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Federal Advocacy
Regulatory Issues (HIPAA/Medicare/FCLCA/NPI)

Medicaid Prescription Pad Requirements



Beginning April 1, 2008, all outpatient drug written prescriptions for Medicaid recipients must be on paper with at least one tamper-resistant feature as outlined by CMS and defined by your State. Beginning October 1, 2008, these same prescriptions must be on paper that meets all three baseline characteristics of tamper-resistant pads. CMS has outlined the three baseline characteristics as those that:

  1. prevent unauthorized copying of a completed or blank prescription form
  2. prevent the erasure or modification of information written on the prescription by the prescriber
  3. prevent the use of counterfeit prescription forms.

The Medicaid tamper-resistant pad requirement currently applies to outpatient drugs only, not eyeglasses or contact lenses. There is a general movement towards e-prescribing for all outpatient drug prescriptions. While this may not impact eyeglasses and spectacles, it may be a leading trend that may migrate into that area should the vendors choose to go paperless/electronic and as providers move into implementation of the EHR (electronic health record).

States are responsible for defining specific features that meet the baseline characteristics in order for a prescription to be considered tamper-resistant in that State. Therefore, we recommend reviewing your State's website for guidance on acceptable tamper-resistant features. Additional information on CMS' requirements can be found at: http://www.cms.hhs.gov/DeficitReductionAct/30_GovtInfo.asp

Please note that electronic prescriptions, faxed prescriptions and prescriptions sent over the telephone are exempt from this requirement.

Failure to comply with this requirement could result in a withholding of Medicaid reimbursement.