STATE - Pearson



|STATE |REGULATIONS |EXCEPTIONS |

|Alabama |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Alaska |Medical assistants work under the direct |Patient care tasks cannot be delegated by a RN. |

| |supervision of physicians and are allowed |Medical assistants cannot do anything supervised by a nurse. A |

| |to perform those tasks which are directed |medical doctor must be present in the building at all times. |

| |and supervised by the physician. |Certain intravenous procedures may be delegable to a medical |

| | |assistant by a physician if: 1) the degree of supervision is greater|

| |The Alaska State Medical Board |than for other less advanced procedures; 2) the delegation is |

| |Regulations, 112 AAC 40.480 state the |confirmed in writing by the physician; 3) the medical assistant has |

| |following: |specific documented training in IV procedures; 4) the medical |

| |EXEMPTIONS. (b) Nothing in this chapter |assistant is competent in the procedures; and 5) the malpractice |

| |regulates, restricts, or alters the |insurance carrier does not object. |

| |functions of a person traditionally | |

| |employed in an office by a physician in a | |

| |position not regulated by the State | |

| |Medical Board under Alaska Statutes 08.64.| |

| | | |

| | | |

|STATE |REGULATIONS |EXCEPTIONS |

|Arizona |Medical assistants assist in the medical |In addition to the medical procedures in subsection (A) of the |

| |practice under the supervision of a |Commission on Accreditation of Allied Health Education Program's, |

| |physician, physician’s assistant, or nurse|"Standards and Guidelines for an Accredited Educational Program for |

| |practitioner, and perform delegated |the Medical Assistant”, a medical assistant may administer the |

| |procedures commensurate with the MA’s |following under the direct supervision of a physician or physician |

| |education and training. |assistant: |

| | |1. Whirlpool treatments |

| | |2. Diathermy treatments |

| | |3. Electronic galvation stimulation treatments |

| | |4. Ultrasound therapy |

| | |5. Massage therapy |

| | |6. Traction treatments |

| | |7. Transcutaneous Nerve Stimulation unit treatments |

| | |8. Hot and cold pack treatments |

| | |9. Small volume nebulizer treatments |

| | |10. Taking body fluid specimens |

| | |11. Administering injections |

|STATE |REGULATIONS |EXCEPTIONS |

|Arkansas |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|California |Medical assistants work under the direct |Medical assistants may not place the needle or start and disconnect |

| |supervision of physicians and are allowed |the infusion tube of an IV. |

| |to perform those tasks which are directed |Medical assistants are not allowed to administer medications or |

| |and supervised by the physician. A |injections into the IV line. |

| |supervising physician and surgeon at a |Medical assistants are not allowed to inject anesthetic agents. |

| |"community clinic" licensed under Health |Medical assistants are allowed to perform nasal smears only if the |

| |and Safety Code section 1204(a) may, at |procedure is limited to the opening of the nasal cavity. |

| |his or her discretion, in consultation |With regard to having access to the keys of the narcotic medication |

| |with the nurse practitioner, nurse |cabinet, the supervising physician or podiatrist should be |

| |midwife, or physician assistant provide |questioned about this access. |

| |written instructions to be followed by a |Medical assistants are not allowed to chart pupillary responses. |

| |medical assistant in the performance of |Medical assistants may not insert a urine catheter. |

| |tasks or supportive services. The written |Medical assistants cannot independently perform telephone triage. |

| |instructions may provide that the |The injection of collagen is not within the medical assistant’s |

| |supervisory function for the medical |scope of practice. |

| |assistant in performing these tasks or |Medical assistants are not legally authorized to use lasers to |

| |supportive services may be delegated to |remove hair, wrinkles, scars, moles, or other blemishes. |

| |the nurse practitioner, nurse midwife, or |Medical assistants are not legally authorized to administer |

| |physician assistant and that those tasks |chemotherapy or make an assessment of the patient. |

| |may be performed when the supervising |Medical assistants are not legally authorized to apply orthopedic |

| |physician and surgeon is not on site. |splints. They can only remove casts, splints, and other external |

| |Medical assistants who draw blood in |devices. |

| |California are required to be certified. |Medical assistants are not allowed to interpret the results of skin |

