I recently received the following question:

In Pennsylvania, are [medical assistants] limited in their scope of practice when in [hospital outpatient department]–based ambulatory sites?

There is a question from our regulatory team about whether the [Department of Health] recognizes [medical assistants] despite their not being licensed.

To answer this question, see the regulations of the Pennsylvania Department of Health regarding hospital outpatient departments. Note the following excerpt:

GENERAL PROVISIONS

§ 119.1. Principle.

(a) When outpatient services are provided by the hospital, those services shall be rendered in an effective and timely manner.

(b) When outpatient services are provided indirectly, through contract between the hospital and other organizations or individuals or through alternative, innovative organizational approaches, these services should meet the principles and standards in this chapter.

…

§ 119.5. Staffing.

(a) The outpatient services shall be staffed with sufficient personnel to meet the needs of the patients.

(b) The responsibility for the delivery of outpatient health care services by the professional staff shall be clearly defined and documented. The levels of professional responsibility assigned to practitioners having clinical privileges in any outpatient service shall be defined by the medical staff of the hospital.

(c) House staff assigned to the outpatient services shall be responsible to the medical director of the service or to a member of the medical staff of the hospital.

(d) The responsibilities and organization of nursing services shall be clearly defined and shall be in accordance with the provisions of Chapter 109 of this title (relating to nursing services) modified as required.

(e) Other necessary personnel shall be provided, and their responsibilities clearly defined.

Also see the Pennsylvania law regarding physician delegation to unlicensed “technicians,” which would include medical assistants. Note that Pennsylvania law gives physicians substantial (but not unlimited) latitude in delegating to unlicensed personnel such as medical assistants a reasonable scope of duties as long as the medical assistant is knowledgeable and competent in the tasks and the required degree of supervision is being exercised.

I am not aware of any legal distinction between the scope of practice of unlicensed personnel such as medical assistants in hospital outpatient departments and both clinics and provider offices not affiliated with a hospital.

I am aware that the Pennsylvania Department of Health regulations have different requirements as to which personnel are permitted to administer medication in the inpatient departments of hospitals. My legal opinion is that these inpatient regulations are not applicable to hospital outpatient settings. If they were, in my opinion, the Department of Health would not have issued separate regulations for outpatient personnel.

I recently received the following question:

In Pennsylvania, are [medical assistants] limited in their scope of practice when in [hospital outpatient department]–based ambulatory sites?

There is a question from our regulatory team about whether the [Department of Health] recognizes [medical assistants] despite their not being licensed.

To answer this question, see the regulations of the Pennsylvania Department of Health regarding hospital outpatient departments. Note the following excerpt:

GENERAL PROVISIONS

§ 119.1. Principle.

(a) When outpatient services are provided by the hospital, those services shall be rendered in an effective and timely manner.

(b) When outpatient services are provided indirectly, through contract between the hospital and other organizations or individuals or through alternative, innovative organizational approaches, these services should meet the principles and standards in this chapter.

…

§ 119.5. Staffing.

(a) The outpatient services shall be staffed with sufficient personnel to meet the needs of the patients.

(b) The responsibility for the delivery of outpatient health care services by the professional staff shall be clearly defined and documented. The levels of professional responsibility assigned to practitioners having clinical privileges in any outpatient service shall be defined by the medical staff of the hospital.

(c) House staff assigned to the outpatient services shall be responsible to the medical director of the service or to a member of the medical staff of the hospital.

(d) The responsibilities and organization of nursing services shall be clearly defined and shall be in accordance with the provisions of Chapter 109 of this title (relating to nursing services) modified as required.

(e) Other necessary personnel shall be provided, and their responsibilities clearly defined.

Also see the Pennsylvania law regarding physician delegation to unlicensed “technicians,” which would include medical assistants. Note that Pennsylvania law gives physicians substantial (but not unlimited) latitude in delegating to unlicensed personnel such as medical assistants a reasonable scope of duties as long as the medical assistant is knowledgeable and competent in the tasks and the required degree of supervision is being exercised.

I am not aware of any legal distinction between the scope of practice of unlicensed personnel such as medical assistants in hospital outpatient departments and both clinics and provider offices not affiliated with a hospital.

I am aware that the Pennsylvania Department of Health regulations have different requirements as to which personnel are permitted to administer medication in the inpatient departments of hospitals. My legal opinion is that these inpatient regulations are not applicable to hospital outpatient settings. If they were, in my opinion, the Department of Health would not have issued separate regulations for outpatient personnel.

I recently received the following question:

In Pennsylvania, are [medical assistants] limited in their scope of practice when in [hospital outpatient department]–based ambulatory sites?

There is a question from our regulatory team about whether the [Department of Health] recognizes [medical assistants] despite their not being licensed.

To answer this question, see the regulations of the Pennsylvania Department of Health regarding hospital outpatient departments. Note the following excerpt:

GENERAL PROVISIONS

§ 119.1. Principle.

(a) When outpatient services are provided by the hospital, those services shall be rendered in an effective and timely manner.

(b) When outpatient services are provided indirectly, through contract between the hospital and other organizations or individuals or through alternative, innovative organizational approaches, these services should meet the principles and standards in this chapter.

…

§ 119.5. Staffing.

(a) The outpatient services shall be staffed with sufficient personnel to meet the needs of the patients.

(b) The responsibility for the delivery of outpatient health care services by the professional staff shall be clearly defined and documented. The levels of professional responsibility assigned to practitioners having clinical privileges in any outpatient service shall be defined by the medical staff of the hospital.

(c) House staff assigned to the outpatient services shall be responsible to the medical director of the service or to a member of the medical staff of the hospital.

(d) The responsibilities and organization of nursing services shall be clearly defined and shall be in accordance with the provisions of Chapter 109 of this title (relating to nursing services) modified as required.

(e) Other necessary personnel shall be provided, and their responsibilities clearly defined.

Also see the Pennsylvania law regarding physician delegation to unlicensed “technicians,” which would include medical assistants. Note that Pennsylvania law gives physicians substantial (but not unlimited) latitude in delegating to unlicensed personnel such as medical assistants a reasonable scope of duties as long as the medical assistant is knowledgeable and competent in the tasks and the required degree of supervision is being exercised.

I am not aware of any legal distinction between the scope of practice of unlicensed personnel such as medical assistants in hospital outpatient departments and both clinics and provider offices not affiliated with a hospital.

I am aware that the Pennsylvania Department of Health regulations have different requirements as to which personnel are permitted to administer medication in the inpatient departments of hospitals. My legal opinion is that these inpatient regulations are not applicable to hospital outpatient settings. If they were, in my opinion, the Department of Health would not have issued separate regulations for outpatient personnel.