About PAs >Legislative and Regulatory Information
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Legislative and Regulatory Information
Certification, Credentialing, and Licensing: the basics
Certification: a voluntary process, usually administered on a national scale, whereby an individual meets specific educational and knowledge/skill-based criteria to demonstrate his or her qualifications. Employers might choose to require a certification before hiring someone, as a means of ensuring that their employees meet a defined standard when it comes to qualifications. This is not mandatory and nothing says an employer in our field has to hire only certified people. (There are other jobs in a hospital, such as nursing, where states have already mandated that people performing such work must be certified and/or licensed, but our field is not one of those.) Pathologists’ Assistants may become certified through the American Society for Clinical Pathology’s Board of Certification. Pathologists’ Assistants who are certified by the ASCP may use the initials PA(ASCP) after their name. More information about ASCP certification may be obtained by visiting
Additional contact information for information regarding certification:
ASCP Board of Certification
33 W. Monroe St., Suite 1600
Chicago, IL 60603
Phone: 1.800.267.2727, option 2, 2
Fax: 312.541.4845
Fax: 312.541.4845
Credentialing: an in-house verification process performed by an institution (hospital) to establish the qualifications of professionals and assess their backgroun and legitimacy. JCAHO says "practitioners" have to be credentialed. Because our profession has not until recently been nationally recognized or well defined, different hospitals do not agree on whether or not a Pathologists’ Assistant working in their facility must be credentialed. So the requirement for credentialing will vary within a state or even city, depending on whether or not the particular hospital in question requires credentialing for Pathologists’ Assistants. For more information contact your institution’s Medical Staffing office.
Licensing: the granting of permission by a competent authority (in this case, any state which mandates licensure) to an individual to perform medical acts and procedures whithin that state not permitted by persons without such a license. The criteria for getting a state license, when one is required, do not necessarily match those required to obtain certification.
State and Federal laws and regulations governing Pathologists’ Assistants
Nevada: Nevada is currently the only state which requires a license to practice as a Pathologists’ Assistant. The license does NOT require that you be an ASCP Certified Pathologists’ Assistant. They allow experience-based applications as well. If the applicant is not Certified, then they must possess a baccalaureate degree with a major or minor in a biological science or an allied health field; and have at least 3 years of combined experience in surgical pathology and autopsy pathology.
An application form and information on how to apply for a Nevada license can be found at:
http://health.nv.gov/HCQC_Forms.htm#2 under “Clinical Laboratory Personnel Certification Guidelines” and “Clinical Laboratory Personnel Certification Application”
The entire text of the Nevada code (law) may be found at:
http://leg.state.nv.us/NAC/NAC-652.html#NAC652Sec470 specifically under subsection 652.452
California: California does NOT currently require a license or Certification to practice. California did, however, pass a law which says that if you are not Certified and are doing Anatomic Pathology work which involves the dissection of tissue specimens in California, then a Pathologist must be physically present on-site, in the facility, available for immediate consultation during the entire time the work is being performed. If the person performing the work is Certified then a Pathologist does not need to be present when the work is being performed. These California stipulations apply to specimens which have to be “dissected”. There is an exception for specimens that are so small that they do not require dissection, but can just be described and totally embedded without cutting. In that case, a non-certified person may process those specimens with indirect supervision by a Pathologist. Here is the wording: "For tissue processing that does not involve dissection, a qualified pathologist may be available by telephone or other electronic means." People doing any kind of grossing in California must still of course be qualified to perform high complexity testing per CLIA regulations (which are also cited in the California rule); see “Federal” below.
Federal: Anatomic Pathology was long ago classified by the federal government as "high complexity" testing. CLIA does require certain minimum qualifications for persons performing high complexity testing. It's pretty basic: an associate degree in a related field or the equivalent, etc. Anyone doing Anatomic Pathology in the United States DOES have to meet CLIA requirements for a person doing high complexity testing, but does not have to be Certified. The full text of the CLIA requirements for personnel performing high complexity testing can be found at:
Scroll down (quite a ways) to 493.1489 for these qualifications.
