Changes to Medicaid Tamper-Proof Prescription Requirements
Changes to the Medicaid tamper-resistant prescription regulation will go into effect on October 1, 2008.
Under the changes all Medicaid prescriptions that are hand-written or printed from a computer application (such as an electronic health record or e-prescribing system) must contain at least one feature from each of three different categories of tamper-resistance. Previously prescriptions only needed to contain one feature from any one of the categories.
The three categories of tamper-resistance, as defined by CMS are:
- One or more industry recognized features designed to prevent unauthorized copying of a completed or blank prescription.
- One or more industry recognized features designed to prevent the erasure or modification of information written on the prescription by the prescriber.
- One or more industry recognized features designed to prevent the use of counterfeit prescription.
As part of the upcoming changes, CMS has also clarified the regulation as it pertains to prescriptions printed from computer applications. While these prescriptions may be deemed tamper-resistant through the use special paper, the tamper-resistant paper is not necessary. The printed prescriptions can also comply with the regulation through the use of certain printer modifications and/or the use of special software.
Medicaid regulations vary greatly by state, and the states have considerable leeway in how they can interpret and implement the new rules. ACP recommends that members contact the office of the State Medicaid Director for more information on how the regulations will affect health care providers in their state. Acess a complete list of contact information for State Medicaid Directors.
The tamper-resistant regulations under Medicaid first went into effect in April 2008, and the other aspects of the regulation remain in effect. The regulation does not apply to electronic prescriptions transmitted to pharmacies; prescriptions faxed to pharmacies; or prescriptions communicated to a pharmacy by telephone or prescriber. The regulation also does not apply to dual eligible beneficiaries (beneficiaries who have both Medicare and Medicaid); for prescriptions to individuals in nursing and similar institutional facilities; or for state Medicaid programs that employ a managed care entity to pay for the prescription.
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