LFMD 10-K & 10-Q changes, risk factors and insider trading
LifeMD, Inc. (also LFMDP) · Nasdaq · Services-Offices & Clinics Of Doctors Of Medicine · CIK 948320 · All filings on SEC.gov
At a glance
What changed in the latest 10-K
Risk Factors
New heading “These disclosures reflect our beliefs and opinions as to risk factors that could materially and adversely affect the Company and its securities in the future. References to past events are provided by way of example only and are not intended to be a complete listing or a representation as to whether or not any other events have occurred in the past or their likelihood of occurring in the future.”
Largest changes
“OCR has substantially increased enforcement of HIPAA compliance in recent years. This includes, but is not limited to, a steady increase in the number of settlements with substantial financial penalties with governmental authorities as a result of breaches. If OCR conducts an investigation (whether as a result of an audit or reporting of such a breach), OCR could impose significant fines and penalties and could also require LifeMD and its affiliates to enter into a corrective action plan. …”see in full comparison
see in full comparisonFromLitigationtime to time, we are party to lawsuits and legal proceedings in the normal course of business. These matters are often expensive and disruptive to normal business operations. We may face allegations, lawsuits,and regulatoryinquiries, audits, and investigations regarding data privacy, security, labor and employment, consumer protection, practice of medicine, and intellectual property infringement, including claims related to privacy, patents, publicity, trademarks, copyrights, and other rights. A portion of the technologies we use incorporates open source software, and we may face claims claiming ownership of open source software or patents related to that software, rights to our intellectual property or breach of open source license terms, including a demand to release material portions of our source code or otherwise seeking to enforce the terms of the applicable open source license. We may also face allegations or litigation related to our acquisitions, securities issuances, or business practices, including public disclosures about our business. Litigation and regulatoryproceedings, and particularly the healthcare regulatory and class action matters we could face, may be protracted and expensive, and the results are difficult to predict. Certain of these matters may include speculative claims for substantial or indeterminate amountsamountsof damages and include claims for injunctive relief. Additionally, our litigation costs could be significant. Adverse outcomes with respect to litigation or any of these legal proceedings may result in significant settlement costs or judgments, penalties and fines, or require us to modify our solution or require us to stop offering certain features, all of which could negatively impact our acquisition of customers and revenue growth. We may also become subject to periodic audits, which could likely increase our regulatory compliance costs and may require us to change our business practices, which could negatively impact our revenue growth. Managing legal proceedings, litigationlitigationand audits, even if we achieve favorable outcomes, is time-consuming and diverts management’s attention from our business.
“As cyber threats continue to evolve, we may be required to expend additional resources to further enhance our information security measures and/or to investigate and remediate any information security vulnerabilities. If our security measures fail or are breached, it could result in unauthorized persons accessing sensitive consumer or partner data (including personal information), a loss of or damage to our data, an inability to access data sources, or process data or provide our services to our customers. …”see in full comparison
Our services involve the storage and transmission of customers’ and our vendors’ proprietary information, sensitive or confidential data, including valuable intellectual property and personal information of employees, consumers, customers, and others, as well as the personal information (including health information and other sensitive information as defined under applicable laws) of our customers. Because of the extreme sensitivity of the information we store and transmit, the security features of our computer, network, and communications systems infrastructure are critical to the success of our business. A breach or failure of our security measures could result from a variety of circumstances and events, including third-party action, employee negligence or error, malfeasance, computer viruses, cyber-attacks by computer hackers, failures during the process of upgrading or replacing software and databases, power outages, hardware failures, telecommunication failures, user errors, or catastrophic events. Information security risks have generally increased in recent years because of the proliferation of new technologies and the increased sophistication and activities of perpetrators of cyber-attacks.see in full comparisonAsWecyberalsothreatsutilizecontinueAI toevolve,provideweservices, and this technology may berequiredsusceptible toexpendcybersecurityadditional resources to further enhance our information security measures and/or to investigate and remediate any information security vulnerabilities. If our security measures fail or are breached, it could result in unauthorized persons accessing sensitive consumer or partner data (including personal information), a loss of or damage to our data, an inability to access data sources, or process data or provide our services to our customers. Such failures or breaches of our security measures, or our inability to effectively resolve such failures or breaches in a timely manner, could severely damage our reputation, adversely affect customers, vendors, or investor confidence in us, and reduce the demand for our services from existing and potential customers. In addition, we could face litigation, damages for contract breach, monetary penalties, or regulatory actions for violation of applicable laws or regulations, and incur significant costs for remedial measures to prevent future occurrences and mitigate past violations. Although we maintain insurance covering certain security and privacy damages and claim expenses, we may not carry insurance or maintain coverage sufficient to compensate for all liability and in any event, insurance coverage would not address the reputational damage that could result from a security incident.threats.
“From time to time, we are party to lawsuits and legal proceedings in the normal course of business. These matters are often expensive and disruptive to normal business operations. …”see in full comparison
“Existing laws and regulations, including competition and antitrust laws, may be interpreted in ways that would limit our ability to use AI technologies for our business, or require us to change the way we use AI technologies in a manner that negatively affects the performance of our business and the way in which we use AI technologies. We may need to expend resources to adjust our operations in certain jurisdictions if the laws, regulations, or decisions are not consistent across jurisdictions. …”see in full comparison
Full comparison: every changed paragraph (53)
These disclosures reflect our beliefs and opinions as to risk factors that could materially and adversely affect the Company and its securities in the future. References to past events are provided by way of example only and are not intended to be a complete listing or a representation as to whether or not any other events have occurred in the past or their likelihood of occurring in the future.
We
have incurred net losses onfrom aninception annualthrough basis2025. since our inception. We incurred net losses of $18.7 million and $17.8 million inFor the years
year ended December 31, 20242025, andwe 2023,incurred respectively.a net loss from continuing operations
of $10.2 million, compared to $23.2 million for the year ended December 31, 2024. We expect our costs will increase in the foreseeable
future and we expect our losses
will continue as we expect to invest significant additional funds towards growing our platform, growing
our provider network, enhancing
our pharmacy fulfillment system, and operating as a public company and as we continue to invest in increasing
our customer base, hiring
additional employees, and developing new products and technological capabilities to enhance our customers’
experience on our platform.
These efforts may prove more expensive than we currently anticipate, and we may not succeed in increasing
our revenue sufficiently to
offset these higher expenses. To date, we have financed our operations principally from the sale of our equity,
revenue from our platform,
and the incurrence of indebtedness.
We
mayare expanding the use of AI in our business, and challenges with properly managing its use could result in reputational harm,
competitive harm, and legal
liability, and adversely affect our results of operations.
We
may use technologies such as generative AI to help us develop and market new products.products and we may in the future integrate additional AI
solutions into our offerings, products and services. The importance of these applications is increasing over time. Our competitors
or other third parties may incorporate
AI into their products and offerings more quickly or more successfully than us, which could
impair our ability to compete effectively
and adversely affect our results of operations. Additionally, AI may generate content that
is not relevant or useful to our users and
can subject us to risks related to inaccurate content, discrimination, intellectual
property infringement or misappropriation, data privacy
and cybersecurity breaches, among others. If the content, analyses, or
recommendations that AI applications assist in producing are or
are alleged to be inaccurate, deficient, or biased, our business,
financial condition and results of operations may be adversely affected.
The use of AI applications has resulted in, and may in the
future result in, cybersecurity incidents that implicate the personal medical
and genetic data of patients analyzed within such
applications. Any such cybersecurity incidents related to our use of AI applications
to analyze personal data could adversely affect
our reputation and results of operations. AI also presents emerging ethical issues and
if our use of AI becomes controversial, we
may experience brand or reputational harm, competitive harm, or legal liability. The rapid
evolution of AI, including potential
government regulation of AI and its various uses, will require significant resources to help us
implement AI ethically in order to
minimize unintended, harmful impact.
The
markets for healthcare are intensely competitive, subject to rapid change and significantly affected by new product and technological
introductions and other market activities of industry participants. We compete directly not only with other established telehealth providers
but also traditional drug manufacturers and healthcare providers, pharmacies, and large retailers that sell non-prescription products,
including, for example, nutritional supplements, vitamins, and hair care treatments. Our current competitors include traditional drug
manufacturers healthcare providers expanding into the telehealth market, incumbent telehealth providers, as well as new entrants into
our market that are focused on direct-to-consumer healthcare. Our competitors include enterprise-focused companies who may enter the
direct-to-consumer healthcare industry, as well as direct-to-consumer healthcare providers. ManyNew ofdevelopments, oursuch currentas cloud computing, AI, and potentialmachine competitors
maylearning, have greatermade nameit easier for competition to enter
our markets due to lower up-front technology costs. The Presidential administration launched
an online platform in February 2026, designed to provide lower cash prices for prescription drugs, with a heavy focus on GLP-1 medications
for weight loss and brand recognition, longer operating histories, significantly greater resources than we do, and may be able
to offer products and services similar to those offered on our platform at more attractive prices than we can. Further, our current or
potential competitors may be acquired by third parties with greater available resources, which has recently occurred in our industry.
As a result, our competitors may be able to respond more quickly and effectively than we can to new or changing opportunities, technologies,
standards, or customer requirements and may have the ability to initiate or withstand substantial price competition. In addition, our
competitors have established, and may in the future establish, cooperative relationships with vendors of complementary products, technologies,
or services to increase the availability of their solutions in the marketplace.diabetes.
Many of our current and potential competitors may have greater name and brand recognition, longer operating histories, significantly greater resources than we do, and may be able to offer products and services similar to those offered on our platform at more attractive prices than we can. Further, our current or potential competitors may be acquired by third parties with greater available resources, which has recently occurred in our industry. As a result, our competitors may be able to respond more quickly and effectively than we can to new or changing opportunities, technologies, standards, or customer requirements and may have the ability to initiate or withstand substantial price competition. In addition, our competitors have established, and may in the future establish, cooperative relationships with vendors of complementary products, technologies, or services to increase the availability of their solutions in the marketplace.
New
competitors or alliances may emerge that have greater market share, a larger customer base, more widely adopted proprietary technologies,
greater marketing expertise, and greater financial resources, which could put us at a competitive disadvantage. For example, some state
and federal regulatory authorities lowered certain barriers to the practice of telehealth in order to make remote healthcare services
more accessible in response to the COVID-19 pandemic. Although it is unclear whether these regulatory changes will be permanent or that
they will have a long-term impact on the adoption of telehealth services by the general public or legislative and regulatory authorities,
these changes may result in greater competition for our business. The lower barriers to entry may allow various new competitors to enter
the market more quickly and cost effectively than before the COVID-19 pandemic. Additionally, we believe that the COVID-19 pandemic has
introduced many new users to telehealth and further reinforced its benefits to potential competitors. We believe this may drive additional
industry consolidation or collaboration involving competitors that may create competitors with greater resources and access to potential
customers. In addition, traditional
healthcare providers may evaluate and eventually pursue telehealth options that can be paired with
their in-person capabilities. These
industry changes could better position our competitors to serve certain segments of our current or
future markets, which could create
additional price pressure. In light of these factors, even if our offerings are more effective than
those of our competitors, current
or potential customers may accept competitive solutions in lieu of purchasing from us. If we are unable
to successfully compete with
existing and potential competitors, our business, financial condition, and results of operations could be
adversely affected.
Our
success depends in large part on our ability to attract and retain high-quality managementpersonnel in marketing, engineering, operations,
healthcare, healthcare,
regulatory, legal, finance and support functions. Competition for qualified employees is intense in our industry, particularly for engineers with expertise in areas like programming, machine learning and theartificial intelligence.
The loss of even
a few qualified employees, or an inability to attract, retain and motivate additional highly skilled employees
required for the planned
expansion of our business could harm our results of operations and impair our ability to grow. To attract
and retain key personnel, we
use various measures, including an equity incentive program for key executive officers and other
employees. These measures may not be
enough to attract and retain the personnel we require to operate our business effectively. We
permit most of our employees to work remotely
should their particular positions allow. While we believe that most of our operations
can be performed remotely, there is no guarantee
that we will be as effective while working remotely because our team is dispersed
and many employees may have additional personal needs
to attend to or distractions in their remote work environment. To the extent
our current or future remote work policies result in decreased
productivity, harm our company culture, or otherwise negatively
affect our business, our financial condition and results of operations
could be adversely affected.
Our
services involve the storage and transmission of customers’ and our vendors’ proprietary information, sensitive or confidential
data, including valuable intellectual property and personal information of employees, consumers, customers, and others, as well as the
personal information (including health information and other sensitive information as defined under applicable laws) of our customers.
