Minnesota Medical Bill Rights & Programs: The Debt Fairness Act and Mandatory Charity Care Screening
Minnesota passed one of the strongest medical debt protection laws in the country with the 2024 Debt Fairness Act. Medical debt is banned from credit reports, interest charges on medical debt are prohibited, hospitals must screen patients for charity care before collecting, and wage garnishment is capped based on income. Combined with MinnesotaCare (covering residents up to 200% FPL), the state's charity care screening law (MN Statute 144.587), and a $510,000 homestead exemption, Minnesota patients have powerful tools to fight unfair medical bills.
Minnesota Patient Protections at a Glance
Medical Debt Off Credit Reports
Debt Fairness Act bans reporting (Oct 2024)
No Interest on Medical Debt
Charging interest on medical bills is banned
Mandatory Charity Care Screening
MN 144.587: Screen before collecting (Nov 2023)
Income-Based Garnishment Caps
10-25% based on income (April 2025)
$510,000 Homestead Exemption
$1.275M for agricultural property
Surprise Billing Protections
State and federal laws protect patients
The Minnesota Debt Fairness Act (2024)
Signed June 17, 2024, Key Provisions Effective October 1, 2024
Championed by Attorney General Keith Ellison, Senator Liz Boldon, and Representative Liz Reyer, the Debt Fairness Act is one of the most comprehensive medical debt protection laws in the nation. It fundamentally changes how medical debt is collected in Minnesota.
- Credit reporting ban: Medical debt cannot be reported to any credit bureau. Unpaid medical bills will not affect your credit score.
- Interest ban: No interest, fees, or incidental charges can be added to charged-off medical debt.
- No spousal transfer: Medical debt can no longer be automatically transferred to a patient's spouse.
- Cannot deny care: Medical providers are banned from withholding medically necessary care due to unpaid debt.
- Collection restrictions: Debt collectors cannot use robocalls, contact third parties, or threaten to withhold medical care.
- Transparency: Medical providers must publish their debt collection practices and create a process for patients to dispute billing and coding errors.
- Attorney's fees: Patients who successfully defend against medical debt lawsuits can have their attorney's fees paid by the plaintiff.
Warning: Credit Card Exception
If you pay a medical bill with a credit card (including medical credit cards like CareCredit), it becomes regular consumer debt and loses all medical debt protections, including the credit reporting ban and interest prohibition. Always explore charity care, financial assistance, and payment plans before using a credit card.
Hospital Charity Care Screening (MN Statute 144.587)
Effective November 1, 2023
Minnesota requires every hospital to screen uninsured patients for charity care eligibility before pursuing any collection action. This law applies to all nonprofit hospitals in the state, including Mayo Clinic, Fairview, Allina Health, Essentia Health, CentraCare, and Sanford Health facilities.
- Hospitals must screen all uninsured patients for charity care eligibility within 30 days of service
- Screening must be completed in person or by telephone (not just a mailed form)
- If a patient may qualify, the hospital must assist them with the application
- Charity care policies, plain-language summaries, and application forms must be on the hospital's website in all languages spoken by 5%+ of the service area population
What Hospitals Cannot Do Before Completing Charity Care Screening:
- Cannot enroll you in a payment plan or change payment plan terms
- Cannot offer you a loan or credit line (including CareCredit applications)
- Cannot refer your debt to collections (in-house, third-party, or revenue recapture)
- Cannot accept a credit card payment over $500 for the medical debt
Mayo Clinic Financial Assistance
Mayo Clinic, the largest hospital system in Minnesota, provides free care (100% discount) for patients at or below 200% FPL (about $31,300/year for a single person in 2026). Patients between 201% and 400% FPL receive partial discounts averaging around 50%. Mayo Clinic must comply with the charity care screening requirement under MN Statute 144.587 and cannot pursue collection until screening is complete.
In 2023, a state auditor report found that many Minnesota hospital systems increased charity care spending after the screening law took effect, confirming that patients were being sent to collections who should have received free or discounted care.
Need Help With a Minnesota Hospital Bill?
Minnesota's protections are strong, but navigating charity care applications, the Debt Fairness Act, and billing disputes takes time and knowledge. Our Bill Defense team handles the entire process for you, from requesting itemized bills to filing charity care applications and negotiating directly with hospitals. You pay nothing unless we reduce your bill.
