South Carolina Medicare and Medicaid Fraud Lawyer:

Protecting Taxpayers and Whistleblowers

When Healthcare Companies Cheat the System

Medicare and Medicaid are vital programs designed to provide healthcare to seniors, people with disabilities, and low-income families. When corporations, hospitals, or clinics defraud these programs, they aren’t just stealing from the government (they are draining resources meant for patient care and driving up costs for every taxpayer in South Carolina).

At The Law Offices of David L. Hood, we represent “whistleblowers”—the courageous insiders who witness fraud and choose to speak up. Healthcare fraud has reached record levels, with the Department of Justice reporting over $5.7 billion in healthcare-related recoveries in fiscal year 2025 alone. With over 30 years of experience, attorney David L. Hood and his co-counsel legal team provide the confidential, high-level advocacy needed to navigate complex federal laws and help you hold dishonest entities accountable.

black and gray stethoscope
Claims

The Power of the False Claims Act (FCA)

person sitting while using laptop computer and green stethoscope near

Most Medicare and Medicaid fraud cases are brought under the False Claims Act, a powerful federal law that allows private citizens to file a lawsuit on behalf of the government. This is known as a Qui Tam action.

Under this law, a whistleblower (or “relator”) is not just a witness; they are a partner in the recovery. If the lawsuit is successful, the whistleblower is entitled to a significant portion of the recovered funds:

Government Intervention:
If the government joins your case, you typically receive 15% to 25% of the total recovery.
Declined Cases:
If the government declines to intervene but you proceed with your attorney and win, your reward can increase to between 25% and 30%.
Modern

Healthcare Fraud Schemes in 2026

person wearing lavatory gown with green stethoscope on neck using phone while standing

Fraud has evolved beyond simple double-billing. Today, our firm investigates sophisticated schemes that often involve data manipulation and corporate pressure:

Upcoding and "Phantom" Billing:
Charging for a more expensive service than provided or billing for appointments and equipment that patients never received.
Medicare Advantage (Part C) Fraud:
Insurers or providers using unsupported diagnosis codes to "juice" the risk-adjustment payments they receive from the government.
Illegal Kickbacks:
Offering or receiving financial incentives (disguised as "consulting fees" or "speaker programs") in exchange for patient referrals or prescribing specific drugs.
Medically Unnecessary Services:
Performing surgeries, tests, or therapy sessions that a patient does not actually need, solely to generate a bill.
Telehealth Scams:
Billing for virtual visits that never happened or using stolen patient identities to file thousands of fraudulent claims.
a person writing on a piece of paper with a stethoscope
Protecting

Your Identity and Career

Coming forward as a whistleblower is a monumental decision. The Law Offices of David L. Hood prioritizes your protection through every stage of the process:

1
Strict Confidentiality:
Qui tam lawsuits are filed "under seal," meaning they are kept secret from the public and the defendant while the government investigates.
2
Anti-Retaliation Protections:
Federal law strictly prohibits employers from firing, demoting, or harassing employees for reporting fraud. If you are retaliated against, you may be entitled to double back pay, reinstatement, and other damages.
3
Data-Driven Investigation:
We work with forensic accountants and medical billing experts to build a "bulletproof" case before ever presenting it to the U.S. Attorney’s Office.

Statute of Limitations

The window to report government fraud is strictly regulated. Generally, an FCA claim must be filed within six years of the date the fraud was committed (though this can sometimes be extended to ten years in specific circumstances). Because the “first-to-file” rule usually prevents second or third whistleblowers from collecting a reward, timing is the most critical factor in a fraud case.

a doctor showing a patient something on the tablet
doctor holding red stethoscope

Do Not Face This Burden Alone

If you have insider knowledge of healthcare fraud at a South Carolina hospital, pharmaceutical company, or medical group, your information is valuable. You have the power to protect the integrity of our healthcare system and be compensated for your bravery.

Contact The Law Offices of David L. Hood today or reach out online for a 100% confidential, free consultation. We work on a contingency fee basis; we only get paid if the government recovers money based on your information.

The Law Offices of David L. Hood’s principal office is located in Murrells Inlet, SC and that is where Attorney Hood principally performs legal services and practices law. This website constitutes attorney advertising and is designed for general information only. The information presented in this website should not be construed to be formal legal advice or create an attorney client relationship.
© 2026 The Law Offices of David L. Hood All rights reserved.