| | |tests. |

| | |Medical assistants may not call in new prescriptions or any |

| | |prescriptions that have changes. |

| | |Medical assistants may administer influenza vaccinations in a clinic|

| | |or physician’s office setting after receiving appropriate training |

| | |and dosage verification; however, if the shot is being provided at a|

| | |local governmental or private, nonprofit agency the vaccine shall be|

| | |administered only by a physician, a registered nurse, or a licensed |

| | |vocational nurse acting within the scope of their professional |

| | |practice acts. |

| | |Medical assistants must be licensed (licensed phlebotomist) in order|

| | |to perform blood extraction with a needle. |

|STATE |REGULATIONS |EXCEPTIONS |

|Colorado |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

| | | |

| |Section 12-36-106(3)(L) of the Colorado | |

| |Medical Practice Act states: | |

| | | |

| |(3) Nothing in this section shall be | |

| |construed to prohibit, or to require a | |

| |license under this article with respect to| |

| |any of the following acts: | |

| | | |

| |(L) The rendering of services under the | |

| |personal and responsible direction and | |

| |supervision of a person licensed under the| |

| |laws of this state to practice medicine, | |

| |but nothing in this exemption shall be | |

| |deemed to extend the scope of any license,| |

| |and this exemption shall not apply to | |

| |persons otherwise qualified to practice | |

| |medicine but not licensed to [do] so in | |

| |this state. | |

| | | |

| | | |

|STATE |REGULATIONS |EXCEPTIONS |

|Connecticut |Medical assistants work under the direct |Medical assistants are NOT allowed to perform radiography or |

| |supervision of physicians and are allowed |medication administration by any route (including oxygen, |

| |to perform those tasks which are directed |immunizations, and tuberculin testing). |

| |and supervised by the physician. |The professional judgment piece of any regulated profession, e.g., |

| | |assessment, diagnosing, planning, and evaluation of clients or their|

| | |care, can never be delegated to a medical assistant. |

| | |Physicians may not delegate injections to medical assistants. |

|STATE |REGULATIONS |EXCEPTIONS |

|Delaware |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|District of |Medical assistants work under the direct | |

|Columbia |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Florida |Under the direct supervision and |The medical assistant may not use radiation or otherwise practice |

| |responsibility of a licensed physician, a |radiologic technology or any of the duties of a radiologist |

| |medical assistant may undertake the |assistant on a human being unless he or she is the holder of a |

| |following duties: |certificate and is operating under the direct supervision or general|

| |1.  Perform aseptic procedures |supervision of a licensed practitioner in each particular case. |

| |2.  Take vital signs | |

| |3.  Prepare patients for the physician's | |

| |care | |

| |4.  Perform venipunctures and | |

| |nonintravenous injections | |

| |5.  Observe and report patients' signs or | |

| |symptoms. | |

| |6. Administer basic first aid | |

| |7.  Assist with patient examinations or | |

| |treatments | |

| |8.  Operate office medical equipment | |

| |9. Collect routine laboratory specimens as| |

| |directed by the physician | |

| |10.  Administer medication as directed by | |

| |the physician | |

| |11.  Perform basic laboratory procedures | |

| |12. Perform office procedures including | |

| |all general administrative duties required| |

| |by the physician | |

| |13. Perform dialysis procedures, including| |

| |home dialysis | |

|STATE |REGULATIONS |EXCEPTIONS |

|Georgia |Medical assistants work under the direct |Medical assistants who perform point of care testing in Georgia are |

| |supervision of physicians and are allowed |required to be certified. |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Hawaii |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

| | | |

| |Section 453-2(H) of the Hawaii Statutes | |

| |exempts from medical licensure | |

| |requirements the rendering of services: by| |

| |any physician, support personnel, or any | |

| |physician's assistant when such services | |

| |are rendered under the direction and | |

| |control of a physician licensed in this | |

| |State......Any physician who employs or | |

| |directs such personnel and physician's | |

| |assistant shall retain full professional | |

| |and personal responsibility for any act | |

| |which constitutes the practice of medicine| |

| |when performed by such personnel or | |

| |physician's assistant. The board of | |

| |medical examiners shall, in conformity | |

| |with chapter 92, promulgate rules and | |

| |regulations regarding standards of medical| |

| |education and training governing physician| |

| |support personnel and physician's | |

| |assistants, such standards to equal but | |

| |not be limited by existing national | |

| |educational and training standards...... | |

|STATE |REGULATIONS |EXCEPTIONS |

|Idaho |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

| | | |

| |Idaho Medical Practice Act 54-1804 states:| |

| |Unlicensed practice—Penalties and remedies| |

| |relating to unlicensed practice. – (1) | |

| |Under the circumstances described and | |

| |subject in each cast to the limitations | |

| |stated, the following persons, though not | |

| |holding a license to practice medicine in | |

| |this state, may engage in activities | |

| |included in the practice of medicine: … | |

| |(g) A person administering a remedy, | |

| |diagnostic procedure or advice as | |

| |specifically directed by a physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Illinois |Medical assistants work under the direct |Medication administration can be delegated only to a registered |

| |supervision of physicians and are allowed |nurse or a licensed practical nurse. |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

