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STATE
Alabama
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
STATE
Alaska
REGULATIONS
EXCEPTIONS
Medical assistants work
1. Patient care tasks cannot be delegated by
under the direct supervision
a RN.
of physicians and are allowed
2. Medical assistants cannot do anything
to perform those tasks which
supervised by a nurse. A medical doctor
are directed and supervised
must be present in the building at all
by the physician.
times.
3. Certain intravenous procedures may be
The Alaska State Medical
delegable to a medical assistant by a
Board Regulations, 112 AAC
physician if: 1) the degree of supervision
40.480 state the following:
is greater than for other less advanced
EXEMPTIONS. (b)
procedures; 2) the delegation is
Nothing in this chapter
confirmed in writing by the physician; 3)
regulates, restricts, or alters the
the medical assistant has specific
functions of a person
documented training in IV procedures; 4)
traditionally employed in an
the medical assistant is competent in the
office by a physician in a
procedures; and 5) the malpractice
position not regulated by the
insurance carrier does not object.
State Medical Board under
Alaska Statutes 08.64.
STATE
Arizona
REGULATIONS
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.
EXCEPTIONS
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
Arkansas
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
STATE
California
REGULATIONS
EXCEPTIONS
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
Medical assistants work
under the direct supervision
of physicians and 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.
STATE
Colorado
REGULATIONS
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:
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.
EXCEPTIONS
(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
Connecticut
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
1. Medical assistants are NOT allowed to
perform radiography or medication
administration by any route (including
oxygen, immunizations, and tuberculin
testing).
2. 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.
3. Physicians may not delegate injections to
medical assistants.
STATE
Delaware
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
STATE
District of
Columbia
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
STATE
Florida
REGULATIONS
Under the direct supervision
EXCEPTIONS
1. The medical assistant may not use
and responsibility of a
licensed physician, a medical
assistant may undertake the
following duties:
1. Perform aseptic
procedures
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.
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
Georgia
REGULATIONS
Medical assistants work
under the direct supervision
EXCEPTIONS
Medical assistants who perform point of care
testing in Georgia are required to be certified.
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
STATE
Hawaii
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
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
Idaho
REGULATIONS
EXCEPTIONS
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
Illinois
REGULATIONS
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 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
EXCEPTIONS
Medication administration can be delegated only
to a registered nurse or a licensed practical nurse.
the Act)
STATE
Indiana
REGULATIONS
EXCEPTIONS
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
Iowa
REGULATIONS
STATE
REGULATIONS
EXCEPTIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
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
Kentucky
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician
EXCEPTIONS
STATE
Louisiana
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks, which
are directed and supervised
by the physician.
EXCEPTIONS
Medical assistants must be licensed (licensed
phlebotomist) in order to perform blood
extraction with a needle.
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
Maine
REGULATIONS
EXCEPTIONS
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
Maryland
REGULATIONS
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.
EXCEPTIONS
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 onsite 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
Massachusetts Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks, which
are directed and supervised
by the physician.
EXCEPTIONS
Physicians are not permitted to delegate
injections to medical assistants in those clinics
that are licensed by the state.
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
Michigan
REGULATIONS
EXCEPTIONS
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
Minnesota
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and 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.
EXCEPTIONS
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.
STATE
Mississippi
REGULATIONS
EXCEPTIONS
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
Missouri
REGULATIONS
EXCEPTIONS
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
Montana
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
EXCEPTIONS
are directed and supervised
by the physician. Onsite
supervision of medical
assistants is required for
certain procedures.
STATE
Nebraska
REGULATIONS
EXCEPTIONS
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
Nevada
REGULATIONS
The medical assistant must be
employed by the physician or
physician assistant, so
independent contractors or
employees of somebody other
than the physician or
physician may not act as
medical assistant.
EXCEPTIONS
1. Except for the administration of an
immunization or vaccination, the MA
cannot perform or provide any invasive
procedure upon or injection into the body
of the patient unless the physician or
physician assistant:
a. Has previously examined the patient;
b. Has determined that the patient has a
medical condition for which the
The medical assistant must be
physician or physician assistant has
directed and supervised by
determined a course or plan of treatment;
the physician or physician
c. Directs and supervises the service
assistant in assistance to him
performed or provided by the medical
or her, so medical assistants
assistant.
may not act independently of
2. The MA may not administer any
a physician or physician’s
prescription drugs. MAs may not give
assistant.
injections. MAs may not administer an
inhaled drug. MA’s may not apply
The medical assistant may not
prescription ophthalmic or otic drops.
perform any task for which
MAs may not insert prescription
licensure would otherwise be
suppositories. MAs may not start IVs.
required. A medical assistant
MAs may not apply or provide
may not perform any task that
prescription drugs to the body of a
is within the scope of practice
patient by any other means.
of any licensed or registered
3.
profession such as medicine,
nursing, pharmacy,
optometry, dentistry, physical
therapy, a mental health
profession, and any other
similar profession.
