New Medicaid Regulation for Tamper-Resistant Prescription Pads

 

Effective April 1, 2008, all Medicaid prescriptions must be written on pads that contain at least one industry-recognized feature to prevent copying, erasing, or counterfeiting. By October 1, 2008, all prescription pads must prevent all three forms of tampering.

 

As of April 1, 2008, an amendment to 42 U.S.C. § 1396(b)(i) requires that all written, non-electronic prescriptions must be issued on “tamper-resistant” prescription pads.

 

The amendment applies to Medicaid prescriptions for covered outpatient drugs. Under Section 7002(b) of the federal law 110-28, all Medicaid prescriptions must be written on “tamper-resistant” prescription pads in order to be eligible for pharmacy reimbursement.

 

The provision, enacted to reduce government spending on fraudulent prescriptions, is intended to make it more difficult for patients to obtain controlled drugs illegally. The Centers for Medicare and Medicaid Services (CMS) has outlined the characteristics of tamper-resistant prescription pads. Each State will define which features it will require to meet these characteristics in order to be considered tamper-resistant. To be considered tamper resistant on April 1, 2008, a prescription pad must have at least one of the following three characteristics:

 

1.    One or more industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form.  Our prescription pads feature a repetitive “VOID” pattern when copied and the reverse Rx fades or disappears when copied a lighter settings.

 

2.    One or more industry-recognized features designed to prevent the erasure or modification of information written on the prescription by the provider.  Our prescription pads feature chemically sensitive paper that causes a stain to appear where attempts are made to chemically alter a prescription.

 

3.       One or more industry-recognized features designed to prevent the use of counterfeit prescription forms.  Our prescription pads feature a water mark on the back, a micro-printed border, a blue or green background color and the Rx logo disappears or changes color temporarily with hot breath or when rubbed briskly with a finger.

 

A prescription pad will be required to have all three characteristics by October 1, 2008.

 

CMS encourages the use of e-prescriptions and has made them an exception, along with prescriptions communicated by telephone by a prescriber and prescriptions faxed to the pharmacy. (Some prescriptions, however, are not allowed to be faxed because the Drug Enforcement Administration classifies them as controlled substances.)

 

The requirement does not apply:

·         When the prescription is electronic, faxed, or verbal; (CMS encourages the use of e-prescribing)

·         When managed care entity pays for the prescription;

·         To refills of written prescriptions presented to the pharmacy before April 1, 2008;

·         In most situations when drugs are provided in nursing facilities, intermediated care facilities for the mentally retarded, institutions for mental disease, and certain other institutional and clinical facilities.

 

For additional information on this new requirement, visit the Centers for Medicare and Medicaid Services (http://www.cms.hhs.gov) and the following helpful links to information on the CMS site:

 

·         CMS released guidance through a State Medicaid Director Letter  providing baseline requirements to States to define and implement tamper-resistant prescription pads as required by law.  

 

·         The documents "Medicaid Tamper Resistant Prescription Information for State Policymakers " and "Frequently Asked Questions on Tamper Resistant Prescriptions " provide additional background information.  These documents have been recently updated for October 1, 2008 implementation.  

 

·         Please refer to the Frequently Asked Questions for new information on CMS' policy with respect to computer-generated prescriptions.  

 

·         An updated fact sheet for pharmacists  is available to assist pharmacists with implementation of the new policy.

 

 

Christine Wojdyla is a Medical Records Expert at Amerifile, Inc.  Amerifile is a direct marketer of specialized office products including cabinets, folders, dividers, labels and forms.  Its customers depend on its service and expertise to help them create, store, maintain and retrieve medical records.  For more information, visit http://www.amerifile.net.