Exhibit 10.21


 


2015 Board of Director NQSO
Agreement


<Participant Full Name>


 


Dear <Participant First Name>


 


Congratulations, you have been granted a stock option pursuant to the HMS Holdings Corp.
Fourth Amended and Restated 2006 Stock Plan (the (“Plan”) for your service on the Board of Directors
of HMS Holdings Corp. (the “Company”). A stock option grant gives you the right to purchase a specific
number of shares of the Company’s common stock at a fixed price, assuming that you satisfy conditions of the Plan and the
award agreement. We would like you to have an opportunity to share in the continued success of the Company through this stock option
grant under the Plan. The following represents a brief description of your grant. Additional details regarding your award are provided
in the attached Nonqualified Stock Option Agreement (the “Grant Agreement”) and in the Plan.


 


Stock Option Grant Summary: 


 


	Date of Grant	November 11, 2015
	Option Shares	<Number of Shares Granted>
	Exercise Price per Share	$<XX.XX>
	Exercisability 	One-quarter of the Option Shares on December 31 of the year in which the Grant is made and an additional one-quarter on the last day of each of the first three quarters of the following calendar year.  Each of those dates is an “Exercisability Date.”
	Term Expiration Date	November 10, 2022


 


You have been granted a nonqualified stock option to purchase Shares of the Company’s
common stock. The total number of Shares under your grant is in the chart above under “Option Shares” and the price
per share is under “Exercise Price per Share.”


The potential value of your stock option grant increases if the price of the Company’s
stock increases, but you also have to continue to provide services to the Company (except as the Grant Agreement provides) to actually
receive such value. Of course, the value of the stock may go up and down over time.


You can’t exercise the stock option (actually purchase the shares) until it becomes
exercisable. Your stock option becomes exercisable as provided in the chart above under Exercisability, assuming you remain an
employee of or member of the Board of Directors of the Company and subject to the terms in the Grant Agreement.


Whether or not you decide to exercise your stock option and purchase the stock is your
decision, and, you have until the stock option expires (which will be no later than the seventh anniversary of the Date
of Grant, but can end earlier in various situations) to make that decision.


Once you have purchased the Shares, you will own them and may decide whether to hold the
stock, sell the stock or give the stock to someone as a gift.


 


You can access the Merrill Lynch portal updates and information: https://www.benefits.ml.com.
Please email IR@hms.com with any questions. 


 






     


     

    

HMS Holdings Corp.


Nonqualified Stock Option Grant
Agreement for Board of Directors


 


 


HMS Holdings Corp. (the “Company”) has granted you an option
(the “Option”) under the HMS Holdings Corp. Fourth Amended and Restated 2006 Stock Plan (as it may be
amended from time to time) (the “Plan”). The Option lets you purchase a specified number (the “Option
Shares”) of Shares of the Company’s common stock, at a specified price per Share (the “Exercise
Price”).


 


The individualized communication you received (the “Cover
Letter”) provides the details for your Option. It specifies the number of Option Shares, the Exercise Price, the
Date of Grant, the schedule for exercisability, and the latest date the Option will expire (the “Term Expiration Date”).


 


The Option is subject in all respects to the applicable provisions of
the Plan. This Grant Agreement does not cover all of the rules that apply to the Option under the Plan; please refer to the Plan
document. Capitalized terms are defined either further below in this grant agreement (the “Grant Agreement”)
or in the Plan.


 





 






 


The Plan document is available on the Merrill Lynch website. The Prospectus for the Plan,
the Company’s S-8, Annual Report on Form 10-K, and other filings the Company makes with the Securities and Exchange Commission
are available for your review under the Investor Relations tab on the Company’s web site. You may also obtain paper copies
of these documents upon request to the Company’s Investor Relations department (IR@HMS.com).


 


Neither the Company nor anyone else is making any representations or promises regarding the
duration of your service, exercisability of the Option, the value of the Company's stock or of this Option, or the Company's prospects.
The Company is not providing any advice regarding tax consequences to you or regarding your decisions regarding the Option; you
agree to rely only upon your own personal advisors.


 


No one may sell, transfer, or distribute the Option
or the securities that may be purchased upon exercising the Option without an effective registration statement relating thereto
or an opinion of counsel satisfactory to HMS Holdings Corp. or other information and representations satisfactory to it that such
registration is not required.


 


 


 


 






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In addition to the Plan’s terms and restrictions,
the following terms and restrictions apply:


 


	Option 

Exercisability		While your Option remains in effect under the Option Expiration section, you may exercise any exercisable portions of the Option (and buy the Option Shares) under
the timing rules of this section, provided that you may not exercise the Option for fewer than 100 full shares at any particular
time unless fewer than 100 remain unexercised.








