CME Handbook – NCCAA

No part of this publication may be reproduced, transmitted, or stored in any form or by any means — electronic, mechanical, or otherwise (including but not limited to photocopying, photographing, scanning, recording, facsimile transmission) — without permission in writing from the National Commission for Certification of Anesthesiologist Assistants, Inc.

NCCAA Overview

The National Commission for Certification of Anesthesiologist Assistants (NCCAA) is a not-for-profit corporation organized under the laws of the state of Georgia. NCCAA certification provides assurances to the public that Certified Anesthesiologist Assistants (CAA) possess the knowledge, skills and competency to practice as CAAs.

While individual states provide the legal credential for the practice of anesthesiologist assistants, private voluntary certification with the NCCAA indicates compliance with the professional standards for practice as an anesthesiologist assistant. The certification credential for anesthesiologist assistants has been adopted by many health care facilities, practice groups and health systems as a requirement for practice. The certification credential for anesthesiologist assistants has also been recognized in state medical practice acts as well as state administrative rules and regulations.

NCCAA Mission

The mission of the NCCAA is to promote patient safety through certification programs which assess the knowledge, skills and competency of the anesthesiologist assistant and to instill lifelong learning through continuing education requirements.

History

In 1989, a group of five anesthesiologists, two anesthesiologist assistants and one member of the public formed the National Commission for Certification of Anesthesiologist Assistants (NCCAA). Anesthesiologist Assistants had been in practice for a couple of decades. The need for independent credentialing of anesthesiologist assistants was deemed important to:

Ensure the public of the training, knowledge and skill of anesthesiologist assistants.
Protect the anesthesiologist assistants in practice by developing and ensuring standards for practice as an anesthesiologist assistant.

Purpose

The purpose of the NCCAA is to ensure that CAAs have the necessary knowledge and skills to practice safely and effectively. In so doing, the NCCAA also protects the value of the CAA credential. The NCCAA is responsible for:

Establishing and maintaining criteria for the earning of designation as a Certified Anesthesiologist Assistant, including requirements for initial certification and continued certification.
Adopting and confirming compliance of initial and continued certification eligibility requirements for certified anesthesiologist assistants.
Formulating, adopting, and confirming compliance of the requirements for eligibility for admission to NCCAA-administered examinations or assessments including, but not limited to, the NCCAA Certification Exam (CERT) and the NCCAA Continued Demonstration of Qualifications (CDQ) Exam.
Developing, administering, scoring and analyzing the NCCAA examination to establish proficient applicants for the credential of Certified Anesthesiologist Assistant.
Formulating, adopting and administering NCCAA-created examinations or assessments to candidates who have met all requirements for examination or assessment and have been found eligible.

No national organization can expect to determine the specific procedures that any individual CAA is qualified to perform. Nor can any national organization adequately determine whether an individual CAA may have developed an impairment that could interfere with the proper administration of anesthesia. Ultimately, these judgments must be entrusted to the individual CAA, to those with whom they work, and those that provide state licensing for CAAs. The NCCAA seeks to protect the public’s interest by enacting a plan of certification and recertification on evidence of continued competence in providing anesthesia as indicated by participation in continuing medical education, substantiation of satisfactory performance, and undergoing periodic re-examination to confirm maintenance of current medical knowledge.

Structure

The NCCAA Board of Directors is composed of certified anesthesiologist assistants who hold the NCCAA-issued credential of CAA, board certified physician anesthesiologists and representatives of the public.

Communications

Five mechanisms are available for communicating with the National Commission:

Website: www.nccaa.org
Email: [email protected]
US Postal Service:

NCCAA
Box # 160
8459 US HWY 42

Florence, KY 41042

Phone: 859-903-0089
Direct Message through NCCAA Mobile Application

Change of Address

The NCCAA maintains on file the mailing address of each applicant/candidate/practitioner as they submit it via the practitioner portal of the NCCAA application. It is the responsibility of the applicant/candidate/practitioner to maintain accurate contact information, including address, email and telephone number, with the NCCAA by use of the practitioner portal available on the NCCAA application.

The NCCAA will not make changes of address based on letterheads, return addresses on envelopes, plain text email requests, etc. The NCCAA will not be responsible for lost or missed communications due to failure by the applicant/candidate/ practitioner to update the NCCAA of a change of address or contact information.

Change of Name

The NCCAA maintains on file the name of each applicant/candidate/practitioner as they submit it via the practitioner portal of the NCCAA application. The name on file is used for communications, verification of certification, entrance to testing center, and other documents. It is the responsibility of the applicant/ candidate/practitioner to maintain accurate name information with the NCCAA by use of the practitioner portal available on the NCCAA application.

A name change is a two-step process within the NCCAA appliation. Upon changing a name within the practitioner account, notification must be made via email to [email protected] before the change of name will appear on the certificate of certification.

The NCCAA will not make changes of names based on letterheads, return addresses on envelopes, plain text email requests et cetera. The NCCAA will not be responsible for lost or missed communications due to failure by the applicant/candidate/ practitioner to update the NCCAA of a change of name or contact information.

