delegation, On the Job, Scope of Practice

Standing Orders from an Overseeing Provider

I receive the following question about standing orders fairly often, and it is a bit difficult to answer because state law seldom addresses it:

Our new office manager claims that it is illegal for medical assistants to perform tasks based on standing orders of our licensed providers. She states that only licensed professionals, such as registered nurses (RNs), are permitted to work under standing orders. Is this legally accurate?

Most state laws do not prohibit physicians, nurse practitioners, and physician assistants from assigning tasks to unlicensed allied health professionals such as medical assistants by means of standing orders.

However, the crucial issue is what tasks medical assistants may or may not be delegated by standing order.

It is my legal opinion that medical assistants are permitted to receive and execute standing orders from an overseeing/delegating provider as long as the following conditions are met:

  1. The standing order is understood by the medical assistant.
  2. The standing order is for a task that is delegable to medical assistants under the laws of the state, and the delegating provider is exercising the degree of supervision required by the laws of the state.
  3. The standing order is either patient-specific or applicable to all patients without exception.
  4. The standing order does not require the medical assistant to exercise independent clinical judgment or make clinical assessments, evaluations, or interpretations.

If you’d like to know more about your specific state laws, visit the State Scope of Practice Laws webpage on the AAMA website.

4 thoughts on “Standing Orders from an Overseeing Provider”

  1. Great information, I would caution to still review your state scope, if you have one, for instance with Washington state having a MA-C license per 18.360.060 “Nothing in this section prohibits the use of protocols that do not involve clinical judgment and do not involve the administration of medications, other than vaccines.”. That being said, medications can never have a standing protocol for MA-C. My company has standing protocols for POCT but I know many do not have written protocols and they must be written down and not just word of mouth as MA-C can not take verbal orders.

    1. Thank you for good points about Washington State medical assisting law.

      Donald A. Balasa, JD, MBA
      Chief Executive Officer, Legal Counsel
      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 |
      The CMA (AAMA): Health Care’s Most Versatile Professional®

  2. Hi Vicky,

    Do you receive these blog posts? This is a good one. Don’s list for what’s okay, goes really well with the language of the law for WA MAs.


    Elizabeth Engel, MDiv, CMA (AAMA) Program Director for Medical Assisting ________________________________________ Lower Columbia College 1600 Maple Street Longview WA 98632-0310 360-442-2867 FAX 360-442-2879 ________________________________

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