The Minnesota Department of Human Services on Thursday called a Mayo Clinic plan to give preference to privately insured patients "very concerning" and said it will examine it for possible violations of civil and human rights laws.

In response to a video transcript obtained by the Star Tribune in which Mayo CEO Dr. John Noseworthy explained the policy to employees, DHS Commissioner Emily Piper said in a statement early Thursday afternoon that her department has a lot of questions about "how it will implement the directive."

"I was really surprised" by Noseworthy's comments, Piper said later Thursday evening in a phone interview. In the statement, she said, "The Department of Human Services expects that the Mayo Clinic will serve enrollees in public programs just as they would any other Minnesotan."

Piper said she sent a letter and an e-mail to Noseworthy, but has not received a response. Separately, Mayo staff members invited the commissioner for a sit-down.

"I really hope to understand more what their plans are and just make sure my members' voices are heard, regardless," Piper said.

The number of patients affected by Mayo's move probably would be small, but the selective strategy reveals the financial pressures Mayo is facing in part due to federal health reforms.

The clinic will always take patients, regardless of payer source, when it has medical expertise that they can't find elsewhere, Noseworthy said in his talk to employees. But when two patients are referred with equivalent conditions, he said the health system should "prioritize" those with private insurance.

"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 in the videotaped speech to staff late last year. Mayo has confirmed the transcript's authenticity.

Piper said DHS will also take a look at its contracts with the Mayo Clinic, as well as investigate complaints made by Medicaid patients and their "dissatisfactory service at the Mayo."

It is rare that a hospital leader would espouse a strategy that promotes access for privately insured patients at the expense of publicly funded patients, Piper said.

"Never, in my recollection, has a reputable [institution] such as the Mayo Clinic come out to say this," she said.

Staff writer Jeremy Olson contributed to this report.

Karen Zamora • 612-673-4647 Twitter: @KarenAnelZamora