Effective April 1, 2008, all new written Medicaid prescriptions (except those for residents of nursing facilities, intermediate care facilities for the mentally retarded (ICF’s/MR’s), or other specified institutional and clinical settings) must be written on tamper-resistant prescription pads. The following requirements are mandated:

1. Applies only to written prescriptions. Prescriptions that are electronic (those that are faxed, taken over the phone, or transmitted through other electronic means) are not covered under this law.
2. Applies only to new prescriptions filled on or after April 1, 2008. Does not apply to refills of prescriptions initially filled prior to April 1, 2008 until law requires a new prescription.
3. Compliance with all federal and state laws regarding the types of documentation and how prescriptions are filled must be maintained .

If a pharmacy fills a prescription that does not comply with the requirements above, funds paid by Medicaid will be recovered. Prescribers will have to ensure that pads used to write Medicaid prescriptions meet the following requirements in order to be considered “tamper-resistant”. If not, the patient will likely be sent back to get another prescription written on a compliant prescription form.

Effective April 1, 2008, the prescription form must contain 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;
2. One or more industry-recognized features designed to prevent the erasure or modification of information written on the prescription by the prescriber;
3. One or more industry-recognized features designed to prevent the use of counterfeit prescription forms.

Effective October 1, 2008, to be considered tamper-resistant, a prescription pad must contain all three of the above characteristics.

Please Note: When obtaining tamper-resistant prescription pads, any printer that is able to produce compliant pads may be used. Medicaid is not currently endorsing any printers.

Successful implementation of the above requirements will require support of both prescribers and pharmacies. We recognize that the time frame is difficult to meet, but the requirement is a federal law, and we do not have the authority to change it. Please contact the Medicaid Pharmacy team at (801) 538-6293 or (801) 538-6495 if you have any questions.

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