The Significance of the Words Registered and Certified in Credentials

I recently received the following question about medical assisting credentials: 

My new employer tells me that the [RMA(AMT)] credential is better than the CMA (AAMA) credential because the R in RMA stands for registered, and registered nurses (RNs) are licensed. Is this correct? 

This understanding is incorrect. The registered medical assistant (RMA) of American Medical Technologists (AMT) and the CMA (AAMA) are both national credentials. The presence of the word registered in a credential does not make it equivalent to a license. Similarly, the presence of the word certified in a credential does not make it inferior to a credential containing the word registered. Certified Public Accountants (CPAs), for example, are licensed. 

Only Select Professionals May Legally Use “Nurse” As a Title

I recently received the following significant question about permissible titles:

Recently [someone] was hired in my company, and she is a CMA (AAMA).

Can she call herself a “nurse”? She insisted on getting a name badge that identifies her as a nurse. … I remember being taught we cannot. I found and read the June 2019 article you wrote saying we cannot.

As stated in the 2019 Public Affairs article, the laws in all American jurisdictions continue to forbid anyone—other than registered nurses (RN), licensed practical nurses (LPN), or licensed vocational nurses (LVN)—from calling themself a nurse.

Note the following from a 2019 Advisory Opinion issued by the Kentucky Board of Nursing:

KRS 314.031(1) states: “It shall be unlawful for any person to call or hold [themself] out as or use the title of nurse or to practice or offer to practice as a nurse unless licensed or privileged under the provisions of this chapter.”

AAMA Board of Trustees Creates the Advisory Program

During the 65th AAMA Annual Conference in September 2021, the AAMA Board of Trustees unveiled a new service to support medical assistants: the Advisory Task Force Advisory Program.

The Advisory Program was created to facilitate the effective deployment of medical assistants and CMAs (AAMA)® in the rapidly changing U.S. health care delivery system. The primary charge of the Advisory Program is providing concrete and reliable information that will remove barriers to the full utilization of medical assistants. Dispelling misconceptions and imparting trustworthy knowledge will be a key step in unlocking the untapped potential of medical assisting professionals.

Learn more about the origin and goals of the Advisory Program, as well as its target audiences, by reading the November/December Public Affairs article in CMA Today, “AAMA Board of Trustees Creates the Advisory Program.” Then, visit the “Advisory Task Force Advisory Program” webpage to meet the experts of the Advisory Task Force and download Advisory Program materials.

“Certified Medical Assistant” vs. “Medical Assistant-Certified” in Washington: A Review of Permissible Usage among Programs

The distinction between “certified medical assistant” and its variations can be difficult for medical assisting programs to make. Trademark registrations and state law need to be taken into consideration.

Take this question for example:

Can a Washington-based medical assisting program that meets the requirements of the Washington State Department of Health (e.g., graduates can become a “medical assistant-certified” [MA-C]) but not the CMA (AAMA)® Certification Exam use the phrase “certified medical assistant” in connection with their program?

The American Association of Medical Assistants® (AAMA) holds a trademark registration with the U.S. Patent and Trademark Office for the phrase “certified medical assistant.” Any party’s use of the phrase that is likely to confuse or mislead the public is an infringement of the AAMA’s intellectual property rights in the phrase.

Medical assisting programs that are not accredited by either the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES) should not use the phrase because it could be misconstrued as their graduates being eligible for the CMA (AAMA) Certification Exam.

Washington State Legislature has established several categories for medical assistants (WAC 246-827-0010), but the medical assistant-certified (MA-C) category is the one most likely to be confused with “certified medical assistant” permissible usage. Note the requirements for becoming an MA-C:

WAC 246-827-0200

Medical assistant-certified—Training and examination.

An applicant for a medical assistant-certified credential must meet the following requirements:

(1) Successful completion of one of the following medical assistant training programs:

(a) Postsecondary school or college program accredited by the Accrediting Bureau of Health Education Schools (ABHES) or the Commission of [sic] Accreditation of Allied Health Education Programs (CAAHEP);

(b) Postsecondary school or college accredited by a regional or national accrediting organization recognized by the U.S. Department of Education, which includes a minimum of seven hundred twenty clock hours of training in medical assisting skills, including a clinical externship of no less than one hundred sixty hours;

(c) A registered apprenticeship program administered by a department of the state of Washington unless the secretary determines that the apprenticeship program training or experience is not substantially equivalent to the standards of this state. The apprenticeship program shall ensure a participant who successfully completes the program is eligible to take one or more examinations identified in subsection (2) of this section; or

(d) The secretary may approve an applicant who submits documentation that he or she completed postsecondary education with a minimum of seven hundred twenty clock hours of training in medical assisting skills. The documentation must include proof of training in all of the duties identified in RCW [Revised Code of Washington] 18.360.050(1) and a clinical externship of no less than one hundred sixty hours.

(2) Pass a medical assistant certification examination, approved by the secretary, within five years of submitting an initial application. A medical assistant certification examination approved by the secretary means an examination that:

(a) Is offered by a medical assistant program that is accredited by the National Commission for Certifying Agencies (NCCA); and

(b) Covers the clinical and administrative duties under RCW 18.360.050(1).

Consequently, if the medical assisting program meets (1)(a), (b), (c), or (d), it would be permissible for the program to state that graduates meet the educational portion of the MA-C requirements. It would also be permissible to state that graduates would be eligible for one or more of the NCCA-accredited medical assisting certification programs.

For more information on whether a Washington-based MA-C can write “CMA” after their name, see my blog post “Can Washington State Medical Assistants Use the ‘CMA’ Initialism?”

Appropriate Use Criteria Program: CMAs (AAMA)® Meet Clinical Staff Criteria under the CMS Rule

In the Public Affairs article of the March/April 2018 CMA Today, I argued that “appropriately educated and credentialed medical assistants” such as CMAs (AAMA)® are clinical staff under the Medicare Chronic Care Management (CCM) and Transitional Care Management (TCM) programs.

I now add that CMAs (AAMA) are also clinical staff according to the Centers for Medicare & Medicaid Services (CMS) rule regarding the appropriate use criteria (AUC) program. Therefore, as a result of their clinical staff status, I assert that CMAs (AAMA) are permitted to do the following:

1. Consult a clinical decision support mechanism (CDSM) about the appropriateness of ordering a particular advanced diagnostic imaging service
2. Report findings to their overseeing or delegating licensed providers

Review the supporting evidence in the September/October 2019 Public Affairs article, “Appropriate Use Criteria Program,” on the AAMA website.