			The Option will become exercisable on the schedule provided in the Cover Letter to this Grant
                                                                            Agreement assuming that through each Exercisability Date, (i) if you received the Option in your capacity as an employee of
                                                                            the Company, you remain an employee or (ii) if you received the Option in your capacity as a member of the
                                                                            Company’s Board, you remain a member of the Company’s Board. Any fractional shares will be carried forward to the
                                                                            following Exercisability Date, unless the Committee selects a different treatment. For purposes of this Grant Agreement,
                                                                            employment with the Company will include employment with any Affiliate whose employees are then eligible to receive Awards
                                                                            under the Plan. Unless the Committee determines otherwise, if an entity employing you ceases to be an Affiliate, your
                                                                            employment with the Company will be treated as ended even though you continue to be employed by that entity.



 


			Exercisability will accelerate fully on your disability or death. For this purpose,
                                                                            “disability” means permanent and total disability as defined by Section 22(e)(3) of the Code.
                                                                            Exercisability will continue and increase (until fully exercisable) over the two years following your date of Retirement.
                                                                            “Retirement” for this purpose means cessation of service on or after attaining age 60 and
                                                                            completing five years of service with the Company.



 


	Change in Control 		If a Change in Control occurs, your Option will be treated as provided
in Section 11 of the Plan if, within 24 months following the Change in Control, your
employment or service ends on a termination without cause (as determined by the Committee or the Board), provided also that the
Option will remain outstanding for 12 months following such termination but not beyond the Term Expiration Date.







	Option Expiration		The Option will expire no later than the close of business on
the Term Expiration Date. Unexercisable portions of the Option expire immediately when you cease to be employed (unless you are
concurrently remaining or becoming a member of the Board, or, for a Board member, concurrently remaining or becoming an employee
of the Company). If the Company terminates your employment or service for cause or if you violate any then applicable restrictive
covenant agreement (such as agreements pertaining to confidentiality, intellectual property, nonsolicitation, and/or noncompetition),
the Option will immediately expire without regard to whether it is then exercisable.



 


			Exercisable portions of the Option remain exercisable until the first to occur of the
                                                                            following (the “Final Exercise Date”), each as defined further in the Plan or the Grant
                                                                            Agreement:



 


		·	Three months (measured to the corresponding date in the month) after your employment (or directorship) ends if you resign or
if the Company terminates your employment or service without cause (as determined under the Plan), except as provided above under
Change in Control


 



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		·	For death or Disability, the first anniversary of the date employment or service ends



		·	For Retirement, the end of the second year following your date of Retirement



		·	The Term Expiration Date



 


			The Committee can override the expiration provisions of this Grant Agreement.



 


	Method of 
 Exercise and 

Payment for

Shares		Subject to this Grant Agreement and the Plan, you may exercise the Option
only by providing a written notice (or notice through another previously
approved method, which could include a web-based or voice- or e-mail system)
to the Secretary of the Company or to whomever the Committee designates, received on or before
the date the Option expires. Each such notice must satisfy whatever then-current procedures apply to that Option and must contain
such representations (statements from you about your situation) as the Company requires. You must, at the same time, pay the Exercise
Price using one or more of the following methods:











		Cash/Check	cash or check in the amount of the Exercise Price payable to the order of the Company;



 


		Cashless	an approved cashless exercise method, including directing the Company


 

		Exercise	to send the stock certificates (or other acceptable evidence of ownership) to be issued under the Option to a licensed broker
acceptable to the Company as your agent in exchange for the broker’s tendering to the Company cash (or acceptable cash equivalents)
equal to the Exercise Price and, if you so elect, any required tax withholdings;



 





		Net Exercise	by delivery of a notice of “net
exercise” to or as directed by the Company, as a result of which you will receive (i) the number of shares underlying the
portion of the Option being exercised less (ii) such number of shares as is equal to (A) the aggregate Exercise Price for the portion
of the Option being exercised divided by (B) the Fair Market Value on the date of exercise;








 


		Stock	if permitted by the Committee, by delivery of Shares owned by you, valued at their Fair Market Value, provided (i) applicable
law then permits such method of payment, (ii) you owned such Shares, if acquired directly from the Company, for such minimum period
of time, if any, as the Committee may establish in its discretion, and (iii) the Shares are not subject to any repurchase, forfeiture,
unfulfilled vesting, or other similar restrictions; or



 


			any combination of the above permitted forms for payment.



 


	Withholding		Issuing the Option Shares is contingent on satisfaction of all obligations with respect
to required tax or other required withholdings (for example, in the U.S., Federal, state, and local taxes). The Company may take
any action permitted under Section 14(c) of the Plan to satisfy such obligation, including satisfying the tax obligations by (i)
reducing the number of Option Shares to be issued to you in connection with any exercise of the Option by that number of Option
Shares (valued at their Fair Market Value on the date of exercise) that would equal all taxes required to be withheld (at their
minimum withholding levels), (ii) accepting payment of the withholdings from a broker in connection with a Cashless Exercise of
the Option or directly from you, or (iii) taking any other action under Section 14(c) of the Plan. If a fractional share remains
after deduction for required withholding, the Company will pay you the value of the fraction in cash.



