Certification and the CMA (AAMA) Credential, Computerized Provider Order Entry (CPOE), EHR Incentive Programs, On the Job, Scope of Practice

Breaking News: Proposed CMS Rule is Favorable for CMAs (AAMA)

On March 20, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a notice of proposed rulemaking (NPRM) for Stage 3 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs.  I am pleased to report that the Proposed Objective for computerized provider order entry (CPOE) in the NPRM is very favorable for credentialed medical assistants such as CMAs (AAMA).  Note the following excerpts from the Notice of Proposed Rulemaking:

Proposed Objective: Use computerized provider order entry (CPOE) for medication, laboratory, and diagnostic imaging orders directly entered by any licensed healthcare professional, credentialed medical assistant, or a medical staff member credentialed to and performing the equivalent duties of a credentialed medical assistant; who can enter orders into the medical record per state, local, and professional guidelines.…

In Stage 3, we propose to continue the policy from the Stage 2 final rule at

77 FR 53986 that orders entered by any licensed healthcare professional or credentialed medical assistant would count toward this objective. A credentialed medical assistant may enter orders if they are credentialed to perform the duties of a medical assistant by a credentialing body other than the employer. If a staff member of the eligible provider is appropriately credentialed and performs assistive services similar to a medical assistant, but carries a more specific title due to either specialization of their duties or to the specialty of the medical professional they assist, orders entered by that staff member would be included in this objective. We further note that medical staff whose organizational or job title, or the title of their credential, is other than medical assistant may enter orders if these staff are credentialed to perform the equivalent duties of a credentialed medical assistant by a credentialing body other than their employer and perform such duties as part of their organizational or job title. We defer to the provider’s discretion to determine the appropriateness of the credentialing of staff to ensure that any staff entering orders have the clinical training and knowledge required to enter orders for CPOE.…

However, as stated in the Stage 2 final rule at 77 FR 53986, it is apparent that the prevalent time when CDS [Clinical Decision Support] interventions are presented is when the order is entered into CEHRT [Certified Electronic Health Record Technology], and that not all EHRs also present CDS when the order is authorized (assuming such a multiple step ordering process is in place). This means that the person entering the order would be required to enter the order correctly, evaluate a CDS intervention either using their own judgment or through accurate relay of the information to the ordering provider, and then either make a change to the order based on the information provided by the CDS intervention or bypass the intervention. The execution of this role represents a significant impact on patient safety; therefore, we continue to maintain for Stage 3 that a layperson is not qualified to perform these tasks. [Emphasis added]

The full document can be found here. I will provide further excerpts and summaries later this week and next week.

5 thoughts on “Breaking News: Proposed CMS Rule is Favorable for CMAs (AAMA)”

  1. I have followed this particular ruling and all the posts that have followed . Unfortunately, the hospital where I work still does not recognize the Certified Medical Assistant and therefore will not let me work to my full scope of practice. I have not given up this battle! I pass this info to my supervisors, directors and anyone else I can get to read it. We must continue to educate and spread the word about CMA’s!

  2. The sadest part about it all is that medical assistant’s are being booted out of a positon they were trained to do because the nurses are not wanting to work hospital hours any more. when I graduated from cma school 27yrs ago that was the norm to have ma running it. Now they are treating us as though we are the least of nursing staff. Someone needs to realize that paying RN’s to do what CMA’s can do is what is affecting their bottom line in clinic staffing and budget. Also depending on the state you can even be trained to do IV starts. Looks as though someone did their homework about the scope of practice of the MA’s

  3. Also in the state I live in currently you can be hired to work in a position that a LPN work in as well. Because there are job posting that state LPN/CMA

  4. I am a CMA- AAMA, that has worked in my field for 36 years in the state of Ohio, under the same physician. I have recently been told by my employer (Medical office that has been recently purchased through a hospital) that I can no longer sign orders in EHR. Are you telling me that CMA-AAMA by law can sign?

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