medication reconciliation, Scope of Practice

Medication Reconciliation Post-Discharge Measure Victory

The ability of appropriately educated and professionally credentialed medical assistants to perform—under the authority of licensed providers—medication reconciliation post-discharge has become widely recognized by providers. However, the fact that medical assistants are not explicitly mentioned in the National Committee for Quality Assurance (NCQA) post-discharge medication reconciliation measure had given rise to some uncertainty about whether medication reconciliation by medical assistants would count toward determining whether the following measure has been met:

Quality ID #46 (NQF 0097): Medication Reconciliation Post-Discharge

NUMERATOR (SUBMISSION CRITERIA 1 & 2 & 3):

Medication reconciliation conducted by a prescribing practitioner, clinical pharmacist or registered nurse on or within 30 days of discharge

I asked the NCQA whether medication reconciliation by medical assistants would count toward meeting the above quality measure. An excerpt and further details about this letter are available in my November 2020 Legal Eye post. The NCQA provided the following answer:

NCQA recognizes the supervising physician as providing the service when they have signed off on the medical record/documentation. It is our understanding many licensed practical nurses (LPNs) and medical assistants work with physicians and registered nurses (RNs). With this in mind, medication reconciliation provided by the medical assistant and signed off by a physician, [nurse practitioner, physician assistant, or clinical pharmacist with prescribing privileges], or RN may be counted toward NCQA Medication Reconciliation indicators as the signature indicates additional clinical oversight for this work.

Additional updates from the NCQA will be reported in future Legal Eye blog posts.