Jill H. Gordon

My focus

I assist healthcare providers and others in the industry with transactional and regulatory matters. My practice is primarily focused on hospital/physician alignment strategies; forming joint ventures and other alliances; structuring mergers and acquisitions; and negotiating managed care and other agreements, such as physician contracts, facility leases and management and co-management arrangements.

Many of my transactions incorporate bundled payment relationships, pay for performance and shared savings incentive programs and the creation of clinically integrated or “narrow” networks. I also provide counsel with respect to physician self-referral (Stark law), anti-kickback, licensing and certification and other healthcare compliance matters and serve as outside general counsel to a number of providers.

Increasingly, many traditional healthcare providers and suppliers, as well as emerging companies, turn to me for counsel with respect to the creation of new products and services within the traditional healthcare market that have some “digital health” component such as sensor technology, remote monitoring, health-related apps or other forms of software. Much of this work focuses on integrating novel products and services into the existing market and addressing issues such as reimbursement, licensing, state law prohibitions, access to and use of data and fraud and abuse compliance.

Representative experience

• Multi-state hospital system in its ongoing review and implementation of multiple novel technologies and delivery systems (including the use of apps, telehealth services, middleware and home visits) aimed at improving service delivery direct to consumers, addressing reimbursement, licensing, privacy, IP, risk management and other legal issues
• Several community hospitals and hospital systems in the development and expansion of physician foundations, hospital-based clinics and community clinic networks, including physician practice acquisition and the negotiation and structuring of governance systems and complex services agreements
• Five-hospital health system in the formation of a physician joint-venture with over 800 physicians for purposes of creating a managed care narrow network, system-wide co-management and a framework for clinical integration
• Community hospital in the creation of a physician joint venture with over 400 physicians; establishment of the joint venture as both a Medicare and commercial payor accountable care organization (ACO)
• Large national health system, as well as several other hospitals, health plans, PHOs and medical groups around the country in the development of internal guidelines for physician incentive payments focused on quality and cost-saving measures (gainsharing and P4P)
• Several hospital systems and community hospitals in the design and implementation of an electronic medical record (EMR) donation program and health information exchange (HIE) structure
• Several hospital systems, health plans, IPAs and medical groups with respect to their managed care contracting strategy, joint contracting, the establishment of narrow networks, risk pools and delegated services arrangements
• Multi-stakeholder nonprofit entity in the development and implementation of a statewide commercial payor bundled payment demonstration program
• Several academic medical centers in their overall physician alignment strategy and ACO development
• Several telemedicine and mobile imaging companies with respect to their startup operations and expansion to multiple states
• National developer of radiation therapy joint ventures with respect to regulatory compliance matters for over twenty transactions
• Several skilled nursing and assisted-living landlords and operators with respect to facility sales and acquisitions, lease agreements and operations transfers

Looking ahead

Healthcare is increasingly more consumer-facing, fueled by advances in technology and our comfort level with remote communication. The challenge for the industry is navigating this rapid change and staying relevant in the market, while simultaneously juggling regulatory compliance, work-flow modifications, and managing patient expectations.

Insights

Publications

Jill has been quoted in or published more than 50 articles, including:

• “Key considerations for telehealth providers following the Dobbs decision,” Association of Corporate Counsel, August 25, 2022
• “Nixon Peabody Looks to Tie Billable 'Impact Lawyering' to Pro Bono Work With New Hire,” The American Lawyer, December 15, 2021 (Quoted)
• “Hospitals See Opportunity, Risk in Ambulatory Surgery Centers,” Modern Healthcare, January 25, 2021 (Quoted)
• “What the New Medicare Waivers Mean for Providers,” Oliver Wyman, April 2, 2020 (Author)
• Featured in an article by Bonnie Marcus, “Here's How To Be A Positive Role Model For Your Daughter,” Forbes, July 31, 2017
• “It's Time for Healthcare Entities to Heed the Ransomware Warning,” American Health Lawyers Association, June 2017 (Co-author)
• “Firm makes courting diversity full-time focus,” Los Angeles Business Journal, November 14, 2016 (Quoted)
• “Rainmaker Q&A: Nixon Peabody’s Jill Gordon,’ Law 360, October 3, 2016
• “Can't I Just ‘Uber’ My Doctor?” Medical Home News, October 1, 2015. (Co-author with Daniel Eliav) Click here to read the full article.
• “Trends to watch for in healthcare and delivery system transformation,” American Health Lawyers Association, June 1, 2015
• “Legal Issues in Designing Bundled Payments and Shared Savings Arrangements in the Commercial Payor Context,” Robert Wood Johnson Foundation, September 4, 2013 (Co-author with The Camden Group and Pacific Business Group on Health)
• “Contracting for Bundled Payment,” Prepared for: Centers for Medicare & Medicaid Services, MITRE, December 16, 2011
• “Overview, Issues Raised, and Probable Controversies,” Accountable Care News, Special Edition — ACO Regulations, April 2011
• “Do the Right Thing: Can the ACO Reinvent the Payor-Provider Relationship?” The Healthcare Innovator’s Forum, Vol. 1, No. 1, March 2011
• “Hospital-Physician Alignment Strategies,” White Paper for the California Hospital Association, January 2011