Get Bill Defense HelpMedical Debt Banned from Credit Reports
Debt Fairness Act (Effective October 1, 2024)
Minnesota bans medical debt from appearing on credit reports. Under this law:
- Medical providers and collection agencies cannot report medical debt to any credit bureau
- All medical debt is excluded from credit reports regardless of age or status
- Medical debt cannot be used against you when applying for housing, auto loans, or other credit
- No interest can be charged on medical debt (a protection many other states do not offer)
What about the Medical Debt Reset Act? In February 2025, AG Ellison proposed the Minnesota Medical Debt Reset Act, which would have used $5 million in state funds to purchase and forgive roughly $500 million in medical debt for 250,000 to 400,000 Minnesotans through a partnership with Undue Medical Debt. The bill did not advance in the 2025 legislative session but may be reintroduced. Check the AG's office for updates.
Surprise Billing Protections
Minnesota Statutes 62Q.556 and 62K.11:
Minnesota law prohibits balance billing in several key situations. These state protections work alongside the federal No Surprises Act, with the stronger protection applying:
- Emergency services: You pay only in-network cost-sharing, regardless of whether the facility or provider is in-network.
- Out-of-network providers at in-network facilities: If you receive care from a nonparticipating provider (such as an anesthesiologist or radiologist) at a participating hospital or ambulatory surgical center, balance billing is prohibited.
- Lab specimens sent out-of-network: If your in-network provider sends a specimen to an out-of-network lab, pathologist, or testing facility, you cannot be balance billed.
- Good faith estimates required: Uninsured patients must receive a written good faith estimate when scheduling care at least 3 business days in advance, or upon request.
Informed Consent Exception:
Balance billing is permitted only if you provide informed consent in advance, acknowledging that the provider or services may result in costs not covered by your plan. You are never required to give up your protections. If you were not given advance notice and consent forms, the balance bill is not valid.
Which Law Applies to You:
State-regulated plans (individual and small employer plans through MNsure): Minnesota state law applies.
Self-funded employer plans (common at large companies): Federal No Surprises Act applies.
State and school employee plans: Minnesota state law applies.
When both could apply, the law that gives you more protection prevails.
Lawsuit & Collection Protections
Wage Garnishment Protections (Debt Fairness Act, Effective April 1, 2025):
Minnesota replaced its old flat 25% garnishment cap with income-based tiers that protect low-wage workers:
| Weekly Earnings | Maximum Garnishment |
|---|---|
| Under 40x minimum wage (~$445/wk) | Fully exempt (0%) |
| 1 to 1.5x minimum wage | 10% of disposable earnings |
| 1.5 to 2x minimum wage | 15% of disposable earnings |
| Over 2x minimum wage | 25% of disposable earnings |
Bank Account Protection:
Under the Debt Fairness Act, the first $4,000 in your bank account is protected from seizure by creditors. Before this law, debt collectors could drain your entire account. This protection applies to all consumer debt, including medical debt.
6-year statute of limitations: Medical debt in Minnesota has a 6-year statute of limitations from the date of the last payment or original default (MN Statute 541.053). Warning: making a partial payment or acknowledging the debt in writing can restart the 6-year clock. If a creditor obtains a court judgment, that judgment is enforceable for 10 years and can be renewed.
Homestead exemption: Minnesota protects up to $510,000 of your home equity from creditors (up to $1,275,000 for agricultural property). A medical debt judgment generally cannot force the sale of your home if your equity is below this threshold. The homestead exemption covers up to 160 acres (half an acre if platted/in town). The exemption amount increases every two years, with the next adjustment expected July 1, 2026.
Healthcare Merger Oversight and the Fairview-Sanford Case
Why This Matters for Your Medical Bills
In 2022, Fairview Health Services (the largest hospital system in the Twin Cities) proposed merging with South Dakota-based Sanford Health. Attorney General Keith Ellison launched an investigation into the merger's impact on patients, pricing, and charity care obligations. When Sanford and Fairview initially refused to provide information needed for the review, the legislature acted.
Minnesota passed landmark legislation giving the Attorney General authority to reject healthcare mergers if they would decrease care quality, reduce patient access, or harm healthcare workers. The law covers transactions involving entities with $80 million or more in average annual revenue.
Fairview ultimately pulled out of the merger. Minnesota's merger oversight law is now one of the strongest in the country, helping prevent the hospital consolidation that drives up prices in other states.
Medical Assistance (Medicaid) and MinnesotaCare
Minnesota Medical Assistance (Medicaid):
- • Adults 19-64: Up to 138% FPL (~$22,025/year for a single person in 2026)
- • Children: Up to 275% FPL
- • Pregnant women: Up to 319% FPL (~$50,930/year)
- • No asset test for MAGI-based programs
- • Comprehensive benefits: Medical, dental, vision, behavioral health, and substance use treatment
- • Apply through MNsure or call 651-431-2670 (Metro) or 800-657-3739 (Greater MN)
MinnesotaCare: Coverage Beyond Medicaid
MinnesotaCare is a state-subsidized health insurance program for residents who earn too much for Medical Assistance but cannot afford private coverage. It is one of the most generous state-funded coverage programs in the country.