Because of the extreme sensitivity of the information we store and transmit, the security features of our computer, network, and communications
systems infrastructure are critical to the success of our business. A breach or failure of our security measures could result from a
variety of circumstances and events, including third-party action, employee negligence or error, malfeasance, computer viruses, cyber-attacks
by computer hackers, failures during the process of upgrading or replacing software and databases, power outages, hardware failures,
telecommunication failures, user errors, or catastrophic events. Information security risks have generally increased in recent years
because of the proliferation of new technologies and the increased sophistication and activities of perpetrators of cyber-attacks. AsWe
cyberalso threatsutilize continueAI to evolve,provide weservices, and this technology may be requiredsusceptible to expendcybersecurity additional resources to further enhance our information security measures
and/or to investigate and remediate any information security vulnerabilities. If our security measures fail or are breached, it could
result in unauthorized persons accessing sensitive consumer or partner data (including personal information), a loss of or damage to
our data, an inability to access data sources, or process data or provide our services to our customers. Such failures or breaches of
our security measures, or our inability to effectively resolve such failures or breaches in a timely manner, could severely damage our
reputation, adversely affect customers, vendors, or investor confidence in us, and reduce the demand for our services from existing and
potential customers. In addition, we could face litigation, damages for contract breach, monetary penalties, or regulatory actions for
violation of applicable laws or regulations, and incur significant costs for remedial measures to prevent future occurrences and mitigate
past violations. Although we maintain insurance covering certain security and privacy damages and claim expenses, we may not carry insurance
or maintain coverage sufficient to compensate for all liability and in any event, insurance coverage would not address the reputational
damage that could result from a security incident.threats.
As cyber threats continue to evolve, we may be required to expend additional resources to further enhance our information security measures and/or to investigate and remediate any information security vulnerabilities. If our security measures fail or are breached, it could result in unauthorized persons accessing sensitive consumer or partner data (including personal information), a loss of or damage to our data, an inability to access data sources, or process data or provide our services to our customers. Such failures or breaches of our security measures, or our inability to effectively resolve such failures or breaches in a timely manner, could severely damage our reputation, adversely affect customers, vendors, or investor confidence in us, and reduce the demand for our services from existing and potential customers. In addition, we could face litigation, damages for contract breach, monetary penalties, or regulatory actions for violation of applicable laws or regulations, and incur significant costs for remedial measures to prevent future occurrences and mitigate past violations. Although we maintain insurance covering certain security and privacy damages and claim expenses, we may not carry insurance or maintain coverage sufficient to compensate for all liability and in any event, insurance coverage would not address the reputational damage that could result from a security incident.
The
U.S. healthcare industry is heavily regulated and closely scrutinized by federal, state and local governments. Comprehensive statutes
and regulations govern the manner in which we provide and bill for services and collect reimbursement from governmental programs and
private payors; our contractual relationships with LifeMD PC, other third-party providers, vendors, and customers; our marketing activities;
and other aspects of our operations. Of particular importance are:
Federal
False Claims Act and Civil Monetary Penalties Law
There
are multiple federal laws covering the submission of inaccurate or fraudulent claims for reimbursement and errors or misrepresentations
on cost reports by hospitals and other health care providers. The coding, billing and reporting obligations of Medicare providers are
extensive, complex and highly technical. In some cases, errors and omissions by billing and reporting personnel may result in liability
under one of the federal False Claims Act or similar laws, exposing a health care provider to civil and criminal monetary penalties,
as well as exclusion from participation in the Medicare and Medicaid programs.
The
federal False Claims Act prohibits (1) knowingly submitting a false or fraudulent claim for payment to the United States; (2) knowingly
making, using or causing to be made or used a false record or statement to obtain payment from the United States; or (3) engaging in
a conspiracy to defraud the federal government by getting a false or fraudulent claim allowed or paid. This statute is violated if a
person acts with actual knowledge, or in deliberate ignorance or reckless disregard of the falsity of the claim. Penalties under the
False Claims Act include fines (subject to annual escalations based on the Consumer Price Index) per violation, plus treble damages,
potentially resulting in penalties aggregating millions of dollars for ongoing claims submission errors. Anyone who knowingly makes a
false statement or representation in any claim to the Medicare or Medicaid programs may be subject to criminal penalties, including fines
and imprisonment.
The
False Claims Act includes “whistleblower” provisions under which a person who believes that someone is violating the False
Claims Act can file a sealed complaint against the alleged violator in the name of the United States government. The nature of the allegations
is not revealed to the target during the time the United States Justice Department investigates the complaint and determines whether
to join in the suit. If the Justice Department decides not to join in the suit, the original whistleblower nonetheless can proceed. If
the case is successful, the whistleblower is entitled to between 15% and 30% of the proceeds of any fines or damages paid. Although the
False Claims Act has been in effect for many years, in recent years there has been a significant increase in the number of whistleblower
allegations filed under the False Claims Act, a large number of which involve the health care and pharmaceutical industries. In 2009,
former President Obama signed into law the Fraud Enforcement Recovery Act which authorized increased funding for fraud investigation
and prosecution, and expanded the scope of the False Claims Act to impose liability for false claims with more remote connections to
the federal government.
In
addition, the Civil Monetary Penalties Law under the Social Security Act (the “CMP Law”) provides for the imposition of civil
money penalties against an entity that engages in activities including, but not limited to, (a) knowingly presenting or causing to be
presented, a claim for services not provided as claimed or which is otherwise false or fraudulent in any way; (b) knowingly giving or
causing to be given false or misleading information reasonably expected to influence the decision to discharge a patient; (c) offering
or giving remuneration to any beneficiary of a federal health care program likely to influence the receipt of reimbursable items or services;
(d) arranging for reimbursable services with an entity which is excluded from participation from a federal health care program; (e) knowingly
or willfully soliciting or receiving remuneration for a referral of a federal health care program beneficiary; (f) using a payment intended
for a federal health care program beneficiary for another use; (g) the practice or pattern of presenting a claim for an item or service
on a reimbursement code that the person knows or should know will result in greater payment than appropriate, i.e., upcoding; and (h)
engaging in a practice of submitting claims for payment for medically unnecessary services. Penalties under the CMP Law include fines
per item or service claimed under Medicare, Medicaid, or any other federal health care program by an excluded individual or additional
fines for a violation of the anti-kickback statute. Penalties are subject to annual escalation based on the Consumer Price Index.
The
threats of large monetary penalties and exclusion from participation in Medicare, Medicaid and other federal health care programs, and
the significant costs of mounting a defense, create serious pressures on providers who are targets of false claims actions or investigations
to settle. Therefore, an action under the False Claims Act or the CMP Law could have an adverse financial impact on LifeMD and its affiliates,
regardless of the merits of the case. Additionally, on June 1, 2023, the Supreme Court in United States ex rel. Schutte v. SuperValu
Inc. unanimously held that liability under the False Claims Act depends upon a defendant’s subjective belief (rather than what
an objectively reasonable person may have known or believed). As a result, any False Claims Act litigation related to LifeMD will be
more complex and will likely incur higher administrative costs.
Stark
The
federal Ethics in Patient Referrals Act (known as the “Stark Law”) prohibits a physician who has a financial relationship,
or whose immediate family member has a financial relationship, with an entity that provides certain designated health services from referring
Medicare or Medicaid patients to that entity for the provision of such designated health services, with limited exceptions. The Stark
Law designated health services include outpatient prescription drugs and clinical laboratory services. The Stark Law also prohibits an
entity that receives a prohibited referral from filing a claim or billing for the services arising out of that prohibited referral. Unlike
the Anti-Kickback Law, the Stark Law is not an intent based statute. No wrongful intent or culpable conduct is required for violation
of the Stark Law. When a financial relationship exists between an entity and a physician, the arrangement must meet the necessary elements
of a Stark Law exception in order for a referral to be made for designated health services to that entity and for that entity to bill
for those designated health services generated by the referral. Sanctions under the Stark law include denial and refund of payments,
civil monetary penalties for each claim for a service arising out of the prohibited referral, a civil penalty against parties that enter
into a scheme to circumvent the Stark Law’s prohibition, and exclusions from the Medicare and Medicaid programs. Civil monetary
penalties are subject to annual escalations based on the Consumer Price Index. Also, because the Stark law is a Medicare payment rule,
claims prohibited by the Stark law may also be the predicate for liability under the False Claims Act. Although the Stark Law is a federal
prohibition, a number of states have passed similar statutes pursuant to which similar types of prohibitions are made applicable to all
other health plans or third-party payors.
Because
of the complexity of the Stark Law and the evolving nature of quality improvement and cost-reduction efforts, there can be no assurances
that LifeMD and its affiliates will not be found to have violated the Stark Law or the state law equivalent. If such violation were found
to have occurred, any sanctions imposed could have a material adverse effect upon the future operations and financial condition of LifeMD
and its affiliates. Additionally, amendments to regulations promulgated under the Stark Law may require LifeMD to amend or terminate
certain arrangements with physicians to comply with new regulatory requirements.
Anti-Kickback
The
federal Medicare/Medicaid Anti-Fraud and Abuse Amendments to the Social Security Act (known as the “Anti-Kickback Law”) prohibit
the knowing and willful offer, payment or receipt of remuneration in exchange for or as an inducement to make or influence a referral
of a patient, or furnishing of any goods or services that may be reimbursed under federal health benefit programs. The scope of the Anti-Kickback
Law is very broad, and it potentially implicates many practices and arrangements common in the health care industry, including space
and equipment leases, personal services contracts, purchase of physician practices, joint ventures, and relationships with vendors. Violation
of the Anti-Kickback Law is a felony and may result in imprisonment of up to ten years, statutory fines per violation, and exclusion
from the federal health care programs, as well as other state healthcare programs. In addition, civil monetary penalties may include
fines for each act (subject to annual escalations based on the Consumer Price Index), damages of not more than three times the remuneration
offered, paid, solicited, or received, and/or exclusion from participation in Medicare and Medicaid, and may be imposed on individuals
or entities that commit acts prohibited by the Anti-Kickback Law. The Patient Protection and Affordable Care Act amended the intent requirement
to provide that a person need not have actual knowledge of the Anti-Kickback law or specific intent to commit a kickback violation, to
violate the statute. In addition to the federal Anti-Kickback Statute, many states have anti-kickback and/or fee-splitting statutes designed
to prohibit inducements or improper remuneration for the referral of patients.
Federal
statutory exceptions and “safe harbor” regulations describe certain arrangements that will not be deemed to violate the Anti-Kickback
Law. However, the exceptions and safe harbors are narrow and do not cover a wide range of economic relationships that many physicians
and other health care providers historically have considered to be legitimate business arrangements not prohibited by the Anti-Kickback
Law. Because the exceptions and safe harbor regulations do not purport to describe comprehensively all lawful or unlawful economic arrangements
or other relationships between health care providers and referral sources, it is uncertain whether physicians and other health care providers
that have these arrangements or relationships may need to alter them in order to ensure compliance with the Anti-Kickback Law. Failure
to comply with an exception or safe harbor does not mean an arrangement necessarily violates the Anti-Kickback Law. However, failure
to do so may increase the likelihood of a regulatory challenge or the potential for investigation.
Because
the safe harbor exceptions are narrowly drawn and the case law interpreting the Anti-Kickback Law is sparse, there can be no assurances
that LifeMD or its affiliates will not be found to be in violation of the Anti-Kickback Law. If such a violation were found, any sanctions
imposed could have a material adverse effect upon the future operations and financial condition of LifeMD and its affiliates. In addition,
the government may assert that a claim including items or services resulting from a violation of the federal Anti-Kickback Statute constitutes
a false or fraudulent claim for purposes of the False Claims Act.
Fraud
Provisions of HIPAA
The
criminal healthcare fraud provisions of HIPAA, and related rules that prohibit knowingly and willfully executing a scheme or artifice
to defraud any healthcare benefit program or falsifying, concealing, or covering up a material fact or making any material false, fictitious
or fraudulent statement in connection with the delivery of or payment for healthcare benefits, items, or services. Similar to the federal
Anti-Kickback Statute, a person or entity does not need to have actual knowledge of the statute or specific intent to violate it to have
committed a violation.
The Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act, each enacted in March 2010, generally known as the “Affordable Care Act,” significantly expanded health insurance coverage to uninsured Americans and changed the way healthcare is financed by both governmental and private payers. Over the past several years, various laws and regulations lengthened the enrollment period, expanded income eligibility, and provided enhanced premium tax credits to eligible individuals purchasing Affordable Care Act coverage through state and federal health insurance marketplaces - all of which led to higher enrollment numbers. Certain of these provisions expired at the end of 2025, resulting in significant increases in health insurance premiums. Such increases have led to decreases in enrollment and insurance coverage, and are expected to cause a corresponding rise in the uninsured or a shift of individuals from commercial coverage to government program coverage or other more limited coverage alternatives beginning in 2026. As such, we may experience decreased patient volumes, reduced revenues and an increase in uncompensated care, which would adversely affect our results of operations and cash flows.
The
Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act, each enacted in March 2010,
generally known as the “Health Care Reform Law,” significantly expanded health insurance coverage to uninsured Americans
and changed the way healthcare is financed by both governmental and private payers. Since then, the Health Care Reform Law has prompted
legislative efforts to significantly modify or repeal the Health Care Reform Law, which may impact how the federal government responds
to lawsuits challenging the Health Care Reform Law. We cannot predict what further reform proposals, if any, will be adopted, when they
may be adopted, or what impact they may have on our business. If we are required to comply with the Health Care Reform Law and fail to
comply or are unable to effectively manage such risks and uncertainties, our financial condition and results of operations could be adversely
affected. Further, Federal budget proposals and/or approvals impacting funding for government health care programs, such as Medicare
and Medicaid, could result in adverse impacts to health care services pricing strategies across the health care industry.
The
products we sell and our third-party suppliers are subject to FDA regulations and other state and local requirements, and if we or our
third party suppliers fail to comply with federal, state, and local requirements, ourwe abilitymay toface fulfillenforcement customers’ orders through
our platform could be impaired.actions.
The
products available through our platform, and the third-party suppliers and manufacturers of these products, are subject to extensive
regulation by the FDA and state and local authorities, including pharmaceuticals, OTC drugs, OTC devices, cosmetics, and dietary supplements.
These authorities can enforce regulations related to methods and documentation of the testing, production, compounding, control, quality
assurance, labeling,labelling, packaging, sterilization, storage, and shipping of products. Government regulations specific to pharmaceuticals
are wide ranging and govern, among other things: the ability to bring a pharmaceutical to market, the conditions under which it can be
sold, the conditions under which it must be manufactured, and permissible claims that may be made for such product. With the FDA declaring
GLP-1 shortages resolved, telehealth firms relying on compounded semaglutide or tirzepatide face “mass-marketed” drug enforcement.
Furthermore, the FDA and FTC are increasingly issuing warning letters for “false and misleading” claims that compounded drugs
are “identical” to branded versions. Failure to meet—or
significant changes to—any federal, state, or local requirements
attendant to the sales and marketing of a regulated product could
result in enforcement actions, impede our ability to provide access
to affected products, and have a material adverse effect on our business,
financial condition and results of operations.
FDA
potential restrictions on compounding of GLP-1s, including removal of tirzepatide (marketed as Mounjaro® and Zepbound®) and/or
semaglutide (marketed as Ozempic® and Wegovy®) from the drug shortage list, have the potential to disrupt patient treatment
continuity, by limiting our ability to provide personalized treatment plans that meet individual patient needs, and could adversely impact
our financial results. For additional discussion of the regulatory landscape applicable to GLP-1s, see “Government Regulation”
under Part I, Item 1. “Description of Business”.
In
addition, the Trump administration issued an executive order on February 11, 2025, called “Implementing the President’s ‘Department
of Government Efficiency’ Workforce Optimization Initiative.” This Workforce Optimization Initiative may significantly reducereduced
the size of the federal government workforce, including FDA workforce. This initiative couldhas resultresulted in fewer FDA staff available to review
and approve new drug products. It is possible that the Workforce Optimization Initiative could significantly lengthen the time it takes
to obtain FDA approval of a new medical device or drug product, which could inhibit our ability to offer access to new products.
We
collect and transmit healthcare-related information to and from our customers, providers, and partner pharmacies in connection with the
telehealth consultations conducted by the providers and prescription medication fulfillment by our partner pharmacies.pharmacies, and these efforts may be assisted by AI applications in certain instances. If the data that
we provide to our customers, providers, or partner pharmacies are incorrect or incomplete or if we make mistakes in the capture or input
of these data, our reputation may suffer and we could be subject to claims of liability for resulting damages. While we maintain insurance
coverage, this coverage may prove to be inadequate or could cease to be available to us on acceptable terms, if at all. Even unsuccessful
claims could result in substantial costs and the diversion of management resources. A claim brought against us that is uninsured or under-insured
could harm our business, financial condition, and results of operations.
Numerous
state and federal laws and regulations govern the collection, dissemination, use, privacy, confidentiality, security, availability, integrity,
and other processing of health information and other types of personal data or personally identifiable information (“PII”).
In particular:
HIPAA
Congress
enacted The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) as part of a broad health care reform effort.
Among other things, HIPAA established a program administered jointly by the Secretary of HHS and the United States Attorney General designed
to coordinate federal, state and local law enforcement programs to control fraud and abuse in connection with the federal health care
programs. In addition, Congress greatly increased funding for health care fraud enforcement activity, enabling the OIG to substantially
expand its investigative staff and authorizing the Federal Bureau of Investigation to quadruple the number of agents assigned to health
care fraud. The result has been a dramatic increase in the number of civil, criminal and administrative prosecutions for alleged violations
of the laws relating to payment under the federal health care programs, including the Anti-Kickback Law and the False Claims Act. This
expanded enforcement activity, together with the whistleblower provisions of the False Claims Act, has significantly increased the likelihood
that health care providers, including LifeMD and its affiliates, could face inquiries or investigations concerning compliance with the
many laws governing claims for payment and cost reporting under the federal health care programs.
In
addition to the expanded enforcement activity noted above, the “Administrative Simplification” provisions of HIPAA mandate
the use of uniform standard electronic formats for certain administrative and financial health care transactions, the adoption of minimum
security standards for individually identifiable health information maintained or transmitted electronically, and compliance with privacy
standards adopted to protect the confidentiality of personal health information. The Administrative Simplification provisions apply to
health care providers, health plans, and health care clearinghouses, and their agents and subcontractors referred to as Business Associates
(collectively “Covered Entities”). Use and disclosure of certain broadly defined protected health information is prohibited
unless expressly permitted under the provisions of HIPAA and related regulations or authorized by the patient. HIPAA’s privacy
and security provisions extend not only to patient medical records but also to a wide variety of health care clinical and financial settings
where patient privacy restrictions often impose new communication, operational accounting and billing restrictions. These restrictions
add costs and create potentially unanticipated sources of legal liability.
On
January 25, 2013, HHS issued comprehensive modifications to the existing HIPAA regulations to implement the requirements of the HITECH
Act (see below for more on the HITECH Act), commonly known as the “HIPAA Omnibus Rule.” The HIPAA Omnibus Rule became effective
on March 26, 2013, and covered entities were required to be in compliance by September 23, 2013 (though certain requirements have a longer
timeframe), Key aspects of the HIPAA Omnibus Rule include but are not limited to: (i) a new standard for what constitutes a breach of
protected health information, (ii) establishing four levels of culpability with respect to civil monetary penalties assessed for HIPAA
violations, (iii) direct liability of business associates for certain violations of HIPAA, (iv) modifications to the rules governing
research, (v) stricter requirements regarding non-exempt marketing practices, (vi) modification and re-distribution of notices of privacy
practices, and (vii) stricter requirements regarding the protection of genetic information.
OCR
has substantially increased enforcement of HIPAA compliance in recent years. This includes, but is not limited to, a steady increase
in the number of settlements with substantial financial penalties with governmental authorities as a result of breaches. If OCR conducts
an investigation (whether as a result of an audit or reporting of such a breach), OCR could impose significant fines and penalties and
could also require LifeMD and its affiliates to enter into a corrective action plan. There are also costs and risks associated with vendors
and contractors and it is possible that LifeMD and its affiliates could be responsible for HIPAA violations or breaches of their vendors
and contractors. In addition, as data breaches continue to have greater exposure both inside and outside of the health care industry,
and awareness of such breaches continues, private litigation is expected to increase. As a result, no assurances can be given that LifeMD
and its affiliates will not be faced with potential private litigation in the event of a data breach.
HITECH
Act
The
American Recovery and Reinvestment Act of 2009 (“ARRA”), which includes the Health Information Technology for Economic and
Clinical Health Act (“HITECH Act”), appropriated approximately $20 billion for the development and implementation of health
information technology (“HIT”) standards and the adoption of electronic health care records. The HIT infrastructure is intended
to improve health care quality, reduce health care costs and facilitate access to necessary information. Among other things, the HITECH
Act provides financial incentives (through the Medicaid and Medicare programs) as well as loans and grants to encourage practitioners
and providers to engage in “meaningful use” of electronic health record (“EHR”) technology. Health care providers
demonstrate their meaningful use of EHR technology by meeting objectives specified by CMS for using HIT and by reporting on specified
clinical quality measures. Medicare payments are significantly reduced for physicians who have not satisfied the performance and reporting
criteria for demonstrating meaningful use.
ARRA
also significantly expanded the HIPAA privacy and security provisions applicable to Covered Entities and their business associates. The
law provides that individuals be notified when there is a breach of their unsecured electronic personal health information, increases
civil monetary and criminal penalties for HIPAA violations, and authorizes the state attorneys general to enforce its provisions. Each
Covered Entity must report any breach involving over 500 individuals in a state to HHS and the local media. All other breaches must be
reported annually to HHS. The financial costs of continuing compliance with HIPAA and the Administrative Simplification regulations are
substantial and will increase as a result of the ARRA amendments. The HITECH Act also limits a Covered Entity’s discretion in determining
what health care information about a person may be properly disclosed under the HIPAA privacy regulations.
InNumerous
addition, numerous other federal, state,state and foreignfederal laws and regulations protectgovern the confidentiality,collection, dissemination, use, privacy, confidentiality, security, availability,
integrity, integrity
and securityother processing of health information and other types of PII,personal data or personally identifiable information
(“PII”), including without limitation the California Confidentiality of Medical Information
Act and Washington
State’s MHMDA. These laws and regulations in many cases are more restrictive than, and may not be preempted
pre-empted by, HIPAA and its
implementing rules. These laws and regulations are often uncertain, contradictory, and subject to changed or differing
interpretations, and we expect new laws, rules and regulations regarding privacy, data protection, and information security to be
proposed proposed
and enacted in the future. This complex, dynamic legal landscape regarding privacy, data protection, and information security
and AI creates
significant compliance issues for us, the LifeMD PC and the providers and potentially exposes us to additional
expense, adverse publicity,
and liability. While we have implemented data privacy and security measures in an effort to comply with
applicable laws and regulations
relating to privacy and data protection, some health information and other PII or confidential
information is transmitted to us by third
parties, who may not implement adequate security and privacy measures, and it is possible
that laws, rules, and regulations relating
to privacy, data protection, or information security may be interpreted and applied in a
manner that is inconsistent with our practices
or those of third parties who transmit health information and other PII or
confidential information to us. If we or these third parties
are found to have violated such laws, rules or regulations, it could
result in government-imposed fines, orders requiring that we or
these third parties change our or their practices, or criminal
charges, which could adversely affect our business. Complying with these
various laws and regulations could cause us to incur
substantial costs or require us to change our business practices, systems, and compliance
procedures in a manner adverse to our
business.
The
regulatory framework for privacy and security issues worldwide is evolving and is likely to remain in flux for the foreseeable future.future, including the intersection of such issues with the integration of AI.
Various government and consumer agencies have also called for new regulation and changes in industry practices and multiple U.S. states
have passed comprehensive consumer privacy laws and consumer health privacy laws over the last three years. Practices regarding the registration,
collection, processing, storage, sharing, disclosure, use, and security of personal and other information by companies offering an online
service like our platform have recently come under increased public and regulatory scrutiny.
For
example, the CCPA and nineteen other state consumer privacy laws require, among other things, covered companies to provide certain disclosures
to consumers and afford such consumers new abilities to opt-out or sharing of personal information and limit the use of sensitive information,
including health information. Similar legislation has been proposed or adopted in other states. Furthermore, state consumer health data
privacy laws including Washington State’s MHMDA creates new data processing requirements specifically for consumer health data
that is not subject to HIPAA, limiting how organizations may use a wide range of consumers’ health-related data, and requiring
changes to how impacted organizations obtain consent and authorization to collect, process, and share such information. Aspects of the
CCPA, the MHMDA, other comprehensive privacy laws, consumer health data privacy laws, and regulations, as well as their enforcement,
remain unclear, and we may be required to modify our internal compliance and data-use practices in an effort to comply with them.
