April 5, 2024

Attention All Providers,

We have recently received updated Vendor Guidance from the VA regarding situations when a TERA Medical Opinion will not be warranted. Updates have been completed in MEP® to allow for bypassing TERA Medical Opinions for these scenarios in accordance with this VA Guidance.

TERA Medical Opinion will not be warranted under the following circumstances:

• When a separate "at least as likely" opinion has already been given for the SAME contention
• When the contention is specifically identified by VA in the Exam Scheduling request as a "PACT 1168 Exclusion". NOTE: PACT 1168 Exclusion will be identified for examiners within the Requested Opinion.
• When the appointment includes a Separation Health Assessment (SHA) and TERA Medical Opinion. Active duty pre-discharge claims should not be considered under the PACT Act unless the claimed condition is from prior period of activity duty that could be associated with the provisions of the PACT Act.

Example Requested Opinion for PACT 1168 Exclusion:

MEP Update: The following selections will close out all TERA Medical Opinion fields. Ensure to properly use these selections only for their respective scenarios.

If you have any questions regarding this memo, please reach out to the Provider Support Hotline at (844) 782-7783 or email us at QTCProviderSupport@qtcm.com. As always, thank you for your continued service to our Nation’s Heroes!

Regards,

Leidos QTC Provider Training Team