After diligent efforts by the state’s physical therapists, the New Hampshire Department of Health and Human Services (NH DHHS) has issued a clarification on the supervision requirement of physical therapist assistants. On June 11 NH DHHS issued a memo stating that no recoupment action would be taken for any Medicaid claims submitted since June 2005 related to the "physical presence" requirement. Previously, claims would not be covered by Medicaid if the physical therapist was not physically present when services were provided by a physical therapist assistant. After receiving interpretation from federal regulators this summer, the department will be replacing the current "physical presence" requirement (He-W 568.05) with a requirement that the physical therapist must be available at least by telecommunication for direction and supervision but does not have to be on site, which aligns with the New Hampshire statute. Providers must continue to meet the requirements of:

• NH statutes related to therapy services;
• Rules promulgated by the governing boards of physical therapists, occupational therapists, or speech pathologists, as applicable, regarding licensure and supervision; and
• NH Medicaid rules with the exception of the "physical presence requirement" at He-W 568.05.

On a related note, APTA has submitted comments emphasizing the vital importance of access to physical therapy services for Medicaid beneficiaries, in response to the Center for Medicare and Medicaid Services (CMS) proposed rule that would require states to implement a standardized review process to ensure compliance with Medicaid access requirements. The rule was published May 6 and reported in a May 25 News Now article.