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INNEAPOLIS — Mayo Clinic is facing questions from the state of Minnesota after its CEO told employees that if patient conditions are equal, its hospitals should prioritize privately insured patients over those under government-subsidized programs like Medicaid.

John Noseworthy’s comments were made late last year in a videotaped speech to staff but surfaced only this week after a transcript of his speech was obtained by the Star Tribune newspaper. The Mayo Clinic has verified the transcript is accurate.

Minnesota Department of Human Services Commissioner Emily Piper said she was surprised and concerned by the comments, and has questions about what they really mean and how Noseworthy’s directive would be carried out. The department is looking into whether there are possible violations of civil and human rights laws.

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The agency also is reviewing its contracts with Mayo Clinic to ensure the hospital is meeting its obligations to serve patients in public programs.

In his comments last year, Noseworthy told staff that when Mayo Clinic has expertise that can’t be found elsewhere, it will always take patients, regardless of how they are paying for care.

But when patients have equal conditions, he said, the health system should “prioritize” those with private insurance, according to the Star Tribune.

“We’re asking if the patient has commercial insurance, or they’re Medicaid or Medicare patients and they’re equal, that we prioritize the commercial insured patients enough so we can be financially strong at the end of the year to continue to advance our mission,” Noseworthy said.

Mayo Clinic released a statement this week saying it’s always been committed to serving patients, regardless of insurance coverage, and medical need is the top factor in scheduling appointments.

The clinic says about 50 percent of services it provides go toward those under government programs. It provided $629.7 million in care to people in need in 2016, including $546.4 million in unpaid portions of Medicaid and other programs for the uninsured or underinsured.

The statement said that as Mayo’s percentage of publicly funded patients has grown, the health system is working to increase commercially insured patients.

“To fund its research and education mission, Mayo needs to support its commercial insurance patient numbers in order to continue to subsidize the care of patients whose insurance does not cover the cost of their care,” the statement said.

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Piper said Noseworthy’s statements do not reflect routine hospital practices, and she found them to be troubling.

As Human Services commissioner, Piper is focused on ensuring access to health care for those enrolled in public programs. She said providers have to follow the law and uphold agreements to provide such care. She said that in her view, nothing that is happening with the health care law on the federal level changes those requirements.

“Health insurance coverage for health insurance coverage’s sake is not the end goal,” she said. “It’s access — that’s what’s important.”

— Amy Forliti

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