On September 29th, I gave a joint presentation with Robert Anthony, deputy director of the Health Information Technology Initiatives Group of the Centers for Medicare and Medicaid Services (CMS) to the House of Delegates at the AAMA 57th Annual Conference in Atlanta. The presentation dealt with the CMS rule for meaningful use order entry. Deputy Director Anthony affirmed some key points I had presented in previous articles and speeches, and provided an overview of the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs. He was also kind enough to provide his presentation for your viewing. His presentation and mine are available below, as well as a summary of the key points, as written for the upcoming November/December 2013 issue of CMA Today.
Since my post dealing with scope of practice issues under nurse practitioners and physician assistants, I have received a number of questions asking for clarification, particularly regarding the separate medical assisting credentials in Washington State.
Below are the documents outlining the credentialing requirements for two of the medical assistant categories (Registered and Phlebotomist) from the Washington State Department of Health. The credentialing requirements for the “Certified or Interim” category of medical assistants will appear in a follow-up post.
I hope these documents prove useful in answering your queries, but as usual, please contact me with any additional questions or concerns.
It had been brought to my attention that the standard electronic health record (EHR) software product of Epic Systems Corporation did not permit medical assistants to enter orders into it unless the software was specially customized.
Yesterday I spoke with Stirling Martin, senior vice president of Epic. He informed me that Epic’s EHR product allows users to configure the authorizations to enter data as they think best. Mr. Martin assured me that Epic’s software permits medical assistants to enter orders into it if the user authorizations are set up properly.
Please contact me if you have any questions.
I have been receiving an increasing number of questions about the scope of practice for medical assistants when they are working under the supervision of nurse practitioners (NPs) or physician assistants (PAs), and not under the direct supervision of a physician. This scenario will become more frequent because of the Affordable Care Act and the anticipated increase in demand for primary care, which is often provided by NPs and PAs.
Because physician assistants always work under physician authority and supervision—although, in some states, very general physician supervision—the scope of practice for medical assistants working under PAs is usually very similar to their scope of practice when working under physician supervision. However, there are some state laws that do not permit medical assistants to administer medication unless a physician (MD) or osteopath (DO) is on the premises.
Medical assistants’ scope of practice when working under nurse practitioners (or other advanced practice nurses) is usually more difficult to ascertain from state law. The controlling law is the state nurse practice act and the regulations and policies of the state board of nursing. Often, the legal analysis is complicated.
If you work under the direct supervision of a nurse practitioner or a physician assistant and have questions about scope of practice, please feel free to direct your questions to me.
Many of you came forward with anecdotes in the comments section of my last post about the importance of properly identifying “Certified Medical Assistants.” In light of all the issues you have highlighted, I thought it important to further elaborate on the topic.
MA is Not a Medical Assisting Credential
Some medical assistants, in an attempt to abbreviate the name of the profession, refer to themselves as “MAs.” While this is a fairly common and innocuous usage, it is best to write or state the full profession name (i.e., medical assistant). Doing so helps promote the profession, while clearing up potential confusion in the marketplace.
Concern arises when the intialism for the profession is presented after an individual’s name, giving the appearance of a credential. Only professional or academic credentials—not positions of employment—belong after the person’s name. Furthermore, the MA credential indicates the person possesses a Master of Arts degree. No MA credential exists in the medical assisting profession, and thus the letters should not appear after the name of any person who does not possess a Master of Arts degree.
Graduation is Not Certification
Much of the confusion around my previous post comes from the similar natures, and appearances, of certificates, certification, and “Certified Medical Assistant (AAMA).” While there is some overlap between the terms, the distinctions are specific. More importantly, they carry legal implications.
The completion of a medical assisting education program—whether accredited or not—will most likely earn the graduating student a certificate, diploma, or associate degree, which represents only the individual’s completion of the program.
Certification is a process by which a professional demonstrates competency in a field. To demonstrate this competency, that person is often required to pass an examination, as is the case with CMA (AAMA) credential. However, as I have written in the past, different medical assisting credentials exist, along with different pathways to certification. Remember, certification is always a separate process. For instance, successful completion of a CAAHEP or ABHES accredited medical assisting program is the first step toward CMA (AAMA) certification, but individuals must pass the CMA (AAMA) Certification Examination before they can use the CMA (AAMA) credential after their names.
Remember, employers can immediately verify their employees’ CMA (AAMA) status on the AAMA website.