Medical Assistant Scope of Practice
Overview
Medical Assistants (MAs) are unlicensed assistive personnel in Massachusetts, Maine, New Hampshire, and Vermont. They do not have an independent scope of practice. All MA functions are performed under a delegation model based on provider authorization, organizational policy, and validated competency.
Safe and compliant MA utilization requires clearly defined role boundaries, structured training, and appropriate supervision.
Functions MAs May Perform When Delegated and Competency-Validated
- Obtain vital signs and conduct patient intake
- Room patients and collect medical history (non-assessment)
- Perform basic specimen collection
- Conduct CLIA-waived point-of-care testing
- Administer medications only when permitted and under direct supervision
- Provide non-clinical instruction
- Document tasks (not assessments)
- Perform compliance-related activities (e.g., temperature logs, supply expiration checks)
- Order clinical supplies per organizational policy
Functions MAs May Not Perform
- Conduct clinical assessment or triage
- Interpret diagnostic results or make clinical decisions
- Administer IV medications or perform invasive procedures other than phlebotomy
- Perform duties without required direct or immediate supervision
- Perform tasks reserved for licensed nurses or providers
Training & Competency Requirements
- Have a formal MA onboarding program
- Documented initial competence
- Annual competency reassessment
- Ongoing education and skills maintenance
- Supervision & Delegation Standards
- Providers trained in delegation limits
- Direct supervision for medication administration, until competency is established, cannot delegate assessment, triage, or decision-making duties
- Supervisor availability must meet state-specific requirements
Documentation & Workflow Controls
- EMR configuration prevents MA documentation of assessments
- POC testing logs maintained
- Medication administration logs identify supervising provider
- Routine audits conducted to ensure compliance
State-Specific Highlights
- Massachusetts (MA): Delegation model, direct supervision required for medication administration.
- Maine (ME): Delegation permitted with strong emphasis on competency; meds require direct onsite supervision.
- New Hampshire (NH): MAs recognized under physician delegation; injectable meds restricted.
- Vermont (VT): Broad delegation allowed; supervisors must be “reasonably available”; no nursing-level tasks.
Best Practices
- Written MA scope and delegation policies
- Standardized training and competency validation
- Clear supervision guidelines
- No delegation involving clinical judgment
Sample Medical Assistant Scope of Practice & Delegation Policy
Medical Mutual Insurance Company of Maine's risk management resources are offered only as references for informational purposes. They are not intended to establish practice standards or take the place of medical judgment or legal advice. Medical Mutual recommends you consult with your medical staff leadership and a qualified attorney for any specific application to your practice. No risk management resource provided by Medical Mutual is intended to affect the applicability, scope, or limit of your liability insurance coverage or to otherwise amend or add to the terms and conditions stated expressly in the liability insurance policy issued to the identified policyholder for the applicable policy year.