| | | |

| |Section 1285.335. Physician Delegation of | |

| |Authority | |

| |… | |

| |(f) Nothing in this Section shall be | |

| |construed to limit the delegation of tasks| |

| |or duties by a physician licensed to | |

| |practice medicine in all its branches to a| |

| |licensed practical nurse, a registered | |

| |professional nurse, or other personnel | |

| |including, but not limited to, certified | |

| |nursing assistants or medical assistants. | |

| |(Section 54.5 of the Act) | |

| | | |

|STATE |REGULATIONS |EXCEPTIONS |

|Indiana |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

| |According to 25-22.5-1-2, Section 2(r) of | |

| |the Indiana statutes, the provisions | |

| |relating to the unlawful or unauthorized | |

| |practice of medicine or osteopathic | |

| |medicine shall not apply: to any employee,| |

| |including a physician’s assistant, of a | |

| |physician or group of physicians who | |

| |performs an act, duty or function which is| |

| |customarily within the specific area of | |

| |practice of the employing physician or | |

| |group of physicians, if the act, duty or | |

| |function is perfumed under the direct | |

| |supervision of the employing physician or | |

| |a physician of the employing group within | |

| |whose area of practice the act, duty or | |

| |function falls..... | |

| | | |

|STATE |REGULATIONS |EXCEPTIONS |

|Iowa |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Kansas |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

| | | |

| |Section 65-2872(g) of the Kansas Healing | |

| |Arts Act states that the practice of the | |

| |healing arts shall not be construed to | |

| |include the following persons: | |

| |(g) Persons whose professional services | |

| |are performed under the supervision or by | |

| |order or referral from a practitioner who | |

| |is licensed under this act | |

|STATE |REGULATIONS |EXCEPTIONS |

|Kentucky |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician | |

|STATE |REGULATIONS |EXCEPTIONS |

|Louisiana |Medical assistants work under the direct |Medical assistants must be licensed (licensed phlebotomist) in order|

| |supervision of physicians and are allowed |to perform blood extraction with a needle. |

| |to perform those tasks, which are directed| |

| |and supervised by the physician. | |

| | | |

| |The Louisiana Physician Assistants | |

| |Practice Act, Section 1360.27(B), reads as| |

| |follows: Nothing herein shall prohibit or | |

| |limit the authority of physicians to | |

| |employ auxiliary personnel not recognized | |

| |under this part. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Maine |Medical assistants work under the “direct | |

| |control and in the personal presence” of | |

| |physicians or surgeons, and are allowed to| |

| |perform those tasks which are directed and| |

| |supervised by the physician or surgeon. | |

| |The delegating/supervising physician is | |

| |present on the premises at the time the | |

| |activities are performed. | |

| | | |

| |Chapter 48, Section 3270-A of the Maine | |

| |statutes contains the following language: | |

| |Further, nothing in this chapter shall be | |

| |construed as prohibiting a physician or | |

| |surgeon from delegating to his employees | |

| |certain activities relating to medical | |

| |care and treatment now being carried out | |

| |by custom and usage when such activities | |

| |are under the direct control of and in the| |

| |personal presence of the physician or | |

| |surgeon. The physician delegating such | |

| |activities......shall be deemed legally | |

| |liable for such activities of such | |

| |persons, and such persons shall in this | |

| |relationship be construed as the | |

| |physician's agent. | |

| | | |

|STATE |REGULATIONS |EXCEPTIONS |

|Maryland |Medical assistants work under the “on-site|10.32.12 |

| |supervision” of a delegating physician who|.04 Scope of Delegation. |

| |is present at the site and able to be | |

| |immediately available in person during the|A. A physician may not delegate to an assistant technical acts which|

| |performance of a delegated act. |are exclusively limited to any individual required to be licensed, |

