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Elliot Gordon

Elliot K. Gordon, Esq.

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Case Manager
Dana Schuler
T: 310-309-6205
F: 310-396-7576
1925 Century Park East, Suite 1400 , The Watt Plaza , Los Angeles , CA 90067

Elliot K. Gordon, Esq. is a full-time mediator and arbitrator who enjoyed a 30-year legal career in private practice and as an in-house counsel with an emphasis on health care, employment law and complex business litigation.

Mr. Gordon served in leadership positions in the legal departments of two of the country’s largest health care companies, where he had responsibility for the entire portfolio of litigation, including individual and class claims brought under ERISA, the Knox-Keene Act, the California Insurance Code, Business & Professions Code Section 17200, antitrust laws and the Confidentiality of Medical Information Act, as well as numerous disputes involving claims of breach of contract and bad faith.

Additionally, while in-house, Mr. Gordon was responsible for all employment litigation and managed intellectual property disputes, derivative shareholder actions, insurance coverage disputes and contract disputes involving vendors. He started his legal career as a litigator at a major global law firm.

Prior to going in-house, Mr. Gordon practiced as a litigator for 13 years, specializing in the full range of individual and collective employment disputes, including discrimination, harassment, wrongful termination, retaliation, wage and hour, employee benefits and employment contract disputes.

ADR Experience and Qualifications

  • Full-time mediator and arbitrator since 2015
  • Executive level experience at two of the country’s largest health care companies, where he was responsible for a wide range of employment, health care, business/commercial and risk management matters
  • 13-year litigation career focused on the full range of employment and labor law matters
  • Extensive training and frequent lecturer on ADR-related subjects, including mediation, arbitration, health care, coverage and class actions

Representative Matters

Business/Commercial

  • Claim for wrongful termination of pharmacy benefit management services agreement
  • Contract dispute between school district and workers’ compensation plan administrator
  • Breach of contract and misrepresentation claims by health plan against consulting services company for failure to deliver required services
  • Antitrust claims against outpatient health care providers by health plan
  • Claim by broker against insurance company for failure to pay commissions
  • Dispute between insurance companies and third-party administrator retained to process claims
  • Dispute between hospital and nurse staffing agency over failure to pay for delivered services
  • Numerous disputes between health plans and contracted hospitals over reimbursement issues
  • Claim of wrongful termination by physician against medical group
  • Dispute between pharmacy benefit manager (PBM) and health plan over terms of contract
  • Indemnification claim by company against IT vendor for mishandling of data

Class Actions

  • Multiple class action lawsuits on behalf of over 2 million individuals alleging that loss of server drives containing medical information violated California Confidentiality of Medical Information Act and B&P Code 17200
  • Class action lawsuits and actions by state attorneys general claiming that theft of portable hard drive violated HIPAA and state laws
  • Nationwide consumer class action claiming that health plans violated ERISA and RICO by systematically underpaying out-of-network claims and failing to adequately disclose out-of-network reimbursement practices
  • Multiple class actions and individual lawsuits, as well as action by Los Angeles City Attorney, alleging that rescission of insurance policies for misrepresentation on applications violated Knox-Keene Act and Insurance Code, as well as health plan contracts
  • Bad faith action by Medi-Cal members alleging that denial of second opinion and delays in approval for surgery constitute bad faith
  • Nationwide class action on behalf of providers challenging health insurers’ reimbursement and business practices, resulting in settlements containing significant business practice changes
  • Several employment-related class actions concerning alleged wage/hour violations and ERISA violations

Employment

  • Dispute over misclassification of retail cell phone store manager as exempt from overtime
  • Pregnancy discrimination claim against convenience store for refusal to reinstate to same position following return from leave
  • Dispute over amount of pension benefits to which retired employee was entitled
  • Wrongful termination claim by physician against medical group
  • Class action on behalf of truck drivers alleging numerous wage/hour violations
  • Dispute between terminated physician and medical group over bonus eligibility
  • Wrongful termination claim against government contractor alleging whistleblower retaliation
  • Race discrimination/wrongful termination claim by terminated employee against package delivery service company
  • PAGA claim against building products company for failure to provide meal and rest periods
  • Age and disability discrimination claim against hotel by terminated management employee
  • Class action for alleged wage/hour violations against restaurant chain
  • Claim against employee for conversion and breach of fiduciary duty and counterclaim for wage/hour violations
  • Multi-plaintiff wage/hour claim alleging misclassification of pharmacy’s store managers
  • Hybrid collective and class action lawsuit contending that employer misclassified individuals working on military bases under federal contract as independent contractors, in violation of state wage/hour law and federal Fair Labor Standards Act

ERISA/Employee Benefits

  • Multiple disputes over eligibility for long-term-disability benefits under ERISA
  • Claim that company wrongfully sought to recoup pension benefits many years after employee had retired
  • Numerous disputes by health plan members or assignees over medical necessity of health care services, such as reconstructive surgery, proton beam therapy, artificial disc replacement, skull reduction surgery, deep brain stimulation therapy and residential treatment for eating and other mental health disorders
  • Multiple cases involving claims by multi-employer ERISA plans for delinquent contributions owed by employers
  • Dispute between disabled employee and long-term-disability carrier over timeliness of claim for benefits
  • Disputes over whether ERISA preempts state law claims by health plan members and health care providers
  • Class action alleging that employer violated ERISA by reducing retiree health care benefits
  • Dispute among family members over entitlement to deceased relative’s 401(k) proceeds
  • Dispute over eligibility for group life insurance benefits

