mr. Peizer disclaims beneficial ownership of any such securities.

(5)

Includes options to purchase 151,340 shares of common stock, which are exercisable within the next 60 days.

(6)

Includes options to purchase 1,625 shares of common stock, which are exercisable within the next 60 days.

reference.

(7)

Incudes options to purchase 250,000 shares of common stock, which are exercisable within the next 60 days.

(8)

Consists of 10,057,074 sharesof common stock held by Shamus, LLC ("Shamus"). As the sole member of Shamus, The Coast Fund L.P. ("Coast Fund") may be deemed to beneficially own all common stock beneficially owned by Shamus. Similarly, as the managing general partner of the Coast Fund, Coast Offshore Management (Cayman), Ltd. ("Coast Offshore Management") may be deemed to beneficially own all common stock beneficially owned by the Coast Fund. Except to the extent it is deemed to beneficially own any common stock beneficially owned by Shamus, neither the Coast Fund nor Coast Offshore Management beneficially owns any common stock. As the president of Coast Offshore Management, Mr. Smith may be deemed to beneficially own all common stock beneficially owned by Coast Offshore Management, Coast Fund and Shamus. In addition, Mr. Smith directly owns (i) 9,422 shares of common stock and (ii) 200,000 shares of common stock issuable upon the exercise of options granted to Mr. Smith for his service on our board of directors that are either currently exercisable or will become exercisable within the next 60 days (iii) warrants to purchase 1,034,759 shares of common stock and (iv) convertible debentures to purchase 1,265,220 shares of common stock. As a result, Mr. Smith may be deemed to beneficially own, in the aggregate, 12,566,475 shares of our common stock.

(9)

Includes options to purchase 200,000 shares of common stock, which are exercisable within the next 60 days.

(10)

Consists of 450,000 shares of common stock and options to purchase 200,000 shares of common stock, which are exercisable within the next 60 days.



ITEM 13. CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS AND DIRECTOR INDEPENDENCE

Review and Approval of Transactions with Related Persons

Either the audit committee or the Board of Directors approves all related party transactions.

The procedureinformation required by this item will be included in our Proxy Statement for the review, approval or ratification2020 Annual Meeting of related party transactions involves discussing the proposed transaction with management, discussing the proposed transactionStockholders to be filed with the external auditors, reviewing financial statements and related disclosures, and reviewing the details of major deals and transactions to ensure that they do not involve related party transactions. Members of management have been informed and understand that they are to bring related party transactions to the audit committee or the Board of Directors for pre-approval. These policies and procedures are evidenced in the audit committee charter and our code of ethics.

Certain Transactions

In July 2015, we entered into $3.55 million 12% Original Issue Discount Convertible Debenture due January 18, 2016 (the “July 2015 Convertible Debenture”) with Acuitas Group Holdings, LLC (“Acuitas”), one hundred percent (100%) of which is owned by Terren S. Peizer, Chairman and Chief Executive OfficerSEC within 120 days of the Company,fiscal year ended December 31, 2019, and five-year warrants to purchase 935,008 sharesis incorporated herein by reference.


26



Table of our common stock, at an exercise price of $1.90 per share, subject to adjustment, including for issuances of common stock and common stock equivalents below the then current conversion or exercise price, as the case may be (the “July 2015 Warrants”).

The conversion price of the July 2015 Convertible Debenture is $1.90 per share, subject to adjustments, including for issuances of common stock and common stock equivalents below the then current conversion or exercise price, as the case may be.  The July 2015 Convertible Debentures are unsecured, bear interest at a rate of 12% per annum payable in cash or shares of common stock, subject to certain conditions, at our option, and are subject to mandatory prepayment upon the consummation of certain future financings. 

The conversion price of the July 2015 Convertible Debenture and the July 2015 Warrants were subsequently adjusted to $0.30 per share based upon the September Offering.

In September 2015, we entered into a Stock Purchase Agreement with Acuitas, relating to the sale and issuance of approximately 1.5 million shares of common stock for gross proceeds of $463,000 (the “September Offering”).

 In October 2015, we entered into Stock Purchase Agreements with each of Acuitas, Shamus, LLC (“Shamus”), a Company owned by David E. Smith, a member of our board of directors, and Steve Gorlin, a member of our board of directors, pursuant to which we received gross proceeds of $2.0 million for the sale of approximately 6.7 million shares of the Company’s common stock, at a purchase price of $0.30 per share (the “October Offering”).

In August 2016, Acuitas loaned us $225,000. No terms were discussed nor were any agreements executed in connection with such loan, but the $225,000 was paid back out of the August 2016 Notes.

In August 2016, we entered into subscription agreements with three accredited investors, (collectively, the “Investors”), including Shamus, pursuant to which we issued to the Investors short-term senior promissory notes in the aggregate principal amount of $2.8 million (the “August 2016 Notes”) and five-year warrants to purchase up to an aggregate of 875,000 shares of our common stock, at an exercise price of $1.10 per share (the “August 2016 Warrants”).

The August 2016 Warrants include price protection provisions pursuant to which, subject to certain exempt issuances, the then exercise price of the August 2016 Warrants will be adjusted in the event we issue shares of our common stock for consideration per share less than the then exercise price of the August 2016 Warrants, to the lowest consideration per share for the shares issued or sold in such transaction. The price protection will be in effect until the earliest of (i) the termination date of the August 2016 Warrants, (ii) such time as the Warrants are exercised or (iii) contemporaneously with the listing of our shares of common stock on a registered national securities exchange.

In addition, in August 2016, Acuitas, agreed to exchange its existing promissory note for short-term senior promissory notes, in the aggregate principal amount of $2.8 million plus accrued interest, in the form substantially identical to the form of the August 2016 Notes. Acuitas also agreed to exchange certain of its outstanding warrants to purchase an aggregate of 2,028,029 shares of our common stock at an exercise price of $0.33 per share, for warrants to purchase an aggregate of 2,993,561 shares of our common stock at an exercise price of $1.10 per share, in the form substantially identical to the form of the August 2016 Warrants.

In December 2016, we exchanged the August 2016 Notes issued to the Investors, which had an aggregate outstanding principal amount of $5.6 million, for (i) 8% Convertible Debentures in the same principal amount due on March 15, 2017 (the “Debentures”) and (ii) five-year warrants to purchase shares of the Company’s common stock in amount equal to forty percent (40%) of the initial number of shares of common stock issuable upon conversion of each Investor’s Debentures, at an exercise price of $1.10 per share (the “December 2016 Warrants”).

The December 2016 Warrants include a price protection provision pursuant to which, subject to certain exempt issuances, the then exercise price of the December 2016 Warrants will be adjusted if the Company issues shares of common stock at a price that is less than the then exercise price of the December 2016 Warrants. Such price protection provisions will remain in effect until the earliest of (i) the termination date of the December 2016 Warrants, (ii) such time as the December 2016 Warrants are exercised or (iii) contemporaneously with the listing of our shares of common stock on a registered national securities exchange.

In December 2016, we entered into an agreement with Shamus pursuant to which the Company received gross proceeds of $300,000 for the sale of (i) an 8% Series B Convertible Debenture due March 31, 2017 (the “December 2016 Convertible Debenture”) and (ii) five-year warrants to purchase shares of the Company’s common stock in an amount equal to seventy-five percent (75%) of the initial number of shares of common stock issuable upon the conversion of the December 2016 Convertible Debenture, at an exercise price of $0.85 per share (the “Shamus Warrants”).

The Shamus Warrants include price protection provisions pursuant to which, subject to certain exempt issuances, the then exercise price of the Shamus Warrants will be adjusted if the Company issues shares of common stock at a price that is less than the then exercise price of the Shamus Warrants. Such mechanism will remain in effect until the earliest of (i) the termination date of the Shamus Warrants, (ii) such time as the Shamus Warrants are exercised or (iii) contemporaneously with the listing of our shares of common stock on a registered national securities exchange.

In January 2017, we entered into a Subscription Agreement (the “Subscription Agreement”) with Acuitas, pursuant to which the Company will receive aggregate gross proceeds of $1,300,000 (the “Loan Amount”) in consideration of the issuance of (i) an 8% Series B Convertible Debenture due March 31, 2017 (the “January 2017 Convertible Debenture”) and (ii) five-year warrants to purchase shares of the Company’s common stock in an amount equal to one hundred percent (100%) of the initial number of shares of common stock issuable upon the conversion of the January 2017 Convertible Debenture, at an exercise price of $0.85 per share (the “January 2017 Warrants”). The Loan Amount is payable in tranches through March 2017. In addition, any warrants issued in conjunction with the December 2016 Convertible Debenture currently outstanding with Acuitas have been increased by an additional 25% warrant coverage, exercisable for an aggregate of 827,293 shares of the Company’s common stock.

The January 2017 Warrants include, among other things, price protection provisions pursuant to which, subject to certain exempt issuances, the then exercise price of the January 2017 Warrants will be adjusted if the Company issues shares of common stock at a price that is less than the then exercise price of the January 2017 Warrants. Such price protection provisions will remain in effect until the earliest of (i) the termination date of the January 2017 Warrants, (ii) such time as the January 2017 Warrants are exercised or (iii) contemporaneously with the listing of the Company’s shares of common stock on a registered national securities exchange.

In connection with the Subscription Agreement described above, the number of Shamus Warrants were increased from 75% to 100% warrant coverage, exercisable for an aggregate of 352,941 shares of the Company’s common stock.


ITEM 14.

PRINCIPAL ACCOUNTANT FEES AND SERVICES

ITEM 14. PRINCIPAL ACCOUNTING FEES AND SERVICES
The following table presents fees for professional audit services renderedinformation required by Rose, Synder & Jacobs LLPthis item will be included in our Proxy Statement for the audit2020 Annual Meeting of Stockholders to be filed with the SEC within 120 days of the Company’s annual financial statements for the yearsfiscal year ended December 31, 20162019, and December 31, 2015, and fees billed for other services renderedis incorporated herein by Rose, Synder & Jacobs LLP during those periods.

  

2016

  

2015

 

Audit fees (1)

 $80,000  $82,000 

Audit-related fees

  -   - 

Tax fees:

  -   - 

All other fees:

  -   - 

Total

 $80,000  $82,000 

(1) Audit fees consisted of audit work performed in the preparation of financial statements, as well as work generally only the independent registered public accounting firm can reasonably be expected to provide, such as statutory audits.

Policy on Audit Committee Pre-Approval of Audit and Permissible Non-audit Services of Independent Public Accountant

Consistent with SEC policies regarding auditor independence, the Audit Committee has responsibility for appointing, setting compensation and overseeing the work of our independent registered public accounting firm. In recognition of this responsibility, the Audit Committee has established a policy to pre-approve all audit and permissible non-audit services provided by our independent registered public accounting firm.

Prior to engagement of an independent registered public accounting firm for the next year’s audit, management will submit an aggregate of services expected to be rendered during that year for each of four categories of services to the Audit Committee for approval.

1.         Auditservices include audit work performed in the preparation of financial statements, as well as work that generally only an independent registered public accounting firm can reasonably be expected to provide, including comfort letters, statutory audits, and attest services and consultation regarding financial accounting and/or reporting standards.

2.         Audit-Related services are for assurance and related services that are traditionally performed by an independent registered public accounting firm, including due diligence related to mergers and acquisitions, employee benefit plan audits, and special procedures required to meet certain regulatory requirements.

3.         Tax services include all services performed by an independent registered public accounting firm’s tax personnel except those services specifically related to the audit of the financial statements, and includes fees in the areas of tax compliance, tax planning, and tax advice.

4.         Other Fees are those associated with services not captured in the other categories. The Company generally does not request such services from our independent registered public accounting firm.

Prior to engagement, the Audit Committee pre-approves these services by category of service. The fees are budgeted and the Audit Committee requires our independent registered public accounting firm and management to report actual fees versus the budget periodically throughout the year by category of service. During the year, circumstances may arise when it may become necessary to engage our independent registered public accounting firm for additional services not contemplated in the original pre-approval. In those instances, the Audit Committee requires specific pre-approval before engaging our independent registered public accounting firm.

The Audit Committee may delegate pre-approval authority to one or more of its members. The member to whom such authority is delegated must report, for informational purposes only, any pre-approval decisions to the Audit Committee at its next scheduled meeting.

reference.



PART IV

IV

ITEM 15. EXHIBITS, FINANCIAL STATEMENT SCHEDULES

(a)(1),(2) Financial Statements

The Financial Statements and Financial Statement Schedules listed on page F-1 of this document are filed as part of this filing.

(a)(3) Exhibits

The following exhibits are filed as part of this report:

Exhibit

No.

Description

3.1

Exhibit
No.

Certificate of Incorporation of Catasys, Inc., filed with the Secretary of State of the State of Delaware on September 29, 2003, incorporated by reference to exhibit of the same number of Catasys Inc.’s Form 8-K filed with the Securities and Exchange Commission on September 30, 2003.

Description

3.2

3.1 

Certificate of Amendment to

3.3

Certificate of Amendment, as corrected by the Certificate of Correction, to Certificate of Incorporation of Catasys, Inc., incorporated by reference to exhibit of the same number to Catasys, Inc’s Registration Statement on Form S-1/A filed with Securities and Exchange Commission on September 9, 2011.

3.4

Certificate of Amendment of the Certificate of Incorporation of Catasys, Inc., incorporated by reference to exhibit 3.1 of Catasys, Inc.’s current report on Form 8-KDefinitive Schedule 14 C filed with the Securities and Exchange Commission on August 10, 2012.

October 4, 2019

3.5

3.6*

Certificate of Amendment of the Certificate of Incorporation of Catasys, Inc., incorporated by reference to exhibit 3.1 of Catasys, Inc.’s current report on Form 8-K filed with the Securities and Exchange Commission on May 7, 2013.

3.6

4.1

4.2

4.3

Form of 12% Original Issue Discount Convertible Debenture Due January 18, 2016 incorporated by reference to Exhibit 4.1 of Catasys, Inc.’s Form 8-K filed with the Securities and Exchange Commission on July 31, 2015.

June 15, 2018.

4.4

4.3 

4.5

4.4 

4.6

4.5 

Form

4.7

4.6* 

Form

4.8

10.1#

Form of Warrant incorporated by reference to Exhibit 4.1 of Catasys, Inc.’s current report on Form 8-K filed with the Securities and Exchange Commission on May 30, 2014.

4.9

Form of 8% Promissory Note, dated March 30, 2016, incorporated by reference to Exhibit 4.9 of Catasys, Inc.’s current report on form 10-K filed with the Securities and Exchange Commission on March 30, 2016.

4.10

Form of First Amendment and Restated 8% Promissory Note, dated April 27, 2016, incorporated by reference to Exhibit 4.1 of Catasys, Inc.’s current report on Form 10-Q filed with the Securities and Exchange Commission on May 13, 2016.

4.11

Form of Common Stock Purchase Warrant, dated April 27, 2016, incorporated by reference to Exhibit 4.2 of Catasys, Inc.’s current report on Form 10-Q filed with the Securities and Exchange Commission on May 13, 2016.


4.13

Form of 8% Promissory Note, dated March 30, 2016, incorporated by reference to Exhibit 4.3 of Catasys, Inc.’s Form 10-Q filed with the Securities and Exchange Commission on May 13, 2016.

4.14

Form of Common Stock Purchase Warrant, dated March 30, 2016, incorporated by reference to Exhibit 4.4 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on May 13, 2016.

4.15

Form of Second Amended and Restated Promissory Note, dated May 24, 2016, incorporated by reference to Exhibit 4.1 of Catasys Inc’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

4.16

Form of Common Stock Purchase Warrant, dated May 24, 2016, incorporated by reference to Exhibit 4.2 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

4.17

Form of Third Amended and Restated Promissory Note, dated June 2, 2016, incorporated by reference to Exhibit 4.3 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

4.18

Form on Common Stock Purchase Warrant, dated June 2, 2016, incorporated by reference to Exhibit 4.4 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

4.19

Form of Fourth Amended and Restated Promissory Note, dated June 22, 2016, incorporated by reference to Exhibit 4.5 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

4.20

Form of Common Stock Purchase Warrant, dated June 22, 2016, incorporated by reference to Exhibit 4.6 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

4.21

Form of Fifth Amended and Restated Promissory Note, dated July 5, 2016, incorporated by reference to Exhibit 4.7 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

4.22

Form of Common Stock Purchase Warrant, dated July 5, 2016, incorporated by reference to Exhibit 4.8 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

4.23

Form of Sixth Amended and Restated Promissory Note, dated July 21, 2016, incorporated by reference to Exhibit 4.9 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

4.24

Form of Common Stock Purchase Warrant, dated July 21, 2016, incorporated by reference to Exhibit 4.10 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

4.25

Form of Senior Promissory Note, dated August 15, 2016, incorporated by reference to Exhibit 4.13 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

4.26

Form of Common Stock Purchase Warrant, dated August 15, 2016, incorporated by reference to Exhibit 4.14 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

4.27

Form of 8% Senior Convertible Debenture due March 15, 2017, incorporated by reference to Exhibit 4.1 of Catasys, Inc.’s Form 8-K filed with the Securities and Exchange Commission on December 23, 2016.

