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

754 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.

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

936 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.

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

945 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.

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

958 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.

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PCG Awarded CMS Quality Improvement Organization-like Recertification

1036 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.

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

1253 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. 

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Meet Our Team

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Alicia Stewart

Manager / Education

Alicia Stewart, a manager in PCG’s Nashville office, has over 20 years of experience in the education field including six statewide implementations. Her focus at PCG, for the past 16 years...

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Tony Ong

Business Development Manager / Human Services

Tony Ong believes in better government. As the leader of Public Consulting Group's (PCG) business development in the human services sector, Tony is driving the development of...

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Louise Eichman

Senior Vice President of Technology Strategy, Administration, and Governance / Corporate Technology

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Paul Mancini

Manager / Education

Mr. Mancini joined PCG at the start of 2009 and has 20 years of experience in delivering services and solutions within the private and public sector, with his last eight years focused on pre K – 12 public...

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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...

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Heather Caldwell

Associate Manager / Health

Heather Caldwell is an associate manager in Health at PCG. In this role, she works with the cost allocation team to help government health agencies claim reimbursement from the federal government for administrative activities...

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Christopher Connor

Associate Practice Area Director / Education

Mr. Connor is a shareholder at PCG and assists with management of the Education practice area. He has been with PCG for more than 25 years and brings a wealth of experience in Medicaid reimbursement, case management solutions, technical implementations, and consulting engagements.

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Amy Whitcher Smith

Manager / Education

Ms. Smith has 19 years of experience in public sector education initiatives and is currently South Regional Manager for PCG. She has been with PCG since 1999 in the Charlotte office...

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Nick Loret de Mola

Director / Technology Consulting

Nick Loret de Mola joined PCG in 2023 and serves as a Director for the Technology Consulting team. In this role, Nick is responsible for managing multiple contracts with the state of California and driving growth for PCG’s Project Assurance Major Business Line and Project Management Office (PMO) Service Line...

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Peter Cheesman

Manager / Health

Mr. Cheesman directs PCG’s Member Eligibility Management group. In this capacity, Peter designs and deploys creative technical solutions connecting government agencies...

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Ladd Van Devender

Manager / Education

Mr. Van Devender oversees more than 150 North Carolina education projects and Student Success Planning solutions throughout NC. These services include the implementation and ongoing...

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Gary Reimers

Vice President / Technology Consulting

Gary Reimers joined PCG in 2008 and serves as a vice president of the Technology Consulting team. In this role, Gary is responsible for independent verification and validation (IV&V), quality assurance (QA), and security services provided by the firm nationally.

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Patti Irgens

Director / Technology Consulting

Patti Irgens joined PCG in 2022 and serves as Director for the Technology Consulting team. In this role, Patti is responsible for project management and oversight of independent verification and validation (IV&V) as well as, business development with the system integration team...

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Morgan Bacia

Vice President of Technology / Corporate Technology

Morgan Bacia joined PCG in 2013 and is currently the Director of Employee Experience.  Prior to joining PCG, Morgan was employed as a project manager at Xerox working on Electronic Payment Card (EPC) and Federal...

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Jennifer MacBlane

Associate Manager / Human Services

Jennifer MacBlane is an associate manager at PCG. She has over 20 years of experience in human services, government, and government consulting. Jennifer began her career at PCG in 2006 and works with child welfare and human services agencies across the U.S. to further their goals of improving lives.

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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...

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Jim McGlynn

Manager / Education

Mr. McGlynn is a Manager in PCG's education practice, leading the firm’s statewide longitudinal data system (SLDS) service line and serving as a member of PCG’s Revenue Services and Case Management service line executive team. Jim joined the firm in 2010, bringing to PCG more than a decade of experience working a science teacher and non-profit executive in the education sector.

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Suresh Nagarajan

Director / Technology Consulting

Suresh Nagarajan joined PCG in 2014 and serves as a Director of the Technology Consulting team. In this role, he is responsible for project and relationship management...

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Gary Garofalo

Chief Operating Officer / Corporate

Mr. Garofalo brings a strong record of leadership in the application of analytics, metrics, and business intelligence. He has more than 35 years of experience managing consulting services operations and facilitating growth in large organizations. As Executive Vice President of MAXIMUS Inc., Garofalo served as leader in strategic direction and executive oversight, and in delivering business solutions for health and human services operations programs. Mr. Garofalo earned his bachelor’s degree in Computer Science from the University of Maryland and his master’s degree in Computer Science from George Washington University. 

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Kathy Fallon

Practice Area Director / Human Services

Ms. Fallon has worked in government and government consulting for more than 32 years and has expertise across state and local human service programs. She has been at PCG since 1998 and currently oversees the firm's human services division...

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