- Adults: Up to 200% FPL (~$31,300/year for a single person, ~$64,300 for a family of 4)
- Monthly premiums: $0 to $80 per person on a sliding scale based on income
- Covers: Medical, dental, prescription drugs, mental health, and chemical dependency services
- Public option buy-in: Legislation signed to allow people above the income limit to purchase MinnesotaCare coverage, effective January 1, 2026 or upon federal approval (whichever is later)
Why This Matters for Hospital Bills:
If you qualify for Medical Assistance or MinnesotaCare, your hospital bills should be covered. Under MN Statute 144.587, hospitals must screen you for eligibility for these programs (and their own charity care) before pursuing collection. If a hospital billed you without first checking your coverage eligibility, that is a violation of state law.
If you were billed by a hospital and believe you may have qualified for Medical Assistance or MinnesotaCare at the time of service, contact the hospital's financial assistance department and file a complaint with the Minnesota Attorney General's office.
How to Dispute a Medical Bill in Minnesota (Step-by-Step)
Request Charity Care Screening
Under MN Statute 144.587, hospitals must screen you for charity care eligibility before collecting. Request the hospital's financial assistance application. If the hospital did not screen you within 30 days of service, any subsequent collection action may be invalid.
1 phone call
Request a Detailed Itemized Bill
Ask for a full itemized bill showing every charge, date, and service code. Compare it against your Explanation of Benefits (EOB) from your insurer if you have insurance.
1 phone call
Review for Errors
Common issues: duplicate charges, upcoding, unbundled services, charges for services not received, and unexplained facility fees. The Debt Fairness Act requires hospitals to create a process for patients to dispute billing and coding errors.
30 minutes
File Written Dispute
Send a certified letter referencing MN Statute 144.587 (charity care screening), the Debt Fairness Act (credit reporting and interest bans), and MN Statute 62Q.556 (balance billing) if surprise billing is involved. Request a billing hold during review.
1 hour
Escalate if Needed
File complaints with the MN Attorney General (651-296-3353 or 800-657-3787) for collection violations and charity care issues, MN Department of Commerce (651-539-1500) for insurance and surprise billing, or MN Department of Health for hospital compliance.
Varies
Even with Minnesota's strong protections, navigating charity care applications, the Debt Fairness Act, and billing disputes takes time. For complete peace of mind, our Bill Defense team manages the entire process on your behalf. You pay nothing unless we reduce your bill.
Sample Dispute Letter Template:
Minnesota Agencies & Help Lines
Minnesota Resources for Medical Bill Help:
MN Attorney General's Office (Debt Fairness Act and Charity Care)
For: Hospitals violating the Debt Fairness Act, denying charity care screening, aggressive collection from low-income patients, medical debt credit reporting violations
File complaint online →MN Department of Commerce (Insurance and Surprise Billing)
For: Surprise bills, balance billing disputes, insurance claim denials, health plan issues
File complaint online →MN Department of Health (Hospital Compliance)
For: Hospital compliance with charity care screening law (MN 144.587), billing error review requirements, facility licensing
Visit MN Department of Health →MNsure / Medical Assistance and MinnesotaCare Enrollment
For: Applying for Medical Assistance, MinnesotaCare, checking eligibility, coverage questions
Apply online at MNsure →Mid-Minnesota Legal Aid
For: Free legal help for low-income Minnesotans facing medical debt lawsuits, garnishment, and collection
LawHelpMN.org →Federal No Surprises Help Desk
For: Surprise bills on self-funded employer plans, good faith estimate disputes
File complaint online →Pro Tip: When calling, write down the date, time, representative name, reference number, and what was promised. Attorney General Ellison's office has been proactive on medical debt protection. If a hospital is not screening you for charity care or is violating the Debt Fairness Act (charging interest, reporting to credit bureaus, or denying care over unpaid bills), file a complaint with the AG immediately.
Frequently Asked Questions
Can medical debt appear on my credit report in Minnesota?
Can hospitals charge interest on my medical debt in Minnesota?
Do hospitals have to screen me for charity care before collecting?
What is MinnesotaCare and who qualifies?
Does Minnesota have surprise billing protections?
What is the statute of limitations for medical debt in Minnesota?
How much of my wages can be garnished for medical debt in Minnesota?
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Disclaimer: This information is for educational purposes only and is not legal advice. Laws and regulations may change. Always verify current requirements with official sources or consult with a qualified attorney for specific legal guidance. CareRoute does not provide legal services.