Wendy K. Bodine
Assistant Editor

Members of pharmacy health care teams across the nation breathed a collective sigh of relief in September when President Bush signed the bill that extended the deadline for the implementation of tamper-resistant Medicaid prescription pads. The original bill handed down from Congress required that Medicaid will not pay for outpatient medications if the prescriptions were not written on a tamper-resistant pad.

As the new deadline draws nearer, the National Council of Prescription Drug Programs (NCPDP) is rushing to compile a universal list of requirements so that all states can agree on what exactly “tamper-resistant” means. The Centers for Medicare & Medicaid Services (CMS) stated that each state is to define the term within its own borders. The NCPDP-organized committee was concerned that patients could only fill their prescriptions within the state they were written—a scenario that does not take into account emergency situations when a patient may have to leave that state in a hurry.

By April 1, a prescription pad for Medicaid medicines must have at least 1 of the industry-recognized features from at least 1 of 3 categories. The categories include features that are designed to prevent the following:

• Unauthorized copying of a completed or blank prescription form
•  The erasure or modification of information written on the prescription by the prescriber
• The use of counterfeit prescription forms

By October 1, these pads must include 1 feature from all 3 categories, with each state determining which features they will use. The requirements do not apply to faxed, electronically prescribed, or phoned-in prescriptions, however. The NCPDP is encouraging prescribers to become familiar with these features before the April 1 deadline in order to reduce wasted paper and pads. The group also issued suggestions as to which features would work better and cost less based upon data from the 9 states that already have tamper-resistant prescription pads in place.

A letter went out on January 2 to state Medicaid agencies suggesting that it might be better if characteristics from all 3 categories were in place prior to April 1, in order to avoid a second round of changes in October. The letter pointed out, however, that if full compliance were to be required by April 1, the states should be granted a 60-day moratorium on audits for compliance, in order to give both prescribers and pharmacists adequate time to adjust to the changes.

A copy of the final letter from the NCPDP to state Medicaid directors, which includes a complete list of all features of each of the 3 categories, can be accessed here. 

For other articles in this issue, see:

Baxter Takes Action Against Heparin Reactions

Ledger’s Death Draws Attention to Rx Abuse

Generic Biologics Appear to Be Closer Than Ever

Pharmacy Leaders Approve Bush’s Stimulus Bill

FDA’s Push to Rid Market of Unapproved Drugs Extends to IV Colchicine

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