Additional Guidance on Tamper Resistant Prescription Implementation

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On Saturday, September 29, 2007, President Bush signed the “Transitional Medical Assistance, Abstinence Education, and QI Programs Extension Act of 2007,” delaying the implementation date for all paper Medicaid prescriptions to be written on tamper-resistant paper. Under the new law, as of April 1, 2008, all written Medicaid prescriptions must be on tamper-resistant prescription pads.

The Centers for Medicare & Medicaid Services' (CMS) guidance on the tamper-resistant law, set forth in an August 17, 2007 State Medicaid Director letter, contains two phases. For the first, a prescription must contain at least one of the three tamper-resistant characteristics in order to be considered “tamper resistant.” For the second, prescriptions must contain all three characteristics.

The two-phased approach will still be in effect. At least one of the three tamper-resistant characteristics is required on April 1, 2008. All three characteristics are required on October 1, 2008.

All other guidance that CMS has issued on this requirement contained in the State Medicaid Director letter [pdf] and Frequently Asked Questions [pdf] will still apply once it is implemented. More info on the CMS guidance to States can be found on the CMS website.