Scott Simmer

Scott Simmer is a recognized expert at routing out fraud in government programs, including for-profit education, healthcare (pharmacy benefit managers, drug and device manufacturers, Medicare Part D, Medicare Advantage), customs, and defense contractors. Joining with Baron & Budd as a shareholder in 2018 to form our Washington D.C. office, Mr. Simmer continues to represent whistleblowers bringing qui tam cases of fraud under federal and state False Claims Acts as well as IRS and Foreign Corrupt Practices Act (FCPA) whistleblowers.

Scott Simmer has led the investigation and prosecution of numerous precedent-setting fraud and abuse cases on behalf of whistleblowers and private insurance payors. He has written and spoken widely on legal issues related to the federal False Claims Act (FCA), the Anti-Kickback statute, 340B, Employee Retirement Income Security Act (ERISA) and Consolidated Omnibus Budget Reconciliation Act (COBRA); as well as on healthcare fraud and abuse, antitrust violations and issues related to Pharmacy Benefit Management (PBM) contracting.

Among the many cases that Mr. Simmer has brought to a successful conclusion is a $350 million settlement in 2025 with the chain pharmacy Walgreens involving its fraudulent dispensing of opioids, which followed a $409 million settlement with chain pharmacy Rite Aid and an $8.4 million settlement with Food City, both in 2024. Those cases also alleged claims regarding the retail pharmacies’ fraudulent opioid dispensing.

Mr. Simmer has received several notable accolades while at Baron & Budd. Every year since 2024, he has been a recipient of the Best Lawyers in America – Qui Tam Law award. He has been named to National Trial Lawyers’ Top 100 Civil Plaintiff Lawyers every year since 2023. Lawdragon has named him one of their 500 Leading Plaintiff Financial Lawyers every year since 2024.

His dedication to “doing what’s right” drives every case he takes on behalf of whistleblowers. “Scott Simmer is an outstanding attorney and I am pleased to have him at Baron & Budd,” said President and Managing Shareholder, Russell Budd. “Scott and his team bring a strong record of success pursuing complex litigation which closely aligns with the breadth and scope of Baron & Budd’s existing practice areas.”

Publications

• “First Amendment Interests in Trade Secrets, Private Materials, and Confidential Information: The Use of Protective Orders in Defamation Litigation,” 69 Iowa L. Rev. 1011 (May 1984)
• “Legal Implications of the FCC Deregulation of Electronic Publishing,” 70 Iowa L. Rev. 709 (March 1985)
• “Just What the Doctor Ordered: Avoiding Kickback Pitfalls with Prescription Drugs,” Managed Care Interface
• “Beware of Pharmaceutical Companies Bearing Gifts: There is No Such Thing as a Free Lunch,” Blue Cross and Blue Shield Association Blue Plan Legal Department Cooperative National Teleconference Series
• “Prescription for Reform: Tidal Wave of Change Hitting Prescription Drug Benefit,” American Association of Health Plans Managed Care Conference, San Francisco, reprinted in the July Blue Cross Blue Shield Association Legal Affairs Bulletin
• “Toward a Code of Conduct on Pharmaceutical Issues,” Blue Cross Blue Shield Association Legal Affairs Bulletin

Presentations

• “FCA Relator Anonymity,” Taxpayers Against Fraud Education Fund Conference, Washington, DC.
• “UCR Litigation: Review and Analysis,” Blue Cross Blue Shield Lawyers’ Conference, Glendale, Arizona
• “PBM Litigation,” Pharmacy Benefit Information and Knowledge Exchange, Chicago, Illinois
• “Declination: Not the End of the Road,” Taxpayers Against Fraud Education Fund Conference, Washington, D.C
• “Antitrust Issues in Pharmaceutical Reverse Payment Settlements,” American Health Lawyers Association (“AHLA”), Washington, DC.
• “Sleight of Hand? What Isn’t Said in Your PBM Contract May Be More Important Than What Is Said,” Blue Cross and Blue Shield Association Annual Lawyers Conference, Denver, Colorado
• “Avoiding Pitfalls with Pharmaceutical Deals: A Legal and Business Perspective
• American Association of Health Plans, AHLI, San Francisco, California
• “Fraud and Abuse Exposure in the Pharmaceutical Industry,” Healthcare Compliance Association (“HCCA”) Conference, Washington, DC.
• “Just What the Doctor Ordered: Compliance Guidance to Avoid Pitfalls with Prescription Drugs,” HCCA Conference, Washington, DC
• “Fraud in Managed Care,” National Health Care Anti-Fraud Association Meeting (“NHCAA”), Washington, DC.
• “Working with the Federal Government in Fraud Investigations,” NHCAA Lawyers Meeting, Washington, DC.
• “COBRA: Taking the Sting Out of the Bite,” Defense Research Institute (“DRI”), ERISA and Employee Benefits, Chicago, Illinois