Q and A: Eligible Professionals and Core Objectives, Part 2 (Post 3 of 5)

Because most CMAs (AAMA) work under the direct supervision of “eligible professionals” (as defined in the rules of the Centers for Medicare and Medicaid Services [CMS]), this post focuses on some common questions surrounding the provisions of the Medicare and Medicaid Electronic Health Records (EHR) Incentive Program that are applicable to eligible professionals, not those provisions that are applicable to “eligible hospitals” and “critical access hospitals.”

Q: What Core Objective pertains to the permissibility of CMAs (AAMA) entering orders into the EHR?

A: The relevant Core Objective under Stage 1 of the Incentive Program is titled “CPOE for Medication Orders.” The Stage 2 Core Objective is “CPOE for Medication, Laboratory, and Radiology Orders.”

Q: What does “CPOE” stand for?

A: CPOE stands for “computerized provider order entry.” CPOE is defined as follows: “A provider’s use of computer assistance to directly enter medical orders (for example, medications, consultations with other providers, laboratory services, imaging studies, and other auxiliary services) from a computer or mobile device.”

Q: What are the measures for these Core Objectives in Stages 1 and 2?

A: For Stage 1, the measure is as follows: “More than 30 percent of all unique patients with at least one medication in their medication list seen by the eligible professional (EP) have at least one medication order entered using CPOE.” The Stage 2 measure is more expansive: “More than 60 percent of medication, 30 percent of laboratory, and 30 percent of radiology orders created by the EP during the EHR reporting period are recorded using CPOE.”

Q: Are there exclusions for these measures?

A: Yes. The Stage 1 exclusion is any EP who writes fewer than 100 prescriptions during the EHR reporting period. Under Stage 2, the exclusion is any EP who writes fewer than 100 medication, radiology, or laboratory orders during the EHR reporting period.

About Donald A. Balasa

Donald A. Balasa, JD, MBA, chief executive officer and legal counsel for the American Association of Medical Assistants, keeps his eye on what is happening in the profession.
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6 Responses to Q and A: Eligible Professionals and Core Objectives, Part 2 (Post 3 of 5)

  1. Michelle Veitz says:

    Does a medical assistant need additional credentials to qualify for CPOE other than the direct guidance of the physician/Nurse practitioner?

    • Yes. A medical assistant must have a medical assisting credential as defined in the CMS Rule.

      Sent from my iPhone

    • Thank you for your question. The CMS rule states that only credentialed medical assistants are permitted to enter orders into the EHR (as directed by the overseeing provider) for purposes of having such use count toward fulfillment of the meaningful use Core Objective. According to CMS credentialed means taking and passing a test given by an entity other than the medical assistant’s employer.

      Sent from my iPhone

  2. Karri says:

    I am a CNO of a small CMS certified home care company in Iowa. I am considering adding a CMA to my staff. I am looking for regulations pertaining to this and not having much luck. Could you help me out?

    • Thank you for your question. I am happy to help.

      Medical assistants do not work in home health settings as medical assistants per se. In other words, a medical assistants–even if a graduate of a CAAHEP or ABHES accredited medical assisting and a CMA (AAMA)–must meet the state requirements (which vary from state to state) for home health aides.

      I hope this is helpful, at least as a starting point. Feel free to e-mail me at dbalasa@aama-ntl.org so we can have further e-mail dialogue.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

  3. Teresa wise says:

    I work for the largest non profit provider in southwestern Virginia and was informed today that as a CMA (AAMA) I can no longer enter any electronic orders. I was told that only a licensed nurse, physicians assistant, or physician can do so. I was told this is because “insurance companies are refusing to pay for these services when ordered by CMA” . I was told this is no reflection of my skill, ability, or due to any error or shortcoming.

    I believe wholeheartedly that if this were a breaking issue, the AAMA would have informed members, as they are excellent at communicating vital issues such as this.

    When I have done research, I plan to discuss with human resources, which requires certification for my position. I feel this is disrespectful of my education, skill, training, performance to date, and to expect us to maintain credentialing and not trust us to use it is demeaning.

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