4.28

Form of Common Stock Purchase Warrant, incorporated by reference to Exhibit 4.2 of Catasys, Inc.’s Form 8-K filed with the Securities and Exchange Commission on December 23, 2016.

4.29

8% Series B Convertible Debenture, dated December 29, 2016, incorporated by reference to Exhibit 4.1 of Catasys, Inc’s Form 8-K filed with the Securities and Exchange Commission on December 30, 2016.

4.30

Common Stock Purchase Warrant, dated December 29, 2016, incorporated by reference to Exhibit 4.2 of Catasys, Inc.’s Form 8-K filed with the Securities and Exchange Commission on December 30, 2016.

4.31

8% Series B Convertible Debenture, dated January 31, 2017, incorporated by reference to Exhibit 4.1 of Catasys, Inc.’s Form 8-K filed with the Securities and Exchange Commission on February 1, 2017.

4.32

Common Stock Purchase Warrant, dated January 31, 2017, incorporated by reference to Exhibit 4.2 filed with the Securities and Exchange Commission on February 1, 2017.

10.1#

10.2#

10.3#

Amendment to Employment Agreement of Richard A. Anderson, dated JulyMay 16, 2008,2017, incorporated by reference to Exhibit 10.1 of Catasys, Inc.’s current report on Form 8-K filed with the Securities and Exchange Commission on July 18, 2008.

May 16, 2017.

10.4#

10.3# 

10.5#

10.4# 

2010

10.6

10.7# 

Amendment to 12% Original Issue Discount Convertible Debenture incorporated


10.7

Securities Purchase Agreement, dated October 16, 2015, incorporated by reference to Exhibit 10.1 of Catasys, Inc’s Form 8-K filed with the Securities and Exchange Commission on October 16, 2015.

10.8

Stock Purchase Agreement, dated September 17, 2015, incorporated by reference to Exhibit 10.1 of Catasys, Inc.’s Form 8-K filed with the Securities and Exchange Commission on September 18, 2015.

10.9

Securities Purchase Agreement between Catasys, Inc. and accredited investors dated July 30, 2015 incorporated by reference to Exhibit 10.1 of Catasys, Inc.’s Form 8-K filed with the Securities and Exchange Commission on July 31, 2015.

10.10

Form of Lock-Up Agreement incorporated by reference to Exhibit 10.2 of Catasys, Inc.’s Form 8-K filed with the Securities and Exchange Commission on May 20, 2015.

10.11

Form of Warrant Exchange Agreement incorporated by reference to Exhibit 10.1 of Catasys, Inc’s Form 8-K filed with the Securities and Exchange Commission on May 20, 2015.

10.12

Securities Purchase Agreement between Catasys, Inc. and accredited investorsMr. Richard A. Anderson dated April 16, 201510, 2018, incorporated by reference to Exhibit 10.1 of Catasys Inc.’s Form 8-K filed with the Securities and Exchange Commission on April 21, 2015.

16, 2018.
27

10.13

10.8 

Office Lease

10.9# 

10.14

First Amendment to the Office Lease between Catasys, Inc. and Trizec Wilshire Center, LLC dated March 6, 2015, incorporated by reference to exhibit 10.27 of Catasys, Inc.’s Form 10-K filed with the Securities and Exchange Commission on March 31, 2015.

10.15

Form of Subscription Agreement, dated August 15, 2016, between Catasys, Inc. and accredited investors incorporated by reference to Exhibit 10.1 of Catasys Inc.’s Form 10-Q filed with the Securities and Exchange Commission on August 15, 2016.

10.16

Form of Securities and Exchange Agreement, between Catasys, Inc. and Acuitas Group Holdings, LLC,Mr. Christopher Shirley, incorporated by reference to Exhibit 10.1 of Catasys, Inc.’s Form 8-K filed with the Securities and Exchange Commission on December 23, 2016.20, 2019.

10.17

10.10# 
Subscription

10.18

14.1 
Form of Exchange Agreement, dated August 15, 2016, by and between Catasys, Inc. and Acuitas Group Holdings, LLC, incorporated by reference to Exhibit 4.6 of Catasys, Inc.’s Form 10-Q filed with the Securities and Exchange Commission on November 14, 2016.
10.19#2017 Stock Incentive Plan, incorporated by reference to Exhibit B of Catasys, Inc.'s Preliminary Information Statement on Schedule 14C filed with the Securities and Exchange Commission on February 28, 2017.

14.1

21.1*

23.1*

23.2*

31.1*

31.2*

32.1**

32.2**

101.INS*

XBRL Instance Document


101.SCH*

XBRL Taxonomy Extension Schema Document

101.CAL*

XBRL Taxonomy Extension Calculation Linkbase Document

101.DEF*

XBRL Taxonomy Extension Definition Linkbase Document

101.LAB*

XBRL Taxonomy Extension Label Linkbase Document

101.PRE*

XBRL Taxonomy Extension Presentation Linkbase Document


* Filed herewith.

** Furnished herewith.

# Management contract or compensatory plan or arrangement.



ITEM 16. FORM 10-K SUMMARY
Not applicable
28

SIGNATURES

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.

CATASYS, INC.

CATASYS, INC.
Date: February 28, 2017

March 16, 2020

By:

/s/ TERREN S. PEIZER

Terren S. Peizer

Chief Executive Officer


(Principal Executive Officer)

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed by the following persons on behalf of the registrant and in the capacities and on the dates indicated.

Signature

Title(s)

Date

SignatureTitle(s)Date

/s/ TERREN S. PEIZER

Chairman of the Board of Directors

February 28, 2017

March 16, 2020

Terren S. Peizer

and Chief Executive Officer

(Principal Executive Officer)

/s/ SUSAN E. ETZEL

CURTIS MEDEIROS

Chief Financial Officer

February 28, 2017

 Susan Etzel

(Principal Financial and

Accounting Officer)

/s/ RICHARD A. ANDERSON

President, Chief Operating Officer

February 28, 2017

March 16, 2020

Richard A. Anderson

Curtis Medeiros

and Director

/s/ CHRISTOPHER SHIRLEYChief Financial OfficerMarch 16, 2020
Christopher Shirley(Principal Financial and 

Accounting Officer)
/s/ RICHARD A. BERMAN

Director

February 28, 2017

March 16, 2020

Richard Berman

/s/ EDWARD ZECCHINIDirectorMarch 16, 2020
Edward Zecchini

/s/ DAVID E. SMITH

Director

February 28, 2017

David Smith

/s/ MICHAEL SHERMAN
DirectorMarch 16, 2020
Michael Sherman
/s/ ROBERT REBAKDirectorMarch 16, 2020

/s/ MARVIN IGELMAN

Robert Rebak

Director

February 28, 2017

 Marvin Igelman

/s/ GUSTAVO GIRALDODirectorMarch 16, 2020
Gustavo Giraldo

/s/ STEVE GORLIN

DIANE SELOFF

Director

February 28, 2017

March 16, 2020

 Steve Gorlin

Diane Seloff


29

CATASYS,, INC. AND SUBSIDIARIES

Index toConsolidatedFinancial Statements and Financial Statement Schedules

Financial Statements

Financial Statement Schedules

All financial statement schedules are omitted because they are not applicable not required, or the information is shown in the Financial Statements or Notes thereto.

F-1

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM



To the Board of Directors and Stockholders of Catasys, Inc.



Opinion on the Financial Statements

We have audited the accompanying consolidated balance sheets of Catasys, Inc. and Subsidiaries (the “Company”) as of December 31, 20162019 and 2015,2018, and the related consolidated statements of operations, stockholders’ equity (deficit)deficit, and cash flows for each of the years then ended, 2016 and 2015. The Company’s management is responsible for thesethe related notes (collectively referred to as the “financial statements”). In our opinion, the financial statements present fairly, in all material respects, the consolidated financial statements. Our responsibility is to express an opinion on theseposition of the Company as of December 31, 2019 and 2018, and the consolidated financial statements based on our audits.

results of their operations and their cash flows for each of the years then ended, in conformity with accounting principles generally accepted in the United States of America.


We conducted our auditsalso have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States). (“PCAOB”), the Company’s internal control over financial reporting as of December 31, 2019, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (“COSO”), and our report dated March 16, 2020 expressed an unqualified opinion.

Change in Accounting Principle

As discussed in Note 2 to the financial statements, the Company has changed its method of accounting for leases effective January 1, 2019 due to the adoption of Accounting Standards Codification Topic 842, Leases.

Basis for Opinion

These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our audits. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement. The Company is not requiredmisstatement, whether due to have, nor were we engaged to perform, an audit of its internal control over financial reporting.error or fraud. Our audits included considerationperforming procedures to assess the risks of internal control overmaterial misstatement of the financial reporting as a basis for designing auditstatements, whether due to error or fraud, and performing procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion. An audit also includesrespond to those risks. Such procedures included examining, on a test basis, evidence supportingregarding the amounts and disclosures in the consolidated financial statements, assessingstatements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial statement presentation.statements. We believe that our audits provide a reasonable basis for our opinion.




/s/ EisnerAmper LLP



We have served as the Company’s auditor since 2018.


EISNERAMPER LLP
Iselin, New Jersey
March 16, 2020








F-2


Opinion on Internal Control over Financial Reporting

We have audited Catasys, Inc. and Subsidiaries’ (the “Company”) internal control over financial reporting as of December 31, 2019, based on criteria established in the Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (“COSO”). In our opinion, the consolidated financial statements referred to above present fairly,Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2019, based on criteria established in the Internal Control - Integrated Framework (2013) issued by COSO.

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (“PCAOB”), the consolidated financial positionbalance sheets of Catasys, Inc. and Subsidiaries as of December 31, 20162019 and 2015,2018, and the related consolidated resultsstatements of their operations, stockholders’ deficit, and their cash flows for each of the years then ended and the related notes and our report dated March 16, 2020 expressed an unqualified opinion.

Basis for Opinion

The Company’s management is responsible for maintaining effective internal control over financial reporting and for its assessment of the effectiveness of internal control over financial reporting, included in conformitythe accompanying Management’s Annual Report on Internal Control over Financial Reporting. Our responsibility is to express an opinion on the Company’s internal control over financial reporting based on our audit. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether effective internal control over financial reporting was maintained in all material respects. Our audit of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audit also included performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion.

Definition and Limitations of Internal Control over Financial Reporting

An entity’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. An entity’s internal control over financial reporting includes those policies and procedures that (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the entity; (ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, generally acceptedand that receipts and expenditures of the entity are being made only in accordance with authorizations of management and directors of the United Statesentity; and (iii) provide reasonable assurance regarding prevention or timely detection of America.

The accompanying consolidatedunauthorized acquisition, use, or disposition of the entity’s assets that could have a material effect on the financial statements have been prepared assumingstatements.


Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the Company will continue as a going concern. As discussed degree of compliance with the policies or procedures may deteriorate.


/s/ EisnerAmper LLP


EISNERAMPER LLP
Iselin, New Jersey
March 16, 2020
F-3

CATASYS, INC.
Consolidated Balance Sheets
(in Note 1thousands, except share and per share data)
December 31,
2019
December 31,
2018
Assets
Current assets:
   Cash, cash equivalents and restricted cash$13,610  $3,162  
   Receivables, net3,615  1,382  
   Unbilled receivables2,093  —  
   Prepaid expenses and other current assets1,074  1,108  
Total current assets20,392  5,652  
Long-term assets:
   Property and equipment, net150  263  
   Restricted cash, long-term408  408  
   Deferred commissions112  —  
   Right-of-use assets2,793  —  
Total assets$23,855  $6,323  
Liabilities and stockholders' deficit
Current liabilities:
   Accounts payable$1,385  $497  
   Accrued compensation and benefits3,640  1,537  
   Deferred revenue5,803  4,195  
   Current portion of lease liabilities519  —  
   Other accrued liabilities2,060  1,501  
Warrant liabilities691  86  
Total current liabilities14,098  7,816  
Long-term liabilities:
   Long-term debt, net31,597  7,472  
   Long-term lease liabilities2,069  —  
Total liabilities47,764  15,288  
Commitments and contingencies (Note 8)
Stockholders' deficit:
   Preferred stock, $0.0001 par value; 50,000,000 shares authorized; 0 shares issued and outstanding—  —  
   Common stock, $0.0001 par value, 500,000,000 shares authorized; 16,616,165 and
  16,185,146 shares issued and outstanding at December 31, 2019 and December 31, 2018, respectively
  
   Additional paid in capital307,403  296,688  
   Accumulated deficit(331,314) (305,655) 
Total stockholders' deficit(23,909) (8,965) 
Total liabilities and stockholders' deficit$23,855  $6,323  
See accompanying notes to the consolidated financial statements,statements.
F-4

CATASYS, INC.
Consolidated Statements of Operations
(in thousands, except per share data)
Year Ended December 31,
20192018
Revenue$35,095  $15,177  
Cost of revenue20,408  11,119  
Gross profit14,687  4,058  
Operating expenses34,701  17,684  
Operating loss(20,014) (13,626) 
Other income (expense)(2,538) 40  
Interest expense(3,047) (570) 
Change in fair value of warrant liability(60) (56) 
Net loss$(25,659) $(14,212) 
Net loss per share, basic and diluted$(1.56) $(0.89) 
Weighted-average shares used to compute basic and diluted net loss per share16,418  15,955  
See accompanying notes to the Company has continued to incur significant operating losses and negative cash flows from operations during the year ended December 31, 2016 and continues to have negative working capital at December 31, 2016. These conditions raise substantial doubt about the Company's ability to continue as a going concern. Management's plans regarding those matters also are described in Note 1. The consolidated financial statements do not include any adjustments that might result fromstatements.
F-5

CATASYS, INC.
Consolidated Statements of Stockholders' Deficit
(in thousands, except share and per share data)
Common StockAdditional
Paid-In
Capital
SharesAmountAccumulated
Deficit
Total Stockholders' Deficit
Balance at December 31, 201715,889,171  $ $294,220  $(293,324) $898  
Adoption of accounting standard, ASC 606—  —  —  1,881  1,881  
Balance at Balance at January 1, 201815,889,171  $ $294,220  (291,443) $2,779  
Common stock issued for services24,000  —  112  —  112  
Warrants issued for services—  —  86  —  86  
Warrants issued in connection with A/R facility—  —  64  —  64  
Cashless warrant exercise241,975  —  —  —  —  
Cash warrant exercise30,000  —  150  —  150  
Shared-based compensation expense—  —  2,056  —  2,056  
Net loss—  —  —  (14,212) (14,212) 
Balance at December 31, 201816,185,146  $ $296,688  $(305,655) $(8,965) 
Reclassification of warrant liability to equity upon
adoption of ASU 2017-11
—  —  86  —  86  
Warrants issued for services—  —  43  —  43  
Warrants issued in connection with 2024 notes—  —  2,354  —  2,354  
Exercise of warrant232,461  —  1,128  —  1,128  
Exercise of stock options195,351  —  1,894  —  1,894  
Stock compensation expense3,207  —  5,210  —  5,210  
Net loss—  —  —  (25,659) (25,659) 
Balance at December 31, 201916,616,165  $ $307,403  (331,314) $(23,909) 
See accompanying notes to the outcomeconsolidated financial statements.
F-6

CATASYS, INC.
Consolidated Statements of Cash Flows
(in thousands)
Year Ended December 31,
20192018
Cash flows used in operating activities
Net loss$(25,659) $(14,212) 
Adjustments to reconcile net loss to net cash used in operating activities:
          Stock-based compensation expense5,210  2,056  
          Write-off of debt issuance costs1,505  —  
           Depreciation133  288  
          Amortization696  187  
          Warrants issued for services43  86  
          Change in fair value of warrants60  56  
          Common stock issued for consulting services—  112  
          Loss on disposal of fixed asset—  70  
          Deferred rent(26) (91) 
          Changes in operating assets and liabilities:
                    Accounts payable888  893  
                    Lease liabilities684  —  
                    Other accrued liabilities2,529  —  
                    Prepaid and other current assets(246) (311) 
                    Deferred revenue1,608  3,163  
                    Receivables(2,233) (871) 
                    Unbilled receivables(2,093) —  
Net cash used in operating activities(16,901) (8,574) 
Cash flows provided by investing activities
          Purchases of property and equipment—  (9) 
          Deposits and other assets—  71  
Net cash provided by investing activities—  62  
Cash flows provided by financing activities
          Proceeds from secured promissory note—  7,500  
          Proceeds from revolving loan7,500  —  
          Repayment of revolving loan(15,000) —  
          Proceeds from A/R facility1,938  —  
          Repayment of A/R facility(1,938) —  
          Proceeds from loan36,527  —  
          Debt issuance costs(2,813) (317) 
          Debt termination related fees(1,956) —  
          Proceed from warrant exercise1,128  150  
          Proceed from options exercise1,894  —  
          Capital lease obligations69  (30) 
Net cash provided by financing activities27,349  7,303  
Net increase (decrease) in cash and restricted cash10,448  (1,209) 
Cash and restricted cash at beginning of period3,570  4,779  
Cash and restricted cash at end of period$14,018  $3,570  
Supplemental disclosure of cash flow information:
          Right of use asset obtained in exchange for lease obligation$2,574  $—  
          Interest paid870  363  
Non cash financing and investing activities:
          Reclassification of warrant liability to equity upon amendment of the
loan agreement
86  —  
          Warrant issued in connection with 2024 Note$2,354  $—  
See accompanying notes to that matter.

