On the Job

Age Requirements for Ohio Medical Assistants

I recently received the following question from an Ohio educator regarding age restrictions for medical assistants:

 Can you tell me if there is any legal implication that [a medical assistant] who has completed a high-school training program [but] is not yet 18 might [be unable] to work as a medical assistant until they turn 18? 

The medical assisting laws of all states, including Ohio, are available on the “State Scope of Practice Laws” webpage. 

Notably, Ohio law does not require medical assistants to be at least 18 years of age to work as a medical assistant. 

However, a few states ​(such as California) do require medical assistants to be at least 18 in order to work as a medical assistant. 

Scope of Practice

Multi-State Scope of Practice for Medical Assistants

I recently received an inquiry regarding medical assisting scope of practice laws across the U.S.:

I am a CMA (AAMA) residing in Washington. I am trying to find all the scope of practice laws for my current job. I work for a start-up health care/technology company [that] serves all 50 states. All our physicians are licensed in each state, and we are trying to implement the use of CMAs (AAMA) to better serve our patient load. Would I need to follow each state’s rules, or because the company is in Washington, would I just follow Washington’s rules?

I feel as though Washington [law] is the strictest. [Do you think] any other states seem to be a little stricter?

To find the medical assisting laws of all states, go to the “State Scope of Practice Laws” webpage on the AAMA website

Because medical assistants employed by this company work under the authority of physicians in all states, they are required to abide by the laws of all states.

Washington has more requirements that medical assistants must meet to work as medical assistants than any other state. Further, Washington law requires medical assistants to meet specified requirements for a category of medical assistants and register with the Washington State Department of Health in that category in order to work.

However, some states have more limitations on tasks that medical assistants are permitted to be delegated and to perform.

Two of my Public Affairs articles published in CMA Today, “What Tasks Are Delegable to—and Performable by—Medical Assistants?” part I and part II, contain legal principles generally applicable in all U.S. jurisdictions. Note the following excerpt from the handout that served as the source material for those articles:

7. General legal principles—

• It is not permissible for medical assistants to perform tasks that constitute the practice of medicine, or require the skill and knowledge of physicians or other licensed providers;

• It is not permissible for medical assistants to perform tasks that are restricted in state law to other health professionals—often licensed health professionals;

• It is not permissible for medical assistants to perform tasks that require the exercise of independent clinical judgment, and/or the making of clinical assessments, evaluations, or interpretations;

delegation, Scope of Practice

Nebraska Amendment Clarifies Medical Assisting Scope of Practice

Beginning in 2018, a particular interpretation of Nebraska law has cast doubt on the legal authority of physicians to delegate to medical assistants the performing of certain tasks under direct/on-site physician supervision in outpatient settings.

In response, the Nebraska Medical Association drafted an amendment to the Medicine and Surgery Practice Act to eliminate any ambiguity about medical assistants’ scope of practice. The American Association of Medical Assistants® and the Nebraska Society of Medical Assistants submitted written testimony supporting this legislation, and the amendment was enacted into law.

The new language clarifies the authority of physicians to delegate—and the right of medical assistants to perform—tasks within the standard scope of practice for medical assistants throughout the United States. I have incorporated this new language into my legal opinion letter for Nebraska, which is available on the AAMA State Scope of Practice webpage.

delegation, Scope of Practice

What Tasks Are Delegable to—and Performable by—Medical Assistants? Part II

The COVID-19 pandemic has created many changes in health care. Notably, medical assistants’ roles have shifted and expanded to help ensure patients continue to receive high-quality care.

The January/February 2021 Public Affairs article—adapted from the handout for my presentation of the same title for the 2020 American Academy of Ambulatory Care Nursing Annual (Virtual) Conference— discusses medical assistants’ scope of practice in terms of state law. Specifically, I examine the legality of delegating certain tasks to medical assistants:

  • Performing injections and venipuncture
  • Executing verbal and standing orders from licensed providers
  • Enter­ing orders under the Medicaid Promoting Interoperability Program and its meaningful use provisions for electronic order entry

Review details by reading “What Tasks Are Delegable to—and Performable by—Medical Assistants? Part II” on the AAMA website. And check out “Part I,” which was published in the November/December 2020 issue of CMA Today.

delegation, On the Job, Scope of Practice

Permissible Delegation of IV Infusions in Florida

I recently received the following question regarding the administration of an IV infusion: 

What are the requirements [for administering IV vitamin bags if] I completed schooling for my medical assistant certification? I thought doing an IV certification course would be a good start. What other requirements would be necessary as far as being able to administer the IV [infusion]? 

For medical assistants to be delegated an IV infusion by a physician and perform an IV infusion under the physician’s direct/onsite supervision, Florida law requires the medical assistant to be knowledgeable and competent in all aspects of IV infusion. 

Additionally, there must be written verification by the delegating physician (or another licensed provider) that the medical assistant is knowledgeable and competent in IV infusion. Completing an IV certification course is good evidence of competence. The delegating physician periodically should reverify in writing the medical assistant’s ongoing competence in IV infusion.