Centers for Medicare & Medicaid Services, Computerized Provider Order Entry (CPOE), EHR Incentive Programs, On the Job

MACRA and Order Entry Requirements

The Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act of 2015 (MACRA) mandated that the Medicare Electronic Health Record (EHR) Incentive Program come to an end on December 31, 2016. One of the new payment mechanisms for Medicare established by MACRA is the Merit-Based Incentive Payment System (MIPS). Under the primary reporting method of MIPS, an eligible provider is not required to report to the Centers for Medicare & Medicaid Services (CMS) that medication, laboratory, and diagnostic imaging orders are being entered by credentialed medical assistants or licensed health care professionals.

CMS, however, offers eligible providers an alternate reporting method under MIPS. Under this method, providers are permitted to report on optional measures, such as computerized provide order entry (CPOE).

This issue will be addressed in greater detail in the upcoming January/February 2017 issue of CMA Today. In the meantime, all past Public Affairs articles by CEO Balasa can be found on the AAMA website

Certification and the CMA (AAMA) Credential, IAS Accreditation, Professional Identity

Certifying Board of the AAMA Achieves IAS Accreditation

The AAMA touts the merits of the CMA (AAMA) credential, the highest standard for certification in the medical assisting profession. Those merits have recently been recognized by the International Accreditation Service (IAS), which has granted accreditation for Bodies Operating Certification of Persons to the Certifying Board of the AAMA. The full copy of the press release can be found below.

The Certifying Board of the American Association of Medical Assistants Achieves International Accreditation as a Personnel Certifying Body

CHICAGO—April 20, 2016—The Certifying Board of the American Association of Medical Assistants, Inc. (AAMA) has received independent recognition that its criteria and processes for earning the CMA (AAMA) credential meet ISO/IEC Standard 17024:2012, the global benchmark for personnel certification bodies, distinguishing it from other medical assisting certifications. The Certifying Board of the AAMA has earned accreditation for Bodies Operating Certification of Persons (AC474) from the International Accreditation Service (IAS).

“This recognition demonstrates AAMA’s commitment to ensuring that medical assistants with the CMA (AAMA) credential meet the highest standards,” says Donald A. Balasa, JD, MBA, chief executive officer and legal counsel of the AAMA. “It also further ensures the integrity of the CMA (AAMA) credential for medical assistants, their employers and patients.”

In order to receive accreditation the Certifying Board had to demonstrate that it operates in full compliance with the exacting requirements of ISO/IEC Standard 17024:2012. In so doing, the AAMA has established itself as the most respected and credible personnel certification organization for the medical assisting profession.

A rigorous credential, the CMA (AAMA) is the only certification that requires postsecondary education. Only candidates who graduate from an accredited postsecondary medical assisting program are eligible to sit for the CMA (AAMA) Certification Examination. The CMA (AAMA) must recertify every five years. In addition to ensuring the CMA (AAMA) represents a world class certification, IAS accreditation also validates the credential as an internationally recognized certification, enabling CMAs (AAMA) to obtain similar positions outside of the United States.

Medical assisting is one of the nation’s careers growing much faster than average for all occupations, according to the United States Bureau of Labor Statistics. Medical assistants work in outpatient health care settings and perform both clinical and administrative patient-centered duties. They have knowledge of medical law and regulatory guidelines including HIPAA compliance. Clinical duties vary according to state law and may include taking medical histories, taking and recording vital signs, explaining treatment procedures to patients, preparing patients for examination and assisting the physician during the examination. The administrative duties may include maintaining medical records, including entering the provider’s orders into the electronic health record, managing insurance processes, scheduling appointments, arranging for hospital admission and laboratory services, and billing and coding.

The CMA (AAMA) Certification Program is also accredited by the National Commission for Certifying Agencies (NCCA), a body that reviews and accredits certification programs that meet its Standards for the Accreditation of Certification Programs. The NCCA is an accrediting arm of the Institute for Credentialing Excellence (ICE), formerly called the National Organization for Competency Assurance (NOCA).

