# EDGAR Filing Document

**Accession Number:** 0001797168
**File Stem:** 0001437749-23-004451
**Filing Date:** 2023-2
**Character Count:** 12768
**Document Hash:** 8f9ce7aba2eb7ee19c468832d05fb2d5
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001437749-23-004451.hdr.sgml**: 20230223

**ACCESSION NUMBER**: 0001437749-23-004451

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230105

**FILED AS OF DATE**: 20230223

**DATE AS OF CHANGE**: 20230223

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** PEIZER TERREN S
- **CENTRAL INDEX KEY:** 0000904534

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-31932
- **FILM NUMBER:** 23662166

**MAIL ADDRESS:**
- **STREET 1:** 11111 SANTA MONICABLVD STE.500
- **CITY:** LOS ANGELES
- **STATE:** CA
- **ZIP:** 90025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Acuitas Group Holdings, LLC
- **CENTRAL INDEX KEY:** 0001797168
- **STATE OF INCORPORATION:** CA

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-31932
- **FILM NUMBER:** 23662165

**BUSINESS ADDRESS:**
- **STREET 1:** 2120 COLORADO AVENUE, #230
- **CITY:** SANTA MONICA
- **STATE:** CA
- **ZIP:** 90404
- **BUSINESS PHONE:** 310-444-4321

**MAIL ADDRESS:**
- **STREET 1:** 2120 COLORADO AVENUE, #230
- **CITY:** SANTA MONICA
- **STATE:** CA
- **ZIP:** 90404
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Ontrak, Inc.
- **CENTRAL INDEX KEY:** 0001136174
- **STANDARD INDUSTRIAL CLASSIFICATION:** SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090]
- **IRS NUMBER:** 880464853
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 2200 PASEO VERDE PARKWAY
- **STREET 2:** SUITE 280
- **CITY:** HENDERSON
- **STATE:** NV
- **ZIP:** 89052
- **BUSINESS PHONE:** 310 444 4300

**MAIL ADDRESS:**
- **STREET 1:** 2200 PASEO VERDE PARKWAY
- **STREET 2:** SUITE 280
- **CITY:** HENDERSON
- **STATE:** NV
- **ZIP:** 89052

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** CATASYS, INC.
- **DATE OF NAME CHANGE:** 20110316

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** HYTHIAM, INC.
- **DATE OF NAME CHANGE:** 20101029

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** HYTHIAM INC
- **DATE OF NAME CHANGE:** 20031003

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>PEIZER TERREN S<br><sub>(Last) (First) (Middle)</sub><br>200 DORADO BEACH DRIVE #3831<br><sub>(Street)</sub><br>DORADO, PR 00646<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-01-05 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [X] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_CEO and Chairman of the Board_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>Ontrak, Inc. [ OTRK ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Acuitas Group Holdings, LLC<br><sub>(Last) (First) (Middle)</sub><br>2001 WILSHIRE BLVD., STE 330<br><sub>(Street)</sub><br>SANTA MONICA, CA 90403<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-01-05 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>Ontrak, Inc. [ OTRK ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock<sup>(1)</sup> | 2023-02-21<sup>(2)</sup> |  | A |  | 2038133 | A | <sup>(2)</sup> | 11891933 | I | By Acuitas |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Warrant<sup>(1)(3)</sup> | $1.69 | 2023-01-05<sup>(3)</sup> |  | A |  | 473373 |  | <sup>(3)</sup> | 2028-01-05 | Common Stock | 473373 | <sup>(3)</sup> | 473373 | I | By Acuitas |
| Warrant<sup>(1)(4)</sup> | $1.69 | 2023-02-21<sup>(4)</sup> |  | D |  |  | 591716 | <sup>(4)</sup> | 2027-08-29 | Common Stock | 591716 | <sup>(4)</sup> | 0 | I | By Acuitas |
| Warrant<sup>(1)(4)</sup> | $0.45 | 2023-02-21<sup>(4)</sup> |  | A |  | 11111111 |  | <sup>(4)</sup> | 2027-08-29 | Common Stock | 11111111 | <sup>(4)</sup> | 11111111 | I | By Acuitas |
| Warrant<sup>(1)(5)</sup> | $1.69 | 2023-02-21<sup>(5)</sup> |  | D |  |  | 710059 | <sup>(5)</sup> | 2027-09-07 | Common Stock | 710059 | <sup>(5)</sup> | 0 | I | By Acuitas |
| Warrant<sup>(1)(5)</sup> | $0.45 | 2023-02-21<sup>(5)</sup> |  | A |  | 13333333 |  | <sup>(5)</sup> | 2027-09-07 | Common Stock | 13333333 | <sup>(5)</sup> | 13333333 | I | By Acuitas |
| Warrant<sup>(1)(6)</sup> | $1.69 | 2023-02-21<sup>(6)</sup> |  | D |  |  | 473373 | <sup>(6)</sup> | 2028-01-05 | Common Stock | 473373 | <sup>(6)</sup> | 0 | I | By Acuitas |
| Warrant<sup>(1)(6)</sup> | $0.45 | 2023-02-21<sup>(6)</sup> |  | A |  | 8888889 |  | <sup>(6)</sup> | 2028-01-05 | Common Stock | 8888889 | <sup>(6)</sup> | 8888889 | I | By Acuitas |
| Senior Secured Convertible Note<sup>(1)(7)</sup> | $0.40 | 2023-02-21<sup>(7)</sup> |  | A |  | 37500000 |  | <sup>(7)</sup> | 2024-06-30 | Common Stock | 37500000 | <sup>(7)</sup> | 37500000 | I | By Acuitas |

