Attorney General Ellison announces new steps in renewed focus on medical billing

Will hold public listening sessions in Saint Paul on August 23 and Rochester on September 13; web form for consumers to submit stories and experiences now live

Medical billing to be theme of Attorney General’s State Fair booth; Minnesotans encouraged to share stories

Announces investigation of Allina for billing practices

August 18, 2023 (SAINT PAUL) — Minnesota Attorney General Keith Ellison today announced several new steps his office is taking in its renewed focus on medical-billing practices in Minnesota, which is a longstanding concern of the Minnesota Attorney General’s Office. 

“The high cost of healthcare in Minnesota and across the country makes it tough enough to afford your life. Medical-billing practices that are aggressive, abusive, or deceptive also make it hard to live with the dignity, safety, and respect that everyone is entitled to,” Attorney General Ellison said. “The Minnesota Attorney General’s Office has long been concerned with medical billing and has acted for years to protect Minnesotans from abusive and deceptive practices. With recent reports in the media and from consumers that problems continue, we’re taking several steps to renew our focus on this longstanding concern.” 

Medical-billing listening sessions in Saint Paul and Rochester 

The Attorney General’s Office will soon hold listening sessions for consumers to share their experiences with medical billing.  

The first listening session will be held in Saint Paul on Wednesday, August 23 from 5:30-7:00 p.m. The location is Room 2000 of the Minnesota Department of Revenue building at 600 Robert St. N. Consumers may sign up in advance to speak, though advance sign-up is not required. 

The second listening session will be held in Rochester on Tuesday, September 12 from 5:30-7:00 p.m. The location is the Heintz Center at Rochester Community and Technical College at 1926 Collegeview Rd. E. A sign-up form for this listening session will be available after Labor Day. 

Experiences with medical billing may be submitted online 

Consumers who are unable to attend either listening session may submit their experiences with medical billing online at the Attorney General’s Medical Billing and Health Care Access Community Input Form.  

Medical billing to be theme of this year’s AGO State Fair booth 

Medical billing will be the theme this year of the Attorney General’s Office booth at the Minnesota State Fair. Everyone attending “the Great Minnesota Get-Together” is encouraged to visit the Attorney General’s Office’s booth in the Education Building on Cosgrove St. on the State Fairgrounds to share their experiences with medical billing and healthcare access with Attorney General’s Office staff. The Attorney General’s Office will include information provided by fairgoers in its review of medical billing practices. Attorney General’s Office staff will also have information available about many types of consumer-protection issues and can advise people how to submit a complaint to the Attorney General’s Office regarding those and other concerns. 

Attorney General’s Office investigating Allina’s medical-billing and healthcare-access practices 

Attorney General Ellison also announced today his office is investigating the billing practices of Allina Health. A June 1, 2023 New York Times article reported that Allina has cut off non-emergency medical care to patients who owed medical debt. This Termination of Care Policy has reportedly been enforced upon patients who had relatively small amounts of debt and in some cases, patients with chronic conditions who relied on continuous care to manage their conditions. On June 9, 2023, Allina announced it would “pause” its Termination of Care Policy. 

“I continue to be concerned about reports of Allina denying needed non-emergency medical care solely on the basis of medical debt,” Attorney General Ellison said. “Allina is bound under the Hospital Agreement to refrain from oppressive billing practices and provide charity care when patients need and qualify for it, as all Minnesota hospitals are. Denying patients needed care on the basis of medical debt harms every Minnesotan, whether or not they are Allina patients. My office has heard from a good number of Allina patients who have shared their own upsetting stories of being denied care for this reason. I continue to encourage people who have experienced or are familiar with these practices to keep contacting my office so we can determine the scope of the problem and whether any laws or agreements have been broken.” 

The Attorney General’s investigations of Allina and other medical providers are ongoing. Minnesotans who wish to share their stories of or concerns with Allina’s billing practices or those of any medical provider can do so by completing the Medical Billing and Health Care Access Community Input Form or a consumer assistance request, or by calling the Attorney General’s Office at (651) 296-3353 or (800) 657-3787. 

Medical billing is longstanding concern of Attorney General’s Office 

The Minnesota Attorney General’s Office has long been concerned with medical-billing practices and has continuously taken steps to curb abusive collection practices. Since 2005, the Office has spearheaded what is known as the Hospital Agreement. It provides important protections to Minnesotans who receive healthcare services at Minnesota’s hospitals by protecting patients from abusive, harassing, and deceptive practices when hospitals seek to collect medical debt. The Agreement further prohibits unfair practices in billing and collections, and mandates that Minnesota hospitals provide discounts on healthcare services for certain patients and reasonable payment plan options to all patients.   

The Agreement covers all 128 nonprofit hospitals in Minnesota, including Allina Health System hospitals. The Agreement was most recently renewed in July 2022 for a period of five years. 

In December 2022, the Attorney General’s Office announced an investigation into Mayo Clinic over allegations reported in the Rochester Post-Bulletin that Mayo had sued patients who qualified for charity care over their medical debt. Under the Hospital Agreement, Minnesota hospitals must provide patients with the opportunity to apply for charity care if there is reason to believe the patient may be eligible. In addition, in Minnesota’s most recent legislative session, the Attorney General’s Office supported a new law that will require hospitals to screen certain patients for charity care eligibility starting on November 1, 2023.  The investigation into Mayo Clinic remains ongoing. 

The Attorney General’s Office has in the past enforced provisions of the Hospital Agreement. In October 2020, the Office reached a settlement with Hutchinson Health Hospital that required the hospital to restore more favorable payment plan terms that it had unilaterally terminated for many of its patients, which had the effect of increasing patients’ monthly medical bills beyond what they agreed to pay and led to ballooning payments and defaults. By June 2021, that settlement had resulted in $184,000 in medical-debt forgiveness for affected patients. 

In 2023, the Minnesota Legislature passed and Governor Tim Walz signed a bill that put into state law various provisions that echoed the Hospital Agreement, including:   

• requiring that hospitals post notice of the availability of charity care in various locations and languages throughout the hospital facility; 
• requiring that hospitals screen uninsured patients and patients whose insurance status is unknown for eligibility for charity care; 
• requiring hospitals to assist eligible patients with applying for charity care, including referring the patient to the appropriate department in the hospital for follow-up; 
• barring hospitals from imposing an unreasonable burden on patients during the charity care application process; and 
• prohibiting hospitals from engaging in various types of collection efforts before first determining whether the patient is eligible for charity care.  

Contact the Attorney General’s Office for help with medical-billing disputes 

In addition to these formal actions that the Attorney General’s Office has taken to strengthen medical-billing protections for patients, the Office’s Consumer Action Division and attorneys work on behalf of individual patients on a daily basis to help resolve their medical- and hospital-billing disputes. Patients that have such a dispute or feel they are being treated unfairly by their medical provider should contact the Attorney General’s Office for help. Note that consumers should not submit original copies of medical data if they file a complaint about medical billing.