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Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary

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Statewide Initiatives



211 - Get Connected. Get Answers.

Provider Fraud Form

Provider's Name:

(First Name)

(Last Name)
Provider's Gender:
Male
Female
Provider's Business:
Type of Business:
Medicaid Number:
Provider's Telephone Number:

(Please enter the phone number in XXX-XXX-XXXX format)
Provider's Address:
City:
State:
Zip Code:
Suspected Fraud:
You are able to report suspected fraud complaints anonymously. But, if you would like the Medicaid Fraud Complaints Unit to contact you, please complete the fields below.
Name:
Telephone Number:
E-Mail Address: