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.

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.

Mr. Gordon applies a flexible approach to mediating disputes, ranging from facilitative to evaluative, depending on the nature of the case and the needs and wishes of the parties. He carefully reviews all materials and speaks with the parties' counsel in advance of in-person sessions in order to enhance the prospects of settlement. He is effective at developing rapport with individuals who have little knowledge of the legal process, from terminated employees to individuals whose health benefits were denied. As a former corporate counsel and litigator, he is also able to establish the trust and confidence of both in-house lawyers and litigation counsel.

Mr. Gordon is also methodical in his preparation for arbitrations, and closely manages his cases to ensure that the parties obtain the benefits of arbitration while obtaining access to the information needed to prosecute or defend their case. He encourages parties to bring creativity to the arbitration process in order to conserve time and resources. Mr. Gordon carefully analyzes parties' briefs and cited authorities, gives parties ample time to present oral argument on motions, and writes rulings and awards that carefully explain both his factual findings and legal analysis.

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
• Arbitrated breach of contract and misrepresentation claims by health plan against consulting services company for failure to deliver required services
• Arbitrated claim by broker against insurance company for failure to pay commissions
• Mediated disputes between physicians and medical groups over alleged violations of non-solicitation agreements and wrongful termination of network contracts
• Arbitrated claim of wrongful termination of independent service agreement against national package delivery company
• Arbitrated claims of fraud and misrepresentation by investors in nursing home
• Mediated claims by independent pharmacies for breach of fiduciary duty against pharmacy services administrative organization
• Arbitrated dispute between insurance company and third-party administrator over alleged failure to satisfy contractual claims processing requirements
• Mediated indemnification claim by employer against benefits service provider for failure to properly calculate benefits under deferred compensation plan
• Arbitrated claim by company against corporate executives for breach of fiduciary duty
• Mediated claim by terminated physician against hospital system for interference with prospective economic advantage 
• Class Action & Mass Tort
• Mediated nationwide ERISA class action challenging reimbursements for physical therapy and health plan’s claims handling practices
• Mediated putative nationwide class action challenging health plan’s claims practices relating to prosthetic limbs
• Appointed as special master by state and federal courts to resolve disputes over eligibility for benefits under class action settlement agreements
• As in-house counsel, oversaw defense of nationwide class action on behalf of physicians challenging health insurers’ claims handling and payment practices, resulting in settlements containing significant business practice changes
• As in-house counsel, managed defense of multiple class action lawsuits and state attorney general actions alleging violations of HIPAA and state medical privacy laws
• As in-house counsel, negotiated business practice changes resolving nationwide consumer class actions challenging reimbursement practices relating to out-of-network services
• As in-house counsel oversaw defense and settlement negotiations of class action challenging rescission of insurance policies for misrepresentations on applications
• As litigator, defended multiple employment and ERISA-related class action lawsuits
• As litigator, tried ERISA class action challenging automaker’s reduction in retiree health care benefits
• Employment Law
• Mediated and arbitrated cases alleging discrimination or harassment on the basis of race, age, gender, religion, national origin, pregnancy and marital status 
• Mediated and arbitrated claims alleging disability discrimination, failure to accommodate, and noncompliance with FMLA, CFRA and other state and federal leave statutes
• Mediated and arbitrated multiple cases alleging retaliation for engaging in protected activity and whistleblowing
• Arbitrated claims by corporate CEO and CFO for wrongful termination and improper denial of put rights under employment agreement and stock plan
• Arbitrated dispute over payments under employee profit-sharing plan
• Mediated and arbitrated multiple individual, multi-plaintiff, PAGA and putative class action claims arising under wage-hour laws including alleged misclassification, failure to pay overtime, failure to provide meal and rest breaks, and failure to pay prevailing wages on public works projects
• ERISA/Employee Benefits
• Mediated multiple disputes over eligibility for employer-sponsored long-term disability and life insurance benefits
• Mediated dispute over employer’s effort to recoup allegedly overpaid pension payments
• Mediated multiple claims by multi-employer ERISA plans for delinquent contributions owed by employers
• Arbitrated and mediated disputes over whether ERISA preempts state law claims by health plan members and healthcare providers
• Mediated dispute among family members over entitled to deceased employee’s 401(k) proceeds
• Mediated dispute over enforceability of anti-assignment provisions in group health plan
• Tried nationwide ERISA class action alleging employer unlawfully reduced retiree health care benefits
• Health Care
• Arbitrated and mediated numerous claims by contracted hospitals, physicians, urgent care clinics and other medical providers alleging wrongful nonpayment or underpayment of claims, raising issues such as medical necessity, level of care, stop loss calculations, line- item review, division of financial responsibility, coding rules and other contractual interpretation issues
• Arbitrated and mediated numerous disputes between health plans and providers over “reasonable and customary” payments for emergency and post-stabilization services
• Mediated disputes between physicians and medical groups over alleged violations of non-solicitation agreements and wrongful termination of network contracts
• Mediated numerous claims by members for breach of contract and bad faith alleging improper denial of treatments such as proton beam therapy for head cancers, reconstructive surgery following implant removal, skull reduction surgery relating to gender reassignment treatment and other services denied by health plans as not medically necessary or experimental & investigational
• Mediated disputes between physicians and medical groups or hospital systems over bonus payments
• Mediated dispute between hospital system and Medi-Cal plan over interpretation of statutory reimbursement requirements
• Arbitrated dispute over legality of third-party payments of premiums for health plan members receiving dialysis services
• Arbitrated dispute between health plan and pharmacy over reporting of usual and customary prices
• Arbitrated claim by health plan member for wrongful termination of policy for failure to pay premiums
• Mediated claim for failure to pay for Applied Behavioral Analysis services and counterclaim alleging fraudulent billing
• Arbitrated numerous cases involving employment disputes in healthcare industry
• Mediated multiple claims by health plan members alleging inadequate specialist networks caused improper denial or delay of care
• Mediated claims by independent pharmacies against pharmacy benefit manager for underpayments and against PSAO for breach of fiduciary duty
• Mediated dispute between health plan and medical group over rates applicable to outpatient clinic acquired by group
• Mediated dispute over termination of pharmacy from PBM’s network for alleged improper billing
• Mediated consumer class actions alleging improper denial of benefits
• Insurance
• Mediated multiple lawsuits involving breach of contract and bad faith claims under health, long-term disability, life and long-term care insurance policies
• Arbitrated claim by independent practice association against insurer for failure to pay benefits under stop-loss insurance policy
• Arbitrated dispute between hospital system and excess loss carrier over failure to pay for six-month hospitalization
• As in-house counsel, oversaw all insurance procurement activities for health plan and regularly interfaced with carriers and brokers
• As in-house counsel, oversaw breach of contract action against errors and omissions carriers for failure to defend consumer class action lawsuits

