Fake Patient Reviews in MN: Remove, Demand, or Sue?

How should a practice sort a bad review before deciding what to do?

Sort the review into one of three kinds before you respond: a fake review by someone who was never a patient, a review by a real patient that states a false fact, or a review that gives an opinion or describes a real bad experience. Each kind calls for a different response, and the third kind usually stays up.

1. Fake or non-patient review. The author never visited the practice, or the author is a competitor, a former employee, or someone with a personal grudge. Platform policy and the federal fake-review rule are the main tools.
2. A real patient’s false statement of fact. The review says something that can be proven false, such as a procedure that never happened or a charge the practice never made. This is the only kind with a realistic defamation claim.
3. Opinion or an honest bad experience. The review complains that the doctor was rude, the wait was too long, or the reviewer would not go back. Minnesota protects opinion: in McKee v. Laurion, 825 N.W.2d 725 (Minn. 2013), the Minnesota Supreme Court held that calling a doctor “a real tool” was “pure opinion” because it “cannot be reasonably interpreted as stating a fact and it cannot be proven true or false.” The court also repeated that “true statements, however disparaging, are not actionable.”

For the third kind, the right response is a calm public reply that invites the reviewer to call the office. That reply carries its own risk for a health care practice, so read how to answer a patient review without breaking HIPAA before anyone on staff posts one.

What do Google and Yelp remove, and how do you report it?

Google and Yelp remove reviews that break their content policies, mainly fake reviews, reviews by people with a conflict of interest, and harassment; they do not remove a review because the business says it is unfair. A removal request works best when it names the specific policy the review breaks.

Google’s policy for Maps contributions says fake engagement “is not allowed and will be removed”, and it defines a conflict of interest to include “current or former employment, a contractual or consultory relationship, or other professional or personal affiliations that demonstrate a conflict of interest (such as industry competitors, familial relationships, etc.).” Its offensive-content rule also bars “Unsubstantiated allegations of unethical behavior or criminal wrongdoing.” The same policy states: “We do allow content that describes negative experiences in a respectful manner.” Yelp’s Content Guidelines tell users not to review “your peers or competitors in your industry”. Healthgrades and other physician-rating sites have their own flagging process, and their current guidelines control there.

In a recent matter, I suggested that the clinic’s report to Google name the review policy the post broke and say nothing about whether the author was a patient or about any visit. That approach keeps the report focused on the platform’s rule and keeps patient information out of it. Before you report anything, save a screenshot of the review showing the date, the web address, and the account name, because reviews can be edited or deleted.

Federal law bars treating the platform as the publisher or speaker of a user’s review. Under 47 U.S.C. § 230(c)(1), “No provider or user of an interactive computer service shall be treated as the publisher or speaker of any information provided by another information content provider.” For more on the platform route, see how to deal with fake or defamatory online reviews.

What laws reach a fake review written by a competitor?

Two rules reach a competitor’s fake review. The FTC’s rule on consumer reviews makes it unlawful for a business to write a review that misrepresents whether the reviewer ever used the service, and Minnesota’s Deceptive Trade Practices Act reaches a business that disparages another’s services with a false statement of fact.

The FTC rule, 16 C.F.R. § 465.2(a), states that “It is an unfair or deceptive act or practice and a violation of this part for a business to write, create, or sell a consumer review” that “materially misrepresents, expressly or by implication,” among other things, “That the reviewer or testimonialist used or otherwise had experience with the product, service, or business that is the subject of the review.” The paragraph’s words are not limited to reviews of the writer’s own business, so a competing practice that posts a review of yours under a made-up patient’s name fits them. The platform, though, removes a review under its own policy, which says that fake engagement “is not allowed and will be removed”, so a report should name that policy and include any evidence of who wrote the review.

Minnesota adds a claim the practice can bring itself. Under Minn. Stat. § 325D.44, subd. 1(8), a person engages in a deceptive trade practice when, “in the course of business, vocation, or occupation,” the person “disparages the goods, services, or business of another by false or misleading representation of fact.” Subdivision 2 provides that “a complainant need not prove competition between the parties or actual confusion or misunderstanding.” The remedy is an injunction: under Minn. Stat. § 325D.45, subd. 1, “Proof of monetary damage, loss of profits, or intent to deceive is not required.” The statute’s words reach someone acting in the course of business, so it fits a competitor better than a patient writing about a personal visit. For more on false statements by a competitor, see defamation claims involving competitor comparisons.

