On the Job

Montana Licensure Requirements for CMAs (AAMA)

I recently received the following question from a CMA (AAMA)® working in Montana:

As a [CMA (AAMA)], is it possible and legal for me to take a job as a medical laboratory technician or medical technologist in the state of Montana? … Or, [do] I need to take any classes to be certified to do this type of job?

To answer this question, please review the application for Montana licensure of clinical laboratory scientists, including medical laboratory technicians. Note the following excerpt:

CLINICAL LABORATORY TECHNICIAN

• Graduated with an associate degree or possess 60 semester or 90 quarter hours in a science-related discipline, or completed a military medical laboratory training program of at least 12 months in duration.

• Passed a technician examination offered by a national certifying body for clinical laboratory scientists.

There are some exemptions under federal law, such as those detailed in the Montana Code Annotated 2019. Note the following language, which states that an individual performing only Clinical Laboratory Improvement Amendments (CLIA)–waived tests does not have to become licensed:

37-34-302. Exemptions. (1) This chapter does not limit or regulate the practice of licensed physicians, including but not limited to pathologists.

(2) This chapter does not apply to:

(e) any person performing only waived tests as provided for in the federal clinical laboratory regulations set forth in 42 CFR part 493.

On the Job

Age Requirements for Ohio Medical Assistants

I recently received the following question from an Ohio educator regarding age restrictions for medical assistants:

 Can you tell me if there is any legal implication that [a medical assistant] who has completed a high-school training program [but] is not yet 18 might [be unable] to work as a medical assistant until they turn 18? 

The medical assisting laws of all states, including Ohio, are available on the “State Scope of Practice Laws” webpage. 

Notably, Ohio law does not require medical assistants to be at least 18 years of age to work as a medical assistant. 

However, a few states ​(such as California) do require medical assistants to be at least 18 in order to work as a medical assistant. 

Scope of Practice

North Carolina Medical Assistants in Inpatient Settings

I recently received the following question from a manager at a health care system in North Carolina: 

We are looking at ways to assist nurses in the hospital setting due to the nursing shortage. Can medical assistants practice in a hospital setting without a nursing assistant certification? 

Medical assistants are permitted to meet the requirements and register with the state as certified nursing assistants (CNAs) and medication aides. Short of this, medical assistants are considered unlicensed assistive personnel (UAP) when working under nurse supervision in inpatient settings. 

The North Carolina Board of Nursing has issued some detailed and helpful position statements on what nurses are permitted to delegate to UAP. See the following documents for additional details: 

Scope of Practice

The AAMA Achieves Legislative Victories in Maryland and Washington

During the COVID-19 pandemic, medical assistants have risen to the occasion by undertaking expanded duties. As a result, they have been given opportunities to join in combatting the pandemic because of favorable federal and state legislation, executive orders, and official rules and interpretations by federal agencies. These developments have been chronicled on the “State Scope of Practice Laws” webpage of the AAMA website, via this blog, and in CMA Today

Notably, two such bills from Maryland and Washington will have precedential weight and influence on future medical assisting laws and create a lasting impact extending well beyond the pandemic. 

To learn more about these momentous bills and related trends in medical assisting, read the July/August 2021 Public Affairs article in CMA Today, “The AAMA Achieves Legislative Victories in Maryland and Washington.” 

Scope of Practice

Multi-State Scope of Practice for Medical Assistants

I recently received an inquiry regarding medical assisting scope of practice laws across the U.S.:

I am a CMA (AAMA) residing in Washington. I am trying to find all the scope of practice laws for my current job. I work for a start-up health care/technology company [that] serves all 50 states. All our physicians are licensed in each state, and we are trying to implement the use of CMAs (AAMA) to better serve our patient load. Would I need to follow each state’s rules, or because the company is in Washington, would I just follow Washington’s rules?

I feel as though Washington [law] is the strictest. [Do you think] any other states seem to be a little stricter?

To find the medical assisting laws of all states, go to the “State Scope of Practice Laws” webpage on the AAMA website

Because medical assistants employed by this company work under the authority of physicians in all states, they are required to abide by the laws of all states.

Washington has more requirements that medical assistants must meet to work as medical assistants than any other state. Further, Washington law requires medical assistants to meet specified requirements for a category of medical assistants and register with the Washington State Department of Health in that category in order to work.

However, some states have more limitations on tasks that medical assistants are permitted to be delegated and to perform.

Two of my Public Affairs articles published in CMA Today, “What Tasks Are Delegable to—and Performable by—Medical Assistants?” part I and part II, contain legal principles generally applicable in all U.S. jurisdictions. Note the following excerpt from the handout that served as the source material for those articles:

7. General legal principles—

• It is not permissible for medical assistants to perform tasks that constitute the practice of medicine, or require the skill and knowledge of physicians or other licensed providers;

• It is not permissible for medical assistants to perform tasks that are restricted in state law to other health professionals—often licensed health professionals;

• It is not permissible for medical assistants to perform tasks that require the exercise of independent clinical judgment, and/or the making of clinical assessments, evaluations, or interpretations;