Audits and the Importance of Credentialing for Order Entry

During the coverage of the Centers for Medicare and Medicaid Services (CMS) Stage 2 rule, there was some thought that CMS auditors would not have the authority to  inquire about the credential status of medical assistants entering orders into the computerized provider order entry (CPOE) system.

This thinking is incorrect. To qualify for payments under the Electronic Health Records (EHR) Incentive Programs, providers will be required to present documentation of all entries, many of which are automatically kept by the EHR system. CMS auditors do have the authority to determine whether entry of medication, laboratory, and radiology orders has been made by licensed health care professionals or credentialed medical assistants.  If it is discovered that order entry was done by individuals other than licensed professionals or credentialed medical assistants, the auditors could cite this violation, and it is possible that the order entry by these individuals would not be counted toward meeting the meaningful use thresholds.  As a result, the eligible professional may not meet all the core objectives and consequently would not receive   incentive payments.

The reality of these audits only serves to emphasize the importance of employing credentialed employees in the health care setting. A description of the CMS EHR audit process can be found in the attached document. In addition, I have provided a link to a question and answer session I took part in with Robert Anthony of CMS.

CMS EHR Incentive Programs Audits

The CMS Rule for Meaningful Use Order Entry, Question and Answer Session

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.
This entry was posted in Certification and the CMA (AAMA) Credential, On the Job, Scope of Practice and tagged , . Bookmark the permalink.

3 Responses to Audits and the Importance of Credentialing for Order Entry

  1. Jean A. Costlow cma (aama) says:

    I would like to know if the certification has to be through the AAMA, we have CMA’s who are supposedly credentialed through their school and use the term cma they take a test called rcct which is taken in the school in which they attend. The two employees that we have have tried to take the AAMA test and failed horribly. They are like, I hate to say this little robots who only know how to do not the background behind why to do. Help

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

      To answer your first question, CMS does not require specific credentials in order for the definition of “credentialed medical assistant” in the CMS rule to be satisfied. Note the following FAQ from the CMS website:

      Q: In order to meet the objective for computerized order entry (CPOE) for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, do medical assistants need a specific kind of credential from a specific organization to be considered credentialed and therefore able to enter orders using CPOE that can count in the numerator of the measure?

      A: A credentialed medical assistant is a medical assistant who has received credentials or otherwise been certified by an organization other than the employing organization to perform duties as a medical assistant. CMS does not specify credentialing organizations that would qualify medical assistants under this definition. Medical assistants who are credentialed, certified, licensed, or otherwise affirmed as medical assistants by an organization other than the one which employees them can enter orders for the purpose of this objective.

      To answer your second question, only those medical assistants who have passed the CMA (AAMA) Certification Examination and have maintained currency of the CMA (AAMA) are permitted to use the initials “CMA” or “CMA (AAMA)” after their names, or use the phrase “Certified Medical Assistant” to refer to themselves. Note the following:

      M E M O R A N D U M

      FROM: Donald A. Balasa, JD, MBA, Executive Director and Legal Counsel
      American Association of Medical Assistants
      TO: Medical assistants and their employers
      TOPIC: Use of “certified medical assistant” and “CMA”

      It has been brought to my attention that some employers are putting the phrase “Certified Medical Assistant” and/or the initialism “CMA” on name tags of medical assistants who are not certified by the Certifying Board of the American Association of Medical Assistants (AAMA).

      The AAMA owns Registration No. 2,509,034 issued by the United States Patent and Trademark Office for the mark “Certified Medical Assistant®.” The registration is on the Principal Register, and is registered for use by persons authorized by the AAMA to indicate that the medical assistant services performed or to be performed have been or will be performed by a person whose services are competent in the medical assistant field, such individual’s services having met certain educational standards in the medical assistant field set by the AAMA and having passed examinations administered by the AAMA. To meet these requirements, applicants must have graduated from a postsecondary medical assisting academic program accredited by either the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES), and must have passed the CMA (AAMA) Certification Examination.

      The AAMA first bestowed its “Certified Medical Assistant®” credential and authorized use of the initials “CMA” as an abbreviation therefor in 1963 and has used those marks continually since that time throughout the United States.

      Any medical assistant who represents herself/himself as a “Certified Medical Assistant” or a “CMA,” and any organization which represents its medical assistants as “Certified Medical Assistants” or “CMAs” when such individuals have not been certified by the Certifying Board of the AAMA, are doing so falsely and may be in jeopardy of legal sanction.

      The American Association of Medical Assistants therefore urges all medical assistants and all employers of medical assistants who misuse the “Certified Medical Assistant” or “CMA” to immediately cease from these misleading and illegal practices that are infringing on the rights of the AAMA in these marks.

      Thank you in advance for your cooperation. You may contact me at dbalasa@aama-ntl.org.

      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

  2. Sherry says:

    Agreed as that is why the NHA states they are CCMA’s and not CMA’s.

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