 



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	Compliance with Law		You may not exercise the Option if the Company’s issuing stock upon such exercise would violate any applicable Federal or state securities laws
or other laws or regulations. You may not sell or otherwise dispose of the Option Shares in violation of applicable law. As part
of this prohibition, you may not use the Cashless Exercise methods if the Company’s insider trading policy then prohibits
you from selling to the market.




 


	Additional Conditions to Exercise		The Company may postpone issuing and delivering any Option Shares for so long as the Company determines to be advisable to satisfy the following:










its completing or amending any securities registration or qualification of the Option
Shares or its or your satisfying any exemption from registration under any Federal or state law, rule, or regulation;


 


its receiving proof it considers satisfactory that a person seeking to exercise the
Option after your death is entitled to do so;


 


your complying with any requests for representations under the Plan; and


 


your complying with any Federal, state, or local tax withholding obligations.


 


	Additional Representations from You		If you exercise the Option at a time when the Company does not have a current registration
                                                                                                                     statement (generally on Form S-8) under the Securities Act of 1933 (the “Act”) that covers
                                                                                                                     issuances of shares to you, you must comply with the following before the Company will issue the Option Shares to you. You
                                                                                                                     must —








represent to the Company, in a manner satisfactory to the Company’s counsel,
that you are acquiring the Option Shares for your own account and not with a view to reselling or distributing the Option Shares;
and


 


agree that you will not sell, transfer, or otherwise dispose of the Option Shares
unless:


 


a registration statement under the Act is effective at the time of disposition
with respect to the Option Shares you propose to sell, transfer, or otherwise dispose of; or


 


the Company has received an opinion of counsel or other information and representations
it considers satisfactory to the effect that, because of Rule 144 under the Act or otherwise, no registration under the Act is
required.


 






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	No Employment Effect on Other or Relationship		Nothing in this Grant Agreement restricts the Company’s rights or those of any
                                                                                                                               of its Affiliates to terminate your employment or other relationship at any time and for any or no reason. The termination of
                                                                                                                               employment or other relationship, whether by the Company or any of its Affiliates or otherwise, and regardless of the
reason for such termination, has the consequences provided for under the Plan and any applicable employment or severance agreement
or plan.










	Not a Shareholder		You understand and agree that the Company will not consider
you a shareholder for any purpose with respect to any of the Option Shares until you have exercised the Option, paid for the shares,
and received evidence of ownership.



 


	No Effect on		You understand and agree that the existence of the Option will
not affect in any



	Running Business		way the right or power of the Company or its shareholders to make
or authorize any adjustments, recapitalizations, reorganizations, or other changes in the Company’s capital structure or
its business, or any merger or consolidation of the Company, or any issuance of bonds, debentures, preferred or other stock, with
preference ahead of or convertible into, or otherwise affecting the Company’s common stock or the rights thereof, or the
dissolution or liquidation of the Company, or any sale or transfer of all or any part of its assets or business, or any other
corporate act or proceeding, whether or not of a similar character to those described above.



 


	Governing Law		The laws of the State of New York will govern all matters relating to
the Option, without regard to the principles of conflict of laws.



 


	Notices		Any notice you give to the Company must follow the procedures then in effect. If no
other procedures apply, you must send your notice in writing by hand or by mail to the office of the Company’s Secretary
(or to the Chair of the Committee if you are then serving as the sole Secretary). If mailed, you should address it to the Company’s
Secretary (or the Chair of the Committee) at the Company’s then corporate headquarters, unless the Company directs optionees
to send notices to another corporate department or to a third party administrator or specifies another method of transmitting
notice. The Company and the Committee will address any notices to you using its standard electronic communications methods or
at your office or home address as reflected on the Company’s personnel or other business records. You and the Company may
change the address for notice by like notice to the other, and the Company can also change the address for notice by general announcements
to optionees.



 


	Amendment		Subject to any required action by the Committee or the shareholders of the Company,
the Company may cancel the Option and provide a new Award in its place, provided that the Award so replaced will satisfy all of
the requirements of the Plan as of the date such new Award is made and no such action will adversely affect the Option to the
extent then exercisable.



 






 


Plan Governs Wherever a conflict may arise between the terms of this
Grant Agreement and the terms of the Plan, the terms of the Plan will control. The Committee may adjust the number of Option
Shares and the Exercise Price and other terms of the Option from time to time as the Plan provides.


 


 


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