A bill passed by Congress earlier this year requires that all prescriptions for Medicaid recipients be written on “tamper-resistant” prescription drug pads, including non-narcotic prescriptions . The requirement takes effect on October 1, 2007. The AMA, along with other organizations expressed serious concerns to the Centers for Medicare & Medicaid Services (CMS) about this new requirement and KMA, along with the Kentucky Academy of Family Physicians and the Kentucky Pharmacy Association sent a letter to Governor Fletcher about this new requirement.

CMS has now issued guidance to state Medicaid directors about this new requirement and how it might be implemented. According to the guidance, by October 1, 2007, prescriptions written for Medicaid recipients must be on pads that meet one of the following standards, and by October 1, 2008 they must meet all three:

• Features to prevent unauthorized copying
• Features to prevent erasure or modification of the prescription
• Features to prevent use of counterfeit prescription forms

There are also exemptions to the “tamper-resistant” drug pad requirement:

• Prescriptions provided in nursing facilities and certain other settings are exempt
• Refills of written prescriptions presented at a pharmacy before October 1 are exempt
• Electronic, faxed and telephoned prescriptions are exempt
• Prescriptions paid for by a managed care entity are exempt. This might include Passport, although no such guidance has been issued by the state to that effect.

Note: State laws requiring tamper-resistant drug pads for narcotics still apply.

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