Health Care

  • Multiple lawsuits on behalf of health plan members over medical necessity of residential facility treatments for eating and other mental health disorders
  • Dispute between health care provider and county-operated health plan over reimbursement level for outpatient services
  • Bad faith claim against health plan for denial of skull reduction surgery relating to gender reassignment surgery
  • Multiple lawsuits by hospitals and professional providers claiming wrongful nonpayment or underpayment of claims, raising issues such as medical necessity, stop loss calculations, financial responsibility of delegated entities and other contractual interpretation issues
  • Claim for breach of contract and bad faith for denial of skilled nursing facility stay and related benefits for quadriplegic health plan member
  • Wrongful termination claim by physician against medical group
  • Antitrust claims by health plan against outpatient health care provider
  • Bad faith claim against health plan for denial of spinal fusion surgery
  • Breach of contract and unjust enrichment claim for alleged wrongful termination of pharmacy benefit management services contract
  • Class action against health plan for refusal to cover treatment for hepatitis C medication
  • Disputes over medical necessity of proton beam therapy for head cancers
  • Dispute between terminated physician and medical group over eligibility for bonus
  • Antitrust lawsuit alleging that pharmaceutical manufacturer, PBMs and health plans conspired to delay placement of generic statins on formularies
  • Challenge to health plan’s denial of coverage for reconstructive surgery regarding implant removal
  • Disputes over “reasonable and customary” amounts under Knox-Keene Act for out-of-network emergency services
  • Reimbursement dispute between health plan and capitated medical group over responsibility for treatment costs for critically ill member
  • Claim by subcontractor that health plan failed to make required payments under reinsurance provisions of capitation agreement
  • Contractual dispute between health plan and consulting firm over alleged failure to provide required services
  • Dispute between hospital system and Medi-Cal plan over interpretation of statutory reimbursement requirements
  • Claim by health plan member for alleged wrongful denial of coverage for total disc replacement procedure
  • Contract dispute between insurance companies and third-party administrator responsible for processing health care claims
  • Dispute over legality of third-party payment of premiums for health plan members
  • Claim by broker against health plan for wrongful denial of commissions
  • Disputes over Medicare preemption of state law claims by health care providers
  • Qui tam action claiming that multiple health plans violated federal False Claims Act in connection with risk adjuster payments received under Medicare program

Insurance

  • Lawsuits against errors and omissions carrier alleging failure to pay for losses relating to consumer class action lawsuits
  • Numerous lawsuits against health insurance companies alleging breach of contract and bad faith for failure to provide coverage in accordance with policy terms
  • Dispute with errors and omissions carrier over interpretation of “related acts” provision and wrongful conduct exclusion
  • Dispute over interplay between errors and omissions policy and cybercoverage policy
  • Claim for wrongful denial of life insurance benefits
  • Dispute over coverage for stay at Alzheimer’s care facility under long-term-care insurance policy

ADR Training

  • Advanced Mediation Institute, American Bar Association, 2017
  • Advanced Arbitration Academy, USC-JAMS Arbitration Institute, 2016
  • Arbitration Fundamentals and Best Practices, American Arbitration Association, 2016
  • Health Care Arbitration, American Health Lawyers Association, 2015
  • Advanced Mediation Training, United States District Court, 2015
  • Mediation Panel Training, United States District Court, 2014
  • Mediation of Health Care Disputes, American Health Lawyers Association, 2014
  • ADR Cross-Cultural Training, Los Angeles Superior Court, 2007
  • ADR Neutral Orientation Training, Los Angeles Superior Court, 2007
  • Early Neutral Evaluation Training, Los Angeles Superior Court, 2006
  • Mediating the Litigated Case, Straus Institute at Pepperdine University School of Law, 2005

Professional Organizations

  • American Bar Association
  • American Health Lawyers Association
  • California Society for Healthcare Attorneys
  • Los Angeles County Bar Association
  • Southern California Mediation Association

Community Activities

  • Member and Past President, Board of Trustees, Windward School
  • Member, Board of Directors, Inner City Law Center
  • Member, City of Santa Monica Personnel Board
  • Past President, Haverford College Alumni Association

Selected Speaking Engagements

  • Arbitration of Health Care Payor-Provider Disputes, Boston Bar Association, 2017
  • Settlement of Class Actions, American Health Lawyers Association, 2016
  • Use of ADR in Class Actions, American Health Lawyers Association, 2016
  • Ethics in Employment Litigation, California State Bar, 2015
  • Health Plan/Insurers Network Adequacy, California Society for Healthcare Attorneys, 2015
  • In-House Think Tank on Managed Care Lawsuits, American Conference Institute, 2014
  • Cybercoverage Issues in Managed Care, Willis MCO Roundtable, 2013
  • Arbitration and Other ADR Issues, Association of Corporate Counsel, 2013
  • Health Care Class Actions, American Conference Institute, 2012
  • In-House Think Tank on Managed Care Lawsuits, American Conference Institute, 2011
  • Out-of-Network Reimbursement in the Post-Ingenix Era, Willis MCO Roundtable, 2009
  • VP and Deputy General Counsel, Health Net, Inc., 2007–2015
  • VP and Deputy General Counsel, Wellpoint, Inc. (now Anthem, Inc.), 1997–2006
  • Litigator, Paul Hastings, 1984–1985, 1989–1997
  • Litigator, Goldstein & Manello, 1985–1989
  • J.D., Harvard Law School, 1983
    • Notes Editor, Journal on Legislation
  • Master of Public Policy, Harvard Kennedy School of Government, 1983
  • B.A., Haverford College, magna cum laude, 1978

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    Practice Areas

    • Arbitration
    • Business/Commercial
    • Class Action & Mass Tort
    • Cybersecurity & Privacy
    • Employment
    • Health Care
    • Insurance
    Available nationwide

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    This page is for general information purposes.  JAMS makes no representations or warranties regarding its accuracy or completeness.  Interested persons should conduct their own research regarding information on this website before deciding to use JAMS, including investigation and research of JAMS neutrals. See More

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