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

CMS Final Rule Reaffirms Credentialing Requirement for Medical Assistants

On October 6, 2015, the Centers for Medicare and Medicaid Services (CMS) issued its final rule for the Electronic Health Record (EHR) Incentive Programs. In responding to comments urging that the “credentialed medical assistant” requirement be made less stringent, CMS reaffirmed that medical assistants must have a third-party credential (such as the CMA (AAMA)), and must have sufficient knowledge to handle properly clinical decision support (CDS) alerts.

One party commenting on the CMS notice of proposed rulemaking for the EHR Incentive Programs made the suggestion “that if a standard for medical assistant CPOE [computerized provider order entry] is required, then the standard should be that the medical assistant must be appropriately trained for CEHRT [certified electronic health record technology] use (including CPOE) by the employer or CEHRT vendor in order to be counted [toward meeting the meaningful use requirements of the Incentive Programs].” (page 322 of the attached document)

CMS responded as follows:

We [CMS] disagree that the training on the use of CEHRT is adequate for the purposes of entering an order under CPOE and executing any relevant action related to a CDS. We believe CPOE and CDS duties should be considered clinical in nature, not clerical.  Therefore, CPOE and CDS duties, as noted, should be viewed in the same category as any other clinical task, which may only be performed by a qualified medical or clinical staff. (page 323 of the attached document)

This position of CMS is a resounding affirmation of the fact that only professionally-credentialed medical assistants (such as CMAs (AAMA)) are qualified to enter orders safely into the CPOE system.

More information about the CMS final rule will be forthcoming in Legal Eye: On Medical Assisting and CMA Today.

CMS Final Rule (10/6/15), pages 322-323

21 thoughts on “CMS Final Rule Reaffirms Credentialing Requirement for Medical Assistants”

  1. It’s about time. I pledged this years ago & it’s in the making. Happy & proud to be AAMA CMA. For those colleagues that were saying the opposite now, AAMA CMA is in will be in full force. Go AAMA CMA GO. Thank you Monsieur Donald Balasa. Job we’ll done it

  2. I agree with you Sid. I have been in this field since 1969 and it has taken this long for medical assistants in my home state of Utah to be accepted as a valuable member of the clinical office team. Proud to be a medical assistant all these years but more than that to be a CMA (AAMA).

  3. The CMS needs to sufficiently look into medical facilities who are government funded (community health care centers). MOST of their clinical staff have no education or training to be giving IM medications or Vaccinations. These people are hired just because they can speak Spanish. The company I work for has 2 CERTIFIED Medical Assistants within 4 clinics. The rest are hired “off the streets and taught how to stick needles in people” just because they can speak Spanish. It is unjust for those of us who have a 2 yr associates degree in medical assisting and Certification through the AAMA. These places and their employees NEED to be investigated.

  4. I live and work in the state of Michigan where CNA’s can become registered (as in registry) with the state, after taking an exam, and placed on a “current” CNA list. Although that frustrates me, slightly, what REALLY chaps my backside is when CNA’s work as Patient Care Techs in hospitals, or Patient Care Techs themselves, who have ZERO medical training, are taught by the nurses how to give injections, do venipuncture AND start IV’s. (At least in the area where I live.) Not. Even. Joking.

    Yet Certified Medical Assistants are clawing their way through the bureacracy and red tape, and the oh-so-familiar “pass the buck”, to get noticed – and taken seriously.

    I have been a CMA (AAMA) for about 6 1/2 years and I just cannot wrap my brain around why CNA’s can register (as in registry, not registered or licensed) and be acknowledged by the State of Michigan, yet Certified Medical Assistants cannot. Where is the logic in that?

    Oh. Wait. It’s the government. It has an anaphylaxis reaction to logic and/or common sense.

  5. Since the CMS does not require any certifications to be backed up by formal education, I think we will be seeing more facilities who have hired people off the street with no healthcare training and/or CNAs, being taught by the nurses how to give injections and perform venipuncture and then taking a test to be “certified”. Don’t blame the nurses for this – blame the healthcare providers or the facility for hiring these people and blame CMS. The CMA(AAMA) and RMA(AMT) have to be their own advocates and the best way I know is to join and support your local, state, and national organization. Remember – it was the AAMA that led the way to demonstrating that Medical Assistants can meet the CMS Meaningful Use Requirement.

  6. So what happens with a practice whom has an medical assistant, not certified, who enters orders, rx’s etc. ? Is there a legality involved with this???

    1. My understanding is, and somebody correct me if my understanding is wrong, Medicare imposes HUGE – 10’s of thousands of dollars for each and every entry; not collectively – financial penalties for physicians who allow employees who are not specifically approved to do so (CMA (AAMA); RMA (AMT); PA; NP; etc.) enter orders into an EMR.

      When Medicare catches up to the physician breaking this rule, they take the money back, just as they did when physicians missed a meaningful use objective.

      I know of an office who has at least 2, possibly 3, MA’s who are not certified or registered that enter hundreds of orders and/or prescriptions into their office EMR EVERY week since their go-live 3 years ago AND have absolutely NO interest whatsoever to become certified or registered. The worst part of it is, the physicians they work for are not even forcing the issue. Yet. Maybe they’ll stand up and take notice when Medicare hits them with their first order entry penalty. It’s going to be a doozy.

      1. I know you wrote this some time ago, but in hopes that you see it and can respond:
        Do you know if there is any way to report offices for violating this? I left an office over this reason (plus multiple other violations) after I went head to head with the office manager. I was the only front office staff Certified (her and 2 other girls were not). And only 1 of the 2 back office MAs were certified. And they were all placing orders, giving injections, etc.

        Anyways, if there was a way to report them so they could get audited, I’d like to know. I honestly just want them to follow the rules. I adore the patients and want to keep them sage.

  7. Im looking for affordable online courses to take at home that are accredited so i can take the certification test but cant find any. Does anyone know of any online courses? I tried looking fir 8 days but its complicated. Need an online course since im a single mom and need to work to pay my bills and cant leave my daughter with anyone. Thanks for the help.

    1. So does a RMA that is registered with the American registry of medical assistants qualify?


  8. My employer is seeking clarification on my ability to enter orders (lab, medication, radiology) verbal or not into EHR as we transition to a new system. I graduated in 2013 from a CAAHEP accredited school with my Associates Degree and have maintained my status as CMA (AAMA) since that time. I currently work in the state of Nebraska. Am I considered a credentialed medical assistant??

    1. Thank you for your question. Because you hold a current CMA (AAMA), you meet the CMS definition of “credentialed medical assistant.” Therefore, you are permitted to enter into the CPOE system medication, laboratory, and diagnostic imaging orders for meaningful use calculation purposes under the Medicaid Incentive Program.

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