Certification and the CMA (AAMA) Credential, Professional Identity

Can Washington State Medical Assistants Use the “CMA” Initialism?

With a variety of certifications associated with the medical assisting profession, confusion runs rampant regarding who is permitted to write “CMA” after their name, thereby using the CMACM initialism. For instance, I received the following question:

I have been a CMA (AAMA) for many years and recently moved to Washington state. Washington law requires a medical assistant to register with the Washington Department of Health as a medical assistant-certified (MA-C) or a medical assistant-registered (MA-R) to be delegated certain clinical tasks. My question is this: Is an MA-C allowed to use the CMA initialism?

As you have stated, the MA-C and the MA-R are medical assisting credentials established by the Washington legislature and administered by the Washington Department of Health. They do not have a “legal existence” outside of the provisions of Washington law. The CMA (AAMA)® is a national medical assisting credential. The CMA (AAMA) Certification Program and the Certifying Board of the AAMA are accredited by the National Commission for Certifying Agencies, the National Certification Commission, and under International Standard ISO:IEC 17024, Conformity Assessment—General Requirements for Bodies Operating Certification of Persons. The CMA (AAMA) has a national and international existence as a medical assisting credential.

Only medical assistants who have passed the CMA (AAMA) Certification Exam have been awarded the CMA (AAMA) credential by the Certifying Board of the AAMA and who have kept their CMA (AAMA) current by continuing education or testing are permitted to use the CMA (AAMA) designation. Not all Washington MA-Cs have a current CMA (AAMA). Only those MA-Cs who have a current CMA (AAMA) are permitted to use the CMA (AAMA) or CMACM initialisms after their names.

On the Job, Professional Identity

Misuse of “CMA (AAMA)” and “CMA” Can Have Legal Consequences

Some medical assistants who do not hold the CMA (AAMA) credential awarded by the Certifying Board (CB) of the American Association of Medical Assistants (AAMA) incorrectly use the initialisms “CMA (AAMA)®” or “CMA” after their names. The AAMA has also received reports that some employers are permitting their medical assisting employees to misuse the “CMA (AAMA)” or “CMA” designations.

The AAMA owns Registration Number 4,510,101 issued by the United States Patent and Trademark Office (USPTO) for the certification mark “CMA (AAMA).”

The predecessor credential to the CMA (AAMA) was the CMA. Because of the decades of use of the CMA initialism in interstate commerce, the AAMA has common law rights in the “CMA” designation.

Consequently, using the initialisms “CMA (AAMA)®” or “CMA” or the phrase “Certified Medical Assistant” to describe a medical assistant who has not been awarded or has not maintained currency of the CMA (AAMA) credential from the Certifying Board of the AAMA is both incorrect and a matter of intellectual property law. Anyone who does so may be in jeopardy of legal sanctions.

The AAMA urges all medical assistants who are misusing the CMA (AAMA) or CMA initialisms, and all employers who are permitting their medical assisting employees to do so, to cease and desist immediately. The AAMA also requests that any instances of such misuse be brought to our attention.

I further explain the legality behind the AAMA’s claim to “CMA (AAMA)” variations in “Letters and the Law.”

The CMA (AAMA) Logo and Branding Usage Guide describes who has permission by the Certifying Board of the AAMA to use the CMA (AAMA) designation, initialism, and/or logo and lists common misunderstandings.

On the Job, Professional Identity

Medical Assistants Must Not Refer to Themselves as “Nurses”

Medical assistants must scrupulously avoid conveying the message that they are nursing personnel or members of any profession other than medical assisting.

It is unethical, illegal, and a disservice to the medical assisting profession for medical assistants to refer to themselves as “nurses,” “office nurses,” “doctors’ nurses,” or any other generic term that even remotely implies that medical assistants are nurses.

Review the supporting evidence within excerpts from the National Council of State Boards of Nursing NCSBN Model Act (2012) and several states’ nurse practice acts in the May/June 2019 Public Affairs article, “Medical Assistants Must Not Refer to Themselves as ‘Nurses,’” on the AAMA website.

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

ISMA Urges Indiana Physicians to Hire Competent Medical Assistants

A resolution supporting medical assistants and CMAs (AAMA) was adopted by the House of Delegates of the Indiana State Medical Association (ISMA) in September 2018. The resolution was introduced by William W. Pond, MD. Tammy Daily, CMA (AAMA), liaison to the ISMA from the Indiana Society of Medical Assistants, and I helped craft the final language of the resolution. To read the adopted resolution, access the January/February 2019 Public Affairs article, “ISMA urges Indiana physicians to hire competent medical assistants,” on the AAMA website.

Medicare, On the Job, Professional Identity

Medical Assistants and Incident-to Billing

What is meant by the statement that the services of a medical assistant must be billed “incident to” the services of the delegating physician for the physician to be reimbursed for the medical assistant’s services under Medicare?

Legally, medical assistants work under direct/onsite provider (e.g., physician, nurse practitioner, physician assistant) supervision and authority in outpatient settings. Medical assistants do not have National Provider Identifier (NPI) numbers because they are not reimbursed directly by Medicare for their services. Rather, their services may only be billed and reimbursed incident to the services of the delegating provider.

Note the following from the Medicare Benefit Policy Manual:

Incident to a physician’s professional services means that the services or supplies are furnished as an integral, although incidental, part of the physician’s personal professional services in the course of diagnosis or treatment of an injury or illness. …

Auxiliary personnel means any individual who is acting under the supervision of a physician, regardless of whether the individual is an employee, leased employee, or independent contractor of the physician, or of the legal entity that employs or contracts with the physician. …

Thus, where a physician supervises auxiliary personnel to assist him/her in rendering services to patients and includes the charges for their services in his/her own bills, the services of such personnel are considered incident to the physician’s service if there is a physician’s service rendered to which the services of such personnel are an incidental part.

For more information, see my Public Affairs article from the March/April 2018 CMA Today: “Medicare CCM and TCM Programs: Defining Medical Assistants’ Roles and Services.”