Additional clarification of the federal requirement was issued in a later interpretive guideline by the Centers for Medicare and Medicaid Services which can be found at
http://www.cms.hhs.gov/CLIA/downloads/apcsubm.pdf under D6171 subpart 493.1489(b)(7)
The federal government authorizes private organizations to inspect and accredit laboratories to ensure that the laboratories meet all relevant legal standards and requirements. One such prominent organization is the College of American Pathologists (CAP). The College of American Pathologists issued an announcement in May of 2010 revising their accreditation standards for personnel who perform macroscopic or gross examinations of tissues, in order to clarify the legal requirements. The full text of the CAP announcement and a discussion of what it means to Pathologists’ Assistants can be found in the AAPA e-News Today dated April 7, 2010.
States requiring licensing of other clinical laboratory personnel, and how their regulations may affect Pathologists’ Assistants
A number of states have laws requiring the licensing of other clinical laboratory personnel such as Medical Laboratory Scientists (Medical Technologists/Clinical Laboratory Scientists), Medical Laboratory Technicians (Medical Technicians/Clinical Laboratory Technicians), Histotechnologists, Cytotechnologists, etc. Most of these laws were written and passed years, even decades ago, when Pathologists’ Assistants were not widely recognized as separate practitioners in the laboratory. Many of these state laws contain a generic clause stating something to the effect that their personnel standards and licensing requirements apply to anyone performing any examination, measurement, evaluation, or testing of any material derived from the human body for the purposes of the diagnosis, prognosis, prevention or treatment of disease. This broad catch-all definition technically would include the activities of Pathologists’ Assistants. But since Pathologists’ Assistants have become widely recognized only recently, many of these older state laws do not provide a licensing category for Pathologists’ Assistants, nor do these laws recognize the existence of Pathologists’ Assistants as laboratory practitioners. Occasionally this draws the attention of a local inspector or other persons, and questions arise regarding the legality of Pathologists’ Assistants practicing in these states without a state license. Such questions have come up most recently in West Virginia, New York, and Florida, for example. To date, in every state in which this question has been raised, the question was referred to the state agency responsible for administering the particular law (usually the state Department of Public Health or the equivalent; sometimes the state Department of Education is also involved). In all cases which have come to our attention, senior administrators in the responsible agencies have upon reviewing the matter concluded that their regulations were not intended to apply to Pathologists’ Assistants and that therefore Pathologists’ Assistants practicing in their states do not need a license to do so. This may continue to be an issue for some time in the future in various states. Please feel free to contact the Legislative Committee (see contact information below) of the AAPA for assistance with these kinds of questions. States which currently license clinical laboratory practitioners are:
California (see notes above under state licenses for Pathologists’ Assistants)
Florida
Hawaii
Louisiana
Montana
Nevada (see notes above under state licenses for Pathologists’ Assistants)
New York
North Dakota
Rhode Island
Tennessee
West Virginia
Puerto Rico
States which are currently considering licensing of clinical laboratory personnel (pending legislation and regulatory activity)
Alaska: HB28/SB67, introduced Jan 2009, referred to committee. Last official action listed: Feb 2009. The bill has no category for and no exemption for Pathologists’ Assistants.
Massachusetts: HB 2142, introduced Jan 2009, referred to committee. Last official action dated Jan 2009. This bill has no category for and no exemption for Pathologists’ Assistants.
Minnesota: HF1249/SF0999, introduced Mar 2009, referred to committee. Last official action dated Apr 2009. This bill exempts Pathologists’ Assistants from licensing requirements.
Vermont: No legislation currently pending. A request was submitted to the state Office of Professional Regulation asking the state to consider licensing laboratory personnel. The state held a public hearing on the matter in November 2009. On December 9, 2009 the Office of Professional Regulation issued a report concluding that existing regulations that govern the operation of laboratories and the qualifications of personnel performing testing in laboratories are sufficient to protect the interests of the public, and recommending against the licensing of laboratory personnel in Vermont.
Virginia: HB601, introduced Jan 2010, referred to committee. Last official notice says it was “continued to 2011”. This bill does not license personnel, and is very narrowly worded to say just that Medical Laboratory Scientists and Medical Laboratory Technicians must register with the state in order to practice. Should have no effect on Pathologists’ Assistants.
Questions?
Contact Legislative Committee Chair Rosie Falcon.
Last updated: 04/2010