2/13/2024 0 Comments E scribe presxription![]() Likewise, in most states CMAs can communicate, by telephone or electronically, a physician’s orders for new prescriptions or refills without professional judgments or comments regarding the prescription before transmission. A CMA is able to accept verbal orders from an “overseeing, delegating or supervising physician” as long as such an order doesn’t require the CMA to exercise “independent professional judgment” when carrying out the orders, or to make clinical assessments or evaluations. Professional disciplinary cases are costly, often lengthy and can result in a professional license or certification being suspended or rescinded.īut not all states have the policies in regard to CMAs and their lack of authority to participate in medication refills or orders. The American Association of Medical Examiners states CMAs play a vital role in regard to medication orders or refills, with or without an EMR. These staff members also risk disciplinary action by the state board of nursing and the body who certifies the medical assistant (most often the state board of medical examiners). The RN and CMA also risk being named in such a suit. Additionally, should a patient injury or death occur because of an RN or CMA accepting or rejecting a medication in error, the facility risks a lawsuit alleging the corporate theory of negligence, among other allegations. It also may be violating state and federal laws. When any medical facility allows staff members to practice outside their scope of practice, it legally risks its licensure and risks its reimbursement for these medications by health insurance organizations, including Medicare and Medicaid. It does not matter that the protocol at the facility supports this process, since legally these two groups do not have the authority to be involved in the process. Rather, the issue is the use of RNs and CMAs - who have no prescriptive authority in the NP’s state - in processing refills. The issue here is not with the use of EMRs to refill prescriptions. But after her colleagues understood the issue, they supported her request to process all prescriptions refills she orders. Nor did she initially receive support from her department director. The NP took her concerns to risk management, but they were not addressed, she said. She also points out that neither RNs nor CMAs have prescriptive authority in her state. Moreover, she does not want her name used to refill prescriptions that she has not authorized. The NP personally wants to accept or reject a refill request prior to the prescription being filled. She is concerned about her legal liability.Īt the NP’s facility, when RNs or certified medical assistants order e-prescriptions, they send it to the patient’s healthcare provider for approval or rejection around the same time they send it to the pharmacy. Refills are sent to the pharmacy via the electronic medical records system, which allows prescriptions to be refilled before she issues her approval. A nurse practitioner who reads my blog is concerned about how medication prescriptions are processed at her facility.
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