Effective April 1, 2008, all written, non-electronic prescriptions must be executed on tamper-resistant pads, in order for Medi-Cal outpatient drugs to be reimbursable by the federal government. This tamper-resistant prescription pad requirement applies to all outpatient drugs, including over-the-counter drugs. It is also required whether Medi-Cal is the primary or secondary payer of the prescription being filled. This new law impacts any and all providers who prescribe outpatient drugs.

All relevant information that the Centers for Medicare & Medicaid Services (CMS) has issued on this requirement can be found on the CMS Web site.

As outlined by CMS, a prescription must contain at least one of the three characteristics outlined below by April 1, 2008, in order to be considered “tamper-resistant.” However, all three characteristics are required by October 1, 2008.

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 provider; or,
3. One or more industry-recognized features designed to prevent the use of counterfeit prescription forms.

On January 16, 2008, the National Council for Prescription Drug Programs (NCPDP) held an industry forum in an effort to bring conformity to state-issued guidelines regarding federal legislation on tamper-resistant prescription pads. On February 1, 2008, NCPDP issued the letter to provide Medicaid directors with the result of the forum. The NCPDP letter provides additional information as to which tamper-resistant features fall within the three characteristics.

The California-required, tamper-resistant prescription pads for controlled drugs fully meet the October 1, 2008 federal compliance requirements under the Medi-Cal program. Therefore, providers are encouraged to use the current pads in order to fulfill the new federal law, and may order tamper-resistant prescription pads from pre-approved security prescription printer companies to produce the forms created by the California Department of Justice and Board of Pharmacy. The Approved Security Prescription Printers directory provides an alphabetical listing of security prescription printer companies and is updated as printer companies are added or removed. Providers will need their prescriber’s state license number and a copy of their DEA registration to place an order. Other security prescription printer companies are available and may be used as needed.

Reminder:

To comply with California statute, regardless of how a provider chooses to procure tamper-resistant prescription pads for all other written Medi-Cal prescriptions, providers must continue to procure tamper-resistant prescription pads for controlled drugs from the directory of approved security prescription printer companies.

Please refer to the November 2007 Part 1 Medi-Cal Update for additional information.