How National Accreditation of Health Education Programs Enhances Interstate Mobility of Health Professionals

The following post is adapted from a piece I wrote for Communiqué, a publication of the Commission on Accreditation of Allied Health Education Programs.

The negative effects of states having differing and incompatible licensing requirements for health professionals were brought to light as never before during the COVID-19 pandemic. Emergency legislation, suspension of licensing board rules, and executive orders from state governors (and, in a few instances, from federal agency heads) were necessary to deploy health professionals to areas of the United States that were being impacted most severely by the coronavirus. Legislators and regulators from both political parties were united in advocating that permanent change be made to state licensing laws for health professionals.

Many policy solutions (e.g., interstate compacts, model statutes and rules, licensing reciprocity, and universal license recognition) had been devised and implemented (to some extent) before the pandemic. Efforts to reduce barriers to interstate mobility and practice for health professionals have only intensified during the last 12 months. However, one essential aspect of this problem has not been fully recognized: the importance of education programs in each health profession being held to national standards and being accredited by a national accrediting body.

Professional regulation usually consists of three requirements: education, examination, and (for some professions) experience. I argue that education is the most foundational of these three components. If there are inconsistent education prerequisites for entry into a health profession, it becomes very difficult to even begin the discussion of state licensing reciprocity.

Another major, seemingly unprecedented, current challenge in the labor market for health professionals is the pervasive and persistent shortage of qualified individuals. Decision-makers in some states have sought to address this shortage by creating less rigorous and shorter education pathways. This may offer a minor and temporary solution to the workforce shortage. However, I assert that the short-term benefit of increasing the pool of professionals by attenuating the education requirement would (1) be outweighed by the long-term lessening in the quality of care and (2) perpetuate barriers to interstate mobility because the truncated education would differ from the national standard and from legally mandated education in other states.

In the final analysis, then, adhering to national accreditation standards of health professional education is indispensable for both safeguarding public health and removing barriers to interstate portability of professional credentials. The Commission on Accreditation of Allied Health Education Programs is proud to be a part of the programmatic accreditation community that is committed to accomplishing both policy objectives.

Accreditation, Certification and the CMA (AAMA) Credential

Educational Requirements for Different Medical Assisting Credentials

I have received questions to the following effect: “Which medical assisting academic programs are ‘CMA (AAMA) programs,’ and which are ‘RMA(AMT) programs’?”

This is an imprecise way to frame the question.  It is better to ask what the eligibility pathways are for the CMA (AAMA) Certification Examination, and for the RMA(AMT) Examination.

Applicants for the CMA (AAMA) Certification Examination for initial certification must be graduates of CAAHEP (Commission on Accreditation of Allied Health Education Programs) or ABHES (Accrediting Bureau of Health Education Schools) accredited medical assisting programs, and must meet the other requirements established by the Certifying Board of the AAMA. (Information regarding such programs can be found on the AAMA website.)

There are five eligibility routes for the RMA(AMT) Examination.  One of the five is the education route.  Note the following from the website of AMT:

Graduated from an accredited MA program (ROUTE 1–Education)

  • Training programs must be accredited by an agency approved by the DOE
  • Training programs must have 720 clock hours of instruction, including at least 160 clock hours of externship
  • If graduated more than 4 years ago, must also have 3 out of the last 5 years of work experience as an MA in both clinical and administrative areas

Consequently, in addition to graduates of CAAHEP and ABHES accredited medical assisting programs, graduates of medical assisting programs in schools that are accredited by an accrediting body recognized by the United States Department of Education (DOE), and that have the required clock hours of instruction and externship specified above, are eligible for the RMA(AMT) Examination.

Accreditation, Certification and the CMA (AAMA) Credential, Scope of Practice

Q and A: Medical Assistants and CPOE, Part 1 (Post 4 of 5)

Because most CMAs (AAMA) work under the direct supervision of “eligible professionals” (as defined in the rules of the Centers for Medicare and Medicaid Services [CMS]), this post focuses on some common questions surrounding the provisions of the Medicare and Medicaid Electronic Health Records (EHR) Incentive Program that are applicable to eligible professionals, not those provisions that are applicable to “eligible hospitals” and “critical access hospitals.”

Q: Who can enter orders into the EHR to contribute to the meeting of the Stage 1 and 2 measures for CPOE?

A: Stage 1 of the Incentive Program specified that only “licensed health care professionals” could enter orders into the CPOE system for meaningful use calculation purposes. At the urging of the American Association of Medical Assistants and other parties, on August 23, 2012, CMS issued a final rule allowing “credentialed medical assistants” to enter orders into the CPOE system for the purpose of calculating compliance with this Core Objective. The CMS Stage 2 Eligible Professional Meaningful Use Core Measures document, issued in October of 2012, includes the following statement: “Any licensed healthcare professionals and credentialed medical assistants can enter orders into the medical record for purposes of including the order in the numerator for the objective of CPOE…”

Q: How does CMS define “credentialed medical assistants”?

A: According to the 2012 CMS document cited immediately above, “Credentialing for a medical assistant must come from an organization other than the organization employing the medical assistant.”

Q: Does an associate degree, certificate, or diploma from an academic medical assisting program fall within the CMS definition of a credentialed medical assistant?

A: In my opinion, the context of the August 23, 2012 CMS final rule does not allow an associate degree, certificate, or diploma from a medical assisting program to be considered as a medical assisting credential. The medical assisting credential must be granted by a body that requires medical assistants to pass a standardized test.

Q: Would a “credential” based on experience and recommendations meet the CMS definition of a credentialed medical assistant?

A: No. The intent of CMS was that a medical assistant pass some sort of examination in order to fulfill the definition of a “credentialed medical assistant.”

Accreditation, Certification and the CMA (AAMA) Credential, Scope of Practice

Presentation to the NCSBN

I recently presented a webinar for the National Council of State Boards of Nursing entitled “Medical Assistants: Scope of Practice, Education, and Credentialing.”  This webinar was presented to the boards of nursing of the states and territories of the United States.  The content of this webinar will be published in the Public Affairs department in future issues of CMA Today, but I would like to offer the file for download on Legal Eye.

The substance of this presentation is especially helpful for nurses who have limited knowledge about CMAs (AAMA). The information within touches on some of the following subjects:

  • Defining medical assistants vs. nursing assistants and medication aides
  • Legal principles surrounding medical assisting
  • Education of medical assistants—coursework and accreditation
  • State laws governing medical assisting in South Dakota and New Jersey
  • Medical assisting credentials—trends
  • NCCA accreditation
  • Value of the CMA (AAMA) credential
  • Medical assisting scope of practice

Please view and share this presentation. And, as always, contact me with any questions regarding the legal aspects of the profession.