/s/ Rose, Snyder & Jacobs LLP

Encino, California

February 27, 2017

the consolidated financial statements.
F-7

CATASYS,, INC. AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

(In thousands, except for number of shares)

 

December 31,

  

December 31,

 
  

2016

  

2015

 

ASSETS

        

Current assets

        

Cash and cash equivalents

 $851  $916 

Receivables, net of allowance for doubtful accounts of $0 and $0, respectively

  1,052   590 

Prepaids and other current assets

  420   575 

Total current assets

  2,323   2,081 

Long-term assets

        

Property and equipment, net of accumulated depreciation of $1,620 and $1,491, respectively

  410   412 

Deposits and other assets

  371   387 

Total Assets

 $3,104  $2,880 
         

LIABILITIES AND STOCKHOLDERS' DEFICIT

        

Current liabilities

        

Accounts payable

 $870  $753 

Accrued compensation and benefits

  2,089   1,703 

Deferred revenue

  1,525   1,683 

Other accrued liabilities

  575   682 

Short term debt, related party, net of discount of $216 and $0, respectively

  9,796   - 

Short term derivative liability

  8,122   - 

Total current liabilities

  22,977   4,821 

Long-term liabilities

        

Deferred rent and other long-term liabilities

  117   198 

Long term convertible debt, related party, net of discount $0 and $0, respectively

  -   3,662 

Capital leases

  31   66 

Long term derivative liability

  -   2,348 

Warrant liabilities

  5,307   509 

Total Liabilities

  28,432   11,604 
         

Commitments and contingencies (note 8)

        
         

Stockholders' deficit

        

Preferred stock, $0.0001 par value; 50,000,000 shares authorized; no shares issued and outstanding

  -   - 

Common stock, $0.0001 par value; 500,000,000 shares authorized; 55,288,458 and 55,007,761 shares issued and outstanding at December 31, 2016 and December 31, 2015, respectively

  6   6 

Additional paid-in-capital

  254,385   253,053 

Accumulated deficit

  (279,719)  (261,783)

Total Stockholders' deficit

  (25,328)  (8,724)

Total Liabilities and Stockholders' Deficit

 $3,104  $2,880 

The accompanying Notes to Consolidated Financial Statements

Note 1. Organization
Company Overview
Catasys, Inc. (“Catasys” or the “Company”) is technology-enabled healthcare company whose mission is to help improve the health and save the lives of as many people as possible. The Company’s platform, Catasys PRETM (Predict-Recommend-Engage), organizes and automates healthcare data integration and analytics through application of machine intelligence to deliver analytic insights. The PRE Platform predicts people whose chronic disease will improve with behavior change, recommends effective care pathways that people are an integral partwilling to follow, and engages people who are not receiving the care they need. By combining predictive analytics with human engagement, the Company delivers improved member health and validated outcomes and savings to healthcare payers.

The Company’s integrated, technology-enabled OnTrak solution, a critical component of the Catasys PRE platform, is designed to identify and treat members with behavioral conditions that cause or exacerbate chronic medical conditions such as diabetes, hypertension, coronary artery disease, chronic obstructive pulmonary disease, and congestive heart failure, which result in high medical costs. The Company has the ability to engage these statements.

members, who do not otherwise seek behavioral healthcare, leveraging proprietary enrollment capabilities built on deep insights into the drivers of care avoidance. OnTrak integrates evidence-based psychosocial and medical interventions delivered either in-person or via telehealth, along with care coaching and in-market Community Care Coordinators who address the social and environmental determinants of health, including loneliness.


CATASYS, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF OPERATIONS

  

Twelve Months Ended

 

(In thousands, except per share amounts)

 

December 31,

 
  

2016

  

2015

 

Revenues

        

Healthcare services revenues

 $7,075  $2,705 
         

Operating expenses

        

Cost of healthcare services

  4,670   2,433 

General and administrative

  8,838   9,049 

Depreciation and amortization

  141   122 

Total operating expenses

  13,649   11,604 
         

Loss from operations

  (6,574)  (8,899)
         

Interest and other income

  106   64 

Interest expense

  (5,354)  (2,590)

Loss on impairment of intangible assets

  -   (88)

Loss on exchange of warrants

  -   (4,410)

Loss on debt extinguishment

  (2,424)  (195)

Change in fair value of warrant liability

  2,093   11,665 

Change in fair value of derivative liability

  (5,774)  (2,761)

Loss from operations before provision for income taxes

  (17,927)  (7,214)

Provision for income taxes

  9   9 

Net loss

 $(17,936) $(7,223)
         
         

Basic and diluted net loss per share:

 $(0.33) $(0.18)
         

Basic weighted number of shares outstanding

  55,074   40,372 

The accompanying Notes to Consolidated Financial Statements are an integral part of these statements.


CATASYS, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (DEFICIT)

(Amounts in thousands, except for number of shares)

 

Common Stock

  

Additional

Paid-In

  

Other

Comprehensive

  

Accumulated

     
  

Shares

  

Amount

  

Capital

  

Income

  

Deficit

  

Total

 
                         

Balance at December 31, 2014

  25,244,485  $3  $213,333  $-  $(254,560) $(41,224)
                         

Warrant Exchange

  21,277,220   2   35,531   -   -   35,533 

Common stock issued for outside services

  76,055   -   172           172 

Common stock issued in private placement, net of expenses

  8,410,001   1   2,620   -   -   2,621 

Share-based Compensation Expense

  -   -   1,397   -   -   1,397 

Net loss

  -   -   -   -   (7,223)  (7,223)

Balance at December 31, 2015

  55,007,761  $6  $253,053  $-  $(261,783) $(8,724)
                         

Warrants Exercised

  45,697   -   46           46 

Common stock issued for outside services

  235,000   -   235           235 

Extinguishment of Debt

          354           354 

Share-based Compensation Expense

          697           697 

Net loss

                  (17,936)  (17,936)

Balance at December 31, 2016

  55,288,458  $6  $254,385  $-  $(279,719) $(25,328)

The accompanying Notes to Consolidated Financial Statements are an integral part of these statements.


CATASYS, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

  

Twelve Months Ended

 

(In thousands)

 

December 31,

 
  

2016

  

2015

 

Operating activities:

        

Net loss

 $(17,936) $(7,223)

Adjustments to reconcile net loss to net cash used in operating activities:

        

Depreciation and amortization

  141   122 

Loss on disposal of intangible assets

  -   88 

Amortization of debt discount and issuance costs included in interest expense

  4,651   2,324 

Loss on debt extinguishment

  2,424   195 

Warrants issued for services

  -   168 

Provision for doubtful accounts

  47   10 

Deferred rent

  (70)  (44)

Share-based compensation expense

  697   1,397 

Common stock issued for consulting services

  235   172 

Fair value adjustment on warrant liability

  (2,093)  (11,665)

Loss on exchange of warrants

  -   4,410 

Fair value adjustment on derivative liability

  5,774   2,761 

Changes in current assets and liabilities:

        

Receivables

  (509)  (111)

Prepaids and other current assets

  155   17 

Deferred revenue

  (158)  1,329 

Accounts payable and other accrued liabilities

  916   882 

Net cash used in operating activities of continuing operations

 $(5,726) $(5,168)
         

Investing activities:

        

Purchases of property and equipment

 $(106) $(107)

Deposits and other assets

  16   - 

Net cash used in investing activities

 $(90) $(107)
         

Financing activities:

        

Proceeds from the issuance of common stock and warrants

 $-  $2,463 

Proceeds from the issuance of convertible debt, related party

  300   5,910 

Payments on convertible debenture

  -   (2,681)

Proceeds from the issuance of senior promissory note, related party

  5,505   - 

Transactions costs

  -   (185)

Capital lease obligations

  (54)  (24)

Net cash provided by financing activities

 $5,751  $5,483 
         

Net increase (decrease) in cash and cash equivalents

 $(65) $208 

Cash and cash equivalents at beginning of period

  916   708 

Cash and cash equivalents at end of period

 $851  $916 
         

Supplemental disclosure of cash paid

        

Interest

 $149  $271 

Income taxes

 $48  $41 

Supplemental disclosure of non-cash activity

        

Common stock issued for exercise of warrants

 $46  $- 

Property and equipment acquired through capital leases and other financing

 $34  $54 

The accompanying Notes to Consolidated Financial Statements are an integral part of these statements.


CATASYS, INC. AND SUBSIDIARIES

Notes to Consolidated Financial Statements

Note 1.2. Summary of Significant Accounting Policies

Description

Basis of Business

We provide data analytics based specialized behavioral health managementPresentation

The accompanying consolidated financial statements include Catasys, Inc. and integrated treatment servicesits variable interest entities (VIE's). The accompanying consolidated financial statements for Catasys, Inc. have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”) and instructions to health plansForm 10-K and Article 10 of Regulation S-X. All intercompany balances and transactions have been eliminated in consolidation.
At December 31, 2019, cash and cash equivalents was $13.6 million and the Company had a working capital of approximately $6.3 million. The Company could continue to incur negative cash flows and operating losses for the next twelve months. The Company expect its current cash resources to cover expenses through ourat least the next twelve months from the date of this report, however, delays in cash collections, revenue, or unforeseen expenditures could impact this estimate.
The Company’s ability to fund ongoing operations is dependent on several factors. The Company aims to increase the number of members that are eligible for its solutions by signing new contracts and identifying more eligible members in existing contracts. Additionally, the Company’s funding is dependent upon the success of management’s plan to increase revenue and control expenses. The Company currently operates its OnTrak solution. Our OnTrak solution is designed to improve member health and at the same time lower costs to the insurer for underserved populations where behavioral health conditions are causing or exacerbating co-existing medical conditions. The program utilizes proprietary analytics, member engagement and patient centric treatment that integrates evidence-based medical and psychosocial interventions along with care coaching in a 52-week outpatient program. Our initial focus was members with substance use disorders, but we have expanded our solution to assist members with anxiety and depression. We currently operate our OnTrak solutions in Florida, Georgia, Illinois, Kansas, Kentucky, Louisiana, Massachusetts, Missouri, New Jersey, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia and Wisconsin. WeNaN states. The Company provide services to commercial (employer funded), managed Medicare Advantage, and managed Medicaid and dueldual eligible (Medicare and Medicaid) populations.

Basis of ConsolidationThe Company generates fees from its launched programs and Presentationexpect to increase enrollment and Going Concern

Our financial statementsfees in the near future.

Certain prior year amounts have been prepared onreclassified for consistency with the basis thatcurrent year presentation.

Management’s Plans
Historically, we willhave seen and continue as a going concern. At December 31, 2016,to see net losses, net loss from operations, negative cash flow from operating activities, and cash equivalents was $851,000 and we had ahistorical working capital deficitdeficits as we continue through a period of approximately $20.7 million. We have incurred significant operating losses and negative cash flows from operations since our inception. During the twelve months December 31, 2016, our cash used in operating activities from continuing operations was $5.7 million. We anticipate that we could continue to incur negative cash flows and net losses for the next twelve months.rapid growth. The accompanying financial statements do not includereflect any adjustments relating to the recoverability of the carrying amount of the recorded assets or the amount of liabilities that might result from the outcome of this uncertainty. As of December 31, 2016, these conditions raised substantial doubt as to our abilityif we were unable to continue as a going concern. We expecthave alleviated substantial doubt by both entering into contracts for additional revenue-generating health plan customers and expanding our OnTrak program within existing health plan customers. To support this increased demand for services, we invested and will
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continue to invest in additional headcount needed to support the anticipated growth. Additional management plans include increasing the outreach pool as well as improving our current enrollment rate. We will continue to explore ways to increase operational efficiencies resulting in increase in margins on both existing and new members.
We have a growing customer base and believe we are able to fully scale our operations to service the contracts and future enrollment providing leverage in these investments that will generate positive cash resourcesflow in the near future. We believe we will have enough capital to cover expenses through March 31, 2017; however delays in cash collections, revenue, or unforeseen expenditures could negatively impact our estimate. We are in need of additional capital, however, there is no assurance that additional capital can be timely raised in an amount which is sufficient for us or on terms favorable to us and our stockholders, if at all. If we do not obtain additional capital, there is a significant doubt as to whether we can continue to operate as a going concernthe foreseeable future and we will needcontinue to curtail or cease operationsmonitor liquidity. If we add more health plans than budgeted, increase the size of the outreach pool by more than we anticipate, decide to invest in new products or seek bankruptcy relief. Ifout additional growth opportunities, we discontinue operations, we may not have sufficient funds to pay any amounts to stockholders.

Our ability to fund our ongoing operations and continue aswould consider financing these options with either a going concern is dependent on increasing the number of members that are eligible for our programs by signing new contracts and generating fees from existing and new contracts and the success of management’s plan to increase revenue and continue to control expenses. We currently operate our OnTrak solutions in Florida, Georgia, Illinois, Kansas, Kentucky, Louisiana, Massachusetts, Missouri, New Jersey, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia and Wisconsin. We provide services to commercial (employer funded), managed Medicare Advantage, and managed Medicaid and duel eligible (Medicare and Medicaid) populations.  We have generated fees from our launched solutions and expect to increase enrollment and fees throughout 2017. However, there can be no assurance that we will generate such feesdebt or that new solutions will launch as we expect.

All inter-company transactions have been eliminated in consolidation.

equity financing.

Use of Estimates

The preparation of financial statements in conformity with generally accepted accounting principles in the United States of America (“U.S. GAAP”)GAAP requires management to make estimates and assumptions that affect the reported amounts in the financial statements and disclosed in the accompanying notes. Significant areas requiring the use of management estimates include expense accruals, accounts receivable allowances, accrued claims payable, the useful life of depreciable and amortizable assets, the evaluation of asset impairment,revenue recognition, the valuation of warrant liabilities, the valuation of derivative liabilites, and shared-based compensation. Actual results could differ from those estimates.