---

### Footnotes:

(1) This Form 4 is jointly filed by Terren S. Peizer and Acuitas Group Holdings, LLC ("Acuitas"). Mr. Peizer is the Chairman and sole member of Acuitas and, in such capacity, exercises voting and investment power over any securities held for the accounts of Acuitas. Acuitas Capital LLC ("Acuitas Capital"), an entity wholly owned by Acuitas, entered into a Master Note Purchase Agreement with the issuer and certain other parties dated as of April 15, 2022, which was amended by a Second Amendment to Master Note Purchase Agreement dated as of November 19, 2022, and by a Third Amendment to Master Note Purchase Agreement dated as of December 30, 2022 (the Master Note Purchase Agreement as amended to date, the "Keep Well Agreement").

(2) Under the terms of the Keep Well Agreement, the issuer agreed to issue 2,038,133 shares of its common stock (the "Commitment Shares") to Acuitas Capital subject to conditions specified therein, including the issuer obtaining stockholder approval for the issuance of the Commitment Shares and an amendment to the issuer's certificate of incorporation being accepted for filing by the Delaware Secretary of State (the "Charter Amendment Acceptance"). Such stockholder approval (and the stockholder approvals described in footnotes 3 through 7, below) was obtained at the issuer's special meeting of stockholders held on February 20, 2023 (the "Special Meeting") and the Charter Amendment Acceptance occurred on February 21, 2023.

(3) On January 5, 2023, pursuant to the Keep Well Agreement, the issuer issued and sold a senior secured note in the principal amount of $4,000,000 to Acuitas Capital, and in connection therewith, the issuer issued this warrant to Acuitas Capital.

(4) Pursuant to the Keep Well Agreement, the issuer agreed to exchange warrants to purchase 591,716 shares of the issuer's common stock with an exercise price of $1.69 per share previously issued to Acuitas on August 29, 2022, for warrants to purchase 11,111,111 shares of the issuer's common stock with an exercise price of $0.45 per share, subject to future price adjustments, subject to the issuer obtaining stockholder approval of the foregoing and the Charter Amendment Acceptance occurring.

(5) Pursuant to the Keep Well Agreement, the issuer agreed to exchange warrants to purchase 710,059 shares of the issuer's common stock with an exercise price of $1.69 per share previously issued to Acuitas on September 7, 2022, for warrants to purchase 13,333,333 shares of the issuer's common stock with an exercise price of $0.45 per share, subject to future price adjustments, subject to the issuer obtaining stockholder approval of the foregoing and the Charter Amendment Acceptance occurring.

(6) Pursuant to the Keep Well Agreement, the issuer agreed to exchange warrants to purchase 473,373 shares of the issuer's common stock with an exercise price of $1.69 per share previously issued to Acuitas on January 5, 2023, for warrants to purchase 8,888,889 shares of the issuer's common stock with an exercise price of $0.45 per share, subject to future price adjustments, subject to the issuer obtaining stockholder approval of the foregoing and the Charter Amendment Acceptance occurring.

(7) Pursuant to the Keep Well Agreement, the issuer agreed to exchange senior secured notes in the aggregate principal amount of $15.0 million previously issued to Acuitas Capital, for senior secured convertible notes that give Acuitas Capital, at its election, the right to convert the entire principal amount of such notes, plus all accrued and unpaid interest thereon, in whole or in part, into shares of the issuer's common stock at a conversion price of $0.40, subject to future price adjustments, subject to the issuer obtaining stockholder approval of the foregoing and, the right to receive any such shares upon any such conversion, the Charter Amendment Acceptance occurring. The number of shares reported in Column 5 assumes that all accrued interest is paid in cash.

**Signature:** /s/ Acuitas Group Holdings, LLC by Terren S. Peizer  
**Date:** 2023-02-23

**Signature:** /s/ Terren S. Peizer  
**Date:** 2023-02-23

### Remarks:

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).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

**Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.**