Bridget A. Gordon

Bridget Gordon’s practice is focused on managed care litigation, fraud and abuse matters, inclusive of False Claims Act litigation, managed care contract review, and compliance advising. She has handled a wide array of reimbursement disputes with both commercial and government payors, for both contracted and non-contracted providers. Such disputes also include challenging and responding to payor audits, recoupment requests, and investigations. She also frequently handles Medicare appeals and ALJ hearings, Targeted Probe and Education (TPE) audits, Comprehensive Error Rate Testing (CERT) denials and appeals, and Uniform Program Integrity (UPIC) audits. She routinely defends providers in healthcare fraud and abuse matters ranging from assistance and strategy with responses to Civil Investigative Demands (CIDs) and subpoenas issued by DOJ, OIG, the Department of Insurance, and other governmental entities, to defending providers in qui tam relator actions, False Claims Act actions, and related actions brought under various state laws such as the Insurance Fraud Prevention Act (“IFPA”). She also works closely with clients on managed care contract review and negotiation, as well as compliance advising and internal policy development.

Bridget also has substantial experience in the long-term care space, related to both fraud and abuse matters, as well as citation appeals. She has also regularly handled internal audits and investigations and government agency audits, for a variety of healthcare provider types.

Bridget’s practice comprises both providing effective representation for clients in disputes and providing strategic counsel and guidance concerning regulatory issues and actions. With respect to the former, she has handled dozens of matters through arbitration, mediation, before administrative panels, and in courtroom litigation both at the state and federal level.

Efficiency and focus is pivotal to Bridget’s approach to practicing law. She works to be as effective as possible for her clients, while simultaneously considering the larger context within which they are doing business. By placing her legal work into the setting of each client’s goals, strategy and priorities, she ensures that she’s solving the right problems for them, in the right way.

Bridget prioritizes developing effective working relationships with all parties to a matter or a dispute in order to most efficiently reach the desired outcome for her clients. She prefers approaching a dispute by leading with her client’s business needs, short-term goals, and long-term focus at the forefront.

Representative Matters

• Represented dozens of hospitals and healthcare systems in payor-provider disputes, both contracted and non-contracted, to recover millions of dollars for providers to compensate for services rendered which had been improperly underpaid or denied by commercial and governmental payors.
• Represented a pathology laboratory in an investigation by the Department of Insurance (“DOI”) and associated qui tam relator action for alleged violations of the California Insurance Fraud Prevention Act (“IFPA”) through response to DOI subpoenas, unsealing of the action, litigation, and full resolution through mediation and settlement. 
• Represented dozens of providers in the lab space, pharmacy space, and behavioral health space in disputes with commercial payors regarding alleged overpayments, pre-payment review, audits, and related payor inquiries, through resolution to ensure maintenance of business relationships, retention of prior payments, and ease of future payments. 
• Represented multiple large skilled nursing facility (“SNF”) chains in False Claims Act (“FCA”) actions brought by relators and the Department of Justice (“DOJ”) through initial responses to Civil Investigative Demands (“CIDs”) up through litigation, mediation, and resolution of claims with favorable settlement terms. 
• Represented Reliance Medical Systems in a protracted battle with the Department of Justice and Office of Inspector General, through civil and criminal investigation, negotiations with DOJ, and second-chairing a federal civil trial, ultimately culminating in a favorable $1 million settlement with beneficial terms, ending eight years of civil litigation and criminal investigations against the spinal implant manufacturer, two distributorships, and their owners.
• Provided frequent guidance to numerous healthcare providers throughout the healthcare space on managed care contracting and negotiation, No Surprises Act and related Good Faith Estimate obligations, Medicare appeals, and overpayment and credit balance considerations, including assisting with drafting internal policies and procedures.