| | |certified, registered, or otherwise recognized pursuant to any |

| | |provision of the Health Occupations Article and the Education |

| | |Article, Annotated Code of Maryland. |

| | | |

| | |B. A physician may delegate technical acts consistent with national |

| | |standards in the medical community and the approved policies and |

| | |procedures of the sites for the delivery of health services in the |

| | |following categories: |

| | | |

| | |(1) Surgical technical acts that the delegating physician directly |

| | |orders while present, scrubbed, and personally performing the |

| | |surgery in the same surgical field; and |

| | | |

| | |(2) Nonsurgical technical acts while the assistant is under the |

| | |physician’s direct supervision or on-site supervision if the |

| | |assistant performs the act in accordance with procedures of the |

| | |site. |

| | | |

| | |C. At sites included in Health-General Article, Sections 19-114 and |

| | |19-3B-01(b), Annotated Code of Maryland, or any unit of those sites,|

| | |a physician may delegate technical acts in compliance with State |

| | |regulations and the policies, procedures, and supervisory structures|

| | |of those sites. |

| | | |

| | |D. At sites not included in Health-General Article, Sections 19-114 |

| | |and 19-3B-01(b), Annotated Code of Maryland, when providing the |

| | |following specified levels of supervision, a physician may delegate |

| | |to an assistant technical acts which include but are not limited to:|

| | | |

| | |(1) Without on-site supervision: |

| | | |

| | |(a) Patient preparation for physician examination; |

| | | |

| | |(b) Patient history interview; |

| | | |

| | |(c) Collecting and processing specimens, such as performing |

| | |phlebotomy and inoculating culture media; |

| | | |

| | |(d) Preparation of specimens for selected tests including: |

| | | |

| | |(i) Pregnancy tests, |

| | | |

| | |(ii) Dipstick and microscopic urinalysis, and |

| | | |

| | |(iii) Microbiology (rapid streptococcal testing and throat |

| | |cultures); |

| | | |

| | |(e) Laboratory tests that the physician is satisfied the assistant |

| | |is qualified to perform under State and CLIA regulations; |

| | | |

| | |(f) Clinical tests such as: |

| | | |

| | |(i) Application of tuberculin skin tests, |

| | | |

| | |(ii) Electrocardiography, |

| | | |

| | |(iii) Administering basic pulmonary function |

| | |  |

| | |(g) Transmitting prescriptions to a pharmacy; |

| | | |

| | |(h) Providing sample packets of medication, selected by a physician |

| | |who is physically present at the time of selection, to patients as |

| | |directed by the delegating physician and in conformance with Health |

| | |Occupations Article, Section 12-102(a), (d), and (f), Annotated Code|

| | |of Maryland; and |

| | | |

| | |(i) Preparing and administering oral drugs; |

| | |tests, and |

| | |  |

| | |(ii) Electrocardiography, |

| | |  |

| | |(iii) Administering basic pulmonary functioning tests, and |

| | |  |

| | |(iv) Visual field tests; |

| | |  |

| | |(2) With on-site supervision: |

| | | |

| | |(a) Preparing and administering injections limited to intradermal, |

| | |subcutaneous, and intramuscular (deltoid, gluteal, vastus lateralis)|

| | |to include small amounts of local anesthetics; |

| | | |

| | |(b) Establishing a peripheral intravenous line; and |

| | | |

| | |(c) Injecting fluorescein-like dyes for retinal angiography. |

| | | |

| | |(3) With direct supervision, injecting intravenous drugs or contrast|

| | |materials. |

| | | |

| | |E. A physician may not delegate to an assistant acts which include |

| | |but are not limited to: |

| | | |

| | |(1) Conducting physical examinations; |

| | | |

| | |(2) Administering any form of anesthetic agent or agent of conscious|

| | |sedation other than topical anesthetics or small amounts of local |

| | |anesthetics; |

| | | |

| | |(3) Initiating independently any form of treatment, exclusive of |

| | |cardiopulmonary resuscitation; |

| | | |

| | |(4) Dispensing medications; |

| | | |

| | |(5) Giving medical advice without the consult of a physician; and |

| | | |

| | |(6) Providing physical therapy. |

| | | |

| | | |

|STATE |REGULATIONS |EXCEPTIONS |

|Massachusetts |Medical assistants work under the direct |Physicians are not permitted to delegate injections to medical |

| |supervision of physicians and are allowed|assistants in those clinics that are licensed by the state. |

| |to perform those tasks, which are | |

| |directed and supervised by the physician.| |

| | | |

| | | |

| | | |

| |Chapter 243 of the Code of Massachusetts | |

| |Regulations, Section 2.07(4) states: A | |

| |full licensee may permit a skilled | |

| |professional or nonprofessional assistant| |

| |to perform services in a manner | |

| |consistent with accepted medical | |

| |standards and appropriate to the | |

| |assistant’s skill. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Michigan |333.16215 of the Michigan Public Health | |

| |Code: | |

| |(1) A licensee who holds a license other | |

| |than a health profession subfield license | |

| |may delegate to a licensed or unlicensed | |

| |individual who is otherwise qualified by | |

| |education, training, or experience the | |

| |performance of selected acts, tasks, or | |

| |functions where the acts, tasks, or | |

| |functions fall within the scope of | |

| |practice of the licensee's profession and | |

| |will be performed under the licensee's | |

| |supervision. An act, task, or function | |

| |shall not be delegated under this section | |

| |which, under standards of acceptable and | |

| |prevailing practice, requires the level of| |

| |education, skill, and judgment required of| |

| |a licensee under this article. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Minnesota |Medical assistants work under the direct |Background study by the state is required. Any individual |

| |supervision of physicians and are allowed |disqualified from having direct patient contact as a result of the |

| |to perform those tasks which are directed |background study will not be able to participate in a clinical |

| |and supervised by the physician. Medical |placement in a Minnesota licensed healthcare facility. |

| |assistants are delegated clinical duties | |

| |by physicians. They are not delegated | |

| |nursing duties by a registered nurse. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Mississippi |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Missouri |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Montana |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. Onsite | |

| |supervision of medical assistants is | |

| |required for certain procedures. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Nebraska |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

| | | |

| |According to Nebraska Revised Statute | |

| |38-2218 (3), the Nurse Practice Act does | |

| |not prohibit: (3) Auxiliary patient care | |

| |services provided by persons carrying out | |

| |duties under the direction of a licensed | |

| |practitioner. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Nevada |The medical assistant must be employed by |Except for the administration of an immunization or vaccination, the|