Presentations

Jill is a frequent lecturer for the American Health Lawyers Association, the American Bar Association, the Healthcare Financial Management Association, the Hospital Association of Southern California and numerous other national and regional organizations. Jill has given over 100 presentations, including the following:

• “California’s New Office of Health Care Affordability (OHCA): Key Considerations for Health Industry Transactions,” LACBA Healthcare Law Section’s Roundtable, February, 7, 2024
• “Buy-Sell Issues in Shareholder and Operating Agreements,” LACBA's 20th Annual Healthcare Compliance Symposium, Los Angeles, CA October 5, 2023
• “Transforming Healthcare Delivery Through Innovation, Partnerships, and Growth,” Zephyr Healthcare Advisors 2023 Healthcare Leadership & Executive Conference, Las Vagas, NV, September 13, 2023
• “2023 Healthcare Market Trends & Implications,” Nixon Peabody 2023 California MCLE Virtual Seminar, January 20, 2023
• “Staying Competitive in the Market: Exploring Innovative Solutions to Physician Alignment Models” Zephyr Healthcare Advisors 2022 Healthcare Leadership & Executive Conference, Las Vagas, NV, September 29, 2022
• “Deals and Private Equity Investment Trends 2022,” Connecting The Disruptors™ Healthcare Conference, Dana Point, CA, January 21, 2022
• “Protecting the Digital Health Consumer with Leading Edge Legislation,” USC Body Computing Conference, Webinar, October 22, 2021
• “Digital Health Licensure: Obstacles, Pitfalls and Opportunities for Cross-State Virtual Care Platforms,” 2021 CTel Digital Health Summit, Webinar, June 9, 2021
• “Final Stark AKS Rules,” Women in Health Administration of Southern California, Webinar, March 16, 2021
• “Practice of Health Policy and Management,” Master of Health Administration Program, Sol Price School of Public Policy, University of Southern California, February 10 & 11, 2021
• “Regulatory Compliance for Hospital/Startup Partnerships,” KidsX Roundtable, February 3, 2021
• “Digital Health, Healthcare Regulation, Cybersecurity, and COVID-19,” USC Body Computing Conference, October 2, 2020
• “Traditional Healthcare in Transition: New Models of Care with COVID-19: Hospitalizing Patients at Home, Digital Therapeutics,” USC Body Computing Conference, October 2, 2020
• “Creating a Hospital Quality and Efficiency Program (HQEP) Success Story: Organizational, Legal and Operational Tales from the Trenches,” American Health Law Association Annual Meeting, June 29, 2020
• “The Paradigm Shift to Telehealth: Lessons Learned from the COVID-19 Pandemic,” CTeL Summit, June 19, 2020
• “Telehealth Trends: Risks, Rewards and Reimbursement,” Health Care Compliance Association, Webinar, March 23, 2020
• “Navigating Insurance, Licensing, and HIPAA Regulations During the COVID-19 Crisis,” Inside Reproductive Health Podcast, Fertility Bridge. March 19, 2020
• “Current perspectives/trends in digital health and patient data,” 2020 UCLA MedTech Conference Followup, Los Angeles, CA, March 3, 2020
• “How are Regulatory Issues, Cost Challenges and an Evolving Care Delivery Environment Impacting Hospital and Healthcare System’s Real Estate Usage and Strategy? ” 11th Annual Interface Healthcare Real Estate West Conference, Los Angeles, CA, February 19, 2020
• “IVF: A Discussion of Legal Issues for Non-Lawyers,” SUMMIT:IVF 2020, Aspen, CO, February 6, 2020
• “Creating a Virtual Health System to Support Patient Centric Care, Access and Engagement,” 4th National Telehealth Summit, Las Vegas, NV, January 30, 2020