The
regulatory framework for AI is evolving and is likely to remain in flux for the foreseeable future. InOver the last year, various government
and consumer agencies have called for new regulation and changes in industry practices, while Colorado and other20 states have passed or
are considering laws applicable to the development or use of AI systems. The development and adoption of these new laws may create significant
compliance burdens or inhibit our ability to develop products and services that incorporate AI or do so in a cost-effective manner. Our
business, including our ability to operate and to expand internationally, could be adversely affected if AI laws or regulations are adopted,
interpreted, or implemented in a manner that is inconsistent with our current business practices and that require changes to these practices,
the design of our websites, mobile applications, solutions, or other features. Our use of AI may also result in a risk of investigations
or fines relating to noncompliance with these laws or require us to modify our solution or require us to stop offering certain features,
all of which could negatively impact our acquisition of customers and revenue growth.
Existing laws and regulations, including competition and antitrust laws, may be interpreted in ways that would limit our ability to use AI technologies for our business, or require us to change the way we use AI technologies in a manner that negatively affects the performance of our business and the way in which we use AI technologies. We may need to expend resources to adjust our operations in certain jurisdictions if the laws, regulations, or decisions are not consistent across jurisdictions. Further, the cost to comply with such laws, regulations, or decisions and/or guidance interpreting existing laws, could be significant and would increase our operating expenses (such as by imposing additional reporting obligations regarding our use of AI technologies). Such an increase in operating expenses, as well as any actual or perceived failure to comply with such laws and regulations, could adversely affect our business, financial condition, and results of operations.
We
are subject to legal proceedings and litigation, including intellectual property disputes, which are costly to defend and could materially
harm our business and results of operations.
From time to time, we are party to lawsuits and legal proceedings in the normal course of business. These matters are often expensive and disruptive to normal business operations. Active or potential risk factors include allegations, lawsuits, and regulatory inquiries, audits, and investigations regarding securities law violations and other matters including, data privacy and security, labor and employment, consumer protection, practice of medicine, and intellectual property infringement, including claims related to or arising from privacy rights, patents, publicity rights, trademarks, copyrights, negligence, and other rights. We and our officers and directors are defendants in litigation related to our public disclosures about our business and our compliance with securities laws. Many virtual care sites, including our websites, have been subject to claims for using tracking technologies in ways that improperly share sensitive patient data with third parties.
FromLitigation
time to time, we are party to lawsuits and legal proceedings in the normal course of business. These matters are often expensive and
disruptive to normal business operations. We may face allegations, lawsuits, and regulatory inquiries, audits, and investigations regarding
data privacy, security, labor and employment, consumer protection, practice of medicine, and intellectual property infringement, including
claims related to privacy, patents, publicity, trademarks, copyrights, and other rights. A portion of the technologies we use incorporates
open source software, and we may face claims claiming ownership of open source software or patents related to that software, rights to
our intellectual property or breach of open source license terms, including a demand to release material portions of our source code
or otherwise seeking to enforce the terms of the applicable open source license. We may also face allegations or litigation related to
our acquisitions, securities issuances, or business practices, including public disclosures about our business. Litigation and regulatory
proceedings, and particularly the healthcare regulatory and class action matters we could face, may be protracted and
expensive, and
the results are difficult to predict. Certain of these matters may include speculative claims for substantial or indeterminate
amounts amounts
of damages and include claims for injunctive relief. Additionally, our litigation costs could be significant. Adverse outcomes
with respect
to litigation or any of these legal proceedings may result in significant settlement costs or judgments, penalties and fines,
or require
us to modify our solution or require us to stop offering certain features, all of which could negatively impact our acquisition
of customers
and revenue growth. We may also become subject to periodic audits, which could likely increase our regulatory compliance
costs and may
require us to change our business practices, which could negatively impact our revenue growth. Managing legal proceedings,
litigation litigation
and audits, even if we achieve favorable outcomes, is time-consuming and diverts management’s attention from our business.
Our
substantialexisting leverage could adversely affect our ability to raise additional capital to fund our operations, limit our ability to react to
to changes in the economy or our industry, expose us to interest rate risk to the extent of our variable rate debt and prevent us from meeting
meeting our obligations.
As
of December 31, 2024,2025, the Company had total liabilities of $76.5$47.3 million. As of December 31, 2024,2025, we had availability of $53.3$44.6 million
under the ATM Sales Agreement (as defined below) and $150 million available under the 2024 Shelf (as defined below), after giving effect
to letters of credit and borrowing base limitations.. We and our subsidiaries have the ability to incur additional indebtedness in the future,
future, subject to the restrictions contained in our credit facilities and the indentures governing our outstanding notes. If new indebtedness
is added to our current debt levels, interest rates and the related risks that we now face could intensify. Our ability to make scheduled
payments on or to refinance our debt obligations depends on our financial condition and operating performance, which are subject to prevailing
economic and competitive conditions, and to certain financial, business and other factors beyond our control. We cannot assure you we
will maintain a level of cash flows from operating activities sufficient to permit us to pay the principal, premium, if any, and interest
on our indebtedness.
The
Sarbanes-Oxleyrules Actand requires,regulations of the SEC require, among other things, that we maintain effective internal control over financial reporting and effective disclosure
controls and procedures. In particular, under Section 404 of the Sarbanes-Oxley Act, we are required to perform system and process evaluation
and testing onevaluate the effectiveness of our internal control over
financial reporting,reporting and ourdisclosure independent registered public accounting firm
is required to report on the effectiveness of our internal control over financial reporting. In performing this evaluationcontrols and testing,
bothprocedures. our management andAdditionally, our independent registered public accounting firm concludedis
required thatto our internal control over financial reporting
is not effective as of December 31, 2024 because of material weaknesses and our independent registered public accounting firm expressed
an adverse opinion onaudit the effectiveness of our internal control over financial reporting as of December 31, 2024.2025. Our management and our
independent registered public accounting firm concluded that our internal control over financial reporting is not effective as of
December 31, 2025 because of material weaknesses. See Part II, Item 9A.,
“Controls and Procedures”. We are,are however,focused addressing this issue and on
remediating our material weaknesses. CorrectingRemediating this
issue,the andmaterial thereafter our continued compliance with Section 404weaknesses will require that we incur substantial accounting expenseexpenses and expect
to expend
significant management efforts. Moreover, if we are not able to correctremediate our material weaknesses in internal control issues and comply with the requirementsover
of Section 404 in a timely manner, or if we or our independent registered public accounting firm continues to identify deficiencies in
our internal controls over financial reporting that are deemed to be material weaknesses,reporting, the market price of our stock could decline,
and we could be subject to sanctions or
investigations by the SEC or other regulatory authorities, which would require additional financial
and management resources. It
could adversely affect our ability to report our financial condition and results of operations in a timely
and accurate manner,
which could negatively affect investor confidence in our company, and, as a result, the value of our common stock
could be adversely
affected.
Management's Discussion & Analysis (MD&A)
New heading “Developments in 2025”
New heading “Discontinued Operations”
New heading “Optimal Human Health MD (“OHHMD” Acquisition)”
Removed heading “Developments in 2024”
Removed heading “Vertically Integrated Pharmacy”
Removed heading “Commercial Health Insurance”
Removed heading “Regulatory Landscape”
Largest changes
“Net cash used in financing activities for the year ended December 31, 2024 was approximately $4.1 million as compared with net cash provided by financing activities of approximately $29.1 million for the year ended December 31, 2023. Significant factors contributing to net cash used in financing activities during the year ended December 31, 2024, include preferred stock dividends of approximately $3.1 million, distributions to non-controlling interest of approximately $774 thousand, and repayments of notes payable of approximately $328 thousand. …”see in full comparison
“In September 2025, the FASB issued ASU 2025-06, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software, to simplify and modernize the accounting for internal-use software costs. The amendments remove references to prescriptive software development stages and clarify that capitalization of eligible software development costs begins when management authorizes and commits to funding the project and it is probable the project will be completed, and the software will be used as intended. …”see in full comparison
On March 21, 2023, the Company entered into and closed on a loan and security agreement (the “Avenue Credit Agreement”), and a supplement to the Credit Agreement (the “Avenue Supplement”), with Avenue Venture Opportunities Fund II, L.P. and Avenue Venture Opportunities Fund, L.P. (collectively, “Avenue”). The Avenue Credit Agreementsee in full comparisonprovidesprovided for a convertible senior secured credit facility of up to an aggregate amount of $40 million, comprised of the following: (1) $15 million in term loans funded at closing, (2) $5 million of additional committed term loans which the Company received on September 26, 2023 under the First Amendment to the Avenue Credit Agreement (the “Avenue First Amendment”) and (3) $20 million of additional uncommitted term loans, collectively referred to as the “Avenue Facility”. TheAvenue Facility matures on October 1, 2026. TheCompany issued Avenue warrants to purchase $1.2 million of the Company’s common stock at an exercise price of $1.24, subject toadjustments.adjustments, of which $660 thousand have been exercised (the “Avenue Warrants”). In addition, Avenuemayconvert up toconverted $2 million of the $15 million in term loans funded at closing into shares of the Company’s common stockat any time while the loans are outstanding,at a price per share equal to $1.49. Proceeds from the Avenue Facility were used to repay the Company’s outstanding notes payable balances with CRGFinancialFinancial. On August 5, 2025, the Company paid the remaining $14.0 million in outstanding principal payments on the Avenue Facility andaretheexpectedprepaymenttopenaltybeasusednoted in the Avenue Credit Agreement. As of December 31, 2025, there is no outstanding balance on the Avenue Facility. The Company recorded a loss on debt extinguishment of $1.2 million within its consolidated financial statements forgeneralthecorporateyearpurposes.ended December 31, 2025. As of December 31, 2025, $540 thousand Avenue Warrants remain outstanding.
Full comparison: every changed paragraph (46)
We are a direct-to-patient telehealth company providing a high-quality, cost-effective, and convenient way to access comprehensive, virtual and in-home healthcare. We believe the traditional model of visiting a doctor’s office, traveling to a retail pharmacy, and returning for follow-up care or prescription refills is complex, inefficient, and costly, which discourages many individuals from seeking much-needed medical care. LifeMD is improving the delivery of the healthcare experience through telehealth with our proprietary technology platform, affiliated and dedicated provider network, broad and expanding treatment capabilities, and the unique ability to nurture patient relationships.
The LifeMD telehealth platform integrates best-in-class capabilities including a 50-state medical group, a nationwide pharmacy network, a wholly-owned affiliated commercial pharmacy, nationwide laboratory and diagnostic testing capabilities, a fully integrated electronic medical records (“EMR”) system and a patient care and service call center. These capabilities are integrated by an industry-leading, proprietary telehealth technology that supports a broad range of primary care, chronic disease and lifestyle healthcare needs. Currently, LifeMD treats approximately 328,000 active patient subscribers across a range of their medical needs including primary care, men’s sexual health, weight management, sleep, hair loss and hormonal therapy by providing telehealth clinical services and prescription and over-the-counter (“OTC”) treatments, as medically appropriate. Our virtual primary care services are primarily offered on a subscription basis. Since inception, we have helped more than 1,387,000 customers and patients by providing them with greater access to high quality, convenient, and affordable care.
Our mission is to empower people to live healthier lives by increasing access to high-quality and affordable virtual and in-home healthcare. We believe our success has been, and will continue to be, attributable to an amazing patient experience, made possible by attracting and retaining the highest-quality providers in the country, and our vertically integrated care platform. As we continue to pursue long-term growth, we plan to continue to introduce new telehealth product and service offerings that complement our already expansive treatment areas.
LifeMD,
Inc. is a direct-to-patient telehealth company with a portfolio of health and wellness brands. Our subscriptions and products are marketed
and sold directly to consumers through advertisements on Facebook, Google, Amazon, and other social media and e-commerce platforms. Secondarily,
we also sell our products through third party partner channels. We market branded and generic prescription drugs that are then sold and
shipped online directly to consumers in all 50 states and the District of Columbia and Puerto Rico. We have also established a 50-state
medical group that provides virtual consultations to our patients. Since inception, we have treated approximately 1,118,000 customers
and patients nationwide. We operate our business using a proprietary telehealth technology platform that facilitates a compliant relationship
between the patient, provider, us and pharmacy.
