
Third Party Administrator (TPA) Services
PCG is an expert and trusted third party administrator (TPA) providing end to end claims processing services and solutions on behalf of government agencies and health plans.

Solutions that enhance health and public safety services.
Helping fire and emergency medical service agencies improve operational performance, reduce costs, and deliver better outcomes to those in need.

Solutions that lead to healthier communities.
At PCG, we help our clients meet the financial, regulatory, and operational challenges of today’s changing health care landscape so they can provide the best care, most effectively, to the people they serve.
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.
News & Perspectives
PCG hosts “Translating Fire & EMS Operational Challenges into Financial Needs” Webinar
255 days agoAs 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.
ReadMoreU.S. Supreme Court Ruled That HHS Wrongfully Cut Medicare Reimbursement for Certain Drugs to Hospitals Serving Low-Income Beneficiaries
438 days agoOn 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.
ReadMoreU.S. Supreme Court Decides That States Can Seek Reimbursement for Future Medical Expenses from Medicaid Beneficiaries’ Injury Settlements
447 days agoOn 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.
ReadMoreU.S. Supreme Court Declines to Hear Appeal by UnitedHealth Group, Inc. Requiring Return of Medicare Overpayments Based on Faulty Diagnoses
460 days agoOn 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.
ReadMorePCG Awarded CMS Quality Improvement Organization-like Recertification
538 days agoPublic 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.
ReadMoreDistrict of Columbia Court of Appeals Panel Requires Medicare Advantage Plans to Return Medicare Overpayments
755 days agoOn 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.
ReadMoreMeet Our Team

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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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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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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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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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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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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Megan Morris
Associate Manager / Health
Ms. Morris, an Associate Manager with the firm’s Health Care Financing Solutions team, is an experienced project manager primarily focused on health and Medicaid-based programs. A certified Project Management Professional (PMP)...
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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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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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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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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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Andrew Heaney
Associate Manager / Health
Andrew Heaney, an Associate Manager at PCG, has extensive experience working with health information technology (HIT), health information exchanges (HIE), health insurance exchanges (HIX), electronic health records (EHR), state...
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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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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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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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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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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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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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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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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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