| |the physician or physician assistant, so |MA cannot perform or provide any invasive procedure upon or |

| |independent contractors or employees of |injection into the body of the patient unless the physician or |

| |somebody other than the physician or |physician assistant: |

| |physician may not act as medical |Has previously examined the patient; |

| |assistant. |Has determined that the patient has a medical condition for which |

| | |the physician or physician assistant has determined a course or plan|

| |The medical assistant must be directed and|of treatment; |

| |supervised by the physician or physician |Directs and supervises the service performed or provided by the |

| |assistant in assistance to him or her, so |medical assistant. |

| |medical assistants may not act |The MA may not administer any prescription drugs. MAs may not give |

| |independently of a physician or |injections. MAs may not administer an inhaled drug. MA’s may not |

| |physician’s assistant. |apply prescription ophthalmic or otic drops. MAs may not insert |

| | |prescription suppositories. MAs may not start IVs. MAs may not apply|

| |The medical assistant may not perform any |or provide prescription drugs to the body of a patient by any other |

| |task for which licensure would otherwise |means. |

| |be required. A medical assistant may not | |

| |perform any task that is within the scope |The MA cannot administer: |

| |of practice of any licensed or registered |Chemotherapy |

| |profession such as medicine, nursing, |Corticosteroids or other injected anti-inflammatory drugs unless by |

| |pharmacy, optometry, dentistry, physical |subcutaneous or intramuscular injection |

| |therapy, a mental health profession, and |Anesthetics that would render the patient unconscious or |

| |any other similar profession. |semi-conscious |

| | |Botulinum neurotoxin |

| | |Collagen and other cosmetic or dermal fillers |

| | |Drugs intended to interfere with or block neural function except for|

| | |topical or local anesthetics used to temporarily relieve pain or |

| | |facilitate another medical procedure; |

| | |Any other drug where the therapeutic outcome is dependent upon the |

| | |placement, quantity, or technique uniquely within the discretion, |

| | |training, and judgment of a physician or physician assistant. |

|STATE |REGULATIONS |EXCEPTIONS |

|New Hampshire |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

| | | |

|STATE |REGULATIONS |EXCEPTIONS |

|New Jersey |Medical assistants work under the direct |1) To perform an injection, MA must be certified |

| |supervision of physicians and are allowed |2) May not inject certain substances, including any substance |

| |to perform those tasks which are directed |related to allergenic testing or treatment; controlled dangerous |

| |and supervised by the physician. |substances; local anesthetics; experimental drugs including any drug|

| | |not having approval of the Food and Drug Administration (FDA); or |

| | |any drug used as an antineoplastic chemotherapeutic agent other than|

| | |corticosteroids. |

| | |3) To qualify as a “certified medical assistant” an individual must |

| | |be a graduate of a post-secondary medical assisting program |

| | |accredited by CAHEA (The Committee on Allied Health Education and |

| | |Accreditation of the American Medical Association), or its |

| | |successor, ABHES (Accrediting Bureau of Health Education Schools), |

| | |or its successor, or any accrediting agency recognized by the U.S. |

| | |Department of Education. The MA must also maintain current |

| | |certification from the Certifying Board of the American Association |

| | |of Medical Assistants (AAMA), the National Center for Competency |

| | |Testing (NCCT) or registration from the American Medical |

| | |Technologists (AMT) or any other recognized certifying body approved|

| | |by the Board. |

|STATE |REGULATIONS |EXCEPTIONS |

|New Mexico |Medical assistants work under the direct |1. The medical assistant may not dispense dangerous drugs. |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician | |

| | | |

| |Section 61-6-16(6)(3) of the New Mexico | |

| |statutes indicates that: this subsection | |

| |shall not limit or prevent any physician | |

| |from delegating to a qualified person any | |

| |acts, tasks or functions which are | |

| |otherwise permitted by law or established | |

| |by custom, except the dispensing of | |

| |dangerous drugs. | |

| | | |

|STATE |REGULATIONS |EXCEPTIONS |

|New York |Medical assistants may not: |Unlicensed medical assistants may not perform invasive acts. |

| | | |

| |1. Counsel patients regarding care or |Unlicensed medical assistants may not diagnose or treat a patient. |

| |treatment or engage in any activity that | |

| |could be construed as the diagnosis or |A license is required to administer an intravenous, intramuscular, |