Our
portfolio of brands are included within two operating segments: Telehealth and WorkSimpli. We believe our current segments and brands
within our segments complement one another and position us well for future growth.
Developments
in 2024
Key
developments in our business during 2024 are described below:
Vertically
Integrated Pharmacy
In November 2024, we announced the opening of a state-of-the-art wholly-owned
affiliated commercial pharmacy, marking an important milestone in creating a fully integrated, end-to-end telehealth platform. This 22,500-square-foot
facility, located in Lancaster, PA and designed to fill up to 5,000 daily prescriptions, allows us to offer patients a more cohesive care
journey for relevant conditions from initial consultation to prescription fulfillment within a single integrated ecosystem. The launch
of the LifeMD Pharmacy enhances the Company’s vertically integrated telehealth platform, which now includes a proprietary virtual-first
care technology platform, a 50-state affiliated medical group, a U.S.-based patient care center, and a vertically integrated pharmacy.
Activity through the LifeMD Pharmacy was immaterial for the year ended December 31, 2024.
Commercial
Health Insurance
In
June 2024, the Company launched the acceptance of private health insurance for its virtual primary care services, including weight management
for medically qualified patients. Initially available in select states, the Company plans to continue enrollments with private payors
to facilitate access to medically necessary services, ultimately having broad coverage options across all 50 states. AsIn partApril 2025, the
Company expanded acceptance of itsinsurance earlyto Medicare beneficiaries for qualifying care. Initially available to more than 21 million Medicare
2025Part roadmap,B beneficiaries in 26 states, the Company expectshas continued investing in its Medicare Part B offering
and now has the infrastructure in place to begindeliver acceptingqualifying Medicare.services to Medicare Part B beneficiaries across 49 states. The
One Big Beautiful Bill Act (the “OBBBA”), which was signed in July 2025, permanently extends the safe harbor for high-deductible
health plans to cover telehealth services before the deductible is met, effective for plan years starting on or after January 1, 2025.
This ensures employees with health savings accounts can access, and employers can offer, pre-deductible virtual care without losing tax-advantaged
status.
Developments in 2025
Key developments in our business during 2025 are described below:
Discontinued Operations
On November 4, 2025, we sold our majority ownership interest in WorkSimpli to Lion Buyer, LLC. This transaction represents a key milestone in the Company’s strategic transformation, further positioning the Company as a pure-play healthcare company exclusively focused on expanding its virtual care and pharmacy offerings. WorkSimpli is classified as discontinued operations for all periods presented in these consolidated financial statements included in this Annual Report on Form 10-K. The Company recorded a gain on sale of discontinued operations, net of tax, of $21.3 million which is included in net income from discontinued operations in the consolidated statement of operations for the year ended December 31, 2025. See Note 4—Discontinued Operations to our consolidated financial statements included in this report.
Optimal Human Health MD (“OHHMD” Acquisition)
On April 24, 2025, the Company closed on the OHHMD Asset Purchase Agreement (the “OHHMD APA”) with OHHMD, PLLC, a North Carolina professional limited liability company, Doug Lucas, DO, the sole member of OHHMD, and the Company’s affiliate LifeMD Southern Patient Medical Care, P.C., a Florida professional corporation (the “PC Purchaser”), whereby the Company and the PC Purchaser acquired certain intangible assets of OHHMD, a nationwide virtual care provider focused on women’s health and hormone replacement therapies. The acquisition marked the launch of the Company’s official entry into the women’s health market and establishes a scalable clinical foundation for a comprehensive virtual health program under the LifeMD brand, focused on hormone health, bone density, metabolism, and long-term wellness.
Regulatory
Landscape
The
Food and Drug Administration (“FDA”) potential restrictions on compounding of GLP-1s, including removal of tirzepatide (marketed
as Mounjaro® and Zepbound®) and/or semaglutide (marketed as Ozempic® and Wegovy®) from the drug shortage list, have
the potential to disrupt patient treatment continuity, by limiting our ability to provide personalized treatment plans that meet individual
patient needs, and could adversely impact our financial results. For additional discussion of the regulatory landscape applicable to GLP-1s,
see “Government Regulation” under Part I, Item 1. “Description of Business”.
TotalTelehealth
revenue, net. RevenuesTelehealth revenues for the year ended December 31, 20242025 were approximately $212.4$194.1 million, an increase of 39%25% compared
to approximately
$152.5 $154.8 million for the year ended December 31, 2023.2024. The increase in telehealth revenues was attributable to thean increase
in online sales demand primarily related to telehealth subscription revenue which experienced an increase in telehealth revenue
of 61%approximately slightly$45.6 offset by the decrease in WorkSimpli revenue of 1%. Telehealth revenue accounts for 75% of total revenue and has increasedmillion
during the year ended December 31, 2024 due to an increase in online sales demand primarily for LifeMD virtual primary care which experienced
an increase in revenue of approximately $65.7 million during the year ended December 31, 20242025 compared to the year ended December 31,
2023. WorkSimpli revenue accounts for 25% of total revenue and has decreased year over year due to lower demand.2024.
TotalCost
costof oftelehealth revenue. Total cost of revenue consists of (1) the costCost of telehealth revenues, which primarily include product costs, pharmacy
fulfillment fulfilment costs, physician consult
fees, and shipping costs directly attributable to our prescription and OTC products and (2) the
cost of WorkSimpli revenue consisting primarily of information technology fees related to providing the services made available on our
online platform. Total cost of revenue increased by approximately 27%29% to approximately $24.1 $27.7
million for the year ended December 31,
2024 2025 compared to approximately $18.9$21.4 million for the year ended December 31, 2023.2024. The combined cost of
telehealth revenue increase was due to increased
telehealth sales volume during the year ended December 31, 20242025 when compared to the
year ended December 31, 2023.2024. Telehealth costs decreased
tostayed consistent at 14% of associated telehealth revenues during the year ended December 31, 2024, from 18% of associated telehealth revenues during the
year ended December 31, 2023 primarily due to improved pricing. WorkSimpli costs increased to 5% of associated WorkSimpli revenues during
the year ended December 31, 2024, from 3% of associated WorkSimpli revenues duringboth the year ended
December 31, 2023.2025 and 2024.
Gross profit. Gross profit increased by approximately 25% to approximately $166.3 million for the year ended December 31, 2025 compared to approximately $133.4 million for the year ended December 31, 2024. Gross profit as a percentage of revenues stayed consistent at 86% for both the year ended December 31, 2025 and 2024.
Gross
profit. Gross profit increased by approximately 41% to approximately $188.4 million for the year ended December 31, 2024 compared to
approximately $133.6 million for the year ended December 31, 2023. Gross profit as a percentage of revenues was 89% for the year ended
December 31, 2024 compared to 88% for the year ended December 31, 2023. Gross profit as a percentage of revenues for telehealth was 86%
for the year ended December 31, 2024 compared to 82% for the year ended December 31, 2023, and for WorkSimpli was 95% for the year ended
December 31, 2024 compared to 97% for the year ended December 31, 2023. The increase in sales volume for LifeMD virtual primary care
and improved pricing have contributed to the increase in gross profit.
These increases in operating expenses were partially offset by a decrease in general and administrative expenses. This category mainly consists of stock-based compensation expense, merchant processing fees, payroll expenses for corporate employees, taxes and licenses, amortization expense and legal and professional fees. During the year ended December 31, 2025, the Company had a decrease of approximately $11 thousand, or 0.02%, in general and administrative expenses. Decreases in stock-based compensation expense of $1.7 million and taxes and licenses of $236 thousand were partially offset by increases in legal and professional fees of $1.3 million and merchant processing fees of $490 thousand.
Interest
expense, net. Interest expense, net consists of interest expense on the Avenue Facility and(as notesdefined payable,below), partially offset by interest
income on the Company’s cash account balances for the year ended December 31, 20242025 and interest expensedexpense related to the Avenue Facility
Facility,and notes payablepayable, andpartially offset by interest income on the SeriesCompany’s Bcash Preferredaccount Stockbalances for the year ended December 31, 2023. 2024.
Interest expense decreased by approximately
$415 $814 thousand during the year ended December 31, 20242025 as compared to the year ended December
31, 20232024 primarily due to anthe increaseextinguishment in
interest income onof the Company’sAvenue cashFacility accountduring balances.the year ended December 31, 2025.
Loss
on debt extinguishment. The Company recorded a $325$1.2 thousandmillion loss on debt extinguishment related to the repayment of the CRGAvenue FinancialFacility
loan during the year ended December 31, 20232025 due to a prepayment penalty and various fees associated with the CRGAvenue FinancialFacility. loan.There were
no similar losses on debt extinguishment recorded during the year ended December 31, 2024.
Working Capital (Deficit)
Working
capital decreasedincreased by approximately $19.3$25.3 million during the year ended December 31, 2024.2025. TheCurrent increaseassets indecreased by approximately
$538 thousand, which was primarily attributable to a decrease of $3.4 million related to the Company’s current assets isof
discontinued primarily
attributableoperations tothat anwere increasesold on November 4, 2025 and a decrease in accounts receivable of approximately $2.9$1.2 million, partially offset
by an increase in cash of approximately $1.9 million,
and an increase in other current assets of approximately $1.7$4.1 million. Current liabilities increaseddecreased by approximately $25.5$25.8 million,
which was
primarily attributable to ana increase in accounts payable and accrued expensesdecrease of $11.8$8.9 million asrelated to the Company’s current liabilities of discontinued operations
that were sold on November 4, 2025, a result of the Company
extending payables and credit terms with vendors, an increasedecrease in the current portion of long-term debt of $8.4 million, anda andecrease increase
in deferred
revenue of approximately $5.7$6.3 millionmillion, dueand toa increasednet recurringdecrease telehealthin subscriptionaccounts revenue.payable and accrued expenses of $2.5 million.
Net cash provided by operating activities was approximately $8.3 million for the year ended December 31, 2025, as compared with approximately $17.5 million for the year ended December 31, 2024. Significant factors contributing to net cash provided by operating activities during the year ended December 31, 2025, include: (1) $10.5 million in non-cash stock-based compensation charges, (2) $7.5 million in non-cash depreciation and amortization, (3) net cash provided by operating activities of discontinued operations of $6.0 million, (4) the $1.2 million loss on debt extinguishment recorded related to the repayment of the Avenue Facility on August 5, 2025, and (5) a decrease in accounts receivable of $1.2 million. These factors were partially offset by: (1) the Company’s net loss from continuing operations of $10.2 million, (2) a decrease in deferred revenue of $6.3 million, and (3) a net decrease in accounts payable and accrued expenses of $2.5 million. The significant factors contributing to net cash provided by operating activities during the year ended December 31, 2024, include: (1) an increase in accounts payable and accrued expenses of $14.9 million, (2) $12.2 million in non-cash stock-based compensation charges, (3) an increase in deferred revenue of $9.8 million, (4) $6.6 million in non-cash depreciation and amortization, and (5) net cash provided by operating activities of discontinued operations of $3.1 million. These factors were partially offset by the Company’s net loss from continuing operations of $23.2 million for the year ended December 31, 2024 and an increase in accounts receivable of $4.5 million.
Net
cash provided by operating activities was approximately $17.5 million for the year ended December 31, 2024, as compared with approximately
$8.8 million for the year ended December 31, 2023. Significant factors contributing to net cash provided by operating activities during
the year ended December 31, 2024, include $12.2 million in non-cash stock-based compensation charges, $9.9 million in non-cash depreciation
and amortization, a net increase in accounts payable and accrued expenses of $12.4 million, and an increase in deferred revenue of $5.7
million. These factors were partially offset by the Company’s net loss of $18.7 million for the year ended December 31, 2024. The
significant factors contributing to net cash provided by operating activities during the year ended December 31, 2023, include the decrease
in the Company’s net loss of $27.2 million to $17.8 million for the year ended December 31, 2023, as compared with $45.0 million
for the year ended December 31, 2022. Other significant factors contributing to net cash provided by operating activities during the
year ended December 31, 2023, include $12.5 million in non-cash stock-based compensation charges, $6.9 million in non-cash depreciation
and amortization, a net increase in accounts payable, accrued expenses and other operating activities of $5.1 million, an increase in
deferred revenue of $3.3 million and a $325 thousand loss on debt extinguishment.