Revenue Recognition

Our Catasys

The Company generates healthcare service revenue from contracts with customers as it satisfies its performance obligations to customers and their members. The healthcare service is transferred to a customer when, or as, the customer obtains control of that service. A performance obligation may be satisfied over time or at a point in time. Revenue from a performance obligation satisfied over time is recognized by measuring progress in a manner that depicts the transfer of services to the customer. Revenue from a performance obligation satisfied at a point in time is recognized at the point in time that the Company determines the customer obtains control over the promised service. The amount of revenue recognized reflects the consideration the Company expects to be entitled to in exchange for those promised services (i.e., the “transaction price”). In determining the transaction price, the Company considers multiple factors, including the effects of variable consideration. Variable consideration is included in the transaction price only to the extent it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainties with respect to the amount are resolved. In determining when to include variable consideration in the transaction price, the Company considers the range of possible outcomes, the predictive value of past experiences, the time period of when uncertainties expect to be resolved and the amount of consideration that is susceptible to factors outside the Company's influence, such as the judgment and actions of third parties.
The Company's contracts are generally designed to provide cash fees to us on a monthly basis, an upfront case rate, or fee for service based on enrolled members. ToThe Company’s performance obligation is satisfied over time as the extent our contracts may includeOnTrak service is provided continuously throughout the service period. The Company recognizes revenue evenly over the service period using a time-based measure because the Company is providing a continuous service to the customer. Contracts with minimum performance guarantee; we reserve a portion of the monthly fees that may be at risk until the performance measurement period is completed. To the extent we receive case ratesguarantees or other fees in advance thatprice concessions include variable consideration and are not subject to the revenue constraint. The Company uses an expected value method to estimate variable consideration for minimum performance guarantees we recognizeand price concessions. The Company has constrained revenue for expected price concessions during the case rate ratably over the twelve months of our program.

year ended December 31, 2019.

Cost of Services

Revenue

Cost of healthcare servicesrevenue consists primarily of salaries related to our care coaches, outreach specialists and other staff directly involved in member care, healthcare provider claims payments, and fees charged by our third party administrators for processing these claims. Salaries and fees charged by our third party administrators for processing claims are expensed when incurred and healthcare provider claims payments are recognized in the period in which an eligible member receives services. We
Cashand CashEquivalents
Cash and cash equivalents consist of highly liquid investments with original maturities of three months or less from the
date of purchase. The Company's cash balance does not contain any cash equivalents.
Commissions
Commissions paid to our sales force and engagement specialists are deferred as these amounts are incremental costs of obtaining a contract with doctorsa customer and licensed behavioral healthcare professionals,are recoverable from future revenue that gave rise to the commissions. Commissions for
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initial contracts and member enrollments are deferred on the consolidated balance sheets and amortized on a fee-for-service basis. We determinestraight-line basis over a period of benefit that a member has received services when we receive a claim or in the absence of a claim, by utilizing member data recorded in the eOnTrakTMdatabase within the contracted timeframe, with all required billing elements correctly completed by the service provider.

been determined to be six years and one year, respectively.

Share-Based Compensation

Our 2010 Stock Incentive Plan, as amended (“the Plan”), provides for the issuance of up to 1,825,000 shares of our common stock. Incentive stock options (ISOs) under Section 422A of the Internal Revenue Code and non-qualified options (NSOs) are authorized under the Plan. We have granted stock options to executive officers, employees, members of our board of directors, and certain outside consultants. The terms and conditions upon which options become exercisable vary among grants, but option rights expire no later than ten years from the date of grant and employee and board of director awards generally vest over three to five years. At December 31, 2016, we had an aggregate of 1,464,089 vested and unvested shares outstanding and 303,674 shares available for future awards.

Total share-based compensation expense attributable to operations were $697,000 and $1.4 million for the years ended December 31, 2016 and 2015, respectively.

Stock Options – Employees and Directors

We measure and recognize

Stock-based compensation expense for all share-based payment awards made to employees and directorsstock options granted is measured based on estimatedthe grant-date fair valuesvalue of the awards and recognized on a straight-line basis over the dateperiod during which the employee is required to perform services in exchange for the award (generally the vesting period of grant. We estimatethe award). The Company estimates the fair value of share-based payment awardsemployee stock options using the Black-Scholes option-pricing model. The value of the portion of the award that is ultimately expected to vest isForfeitures are recognized as expense over the requisite service periods in the consolidated statements of operations.

There were no options granted for the year ended December 31, 2016 and 1.3 million options granted for the year ended December 31, 2015.

they occur.

Stock Options and Warrants – Non-employees

We account

Stock-based compensation for the issuance of stock options and warrants granted to non-employees is measured based on the grant-date fair value of the awards and recognized on a straight-line basis over the period during which the employee is required to perform services in exchange for services from non-employees by estimatingthe award (generally the vesting period of the award). The Company estimates the fair value of employee stock options and warrants issued using the Black-Scholes pricingoption-pricing model. This model’s calculations incorporate the exercise price, the market price of shares on grant date, the weighted average risk-free interest rate, expected life of the option or warrant, expected volatility of our stock and expected dividends.

For options and warrants issued as compensation to non-employees for services that are fully vested and non-forfeitable at the time of issuance, the estimated value is recorded in equity and expensed when the services are performed and benefit is received. For unvested shares, the change in fair value during the period is recognized in expense using the graded vesting method.


From time to time, we have retained terminated employees as part-time consultants upon their departure from the company. Because the employees continue to provide services to us, their options continue to vest in accordance with the original terms. Due to the change in classification of the option awards, the options are considered modified at the date of termination. The modifications are treated as exchanges of the original awards in return for the issuance of new awards. At the date of termination, the unvested options are no longer accounted for as employee awards under FASB’s accounting rules for share-based expense but are instead accounted for as new non-employee awards. The accounting for the portion of the total grants that have already vested and have been previously expensed as equity awards is not changed. There were no employees moved to consulting status for the twelve months ended December 31, 2016. There was one employee moved to consulting status for the twelve months ended December 31, 2015. The employee was 100% vested at the date of termination so no entry was recorded, and the employee is no longer a consultant as of December 31, 2016.

Income Taxes

We account

The Company accounts for income taxes using the liability method, under which deferred tax assets and liabilities are determined based on the future tax consequences attributable to differences between the financial reporting carrying amounts of existing assets and liabilities and their respective tax bases and tax credit carry forwards and net operating loss carryforwards. Deferred tax assets and liabilities are measured using the enacted tax rates that are expected to be in accordance with Accounting Standards Committee (“ASC”) 740 “Income Taxes”.effect when the differences are expected to reverse. To date, no current income tax liability has been recorded due to ourthe Company's accumulated net losses. Deferred
The Company assesses the likelihood that deferred tax assets will be recovered from future taxable income, and liabilities are recognized for temporary differences between the financial statement carrying amounts ofa
valuation allowance is established when necessary to reduce deferred tax assets and liabilities andto the amounts that are reported in the tax returns. Deferred tax assets and liabilities are recorded on a net basis; however, ourmore likely than not expected to
be realized. The Company's net deferred tax assets have been fully reserved by a valuation allowance due to the uncertainty of our ability to realize future taxable income and to recover our net deferred tax assets.

allowance.

Basic and DilutedIncome (Loss)per Share

Basic income (loss)loss per share is computed by dividing the net income (loss)loss to common stockholders for the period by the weighted average number of shares of common stock outstanding during the period. Diluted income (loss)loss per share is computed by dividing the net income (loss)loss for the period by the weighted average number of shares of common stock and dilutive common equivalent shares outstanding during the period.

Common equivalent shares, consisting of approximately 9,344,2145,557,326 and 3,277,7445,370,274 of shares as of December 31, 20162019 and 2015,2018, respectively, issuable upon the exercise of stock options and warrants, have been excluded from the diluted earnings per share calculation because their effect is anti-dilutive.

Cashand CashEquivalents

We consider all highly liquid investments with an original maturity of three months or less to be cash equivalents. Financial instruments that potentially subject us to a concentration of credit risk consist of cash and cash equivalents. Cash is deposited with what we believe are highly credited, quality financial institutions. The deposited cash may exceed Federal Deposit Insurance Corporation (“FDIC”) insured limits. At December 31, 2016, cash and cash equivalents exceeding federally insured limits totaled $676,000.

Fair Value Measurements

Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. Assets and liabilities recorded at fair value in the consolidated balance sheets are categorized based upon the level of judgment associated with the inputs used to measure fair value. The fair value hierarchy distinguishes between (1)market participant assumptions developed based on market data obtained from independent sources (observable inputs) and (2) an entity’s own assumptions about market participant assumptions developed based on the best information available in the circumstances (unobservable inputs). The fair value hierarchy consists of three broad levels, which gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level I) and the lowest priority to unobservable inputs (Level III). The three levels of the fair value hierarchy are described below:

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Level Input:

Input Definition:

Level Input:

Input Definition:
Level I

Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date.

Level II

Inputs, other than quoted prices included in Level I, that are observable for the asset or liability through corroboration with market data at the measurement date.

Level III

Unobservable inputs that reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date.


The following tables summarize fair value measurements by level at December 31, 20162019 and 2015,2018, respectively, for assets and liabilities measured at fair value on a recurring basis:

basis (in thousands):
  Balance at December 31, 2015 
                 

(Amounts in thousands)

 

Level I

  

Level II

  

Level III

  

Total

 

Certificates of deposit

  122   -   -   122 

Total assets

  122   -   -   122 
                 

Warrant liabilities

  -   -   509   509 

Derivative Liability

  -   -   2,348   2,348 

Total liabilities

  -   -   2,857   2,857 

 Balance at December 31, 2016 
                Balance at December 31, 2019

(Amounts in thousands)

 

Level I

  

Level II

  

Level III

  

Total

 

Certificates of deposit

  106   -   -   106 
Level ILevel IILevel IIITotal
Letter of credit1
Letter of credit1
$408  $—  $—  $408  

Total assets

  106   -   -   106 Total assets$408  $—  $—  $408  
                

Warrant liabilities

  -   -   5,307   5,307 Warrant liabilities$—  $—  $691  $691  

Derivative Liability

          8,122   8,122 

Total liabilities

  -   -   13,429   13,429 Total liabilities$—  $—  $691  $691  

1 $408,000 is included in restricted cash, long-term, on our balance sheet as of December 31, 2019.

Balance at December 31, 2018
Level ILevel IILevel IIITotal
Letter of credit2
$479  $—  $—  $479  
Total assets$479  $—  $—  $479  
Warrant liabilities$—  $—  $86  $86  
Total liabilities$—  $—  $86  $86  
2 $71,000 is included in cash and restricted cash and $408,000 is included in restricted cash, long-term, on our balance sheet as of December 31, 2018.

Financial instruments classified as Level III in the fair value hierarchy as of December 31, 2016,2019, represent our liabilities measured at market value on a recurring basis which include warrant liabilities and derivative liabilities resulting from recent debt and equity financings.liabilities. In accordance with current accounting rules, the warrant liabilities and derivative liabilities are being marked-to-market each quarter-end until they are completely settled or expire. The warrants and derivative liabilities are valued using the Black-Scholes option-pricing model, using both observable and unobservable inputs and assumptions consistent with those used in ourthe estimate of fair value of employee stock options. SeeWarrant Liabilities below.



The following table summarizes ourcarrying value of the Senior Secured Notes is estimated to approximate their fair value as the variable interest rate of the Senior Secured Notes approximates the market rate for debt with similar terms and risk characteristics.
The fair value measurements using significant Level III inputs, and changes therein, for the years ended December 31, 20162019 and 2015:

  

Level III

   

Level III

 
  

Warrant

   

Derivative

 

(Dollars in thousands)

 

Liabilities

 

(Dollars in thousands)

 

Liabilities

 

Balance as of December 31, 2014

 $40,585 

Balance as of December 31, 2014

 $- 

Issuance (exercise) of warrants, net

  2,712 Issuance (exercise) of derivatives, net  1,019 

Change in fair value

  (11,665)Change in fair value  2,761 

Exchange of warrants

  (31,123)Debt Modification  (1,432)

Balance as of December 31, 2015

 $509 

Balance as of December 31, 2015

 $2,348 

Issuance (exercise) of warrants, net

  4,821 Issuance (exercise) of derivatives, net  - 

Change in fair value

  (2,093)Change in fair value  5,774 

Warrant Exchanged

  2,070 Debt Modification  - 

Balance as of December 31, 2016

 $5,307 

Balance as of December 31, 2016

 $8,122 

Property and Equipment

Property and equipment2018 are stated at cost, less accumulated depreciation. Additions and improvements to property and equipment are capitalized at cost. Expenditures for maintenance and repairs are charged to expense as incurred. Depreciation is computed using the straight-line method over the estimated useful livesfollows:

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Level III
Warrant
Liabilities
Balance as of December 31, 2017$30 
Issuance of warrants— 
Change in fair value56 
Balance as of December 31, 2018$86 
ASU Adoption APIC Reclassification(86)
Issuance of warrants631 
Change in fair value60 
Balance as of December 31, 2019$691 
Capital Leases

Assets held under capital leases include computer equipment, and are recorded at the lower of the net present value of the minimum lease payments or the fair value of the leased asset at the inception of the lease. Depreciation expense is computed using the straight-line method over the estimated useful lives of the assets. All lease agreements meet at least one of the fourfive requirements of a capital lease in accordance with ASC 840842 of the codification.

Warrant Liabilities

In conjunction with

Variable Interest Entities
Generally, an entity is defined as a Variable Interest Entity (“VIE”) under current accounting rules if it either lacks sufficient equity to finance its activities without additional subordinated financial support, or it is structured such that the Securities Purchase Agreements entered intoholders of the voting rights do not substantively participate in April 2015 (the “April Offering”),the gains and losses of the entity. When determining whether an entity that meets the definition of a business, qualifies for a scope exception from applying VIE guidance, the Company issued five year warrantsconsiders whether: (i) it has participated significantly in the design of the entity, (ii) it has provided more than half of the total financial support to purchasethe entity, and (iii) substantially all of the activities of the VIE are conducted on its behalf. A VIE is consolidated by its primary beneficiary, the party that has the power to direct the activities that most significantly affect the economics of the VIE and has the right to receive benefits or the obligation to absorb losses of the entity that could be potentially significant to the VIE. The primary beneficiary assessment must be re-evaluated on an aggregate of 530,303 shares of our common stock, at an exercise price of $2.00 per share, subject to adjustment, including for issuances of common stock and common stock equivalentsongoing basis.
As discussed under the heading Management Services Agreement (“MSA”) below, the then current conversionCompany has an MSA with a Texas nonprofit health organization (“TIH”) and a California Professional Corporation (“CIH”). Under the MSA’s, the equity owners of TIH and CIH have only a nominal equity investment at risk, and the Company absorbs or exercise price, as the case may be (the “April 2015 Warrants”). The exercise pricereceives a majority of the April 2015 Warrants was subsequently adjustedentity’s expected losses or benefits. The Company participates significantly in the design of these MSA’s. The Company also agrees to $0.30 per share based upon the September Offering. In July 2016, 66,288provide working capital loans to allow for TIH and CIH to fund their day to day obligations. Substantially all of the April 2015 Warrants were exercised via a cashless exercise,activities of TIH and 464,015CIH include its decision making, approval or are conducted for its benefit, as evidenced by the facts that (i) the operations of TIH and CIH are conducted primarily using the Company's licensed network of providers and (ii) under the MSA, the Company agrees to provide and perform all non-medical management and administrative services for the entities. Payment of the April 2015 Warrants remain outstanding asCompany's management fee is subordinate to payments of December 31, 2016.

In May 2015, we entered into the Exchange Agreements whereby 21,277,220 warrants, at an exercise priceobligations of $0.58 per shares, issuedTIH and CIH, and repayment of the working capital loans is not guaranteed by the Company between December 2011equity owner of the affiliated medical group or other third party. Creditors of TIH and May 2014, were exchanged for 21,277,220 shares of common stock (the “Warrant Exchange”). We recognized a $0 and $4.4 million loss relatedCIH do not have recourse to the Warrant Exchange forCompany's general credit.

Based on the years ended December 31, 2016 and 2015, respectively.

In July 2015, we entered into a $3.55 million 12% Original Issue Discount Convertible Debenture due January 18, 2016 (the “July 2015 Convertible Debenture”) with Acuitas Group Holdings, LLC (“Acuitas”), 100% owned by Terren S. Peizer, our Chairman and Chief Executive Officer, and five-year warrants to purchase 935,008 shares of our common stock, at an exercise price of $1.90 per share, subject to adjustment, including for issuances of common stock and common stock equivalents below the then current conversion or exercise price, as the case may be (the “July 2015 Warrants”).