| |treatment of a patient. |Intradermal, or subcutaneous injection. |

| |Perform telephone triage. | |

| |Telephone original prescriptions of any | |

| |kind or 5-day emergency prescription | |

| |narcotics to a pharmacy. | |

| |Apply casts and braces | |

| |Remove sutures and casts | |

| |Administering or drawing up any type of | |

| |medication (such as immunization) | |

| | | |

| |Medical assistants may do the following | |

| |ONLY if educated and trained to perform | |

| |the procedure and the education and | |

| |training is documented in the employee’s | |

| |personnel file: | |

| |Take blood | |

| |Draw blood | |

| |Put patients into exam rooms | |

| |Prepare instruments for office procedures | |

| |Hand instruments to the physician during | |

| |office procedures | |

|STATE |REGULATIONS |EXCEPTIONS |

|North Carolina |Medical assistants work under the direct | |

| |supervision of physicians and are allowed |Unlicensed personnel, such as medical assistants, who are |

| |to perform those tasks which are directed |accountable to and supervised by the licensed nurse may not be |

| |and supervised by the physician. |delegated any tasks with unpredictable outcomes or which require the|

| | |judgment of a licensed nurse. |

| | | |

| | |The licensed nurse may not delegate activities, such as medication |

| | |administration or teaching and counseling of clients, to unlicensed |

| | |personnel such as medical assistants. |

| | | |

| | |If the physician has total responsibility/ accountability for the |

| | |role of the medical office assistant, the nursing laws and standards|

| | |do not apply to this physician-assistant relationship. |

| | | |

|STATE |REGULATIONS |EXCEPTIONS |

|North Dakota |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Ohio |4731-23-02 Delegation of medical tasks. |4731-23-03 Delegation of tasks; Prohibitions |

| |Prior to a physician’s delegation of the |(B) A physician shall not delegate a task to an unlicensed person if|

| |performance of a medical task, that |the task is beyond that person’s competence. In a hospital, as |

| |physician shall determine each of the |defined in section 3727.01 of the Revised Code, or an ambulatory |

| |following: |care center affiliated with the hospital (if the center meets the |

| |(1) That the task is within that |same credentialing, quality assurance, and utilization review |

| |physician’s authority; |standards as the hospital) wherein unlicensed persons are employed |

| |(2) That the task is indicated for the |or otherwise authorized by the governing authority of the |

| |patient; |institution to perform specific medical tasks, one factor the |

| |(3) The appropriate level of supervision; |physician shall take into account is the policies by which the |

| |(4) That no law prohibits the delegation; |employer or the governing authority of the institution seeks to |

| |(5) That the person to whom the task will |ensure that competent persons will be performing the delegated |

| |be delegated is competent to perform that |tasks. |

| |task; and, |(C) A physician shall not delegate a medical task that is not within|

| |(6) That the task itself is one that |the authority of that physician or is beyond the physician’s |

| |should be appropriately delegated when |training, expertise, or normal course of practice. |

| |considering the following factors: |(D) A physician shall not transfer his or her responsibility for |

| |(a) That the task can be performed without|supervising an unlicensed person in the performance of a delegated |

| |requiring the exercise of judgment based |medical task, except to another physician who has knowingly accepted|

| |on medical knowledge; |that responsibility. |

| |(b) That results of the task are |(E) A physician shall not authorize or permit an unlicensed person |

| |reasonably predictable; |to whom a medical task is delegated to delegate the performance of |

| |(c) That the task can safely be performed |that task to another person. |

| |according to exact, unchanging directions;|(F) Except as provided in divisions (D)(4) to (D)(8) of section |

| |(d) That the task can be performed without|4731.053 of the Revised Code, a physician shall not delegate to an |

| |a need for complex observations or |unlicensed person the administration of anesthesia, controlled |

| |critical decisions; |substances, or drugs administered intravenously. |

| |(e) That the task can be performed without|(G) The supervising physician retains responsibility for the manner |

| |repeated medical assessments; and, |in which the delegated task is carried out. |

| |(f) That the task, if performed | |

| |improperly, would not present life | |

| |threatening consequences or the danger of | |

| |immediate and serious harm to the patient.| |

| |(C) When a physician delegates the | |

| |administration of drugs, that physician | |

| |shall provide on-site supervision, except | |

| |in the following situations: | |

| |(1) When the physician has transferred | |

| |responsibility for the on-site supervision| |

| |of the unlicensed person who is | |

| |administering the drug to another | |

| |physician and that physician has knowingly| |

| |accepted that responsibility on a | |

| |patient-by-patient basis; or | |

| |(2) In the routine administration of a | |

| |topical drug, such as a medicated shampoo.| |

|STATE |REGULATIONS |EXCEPTIONS |

|Oklahoma |Medical assistants work under the direct | |

| |supervision and control of a licensed | |

| |physician and are allowed to perform those| |

| |tasks which are directed and supervised by| |

| |the physician. | |

| |The Oklahoma Allopathic Medical and | |

| |Surgical Licensure and Supervision Act, | |

| |Title 59, Section 492, E, states: Nothing | |

| |in the Oklahoma Allopathic Medical and | |

| |Surgical Licensure and Supervision Act | |

| |shall prohibit service rendered by a | |

| |physician's trained assistant, if such | |

| |service is rendered under the supervision | |

| |and control of a licensed physician, or | |

| |the service of any other person duly | |

| |licensed or certified by the state to | |

| |practice the healing arts. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Oregon |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Pennsylvania |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Rhode Island |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|South Carolina |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. The | |