Net
cash usedprovided inby investing activities for the year ended December 31, 20242025 was approximately $11.5$6.9 million, as compared with $8.7 million
for the year ended December 31, 2023. Netnet cash
used in investing activities of $11.5 million for the year ended December 31, 20242024. Net cash provided by investing activities for the
year ended December 31, 2025 was primarily due to net cash provided by investing activities of discontinued operations, including the
net proceeds received from the WorkSimpli sale of $19.4 million, partially offset by cash paid for capitalized software costs of approximately $10.0
$7.6 million, and cash paid for the purchase of equipment of approximately
$1.5 $1.9 million. Net cash used in investing activities for the
year ended December 31, 20232024 was primarily due to cash paid for capitalized
software costs of approximately $8.4$6.7 million,million and cash paid
for the purchase of equipment of $204$1.5 thousandmillion. andNet cash paidused forin theinvesting purchase
of intangible assetsactivities of approximatelydiscontinued $149operations thousand.was $3.3 million for
the year ended December 31, 2024.
Net cash used in financing activities for the year ended December 31, 2025 was approximately $13.4 million as compared with approximately $4.1 million for the year ended December 31, 2024. Significant factors contributing to net cash used in financing activities during the year ended December 31, 2025, include: (1) total repayments of debt instruments of $18.7 million, of which $14.7 million relates to the extinguishment of the Avenue Facility on August 5, 2025 and $4.0 million relates to principal payments made on the Avenue Facility prior to extinguishment, and (2) preferred stock dividends of approximately $3.1 million, partially offset by $8.7 million net proceeds received related to sales of common stock under the ATM Sales Agreement and $471 thousand of cash proceeds received from the exercise of options and warrants. Net cash used in financing activities of discontinued operations was $774 thousand for the year ended December 31, 2025. During the year ended December 31, 2024, net cash used in financing activities consisted of: (1) preferred stock dividends of approximately $3.1 million, and (2) repayments of notes payable of approximately $328 thousand, partially offset by proceeds from the exercise of options of approximately $120 thousand. Net cash used in financing activities of discontinued operations was $805 thousand for the year ended December 31, 2024.
Net
cash used in financing activities for the year ended December 31, 2024 was approximately $4.1 million as compared with net cash provided
by financing activities of approximately $29.1 million for the year ended December 31, 2023. Significant factors contributing to net
cash used in financing activities during the year ended December 31, 2024, include preferred stock dividends of approximately $3.1 million,
distributions to non-controlling interest of approximately $774 thousand, and repayments of notes payable of approximately $328 thousand.
During the year ended December 31, 2023, net cash provided by financing activities consisted of: (1) $19.5 million in net proceeds received
from the Avenue Facility, (2) $10.0 million in proceeds received from the Medifast Private Placement, (3) $6.2 million in net proceeds
received from the sale of common stock under the ATM Sales Agreement (as defined below), (4) $2.3 million in proceeds received from notes
payable and (5) $95 thousand in proceeds received from the exercise of stock options. These factors contributing to net cash provided
by financing activities were partially offset by repayments of notes payable of approximately $5.1 million net of a $325 thousand loss
on debt extinguishment on the CRG Financial loan, preferred stock dividends of approximately $3.1 million, contingent consideration payments
made related to the ResumeBuild brand acquisition of approximately $313 thousand, net payments made related to adjustments in the membership
interest units of WorkSimpli of approximately $306 thousand, and distributions to non-controlling interest of $144 thousand.
To
date, the Company has been funding operations primarily through thecash salesgenerated offrom itsoperating products,activities, issuance of common and preferred
stock, and
through loans and advances. The Company’s continued operations are dependent upon obtaining an increase in its sale volumes and
obtaining funding from third-party sources or the issuance of additional shares of common stock. Our primary short-term and long-term
requirements for liquidity and capital are for customer acquisitions,
funding business acquisitions and investments we may make from
time to time, working capital including our noncancelable operating lease
obligations, long-term debt obligations, capital expenditures
and general corporate purposes. For more information on our operating lease
obligations, see Note 911—Leases to our consolidated
financial statements included in this report. There can be no assurances that we will be successful in increasing revenues, improving
operational efficiencies, or that financing will be available or, if available, that such financing will be available under favorable
terms.
On
December 11, 2023, the Company entered into a collaboration with Medifast, Inc. through and with certain of its wholly-owned subsidiaries
(“Medifast”). Pursuant to certain agreements between the parties, Medifast has agreed to pay to the Company the amount of
$10 million to support the collaboration, funding enhancements to the Company platform, operations and supporting infrastructure, of
which $5 million was paid at the closing on December 12, 2023, $2.5 million was paid during the three months ended March 31, 2024, and
the remaining $2.5 million was paid during the three months ended June 30, 2024 (the “Medifast Collaboration”).
In
addition, in connection with the Medifast Collaboration, the Company entered into a stock purchase agreement and registration rights
agreement with Medifast’s wholly-owned subsidiary, Jason Pharmaceuticals, Inc., whereby the Company issued 1,224,425 shares of
its common stock in a private placement (the “Medifast Private Placement”) at a purchase price of $8.1671 per share, for
aggregate proceeds of approximately $10 million.
On
March 21, 2023, the Company entered into and closed on a loan and security agreement (the “Avenue Credit Agreement”), and
a supplement to the Credit Agreement (the “Avenue Supplement”), with Avenue Venture Opportunities Fund II, L.P. and Avenue
Venture Opportunities Fund, L.P. (collectively, “Avenue”). The Avenue Credit Agreement providesprovided for a convertible senior
secured credit facility of up to an aggregate amount of $40 million, comprised of the following: (1) $15 million in term loans funded
at closing, (2) $5 million of additional committed term loans which the Company received on September 26, 2023 under the First Amendment
to the Avenue Credit Agreement (the “Avenue First Amendment”) and (3) $20 million of additional uncommitted term loans, collectively
referred to as the “Avenue Facility”. The Avenue Facility matures on October 1, 2026. The Company issued Avenue warrants
to purchase $1.2 million of the Company’s
common stock at an exercise price of $1.24, subject to adjustments.adjustments, of which $660 thousand have been exercised (the “Avenue Warrants”).
In addition, Avenue
may convert up toconverted $2 million of the $15 million in term loans funded at closing into shares of the Company’s common
stock at any
time while the loans are outstanding, at a price per share equal to $1.49. Proceeds from the Avenue Facility were used to repay the Company’s
outstanding notes
payable balances with CRG FinancialFinancial. On August 5, 2025, the Company paid the remaining $14.0 million in outstanding principal payments
on the Avenue Facility and arethe expectedprepayment topenalty beas usednoted in the Avenue Credit Agreement. As of December 31, 2025, there is no outstanding
balance on the Avenue Facility. The Company recorded a loss on debt extinguishment of $1.2 million within its consolidated financial
statements for generalthe corporateyear purposes.ended December 31, 2025. As of December 31, 2025, $540 thousand Avenue Warrants remain outstanding.
On
November 15, 2023, Avenue converted $1 million of the principal amount of the outstanding term loans into shares of the Company’s
common stock. This resulted in 672,042 shares of common stock issued to Avenue. Additionally on November 15, 2023, Avenue exercised 96,773
of the Avenue Warrants on a cashless basis resulting in 79,330 shares of the Company’s common stock issued. As of December 31,
2024, there was $19.0 million outstanding under the Avenue Facility.
The
Company entered into an At Market Issuance Sales Agreement (the “ATM Sales Agreement”) with B. Riley Securities, Inc. and
Cantor Fitzgerald & Co. relating to the sale of its common stock. In accordance with the terms of the ATM Sales Agreement, the Company
may, but is not obligated to, offer and sell, from time to time, shares of common stock, through or to the Agents, acting as agent or
principal. Sales of common stock, if any, will be made by any method permitted that is deemed an “at the market offering”
as defined in Rule 415 under the Securities Act. On June 7, 2024, the Company filed a shelf registration statement on Form S-3 under
the Securities Act, which was declared effective on July 18, 2024 (the “2024 Shelf”). Under the 2024 Shelf at the time of
effectiveness, the Company had the ability to raise up to $150.0 million by selling common stock, preferred stock, debt securities, warrants,
and units including $53.3 million of its common stock under the ATM Sales Agreement. During the year ended December 31, 2025, the Company
sold 762,990 shares of common stock under the ATM Sales Agreement and net proceeds received were $8.7 million. As of December 31, 2024, 2025,
the Company had $53.3$44.6 million
available under the ATM Sales Agreement, which is part of the $150.0 million available under the 2024 Shelf.Agreement.
The Company expects that its existing cash as of December 31, 2025 of $36.8 million will be sufficient to fund our planned operating expenses and capital expenditure requirements for at least the next 12 months from the issuance date of the consolidated financial statements included in this Annual Report on Form 10-K.
As
of March 7, 2025, the Company has a current cash balance of approximately $27.2 million. The Company reviewed its forecasted operating
results and sources and uses of cash used in management’s assessment, which included the available financing and consideration
of positive and negative evidence impacting management’s forecasts, market, and industry factors. Positive indicators that lead
to the Company’s expectation that it will have sufficient cash over the next 12 months following the date of this report include:
(1) the Company’s continued strengthening of its revenues and improvement of operational efficiencies across the business, (2)
the expected improvement in its cash burn rate over the next 12 months and positive operating cash flows during the year ended December
31, 2024, (3) cash on hand of $35.0 million as of December 31, 2024, (4) $53.3 million available under the ATM Sales Agreement, which
is part of the $150.0 million available under the 2024 Shelf, (5) management’s ability to curtail expenses, if necessary, and (6)
the overall market value of the telehealth industry, which the Company believes will continue to drive interest in the Company as already
evidenced by the Medifast Collaboration and Medifast Private Placement noted above.
Our
significant accounting policies are more fully described in Note 2— Basis of Presentation and Summary of Significant Accounting
Policies to our consolidated financial statements included in this report. We believe that these accounting policies are critical for
one to fully understand and evaluate our financial condition and results of operations.
In
NovemberDecember 2023, the Financial Accounting Standards Board (“FASB”) issued AccountingASU Standards2023-09, UpdateIncome (“ASU”) 2023-07,
Segment ReportingTaxes (Topic 280740).: TheImprovements
to amendmentsIncome Tax Disclosures, to improve its income tax disclosure requirements. Under ASU 2023-09, entities must annually: (1) disclose
specific categories in thisthe updaterate improvereconciliation reportableand segment(2) disclosureprovide requirements,additional primarilyinformation throughfor reconciling items that meet a quantitative
enhanced disclosures about significant segment expenses.threshold. ASU 2023-072023-09 became effective for the Company’s annual period beginning
on January 1, 2024 and interim periods beginning after January 1, 2025. The Company adopted this
guidance in the fourth quarter of 2024.
2025 on a prospective basis. Refer to Note 13-Segment14—Income DataTaxes for additional information.
In
December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, to improve its
income tax disclosure requirements. Under ASU 2023-09, entities must annually: (1) disclose specific categories in the rate
reconciliation and (2) provide additional information for reconciling items that meet a quantitative threshold. This amendments in
this update are effective for annual periods beginning after December 15, 2024. The Company is currently evaluating the impact that ASU
2023-09 will have to its consolidated financial statements and related disclosures.
In September 2025, the FASB issued ASU 2025-06, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software, to simplify and modernize the accounting for internal-use software costs. The amendments remove references to prescriptive software development stages and clarify that capitalization of eligible software development costs begins when management authorizes and commits to funding the project and it is probable the project will be completed, and the software will be used as intended. The amendments in this update are effective for annual reporting periods beginning after December 15, 2027, and interim reporting periods within those annual periods. Early adoption is permitted, and the guidance may be applied prospectively, retrospectively, or using a modified approach for in-process projects. The Company is evaluating the impact this guidance will have on the consolidated financial statements and related disclosures.
All other accounting standards updates that have been issued or proposed by the FASB that do not require adoption until a future date are not expected to have a material impact on the consolidated financial statements upon adoption.
What changed in the latest 10-Q
Risk Factors
An investment in the Company’s common stock involves a number of very significant risks. You should carefully consider the risk factors included in the “Risk Factors” section of our Annual Report on Form 10-K for the year ended December 31, 2025, as filed with the SEC on March 10, 2026, in addition to other information contained in our reports and in this quarterly report in evaluating the Company and its business before purchasing shares of our common stock. There have been no material changes to our risk factors contained in our Annual Report on Form 10-K for the year ended December 31, 2025. The Company’s business, operating results and financial condition could be adversely affected due to any of those risks.
No wording changes found in this section.
