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State and Federal Laws and Regulations Governing PAs
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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 applicants 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 does NOT currently require a license or certification to practice.  California did however pass a law which states that if you are not certified and are doing anatomic pathology work which involves the dissection of tissue specimens, 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.  The specific wording is:  "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 be qualified to perform high complexity testing per Clinical Laboratory Improvement Amendments (CLIA) regulations (which are also cited in the California rule).  See "Federal” below.

Federal law classifies anatomic pathology as "high complexity" testing.  CLIA requires an associate degree in a related field or the equivalent for persons performing high complexity testing.  Anyone working in anatomic pathology in the United States must meet CLIA requirements for high complexity testing but does not need to be certified.  The full text of the CLIA requirements for personnel performing high complexity testing can be found at
http://www.gpo.gov/fdsys/pkg/CFR-2010-title42-vol5/pdf/CFR-2010-title42-vol5-part493-subpartM.pdf. Refer to paragraph 493.1489 beginning on page 611 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.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 laboratories meet all relevant legal standards and requirements.  One such prominent organization is the College of American Pathologists (CAP).  The CAP issued an announcement in May, 2010 revising their accreditation standards for personnel who perform macroscopic or gross examinations of tissues.  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.

Legislative and Regulatory Information

States requiring licensing of other clinical laboratory personnel, and how their regulations may affect pathologists’ assistants

 

The AAPA is an approved provider of continuing education programs in the clinical laboratory sciences through the ASCLS PACE program.
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