Exhibit 10.1

SECOND AMENDMENT TO EMPLOYMENT AGREEMENT
ROBERT M. HOLSTER
HMS HOLDINGS
JULY 2007

          The Board of Directors of HMS Holdings Corp., the successor company to
Health Management Systems, Inc. (hereafter the “Company”) has agreed to the
following modifications and extension of the employment agreement (hereafter the
“Agreement”), dated April 2, 2001 between the Health Management Systems, Inc.,
and Robert M. Holster, (hereafter the “Employee”):

 * Article 2(a) Term of Employment: Unless earlier terminated as provided in the
   agreement, the term of the Employee’s employment, under the Agreement, is
   extended three years, to end on April 2, 2010.

This amendment constitutes the entire and final expression of the agreement of
the parties with respect to subject matter hereof. The remainder of the
Agreement as amended remains in full force and effect.

          IN WITNESS WHEREOF, the Company and the Employee have duly executed
and delivered this Amendment as of July 16, 2007.

 

/s/   Richard H. Stowe
Name:   Richard H. Stowe Title: Chairman, Compensation Committee   HMS Holdings
Corp.            
/s/ Robert M. Holster
Robert M. Holster

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