Full comparison: every changed paragraph (0)
Management's Discussion & Analysis (MD&A)
New heading “Comparison of the Six Months Ended June 30, 2026 to the Six Months Ended June 30, 2025”
Largest changes
On January 2, 2026, the Company entered into a Credit Agreement (the “Credit Agreement”) with Citizens Bank, N.A. (“Citizens”), which provides for a senior secured revolving credit facility in an aggregate outstanding amount not exceeding $30 million (the “Credit Facility”)see in full comparisontoforsupport potentialgeneral corporatedevelopment and/or shareholder value creation initiatives.purposes. The Credit Facility may be increased in the aggregate principal amount of up to $20 million on the terms and subject to the conditions described in the Credit Agreement. In connection with the Credit Agreement, among other things, the Company issued a revolving loan note to Citizens for any loans that may be made under the Credit Facility. Additionally, among other things, the Company and its subsidiaries entered into a pledge and security agreement and a guarantee agreement to provide credit support for the Credit Facility. The CreditFacilityAgreementrequiresrequired the Company to maintain (i) a Consolidated Leverage Ratio not to exceed 2.50 to 1.00 and (ii) a Consolidated Interest Coverage Ratio of at least 3.00 to1.00.1.00, in each case commencing with the quarter ended March 31, 2026. As of March 31, 2026, the Company was in compliance with the Consolidated Leverage Ratio covenant and was out of compliance with the Consolidated Interest Coverage Ratio covenant contained in the CreditFacility,Agreement. On June 30, 2026, the Company entered into the Waiver and First Amendment to the Credit Agreement (“Credit Agreement Waiver and First Amendment”) with Citizens. Under the terms of the Credit Agreement Waiver and First Amendment, the Company received a waiver of any Event of Default whichishas occurred as a result of theratioCompany’sofnon-compliance(a)with the ConsolidatedEBITInterest Coverage Ratio covenant as ofthe Company and its Subsidiaries for the most recently completed four consecutive fiscal quarters endedMarch 31,2026,2026.toAdditionally, the(b)Credit Agreement Waiver and First Amendment further amends the Credit Agreement by removing the Consolidated InterestExpenseCoverageofRatio test and requiring the Company to maintain (i) a Consolidated Leverage Ratio not to exceed 2.50 to 1.00, (ii) a Consolidated Fixed Charge Coverage Ratio of at least 1.25 to 1.00, and (iii) the sum of itsSubsidiariesCashforon Hand and Unused Availability of at least $40 million, in each case, commencing with themost recently completed four consecutive fiscal quartersquarter endedMarchSeptember31,30, 2026,aswith those capitalized termsareas defined in the CreditAgreement.AgreementCompliance with the Consolidated Interest Coverage Ratio was adversely impacted by an increase of approximately $7.6 million, or 34%, in sellingWaiver and Firstmarketing costs during the three months ended March 31, 2026, resulting from additional sales and marketing initiatives to drive the current and future periods’ sales growth. Among its remedies, Citizens could determine that there has been an Event of Default, deny access to funds under the Credit Facility, and/or it could terminate the Credit Facility. Discussions on the terms of an amendment to the Credit Agreement or waiver of compliance with the covenant are ongoing.Amendment. As ofMarchJune31,30, 2026 and to date, the Company had not drawn any amounts under the Credit Facility. Refer to Note 8—Indebtedness for additional information.
“Comparison of the Six Months Ended June 30, 2026 to the Six Months Ended June 30, 2025”see in full comparison
see in full comparisonOurComparisonfinancial results forof thethreeThreemonthsMonthsendedEndedMarchJune31,30, 2026are summarized as follows in comparisonto thethreeThreemonthsMonthsendedEndedMarchJune31,30, 2025:
“Net cash provided by operating activities was approximately $445 thousand for the three months ended March 31, 2026, as compared with approximately $3.1 million for the three months ended March 31, 2025. The significant factors contributing to the net cash provided by operating activities during the three months ended March 31, 2026, include: (1) an increase in accounts payable and accrued expenses of $6.8 million, (2) $2.0 million in non-cash depreciation and amortization, (3) $1.4 million in non-cash stock-based compensation charges, and (3) an increase in deferred revenue of $1.2 million. …”see in full comparison
“Net cash used in operating activities was approximately $6.5 million for the six months ended June 30, 2026, as compared with net cash provided by operating activities of approximately $11.7 million for the six months ended June 30, 2025. The significant factors contributing to the net cash used in operating activities during the six months ended June 30, 2026, include: (1) the Company’s net loss of $16.0 million and (2) an increase in accounts receivable of $2.0 million. These decreases were partially offset by: (1) an increase in accounts payable and accrued expenses of $5.0 million, (2) $4. …”see in full comparison
“Cost of telehealth revenue. Cost of telehealth revenue, which primarily include product costs, pharmacy fulfilment costs, physician consult fees, and shipping costs directly attributable to our prescription and OTC products decreased by approximately 25% to approximately $11.2 million for the six months ended June 30, 2026 compared to approximately $15.0 million for the six months ended June 30, 2025. …”see in full comparison
Full comparison: every changed paragraph (30)
As
of MarchJune 31,30, 2026, LifeMD served overapproximately 365,000356,000 active patient subscribers across a range of healthcare needs, including primary
care, care,
men’s and women’s health, hormone health, weight management, insomnia, dermatology and cardiology. We provide virtual
clinical clinical
services as well as prescription and over-the-counter (“OTC”) treatments, when medically appropriate.
Our
virtual primary care services are primarily offered through a subscription model. Since inception, we have served approximatelymore 1,492,000than 1,552,000
patients and customers, expanding access to convenient, and high-quality healthcare.
In
June 2024, we began accepting commercial and government health insurance for our virtual primary care services, including obesity-related
care for medically qualified patients. As of MarchJune 31,30, 2026, our network coveredcovers approximately 112175 million lives,lives including approximatelycommercially
30 million Medicare Fee-for-Service beneficiaries. By June 1, 2026, we expect to expand coverage to approximately 230 millioninsured lives,
representing approximately 80% of commercially insured lives in the U.S., 70% of Medicare Advantage beneficiaries, and Medicare Fee-for-Service
beneficiaries.
The
LifeMD brand is our flagship virtual primary care and specialty platform, having served overapproximately 514,000559,000 customers and patients
to date.
This brand provides patients with access to affiliated high-quality providers for their urgent care and chronic care needs.
The LifeMD
brand is a mobile-first full-service destination that provides seamless access to comprehensive virtual medical care including
on-demand on-demand
consultations and treatment, prescription medications, diagnostics and imaging, wellness coaching, integration with in-home
tools and
more. This offering is also supported by partnerships that provide our patients with benefits such as substantial discounts
on lab work
and direct integrations and collaborations with pharmaceutical manufacturers that offer patients convenient and affordable
access to
important medications. The LifeMD brand addresses high-growth and historically underserved healthcare verticals through defined
specialty specialty
care programs as noted below.
Our
Weight Management Program, launched in April 2023 with a focus on GLP-1 medications, provides primary care, metabolic coaching, lab work
and prescription services (as appropriate) to patients seeking to access a medically supported weight loss solution. In September 2024,
we expanded our Weight Management Program to offer personalized, non-GLP-1 treatment plan consisting of three oral medications –
metformin, bupropion, and topiramate – which is expected to grow the program’s addressable market. Since inception, our Weight
Management Program has grown exponentially to overapproximately 98,000108,000 patient subscribers as of MarchJune 31,30, 2026.
During
the three months ended September 30, 2025, the Company identified and corrected errors related to the recording of net revenue as agent
in certain arrangements with the Company’s third-party pharmacy providers as well as various out-of-period amounts included in
our previously issued financial statements that were deemed to be quantitatively and qualitatively immaterial, individually and in the
aggregate, to the financial statements in the periods recorded or to the relevant prior periods. Information presented in the tables
below for the three and six months ended MarchJune 31,30, 2025 has been revised to reflect these corrections. See Note 3—Revisions to Previously
Issued Financial Statements for more details.
OurComparison
financial results forof the threeThree monthsMonths endedEnded MarchJune 31,30, 2026 are summarized as follows in comparison to the threeThree monthsMonths endedEnded MarchJune 31,
30, 2025:
Our financial results for the three months ended June 30, 2026 are summarized as follows in comparison to the three months ended June 30, 2025:
TelehealthTotal
revenue, net. Telehealth revenuesRevenues for the three months ended MarchJune 31,30, 2026 decreased bywere approximately 1%$47.3 tomillion, approximatelya $50.2decrease million
of 4% compared to approximately $50.9
$49.0 million for the three months ended MarchJune 31,30, 2025. The decrease in revenues was attributable to a decrease
in telehealth product
revenue of approximately $1.0$2.0 million during the three months ended June 30, 2026 compared to the three months ended June 30, 2025 primarily
due to a decrease in online sales demand partially offset by an increase
in telehealth subscription revenue which experienced an increase of approximately $280 thousand during the three months ended March 31,
2026 compared to the three months ended March 31, 2025 primarily due to an increase in online sales demand.
Cost
of telehealth revenue. Cost of telehealth revenue, which primarily includeincludes product costs, pharmacy fulfilment costs, physician consult
fees, and shipping costs directly attributable to our prescription and OTC products decreased by approximately 27%23% to approximately $5.9$5.3
million for the three months ended MarchJune 31,30, 2026 compared to approximately $8.1$6.8 million for the three months ended MarchJune 31,30, 2025. The
cost of telehealth revenue decrease was due to product mix, decreased telehealth product sales volume and decreased shipping costs during
the three months ended MarchJune 31,30, 2026 when compared to the three months ended MarchJune 31,30, 2025. Telehealth costs were 12%11% of associated telehealth
telehealth revenues during the three months ended MarchJune 31,30, 2026 compared to 16%14% of associated telehealth revenues during the three months ended
endedJune March 31,30, 2025.
Gross
profit. Gross profit increaseddecreased by 3%0.4% to approximately $44.2$42.0 million for the three months ended MarchJune 31,30, 2026 compared to approximately
$42.8$42.2 million for the three months ended MarchJune 31,30, 2025. Gross profit as a percentage of revenues was approximately 88%89% for the three
months ended MarchJune 31,30, 2026 as compared to approximately 84%86% for the three months ended MarchJune 31,30, 2025. The increase in gross profit as
as a percentage of revenues was primarily due to product mix and decreased shipping costs on telehealth product revenues in the three months
months ended MarchJune 31,30, 2026.
Total
expenses. Operating expenses for the three months ended MarchJune 31,30, 2026 were approximately $53.2$49.1 million, as compared to approximately
$43.9$44.5 million for the three months ended MarchJune 31,30, 2025. This represents an increase of 21%,10%, or approximately $9.2$4.6 million. The increase
is primarily attributable to:
The
above increases in operating expenses were partially offset by the following decreasedecreases in operating expenses:
Interest
income (expense), net. Interest income (expense), net consists of interest income on the Company’s cash account balances for the
three months ended MarchJune 31,30, 2026 and interest expense on the Avenue Facility, partially offset by interest income on the Company’s
cash account balances for the three months ended MarchJune 31,30, 2025. Interest income was approximately $56$46 thousand for the three months ended
endedJune March 31,30, 2026 compared to interest expense of $464$661 thousand for the three months ended MarchJune 31,30, 2025. The Company extinguished
the Avenue
Facility on August 5, 2025.
Comparison of the Six Months Ended June 30, 2026 to the Six Months Ended June 30, 2025
Our financial results for the six months ended June 30, 2026 are summarized as follows in comparison to the six months ended June 30, 2025:
Total revenue, net. Revenues for the six months ended June 30, 2026 were approximately $97.4 million, a decrease of 2% compared to approximately $99.9 million for the six months ended June 30, 2025. The decrease in revenues was attributable to a decrease in telehealth product revenue of approximately $3.0 million primarily due to a decrease in online sales demand, partially offset by an increase in telehealth subscription revenue, primarily for LifeMD virtual primary care which experienced an increase of approximately $534 thousand during the six months ended June 30, 2026 compared to the six months ended June 30, 2025 primarily due to an increase in online sales demand.
Cost of telehealth revenue. Cost of telehealth revenue, which primarily include product costs, pharmacy fulfilment costs, physician consult fees, and shipping costs directly attributable to our prescription and OTC products decreased by approximately 25% to approximately $11.2 million for the six months ended June 30, 2026 compared to approximately $15.0 million for the six months ended June 30, 2025. The cost of telehealth revenue decrease was due to product mix, decreased telehealth product sales volume and decreased shipping costs during the six months ended June 30, 2026 when compared to the six months ended June 30, 2025. Telehealth costs were 11% of associated telehealth revenues during the six months ended June 30, 2026 compared to 15% of associated telehealth revenues during the six months ended June 30, 2025.
