Category: Medicaid

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

Donald Balasa

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

EHR Incentive Programs, Eligible Professionals, Medicaid, Medicare, On the Job

Eligible Professionals for Medicare and Medicaid EHR Incentive Programs

Donald Balasa

The Medicare Electronic Health Record (EHR) Incentive Program and the Medicaid EHR Incentive Program are two similar, but different, federal initiatives.  Questions have arisen about which health care providers are eligible to participate in the Medicare Program, the Medicaid Program, or both.

Medicare-only eligible professionals (EPs) are optometrists, podiatrists, and chiropractors. Medicaid-only EPs are nurse practitioners, nurse midwives, and physician assistants—when working at a federally qualified health center (FQHC) or rural health clinic (RHC) that is led by a physician assistant.  In some circumstances, physicians, osteopaths, and dentists could be eligible for both the Medicare and Medicaid Incentive Programs.