Notification

Communication from the NCCAA via telephone, email or US postal service shall be considered valid notification. The NCCAA will not be responsible for loss of communications by the US Postal Service, facsimile, email or electronic communication via the NCCAA appliation.

Continuing Medical Education (CME) Purpose

In 2019, through an open email to the entire CAA population, the NCCAA invited CAAs to participate on a project team to review, gather input and make recommendations to the NCCAA on the process of NCCAA continued certification. A group of CAAs was appointed to the Continued Certification Feedback Workgroup (CCFW). Through survey, collection and analysis of data, and discussion, the CCFW developed a list of potential measures to be included in the continued certification of CAAs. The identified measures were reduced to the nine (9) most frequently identified measures to include in a continued certification of CAAs. Then, the CCFW prioritized the nine most frequently identified measures based on their individual criteria, which included objectivity of the measure, the ability to universally apply the measure to all CAAs, and feasibility both financially and administratively, etc.

The CCFW ranking of the items was allotted a numerical ranking based on the prioritization of each by the CCFW member. If ranked 1st, the measure was allotted 9 points; ranked 2nd, the measure was allotted 8 points, etc., until the 9th ranked measure was allotted 1 point.

Through this method, the CCFW applied their subjective understanding of the CAA profession, CAA education, and practice into an objective process. This resulted in a hierarchy of measurable components that could be considered for inclusion into a continued certification process for CAAs.

Through this process, the top two (2) measures to be considered for continued certification of CAAs by a large margin were:

Increased CME Requirements.
Continued CDQ Examination (assessment of knowledge), virtually equal in their importance.

The Continuing Medical Education (CME) requirements for CAA continued certification are a result of this research.

Process Overview

Continued certification is contingent upon registration of 50 hours of eligible continuing medical education (CME) every two (2) years, including the year in which the CDQ Examination is taken. As a courtesy, CAAs may be reminded of CME submissions beginning in March and again in April. Omission of reminder notifications does not negate the CAA’s responsibility to register CMEs by the deadline of June 1st in the year CME registration is due. Continuing medical education must be registered according to the following regulations:

Continuing medical education must be submitted within the NCCAA mobile app.
The CAA should “Sign In” and complete the submission, including payment of the CME registration fee.
CMEs may be entered within the CAA’s account as the credits are earned. The payment button will populate once the appropriate number of hours are entered.
The deadline for CME registration and payment of CME registration fee is June 1st of the CME registration year. If the CAA was initially certified in an odd year, then each odd year, CME registration will be due.
The CME registration fee is $295. Any change to the registration fee shall be posted on the NCCAA’s website with the effective date of change.
For each two-year CME registration cycle, 50 hours of eligible continuing medical education must be completed and registered to maintain NCCAA certification. For each two-year CME registration cycle (June 1 – June 1), only CME credit earned in the applicable two-year time period will be eligible for registration. “Carrying over” previously earned credits is not acceptable.
CME hours exceeding the 50 required hours for a registration period will not be registered.
The content for 40 hours of each registration period must be CAA Category I – Anesthesia CME. That is CME in the field of anesthesia or one of its subspecialties (see Categories of CME below). The content for the remaining 10 hours may be CAA Category II – General Medicine or CAA Category II – Professional Development.
ACLS/PALS instruction will be tabulated as anesthesia-related content and shall be eligible for submission provided the instructional course is approved by either the AAPA or ACCME. The practitioner must obtain and submit a certificate of CME credit awarded for the ACLS/PALS course to be eligible for registration. A maximum of four (4) hours of CME credit will be recognized by NCCAA for any ACLS or PALS course, regardless of the credit awarded on the certificate from the approved provider.
CAAs must only claim the hours actually spent in the CME activity, regardless of the credit awarded on the certificate.
The NCCAA will grant 50 hours of CME credit to any CAA who is a full-time student in good standing in a Liaison Committee on Medical Education-accredited school of medicine during a two- year CME registration cycle. Proof of status must be submitted to [email protected].
The NCCAA will grant 50 hours of CME credit to any CAA who is a full-time student in good standing in a Commission on Osteopathic College Accreditation-accredited school of osteopathic medicine during a two- year CME registration cycle. Proof of status must be submitted to [email protected].

Categories of CME

There are two (2) types of eligible CME. CAA Category I – Anesthesia CME and CAA Category II General Medicine & Professional Development CME. All CME, regardless of type, must be accredited by an NCCAA-approved accrediting organization. Below is a further description of the CME Categories:

CAA Category I – Anesthesia CME

CME activity accredited by ACCME or AAPA. These must be anesthesia CME or one of the American Board of Anesthesiology subspecialties listed below:

Critical Care Medicine
Neurocritical Care
Pain Medicine
Pediatric Anesthesia

CAA Category II – General Medicine

CME activity that is not CAA Category I – Anesthesia CME, but is however still accredited by ACCME or AAPA.

