Drug Topics - February 11, 2008 - (Page 14) 14 DRUG TOPICS FEBRUARY 11, 2008 www.drugtopics.com > > > Latebreakers In Depth NCPDP group racing to recommend tamper-resistant pad rules Kathryn Foxhall A n ad hoc group under the auspices of the National Council of Prescription Drug Programs (NCPDP) is racing to write recommendations on what state Medicaid programs should say are “tamper-resistant” prescription pads. The NCPDP-convened group met to consider the best recommendations to states for tamper-resistant pad requirements. Last May, Congress slipped a provision in a defense spending bill mandating that Medicaid not pay for outpatient drugs if the prescriptions written were not on a tamper-resistant pad, as of October 1, 2007. Although at least nine states have some type of tamper-resistant pad requirements for some types of prescriptions, the new federal requirement met heavy complaints from pharmacists and medical groups due to the short time frame and the lack of a standard definition of what a tamper-resistant pad or prescription form is. President Bush signed a law in September delaying the requirement by six months. Currently, the Centers for Medicare & Medicaid Services rules that each state will define which features will meet the requirements in its borders. However, by April 1, a prescription pad must have at least one industry-recognized feature from at least one of three categories: those designed to prevent unauthorized copying of a completed or a blank prescription form; those designed to prevent the erasure or modification of information written by the prescriber; and those designed to prevent the use of counterfeit forms. But, by October 1, the pads must have at least one feature from all three of the categories. The requirements do not apply to prescriptions sent by fax, e-prescribing, or THE AUTHOR is a writer based in the Washington, D.C., area. Photo: Kathryn Foxhall telephone calls from the provider. Last month in Arlington, Va., the NCPDP-convened group spent a day-long session filtering through the various security characteristics available for prescription pad printing. The 30 participants included representatives from CMS, state Medicaid programs, pharmacy associations, at least one practicing physician, and one representative of a printing firm. They are to review the recommendations made by industry and attempt to have communications out to the state Medicaid programs by the first part of this month. That will allow, as the participants noted, only two months for states to communicate to physicians, pharmacists, and beneficiaries, and for the prescription pads to be ordered, printed, and shipped. Participants repeatedly raised a concern that beneficiaries will not be able to have prescriptions filled in a state other than where their provider wrote them. One question raised by Peter Basch, M.D., was how prescriptions printed from an electronic medical record can be made compliant with some of the potential requirements. Arguing that even with electronic prescribing, there’s likely to be a need for some printed prescriptions, he noted that physicians will not want to change to special paper to print out a prescription, as opposed to patient medical information or other material. In the meantime a January 2 letter to state Medicaid agencies from about 90 national and state medical and pharmacy groups indicated that it might be preferable to implement characteristics in all three categories by April 1, rather than change the requirements again in six months. However, the letter “strongly” suggested that if full compliance is required by April 1, states should have a 60-day moratorium on audits for compliance to give prescribers and pharmacists time to get used to the rules. The letter also reminded the administrators that CMS has said it will provide an administrative funding match for states that wish to adopt and distribute official prescription forms themselves. New York currently provides prescribers with forms. The groups also noted the problems that might arise from states compiling a list of compliant pads rather than adopting one official form. The call backs from pharmacists to prescribers caused by a variety of forms would create a substantial administrative burden. http://www.drugtopics.com
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