Overview

Jeannie is a part of the national Healthcare Consulting Practice, which focuses on disputes, investigations, and litigation support. Her clients include provider-based organizations, payers, and law firms. Her specialties include healthcare operations, forensic accounting, forensic analytics, litigation support, provider/payer reimbursement disputes, internal audit, information systems audit, risk assessments, privacy and security, regulatory compliance, investigations, monitorships, and related government mandated claims and transactional reviews. Ms. O’Donnell is a Certified Internal Auditor (CIA), a Certified Information Systems Auditor (CISA), Certified in Healthcare Compliance (CHC), a Certified Professional Coder (CPC), and Certified Healthcare Internal Audit Professional (CHIAP).

Experience +

Conducted a Center for Medicare & Medicaid Services required Readiness Assessment and NIST [National Institute of Standards and Technology) Controls Review for an internet healthcare broker. This was a requirement for direct enrollment ["DE") entities [qualified health plan] issuers and web -brokers to use a "proxy DE" pathway, which eliminated the prior, consumer-facing “double redirect" requirement for certain individual market exchange enrollments.

Analyzed relationships, ownership, financial control, management, and referral patterns between parties under a managed service agreement to assess Stark and Anti-Kickback risk.

Compliance and financial review of a specialty pharmacy for potential acquisition. Includes review of controls for purchasing, receiving, dispensing and inventory management.  Review of contracts with Pharmacy Benefit Managers and other contracted distributors.  Review of 340B processes for purchasing, receiving, dispensing and inventory management.  Review of 340B contracts with 340B entities.

Served as an extension of the Special Investigations Unit (SIU) for the largest single health carrier in the US, among others. Provided independent and objective investigation of suspect providers, including review of medical records, claims data, licensure, accreditation, onsite inspection and live interviews. Assisted in-house/outside counsel with over payment recovery efforts.

Assisted with the investigation of a $200 million fraud perpetrated through a Critical Access Hospital, whose magnitude rose to the attention of national news media. Investigated the validity of claims, identified co-conspirators, participated in depositions, mediations and related legal proceedings.

Contributed to the expert report involving a significant data breach.  Reviewed depositions, provided analysis and coordinated with outside experts in dark web searches to substantiate damages.

Perform monitoring for compliance with Certificate of Need requirements as set forth by the Connecticut Office of Health Strategy.

Served as Independent Review Organization for monitoring under Corporate Integrity Agreement terms with focus on transactions (focused arrangements) and systems reviews.

Education +

Coursework toward Masters of Health Services Administration, Marywood University, Pennsylvania

Major, Accounting, Kings College, Pennsylvania

B.A. Psychology and Sociology, Wilkes University, Pennsylvania

Certifications +

Certified Internal Auditor (CIA), IIA, July 2012 to Present

Certified Information Systems Auditor (CISA), ISACA, May 2013 to Present

Certified in Healthcare Compliance (CHC), HCCA, January 2013 to Present

Certified Professional Coder (CPC), AAPC, July 2017 to Present

Certified Healthcare Internal Audit Professional (CHIAP), AHIA, August 2019 to Present

Memberships +

Board of Governors - Institute of Internal Auditors (IIA), Phoenix Chapter

Committee Member, Academic Relations, IIA, Phoenix Chapter

Committee Member, Certification Committee, IIA, Phoenix Chapter

Marketing Committee – Association of Healthcare Internal Auditors (AHIA), National

Member - American Academy of Professional Coder’s (AAPC)

Member - Association of Healthcare Internal Auditors (AHIA)

Member - ISACA

Member - Health Care Compliance Association (HCCA)

Member - National Healthcare Antifraud Association (NHCAA)

Committee Member, Phoenix Security and Audit Conference

Publications & Speaking Engagements+

Publications:

Author: Journal of Health Care Compliance, “The Role of Internal Auditor”, Vol. 17, No. 6, Nov/Dec 2015

Co-author: HCCA (Health Care Compliance Association) Compliance Today, “Exploring Compliance and Internal Audit Organizational Roles and Relationship’’, 2015

Author: HCCA (Health Care Compliance Association) Compliance Today, “Unallowable Costs Related to a Corporate Integrity Agreement”, 2014

Author: New Perspectives, “Worst Case Scenarios: Business Continuity Plans Save the Day”, 2012

Presentations:

Presenter: “Internal Audit 101”, B. Riley Webinar, 2020

Presenter: “Business Continuity in a Pandemic”, B. Riley Webinar, 2020

Presenter: “Business Continuity, Will You Be Open?”, AHIA (Association of Healthcare Internal Auditors) National Conference, Nashville, Tennessee, 2019

Presenter: “Business Continuity, Will You Be Open?”, PHXSAC (Phoenix Security & Audit Conference), Scottsdale, Arizona, 2019.

Co-Presenter: “The 1-2-3 of SOC Reports”, Health Plan Alliance Webinar, 2019

Co-Presenter: “Access Controls”, Epic User Group, AHIA (Association of Healthcare Internal Auditors) National Conference, Boston, MA, 2017

Co-Presenter: “Laboratory Schemes and Red Flags”, NHCAA (National Health Care Anti-Fraud Association), Skills and Schemes for the Health Care Fraud Investigator Conference, Dallas, TX, 2016

Presenter: “HIPAA Security”, Colorado Chapter, HFMA (Healthcare Financial Management Association), Webinar, 2014

Presenter: “Meaningful Use, a Self-Assessment”, Northern California Chapter, HFMA (Healthcare Financial Management Association), Webinar, 2013

Presenter: “Planning for Business Continuity”, PMI (Project Management Institute), Keystone Chapter, State College, PA, 2011, and North Central Region, Bloomsburg, PA, 2010

Practices +