Alabama / Medical assistants work under the direct supervision of physiciansand are allowed to perform those tasks which are directed and supervised by the physician.
STATE / REGULATIONS / EXCEPTIONS
Alaska / Medical assistants work under the direct supervision of physiciansand are allowed to perform those tasks which are directed and supervised by the physician.
The Alaska State Medical Board Regulations, 112 AAC 40.480 state the following:
EXEMPTIONS. (b) Nothing in this chapter regulates, restricts, or alters the 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. /
- Patient care tasks cannot be delegated by a RN.
- Medical assistants cannot do anything supervised by a nurse. A medical doctor must be present in the building at all times.
- Certain intravenous procedures may be delegable to a medical assistant by a physician if: 1) the degree of supervision is greater than for other less advanced procedures; 2) the delegation is confirmed in writing by the physician; 3) the medical assistant has specific documented training in IV procedures;4) the medical assistant is competent in the procedures;and 5) the malpractice insurance carrier does not object.
STATE / REGULATIONS / EXCEPTIONS
Arizona / Medical assistants assist in the medical practice under the supervision of a physician, physician’s assistant, or nurse practitioner, and perform delegated procedures commensurate with the MA’s education and training. / In addition to the medical procedures in subsection (A) of the Commission on Accreditation of Allied Health Education Program's, "Standards and Guidelines for an Accredited Educational Program for the Medical Assistant”, a medical assistant may administer the following under the direct supervision of a physician or physician 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 physiciansand are allowed to perform those tasks which are directed and supervised by the physician.
STATE / REGULATIONS / EXCEPTIONS
California / Medical assistants work under the direct supervision of physiciansand are allowed to perform those tasks which are directed and supervised by the physician. A supervising physician and surgeon at a "community clinic" licensed under Health and Safety Code section 1204(a) may, at his or her discretion, in consultation with the nurse practitioner, nurse midwife, or physician assistant provide written instructions to be followed by a medical assistant in the performance of tasks or supportive services. The written instructions may provide that the supervisory function for the medical assistant in performing these tasks or supportive services may be delegated to the nurse practitioner, nurse midwife, or physician assistant and that those tasks may be performed when the supervising physician and surgeon is not on site.
Medical assistants who draw blood in California are required to be certified. / 1.Medical assistants may not place the needle or start and disconnect the infusion tube of an IV.
2.Medical assistants are not allowed to administer medications or injections into the IV line.
3.Medical assistants are not allowed to inject anesthetic agents.
4.Medical assistants are allowed to perform nasal smears only if the procedure is limited to the opening of the nasal cavity.
5.With regard to having access to the keys of the narcotic medication cabinet, the supervising physician or podiatrist should be questioned about this access.
6.Medical assistants are not allowed to chart pupillary responses.
7.Medical assistants may not insert a urine catheter.
8.Medical assistants cannot independently perform telephone triage.
9.The injection of collagen is not within the medical assistant’s scope of practice.
10.Medical assistants are not legally authorized to use lasers to remove hair, wrinkles, scars, moles, or other blemishes.
11.Medical assistants are not legally authorized to administer chemotherapy or make an assessment of the patient.
12.Medical assistants are not legally authorized to apply orthopedic splints. They can only remove casts, splints, and other external devices.
13.Medical assistants are not allowed to interpret the results of skin tests.
14.Medical assistants may not call in new prescriptions or any prescriptions that have changes.
15.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.
16.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 physiciansand 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 supervision of physiciansand are allowed to perform those tasks which are directed and supervised by the physician. /
- Medical assistants are NOT allowed to perform radiography or medication administration by any route (including oxygen, immunizations, and tuberculin testing).
- 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 physiciansand are allowed to perform those tasks which are directed and supervised by the physician.
STATE / REGULATIONS / EXCEPTIONS
District of Columbia / Medical assistants work under the direct supervision of physiciansand are allowed to perform those tasks which are directed and supervised by the physician.
STATE / REGULATIONS / EXCEPTIONS
Florida / Under the direct supervision and responsibility of a licensed physician, a medical assistant may undertake the following duties:
1.Perform aseptic procedures
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.Assistwith 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 /
- The medical assistant may not use radiation or otherwise practice radiologic technology or any of the duties of a radiologist assistant on a human being unless he or she is the holder of a certificate and is operating under the direct supervision or general supervision of a licensed practitioner in each particular case.
STATE / REGULATIONS / EXCEPTIONS
Georgia / Medical assistants work under the direct supervision of physiciansand are allowed to perform those tasks which are directed and supervised by the physician. / Medical assistants who perform point of care testing in Georgia are required to be certified.
STATE / REGULATIONS / EXCEPTIONS
Hawaii / Medical assistants work under the direct supervision of physiciansand 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 physiciansand 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.
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Illinois / Medical assistants work under the direct supervision of physiciansand are allowed 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) / Medication administration can be delegated only to a registered nurse or a licensed practical nurse.
STATE / REGULATIONS / EXCEPTIONS
Indiana / Medical assistants work under the direct supervision of physiciansand 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 physiciansand 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 physiciansand 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 physiciansand are allowed to perform those tasks which are directed and supervised by the physician
STATE / REGULATIONS / EXCEPTIONS
Louisiana / Medical assistants work under the direct supervision of physiciansand are allowed 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. / Medical assistants must be licensed (licensed phlebotomist) in order to perform blood extraction with a needle.
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 supervision” of a delegating physician who is present at the site and able to be immediately available in person during the performance of a delegated act. / 10.32.12
.04 Scope of Delegation.
A. A physician may not delegate to an assistant technical acts which 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 supervision of physiciansand are allowed 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. / Physicians are not permitted to delegate injections to medical assistants in those clinics that are licensed by the state.
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 supervision of physiciansand are allowed to perform those tasks which are directed and supervised by the physician. Medical assistants are delegated clinical duties by physicians. They are not delegated nursing duties by a registered nurse. / Background study by the state is required. Any individual disqualified from having direct patient contact as a result of the background study will not be able to participate in a clinical placement in a Minnesota licensed healthcare facility.