4. The MA cannot administer:
a. Chemotherapy
b. Corticosteroids or other injected antiinflammatory drugs unless by
subcutaneous or intramuscular injection
c. Anesthetics that would render the patient
unconscious or semi-conscious
d. Botulinum neurotoxin
e. Collagen and other cosmetic or dermal
fillers
f. 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;
g. 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
New
Hampshire
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
STATE
New Jersey
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
1) To perform an injection, MA must be certified
2) May not inject certain substances, including
any substance related to allergenic testing or
treatment; controlled dangerous 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
New Mexico
REGULATIONS
EXCEPTIONS
Medical assistants work 1. The medical assistant may not dispense
under the direct supervision dangerous drugs.
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
New York
REGULATIONS
Medical assistants may not:
1. Counsel patients regarding care
or treatment or engage in any
activity that could be construed as
the diagnosis or treatment of a
patient.
2. Perform telephone triage.
3. Telephone original
prescriptions of any kind or
5-day emergency
prescription narcotics to a
pharmacy.
4. Apply casts and braces
5. Remove sutures and casts
6. Administering or drawing
up any type of medication
EXCEPTIONS
Unlicensed medical assistants may not
perform invasive acts.
Unlicensed medical assistants may not
diagnose or treat a patient.
A license is required to administer an
intravenous, intramuscular, Intradermal, or
subcutaneous injection.
(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:
1. Take blood
2. Draw blood
3. Put patients into
exam rooms
4. Prepare
instruments for
office procedures
5. Hand instruments
to the physician
during office
procedures
STATE
North
Carolina
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
Unlicensed personnel, such as medical assistants,
who are accountable to and supervised by the
licensed nurse may not be 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
North
Dakota
REGULATIONS
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
Ohio
REGULATIONS
4731-23-02 Delegation
EXCEPTIONS
EXCEPTIONS
of 4731-23-03 Delegation of tasks; Prohibitions
medical tasks.
(B) A physician shall not delegate a task to an
unlicensed person if the task is beyond that
person’s competence. In a hospital, as defined in
section 3727.01 of the Revised Code, or an
ambulatory care center affiliated with the hospital
(if the center meets the same credentialing,
quality assurance, and utilization review
(1) That the task is within that standards as the hospital) wherein unlicensed
persons are employed or otherwise authorized by
physician’s authority;
the governing authority of the institution to
(2) That the task is indicated perform specific medical tasks, one factor the
physician shall take into account is the policies
for the patient;
by which the employer or the governing authority
(3) The appropriate level of of the institution seeks to ensure that competent
persons will be performing the delegated tasks.
supervision;
Prior to a physician’s
delegation of the performance
of a medical task, that
physician shall determine
each of the following:
(4) That no law prohibits the (C) A physician shall not delegate a medical task
that is not within the authority of that physician
delegation;
or is beyond the physician’s training, expertise,
(5) That the person to whom or normal course of practice.
the task will be delegated is
competent to perform that (D) A physician shall not transfer his or her
responsibility for supervising an unlicensed
task; and,
person in the performance of a delegated medical
(6) That the task itself is one task, except to another physician who has
that should be appropriately knowingly accepted that responsibility.
delegated when considering
(E) A physician shall not authorize or permit an
the following factors:
unlicensed person to whom a medical task is
(a) That the task can be delegated to delegate the performance of that task
performed without requiring to another person.
the exercise of judgment
based on medical knowledge; (F) Except as provided in divisions (D)(4) to
(D)(8) of section 4731.053 of the Revised Code,
(b) That results of the task are a physician shall not delegate to an unlicensed
person the administration of anesthesia,
reasonably predictable;
controlled substances, or drugs administered
intravenously.
(c) That the task can safely be
performed according to exact,
(G) The supervising physician retains
unchanging directions;
responsibility for the manner in which the
delegated task is carried out.
(d) That the task can be
performed without a need for
complex observations or
critical decisions;
(e) That the task can be
performed without repeated
medical assessments; and,
(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
Oklahoma
REGULATIONS
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
EXCEPTIONS
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
Oregon
REGULATIONS
EXCEPTIONS
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
Rhode
Island
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
STATE
South
Carolina
REGULATIONS
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.
