Do Allina Health’s alleged billing practices violate MN law? The attorney general is looking into it

a man is speaking at a podium
Attorney General Keith Ellison talks during the annual Dr. Martin Luther King Jr. holiday celebration in January. He wants to hear from people who have been affected by Allina's billing practices.
Tim Evans for MPR News

Minnesota Attorney General Keith Ellison is asking people who’ve experienced “aggressive billing practices” at Allina Health, or those with knowledge of the alleged practices and policies, to contact his office “so we can determine the scope of the problem and whether any laws or agreements have been broken.”

On Thursday, the New York Times published an investigation into Allina’s billing practices. The story alleges the company refused to provide certain types of care for patients with at least $4,500 in medical debt. While the system will provide emergency care, the article said, it may withhold services until that debt is paid off.

“I read the New York Times article with great concern and am reviewing it closely,” Ellison said in a statement to MPR News. “Allina is bound under the Hospital Agreement to refrain from aggressive 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.”

The hospital agreement details negotiated protections for patients between the AG’s office and nonprofit hospitals across Minnesota. It states hospitals must “develop policies for assessing patients’ ability to pay, and to provide free healthcare, known as ‘charity care,’ to qualifying patients.”

The boards of directors at each hospital are also required to have “a zero tolerance policy for abusive, harassing, oppressive, false, deceptive or misleading language” when recouping medical debt, as well as other protections for patients. It goes through July 1, 2027.

In a statement, Allina Health said it’s “in full compliance with the Attorney General hospital billing agreement,” and that it would “welcome a conversation with the Attorney General on our billing practices and our exhaustive efforts to work with patients to address financial and other barriers to care.”

Minnesota law may have gaps

Minnesota legislators say they have passed some protections around patient medical debt, but it mainly focuses on hospitals.

Rep. Liz Reyer, DFL-Eagan, said they’ve limited revenue recapture from certain hospitals, and ensured a “much more explicit screening process for hospitals to use for patients who may have issues with paying medical bills,” designed to align with the AG’s agreement.

But, she said, the Times investigation indicates there are gaps.

“I knew we weren't going far enough,” Reyer said. “And it's not the hospitals, it's the care systems. The hospitals we're talking about will have to … follow the requirements of the legislation that we just set up, which is effective on Nov. 1. But the clinics are not bound by that.”

Reyer said she’s looking through statute to determine if any of Allina’s alleged practices violate Minnesota law, and plans to set up time to speak with the attorney general about next steps. She says she wants to know to what extent people may have been denied care.

“I don’t want corporate platitudes — I spent my career in the corporate world, I know how that goes. I want numbers,” she said. “And I want to know what the outcomes were for those people … What have been the consequences, in data, of what they have done?”

The lack of that data around how often care is denied is something Rep. Tina Liebling, DFL-Rochester, says the state Legislature should address.

“It's just very concerning. People don't choose to incur medical debt. It’s not like they're out buying luxury goods, this is something they need to stay healthy and sometimes even to stay alive,” she said. “It’s just terrible that in this country this is happening at all. But I think here in Minnesota, we can do better.”