new requirements for tamper-resistant Rxs

Medicaid will phase in new requirements for tamper-resistant Rxs.

Starting April 1, any Medicaid Rx given to a patient must have at least ONE tamper-resistant feature.

By October 1, Rxs must have at least THREE features...with at least one from EACH of these three categories.

Copy-resistant. For example, paper that displays a hidden word like "void" or "illegal" when copied.

This word also shows up if the Rx is faxed...making it hard or impossible to read. Encourage prescribers to use regular paper for Rxs that will be faxed.

Unalterable. This may include a background color or design that makes erasure obvious. Other features are check-off boxes for quantity...refills...or number of meds on the Rx.

If you get an altered Rx, verify any changes.

Counterfeit-resistant. For example, features that would be hard for an amateur to replicate...bar codes, imprints, etc.

Many Rxs will have a list of all of their security features so pharmacists know what to look for.

Keep in mind this new rule applies only to Medicaid Rxs...not Medicare or others. It's also only for Rxs given to patients...NOT those that are faxed, phoned, or sent electronically.

If you fill a noncompliant Rx, you risk not getting paid.

If you receive a noncompliant Rx, you CAN give the patient an emergency supply until you can verify the Rx verbally with the prescriber...or get a new written Rx. Most states allow at least a 72-hour supply. Be sure to get a compliant Rx within 72 hours.

Each state can impose its own rules on this. See our Detail-Document for a list of features required by each state.

For help explaining this, go to our Detail-Document for a letter you can send to prescribers...and a handout for patients.

• Commentary: Tamper-Resistant Prescription Requirements For Medicaid Patients
• Other: Medicaid Tamper-Resistant Prescription Law (update July 17, 2008)
• Other: Pharmacist Letter to Prescriber
• Patient Education: Patient Information
• Other: Tamper-Resistant Prescription Pad Information