Wiki Medical Assistants signing off progress notes and listed as providers

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marilesyt@aol.com

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Good Morning,

Please help!!!

Does anyone know where I can get clear verbiage regarding medical assistants not being able to list themselves as providers and sign as the provider on a progress note/ nurse note? Also can Medical assistants administer chemo-therapy and hormonal therapy for prostate cancer.

Any information will be greatly appreciated.
 
I don't even know how to begin to express the level of "HELL NO" that goes with this.

A licensed provider signs medical records, not unlicensed staff. Someone needs a regulation to state this? Check your state's scope of practice laws. Ask your malpractice carrier. Hide from your physician's stated licensing board, because hellfire is surely going to rain down upon the provider that allows the unlicensed practice of medicine, because that's exactly what this is - the unlicensed practice of medicine.
 
I just had a panic attack with the thought of a medical assistant administering chemo. We haven't done chemo in 10+ years, but required the RN to be ONCC certified. Medical assistants are not licensed providers and cannot act as such.
Here's a good reference from the California state medical board about some of the scope of practice. https://www.mbc.ca.gov/Licensees/Ph...ical_Assistants/Medical_Assistants_FAQ.aspx#5
 
SharonCollachi said:
I don't even know how to begin to express the level of "HELL NO" that goes with this.
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Thank you for this, Sharon! I've been struggling for several minutes to find a polite way to say just that.

OP - I suspect you're trying to research this under the table so getting answers from official practice sources may not be an option right now. Check your state medical board website. They should have scope of practice for various office staff as permitted by state law. Are your MAs certified? If so, I would look at companies providing those certifications to see if they have references to point you in the right direction. No one but the person performing the service documented should be signing the corresponding note. No one should sign a progress note in place of or on behalf of a provider. Ever. Compliance 101 as far as I'm concerned.

In regards to administering cancer treatment? No, they should NOT unless your state specifically allows it and I suspect most states do not - again, your state medical board should be able to provide guidance on this topic. We are an oncology practice and do not allow our MAs to do injections, including flu shots. There are risks involved in handling and administering those types of medications, even if they're just doing injections like Lupron.

I found a scope of practice document that may help: https://www.medpro.com/documents/10...r+Medical+Assistants_07-2018_MedPro+Group.pdf

Best of luck to you. This is an ugly situation.
 
marilesyt@aol.com said:
Good Morning,

Please help!!!

Does anyone know where I can get clear verbiage regarding medical assistants not being able to list themselves as providers and sign as the provider on a progress note/ nurse note? Also can Medical assistants administer chemo-therapy and hormonal therapy for prostate cancer.

Any information will be greatly appreciated.
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You should not need clear verbiage for this - it's quite simply fraudulent and falsification of documentation for one individual to represent themselves as someone else with a signature or other credentials. Report this to your compliance officer for the appropriate action - you are not obligated to produce 'clear verbiage' to prove that a practice such as this is not acceptable.
 
thomas7331 said:
You should not need clear verbiage for this - it's quite simply fraudulent and falsification of documentation for one individual to represent themselves as someone else with a signature or other credentials. Report this to your compliance officer for the appropriate action - you are not obligated to produce 'clear verbiage' to prove that a practice such as this is not acceptable.
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True but if you're dealing with someone who is willing to knowingly do these things, they're not usually going to stop just because you say "don't do that!". Having the documentation from verified sources may convince them and if not, it can be added to the paper trail for what hopefully becomes a successful whistleblower report to the OIG. I personally would want documentation in hand before I addressed my concerns with whomever I was escalating to, just to reassure myself that I know what I know.
 
Where has the accountability in the medical profession gone?! Definitely keep a record of documents you know have been handled this way as evidence to provide authorities. Compliance officer is a good way to go.
 
I see this as another failure of electronic medical records. We were told that EMR were going to save us from all of our problems with charts. It's just too easy for a medical provider to give their log in information to staff members and have the staff members document & authenticate the note. As long as the MA or whoever uses the physicians password no one will know it was the MA and not the provider!
 
trarut said:
True but if you're dealing with someone who is willing to knowingly do these things, they're not usually going to stop just because you say "don't do that!". Having the documentation from verified sources may convince them and if not, it can be added to the paper trail for what hopefully becomes a successful whistleblower report to the OIG. I personally would want documentation in hand before I addressed my concerns with whomever I was escalating to, just to reassure myself that I know what I know.
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I hear what your saying, and in many cases where it involves the technicalities of billing and coding, that approach is certain best - it's within the scope of coding to use our knowledge of the guidelines and to be able to show to our employers and providers what we've been trained. But coders are not attorneys and shouldn't be expected to have to evaluate the legality of every situation encountered in the workplace. In fact, one of the very basic purposes of a compliance program is to ensure that employee concerns about potential wrong-doing are able to be voiced and heard without fear of retribution, and it is then the responsibility of the compliance offer to evaluate the situation. The burden of proof does not fall on the employee.

For something as basic as misrepresenting the medical records, it should not be necessary for a concerned individual to seek out specific documentation to prove to the employer that this is wrong. Think of it this way - if you became aware that an employee was misrepresenting their time worked, or was stealing from the employer in some way, is it necessary to go find a copy of the law that says you can't do this before you can report it? Really I think there has to be a limit to this and common sense needs to prevail at times. This is just basic workplace ethics here.
 
thomas7331 said:
I hear what your saying, and in many cases where it involves the technicalities of billing and coding, that approach is certain best - it's within the scope of coding to use our knowledge of the guidelines and to be able to show to our employers and providers what we've been trained. But coders are not attorneys and shouldn't be expected to have to evaluate the legality of every situation encountered in the workplace. In fact, one of the very basic purposes of a compliance program is to ensure that employee concerns about potential wrong-doing are able to be voiced and heard without fear of retribution, and it is then the responsibility of the compliance offer to evaluate the situation. The burden of proof does not fall on the employee.

For something as basic as misrepresenting the medical records, it should not be necessary for a concerned individual to seek out specific documentation to prove to the employer that this is wrong. Think of it this way - if you became aware that an employee was misrepresenting their time worked, or was stealing from the employer in some way, is it necessary to go find a copy of the law that says you can't do this before you can report it? Really I think there has to be a limit to this and common sense needs to prevail at times. This is just basic workplace ethics here.
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I don't disagree with you but we don't know the OPs situation. I've always been required to produce supporting documents when bringing a compliance concern to a supervisor - whether it was my manager or the Compliance officer. If common sense was prevailing, we wouldn't be answering a question about it on a message board lol
 
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