EXCEPTIONS
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
South
Dakota
REGULATIONS
Medical assistants assist in all
aspects of medical practice
under the responsibility and
direct supervision of a
person licensed to practice
medicine in the State of South
Dakota. A medical assistant
assists with patient care
management, executes
administrative and clinical
procedures, and performs
EXCEPTIONS
1. Registration required. No person may
practice as a medical assistant unless he
or she is registered with the Board of
Medical and Osteopathic Examiners.
Applicants for registration must have
graduated from an accredited school and
meet other qualifications as established
by the Board of Medical and Osteopathic
Examiners and the Board of Nursing.
2. The medical assistant may report
diagnostic lab findings to patients only
managerial and supervisory
functions over unlicensed
personnel.
“Direct supervision” of a
medical assistant means
supervision of all activities
performed by the medical
assistant. Should the
physician be unable to
provide on-site supervision,
supervision by a properly
supervised physician’s
assistant, nurse practitioner,
or nurse midwife shall satisfy
the medical assistant act’s
direct supervision
requirements.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
after appropriate interpretation by the
physician.
The medical assistant may only provide
education information to the patient and
may not perform health teaching or
counseling.
The medical assistant may perform
EKGs and glucose testing.
The medical assistant may not administer
medications which require calculation of
a dose.
The medical assistant may only distribute
pre-printed information to a patient on
medications and inhalers.
The medical assistant may not perform
irrigations for ostomy/stoma care.
The medical assistant may apply ace
bandages and splints to extremities.
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
Tennessee
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
STATE
Texas
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
STATE
Utah
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
STATE
Vermont
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
STATE
Virginia
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
1. Prescriber may authorize the
administration of controlled substances
by personnel who have been properly
trained to assist a doctor of medicine or
osteopathic medicine, provided the
method does not include intravenous,
intrathecal, or epidural administration
and the prescriber remains responsible
for such administration.
Section 54.1-2901.
Exceptions and exemptions
generally.
A. The provisions of this
chapter shall not prevent or
prohibit:
6. Any practitioner licensed
or certified by the Board
The Regulations Governing the Practice of
Medicine, Osteopathy, Podiatry, and
Chiropractic of the Virginia Board of Medicine
state the following:
from delegating to personnel
supervised by him, such
activities or functions as are
nondiscretionary and do not
require the exercise of
professional judgment for
their performance and which
are usually or customarily
delegated to 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
Washington
18VAC85-20-29. Practitioner responsibility.
A. A practitioner shall not:
1. Knowingly allow subordinates to jeopardize
patient safety or provide patient care outside of
the subordinate’s scope of practice or area of
responsibility. Practitioners shall delegate patient
care only to subordinates who are properly
trained and supervised.
REGULATIONS
Medical assistants (also referred to as
Health Care Assistants) must be
supervised by a "delegator". The
delegator may be a physician (MD or
DO), a podiatrist, or an Advanced
Registered Nurse Practitioner (ARNP)
with prescriptive ability. Delegators
must be physically present and
immediately available during the
administration of injections; however,
they need not be present during the
withdrawal of blood.
Individuals who are not licensed must
be certified as a “health care assistant”
in order to legally perform invasive
procedures. The Health Care Assistant
Law in Washington “grants limited
authority, under appropriate
supervision, to administer skin tests
and subcutaneous, intradermal,
intramuscular, and intravenous
injections and to perform minor
invasive procedures to withdraw
blood.”
(http://www.wssma.org/hcalaw.php)
EXCEPTIONS
1. Assistants who perform venous
and capillary invasive
procedures for blood
withdrawal require a high
school education and the ability
to read and write in English; on
the job training and instruction;
and they must practice and
observe under a qualified
trainer and all training must be
documented.
2. Assistants who perform arterial
invasive procedures for blood
withdrawal require a high
school education, with
additional education in
anatomy, physiology, concepts
of asepsis, and microbiology;
the ability to read and write in
English; and they must practice
and observe under a qualified
trainer and all training must be
documented.
3. Assistants who perform
intramuscular, intradermal
(including skin tests),
subcutaneous, and
intramuscular injections for
diagnostic agents must have
nine hundred 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.
4. 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.
5. 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.
6. 7 hours of AIDS education
training required.
7. It is the responsibility of the
delegator to assure that the
health care assistant is
appropriately trained.
STATE
West
Virginia
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
STATE
Wisconsin
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS
Medical assistants must meet guidelines
established by state statutes regarding caregiver
background check information prior to
participating in any clinical placement. Those
individuals who receive a negative report are not
permitted to work with patients in a licensed
health care or medical facility.
STATE
Wyoming
REGULATIONS
Medical assistants work
under the direct supervision
of physicians and are allowed
to perform those tasks which
are directed and supervised
by the physician.
EXCEPTIONS