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Schedule II - Valuation and Qualifying Accounts (Tables)
12 Months Ended
Dec. 31, 2015
Notes Tables  
Valuation and Qualifying Accounts Disclosure [Table Text Block]
Allowance for doubtful accounts (in thousands):    
Balance, December 31, 2012   $ 3,476  
Provision     2,225
Recoveries     (2,220 )
Charge-offs     (1,521 )
Balance, December 31, 2013   $ 1,960  
Provision     8,195
Recoveries     (17 )
Charge-offs     (5,603 )
Balance, December 31, 2014   $ 4,535  
Provision     3,509
Recoveries     (100 )
Charge-offs     (3,095 )
Balance, December 31, 2015   $ 4,849  
Estimated liability for appeals and estimated allowance for appeals (in thousands):    
Balance, December 31, 2012   $ 34,426  
Provision     41,076  
Appeals found in providers favor     (19,711 )*
Balance, December 31, 2013   $ 55,791 **
Provision     16,822  
Appeals found in providers favor     (30,990 )*
Balance, December 31, 2014   $ 41,623 **
Provision     15,642  
Appeals found in providers favor     (17,573 )*
Balance, December 31, 2015   $ 39,692 **