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                                                                EXHIBIT 10.1(vi)


                             FIFTH AMENDMENT OF LEASE


     THIS AGREEMENT, made as of the 1st day of May, 2003 between 401 PARK AVENUE
SOUTH ASSOCIATES LLC, A New York Limited Liability Company having an office at
30 West 26th Street, Eighth Floor, New York, New York ("Landlord") and HEALTH
MANAGEMENT SYSTEMS, INC., a New York Corporation having an office at 401 Park
Avenue South, New York New York ("Tenant").

                                   WITNESSETH:

     WHEREAS, Landlord and Tenant entered into an Agreement of Lease made as of
January 6, 1986, as amended by a First Amendment of Lease dated November 25,
1987, a Second Amendment of Lease dated February 28, 1990, a Third Amendment of
Lease dated May 30, 2000 and a Fourth Amendment of Lease dated May 1, 2003,
covering certain premises on a portion of the 11th floor in the building known
as 401 Park Avenue South in the City, County and State of New York (said
Agreement of Lease, being hereinafter called the "Lease"); and

     WHEREAS, the parties hereto desire to amend the Lease in the respects and
upon the terms and conditions hereinafter set forth.

     NOW THEREFORE, in consideration of the sum of One Dollar ($1.00) paid by
each of the Parties hereto to the other (the receipt and sufficiency of which is
hereby acknowledged) and of other good and valuable consideration, including the
covenants: and understandings herein contained, it is hereby agreed as follows:

     1. Landlord shall have the option (hereinafter the "Elevator Option") to
reclaim an area within the Demised Premises immediately adjacent to the two
passenger elevators located in the southwestern portion of the Demised Premises.
Such area shall be equal in size to the area occupied by the existing passenger
elevators. Landlord may only exercise the Elevator Option for the purpose of
installing a third passenger elevator (the "Proposed Elevator"). Landlord shall
exercise the Elevator Option in writing 120 days in advance of the date Landlord
shall reclaim the: area required for the Proposed Elevator. Landlord shall
proportionately reduce the rent and additional rent equal to the percentage that
the area reclaimed for the Proposed Elevator bears to the total area of the
floor. Landlord shall bear all costs and expenses associated with severing the
area for the Proposed Elevator from the Demised Premises and Landlord at its
sole cost and expense shall (i) reconstruct the area of the Demised Premises
immediately adjacent to the Proposed Elevator to match the condition and repair
of such immediately adjacent space, and (ii) shall relocate any of Tenant's
equipment or fixtures which may be installed in the area of the Proposed
Elevator.

     2. Effective January 1, 2001, the amount $14,896 as defined in Paragraph 5
of the Second Amendment of Lease shall be changed to $11,586.

     3. All other terms and conditions of this Lease are hereby confirmed and
shall remain in full force and effect.

     4. This Amendment of Lease shall not be binding upon Landlord unless and
until it has been duly executed by Landlord and delivered by Landlord to Tenant.

     IN WITNESS WHEREOF, the parties hereto have duly executed this Agreement as
of the day and year first above written.


                                      401 PARK AVENUE SOUTH ASSOCIATES LLC
                                      BY: STEPHEN J. MERINGOFF, MEMBER


                                      BY: /s/ FARRELL VIRGA
                                          ---------------------------------
                                          FARRELL VIRGA, ATTORNEY-IN-FACT

                                      HEALTH MANAGEMENT SYSTEMS, INC.


                                      BY: /s/ VINCENT C. HARTLEY