What makes a patient’s review defamatory under Minnesota law?

A review is defamatory in Minnesota only if it states something false about the practice, the review was communicated to others, the statement tends to harm the practice’s reputation, and readers understand it to refer to the practice. Truth defeats the claim, minor inaccuracies do not make a statement false, and opinion is protected.

McKee is the leading Minnesota case on online reviews of a doctor, and the doctor lost. A patient’s son posted an account of a neurologist’s visit on rate-your-doctor websites, and the doctor sued. Six of the statements he sued over reached the Minnesota Supreme Court, which held that “none of the six statements is actionable either (1) because there is no genuine issue of material fact as to the falsity of the statements or (2) because the statements are not capable of conveying a defamatory meaning that would harm respondent’s reputation.” On falsity, the court applied the substantial-truth rule: “If the statement is true in substance, minor inaccuracies of expression or detail are immaterial.” For three of the statements, the court compared the post with the doctor’s own account of what he said, found the same “gist” in both, and held those statements substantially true; it held that the other three were not capable of conveying a defamatory meaning. The court reviewed the posting “as a whole” and found nothing actionable there either.

What this means for a practice: a review that gets details slightly wrong but captures what happened is not defamatory. A review that invents a fact (a procedure that never happened, a diagnosis never given, a charge never made) is the kind that can be. For the general rules, see Minnesota defamation law.

When does a demand letter work, and when does it backfire?

A demand letter works best when the review states a provable false fact, the author is identifiable, and the letter asks for a specific, modest result, such as removing or correcting the false sentence. It backfires when the reviewer posts about the letter, and a letter that rests on no real claim can violate the FTC’s rule against groundless legal threats.

The Minnesota Court of Appeals’ decision in J&D Dental v. Hou, 26 N.W.3d 491 (Minn. App. 2025) shows the backfire risk. After the practice’s lawyer sent a patient a demand letter about her Google review, she “posted seven additional and substantially similar Google reviews”, each stating that the practice had threatened legal action after she shared her experience. One review became eight, and each new one told readers about the threat.

Federal law also limits what a letter may say. Under 16 C.F.R. § 465.7(a), it is unlawful “For anyone to use an unfounded or groundless legal threat, a physical threat, intimidation, or a public false accusation in response to a consumer review that is made with the knowledge that the accusation was false or made with reckless disregard as to its truth or falsity, in an attempt to” “Prevent a review or any portion thereof from being written or created” or to “Cause a review or any portion thereof to be removed.” The rule defines a groundless threat in 16 C.F.R. § 465.1(p) as “a legal threat based on claims, defenses, or other legal contentions unwarranted by existing law or based on factual contentions that have no evidentiary support.” A letter about an opinion review fits that definition far more easily than a letter about a provable false fact.

My approach follows the kind of review. In one recent matter where a review contained false statements of fact, I was inclined to go straight to a cease-and-desist letter, because it asks for the result the practice actually wants, removal or correction, without the cost of a lawsuit. For an opinion review, I would not send one. For more on the risks, see how a cease-and-desist letter can backfire.

How does Minnesota’s anti-SLAPP law apply to a lawsuit over a review?

Minnesota’s anti-SLAPP law, the Uniform Public Expression Protection Act, lets a reviewer who is sued ask the court to dismiss the case early, and it requires the court to award the reviewer’s attorney fees related to the motion if the reviewer wins it. The law applies only if the review is speech on a matter of public concern, which courts decide case by case; the Court of Appeals has twice held that a personal-grievance review is not.

The act applies to a lawsuit based on a person’s exercise of free speech “on a matter of public concern,” under Minn. Stat. § 554.08(b)(3). Paragraph (d) provides that the act applies “to a cause of action asserted under paragraph (c), clause (3), (8), or (11)”, causes of action that paragraph (c) otherwise excludes, when the cause of action is “a legal action against a person related to the communication, gathering, receiving, posting, or processing of consumer opinions or commentary, evaluations of consumer complaints, or reviews or ratings of businesses.” Under Minn. Stat. § 554.09, the reviewer “may file a special motion for expedited relief to dismiss the cause of action.” Filing it freezes the practice’s case: under Minn. Stat. § 554.10(a)(1), “all other proceedings between the moving party and responding party, including discovery and a pending hearing or motion, are stayed.” If the act applies, Minn. Stat. § 554.13(a) requires dismissal with prejudice when, among other grounds, the practice “fails to establish a prima facie case as to each essential element of the cause of action.” And under Minn. Stat. § 554.16, “the court shall award court costs, reasonable attorney fees, and reasonable litigation expenses related to the motion” “to the moving party if the moving party prevails on the motion.”

