Starting on October 1, 2008, in order for Medicaid outpatient drugs to be reimbursable by the federal government, all written, non-electronic prescriptions must contain at least three tamper-resistant features, one from each of the three baseline characteristics outlined in guidance issued by the Centers for Medicare & Medicaid Services (CMS) on August 17, 2007 in a letter to State Medicaid Directors. This is the second and final phase of implementation of the tamper resistant prescription policy. Pharmacies will be required to verify that the Medicaid prescriptions they fill are in compliance with the State and Federal requirements.

Although CMS has outlined three baseline characteristics of tamper-resistant prescriptions, each State will define which features it will require to meet those characteristics in order to be considered tamper-resistant. The baseline characteristics must: (1) prevent unauthorized copying of a completed or blank prescription form; (2) prevent the erasure or modification of information written on the prescription by the prescriber; or (3) prevent the use of counterfeit prescription forms. As of April 1, 2008, States were to require that impacted prescriptions contain at least one of these baseline requirements. By October 1, 2008, States must require that impacted prescriptions contain all three characteristics in order to be considered tamper-resistant.

In addition, you can find additional information on this provision at Please note the new information with respect to computer-generated prescriptions in the Frequently Asked Questions.