New Va Rule: Physicians No Longer Need To Co-Sign C&p Exams

[pacmanx1]

NEW VA RULE: PHYSICIANS NO LONGER NEED TO CO-SIGN C&P EXAMS

NEW VA RULE: PHYSICIANS NO LONGER NEED TO CO-SIGN C&P EXAMS A physician's co-signature is no longer required for a C&P examination performed by a mid-level practitioner. This should expedite the claims process.

by Larry Scott, VA Watchdog dot Org

I am not sure if this is good or bad.

It certainly could speed up the claims process.

However, I already hear complaints from many veterans that they don't want mid-level practitioners, such as a NP or PA, doing their C&P exam ... they want a doctor.

Now, in many cases, doctors are being taken completely out of the loop.

VBA's Fast Letter 10-32 is posted below.

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DEPARTMENT OF VETERANS AFFAIRS

Veterans Benefits Administration

Washington, D.C. 20420

September 1, 2010

Director (00/21)

All VA Regional Offices and Centers

In Reply Refer to: 211

Fast Letter 10-32

SUBJ: Removal of Certain Co-Signature Requirements and Ordering Specialist Examinations

Purpose

A joint workgroup of the Veterans Benefits Administration (VBA) and the Veterans Health Administration (VHA) identified several initiatives to expedite compensation and pension (C&P) examinations. This fast letter implements one of these initiatives by liberalizing signature requirements for VHA clinicians performing C&P examinations.

Examination Report Signature Requirements

Effective immediately, regional office and center staff may accept examination reports signed by a nurse practitioner or physician's assistant that are not co-signed by a physician. This change in signature requirements does not apply to examinations conducted by specialists, such as mental health, dental, audiology and optometry.

The M21-1 Manual Rewrite (MR) requires that a physician signs all original examination reports (see M21-1MR Part III, Subpart iv, Chapter 3, Section D, Topic 18, Block a, or

M21-1MR III.iv.3.D.18.a). Law does not mandate this policy, and it can unduly delay processing C&P examinations. In VHA, an individual physician accepts legal responsibility for the unsigned work of a mid-level practitioner, such as a nurse practitioner or physician's assistant. As a result, a physician's co-signature is no longer required for a C&P examination performed by a mid-level practitioner.

We will update the MR to reflect this change.

Specialist Versus Specialty Examinations

Please note that a specialist is only required in limited situations such as dental, vision, hearing, and psychiatric examinations, as indicated by

M21-1MR III.iv.3.A.8. For all other types of examinations, a generalist clinician may perform the examination. For example, an office may order a cardiac examination, but it should not generally request that a cardiologist (a specialist) conduct it.

Questions

E-mail questions concerning this letter to VAVBAWAS/CO/21Q&A.

/S/

Thomas J. Murphy

Director

Compensation and Pension Service

[carlie]

IMO, this is just more crap - not for the benefit of VBA claimants

and will in NO WAY help speed up the claims processing system.

Maybe I'm just feeling a little pissy about it for nothing -

I mean after all, it's not like the VBA ever hold's the sign off doctor accountable for C&P examination mistakes anyway.

"In VHA, an individual physician accepts legal responsibility for the unsigned work of a mid-level practitioner, such as a nurse practitioner or physician's assistant. As a result, a physician's co-signature is no longer required for a C&P examination performed by a mid-level practitioner."

I see negative happenings with this and I feel there's a huge difference in VHA and VBA.

[Ricky]

I see no speed added to the claims process by this change. Exams are not the problem with the backlog as most only take a few seconds to complete anyway. Even if it helps you get an exam a month earlier it still takes the normal processing time at the RO. Things that make one go Hmmmm.......

[Teac]

This may or may not be a good thing. I just had a c/p for allergic rhinitis, and the doctor didn't even check for polops...

I would expect this could open the flood gates to inadaquate exam claims.

and it damn sure isn't going to speed up the process...

[71M10]

Greetings all:

This will certainly speed-up the denials process!

However, the Appeals process will become more backlogged.

Best regards,

Tyler

[Vync]

The only speed-up I see is the number of NOD's due to shoddy C&P exams will grow faster

[JR Reihs]

IMO, this is just more crap - not for the benefit of VBA claimants

and will in NO WAY help speed up the claims processing system.

Maybe I'm just feeling a little pissy about it for nothing -

I mean after all, it's not like the VBA ever hold's the sign off doctor accountable for C&P examination mistakes anyway.

"In VHA, an individual physician accepts legal responsibility for the unsigned work of a mid-level practitioner, such as a nurse practitioner or physician's assistant. As a result, a physician's co-signature is no longer required for a C&P examination performed by a mid-level practitioner."

I see negative happenings with this and I feel there's a huge difference in VHA and VBA.

I agree with Carlie, I see no good that will come with this. No one should be preforming a C&P without an MD beside their name, there is just to much at stake here.

I see the backlog increasing due to awards being challenged based on the fact it was not preformed by a doctor. If I were in the position of needing a C&P now, I would have a IMO ready before the C&P took place................This is CRAP!