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South Dakota News: Tamper-Proof Prescription Pads
Published in the October 2007 South Dakota State Board of Pharmacy Newsletter
The Centers for Medicare and Medicaid Services (CMS) has provided partial guidance and background information on the requirements to use tamper-proof prescription pads.
Beginning on October 1, 2007, in order for Medicaid outpatient drugs to be reimbursable by the federal government, all written, non-electronic prescriptions must be executed on tamper-resistant pads. This requirement was included in section 7002(b) of the US Troop Readiness, Veterans’ Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007. On August 17, 2007, CMS issued a letter to State Medicaid Directors with guidance on implementing the new requirement.
CMS has outlined three baseline characteristics of tamper-resistant prescription pads, but each state will define which features it will require to meet those characteristics in order to be considered tamper-resistant. The baseline characteristics are one or more industry-recognized features 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) and prevent the use of counterfeit prescription forms. On October 1, 2007, states must require at least one of these baseline requirements. After October 1, 2008, states must require all three characteristics on prescription pads in order for the pads to be considered tamper resistant.
The letter to State Medicaid Directors outlines situations where the new requirement does and does not apply. The requirement does not apply when the prescription is electronic, faxed, or verbal; when a managed care entity pays for the prescription; or in most situations when drugs are provided in certain institutional and clinical facilities. The letter also allows emergency fills as long as a prescriber provides a verbal, faxed, electronic, or compliant prescription within 72 hours. This restriction applies to all outpatient drugs, including over-the-counter drugs in states that reimburse for prescriptions for such items.
The South Dakota Pharmacists Association has requested a meeting with the Department of Social Services Division of Medical Services regarding further clarification and will update members as information becomes available.
The state of South Dakota and State Board of Pharmacy currently do not have requirements for tamper-proof prescription pads, but the federal law takes precedence. Therefore, prescribers should be looking at secure pads to meet the law.
