Scott Simmer

Scott Simmer founded the Simmer Law Group in Washington D.C., in 2014, but he’s been practicing law for decades and is a seasoned expert at rooting out deceit and fraud in hidden corners of government programs, education, and healthcare industries. 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, Securities and Exchange Commission (SEC) and Foreign Corrupt Practices Act (FCPA) whistleblowers. Mr. Simmer also continues to represent private health insurance plans in large-scale recovery actions under the Racketeer Influenced and Corrupt Organizations (RICO) Act, federal anti-trust laws and state consumer fraud/deceptive trade practices statutes.

For more than thirty years, 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, 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 Managing (PBM) contracting.

The son of a Methodist minister, Mr. Simmer grew up in Nebraska with a strong sense of social justice and respect for the underdog. He was teaching English in college academia when the desire to attend law school struck him. After considering a legal career in publishing, Mr. Simmer found his legal calling while managing health care fraud investigations as head of litigation for a major health insurer. When he learned that the federal government was investigating for-profit healthcare companies for submitting fraudulent Medicare and Medicaid claims, Mr. Simmer convinced his insurance colleagues that similar fraud was adding burdensome costs to private health plans. He subsequently designed legal approaches to combat such healthcare fraud, including building a consortium of health insurers to investigate and pursue recovery actions.

Mr. Simmer eventually left the insurance business to take on the representation of qui tam whistleblowers bringing claims on behalf of the government. At the same time, he began representing groups of health plans in large-scale recovery litigation. His zeal for doing what’s right drives every case he takes on behalf of whistleblowers and every recovery action he undertakes for health insurers. “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.”

Scott Simmer serves as a trustee for his undergraduate alma mater, Cornell College, in Mount Vernon, Iowa. Whenever he returns to Cornell for meetings in the fall, he makes sure to attend Iowa Hawkeye football games with his sons, Reid and Ryan, their wives, and his granddaughter, Claudia. Scott and his wife, Peg, frequently plan family vacations to include a round of golf, a game of tennis or a Boston Red Sox game, another passion Scott shares with both his brothers and his sons.

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

Speeches

• “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