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 Health Plans

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

News & Perspectives

U.S. Supreme Court orders Trump administration and states challenging the ACA to file responses by January 17, 2020

8 days ago

Following last month’s decision by the Fifth Circuit Court of Appeals holding the “mandate” of the Affordable Care Act (ACA) to be unconstitutional, the states defending the ACA requested the U.S. Supreme Court hear the case during its current term.

ReadMore

Federal Appeals Court rules that mandate provision of ACA is unconstitutional

10 days ago

On Wednesday, December 18, 2019, a 3-judge panel of the Federal Fifth Circuit Court of Appeals held that the “mandate” provision of the Affordable Care Act (ACA) is unconstitutional. The panel sent the case back to Judge Reed O’Connor of the Federal District Court in Fort Worth Texas to “conduct a more searching inquiry” into which of the law’s many provisions could survive without the mandate.

 

ReadMore

Hospitals file lawsuit to challenge federal rule requiring disclosure of prices negotiated with insurers

28 days ago

On Wednesday, December 4, 2019, several hospitals and the American Hospital Association filed a lawsuit in the U.S. District Court in Washington, D.C., to overturn a rule issued in November by the United States Department of Health and Human Services (DHHS) that would require hospitals to disclose the private discounted prices they give to insurers for many procedures. 

 

ReadMore

U.S. Court of Federal Claims awards nearly $1.6 billion to a class of health insurers under a provision of the Affordable Care Act (ACA)

78 days ago

On October 22, 2019, Chief Judge Margaret M. Sweeney held that a class of health insurers were entitled to nearly $1.6 billion from the U.S. government pursuant to a provision of the ACA. 

ReadMore

Recent federal court happenings affecting Medicare reimbursement

107 days ago

On September 16, 2019, a federal district court judge in the District of Columbia removed a policy of the Centers for Medicare and Medicaid Services (CMS) that lowered the amounts off-campus, hospital-based clinics can receive for treating Medicare patients. 

ReadMore

The District of Columbia United States Circuit Court of Appeals reinstates the Medicaid Disproportionate Share (DSH) payment rule

147 days ago

On August 13, 2019, the D.C. Circuit Court of Appeals overturned a lower court’s nationwide injunction order that had vacated a Centers for Medicare and Medicaid Services (CMS) final rule that permitted payments from Medicare and private insurers to be included in calculating the hospital-specific limit on Medicaid DSH payments.

ReadMore

Meet Our Team

team-member

Tony Curatola

Manager / Health

Mr. Curatola, a Manager with PCG and certified PMP, has more than 29 years of experience in the Information Systems industry with over 22 years in project management and 18 years in Medicaid.  He has extensive project management experience in both the public and private sectors including state government, property and casualty Insurance, healthcare insurance, and banking.

ReadMore
team-member

James Waldinger

Manager / Health

Mr. Waldinger, a Manager at PCG, is an experienced Medicaid policy and reimbursement professional who focuses on healthcare operations and reimbursement transformation, as well as mental health and substance abuse policy and integration.

ReadMore
team-member

Kevin Hutchinson

Manager / Health

Mr. Hutchinson oversees PCG's Program Integrity and Provider Management solutions, advising and aiding Medicaid agencies and healthcare care plans in improving compliance and quality, while preventing fraud, waste, and abuse. He leads a team that provides...

ReadMore
team-member

Marc Staubley

Practice Area Director / Health

Mr. Staubley is Practice Area Director (PAD) of PCG’s Health division and a PCG shareholder. In this role, he provides executive leadership to over 400 staff who manage a portfolio of over 200 projects that span across more than 35 states...

ReadMore
team-member

Kelly Gallagher

Associate Manager / Health

Ms. Gallagher has been with PCG for 10 years. Ms. Gallagher helps lead the Cost Allocation Center of Excellence, specializing in cost allocation, time studies, Medicaid and Title IV-E claiming programs, business process review, Targeted Case Management (TCM)...

