Health - PCG | Public Consulting Group

PCG’s Health practice offers in-depth programmatic knowledge and regulatory expertise to help state and municipal health agencies respond to regulatory change, improve access to health care, maximize program revenue, improve business processes, and achieve regulatory compliance. Using industry best practices, PCG’s Health team helps organizations deliver quality services with constrained resources to promote improved client outcomes.

What We Do

For State Health & Medicaid Agencies

See how we can help you increase program revenue, cut costs, and improve compliance with state and federal regulations.

For State Insurance Departments

Let us help you navigate the regulatory landscape, including the Affordable Care Act (ACA), and implement changes and new requirements with confidence.

For Provider Organizations

Boost your financial performance and compliance with our proven approach to improving claiming practices and operations management.

For COVID-19 Health Services

Together, we can implement the innovative solutions necessary to help public health systems rise to the challenges of COVID-19.

For Health Plans

Optimize your plan’s performance and compliance without sacrificing patient outcomes with our program integrity services.

For Fire and EMS Provider Organizations

Helping fire and emergency medical service agencies improve operational performance, reduce costs, and deliver better outcomes to those in need.

News & Perspectives

PCG hosts “Translating Fire & EMS Operational Challenges into Financial Needs” Webinar

712 days ago

As more fire and EMS departments have been expressing the need for additional funding, countless have struggled through referendums and challenging budget meetings to justify every penny of increase. Public Consulting Group (PCG) is here to provide support to fire and EMS administrators on how to step back from challenges, consider the perspectives of the community, and determine how to communicate operational needs into simple and actionable requests that anyone can understand.

U.S. Supreme Court Ruled That HHS Wrongfully Cut Medicare Reimbursement for Certain Drugs to Hospitals Serving Low-Income Beneficiaries

894 days ago

On Wednesday, June 15, 2022, the U.S. Supreme Court unanimously held that the U.S. Department of Health and Human Services (HHS) improperly cut more than $1 billion per year since 2018 in Medicare payments for certain drugs to hospitals serving low-income communities.

U.S. Supreme Court Decides That States Can Seek Reimbursement for Future Medical Expenses from Medicaid Beneficiaries’ Injury Settlements

903 days ago

On June 6, 2022, the U.S. Supreme Court held, in a seven-to-two decision, that the Medicaid statute permits a state to seek reimbursement from settlement payments allocated for future medical care.

U.S. Supreme Court Declines to Hear Appeal by UnitedHealth Group, Inc. Requiring Return of Medicare Overpayments Based on Faulty Diagnoses

916 days ago

On Tuesday, June 21, 2022, the U.S. Supreme Court rejected an appeal by UnitedHealth Group, Inc., leaving in place a federal rule requiring Medicare Advantage plans to return overpayments based upon wrongful diagnoses.

PCG Awarded CMS Quality Improvement Organization-like Recertification

994 days ago

Public Consulting Group (PCG) is proud to announce its five-year recertification as a Quality Improvement Organization-like (QIO-like) entity by the Centers for Medicare and Medicaid Services (CMS). A QIO-like entity consists of health quality experts, clinicians, and consumers who work together to improve the quality of care delivered to Medicare and Medicaid beneficiaries.

District of Columbia Court of Appeals Panel Requires Medicare Advantage Plans to Return Medicare Overpayments

1211 days ago

On Friday, August 13, 2021, a panel of the D.C. Court of Appeals held that Medicare Advantage private insurers must return potentially billions of dollars in overpayments they receive based on incorrect diagnoses.

Tom Kapusta

Associate Manager / Health

An Associate Manager within the firm’s Health Innovation, Policy, and Information Technology (HIPIT) team, Tom has extensive experience in health information technology (HIT), particularly in the areas of Medicaid eligibility...

Thomas Aldridge

Manager / Health

Mr. Aldridge is a Manager with Public Consulting Group (PCG) and has been with the firm for more than 20 years. Throughout his tenure, he has managed dozens of engagements within...

Anna d’Entremont

Associate Manager / Education

Anna d’Entremont is an associate manager in Education. She joined PCG in 2008 and has dedicated the last 20 years to improving outcomes for young people and the communities in which they live. She is deeply committed to the belief that every child deserves success...

Robbie Ammons

Manager / Education

Mr. Ammons has worked for the past 15 years on IEP and Medicaid school-based projects for North Carolina, Georgia, Tennessee, South Carolina, Minnesota, Illinois, Florida and Virginia.

Stephen Skinner

Principal, Director of Marketing / Marketing

Stephen Skinner currently directs marketing efforts for PCG. The PCG Marketing Department provides strategy, social media, communications, and administrative infrastructure support to PCG's...

Natasha Newman

Associate Manager / Education

Natasha Newman is an Associate Manager in Education. In this role, she collaborates with client teams across the U.S. who specialize in school-based Medicaid fee for service. Natasha provides leadership in the areas of project management, reimbursement optimization, and policy and program compliance.

Heather Gann

Associate Manager / Human Services

Heather Gann is an associate manager for Early Childhood Education (ECE) in Human Services. She joined PCG in 2014 with over 15 years of experience in the field. In her current role, Heather manages all sectors of early childhood—from home visitation to state-funded pre-kindergarten (Pre-K)...

William S. "Bill" Mosakowski

President / CEO / Corporate

William S. “Bill” Mosakowski is Founder, President, and Chief Executive Officer of Public Consulting Group (PCG), a management consulting, operations and technology firm serving government clients across the US and abroad in health care, human services, and education sectors.