Statement of Changes in Beneficial Ownership (4)

FORM 4 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).	UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES	OMB APPROVAL OMB Number: 3235-0287 Estimated average burden hours per response... 0.5
	Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940

1. Name and Address of Reporting Person * Nustad Cynthia	2. Issuer Name and Ticker or Trading Symbol HMS HOLDINGS CORP [ HMSY ]	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) _____ Director                      _____ 10% Owner __ X __ Officer (give title below)      _____ Other (specify below) EVP, Chief Strategy Officer
(Last)          (First)          (Middle) 5615 HIGH POINT DRIVE	3. Date of Earliest Transaction (MM/DD/YYYY) 11/19/2018
(Street) IRVING, TX 75038 (City)        (State)        (Zip)	4. If Amendment, Date Original Filed (MM/DD/YYYY)	6. Individual or Joint/Group Filing (Check Applicable Line) _ X _ Form filed by One Reporting Person ___ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security (Instr. 3)	2. Trans. Date	2A. Deemed Execution Date, if any	3. Trans. Code (Instr. 8)		4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
			Code	V	Amount	(A) or (D)	Price
Common Stock	11/19/2018		M		15043.0000	A	$27.7900	95541.0000	D
Common Stock	11/19/2018		S		700.0000	D	$37.0036   (1)	94841.0000	D
Common Stock	11/19/2018		S		2120.0000	D	$36.1094   (2)	92721.0000	D
Common Stock	11/19/2018		S		12223.0000	D	$35.2340   (3)	80498.0000	D
Common Stock	11/20/2018		M		16226.0000	A	$21.3600	96724.0000	D
Common Stock	11/20/2018		M		4988.0000	A	$27.7900	101712.0000	D
Common Stock	11/20/2018		S		21214.0000	D	$35.0267   (4)	80498.0000	D
Common Stock	11/21/2018		M		8752.0000	A	$21.3600	89250.0000	D
Common Stock	11/21/2018		S		2100.0000	D	$35.7504   (5)	87150.0000	D
Common Stock	11/21/2018		S		6652.0000	D	$35.2721   (6)	80498.0000	D

Table II - Derivative Securities Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Trans. Date	3A. Deemed Execution Date, if any	4. Trans. Code (Instr. 8)		5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)		6. Date Exercisable and Expiration Date		7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)		8. Price of Derivative Security (Instr. 5)	9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)	10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
				Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares
Nonqualified Stock Option (Right to Buy)	$27.7900	11/19/2018		M			15043.0000	(7)	10/4/2019	Common Stock	15043.0000	$0.0000	4988.0000	D
Nonqualified Stock Option (Right to Buy)	$27.7900	11/20/2018		M			4988.0000	(7)	10/4/2019	Common Stock	4988.0000	$0.0000	0.0000	D
Nonqualified Stock Option (Right to Buy)	$21.3600	11/20/2018		M			16226.0000	(8)	11/14/2020	Common Stock	16226.0000	$0.0000	12468.0000	D
Nonqualified Stock Option (Right to Buy)	$21.3600	11/21/2018		M			8752.0000	(8)	11/14/2020	Common Stock	8752.0000	$0.0000	3716.0000	D

Explanation of Responses:
(1)	The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $36.86 to $37.19, inclusive. The reporting person undertakes to provide to HMS Holdings Corp., any security holder of HMS Holdings Corp., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnotes (1), (2), (3), (4), (5) and (6) to this Form 4.
(2)	The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $35.86 to $36.78, inclusive.
(3)	The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $34.86 to $35.85, inclusive.
(4)	The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $34.415 to $35.39, inclusive.
(5)	The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $35.58 to $35.91, inclusive.
(6)	The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $34.56 to $35.50, inclusive.
(7)	One-half of the option vested in three equal installments on December 31, 2013, 2014 and 2015. The other one-half of the option vested as follows: one-third vested on December 31, 2013, one-third vested on October 5, 2014 and one-third vested on October 5, 2015.
(8)	One-half of the stock option vested in three equal installments on November 15, 2014, 2015 and 2016. The other one-half of the stock option was cancelled due to non-satisfaction of certain performance conditions.

Reporting Owners
Reporting Owner Name / Address	Relationships
	Director	10% Owner	Officer	Other
Nustad Cynthia 5615 HIGH POINT DRIVE IRVING, TX 75038			EVP, Chief Strategy Officer

Signatures
Kimberly J. Day, as Attorney-in-Fact for Cynthia Nustad		11/21/2018
** Signature of Reporting Person		Date

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
*	If the form is filed by more than one reporting person, see Instruction 4(b)(v).
**	Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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