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Medicaid Requirement for Tamper-Resistant Prescription Pads

Effective October 1, 2007, all outpatient drugs for Medicaid beneficiaries reimbursed by the federal government must be written on a tamper-resistant pad. This includes over-the-counter drugs written in states that reimburse for these items. This provision comes from the U.S. Troop Readiness, Veterans Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007.

According to a letter written to state Medicaid directors, a prescription pad 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. or more industry-recognized features designed to prevent the use of counterfeit prescription forms.

This requirement applies if Medicaid is the primary or the secondary payor for the prescription, so affects patients with Medicare primary and Medicaid secondary.

This provision does not apply to refills of written prescriptions delivered prior to October 1, 2007. Additional exceptions apply, such as electronically transmitted prescriptions, faxed prescriptions or phoned-in prescriptions.

Additional information can be found on the CMS website at:

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