Social Media Is Becoming a Flashpoint for HIPAA, NLRA Violations; Experts Offer Advice in AIS Newsletter

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The May 18 issue of Atlantic Information Services’ Report on Medicare Compliance provides examples of what to include in health care social media policies.

With Americans spending a significant amount of time on social media, health care organizations should consider how it implicates different laws — the Health Insurance Portability and Accountability Act (HIPAA) most importantly but also the National Labor Relations Act (NLRA). Only a third of health care organizations have a social media policy in place, Jennifer Maggiore, CEO of social media consulting firm Red Balloon Inc., tells Atlantic Information Services, Inc.’s (AIS) Report on Medicare Compliance (RMC). The May 18 issue of RMC provides examples of what to include in such guidelines. “We can’t leave it up to chance,” Maggiore says. “Never assume employees will use the same good judgment that you would.”

Against a backdrop of respect for free speech, hospital workers are nevertheless held to certain restrictions, Nickie Braxton, privacy officer at Boston Medical Center, tells RMC. For example, health care workers may not mention patients or post photos of them on social media, she says. An emergency room technician in Pennsylvania was fired last year after complaining about and posting photos of patients – including of a severed finger — on her personal Twitter account, according to RMC. Also, nurses and other clinicians can form intimate relationships with patients and may be tempted to friend them on social media. Because employees use their own personal devices and social media accounts, they may think that it’s not their employer’s business, but, the superseding message is “what you learn in the hospital stays in the hospital,” Braxton says.

“The challenge is to help people understand there is a professional life and there is a personal life. In your professional life, you are expected to be friendly toward patients, but you are not expected to friend a patient,” Braxton continues. “People come here not because we are friends but because we uphold a certain professionalism and standard of care that we are expected to maintain at all times.”

Employees also use social media to criticize their employers, and how the health care organization reacts could put it in danger of violating NLRA, which gives employees the right to discuss the terms and conditions of employment. And because social media is a popular forum on which to air grievances, it’s becoming a flashpoint with the National Labor Relations Board (NLRB), which is “heavily focused on social media firing cases,” attorney Norah Olson Bluvshtein, with Fredrikson & Byron, tells RMC. If the NLRB, which enforces the NLRA, overturns a termination, the result is back pay for and reinstating the employee.

Maggiore suggests that employers ask their employees to include a disclaimer with their posts. “The NLRB says you can’t require a disclaimer, but you may suggest it,” she said. The disclaimer can be very simple — “opinions expressed are my own” — and preserve the objectivity of the comments, whether positive or negative.

Visit to read the article in its entirety, including a link to a sample social media policy developed by Boston Medical Center.

About Report on Medicare Compliance
The industry's #1 source of timely news and proven strategies on Medicare compliance, Stark and other big-dollar issues of concern to health care compliance officers, the award-winning Report on Medicare Compliance identifies and provides valuable guidance on dozens of high-risk billing and documentation problems and foreshadows the next moves of federal enforcers and their armies of RAC, ZPIC and MAC auditors. “The best information there is for hospital compliance officers,” the 8-page weekly newsletter includes insights and strategies not available anywhere else.

Since 1992, Report on Medicare Compliance has been written by Nina Youngstrom, who has a reputation for being one of the most knowledgeable journalists and incisive writers in the field. With excellent contacts at the IG's office and at CMS, and strong relationships among industry experts and compliance officers, each issue of Report on Medicare Compliance contains exclusive, inside news. Visit for more information.

About AIS
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at

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Jill Brown, Executive Editor
Atlantic Information Services
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