The conversion pricedesign of the July 2015 Convertible Debentureentity and the lack of sufficient equity to finance its activities without additional working capital loans the Company has determined that TIH and CIH are VIE’s. The Company is $1.90 per share, subjectthe primary beneficiary required to adjustments, including for issuances of common stockconsolidate the entities as it has power and common stock equivalents belowpotentially significant interests in the then current conversion or exercise price, asentities. Accordingly, the case may be.  The July 2015 Convertible Debentures are unsecured, bear interest at a rate of 12% per annum payable in cash or shares of common stock, subjectCompany is required to certain conditions, at our option,consolidate the assets, liabilities, revenues and are subject to mandatory prepayment upon the consummation of certain future financings. 

In September 2015, the conversion priceexpenses of the managed treatment centers.

Management Services Agreement
In April 2018, the Company executed an MSA with TIH and in July 2015 Convertible Debenture2018, the Company executed an MSA with CIH. Under the MSA’s, the Company licenses to TIH and CIH the July 2015 Warrants were subsequently adjustedright to $0.30 per share, based upon the Stock Purchase Agreement with Acuitas,use its proprietary treatment programs and related trademarks and provide all required day-to-day business management services, including, but not limited to:
general administrative support services;
information systems;
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recordkeeping;
billing and collection;
obtaining and maintaining all federal, state and local licenses, certifications and regulatory permits.
All clinical matters relating to the saleoperation of TIH and issuanceCIH and the performance of approximately 1.5 million sharesclinical services through the network of Common Stock for gross proceedsproviders shall be the sole and exclusive responsibility of $463,000 (the “September Offering”).

In March 2016, we entered intothe TIH and CIH Board free of any control or direction from the Company.

TIH pays the Company a promissory note with Acuitas Group Holdings, LLC (“Acuitas”), pursuantmonthly fee equal to which we receivedthe aggregate gross proceedsamount of $900,000(a) its costs of providing management services (including reasonable overhead allocated to the delivery of its services and including salaries, rent, equipment, and tenant improvements incurred for the issuancebenefit of the note withmedical group, provided that any capitalized costs will be amortized over a principalfive-year period), (b) 10%-15% of the foregoing costs, and (c) any performance bonus amount, as determined by TIH at its sole discretion. The Company's management fee is subordinate to payment of the entities’ obligations.
CIH pays the Company a monthly fee equal to the aggregate amount of $900,000 (the “March 2016 Promissory Note”). The March 2016 Promissory Note is due within 30 days(a) its costs of demand by Acuitas (the “Maturity Date”)providing management services (including reasonable overhead allocated to the delivery of its services and including salaries, rent, equipment, and tenant improvements incurred for the benefit of the entity, provided that any capitalized costs will be amortized over a five-year period), and carries an interest rate on(b) any unpaid principal amount of 8% per annum untilperformance bonus, as determined by CIH at its sole discretion.
The Company's consolidated balance sheets include the Maturity Date, after which the interest will increase to 12% per annum. In addition, we issued Acuitas five-year warrants to purchase an aggregate of 450,000 shares of our common stock, at an exercise price of $0.47 per share, which warrants include, subject to certain exceptions, a full-ratchet anti-dilution protection (the “March 2016 Warrants”). following assets and liabilities from its VIE's (in thousands):
December 31,
2019
December 31,
2018
Cash and cash equivalents$379  $45  
Accounts receivable564  94  
Prepaid and other current assets26  29  
Total assets$969  $168  
Accounts payable$ $ 
Accrued liabilities100  14  
Deferred revenue73  —  
Intercompany payable685  147  
Total liabilities$867  $168  

Warrant Liabilities
The number of warrants were subsequently increased to 640,909 and the exercise price of the March 2016 Warrants was subsequently reduced to $0.33 per share based upon the May 2016 Promissory Note.

In April 2016, we amended and restated the March 2016 Promissory Note to increase the principal amount by $400,000, for a total of $1.3 million (the “April Promissory Note”). In connection with the amendment, we issued Acuitas five-year warrants to purchase an additional 200,000 shares of our common stock, at an exercise price of $0.47 per share, which warrants include, subject to certain exceptions, a full-ratchet anti-dilution protection (the “April 2016 Warrants”). The number of warrants were subsequently increased to 284,848 and the exercise price of the April 2016 Warrants was subsequently reduced to $0.33 per share based upon the May 2016 Promissory Note.

In May 2016, we amended and restated the April 2016 Promissory Note to increase the principal amount by $405,000, for a total of $1.7 million (the “May Promissory Note”). In connection with the amendment, we issued Acuitas five-year warrants to purchase an additional 306,818 shares of our common stock, at an exercise price of $0.33 per share, which warrants include, subject to certain exceptions, a full-ratchet anti-dilution protection (the “May 2016 Warrants”).

In June 2016, we amended and restated the May 2016 Promissory Note to increase the principal amount by $480,000, for a total of $2.2 million (the “June 2016 Promissory Note”). In connection with the amendment, we issued Acuitas five-year warrants to purchase an additional 363,636 shares of our common stock, at an exercise price of $0.33 per share, which warrants include, subject to certain exceptions, a full-ratchet anti-dilution protection (the “June 2016 Warrants”).

In July 2016, we amended and restated the June 2016 Promissory Note to increase the principal amount by $570,000, for a total of $2.8 million (the “July 2016 Promissory Note”). In connection with the amendment, we issued Acuitas five-year warrants to purchase an additional 431,818 shares of our common stock at an exercise price of $0.33 per share, which warrants include, subject to certain exceptions, a full-ratchet anti-dilution protection (the “July 2016 Warrants”)

In August 2016, we entered into subscription agreements with three accredited investors, including Shamus (collectively, the “Investors”), pursuant to which we issued to the Investors short-term senior promissory notesassumptions used in the aggregate principal amount of $2.8 million (the “August 2016 Notes”) and five-year warrants to purchase up to an aggregate of 875,000 shares of our common stock, at an exercise price of $1.10 per share (the “August 2016 Warrants”).

The August 2016 Warrants include price protection provisions pursuant to which, subject to certain exempt issuances, the then exercise price of the August 2016 Warrants will be adjusted, in the event we issue shares of our common stock for consideration per share less than the then exercise price of the August 2016 Warrants, to the lowest consideration per share for the shares issued or sold in such transaction. The price protection will be in effect until the earliest of (i) the termination date of the August 2016 Warrants, (ii) such timeBlack-Scholes option-pricing model are determined as the Warrants are exercised or (iii) contemporaneously with the listing of our shares of common stock on a registered national securities exchange.

follows:

December 31, 2019December 31, 2018
Volatility98.04 %102.90 %
Risk-free interest rate1.81 %2.63 %
Weighted average expected life (in years)6.251.29
Dividend yield%%

In addition, in August 2016, Acuitas agreed to exchange its July 2016 Promissory Note for a short-term senior promissory note, in the aggregate principal amount of $2.8 million plus accrued interest, in the form substantially identical to the form of the August 2016 Notes. Acuitas also agreed to exchange certain of its outstanding warrants to purchase an aggregate of 2,028,029 shares of our common stock at an exercise price of $0.33 per share for warrants to purchase an aggregate of 2,993,561 shares of common stock at an exercise price of $1.10 per share, in the form substantially identical to the form of the August 2016 Warrants.

       In December 2016, we exchanged the August 2016 Notes issued to the Investors, which had an aggregate outstanding principal amount of $5.6 million, for (i) 8% Convertible Debentures in the same principal amount due on March 15, 2017 (the “Debentures”) and (ii) five-year warrants to purchase shares of the Company’s common stock in amount equal to forty percent (40%) of the initial number of shares of common stock, or 2,022,835 warrants, issuable upon conversion of each Investor’s Debentures, at an exercise price of $1.10 per share (the “December 2016 Warrants”).

 The December 2016 Warrants include a price protection provision pursuant to which, subject to certain exempt issuances, the then exercise price of the December 2016 Warrants will be adjusted if the Company issues shares of common stock at a price that is less than the then exercise price of the December 2016 Warrants. Such price protection provisions will remain in effect until the earliest of (i) the termination date of the December 2016 Warrants, (ii) such time as the December 2016 Warrants are exercised or (iii) contemporaneously with the listing of our shares of common stock on a registered national securities exchange.

       In December 2016, we entered into an agreement with Shamus pursuant to which the Company received gross proceeds of $300,000 for the sale of (i) an 8% Series B Convertible Debenture due March 31, 2017 (the “December 2016 Convertible Debenture”) and (ii) five-year warrants to purchase shares of the Company’s common stock in an amount equal to seventy-five percent (75%) of the initial number of shares of common stock, or 264,706 warrants, issuable upon the conversion of the December 2016 Convertible Debenture, at an exercise price of $0.85 per share (the “Shamus Warrants”).

The Shamus Warrants include price protection provisions pursuant to which, subject to certain exempt issuances, the then exercise price of the Shamus Warrants will be adjusted if the Company issues shares of common stock at a price that is less than the then exercise price of the Shamus Warrants. Such mechanism will remain in effect until the earliest of (i) the termination date of the Shamus Warrants, (ii) such time as the Shamus Warrants are exercised or (iii) contemporaneously with the listing of our shares of common stock on a registered national securities exchange.

       The warrant liabilities were calculated using the Black-Scholes model based on upon the following assumptions:

  

December 31,

2016

  

December 31,

2015

 

Expected volatility

  104.31% 

 

  133.19%  

Risk-free interest rate

 1.20%-1.93%

 

 0.65-1.76% 

Weighted average expected lives in years

 2.25-4.99  0.99-4.29 

Expected dividend

  0% 

 

  0%  

For the years ended December 31, 20162019 and 2015, we recognized a gain of $2.1 million and a gain of $11.7 million, respectively,2018, losses related to the revaluation of our warrant liabilities.

liabilities were $0.1 million, respectively.

Concentration of Credit Risk

F-13

Financial instruments, which potentially subject us to a concentration of risk, include cash, restricted cash and accounts receivable. All of our customers are based in the United States at this time and we are not subject to exchange risk for accounts receivable.


The Company maintains its cash in domestic financial institutions subject to insurance coverage issued by the Federal Deposit Insurance Corporation (FDIC). Under FDIC rules, the company is entitled to aggregate coverage as defined by the Federal regulation per account type per separate legal entity per financial institution. The Company has incurred no losses as a result of any credit risk exposures.

For the year ended December 31, 2016, two2019, 4 customers accounted for approximately 78%85% of revenues and two4 customers accounted for approximately 81%89% of accounts receivable.

For the year ended December 31, 2015, three2018, 4 customers accounted for approximately 82%76% of revenues and three4 customers accounted for approximately 90%88% of accounts receivable.

Derivative Liability


Recently Adopted Accounting Standards
Effective January 1, 2019, the Company adopted Accounting Standards Codification (“ASC”) Topic 842, Leases. Under this guidance, arrangements meeting the definition of a lease are classified as operating or financing leases and are recorded on the consolidated balance sheet as both a right-of-use asset and lease liability, calculated by discounting fixed lease payments over the lease term at the rate implicit in the lease or the Company’s incremental borrowing rate. Lease liabilities are increased by interest and reduced by payments each period, and the right-of-use asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the right-of-use asset result in straight-line rent expense over the lease term. For finance leases, interest on the lease liability and the amortization of the right-of-use asset results in front-loaded expense over the lease term. Variable lease expenses are recorded when incurred.

In calculating the right-of-use asset and lease liability, the Company elected to combine lease and non-lease components. The Company also elected to exclude short-term leases having initial terms of 12 months or less from the new guidance as an accounting policy election and recognizes rent expense on a straight-line basis over the lease term.

In June 2018, the FASB issued ASU 2018-07, Improvements to Nonemployee Share-Based Payment Accounting (“ASU 2018-07”), which supersedes ASC 505-50 and expands the scope of ASC 718 to include all share-based payments arrangements related to the acquisition of goods and services from both employees and nonemployees. For public companies, the amendments are effective for annual reporting periods beginning after December 15, 2018, including interim periods within those annual periods. Early adoption is permitted, but no earlier than a company's adoption date of ASC 606. The adoption of this ASU 2018-07 on January 1, 2019 did not have a material impact on its financial statements.

In July 2015, we2017, the FASB issued ASU 2017-11, Earnings Per Share (Topic 260); Distinguishing Liabilities from Equity (Topic 480); Derivatives and Hedging (Topic 815): (Part I) Accounting for Certain Financial Instruments with Down Round Features, (Part II) Replacement of the Indefinite Deferral for Mandatorily Redeemable Financial Instruments of Certain Nonpublic Entities and Certain Mandatorily Redeemable Noncontrolling Interests with a Scope Exception (“ASU 2017-11”). The amendments in this update are intended to simplify the accounting for certain equity linked financial instruments and embedded features with down round features that result in the strike price being reduced on the basis of the pricing of future equity offerings. Under the new guidance, a down round feature will no longer need to be considered when determining whether certain financial instruments or embedded features should be classified as liabilities or equity instruments. That is, a down round feature will no longer preclude equity classification when assessing whether an instrument or embedded feature is indexed to an entity's own stock. In addition, the amendments clarify existing disclosure requirements for equity-classified instruments. These amendments are effective for fiscal years, and interim periods within those years, beginning after December 15, 2018, with early adoption permitted. The adoption of this ASU 2017-11 on January 1, 2019 did not have a material impact on its financial statements.

Recently Issued Accounting Pronouncements
In August 2018, the FASB issued Accounting Standard Update (“ASU”) No. 2018-13, Fair Value Measurement (Topic 820), which modifies the disclosure requirements on fair value measurements in Topic 820, Fair Value Measurement, including, among
F-14

other changes, the consideration of costs and benefits when evaluating disclosure requirements. For public companies, the amendments are effective for annual reporting periods beginning after December 15, 2019, including interim periods within those annual periods. Early adoption is permitted. We are currently assessing the impact that adopting this new accounting guidance will have on our financial statements and footnote disclosures.
In December 2019, the FASB issued ASU No. 2019-12, "Simplifying the Accounting for Income Taxes" which enhances and simplifies various aspects of income tax accounting guidance. The guidance is effective for the Company in the first quarter of 2021, although early adoption is permitted. The Company is currently evaluating the impact of adoption of ASU 2019-12 on its consolidated financial statements and related footnote disclosures.
In June 2016, the FASB issued Accounting Standards Update No. 2016-13, “Financial Instruments - Credit Losses (Topic 326) - Measurement of Credit Losses on Financial Instruments,” (“ASU 2016-13”). The ASU requires recognition of an estimate of lifetime expected credit losses as an allowance. The Company is currently evaluating the impact of adoption of ASU 2016-13 on its consolidated financial statements and related footnote disclosures.

Note 3. Common Stock
Net loss per share

Basic net loss per share is computed by dividing the net loss by the weighted-average number of shares of common stock outstanding during the period. Diluted net loss per share is computed by giving effect to all potential shares of common stock, preferred stock and outstanding stock options and warrants, to the extent dilutive. Basic and diluted net loss per share was the same for each period presented as the inclusion of all potential shares of common stock outstanding would have been anti-dilutive.

Basic and diluted net loss per share (in thousands, except per share amounts) are as follows:


December 31,December 31,
20192018
Net loss$(25,659) $(14,212) 
Weighted-average shares of common stock outstanding16,418  15,955  
Net loss per share - basic and diluted$(1.56) $(0.89) 



The following common equivalent shares as of December 31, 2019 and 2018, respectively, issuable upon the exercise of stock options and warrants have been excluded from the diluted earnings per share calculation as their effect is anti-dilutive:

December 31,December 31,
20192018
Warrants to purchase common stock1,550,975  1,608,996  
Options to purchase4,006,351  3,761,278  
Total shares excluded from net loss per share5,557,326  5,370,274  

Note 4. Debt
2024 Notes

In September 2019, the Company entered into a $3.55Note Agreement dated September 24, 2019 (the “Note Agreement”) with certain subsidiaries of the Company party thereto as guarantors, Goldman Sachs Specialty Lending Holdings, Inc. and any other purchasers party thereto from time to time (collectively, the “Holders”). Under the Note Agreement, the Company initially issued
F-15

$35.0 million 12% Original Issue Discount Convertible Debentureaggregate principal amount of senior secured notes (the "2024 Notes"), which bear interest at either a floating rate plus an applicable margin in the case of 2024 Notes subject to cash interest payments or a floating rate plus a slightly higher applicable margin in the case of 2024 Notes as to which current interest has been accrued during the period ending September 24, 2020, which resulted in interest rate of 15.75% for the year-ended December 31, 2019. The applicable margins are subject to stepdowns, in each case, following the achievement of certain financial ratios. The Company has elected for the $35 million in aggregate principal amount of 2024 Notes issued on the date of the Note Agreement that such interest shall be payable in cash. The Holder is obligated to purchase up to an additional $10.0 million in principal amount of 2024 Notes during the period from the date of the Note Agreement until the second anniversary thereof. The entire principal amount of the 2024 Notes is due January 18, 2016and payable on the fifth anniversary of the Note Agreement unless earlier redeemed upon the occurrence of certain mandatory prepayment events, including with Acuitasthe proceeds of equity or debt issuances, 50% of excess cash flow, asset sales and the amount by which total debt exceeds an applicable leverage multiple.

