< 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:

prevent unauthorized copying of a completed or blank prescription form
prevent the erasure or modification of information written on the prescription by the prescriber
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.