• vcard
  • Education
    • J.D., University of Mississippi School of Law, 2004
    • B.A., Southern Methodist University, 2001
  • Court Admissions
    • State of Tennessee
    • State of Mississippi
    • U.S. District Court for the Southern District of Mississippi
    • New York - Appellate Division-First Department

Meri Gordon has a deep understanding of the health care legal landscape and routinely represents clients in connection with an array of health care dispute matters. Her practice centers on managed care litigation in counseling providers, hospital systems and device manufactures in disputes over benefit determination, medical necessity denials, contract interpretation, and in and out-of-network reimbursement. With over 15 years of litigation experience, Meri is well-versed in providing tailored strategic solutions to represent clients in the ever-changing landscape of health care litigation. 

Meri’s representative work includes:

Managed Care Disputes 

Resolving disputes amongst providers, insurers, benefit administrators and vendors, focusing on disputes involving prompt pay laws, payment from third-party liability parties and calculation of usual, customary and reasonable charges. Meri has noteworthy experience representing hospitals in medical necessity disputes with insurance companies. Her practice includes navigating the appeals process for ERISA and non-ERISA claims and resolving these claims in arbitrations across the nation.

Alternative Dispute Resolution

Resolving breach of contract matters in arbitrations nationwide with the AAA and AHLA on behalf of healthcare clients regarding denial of benefits and rate of reimbursement disputes with payers.

e-Discovery in Federal Investigations and Business Disputes 

Managing large volumes of data and documents for productions in response to subpoenas from the Department of Justice, SEC as well as discovery in shareholder lawsuits and antitrust litigation. In addition, Meri has extensive experience in data management, data analytics and e-discovery projects involving high-stakes litigation.

  • Represented medical device company in overturn of denials by numerous national and regional administrators of Medicare Advantage plans 
  • Successfully obtained waiver of applicability of a healthcare payer’s avoidable readmission policy to community hospital’s commercial and Medicare claims 
  • Successfully obtained back-pay of enhanced primary care physician fees from national managed Medicaid administrator for regional physician group
  • Represented out-of-network behavioral health company on recoupment and direct pay-to-patient issues against a healthcare payer
  • Counseled critical access hospital in developing an out-of-network strategy
  • Represented national emergency physician provider in challenging several payers’ E/M downcoding policies
  • Represented skilled nursing facility in contract dispute with healthcare payor regarding denials, underpayments and recoupments
  • Represented hospital in challenging the application of  a national payer’s Sepsis-3 clinical policy
  • Represented medical device company on a national basis in challenging medical coverage policies labeling FDA-approved device as “experimental or investigational”
  • Represented eleven hospitals in Tennessee against a commercial insurer for underpaying thousands of out-of-network claims for emergency services
  • Represented intraoperative neuromonitoring company on a national basis in challenging medical coverage policies
  • Represented hospitals part of national system in a series of arbitrations around the country in disputes against a large commercial insurer for underpaying hundreds of claims related to medical necessity