The Note Agreement contains customary covenants, including, among others, covenants that restrict the Company’s ability to incur debt, grant liens, make certain investments and acquisitions, pay dividends, repurchase equity interests, repay certain debt, amend certain contracts, enter into affiliate transactions and asset sales or make certain equity issuances, and covenants that require the Company to, among other things, provide annual, quarterly and monthly financial statements, together with related compliance certificates, maintain its property in good repair, maintain insurance and comply with applicable laws. The Note Agreement also includes covenants with respect to the Company’s maintenance of certain financial ratios, including a fixed charge coverage ratio, leverage ratio and consolidated liquidity as well as minimum levels of consolidated adjusted EBITDA and revenue. The Note Agreement also contains customary events of default, including, among others, payment default, bankruptcy events, cross-default, breaches of covenants and representations and warranties, change of control, judgment defaults and an ownership change within the meaning of Section 382 of the Internal Revenue Code. In the case of an event of default, the Holder may, among other remedies, accelerate the payment of all obligations under the 2024 Notes and all assets of the Company serves as collateral. Any prepayment of the 2024 Notes or reduction of the purchase commitments made on or prior to the second anniversary of the Closing Date must be accompanied by a yield maintenance premium and on or prior to the third anniversary of the Closing Date must be accompanied by a prepayment premium.

In accounting for the issuance of the 2024 Notes, the Company separated the 2024 Notes into liability and equity components. The fair value of the liability component was estimated using an interest rate for debt with terms similar to the 2024 Notes. The carrying amount of the equity component was calculated by measuring the fair value based on the Black-Scholes model. The gross proceeds from the transaction was allocated between liability and equity based on the proportionate value. The debt discount is accreted to interest expense over the term of the 2024 Notes using the interest method. The equity component is not re-measured as long as it continues to meet the conditions for equity classification.
The assumptions used in the Black-Scholes option-pricing model are determined as follows:


December 31, 2019
Volatility98.01 %
Risk-free interest rate1.58 %
Expected life (in years)7
Dividend yield%


The Company is in compliance with all debt covenants at December 31, 2019.

2022 Loan

In June 2018, the Company entered into a venture loan and security agreement (the “July 2015 Convertible Debenture”“2022 Loan”) with Horizon Technology Finance Corporation (“Horizon”), which provides for up to $7.5 million in loans to the Company. In addition, in June 2018, the Company entered into a loan and security agreement (the “A/R Facility”) in connection with a $2.5 million receivables financing facility with Corporate Finance, a division of Heritage Bank of Commerce (“Heritage”). The conversion priceCompany borrowed and subsequently repaid $1.9 million on the A/R Facility during the six months ended June 30, 2019.

In March 2019, the Company entered into an amended and restated 2022 Loan with Horizon, which provides for up to $15.0 million in loans to the Company, including initial term loans in the amount of $7.5 million previously funded under the
F-16

original agreement and an additional up to $7.5 million loan in three revolving tranches of $2.5 million in availability, subject to the Company's achievement of trailing three month billings exceeding $5.0 million, $7.0 million and $8.0 million, respectively (collectively, the “Billing Requirements”). An initial advance of $2.5 million was funded upon the execution and delivery of the July 2015 Convertible Debenture is $1.90 per share,Amended Loan Agreement, subject to adjustments, including for issuances of common stock and common stock equivalents belowrepayment if the then current conversion or exercise price, as the case may be.  In October 2015, weforegoing $5.0 million threshold is not reached by July 1, 2019. The Company concurrently entered into an amendment to the previously disclosed $2.5 million A/R Facility with Heritage intended primarily to reflect the amendment and restatement of the July 2015 Convertible Debenture which extended the maturity dateAmended Loan Agreement. The Company have met all three of the July 2015 Convertible Debenture from JanuaryBilling Requirements and as a result have incurred the full $7.5 million under the Amended Loan Agreement. In connection with our entry into the Amended Loan Agreement, the Company issued Horizon 40,279 seven-year warrants to purchase an aggregate of $600,000 (depending on the level of availability under the Amended Loan Agreement) at the trailing volume weighted average price (“VWAP”) of our common stock on the NASDAQ Capital Market for the five days preceding the relative dates of grants at a per share exercise price equal to the lower of (i) $9.93 or (ii) the price per share of any securities that may be issued by us in an equity financing during the 18 2016 to January 18, 2017. In addition,months following the conversion price of the July 2015 Convertible Debenture was subsequently adjusted to $0.30 per share. agreement date.

The July 2015 Convertible Debenture is unsecured,2022 Loan bears interest at a floating coupon rate of 12% per annum payablethe amount by which one-month LIBOR exceeds 2.00% plus 9.75%. After September 30, 2020, upon the earlier of (i) payment in cashfull of the principal balance of the 2022 Loan, (ii) an event of default and demand by Lender of payment in full or (iii) on the Loan Maturity Date (September 30, 2022), as applicable, the Company shall pay to Lender a payment equal to the greater of $150,000 or 6% of the outstanding principal balance on August 31, 2020.

Upon the issuance of the 2024 Notes, the balance of the 2022 Loan was repaid and terminated. As part of the termination, the Company incurred $1.1 million of early termination costs and wrote off deferred debt issuance costs of $1.5 million, which has been recorded in other income/(expense) in the consolidated statement of operations.

2024 Notes and 2022 Loan

The 2024 Notes and 2022 Loan consist of the following (in thousands):

December 31,December 31,
Liability component20192018
Principal$36,502  $7,950  
Less: debt discount(4,905) (478) 
Net carrying amount$31,597  $7,472  

The following table sets forth total interest expense recognized related to the 2024 Notes and 2022 Loan (in thousands):
December 31,December 31,
20192018
Contractual interest expense$2,653  $388  
Accretion of debt discount394  182  
Total$3,047  $570  

Note 5. Stock Based Compensation
Our 2017 Stock Incentive Plan (the “2017 Plan”) and 2010 Stock Incentive Plan (the “2010 Plan”) provides for the issuance of 4,530,071 shares of our common stock. We have granted stock subjectoptions to executive officers, employees, members of our board of directors, and certain outside consultants. The terms and conditions at ourupon which options become exercisable vary among grants; however, option rights expire no later than ten years from the date of grant and is subjectemployee and Board of Director awards generally vest over three to mandatory prepayment uponfive years on a straight-line basis. As of December 31, 2019, we had 4,006,351 vested and unvested stock options outstanding and 328,369 shares reserved for future awards.
Share-based compensation expense was approximately $5.2 million and $2.1 million for the consummationyears ended December 31, 2019 and 2018, respectively.
F-17

The derivative liability associated with the July 2015 Convertible Debenture was calculated usingassumptions used in the Black-Scholes option-pricing model based upon the following assumptions:

are determined as follows:
  

December31,

2016

  

December 31,

2015

 

Expected volatility

  104.31

%

  133.19%

Risk-free interest rate

  0.44

%

  0.23%

Weighted average expected lives in years

  0.05   1.05 

Expected dividend

  0

%

  0%

December 31, 2019December 31, 2018
Volatility100.34 %100.34% - 102.90
Risk-free interest rate1.63%-2.60%2.56% - 2.85%
Expected life (in years)2.85-6.082.4 - 6.08
Dividend yield%%
The expected volatility assumption for the twelve months ended December 31, 2016 wasassumptions have been based on the historical and expected volatility of our stock, measured over a period generally commensurate with the expected term. The weighted average expected lives in yearsoption term for 2016 reflectthe year ended December 31, 2019, reflects the application of the simplified method set outprescribed in SecuritySecurities and Exchange Commission (SEC)(“SEC”) Staff Accounting Bulletin (SAB)(“SAB”) No. 107 (and as(as amended by SAB 110), which defines the life as the average of the contractual term of the options and the weighted average vesting period for all option tranches. We use historical data
Stock Options – Employees and Directors
A summary of stock option activity for employee and director grants is as follows:
Number of
Shares Outstanding
Weighted-
Average
Exercise Price
Balance, December 31, 20171,885,383  $11.46  
Stock options granted1,985,539  7.70  
Stock options forfeited and canceled(109,644) 14.29  
Balance, December 31, 20183,761,278  $9.44  
Exercisable at December 31, 2018721,766  $17.14  
Stock options granted1,459,289  14.18  
Stock options exercised(195,351) 9.69  
Stock options forfeited and canceled(1,068,865) 10.36  
Balance at December 31, 20193,956,351  $10.93  
Exercisable at December 31, 20191,062,178  $11.24  

Share-based compensation expense relating to estimate the rate of forfeitures assumption for awardsstock options granted to employees.

For the twelve months ended December 31, 2016employees and 2015, we recognized a loss of $5.8directors was $5.1 million and $2.8$2.1 million related to the revaluation of our derivative liability, respectively.

Recently Issued or Newly Adopted Accounting Pronouncements

In April 2016, the FASB issued Accounting Standards Update (“ASU”) 2016-10,Revenue from Contracts with Customers (Topic 606), which amends certain aspects of the Board’s new revenue standard, ASU 2014-09, Revenue from Contracts with Customers. The standard should be adopted concurrently with adoption of ASU 2014-09, which is effective for annual and interim periods beginning after December 15, 2017. Early adoption is permitted. The Company has not yet selected a transition method nor has it determined the effect of the standard on its ongoing financial reporting.

In March 2016, the FASB issued ASU 2016-09, Compensation — Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting(“ASU 2016-09”), which outlines new provisions intended to simplify various aspects related to accounting for share-based payments and their presentation in the financial statements. The standard is effective for the Company for fiscal years beginning after December 15, 2016, and interim periods within those annual periods. Early adoption is permitted. The adoption of ASU 2016-09 did not have a material effect on our consolidated financial positon or results of operations.


In February 2015, the FASB issued ASU,Consolidation (Topic 810): Amendments to the Consolidation Analysis (“ASU 2015-02”). ASU 2015-02 modifies existing consolidation guidance for reporting organizations that are required to evaluate whether they should consolidate certain legal entities. ASU 2015-02 is effective for fiscal years and interim periods within those years beginning after December 15, 2015, and requires either a retrospective or a modified retrospective approach to adoptions. Early adoption is permitted. The adoption of ASU 2015-02 did not have a material effect on our consolidated financial position or results of operations.

In August 2014, the FASB issued FASB ASU 2014-15,Presentation of Financial Statements—Going Concern (Subtopic 205-40): Disclosure of Uncertainties about an Entity’s Ability to Continue as a Going Concern(“ASU 2014-15”).ASU 2014-15 changes the disclosure of uncertainties about an entity’s ability to continue as a going concern. Under U.S. GAAP, continuation of a reporting entity as a going concern is presumed as the basis for preparing financial statements unless and until the entity’s liquidation becomes imminent. Even if an entity’s liquidation is not imminent, there may be conditions or events that raise substantial doubt about the entity’s ability to continue as a going concern. Because there is no guidance in U.S. GAAP about management’s responsibility to evaluate whether there is substantial doubt about an entity’s ability to continue as a going concern or to provide related note disclosures, there is diversity in practice whether, when, and how an entity discloses the relevant conditions and events in its financial statements. As a result, these changes require an entity’s management to evaluate whether there are conditions or events, considered in the aggregate, that raise substantial doubt about the entity’s ability to continue as a going concern within one year after the date that financial statements are issued. Substantial doubt is defined as an indication that it is probable that an entity will be unable to meet its obligations as they become due within one year after the date that financial statements are issued. If management has concluded that substantial doubt exists, then the following disclosures should be made in the financial statements: (i) principal conditions or events that raised the substantial doubt, (ii) management’s evaluation of the significance of those conditions or events in relation to the entity’s ability to meet its obligations, (iii) management’s plans that alleviated the initial substantial doubt or, if substantial doubt was not alleviated, management’s plans that are intended to at least mitigate the conditions or events that raise substantial doubt, and (iv) if the latter in (iii) is disclosed, an explicit statement that there is substantial doubt about the entity’s ability to continue as a going concern. ASU 2014-15 is effective for periods beginning after December 15, 2016. The adoption of ASU 2014-15 did not have a material effect on our consolidated financial position or results of operations.

Note 2. Accounts Receivable

Accounts receivables consisted of the following as of December 31, 2016 and 2015:

  

December 31,

 

(in thousands)

 

2016

  

2015

 

Healthcare fees

 $1,050  $587 

Other

  2   3 

Total receivables

 $1,052  $590 

Less allowance for doubtful accounts

  -   - 

Total receivables, net

 $1,052  $590 

We use the specific identification method for recording the provision for doubtful accounts, which was $0 as of December 31, 2016 and 2015.


Note3. Property and Equipment

Property and equipment consisted of the following as of December 31, 2016 and 2015:

(in thousands)

 

2016

  

2015

 

Furniture and equipment

 $1,712  $1,585 

Leasehold improvements

  318   318 

Total property and equipment

  2,030   1,903 

Less accumulated depreciation and amortization

  (1,620)  (1,491)

Total property and equipment, net

 $410  $412 

Depreciation expense was $141,000 and $110,000 for the years ended December 31, 20162019 and 2015,2018, respectively.

As of December 31, 2019, there was $18.0 million of unrecognized compensation costs related to non-vested share-based compensation arrangements granted to employees and directors under the Plan. These costs are expected to be recognized over a weighted-average period of 2.67 years.

Stock Options and Warrants – Non-employees
The Company issued 50,000 stock options to consultants as of December 31, 2019 at a weighted average exercise price of $9.93. Stock option expense related to consultants was $0.1 million for the year ended December 31, 2019.
In addition to stock options granted under the Plan, we have also granted warrants to purchase common stock to certain non-employees that have been approved by our Board of Directors.
A summary of warrants granted to non-employees outstanding as of December 31, 2019 and 2018 is as follows:
F-18

Number of
Warrants Outstanding
Weighted-
Average
Exercise Price
Warrants issued in connection with debt agreements224,440  $16.04  
Warrants issued for services4,167  13.82  
Balance at December 31, 2019228,607  $16.00  

Number of Warrants OutstandingWeighted-
Average
Exercise Price
Warrants issued in connection with debt agreements9,720  $7.72  
Warrants issued for services24,000  4.68  
Balance at December 31, 201833,720  $5.56  

A summary of warrant activity for the years ended December 31, 2019 and 2018 is as follows:
Number of
Warrants Outstanding
Weighted-
Average
Exercise Price
Balance at December 31, 20172,011,528  $4.85  
Warrants granted33,720  5.56  
Warrants exercised(436,252) (4.70) 
Balance at December 31, 20181,608,996  $4.71  
Warrants granted228,607  16.00  
Warrants exercised(232,461) (4.85) 
Warrants expired(54,167) (12.46) 
Balance at December 31, 20191,550,975  $6.08  


Performance-Basedand Market-BasedAwards
The Company’s Compensation Committee designed a compensation structure to align the compensation levels of certain executives to the performance of the Company through the issuance of performance-based and market-based stock options. The performance-based options vest upon the Company meeting certain revenue targets and the total amount of compensation expense recognized is based on the number of shares that the Company determines are probable of vesting. The market-based options vest
F-19

upon the Company’s stock price reaching a certain price at a specific performance period and the total amount of compensation expense recognized is based on a Monte Carlo simulation that factors in the probability of the award vesting.
Issuances under this structure are as follows:
Grant DatePerformance MeasuresVesting TermPerformance Period# of SharesExercise Price
December 2017Weighted Average Price of our common stock is $15.00 for at least twenty trading days within a period of thirty consecutive trading days ending on the trading day prior to January 1, 2023.Fully vest on January 1, 2023January 1, 2023642,307  $7.50  
August 2018Weighted Average Price of our common stock is $15.00 for at least twenty trading days within a period of thirty consecutive trading days ending on the trading day prior to January 1, 2023.Fully vest on January 1, 2023January 1, 2023397,693  $7.50  
April 2018The Options will be divided into five equal tranches and Performance Targets to be established by Board of Directors for each tranche at the beginning of the fiscal yearAmended and vested 115,950 options based on severance agreementAmended and vested 115,950 options based on severance agreement115,950  $7.50  
August 2018The Options will be divided into five equal tranches and Performance Targets to be established by Board of Directors for each tranche at the beginning of the fiscal yearAmended and fully forfeited based on severance agreementAmended and fully forfeited based on severance agreement—  $7.50  
During the quarter ended September 30, 2019, the Company determined that it is not probable to achieve its internal performance targets for the tranche issued for the fiscal year 2019, resulting the reversal of the compensation expense recognized previously for the shares that did not vest.
During the quarter ended December 31, 2019, the company entered into a separation agreement with a key executive as part of restructuring the organization. As part of the agreement, 115,950 of previously forfeited awards were immediately vested. As a result, $1.1 million of stock compensation expense was recorded during the quarter and has been classified in operating expenses' within the consolidated statement of operations. The remaining awards has been forfeited.
Note 4. 6. Leases
Operating leases
In September 2018, the Company signed an operating lease for the new corporate headquarters in Santa Monica, CA (“Santa Monica Headquarters”). The lease agreement includes 7,869 square feet for 60 months commencing in July 2019, which is 30 days following date the premises were ready for occupancy. The base annual rent is approximately $0.6 million subject to annual adjustments.
The Company’s lease liability resulted from the lease of the Santa Monica Headquarters which expires in 2024. This lease does not require any contingent rental payments, impose any financial restrictions, or contain any residual value guarantees. The lease includes renewal options and escalation clauses; renewal options have not been included in the calculation of the lease liability and right-of-use asset as the Company is not reasonably certain to exercise the options. Variable expenses generally represent the Company’s share of the landlord’s operating expenses. The Company does not act as a lessor or have any leases classified as financing leases. The discount rate used in measuring the lease liability and right of use assets were determined by reviewing our incremental borrowing rate at the measurement date.