In two Court of Appeals decisions on reviews, the businesses defeated this motion. In J&D Dental, the Court of Appeals held that a patient’s reviews were not on a matter of public concern because the bulk of her speech “recounts an individual grievance about her personal experience at J&D Dental”, though the public review site itself weighed the other way. The court held that public concern is decided “on a case-by-case basis given the totality of circumstances, taking into consideration the content, form, and context of the speech, as well as any other pertinent factors,” and it noted that health care speech held to be of public concern in other jurisdictions “was not limited to a personal grievance with a particular provider but instead reached matters of broader public import.” The court added that it expressed “no opinion on the merits” of the practice’s defamation claims. In Paragon Restorations, LLC v. Robinet Productions, LLC, No. A25-0826 (Minn. App. Dec. 29, 2025), the court held that a reviewer must show public concern “regardless of whether” the suit relates to “reviews or ratings of businesses.” The Minnesota Supreme Court granted review in Paragon, and as of October 2026 I have found no decision. A practice that sues over a review a court finds to be on a matter of public concern, whether under the current case-by-case test or a broader rule from the supreme court, and that loses the motion would pay the reviewer’s fees for it. For the statute in more detail, see Minnesota’s anti-SLAPP statute.

What can a practice recover, and what does suing cost?

A practice that wins a defamation case recovers damages for harm to its reputation, but presumed damages (damages awarded without proof of actual loss) are limited when the review involves a matter of public concern. Against that recovery sit attorney fees, months of litigation, and the attention a lawsuit draws to the review.

In Maethner v. Someplace Safe, Inc., 929 N.W.2d 868 (Minn. 2019), the Minnesota Supreme Court held “that a private plaintiff may not recover presumed damages for defamatory statements” involving “a matter of public concern unless the plaintiff can establish actual malice.” If the statements do not involve a matter of public concern, “presumed damages are available if” the plaintiff can show the statements are “defamatory per se.” The same public-concern question therefore decides both whether the anti-SLAPP law applies and what damages are available.

Winning the anti-SLAPP motion does not win the case. In Paragon, the business defeated the reviewer’s motion, yet the district court dismissed its defamation claim anyway, finding that it “failed to state a claim upon which relief could be granted”.

The cost that matters most is often not money. In my experience, a legal fight that a business owner expects to bring closure more often keeps the dispute going and leaves the owner frustrated, distracted, and poorer for the fees. Weigh the review’s real effect on new-patient calls against that cost. For how damages are measured, see business defamation claims.

How do you find out who posted an anonymous review?

A platform will not normally identify an anonymous reviewer because a business asks. Learning who wrote the review usually requires filing a lawsuit against the unnamed author and then asking the court to let you subpoena the platform for the account information.

Because 47 U.S.C. § 230(c)(1) means the platform is not treated as the publisher, the lawsuit must name the author, even as an unnamed defendant, and the platform is only a source of records. That makes unmasking a litigation step with the anti-SLAPP exposure described above, not a separate, cheaper option. Preserve the evidence first: screenshots with the date, the web address, and the account name. For the broader steps, see protecting your reputation against anonymous posters.

What deadline applies to a defamation claim over a review?

Minnesota sets a limitations period for libel and slander claims in Minn. Stat. § 541.07, and a claim filed after it runs is barred. The statute provides: “Except where the Uniform Commercial Code, this section, section 541.05, 541.073, 541.076, or 604.205 otherwise prescribes, the following actions shall be commenced within two years:” including actions “for libel, slander, assault, battery, false imprisonment, or other tort resulting in personal injury.” Because of those exceptions, read the current text, and the date the review was posted, before relying on any deadline. A screenshot showing the posting date keeps a record of when the review appeared.

For most practices, the right order is to reply well, report what is fake, and save legal action for a review that states a provable false fact. A practice that sorts each review first avoids the two most common mistakes: suing over an opinion and sending a letter that becomes the next review. Aaron Hall handles these questions as part of his business torts practice. If you would like a second set of eyes on a specific review, email [email protected] with a link to or screenshot of the review. Please leave out any patient information until after intake and a conflict check.