Medical Assistants Working with Multiple Providers in Wisconsin

I recently received the following question from a Wisconsin medical assistant who was concerned about the possibility of mistakes being made in the pediatric practice where they worked:

[During] the last six months, I have been assisting more than one provider at a time throughout my eight-hour shift. Is this legal?

To answer this question, go to the “State Scope of Practice Laws” webpage on the AAMA website to find the medical assisting law of all states, including Wisconsin.

I am not aware of any Wisconsin law that prohibits a medical assistant from assisting more than one provider during one work shift.

If any health professional is making mistakes, they should be investigated immediately, and appropriate action should be taken.

The Impact of Federal Law on COVID-19 Vaccination in Michigan

I recently received the following concern from a Michigan medical assistant:

A provider is questioning whether medical assistants can administer the COVID-19 vaccine. Under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against COVID-19, it does not list that a [medical assistant] is qualified.

Note the following excerpt from the Department of Health and Human Services (HHS) document:

As qualified persons, these healthcare professionals and students in healthcare profession training programs will be afforded liability protections in accordance with the PREP [Public Readiness and Emergency Preparedness] Act and the terms of this amended Declaration. Second, to the extent that any State law that would otherwise prohibit the healthcare professionals and students in healthcare profession training programs who are a “qualified person” from prescribing, dispensing, or administering COVID-19 vaccines or other Covered Countermeasures, such law is preempted. On May 19, 2020, the Office of the General Counsel issued an advisory opinion concluding that, because licensed pharmacists are “qualified persons” under this declaration, the PREP Act preempts state law that would otherwise prohibit such pharmacists from ordering and administering authorized COVID-19 diagnostic tests. The opinion relied in part on the fact that the Congressional delegation of authority to the Secretary under the PREP Act to specify a class of persons, beyond those who are authorized to administer a covered countermeasure under State law, as “qualified persons” would be rendered a nullity in the absence of such preemption. This opinion is incorporated by reference into this declaration. Based on the reasoning set forth in the May 19, 2020 advisory opinion, any State law that would otherwise prohibit a member of any of the classes of “qualified persons” specified in this declaration from administering a covered countermeasure is likewise preempted. In accordance with section 319F–3(i)(8)(A) of the Public Health Service Act, a State remains free to expand the universe of individuals authorized to administer covered countermeasures within its jurisdiction under State law [emphasis added].

The bold language permits states to expand the categories of individuals who are allowed to administer COVID-19 vaccinations beyond what is stated in the HHS document. More restrictive state laws are preempted by this federal document. However, states are permitted to be more inclusive than what the federal document indicates.

Go to the AAMA website and visit the “State Scope of Practice Laws” page to find the medical assisting law of all states, including Michigan.

Note, especially, the third link to my blog post “Permissible Delegation of Influenza Vaccination Administration in Michigan” in the Michigan subsection of the “State Scope of Practice Laws” webpage. The blog post concludes with my following legal opinion:

Therefore, my legal opinion is that Michigan law permits physicians to delegate the administration of influenza vaccinations to knowledgeable and competent unlicensed individuals such as medical assistants as long as the delegating physician is accessible to the medical assistants by radio, telephone, or telecommunication.

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. 

North Carolina Medical Assistants in Inpatient Settings

I recently received the following question from a manager at a health care system in North Carolina: 

We are looking at ways to assist nurses in the hospital setting due to the nursing shortage. Can medical assistants practice in a hospital setting without a nursing assistant certification? 

Medical assistants are permitted to meet the requirements and register with the state as certified nursing assistants (CNAs) and medication aides. Short of this, medical assistants are considered unlicensed assistive personnel (UAP) when working under nurse supervision in inpatient settings. 

The North Carolina Board of Nursing has issued some detailed and helpful position statements on what nurses are permitted to delegate to UAP. See the following documents for additional details: 

• Chapter 36 – Board of Nursing: Section .0100 – General Provisions 
• Medication Aide Education & Role in Long Term Care/Skilled Nursing Facilities vs Adult Care Settings: Position Statement for RN and LPN Practice 
• Delegation of Medication Administration to UAP: Position Statement for RN and LPN Practice 
• Delegation and Assignment of Nursing Activities: Position Statement for RN and LPN Practice 
• Decision Tree for Delegation to UAP 

The AAMA Achieves Legislative Victories in Maryland and Washington

During the COVID-19 pandemic, medical assistants have risen to the occasion by undertaking expanded duties. As a result, they have been given opportunities to join in combatting the pandemic because of favorable federal and state legislation, executive orders, and official rules and interpretations by federal agencies. These developments have been chronicled on the “State Scope of Practice Laws” webpage of the AAMA website, via this blog, and in CMA Today. 

Notably, two such bills from Maryland and Washington will have precedential weight and influence on future medical assisting laws and create a lasting impact extending well beyond the pandemic. 

To learn more about these momentous bills and related trends in medical assisting, read the July/August 2021 Public Affairs article in CMA Today, “The AAMA Achieves Legislative Victories in Maryland and Washington.”