Medicaid Rx must be on tamper-resistant pads

Although several major exemptions were written into the rules, physicians still could face significant administrative burdens.

By Doug Trapp, AMNews staff. Sept. 3, 2007.

Washington -- A new law requiring tamper-resistant pads for certain Medicaid prescriptions means that many physicians will have to change their prescription-writing habits, depending on how states implement the law.

The Centers for Medicare & Medicaid Services issued guidance Aug. 17 on how to meet the prescription pad provision. It was slipped into a military spending law Congress adopted in late May. The rules focus on written orders, not verbal, faxed or electronically transmitted prescriptions.

CMS exempted from the law prescriptions paid for by Medicaid managed care organizations and those for patients in nursing homes and other institutions, which together constitute a large chunk of Medicaid prescriptions. Of the 53 million Medicaid recipients, nearly two-thirds are enrolled in managed care plans, CMS estimates. It wasn't immediately clear what share of Medicaid prescriptions these two groups generate.

The guidance also allows pharmacists to fill drug orders on an emergency basis as long as the prescriber follows up with a verbal, faxed or compliant written prescription within three days.

But even with the exemptions, the speed at which state Medicaid agencies must implement the law will pose difficulties for physicians and patients in Medicaid, said AMA Board of Trustees Chair Edward L. Langston, MD. "We will continue to work closely with the administration and Congress to delay the implementation date to ensure a smooth transition for patients and physicians," he said.