Medical Payment Law Complaint Form
[Revised Statutes 23: 634 & 23:897]
To Look up the Louisiana Medical Payment Law go to -

If you would like to report someone who you think may be committing a Louisiana Medical Payment Law Violation, complete the information below and press the Submit button. You may choose to submit this information anonymously, however, this may limit the scope of the investigation.

(*) Entry Required

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  2. Character Count: (Max 200, remaining 200.)

  3. Character Count: (Max 100, remaining 100.)

  4. Did you pay for Drug Testing?  
    Did you pay for Background check?  
    Did you pay for Medical Exam?  
    Another Reason?  
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  6. Character Count: (Max 400, remaining 400.)

By submission of this form the complainant affirms and certifies that all information provided and the statements made herein are true, correct to the best of their knowledge, information and belief.

If you have any other questions, please email or call toll-free 1-225-219-2989.