• “Telehealth Trends: Risks, Rewards and Reimbursement,” Nixon Peabody Webinar, November 14, 2019
• “Healthcare Innovators—Digital health startups and what you need to know to represent them,” Representing Health and Technology Startups, Los Angeles County Bar Association, February 13, 2019
• “Healthcare M&A Trends and Disruptions,” 2019 Hunn Group Conference: Connecting the Disruptors Healthcare Conference, January 22, 2019
• “International Healthcare Transactions,” American Health Lawyers Association: Health Care Transactions Conference, May 11, 2018
• “How to do Business with Healthcare Provider Systems,” Biocom and the Cedars-Sinai Medical Center Healthcare Accelerator, February 20, 2018
• “Private Equity Outlook: What is Next for Investing in Health Care,” Nixon Peabody Hot Topics, Los Angeles, CA, February 2018
• “Regulatory Basics for Healthcare and Biotech Entrepreneurs,” LA BioStart Legal Basics Program, Los Angeles, CA, July 14, 2017
• “The Modern IP Lawyer: A Boot Camp for Success in 2017,” Nixon Peabody CLE Seminar, Chicago, IL, June 8, 2017
• “Episode Payment Model Master Class,” webinar with ECG, April 17, 2017
• “Legal Issues for Digital Health Companies,” Cedars-Sinai Medical Center Healthcare Accelerator, Los Angeles, CA, February 16, 2017
• “Legal and Contractual Best Practices for Episodic Care,” CJR Bootcamp, Miami, FL, September 26, 2016
• “Digital Health Access Initiative,” University of Southern California 10th Annual Global Body Computing Conference, Los Angeles, CA, September 23, 2016
• “Bundled Payments for Total Joint Replacement: Early Indications from the First 90 Days,” webinar with BDO, June 30, 2016
• “Regulatory Pitfalls of Physician Transactions,” Providence Health & Services, Renton, WA, June 28, 2016
• “Navigating the Contracting and Legal Intricacies of Episode-Based Payment Programs,” 2nd Annual Bundled Payment Implementation Forum, Orlando, FL, January 25, 2016
• “Technology in Consumer-Facing Healthcare,” Nixon Peabody 11th Annual California MCLE Super Seminar, Los Angeles, CA, January 21, 2016
• “Models for Provider Risk Arrangements,” Southern California State of Reform Health Policy Conference, Los Angeles, CA, November 6, 2015
• “Case Study Approach: Successful Implementation of Complex Gainshare Models,” The National Bundled Payment Summit, Washington, DC, June 3, 2015
• “The Next Generation ACOs — New Regulations” and “ACA Implementation and Challenges for California Health Plans in Creating an Affordable and Accessible System for Consumers,” California Society for Healthcare Attorneys 2015 Annual Meeting & Spring Seminar, Huntington Beach, April 17, 2015
• “Navigating Contracting and Legal Intricacies for Episode-Based Payment Programs,” Bundled Payment Implementation Forum, Coral Gables, January 12, 2015
• “Bundled Payment Gainsharing and Legal Implications,” The Camden Group, October 30, 2014.
• “Big Data Privacy and Health,” USC Body Computing Conference, Los Angeles, October 3, 2014
• “Telemedicine & The New Care Delivery Landscape: Opportunities in Deploying Disruptive Technology,” MDS Healthcare Leadership and Executive Conference, Las Vegas, September 15, 2014
• “Healthcare Reform and Providers — Legal and Policy Issues,” Guest Lecturer, University of California Los Angeles School of Law, Health Law and Policy, April 22, 2014
• “The Next Generation of Bundled Payments,” Webinar, American Health Lawyers Association, April 14, 2014
• “Pay for Performance — Current Legal Issues,” California Society for Healthcare Attorneys, Lake Tahoe, April 12, 2014