For more information about CMA (AAMA) certification or to verify CMA (AAMA) credentials, visit http://www.aama-ntl.org/.

Certification and the CMA (AAMA) Credential, CMS Stage 2 Rule, Computerized Provider Order Entry (CPOE), EHR Incentive Programs, Meaningful Use

Video: “How Medical Assistants Can Meet the CMS Meaningful Use Requirement”

Below is a video of my presentation at the AAMA 58th Annual Conference in St. Louis, in which I discussed order entry into the computerized provider order entry (CPOE) system and answered questions about the Centers for Medicare and Medicaid (CMS) Stage 2 Meaningful Use requirements.

The video can also be accessed through the AAMA YouTube channel: https://www.youtube.com/watch?v=Hz4avFT3XZE

On the Job, Scope of Practice

Scope of Practice With Nurse Practitioners

I have been receiving an increasing number of questions about the scope of practice for medical assistants when they are working under the supervision of nurse practitioners (NPs) or physician assistants (PAs), and not under the direct supervision of a physician. This scenario will become more frequent because of the Affordable Care Act and the anticipated increase in demand for primary care, which is often provided by NPs and PAs.

Because physician assistants always work under physician authority and supervision—although, in some states, very general physician supervision—the scope of practice for medical assistants working under PAs is usually very similar to their scope of practice when working under physician supervision. However, there are some state laws that do not permit medical assistants to administer medication unless a physician (MD) or osteopath (DO) is on the premises.

Medical assistants’ scope of practice when working under nurse practitioners (or other advanced practice nurses) is usually more difficult to ascertain from state law. The controlling law is the state nurse practice act and the regulations and policies of the state board of nursing. Often, the legal analysis is complicated.

If you work under the direct supervision of a nurse practitioner or a physician assistant and have questions about scope of practice, please feel free to direct your questions to me.

Certification and the CMA (AAMA) Credential

Follow-up: The Specific Nature of the “Certified Medical Assistant”

Many of you came forward with anecdotes in the comments section of my last post about the importance of properly identifying “Certified Medical Assistants.”  In light of all the issues you have highlighted, I thought it important to further elaborate on the topic.

MA is Not a Medical Assisting Credential

Some medical assistants, in an attempt to abbreviate the name of the profession, refer to themselves as “MAs.”  While this is a fairly common and innocuous usage, it is best to write or state the full profession name (i.e., medical assistant). Doing so helps promote the profession, while clearing up potential confusion in the marketplace.

Concern arises when the intialism for the profession is presented after an individual’s name, giving the appearance of a credential. Only professional or academic credentials—not positions of employment—belong after the person’s name.  Furthermore, the MA credential indicates the person possesses a Master of Arts degree. No MA credential exists in the medical assisting profession, and thus the letters should not appear after the name of any person who does not possess a Master of Arts degree.

Graduation is Not Certification

Much of the confusion around my previous post comes from the similar natures, and appearances, of certificates, certification, and “Certified Medical Assistant (AAMA).” While there is some overlap between the terms, the distinctions are specific. More importantly, they carry legal implications.

The completion of a medical assisting education program—whether accredited or not—will most likely earn the graduating student a certificate, diploma, or associate degree, which represents only the individual’s completion of the program.

Certification is a process by which a professional demonstrates competency in a field. To demonstrate this competency, that person is often required to pass an examination, as is the case with CMA (AAMA) credential. However, as I have written in the past, different medical assisting credentials exist, along with different pathways to certification. Remember, certification is always a separate process. For instance, successful completion of a CAAHEP or ABHES accredited medical assisting program is the first step toward CMA (AAMA) certification, but individuals must pass the CMA (AAMA) Certification Examination before they can use the CMA (AAMA) credential after their names.

Remember, employers can immediately verify their employees’ CMA (AAMA) status on the AAMA website.