PCG Health consulting services help state and local governments interact more effectively with the Centers for Medicare & Medicaid Services (CMS) in order to better meet the needs of families and children they serve.

PCG Health can maximize the recovery of funds and assess structural and fiscal issues that impede your agency or county’s ability to maximize its revenue. .

 

PCG Health understands our clients’ goals to reduce Medicaid spending without reducing or jeopardizing the recipient's quality of care. PCG Health's Medicaid managed care team is dedicated to helping states accomplish this mission.

 

PCG Health is uniquely qualified to provide your state with health care reform policy analysis. Our team of Medicaid experts can provide assistance with benefit coordination, access, finance, reimbursement, regulatory, and systems implementation. PCG Health is prepared to provide leading edge health care reform strategies to your state’s health programs.

 

PCG Health has experience helping clients design and implement Quality Management Programs in the major behavioral health domains of mental health, substance use, and mental retardation/ developmental disabilities. We understand the unique nature of each of these areas, and the importance of creating connections across them.

 

PCG Health has more than 20 years of experience working with publicly operated facilities and other provider reimbursement cost report data. PCG Health™ has detailed knowledge of cost reporting and rate setting practices of Medicaid agencies across the nation.

 

PCG Health has successfully guided and supported a number of agencies through the implementation of Medicaid Targeted Case Management (TCM) service billing. We have also reviewed rate setting methodologies and existing programs.

 

PCG Health’s experience in state-run facilities, as well as with the complex Medicare Part D system, allows us to help states successfully navigate the network enrollment process and maximize reimbursement for prescription drugs, efficiently and compliantly.

 

PCG Health worked extensively with many SPAPS during the initial implementation of Medicare Part D. We continue to offer comprehensive management, financial, and operations improvement services ranging from an initial complimentary operations assessment to the facilitation of claims adjudication from PDPs.

 

PCG Health can assist states in reviewing and enhancing the integrity of your MMIS operations as well as preparing for and responding to PERM audits as prescribed by CMS. Our consultants have more than 20 years of experience in all facets of the Medicaid operation, including MMIS edits and audits, program policies and procedures, recipient eligibility, quality controls, and best practices.

 

Public Consulting Group (PCG) is a national leader in the review, development, and administration of Random Moment Time Studies (RMTS). We can help you maximize the recovery of funds and ensure compliance with federal and state regulations regarding the operation of time studies.

 

PCG Health will conduct a thorough analysis of your policies and procedures to pinpoint valid revenue enhancement opportunities and put into place a program to help you achieve optimum results. Our goal is to develop strategies and procedures that produce sustainable funding streams to responsibly recover the revenue to which you are entitled, in compliance with all federal and state regulations.

 

PCG Health consultants have extensive experience with CMS requirements and provide clients with unmatched consulting services on state plan design.

 

PCG Health can assist your agency or organization to develop and deliver a training curriculum to better help your staff understand the complex regulatory world in which we operate.

 

PCG Health helps states to obtain waivers and to design, develop, and implement innovative programs that will improve access, continuity, and quality of care, improve consumer satisfaction, and maintain compliance with Centers for Medicare and Medicaid Services (CMS) requirements for cost-effectiveness and budget neutrality.