CAA Category II – Professional Development

Professional Development activities that enhance the CAA’s foundational knowledge of CAA practice and foster the active participation in lifelong learning with the underpinning of improving oneself professionally and the CAA profession. All CME activities regardless of NCCAA CME category must be accompanied by a certificate as outlined below in CME Registration Information – Documentation Requirements. Examples of CME activities that may qualify as CAA Category II CME are:

Presentations at educational meetings (not faculty teaching at an educational institution)
Clinical preceptorship (maximum of 10 hours per CME cycle)
Publication
Academic credit from an institution of higher learning
Quality Improvement (QI) initiatives/projects
Mission activity
Original research
Non-faculty program instructor (e.g., guest lecturer)
Clinical administrative involvement (e.g., committee work)

Important: All CME including the CAA Category II – Professional Development CME must be accredited by a NCCAA recognized CME accreditor as listed below. Further, all CME, including the CAA Category II – Professional Development CME, must be registered with the appropriate documentation as noted below in the section –

CME Registration Information – Documentation Requirements.

CME Accreditation

The NCCAA will accept CME for registration from CME programs accredited by the:

American Academy of Physician Associates (AAPA)
Accreditation Council for Continuing Medical Education (ACCME)

(Which includes organizations like the American Medical Association (AMA) and the American Osteopathic Association (AOA) and other CME providers)

CME Requirements

To maintain NCCAA certification, CAAs must participate in Continuing Medical Education (CME). The NCCAA requires 50 hours of documented participation to be registered with the NCCAA biennially. CAAs are either on an odd year or even year cycle depending on their year of initial certification (e.g., initially certified in 2022, then 50 hours of CME due for registration by June 1, 2024).

Number of CME per Category

50 Hours total of CME is due every two years to maintain certification. Of the 50 hours, 40 hours must be CAA Category I – Anesthesia CME. The remaining 10 hours may be CAA Category II General Medicine or CAA Category II Professional Development or any combination of CAA Category II CME.

Note: CAA Category I – Anesthesia CME may be substituted for any or all CAA Category II CME. However, CAA Category II CME may not be substituted for CAA Category I – Anesthesia CME. Below are examples only of possible CME scenarios:

Example 1:

CAA Category I – Anesthesia CME: 40 hours

CAA Category II – General Medicine: 10 hours

CAA Category II – Professional Development: 0 hours

Example 2:

CAA Category I – Anesthesia CME: 40 hours

CAA Category II – General Medicine: 5 hours

CAA Category II – Professional Development: 5 hours

Example 3:

CAA Category I – Anesthesia CME: 45 hours

CAA Category II – General Medicine: 0 hours

CAA Category II – Professional Development: 5 hours

Example 4:

CAA Category I – Anesthesia CME: 50 hours

CAA Category II – General Medicine: 0 hours

CAA Category II – Professional Development: 0 hours

CME Registration Information

Documentation Requirements

The following information will be necessary to register each CME activity within the NCCAA mobile app:

Title of CME activity
Date(s) of CME activity
Location of CME activity
Name of CME Sponsor Organization (entity offering the activity: e.g., AAAA, ASA, Hospital or Health System)
CME Accrediting Organization entity (e.g. ACCME, or AAPA)
Number of credits awarded/earned for the CME activity

CME Registration Fees

The fees associated with CME registration are as follows:

CME Registration: $295
Late CME Registration: $895

(After the June 1st deadline in the year registration is due)

CME Audit

The NCCAA randomly audits CME submissions of practitioners on an annual basis. The practitioner who is selected for audit must fully comply to remain certified. The submission process has been developed to help guide you in the appropriate entry of documents.

The basis for audit is the CME credit registered during the preceding two-year CME registration period.
The practitioner who is selected for audit will receive notification of audit by email, specifying the additional documentation required to maintain certification.
The return email must be accompanied by complete, legible copies of the original documents of CME credit issued by the credit granting organization.
The documents awarding CME credit must state the source of accreditation of the CME granting organization.
The documents awarding CME credit must be correctly dated.
The return email, containing the additional requested documentation shall serve as verification the documents are authentic and true.
Should the CAA fail to return requested documentation, meeting all requirements, prior to the deadline indicated within the email, de-certification will occur.

Non-Compliance

Registration of CME credit is an ongoing part of the certification process. Failure to comply may result in loss of NCCAA certification. Any practitioner may have their CME submissions audited at any time. Should an audit occur, compliance with the audit process is mandatory for continued certification. It is recommended that CAAs keep original records of CME credit earned in the event of an audit.

The CAA who fails to properly register CMEs and pay the CME registration fee by the June 1st deadline will be considered as having their certification expired by the NCCAA. They will be notified immediately following the June 1st deadline that they:

Have an expired certification.
Are subject to a $600 administrative fee for late CME registration.
Have until August 31st to bring CME registration, including payment of all applicable fees up to date.
The practitioner who takes the CDQ Examination and fails to register CMEs and/or pay the CME registration fee, in the CDQ year, by the June 1 st deadline will be considered as having their certification expired by NCCAA and will be notified immediately following the June 1st deadline.
The practitioner who fails to properly register CME and pay the CME registration and administrative late fee shall be officially decertified on September 1st by the NCCAA and all NCCAA verification of certification data will reflect the decertification.

CME Handbook.

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