Scope of Practice near State Borders

I received the following interesting question:

I’m struggling with a difficult question! I am the clinical operations director for a medical group located in Oregon near the Oregon-Washington border. We provide care to Oregon and Washington residents and employ several medical assistants. As you know, Washington law requires certain medical assistants to meet educational and credentialing requirements and to register with the Washington State Department of Health. There are no such requirements for medical assistants under Oregon law.

Do my medical assistants who assist providers treating Washington residents need to meet the medical assisting requirements of the Washington law? All our providers (e.g., physicians, nurse practitioners, physician assistants) are licensed in Oregon.

The following is my response:

Because you are located in Oregon and the providers are licensed under Oregon law, the governing law is that of Oregon. Therefore, your medical assistants are not required to meet the requirements and register with the Washington State Department of Health. It does not matter that some patients are residents of Washington.

However, if your medical group had another location in Washington, the medical assistants would have to meet the requirements of Washington law to work as medical assistants.

CMAs (AAMA), CNAs, and Medication Aides

I recently received the following question:

Does the law permit a CMA (AAMA) to work as a certified nursing assistant (CNA) in a nursing home without meeting the state requirements for registering as a CNA?

The answer is no. A medical assistant—even a CMA (AAMA) who has graduated from a programmatically accredited medical assisting program—must meet the state requirements for CNAs and register with the state as a CNA in order to perform clinical tasks in a skilled nursing facility or other inpatient settings.

Some states have a category of “medication aides (or assistants).” Medication aides are permitted to distribute medications to patients in an inpatient setting, usually under registered nurse authority and supervision. CMAs (AAMA) must also meet state requirements in order to work as a medication aide.

For more discussion on this topic, read my previous blog post “Medical Assistants and Medication Aides/Assistants/Technicians: Differences and Clarifications.”

Medical Assistants in Camping Settings

I recently received the following question:

I was wondering whether medical assistants in my state are eligible to become overnight camp health officers and whether we are allowed to give intramuscular and subcutaneous injections as needed. No health care provider would be physically present. However, one or more providers (e.g., physicians, nurse practitioners, physician assistants) would be available by phone.

Under the laws of your state, medical assistants are not permitted to serve as camp health officers when no licensed health care provider is present and immediately available. This is because health professionals in a camping setting may be called upon to deal with situations that require the making of immediate clinical assessment and evaluations and the exercise of independent clinical judgments. Medical assistants are not taught the knowledge and skills necessary to function in this capacity.

Medical assistants are permitted to assist licensed health care providers in a camping environment, however.

The Role of Medical Assistants in the Medicare Annual Wellness Visit

The role of medical assistants—especially CMAs (AAMA)—in the Medicare Annual Wellness Visit (AWV) continues to be a topic of interest and inquiry for health care professionals. The latest Public Affairs article attempts to clarify what AWV tasks are and are not delegable to medical assistants. Read “The Role of Medical Assistants in the Medicare Annual Wellness Visit” in the July/August 2018 issue of CMA Today on the AAMA website.

Can LPNs Take the CMA (AAMA) Exam?

I field many questions from health professionals with a variety of educational and professional backgrounds about the eligibility requirements for the CMA (AAMA) Certification Examination. Many wonder, If I have this knowledge and experience, am I eligible to take the CMA (AAMA) Exam? If you are one such person, consider this question and response:

I am a licensed practical nurse (LPN). Would it be possible for me to take the CMA (AAMA) Certification Examination? Some employers in my area prefer to hire CMAs (AAMA) rather than LPNs.

This is my response:

Only graduates of CAAHEP- or ABHES-accredited medical assisting programs are eligible for the CMA (AAMA) Certification Examination. I suggest that you contact CAAHEP- and ABHES-accredited medical assisting programs in your areas and see whether they would accept some of the courses you took in your LPN program in lieu of similar courses in the medical assisting program.