As of December 31, 2019, the Company has an operating lease liability of approximately $2.2 million and right-of-use asset of approximately $2.4 million, which are included in the consolidated balance sheets.
F-20

As of December 31, 2019, supplemental information related to operating leases was as follows (in thousands):

Consolidated Statement of OperationsOperating
Leases 
Operating lease expense$443 
Short-term lease rent expense58 
Total rent expense$501 
Consolidated Statements of Cash Flows
Operating cash flows from operating leases$381 
Right-of-use assets obtained in exchange for lease obligations$2,574 
Other Information
Weighted-average remaining lease term4.5 years
Weighted-average discount rate10.15 %

As of December 31, 2019, the future minimum lease payments under operating leases are as follows (in thousands):
Operating
Leases 
 
2020$581  
2021603  
2022623  
2023644  
2024329  
Total lease payments$2,780  
Less: imputed interest(570) 
Present value of lease liabilities$2,210  
Less: current portion(374) 
Lease liabilities, non-current$1,836  

Total rent expense under operating leases was approximately $0.4 million and $0.3 million for the years ended December 31, 2019 and 2018, respectively.

Capital Lease Obligations

Weleases

The Company entered into agreements to lease certain computer equipment under agreements entered into during 2016 that are classified as capital leases.the year ended December 31, 2019. The computer equipment under capital leases is included in furniture and equipment on ourright of use asset within the consolidated balance sheets and was $103,000 and $110,000$0.4 million as of December 31, 2019. Lease amortization at December 31, 2016 and 2015, respectively. Accumulated depreciation2019 was approximately $0.1 million.
F-21

As of December 31, 2016 and 2015 was approximately $47,000 and $43,000, respectively.

The2019, the future minimum lease payments required under the capital leases and the present values of the net minimum lease paymentsare as of December 31, 2016, is as follows:

follows (in thousands):

(in thousands)

 

Amount

 

Year ending December 31,

    

2017

 $46 

2018

  34 

2019

  2 

Total minimum lease payments

  82 

Less amounts representing interest

  (11)

Capital lease obligations, net of interest

  71 

Less current maturities of capital lease obligations

  (40)

Long-term capital lease obligations

 $31 
Capital
Leases 
Total lease payments$406 
Less: interest(28)
Present value of lease liabilities$378 
Less: current portion(145)
Lease liabilities, non-current$233 


Note 5. 7. Income Taxes

As of December 31, 2016,2019, the Company had net federal operating loss carry forwards and state operating loss carry forwards of approximately $222$277 million and $170$39 million, respectively.  The net federal operating loss carry forwards begin to expire in 2024,2023, and net state operating loss carry forwards begin to expire in 2016. The majority2019.
Due to such uncertainties surrounding the realization of the foreign net operating loss carry forwards expire over the next seven years.

The primary components of temporary differences which give rise to our net deferred tax assets, the Company maintains a valuation allowance of $70.1 million and $64.1 million against all of its deferred tax assets as of December 31, 2019 and 2018, respectively. For the years ended December 31, 2019 and 2018, the total change in valuation allowance was $6.0 million and $1.7 million, respectively. Realization of the deferred tax assets will be primarily dependent upon the Company's ability to generate sufficient taxable income.

Net deferred tax assets and liabilities for the years ended December 31, 2019 and 2018 are as follows:

  

2016

  

2015

 

(in thousands)

        

Federal, state and foreign net operating losses

 $78,466  $78,474 

Stock based compensation

  7,429   7,879 

Accrued liabilities

  664   585 

Other temporary differences

  4,894   3,045 

Valuation allowance

  (91,453)  (89,983)
  $-  $- 

follows (in thousands):

20192018
Net operating losses$66,405  $62,800  
Stock-based compensation1,648  873  
Interest expense1,494  —  
Accrued liabilities and reserves744  218  
Fixed assets51  72  
Lease liability658  —  
Other temporary differences23  315  
Prepaid expenses(186) (176) 
Right-of-use asset(710) —  
Valuation allowance(70,127) (64,102) 
Net deferred tax asset$—  $—  

The Company has provided a valuation allowance in full on its net deferred tax assets in accordance with ASC 740 Income Taxes. Because of the Company's continued losses, management assessed the realizability of its net deferred tax assets as being less than the more-likely-than-not criteria set forth by ASC 740. Furthermore, certain portions of the Company's net operating loss carryforwards were acquired, and therefore subject to further limitation set forth under the federal tax code, which could further limit the Company's ability to realize its deferred tax assets.

A reconciliation between the statutory federal income tax rate and the effective income tax rate for the years ended December 31, 2019 and 2018 is as follows

follows:
  

2016

  

2015

 

Federal statutory rate

  -34.0%  -34.0%

State taxes, net of federal benefit

  26.2%  16.8%

Non-deductible goodwill

  0.0%  0.0%

ISO / ESPP

  0.2%  2.1%

Other

  -0.5%  -27.0%

Change in valuation allowance

  8.0%  42.1%

Tax provision

  -0.1%  0.0%
F-22

Current accounting rules require that companies recognize in the consolidated financial statements the impact


20192018
Tax at federal statutory rate21.0 %21.0 %
Stock-based compensation(1.2)%(29.3)%
Deferred revenue— %(2.8)%
Change in Foreign NOLS due to liquidation— %(8.3)%
Other(0.2)%3.3 %
Change in federal valuation allowance(19.6)%16.1 %
Change in federal NOLs due to 382 study results— %— %
Tax provision— %— %

The Company has adopted guidance issued by the FASB that clarifies the accounting for uncertainty in income taxes recognized in an enterprise's financial statements and prescribes a recognition threshold of more likely than not and a measurement process for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. In making this assessment, a company must determine whether it is more likely than not that a tax position will be sustained upon examination, based solely on the technical merits of the position and must assume that the tax position will be examined by taxing authorities. Our policy is to include interest and penalties related to unrecognized tax benefits in income tax expense. There were no0 interest and penalties for the years ended December 31, 20162019 and 2015,2018, respectively. The Company files income tax returns with the Internal Revenue Service (“IRS”) and the state of California.various states with sufficient nexus. For jurisdictions in which tax filings are prepared, the Company is no longer subject to income tax examinations by state tax authorities for tax years through 2010,prior to 2014, and by the IRS for tax years through 2011.2016. The Company’s net operating loss carryforwards are subject to IRS examination until they are fully utilized and such tax years are closed.

Note6. Equity Financings

In October 2015, we entered into Stock Purchase Agreements (the “Purchase Agreements”) with eachThere are currently no income tax audits in any jurisdictions for open tax years and, as of Acuitas, Shamus, and Steve Gorlin, pursuantDecember 31, 2019, there have been no material changes to which the Company received gross proceeds of $2.0 million for the sale of approximately 6.7 million shares of the Company’s common stock, at a purchase price of $0.30 per share.

In September 2015, we entered into a Stock Purchase Agreement with Acuitas, relating to the sale and issuance of approximately 1.5 million shares of common stock for gross proceeds of $463,000 (the “September Offering”). In May 2015, we entered into the Exchange Agreements whereby 21,277,220 warrants, at an exercise price of $0.58 per shares, issued by the Company between December 2011 and May 2014, were exchanged for 21,277,220 shares of common stock to eliminate the liability associated with these warrants.

our tax positions. 

Note 7. Share-based Compensation

The Plan provides for the issuance of up to 1,825,000 shares of our common stock. Incentive stock options, underUnder Section 422A382 of the Internal Revenue Code non-qualified options, stock appreciation rights, limited stock appreciation rightsof 1986, as amended, or the IRC, substantial changes in our ownership may limit the amount of net operating loss and restricted stock grants are authorized underresearch and development income tax credit carryforwards that could be utilized annually in the Plan.We grant allfuture to offset taxable income. Specifically, this limitation may arise in the event of a cumulative change in ownership of the company of more than 50% within a three-year testing period. Any such share-based compensation awards at no less thanannual limitation may significantly reduce the fair market valueutilization of ourthe net operating loss carryforwards before they expire.

Since the Company's formation, the Company has raised capital through the issuance of capital stock on several occasions which, may have resulted in such an ownership change, or could result in an ownership change in the date of grant, and have granted stock and stock optionsfuture upon subsequent disposition. The Company intends to executive officers, employees, members of our Board of Directors and certain outside consultants. The terms and conditions upon which options become exercisable vary among grants; however, option rights expire no later than ten years fromcomplete a study in the date of grant and employee and Board of Director awards generally vest over threefuture to five years on a straight-line basis. At December 31, 2016, we had 1,464,089 vested and unvested stock options outstanding and 303,674 shares reserved for future awards. Total share-based compensation expense amounted to $697,000 million and $1.4 million for the years ended December 31, 2016 and 2015, respectively.

Stock Options – Employees and Directors

There were no options issued to employeesassess whether an ownership change has occurred or directors during 2016.

There were 250,000 options issued to employees during 2015.

For the twelve months ended December 31, 2015, we granted 1,050,000 to our non-employee directors.

Stock option activity for employee and director grants is summarized as follows:

      

Weighted Avg.

 
  

Shares

  

Exercise Price

 

Balance, December 31, 2014

  378,000  $19.59 
         

2015

        

Granted

  1,300,000   2.20 

Cancelled/Expired

  (207,000)  3.29 

Balance, December 31, 2015

  1,471,000  $6.51 
         

2016

        

Granted

  -   - 

Cancelled/Expired

  (7,000)  11.31 

Balance, December 31, 2016

  1,464,000  $6.49 

The weighted average remaining contractual life and weighted average exercise price of options outstanding as of December 31, 2016 were as follows:

     

Options Outstanding

  

Options Exercisable

 
                 

Range of Exercise Prices

  

Shares

  

Weighted

Average

Remaining

Life (yrs)

  

Weighted

Average

Price

  

Shares

  

Weighted

Average

Price

 
$0.00to$20.00   1,455,000   7.07  $5.48   1,293,000  $5.89 
$20.01to$1,000.00   9,000   2.03   158.98   9,000   158.98 
                        
      1,464,000   7.04  $6.46   1,302,000  $6.99 

Share-based compensation expense relating to stock options granted to employees and directors was $697,000 and $1.4 million for the years ended December 31, 2016 and 2015, respectively.


As of December 31, 2016,whether there was $318,000 of unrecognized compensation costs related to non-vested share-based compensation arrangements granted to employees and directors under the Plan. These costs are expected to be recognized over a weighted-average period of 1.3 years.

Stock Options and Warrants – Non-employees

In addition to stock options granted under the Plan, we have also granted options and warrants to purchase our common stock to certain non-employees that have been approved by our Board of Directors. There were nomultiple ownership changes since the Company's formation.


Note 8. Commitments and Contingencies
The Company has various non-cancelable operating leases for its offices and its managed hosting facilities and services. These leases expire at various times through 2025. Certain lease agreements contain renewal options, granted during 2016rent abatement and 2015, respectively.

Warrantsgranted to non-employees outstanding as of December 31, 2016 and 2015, respectively, are summarized as follows:

December 31, 2016

        

Description

 

Shares

  

Weighted

Average

Exercise

Price

 

Warrants issued in connection with equity offering

  -  $- 

Warrants issued in connection with debt agreement

  6,156,102   0.85 

Warrants issued for services

  -   - 
   6,156,102  $0.85 

December 31, 2015

        

Description

 

Shares

  

Weighted

Average

Exercise

Price

 

Warrants issued in connection with equity offering

  -  $- 

Warrants issued in connection with debt agreement

  1,465,311   0.30 

Warrants issued for services

  341,251   2.16 
   1,806,562  $0.65 

There were no warrants to purchase common stock issued for consulting services for the twelve months ended December 31, 2016. There were 300,000 warrants to purchase common stock issued for investor relations services for the twelve months ended December 31, 2015.

Share-based compensation expense relating to stock options and warrants granted to non-employees amounted to $0 and $3,000 for the years ended December 31, 2016 and 2015, respectively.

Common Stock

In October 2015, we issued 200,000 common shares in connection with the April Offering.

In May 2015, we entered into the Exchange Agreements whereby 21,277,220 warrants, at an exercise price of $0.58 per shares, issued by theescalation clauses. The Company between December 2011 and May 2014, were exchanged for 21,277,220 shares of common stock to eliminate the liability associated with these warrants.

During 2016 and 2015, we issued 235,000 and 76,000 shares of common stock, respectively, for consulting services valued at $235,000 and $172,000, respectively. Generally, the costs associated with shares issued for services are being amortized to the relatedrecognizes rent expense on a straight-line basis over the related service periods.


Employee Stock Purchase Plan

Our qualified employee stock purchase plan (ESPP), approved by our Board of Directors and shareholders and adopted in June 2006, provides that eligible employees (employed at least 90 days) havelease term, commencing when the option to purchase shares of our common stock at a price equal to 85%Company takes possession of the lesserproperty. Certain of the fair market valueCompany’s office leases entitle the Company to receive a tenant allowance from the landlord. The Company records tenant allowances as a deferred rent credit, which the Company amortizes on a straight-line basis, as a reduction of rent expense, over the term of the first day or the last day of each offering period. Purchase options are granted semi-annuallyunderlying lease. Total rent expense under operating leases was approximately $0.4 million and are limited to the number of whole shares that can be purchased by an amount equal to up to 10% of a participant’s annual base salary. As of December 31, 2016, there were no shares of our common stock issued pursuant to the ESPP. There was no share-based compensation expense relating to the ESPP$0.3 million for the years ended December 31, 20162019 and 2015,2018, respectively.

Note8. Commitments and Contingencies

Operating Lease Commitments

We incurred rent expense of approximately $296,000 and $294,000 The Company entered into financing agreements for the years ended December 31, 2016 and 2015, respectively.

��

Our principal executive and administrative offices are located in Los Angeles, California and consist of leasedoffice space totaling approximately 9,120 square feet. The initial term of the lease expires in April 2019. Our base rentcomputer equipment for $0.4 million. Interest is currently approximately $31,000 per month, subject to annual adjustments.

Rent expense is calculated using the straight-line method based on the totalexpensed straight line over three years.

Future minimum lease payments over the initial term of the lease. Landlord tenant improvement allowancesunder capital leases and rent expense exceeding actual rent payments are accounted for as deferred rent liability in the balance sheet and amortized on a straight-line basis over the initial term of the respective leases.

