The Department of Health and Human Services – Centers for Medicare & Medicaid Services (CMS) Issues Information on Tamper-Resistant Prescription Pads

The AMCNO has been monitoring the development of this issue and outlined below is an overview of the requirements and exemptions as provided by CMS. Additional information will be posted by the AMCNO once it is provided.

Starting October 1, 2007, in order for Medicaid outpatient drugs to be reimbursable by the federal government, all written, non-electronic prescriptions must be executed on tamper-resistant pads. CMS has outlined three baseline characteristics of tamper-resistant pads, but each State will define features it will require to meet those characteristics. 

  • By October 1, 2007, prescription pads must meet ONE of the following standards:

  • Features to prevent unauthorized copying of a completed or blank prescription form;

  • Features designed to prevent the erasure or modification of information written on the prescription by the prescriber;

  • Features designed to prevent the use of counterfeit prescription forms.

Note: By October 1, 2008 prescription pads must meet ALL THREE of the standards.

Exemptions are as follows:

  • Prescriptions provided in nursing facilities and some other settings are exempt

  • Refills of written prescriptions presented at a pharmacy before October 1, 2007 are exempt

  • Electronic, faxed or telephoned prescriptions are exempt

  • Prescriptions paid for by a managed care entity are exempt

  • Physician offices are NOT exempt

In addition, prescriptions will be covered if the physicians provides the pharmacy with a verbal, faxed, electronic, or tamper-resistant written prescription within 72 hours of the date the prescription was filled. States that purchase compliant prescription pads for Medicaid prescriptions and provide them to physicians at no cost or at a discounted rate can treat the cost as an administrative expense under Medicaid.

The AMCNO is working with the state pharmacy association on this issue and we are in contact with the Ohio Department of Job and Family Services to ascertain how they plan to roll out this process. The AMCNO will update our members as information becomes available. For a complete copy of the CMS information on this issue go to:

http://www.cms.hhs.gov/SMDL/downloads/SMD081707.pdf