| |physician must be onsite and readily | |

| |available to the medical assistant if | |

| |needed. | |

| | | |

| |Section 40-47-30(5) of the Medical | |

| |Practice Laws of South Carolina states: | |

| |A licensed physician is not prohibited | |

| |from delegating tasks to unlicensed | |

| |personnel in his employ and on his | |

| |premises if: (a) the task is delegated | |

| |directly to unlicensed personnel by the | |

| |physician and not through another licensed| |

| |practitioner; (b) the task is of a routine| |

| |nature involving neither the special skill| |

| |of a licensed person nor significant risk | |

| |to the patient if improperly done; (c) the| |

| |task is performed while the physician is | |

| |present on the premises and in such close | |

| |proximity as to be readily available to | |

| |the unlicensed person if needed; (d) the | |

| |task does not involve the verbal | |

| |transmission of a physician's order or | |

| |prescription to a licensed person if the | |

| |licensed person requires the order or | |

| |prescription to be in writing; and (e) the| |

| |unlicensed person wears an appropriate | |

| |badge denoting to any patient his status. | |

| |The unlicensed person shall wear a clearly| |

| |legible identification badge or other | |

| |adornment at least one inch by three | |

| |inches in size bearing the person’s first | |

| |name at a minimum and staff position. The| |

| |identification badge must be worn in a | |

| |manner so that it is clearly visible to | |

| |patients at all times. | |

|STATE |REGULATIONS |EXCEPTIONS |

|South Dakota |Medical assistants assist in all aspects |Registration required. No person may practice as a medical assistant|

| |of medical practice under the |unless he or she is registered with the Board of Medical and |

| |responsibility and direct supervision of a|Osteopathic Examiners. Applicants for registration must have |

| |person licensed to practice medicine in |graduated from an accredited school and meet other qualifications as|

| |the State of South Dakota. A medical |established by the Board of Medical and Osteopathic Examiners and |

| |assistant assists with patient care |the Board of Nursing. |

| |management, executes administrative and |The medical assistant may report diagnostic lab findings to patients|

| |clinical procedures, and performs |only after appropriate interpretation by the physician. |

| |managerial and supervisory functions over |The medical assistant may only provide education information to the |

| |unlicensed personnel. |patient and may not perform health teaching or counseling. |

| |“Direct supervision” of a medical |The medical assistant may perform EKGs and glucose testing. |

| |assistant means supervision of all |The medical assistant may not administer medications which require |

| |activities performed by the medical |calculation of a dose. |

| |assistant.  Should the physician be unable|The medical assistant may only distribute pre-printed information to|

| |to provide on-site supervision, |a patient on medications and inhalers. |

| |supervision by a properly supervised |The medical assistant may not perform irrigations for ostomy/stoma |

| |physician’s assistant, nurse practitioner,|care. |

| |or nurse midwife shall satisfy the medical|The medical assistant may apply ace bandages and splints to |

| |assistant act’s direct supervision |extremities. |

| |requirements. |The medical assistant may only perform suprapubic catheterizations |

| | |involving an established fistula. |

| | |The Medical Assistant Scope of Practice does not include injection |

| | |of insulin, arterial withdrawal of blood (but does include venous |

| | |withdrawal of blood), administration of medications by unit dose |

| | |(which means medication prepared in the exact amount, in an |

| | |individual packet, for a specific patient). |

| | |Skin testing performed by intradermal and by the scratch technique |

| | |are appropriate for a medical assistant. |

| | |Medical assistants are permitted to administer medications from |

| | |either a single or multi dose vial as along as the supervising |

| | |physician assures appropriate training, competence, and assumes |

| | |ultimate responsibility for administration of such drugs. |

| | |Medical assistants are permitted to telephone prescriptions to a |

| | |pharmacy pursuant to their supervising physician’s written or verbal|

| | |order. |

| | |Certified medical assistants are permitted to administer medications|

| | |by inhalation route as long as the supervising physician assures |

| | |appropriate training, competence, and assumes ultimate |

| | |responsibility for administration of such drugs. |

|STATE |REGULATIONS |EXCEPTIONS |

|Tennessee |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Texas | Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Utah |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Vermont |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Virginia |Medical assistants work under the direct |Prescriber may authorize the administration of controlled substances|

| |supervision of physicians and are allowed |by personnel who have been properly trained to assist a doctor of |

| |to perform those tasks which are directed |medicine or osteopathic medicine, provided the method does not |

| |and supervised by the physician. |include intravenous, intrathecal, or epidural administration and the|

| |Section 54.1-2901.  Exceptions and |prescriber remains responsible for such administration. |