Future minimum payments, by year and in the aggregate, under non-cancelable operating leases with initial or remaining terms of one year or more, consist of the following at December 31, 2016:

2019 are as follows (in thousands):

(In thousands)

    

Year

 

Amount

 

2017

 $376 

2018

 $387 

2019

 $99 
F-23

Clinical Research Commitments

None.

Legal Proceedings

From time to time, we may be involved in certain legal actions and claims arising in the ordinary course


YearAmount
2020$737  
2021757  
2022717  
2023644  
2024328  
$3,183  

Note 9.9. Related Party Disclosure

Mr. Gorlin, an affiliate of the company, entered into securities purchase agreements during the fiscal year ended December 31, 2015, and received approximately 300,000 shares of common stock in exchange for gross proceeds of approximately $90,000.

Terren Peizer, Chairman and Chief Executive Officer, transferred his securities ownership in Catasys to Acuitas from Crede Capital Group, LLC during 2015. Mr. Peizer owns 100% of both entities.

In August 2016, Acuitas loaned us $225,000. No terms were discussed nor were any agreements executed in connection with such loan, but the $225,000 was paid back out of the August 2016 Notes.

Transactions

In August 2016, Acuitas, agreed to exchange its existing promissory note for short-term senior promissory notes, in the aggregate principal amount of $2.8 million plus accrued interest, in the form substantially identical to the form of the August 2016 Notes. Acuitas also agreed to exchange certain of its outstanding warrants to purchase an aggregate of 2,028,029 shares of our common stock at an exercise price of $0.33 per share, for warrants to purchase an aggregate of 2,993,561 shares of our common stock at an exercise price of $1.10 per share, in the form substantially identical to the form of the August 2016 Warrants.

       In December 2016, we exchanged the August 2016 Notes issued to the Acuitas, which had an aggregate outstanding principal amount of $2.8 million, for (i) 8% Convertible Debentures in the same principal amount due on March 15, 2017 (the “Debentures”) and (ii) five-year warrants to purchase shares of the Company’s common stock in amount equal to forty percent (40%) of the initial number of shares of common stock issuable upon conversion of each Investor’s Debentures, at an exercise price of $1.10 per share (the “December 2016 Warrants”).

Acuitas entered into securities purchase agreements as of December 31, 2015 and received approximately 6,953,334 shares of common stock in exchange for gross proceeds of approximately $2.1 million. In addition, Acuitas received warrants to purchase an aggregate 935,008 shares of common stock, at a price of $0.30 per share, as of December 31, 2015.

In addition, we have a $3.7 million Convertible Debenture outstanding with Acuitas, which includes $577,000 in interest as of December 31, 2016. We also have accountsAccounts payable outstanding with Mr. Peizer for travel and expenses of $194,000is approximately $0.4 million and $130,000$0.4 million as of December 31, 20162019 and 2015,2018, respectively.


Note 10. Restricted Cash
In August 2016, weSeptember 2018, the Company entered into subscription agreements with Shamus, pursuant toa lease agreement for the new corporate office space in Santa Monica, California which we issued short-term senior promissory notesrequired a stand-by letter of credit as guarantee for future rent in the aggregate principal amount of $1.0 million$0.4 million. As of December 31, 2019, long-term restricted cash related to the Santa Monica lease totaled $0.4 million.
The following table provides a reconciliation of cash, cash equivalents and five-year warrants to purchase up to an aggregate of 318,182 shares of our common stock, at an exercise price of $1.10 per share. 3

In December 2016, we exchanged the subscription agreement with Shamus, which had an aggregate outstanding principal amount of $1.0 million, for (i) 8% Convertible Debenturesrestricted cash total as presented in the same principal amount due on March 15, 2017 (the “Debentures”) and (ii) five-year warrants to purchase sharesconsolidated statement of the Company’s common stock in amount equal to forty percent (40%) of the initial number of shares of common stock issuable, or 363,636 warrants, upon conversion of each, at an exercise price of $1.10 per share.

       In addition, in December 2016, we entered into an agreement with Shamus pursuant to which we received gross proceeds of $300,000cash flows for the sale of (i) an 8% Series B Convertible Debenture due March 31, 2017 (the “December 2016 Convertible Debenture”) and (ii) five-year warrants to purchase shares of the Company’s common stock in an amount equal to seventy-five percent (75%) of the initial number of shares of common stock issuable, or 264,706 warrants, upon the conversion of the December 2016 Convertible Debenture, at an exercise price of $0.85 per share (the “Shamus Warrants”).

Shamus entered into securities purchase agreements during the fiscal years ended December 31, 20152019 and received approximately 956,667 shares of common stock in exchange for gross proceeds of approximately $287,000.

Note 10.Short-term Debt

In April 2015, we entered into a Securities Purchase Agreement with several institutional accredited investors, pursuant to which we received aggregate gross proceeds of $2.0 million from the investors for the sale of approximately $2.12 million principal amount of 12% Original Issue Discount Convertible Debentures due January 18, 2016 (the “April 2015 Bridge Notes”) and the April 2015 Warrants. The closing of the April 2015 Bridge Notes transaction occurred on April 17, 2015. We received aggregate net proceeds of $1,815,000. We used $560,000 of the net proceeds to repay our outstanding indebtedness due to Acuitas incurred by way of short term, interest free loans in the first and second quarters of 2015.

2018 (in thousands):

The conversion price of the April 2015 Bridge Notes and the exercise price of the April 2015 Warrants was $2.00 per share, subject to adjustment, including for issuances of common stock and common stock equivalents below the then current conversion or exercise price, as the case may be. The April 2015 Bridge Notes were unsecured, bear interest at a rate of 12% per annum payable quarterly in cash or shares of common stock, subject to certain conditions, at our option, and were subject to mandatory prepayment upon the consummation of certain future financings. The exercise price of the April 2015 Warrants was subsequently adjusted to $0.30 per share based upon the September Offering.

In July 2015, we entered into a promissory note with Acuitas, pursuant to which we received gross proceeds of $3.35 million for the sale of $3.35 million in principal amount (the “Promissory Note”). The Promissory Note was due on August 21, 2015, and carried an interest rate on any unpaid principal amount of 8% per annum until the maturity date, after which the interest rate would increase to 12% per annum. We used approximately $2.2 million of the net proceeds of this transaction to redeem the April 2015 Bridge Notes. Following the redemption, all of the April 2015 Bridge Notes were extinguished.

In July 2015, we issued the July 2015 Convertible Debenture and the July 2015 Warrants for the Promissory Note.

The conversion price of the July 2015 Convertible Debenture was $1.90 per share, subject to adjustments, including for issuances of common stock and common stock equivalents below the then current conversion or exercise price, as the case may be.  The July 2015 Convertible Debentures are unsecured, bear interest at a rate of 12% per annum payable in cash or shares of common stock, subject to certain conditions, at our option, and are subject to mandatory prepayment upon the consummation of certain future financings. 

The conversion price of the July 2015 Convertible Debenture and the exercise price of the July 2015 Warrants were subsequently adjusted to $0.30 per share based upon the September Offering.

In October 2015, we amended the July 2015 Convertible Debenture which extended the maturity date of the July 2015 Convertible Debenture from January 18, 2016 to January 18, 2017 and extended the date we must consummate a public offering from December 31, 2015 to June 30, 2016. In accordance with ASC 470-50, Debt Modifications and Extinguishments, we recognized a $195,000 loss on extinguishment of debt in connection with the loan modification.

In March 2016, we entered into a promissory note with Acuitas Group Holdings, LLC (“Acuitas”), pursuant to which we received aggregate gross proceeds of $900,000 for the issuance of the note with a principal amount of $900,000 (the “March 2016 Promissory Note”). The March 2016 Promissory Note is due within 30 days of demand by Acuitas (the “Maturity Date”), and carries an interest rate on any unpaid principal amount of 8% per annum until the Maturity Date, after which the interest will increase to 12% per annum. In addition, we issued Acuitas five-year warrants to purchase an aggregate of 450,000 shares of our common stock, at an exercise price of $0.47 per share, which warrants include, subject to certain exceptions, a full-ratchet anti-dilution protection (the “March 2016 Warrants”). The number of warrants were subsequently increased to 640,909 and the exercise price of the March 2016 Warrants was subsequently reduced to $0.33 per share based upon the May 2016 Promissory Note.

In April 2016, we amended and restated the March 2016 Promissory Note to increase the principal amount by $400,000, for a total of $1.3 million (the “April Promissory Note”). In connection with the amendment, we issued Acuitas five-year warrants to purchase an additional 200,000 shares of our common stock, at an exercise price of $0.47 per share, which warrants include, subject to certain exceptions, a full-ratchet anti-dilution protection (the “April 2016 Warrants”). The number of warrants were subsequently increased to 284,848 and the exercise price of the April 2016 Warrants was subsequently reduced to $0.33 per share based upon the May 2016 Promissory Note.

In May 2016, we amended and restated the April 2016 Promissory Note to increase the principal amount by $405,000, for a total of $1.7 million (the “May Promissory Note”). In connection with the amendment, we issued Acuitas five-year warrants to purchase an additional 306,818 shares of our common stock, at an exercise price of $0.33 per share, which warrants include, subject to certain exceptions, a full-ratchet anti-dilution protection (the “May 2016 Warrants”).

In June 2016, we amended and restated the May 2016 Promissory Note to increase the principal amount by $480,000, for a total of $2.2 million (the “June 2016 Promissory Note”). In connection with the amendment, we issued Acuitas five-year warrants to purchase an additional 363,636 shares of our common stock, at an exercise price of $0.33 per share, which warrants include, subject to certain exceptions, a full-ratchet anti-dilution protection (the “June 2016 Warrants”).

20192018
Cash and cash equivalents$13,610  $3,091  
Restricted cash (current and long-term)408  479  
Total cash, cash equivalents and restricted cash$14,018  $3,570  

In July 2016, we amended and restated the June 2016 Promissory Note to increase the principal amount by $570,000, for a total of $2.8 million (the “July 2016 Promissory Note”). In connection with the amendment, we issued Acuitas five-year warrants to purchase an additional 431,818 shares of our common stock at an exercise price of $0.33 per share, which warrants include, subject to certain exceptions, a full-ratchet anti-dilution protection (the “July 2016 Warrants”).

In August 2016, Acuitas loaned us $225,000. No terms were discussed nor were any agreements executed in connection with such loan, but the $225,000 was paid back out of the August 2016 Notes.

In August 2016, we entered into subscription agreements (each, the “Subscription Agreement”) with three accredited investors, including Shamus, (collectively, the “Investors”), pursuant to which we issued to the Investors short-term senior promissory notes in the aggregate principal amount of $2.8 million (the “August 2016 Notes”) and five-year warrants to purchase up to an aggregate of 875,000 shares of our common stock, at an exercise price of $1.10 per share (the “August 2016 Warrants”).

The August 2016 Warrants include price protection provisions pursuant to which, subject to certain exempt issuances, the then exercise price of the August 2016 Warrants will be adjusted, in the event we issue shares of our common stock for consideration per share less than the then exercise price of the August 2016 Warrants, to the lowest consideration per share for the shares issued or sold in such transaction. The price protection will be in effect until the earliest of (i) the termination date of the August 2016 Warrants, (ii) such time as the Warrants are exercised or (iii) contemporaneously with the listing of our shares of common stock on a registered national securities exchange.

In addition, in August 2016, Acuitas agreed to exchange its July 2016 Promissory Note for a short-term senior promissory note in the aggregate principal amount of $2.8 million including accrued interest, in the form substantially identical to the form of the August 2016 Notes. Acuitas also agreed to exchange certain of its outstanding warrants to purchase an aggregate 2,028,029 shares of our common stock at an exercise price of $0.33 per share for warrants to purchase an aggregate 2,993,561 shares of common stock at an exercise price of $1.10 per share.

       In December 2016, we exchanged the August 2016 Notes issued to the Investors, which had an aggregate outstanding principal amount of $5.6 million, for (i) 8% Convertible Debentures in the same principal amount due on March 15, 2017 (the “Debentures”) and (ii) five-year warrants to purchase shares of the Company’s common stock in amount equal to forty percent (40%) of the initial number of shares of common stock, or 2,022,835 warrants, issuable upon conversion of each Investor’s Debentures, at an exercise price of $1.10 per share (the “December 2016 Warrants”).

 The December 2016 Warrants include a price protection provision pursuant to which, subject to certain exempt issuances, the then exercise price of the December 2016 Warrants will be adjusted if the Company issues shares of common stock at a price that is less than the then exercise price of the December 2016 Warrants. Such price protection provisions will remain in effect until the earliest of (i) the termination date of the December 2016 Warrants, (ii) such time as the December 2016 Warrants are exercised or (iii) contemporaneously with the listing of our shares of common stock on a registered national securities exchange.

In December 2016, we entered into an agreement with Shamus pursuant to which the Company received gross proceeds of $300,000 for the sale of (i) an 8% Series B Convertible Debenture due March 31, 2017 (the “December 2016 Convertible Debenture”) and (ii) five-year warrants to purchase shares of the Company’s common stock in an amount equal to seventy-five percent (75%) of the initial number of shares of common stock, or 264,706 warrants, issuable upon the conversion of the December 2016 Convertible Debenture, at an exercise price of $0.85 per share (the “Shamus Warrants”).

The Shamus Warrants include price protection provisions pursuant to which, subject to certain exempt issuances, the then exercise price of the Shamus Warrants will be adjusted if the Company issues shares of common stock at a price that is less than the then exercise price of the Shamus Warrants. Such mechanism will remain in effect until the earliest of (i) the termination date of the Shamus Warrants, (ii) such time as the Shamus Warrants are exercised or (iii) contemporaneously with the listing of our shares of common stock on a registered national securities exchange.




Note11. Subsequent Events

Financing Activities

       In January 2017, we entered into a Subscription Agreement (the “Subscription Agreement”) with Acuitas, pursuant to which the Company will receive aggregate gross proceeds of $1,300,000 (the “Loan Amount”) in consideration of the issuance of (i) an 8% Series B Convertible Debenture due March 31, 2017 (the “January 2017 Convertible Debenture”) and (ii) five-year warrants to purchase shares of the Company’s common stock in an amount equal to one hundred percent (100%) of the initial number of shares of common stock issuable upon the conversion of the January 2017 Convertible Debenture, at an exercise price of $0.85 per share (the “January 2017 Warrants”). The Loan Amount is payable in tranches through March 2017. In addition, any warrants issued in conjunction with the December 2016 Convertible Debenture currently outstanding with Acuitas have been increased by an additional 25% warrant coverage, exercisable for an aggregate of 827,293 shares of the Company’s common stock.

       The January 2017 Warrants include, among other things, price protection provisions pursuant to which, subject to certain exempt issuances, the then exercise price of the January 2017 Warrants will be adjusted if the Company issues shares of common stock at a price that is less than the then exercise price of the January 2017 Warrants. Such price protection provisions will remain in effect until the earliest of (i) the termination date of the January 2017 Warrants, (ii) such time as the January 2017 Warrants are exercised or (iii) contemporaneously with the listing of the Company’s shares of common stock on a registered national securities exchange.

       In connection with the Subscription Agreement described above, the number of Shamus Warrants were increased from 75% to 100% warrant coverage, exercisable for an aggregate of 352,941 shares of the Company’s common stock.

2017 Stock Incentive Plan


On February 27, 2017, the Board of Directors and our stockholders approved the adoption of the 2017 Stock Incentive Plan (the “2017 Plan”). The 2017 Plan allows the Company, under the direction of the Board of Directors or a committee thereof, to make grants of stock options, restricted and unrestricted stock and other stock-based awards to employees, including the Company’s executive officers, consultants and directors. The 2017 Plan allows for the issuance of up to 14,000,000 additional shares of Common Stock pursuant to new awards granted under the 2017 Plan and up to approximately 1,500,000 shares of Common Stock that are represented by options outstanding under the 2010 Plan (defined below) that are forfeited, expire or are cancelled without delivery of shares of Common Stock or which result in the forfeiture of shares of Common Stock back to the Company.This description is qualified in its entirety by reference to the actual terms of the 2017 Plan, a copy of which is attached as Exhibit B to the Company’s preliminary Information Statement on Schedule 14C, filed with the Securities and Exchange Commission on February 28, 2017. 

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