delegation, On the Job, Scope of Practice

Comments to the Montana Board of Medical Examiners

In the effort to protect patients in Montana from substandard medical assisting services, the Montana Society of Medical Assistants (MSMA) and the American Association of Medical Assistants (AAMA) wrote to the Montana Board of Medical Examiners on the proposed New Rule I “Medical Assistant—Delegation and Supervision.” Read the comments as well as an excerpt from the proposed new rules in the latest Public Affairs article. Access “Comments to the Montana Board of Medical Examiners” in the September/October 2018 issue of CMA Today on the AAMA website.

Certification and the CMA (AAMA) Credential, medication assistant, On the Job, Professional Identity

Levels of Medical Assisting

Here is an interesting question about “levels” of medical assisting:

I work for a very large cardiology practice in North Carolina. Is it permissible to establish tiers of medical assistants based on their skill sets? For example, are we permitted under North Carolina law to have categories such as Medical Assistant I, Medical Assistant II, Medical Assistant III based on the medical assistant’s education, credentialing, and skill sets?

North Carolina law does not forbid employers from establishing tiers or levels of medical assistants. An employer is allowed to determine what elements of knowledge and skill are required for each category of medical assistants and what tasks should be assigned to medical assistants in the respective categories.

However, these levels should not have “CMA” in their titles. The American Association of Medical Assistants (AAMA) has intellectual property rights to the phrase “certified medical assistant” and the initialisms “CMA (AAMA)” and “CMA.”

Titling these classifications as Medical Assistant I, II, III is permitted under North Carolina law and does not infringe on the trademark and intellectual property rights of the AAMA. See the State Scope of Practice Laws webpage on the AAMA website to access key state legislative materials pertaining to medical assisting.

On the Job, Scope of Practice

Scope of Practice near State Borders

I received the following interesting question:

I’m struggling with a difficult question! I am the clinical operations director for a medical group located in Oregon near the Oregon-Washington border. We provide care to Oregon and Washington residents and employ several medical assistants. As you know, Washington law requires certain medical assistants to meet educational and credentialing requirements and to register with the Washington State Department of Health. There are no such requirements for medical assistants under Oregon law.

Do my medical assistants who assist providers treating Washington residents need to meet the medical assisting requirements of the Washington law? All our providers (e.g., physicians, nurse practitioners, physician assistants) are licensed in Oregon.

The following is my response:

Because you are located in Oregon and the providers are licensed under Oregon law, the governing law is that of Oregon. Therefore, your medical assistants are not required to meet the requirements and register with the Washington State Department of Health. It does not matter that some patients are residents of Washington.

However, if your medical group had another location in Washington, the medical assistants would have to meet the requirements of Washington law to work as medical assistants.

medication aide, medication assistant, Scope of Practice

CMAs (AAMA), CNAs, and Medication Aides

I recently received the following question:

Does the law permit a CMA (AAMA) to work as a certified nursing assistant (CNA) in a nursing home without meeting the state requirements for registering as a CNA?

The answer is no. A medical assistant—even a CMA (AAMA) who has graduated from a programmatically accredited medical assisting program—must meet the state requirements for CNAs and register with the state as a CNA in order to perform clinical tasks in a skilled nursing facility or other inpatient settings.

Some states have a category of “medication aides (or assistants).” Medication aides are permitted to distribute medications to patients in an inpatient setting, usually under registered nurse authority and supervision. CMAs (AAMA) must also meet state requirements in order to work as a medication aide.

For more discussion on this topic, read my previous blog post “Medical Assistants and Medication Aides/Assistants/Technicians: Differences and Clarifications.”

On the Job, Scope of Practice

Medical Assistants in Camping Settings

I recently received the following question:

I was wondering whether medical assistants in my state are eligible to become overnight camp health officers and whether we are allowed to give intramuscular and subcutaneous injections as needed. No health care provider would be physically present. However, one or more providers (e.g., physicians, nurse practitioners, physician assistants) would be available by phone.

Under the laws of your state, medical assistants are not permitted to serve as camp health officers when no licensed health care provider is present and immediately available. This is because health professionals in a camping setting may be called upon to deal with situations that require the making of immediate clinical assessment and evaluations and the exercise of independent clinical judgments. Medical assistants are not taught the knowledge and skills necessary to function in this capacity.

Medical assistants are permitted to assist licensed health care providers in a camping environment, however.