Gross profit. Gross profit increased by 2% to approximately $86.2 million for the six months ended June 30, 2026 compared to approximately $84.9 million for the six months ended June 30, 2025. Gross profit as a percentage of revenues was approximately 89% for the six months ended June 30, 2026 as compared to approximately 85% for the six months ended June 30, 2025. The increase in gross profit as a percentage of revenues was primarily due to product mix and decreased shipping costs on telehealth product revenues in the six months ended June 30, 2026.
Total expenses. Operating expenses for the six months ended June 30, 2026 were approximately $102.3 million, as compared to approximately $88.5 million for the six months ended June 30, 2025. This represents an increase of 16%, or approximately $13.8 million. The increase is primarily attributable to:
The above increases in operating expenses were partially offset by the following decreases in operating expenses:
Interest income (expense), net. Interest income (expense), net consists of interest income on the Company’s cash account balances for the six months ended June 30, 2026 and interest expense on the Avenue Facility, partially offset by interest income on the Company’s cash account balances for the six months ended June 30, 2025. Interest income was approximately $102 thousand for the six months ended June 30, 2026 compared to interest expense of $1.1 million for the six months ended June 30, 2025. The Company extinguished the Avenue Facility on August 5, 2025.
Working
capital decreased by approximately $8.1$14.8 million during the threesix months ended MarchJune 31,30, 2026. The decrease in current assets is primarily
attributable to a decrease in cash of $2.3$11.6 million, partially offset by an increase in other current assets of $1.2 million and an increase
in accounts receivable of $550$2.0 thousand.million. Current
liabilities increased by $8.0$5.0 million, which was primarily attributable to an increase
in accounts payable and accrued expenses of $6.8 million and an increase in deferred revenue of $1.2 $5.0
million.
Net cash used in operating activities was approximately $6.5 million for the six months ended June 30, 2026, as compared with net cash provided by operating activities of approximately $11.7 million for the six months ended June 30, 2025. The significant factors contributing to the net cash used in operating activities during the six months ended June 30, 2026, include: (1) the Company’s net loss of $16.0 million and (2) an increase in accounts receivable of $2.0 million. These decreases were partially offset by: (1) an increase in accounts payable and accrued expenses of $5.0 million, (2) $4.0 million in non-cash depreciation and amortization and (3) $2.2 million in non-cash stock-based compensation charges. The significant factors contributing to the net cash provided by operating activities during the six months ended June 30, 2025, include: (1) $4.6 million in non-cash stock-based compensation charges, (2) $3.7 million in non-cash depreciation and amortization, (3) an increase in accounts payable and accrued expenses of $3.2 million and (4) a decrease in accounts receivable of $1.5 million. These increases were partially offset by: (1) the Company’s net loss of $4.7 million and (2) a decrease in deferred revenue of $2.6 million. Net cash provided by operating activities of discontinued operations was $5.3 million for the six months ended June 30, 2025.
Net
cash provided by operating activities was approximately $445 thousand for the three months ended March 31, 2026, as compared with approximately
$3.1 million for the three months ended March 31, 2025. The significant factors contributing to the net cash provided by operating activities
during the three months ended March 31, 2026, include: (1) an increase in accounts payable and accrued expenses of $6.8 million, (2)
$2.0 million in non-cash depreciation and amortization, (3) $1.4 million in non-cash stock-based compensation charges, and (3) an increase
in deferred revenue of $1.2 million. These increases were partially offset by: (1) the Company’s net loss of $8.9 million for the
three months ended March 31, 2026, (2) an increase in other current assets of $1.2 million, and (3) an increase in accounts receivable
of $550 thousand. The significant factors contributing to the net cash provided by operating activities during the three months ended
March 31, 2025, include: (1) $2.5 million in non-cash stock-based compensation charges and (2) $1.8 million in non-cash depreciation
and amortization. These increases were partially offset by: (1) a decrease in accounts payable and accrued expenses of $2.3 million and
(2) the Company’s net loss of $1.6 million for the three months ended March 31, 2025. Net cash provided by operating activities
of discontinued operations was $2.8 million for the three months ended March 31, 2025.
Net
cash used in investing activities for the threesix months ended MarchJune 31,30, 2026 was approximately $2.1$3.7 million, as compared with approximately
$2.9$6.6 million for the threesix months ended MarchJune 31,30, 2025. Net cash used in investing activities for the threesix months ended MarchJune 31,30, 2026, was
was due to cash paid for capitalized software costs of approximately $2.0$3.5 million, and cash paid for the purchase of equipment of approximately
$105$173 thousand. Net cash used in investing activities for the threesix months ended MarchJune 31,30, 2025, was due to cash paid for capitalized software
costs of approximately $1.9$3.9 million, and cash paid for the purchase of equipment of approximately $118$894 thousand. Net cash used in investing
activities of discontinued operations was $863$1.7 thousandmillion for the threesix months ended MarchJune 31,30, 2025.
Net
cash used in financing activities for the threesix months ended MarchJune 31,30, 2026 was approximately $696$1.5 thousandmillion as compared with approximately
$813$3.9 thousandmillion for the threesix months ended MarchJune 31,30, 2025. Net cash used in financing activities for the threesix months ended MarchJune 31,30, 2026, consisted
consisted of preferred stock dividends of $777$1.6 thousandmillion partially offset by $81 thousand of cash proceeds received from the exercise
of options.
Net cash used in financing activities for the threesix months ended MarchJune 31,30, 2025, consisted of: (1) principal repayments on the Avenue Credit
Agreement of approximately $2.1 million and (2) preferred stock dividends of
$777 thousand.$1.6 million. Net cash used in financing activities of discontinued
operations was $36$312 thousand for the threesix months ended MarchJune 31,
30, 2025.
On
January 2, 2026, the Company entered into a Credit Agreement (the “Credit Agreement”) with Citizens Bank, N.A. (“Citizens”),
which provides for a senior secured revolving credit facility in an aggregate outstanding amount not exceeding $30 million (the “Credit
Facility”) tofor support potentialgeneral corporate development and/or shareholder value creation initiatives.purposes. The Credit Facility may be
increased in the aggregate principal amount of up to $20
million on the terms and subject to the conditions described in the Credit Agreement.
In connection with the Credit Agreement, among
other things, the Company issued a revolving loan note to Citizens for any loans that
may be made under the Credit Facility. Additionally,
among other things, the Company and its subsidiaries entered into a pledge and security
agreement and a guarantee agreement to provide
credit support for the Credit Facility. The Credit FacilityAgreement requiresrequired the Company to maintain
(i) a Consolidated Leverage Ratio not to
exceed 2.50 to 1.00 and (ii) a Consolidated Interest Coverage Ratio of at least 3.00 to 1.00.1.00, in each case commencing with the quarter
ended March 31, 2026. As of March 31, 2026, the Company was in compliance with the Consolidated Leverage Ratio covenant and was out of
compliance with the
Consolidated Interest Coverage Ratio covenant contained in the Credit Facility,Agreement. On June 30, 2026, the Company entered
into the Waiver and First Amendment to the Credit Agreement (“Credit Agreement Waiver and First Amendment”) with Citizens.
Under the terms of the Credit Agreement Waiver and First Amendment, the Company received a waiver of any Event of Default which ishas occurred
as a result of the ratioCompany’s ofnon-compliance (a)with the Consolidated EBITInterest Coverage Ratio covenant as of the
Company and its Subsidiaries for the most recently completed four consecutive fiscal quarters ended March 31, 2026,2026. toAdditionally,
the (b)Credit Agreement Waiver and First Amendment further amends the Credit Agreement by removing the Consolidated
Interest ExpenseCoverage ofRatio
test and requiring the Company to maintain (i) a Consolidated Leverage Ratio not to exceed 2.50 to 1.00, (ii) a Consolidated Fixed Charge
Coverage Ratio of at least 1.25 to 1.00, and (iii) the sum of its SubsidiariesCash foron Hand and Unused Availability of at least $40 million, in each
case, commencing with the most recently completed four consecutive fiscal quartersquarter ended MarchSeptember 31,
30, 2026, aswith those capitalized terms areas defined in the Credit Agreement.Agreement Compliance with the Consolidated
Interest Coverage Ratio was adversely impacted by an increase of approximately $7.6 million, or 34%, in sellingWaiver and
First marketing costs
during the three months ended March 31, 2026, resulting from additional sales and marketing initiatives to drive the current and future
periods’ sales growth. Among its remedies, Citizens could determine that there has been an Event of Default, deny access
to funds under the Credit Facility, and/or it could terminate the Credit Facility. Discussions on the terms of an amendment to the Credit
Agreement or waiver of compliance with the covenant are ongoing.Amendment. As of MarchJune 31,30, 2026 and to date, the Company had not drawn any amounts
under the Credit Facility. Refer to Note 8—Indebtedness
for additional information.
The
Company entered into an At Market Issuance Sales Agreement (the “ATM Sales Agreement”) with B. Riley Securities, Inc. and
Cantor Fitzgerald & Co. relating to the sale of its common stock. In accordance with the terms of the ATM Sales Agreement, the Company
may, but is not obligated to, offer and sell, from time to time, shares of common stock, through or to the Agents, acting as agent or
principal. Sales of common stock, if any, will be made by any method permitted that is deemed an “at the market offering”
as defined in Rule 415 under the Securities Act. On June 7, 2024, the Company filed a shelf registration statement on Form S-3 under
the Securities Act, which was declared effective on July 18, 2024 (the “2024 Shelf”). Under the 2024 Shelf at the time of
effectiveness, the Company had the ability to raise up to $150.0 million by selling common stock, preferred stock, debt securities, warrants,
and units including $53.3 million of its common stock under the ATM Sales Agreement. As of MarchJune 31,30, 2026, the Company had $44.6 million
available under the ATM Sales Agreement.
The
Company expects that its existing cash as of MarchJune 31,30, 2026 of $34.5$25.1 million and net proceeds from the sale of common stock under the
ATM Sales Agreement will be sufficient to fund our planned operating expenses and capital expenditure requirements for at least the next
12 months from the issuance date of these unaudited consolidated financial statements.
LFMD insider buying and selling (Form 4)
Since 2026-04-11, insiders reported open-market purchases in 0 Form 4 filings and open-market sales in 0 filings. Totals add up every open-market (code P and S) line in those filings, using the prices reported in the filings. Awards, option exercises, tax withholding and gifts are listed below but not counted.
| Trade date | Insider | Transaction | Shares | Price | Value |
|---|---|---|---|---|---|
| 2026-08-11 | Larovere Joan |
Grant/award | 35,000 | — | — |
| 2026-08-11 | Strawn John R Jr |
Grant/award | 35,000 | — | — |
| 2026-08-11 | Ditrolio Joseph |
Grant/award | 35,000 | — | — |
| 2026-08-11 | Simon Roberto |
Grant/award | 35,000 | — | — |
| 2026-08-11 | Macrae Calum Archibald |
Grant/award | 35,000 | — | — |
| 2026-06-01 | Sripad Umesh |
Grant/award | 75,000 | — | — |
| 2026-05-11 | Kavthekar Atul |
Grant/award | 337,500 | — | — |
| 2026-05-04 | Strawn John R Jr |
Grant/award | 50,000 | — | — |
| 2026-05-04 | Simon Roberto |
Grant/award | 50,000 | — | — |
| 2024-12-02 | Simon Roberto |
Grant/award | 24,648 | — | — |
| 2024-12-02 | Simon Roberto |
Grant/award | 6,162 | — | — |
| 2024-12-02 | Simon Roberto |
Grant/award | 50,000 | — | — |
Well-known investors holding LFMD (13F)
| Investor | Quarter | Shares | Reported value | % of their 13F | Change vs prior quarter |
|---|---|---|---|---|---|
| Renaissance Technologies | 2026-06-30 | 1,079,525 | $4.5M | 0.01% | Reduced 3% |
| AQR Capital Management (Cliff Asness) | 2026-06-30 | 619,506 | $2.6M | 0.0% | Added 212% |
| Millennium Management (Israel Englander) | 2026-06-30 | 401,624 | $1.7M | 0.0% | New position |
| Citadel Advisors (Ken Griffin) | 2026-06-30 | 263,471 | $1.1M | 0.0% | New position |
| D. E. Shaw & Co. | 2026-06-30 | 32,924 | $136.0K | 0.0% | New position |