ReadMore
team-member

Rich Albertoni

Manager / Health

Mr. Albertoni has 16 years of experience working in state public health programming and Medicaid. He has held leadership positions in eligibility, budget and finance, and benefits and waivers.

ReadMore
team-member

Matthew Sorrentino

Manager / Health

Mr. Sorrentino, a Manager and Center of Excellence (COE) lead for our Healthcare Financing Solutions division, is a management consultant with 15 plus years of extensive Medicaid and healthcare experience.

ReadMore
team-member

Peter Cheesman

Associate Manager / Health

Mr. Cheesman leads PCG Health's Member Eligibility Solutions group. In this capacity, he has overseen the implementation and operation of high-profile benefits eligibility verification systems and data broker solutions for health and human services...

ReadMore
team-member

Jay Peck

Associate Manager / Health

Mr. Peck has been with PCG for over 13 years, specializing in Medicaid Program Integrity, Quality Improvement, and Beneficiary Due Process. He has successfully led the implementation of large-scale projects, such as a Provider Oversight effort in Ohio...

ReadMore
team-member

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 Health and Human Service agencies across the country...

ReadMore
team-member

Sean Huse

Manager / Health

Mr. Huse (MBA, CHFP), a Manager at Public Consulting Group, is an experienced health management consultant who focuses on financial management, strategic planning, policy analysis, information...

ReadMore
team-member

Kevin Carlson

Chief Technology Officer / Health

Mr. Carlson has more than 20 years of experience in the health care technology sector. He has overseen the development and implementation of numerous electronic health record, revenue cycle management (RCM), business intelligence, and health...

ReadMore
team-member

Dale McCourt

Associate Manager / Health

Mr. McCourt, Associate Manager, has been a member of the PCG team since 2011. Dale brings over 25 years of experience spanning many industries where he has served in a variety of roles including Chief Operating Officer, Project Manager, Manager...

ReadMore
team-member

Lisa Lee

Associate Manager / Health

Ms. Lee has been with PCG for 1 year and helps lead the Health Innovation, Policy and Information Technology Center of Excellence, specializing in Medicaid, CHIP, and ACA policy. Project accomplishments include the creation of Mississippi’s 1115 Waiver Application...

ReadMore
team-member

Garrett Abrahamson

Associate Manager / Health

Mr. Garrett Abrahamson is a healthcare consultant, delivering impactful financial deliverables with a client-centric approach. An Associate Manager with the Health Care Financing Solutions (HCFS) Center of Excellence at PCG, he has a...

ReadMore
team-member

James Dachos

Associate Manager / Health

Mr. Dachos, an Associate Manager in our Healthcare Financing Solutions division, has 12 years of Medicaid and Healthcare experience with PCG. He leads PCG’s Emergency Medical Services (EMS) division...

ReadMore
team-member

Joe Weber

Associate Manager / Health

Mr. Weber, PMP, has been with PCG for 13 years. Mr. Weber helps lead the Health Care Financing Solutions (HCFS) Center of Excellence with over twelve years of public sector consulting focusing on publicly funded healthcare programs including Medicaid...

ReadMore
team-member

Rick Dwyer

Manager / Health

Mr. Dwyer, a Manager located in our Boston office since 1993, has over thirty years of experience in financial and operations management in corporate and healthcare provider and payer environments.  For providers, Mr. Dwyer has been actively involved...

ReadMore
team-member

Angelene Willetts-Carvi

Associate Solutions Manager / Health

Angelene Willetts-Carvi is an Associate Solutions Manager in Health Payer Services at Public Consulting Group. With over 20 years of experience in Home and Community Based Services (HCBS), she is responsible for the assessment, development, and delivery of HCBS Quality Oversight Support Services.

ReadMore
team-member

Aaron Holman

Associate Manager / Health

Mr. Holman has been working in health policy for the past decade, starting in the United States Senate working on Medicare, CHIP and Health IT areas for Senator Debbie Stabenow (D-Michigan) and the Finance Committee. Mr. Holman also worked as a lobbyist in Washington focusing on health IT financing and standards development...

ReadMore