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.

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

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

21 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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Missouri Supreme Court Orders Implementation of Medicaid Expansion

29 days ago

On Thursday, July 22, 2021, the Missouri Supreme Court reversed a lower court decision and ruled unanimously that the state legislature is required to fund the new Medicaid expansion program. Doyle, et al., Barber and Chaney v. Tidball, et al. (SC 99185).

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U.S. Supreme Court Declines to Review HHS’ Site-Neutral Medicare Pay Rule

60 days ago

On Monday, June 28, 2021, the U.S. Supreme Court declined to hear an appeal upholding the Department of Health and Human Services’ (HHS) site-neutral Medicare pay policy.  American Hospital Association, et al v. Alex M. Azar II in his capacity as Secretary of HHS. 

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U.S. Supreme Court Rejects Challenge to the Affordable Care Act (ACA) for the Third Time

71 days ago

On Thursday, June 17, 2021, the U.S. Supreme Court, by a 7 to 2 vote, held that the plaintiffs in a lawsuit challenging the constitutionality of the ACA lacked standing to bring the action and ordered the case to be dismissed (California et al v. Texas et al, No. 19-840). 

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Contact Tracing: Delivering Solutions When they Matter Most

76 days ago

Throughout the pandemic, PCG has established itself as a recognized leader across multiple states—including New York, Wisconsin, New Jersey, Ohio, and Arkansas—in developing contact tracing solutions that have helped public health systems track thousands of exposures and mitigate the spread of COVID-19. We have partnered with these states and worked with them on the ground to hire, train, and manage local contact tracing teams.

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U.S. Court of Appeals Decision for Contesting Suspension of Provider Medicare Payments

96 days ago

The U.S. Court of Appeals for the Seventh Circuit recently announced the fundamental legal requirement that a Medicare provider must exhaust all administrative remedies before being able to bring a court...

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Meet Our Team

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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...

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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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James Dachos

Manager / Health

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

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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.

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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...

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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...

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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...

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Katie Sherwin

Chief Administrative Officer / Health

Katie Sherwin, Chief Administrative Officer, Public Consulting Group, Inc. (PCG), has eighteen years of experience in strategy, operations, and financial analysis, for companies of all sizes—from Fortune 500 companies and large state governments to early-stage technology start-up companies. 

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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...

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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)...

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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. 

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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...

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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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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...

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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...

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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.

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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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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...

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Peter Cheesman

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...

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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...

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