Honors, Memberships, and Professional Activities

Completed Virtual ADR training conducted by the JAMS Institute, the training arm of JAMS.

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

Community Activities

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

Selected Speaking Engagements

• Arbitration in Managed Care, ABA Managed Care Institute, December 2021  
• Virtual Arbitration Advocacy Workshop, JAMS, September 2020
• Arbitrator's Insights into Managed Care Disputes, American Conference Institute, July 2020
• Co-Moderator, Hot Topics in Arbitrating and Mediating Payor-Provider Disputes, California Society for Healthcare Attorneys, 2019
• Internal Investigations, Daily Journal Employment Law Forum, July 2018
• Mediating Healthcare Disputes, American Bar Association, June 2018
• 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

• "Lessons Learned from Virtual ADR During a Pandemic," Bloomberg Law, December 22, 2020
• "Avoiding Internal Conflict When A Payor Is A Provider" Law 360, September 10, 2020
• "Drafting Effective Arbitration Clauses," ABA Health eSource, Vol. 15, No. 12, September 12, 2019 (Co-authored with Barbara Reeves)
• "Non-Monetary Class Action Settlements: 7 Things You Should Consider," Daily Journal Healthcare Supplement, December 4, 2019  

Background and Education

• 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 in Public Policy, Harvard Kennedy School of Government, 1983
• B.A., Haverford College, magna cum laude, 1978