The achievement page has been that way since before launch.
I've played about 8 hours and Hardcore mode is a gimmick. Instant travel and doctor visits still break the game. Drinking fountains/toilets, beds, and food are very plentiful. Even on Very Hard, hunger and sleep increase at a snails pace. The AI is dumb as ever, falling for chasing you through doors almost every time. It's still easy (and most efficient) to buff lockpicking and sneak and rob every place blind for better equipment. Even the games Help page admits Karma is almost entirely supplanted by Reputation.
I would suggest the following alterations on Hardcore mode. Instant travel should only be possible while above 50% health. If you got into a bad fight and got torn up, you should have brought something to heal yourself at least halfway, instead of teleporting to a doctor. Doctors heal and de-rad price should be higher than 50-100 caps, so you'll rely on your own healing items more often. Drinking fountains should be more rare and have a higher rad hit to prevent abuse, or eventually run out, making you rely more on potable water. With that change I'd also suggest making more water items actually reduce thirst instead of increase it. Finally I'd suggest severely limiting game saves outside of safe or populated areas or your own set up camps - quicksave/quickload is as easy to abuse as ever.
tl;dr - Fallout: New Vegas's 'survival' aspects are still too easy and easily broken even on Hardcore Very Hard. I have a harder time 'surviving' in your average left 4 dead map.