Medi-Cal Prescriptions Must Be Written on Tamper-Resistant Pads Effective April 1
[Posted 03/17/08]

New federal security prescription rules that take effect April 1 require most Medi-Cal prescriptions to be written on tamper proof pads. As you may recall, these new rules were originally scheduled to take effect October 1, but Congress postponed implementation for six months to allow physicians and pharmacists time to make sense of the new and somewhat confusing rules and to ensure that patient care and access to prescription drugs was not negatively impacted.

There are a number of exemptions to this rule. Security prescriptions are not required for:

• Drugs paid for by a managed care entity
• Prescriptions provided in nursing homes and some other institutional settings
• Phoned, faxed, or electronically transmitted prescriptions

Although prescriptions paid for by Medi-Cal managed care plans are exempt from the new federal security prescription rules, County Organized Health Systems (COHS) must comply. Drugs dispensed within a COHS (with the exception of the Health Plan of San Mateo) are defined under the law as “covered outpatient drugs” and must be written on tamper-resistant prescription pads. Therefore, prescriptions for patients enrolled in CalOPTIMA, Santa Barbara Health Initiative, Partnership Health Plans, and Central Coast Alliance for Health must be written on tamper-proof pads.

Of course, all prescriptions for controlled substances, regardless of the payor, must be written on secure tamper-proof pads under California Law. 

Recognizing that this new law is very confusing, and that physicians may not be able to easily determine when Medi-Cal fee-for-service is the secondary payor to private insurance, or if a prescribed drug is carved out of managed care, the California Department of Health Services is recommending that prescribers use tamper-proof prescription pads for all Medi-Cal beneficiaries.

For more information on this new law, see CMA ON-CALL documents #0510, Drug Prescribing (Not Schedule II-V Drugs) and #0509, Controlled Substance Prescribing. ON-CALL documents are free to members at the members-only website. Nonmembers can purchase ON-CALL documents for $2 per page in the CMA Bookstore.

CMA remains concerned, however, that the additional hassle and cost involved will force physicians to leave the Medi-Cal program, where access to care is already a problem. CMA continues to seek to reverse the law or at least make it consistent with current state law, which requires security prescriptions only for controlled substances.

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CMA members receive 15 percent off security prescription pads from RxSecurity. Special pricing is available for hospitals, clinics, and other high-volume purchasers.
Members pay $2.77 - $4.99 per pad for one-part pads, and $4.39 - $4.77 for two part pads, depending on the total number of pads ordered. While some printers charge extra setup and other fees, RxSecurity’s prices include everything, and shipping is free. Click here for more information.

Contact: Samantha Pellon, 916/551-2872 or spellon@cmanet.org.