| |exemptions generally. | |

| |A. The provisions of this chapter shall |The Regulations Governing the Practice of Medicine, Osteopathy, |

| |not prevent or prohibit: |Podiatry, and Chiropractic of the Virginia Board of Medicine state |

| |6. Any practitioner licensed or certified |the following: |

| |by the Board from delegating to personnel|18VAC85-20-29.  Practitioner responsibility. |

| |supervised by him, such activities or |A. A practitioner shall not: |

| |functions as are nondiscretionary and do |1. Knowingly allow subordinates to jeopardize patient safety or |

| |not require the exercise of professional |provide patient care outside of the subordinate’s scope of practice |

| |judgment for their performance and which |or area of responsibility.  Practitioners shall delegate patient |

| |are usually or customarily delegated to |care only to subordinates who are properly trained and supervised. |

| |such persons by practitioners of the | |

| |healing arts, if such activities or | |

| |functions are authorized by and performed | |

| |for such practitioners of the healing arts| |

| |and responsibility for such activities or | |

| |functions is assumed by such practitioners| |

| |of the healing. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Washington |Medical assistants (also referred to as Health Care |Assistants who perform venous and capillary invasive |

| |Assistants) must be supervised by a "delegator". The |procedures for blood withdrawal require a high school |

| |delegator may be a physician (MD or DO), a podiatrist, |education and the ability to read and write in English;|

| |or an Advanced Registered Nurse Practitioner (ARNP) |on the job training and instruction; and they must |

| |with prescriptive ability. Delegators must be |practice and observe under a qualified trainer and all |

| |physically present and immediately available during the|training must be documented. |

| |administration of injections; however, they need not be|Assistants who perform arterial invasive procedures for|

| |present during the withdrawal of blood. |blood withdrawal require a high school education, with |

| | |additional education in anatomy, physiology, concepts |

| |Individuals who are not licensed must be certified as a|of asepsis, and microbiology; the ability to read and |

| |“health care assistant” in order to legally perform |write in English; and they must practice and observe |

| |invasive procedures. The Health Care Assistant Law in |under a qualified trainer and all training must be |

| |Washington “grants limited authority, under appropriate|documented. |

| |supervision, to administer skin tests and subcutaneous,|Assistants who perform intramuscular, intradermal |

| |intradermal, intramuscular, and intravenous injections |(including skin tests), subcutaneous, and intramuscular|

| |and to perform minor invasive procedures to withdraw |injections for diagnostic agents must have nine hundred|

| |blood.” () |hours of formal education at the post secondary level |

| | |to include anatomy, physiology, basic pharmacology, |

| | |concepts of asepsis, and microbiology; and they must |

| | |possess the ability to read and write in English and a |

| | |basic knowledge of mathematics. Specified practical |

| | |training is also required. They must have formal |

| | |training and instruction in ethics, patient |

| | |confidentiality, procedures of injections and |

| | |medications, terminology, medical practices and safety.|

| | |Specified practical training is required. |

| | |Assistants who perform intravenous injections for |

| | |therapeutic agents must have two academic years of |

| | |formal education at the post secondary level to include|

| | |anatomy, physiology, pharmacological principles and |

| | |medication administration, chemistry, mathematics, |

| | |concepts of asepsis, and microbiology. They must |

| | |possess the ability to read and write in English and a |

| | |basic knowledge of mathematics. They must have formal |

| | |training and instruction in ethics, patient |

| | |confidentiality, procedures of injections and |

| | |medications, terminology, medical practices and safety.|

| | |Specified practical training is required. |

| | |Assistants who perform hemodialysis must have a high |

| | |school education or equivalent, the ability to read, |

| | |write, and converse in English, and understand basic |

| | |math including the use of fractions and decimal points.|

| | |Formal training and instruction required. Training must|

| | |be provided by a licensed health care practitioner and |

| | |must be a minimum of six weeks in didactic and |

| | |supervised clinical instruction. Simulated practice and|

| | |practical training required. |

| | |7 hours of AIDS education training required. |

| | |It is the responsibility of the delegator to assure |

| | |that the health care assistant is appropriately |

| | |trained. |

|STATE |REGULATIONS |EXCEPTIONS |

|West Virginia |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

|STATE |REGULATIONS |EXCEPTIONS |

|Wisconsin |Medical assistants work under the direct |Medical assistants must meet guidelines established by state |

| |supervision of physicians and are allowed |statutes regarding caregiver background check information prior to |

| |to perform those tasks which are directed |participating in any clinical placement. Those individuals who |

| |and supervised by the physician. |receive a negative report are not permitted to work with patients in|

| | |a licensed health care or medical facility. |

|STATE |REGULATIONS |EXCEPTIONS |

|Wyoming |Medical assistants work under the direct | |

| |supervision of physicians and are allowed | |

| |to perform those tasks which are directed | |

| |and supervised by the physician. | |

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