Drug Topics - April 14, 2008 - (Page 20)

20 DRUG TOPICS APRIL 14, 2008 www.drugtopics.com Community Practice This time R.Ph.s and states are ready for tamper-resistant Rx pads Reid Paul S ix months after it was initially set to go into effect, pharmacy organizations, physician groups, and state Medicaid directors attest that they are ready for the tamper-resistant prescription pad rule for the Medicaid program. “We are much better prepared,” insists Hrant Jamgochian, director, Congressional and state relations at the American Pharmacists Association. But he cautioned, “There is still a lot of work to be done.” The tamper-resistant prescription pad rule mandates that all nonelectronic Medicaid prescriptions be written on tamper-resistant Rx pads to discourage fraud. Last September, days before the rule was set to go into effect, Congress pushed through legislation to delay implementation until April 1, 2008. Electronic prescriptions, faxed prescriptions, and prescriptions sent over the telephone are exempt from this requirement. According to the legislation, beginning in April, nonelectronic Medicaid prescriptions must have at least one security feature. Beginning in October, Rxs will have to have at least three security features, including at least one feature from each of three categories established by the Centers for Medicare and Medicaid Services: • Features that prevent unauthorized copying; • Features that prevent the erasure or modification of information written by the prescriber; • Features that prevent the use of counterfeit forms. One of the stated reasons for the six-month delay was to give state Medicaid directors more time to establish criteria for what would qualify as a tamper-resistant Rx pad. While CMS offered general guidance to Medicaid A new role for NCPDP NCPDP is increasingly playing an important role in helping the healthcare industry hammer out standards in emerging areas. “It is a role we assumed because the industry needed somebody to do it,” explained Graeff. “It is an ongoing role that NCPDP can play using our core competency of building consensus among various stakeholders because we are a neutral party.” In addition to mediating over the tamper-resistant prescription pads, NCPDP has also helped develop standards for a variety of topics including radio frequency identification (RFID) technology and medication therapy management services. Graeff also expressed optimism that the group could help develop a standard approach to prescription labels. directors, it was ultimately up to each state to establish specific criteria for the Rx pads. “The states were struggling to implement the rule,” recalled Cathy Graeff, R.Ph., senior VP of communications and industry relations for the National Council of Prescription Drug Programs (NCPDP). “They were looking to CMS for guidance, but CMS couldn’t provide more.” In January NCPDP convened a conference, bringing together major stakeholders including pharmacists, physicians, technology vendors, and state Medicaid officials. “We walked out with consensus on what kinds of security features fit in the three categories,” Graeff said. More significantly, she noted, the group also focused on features that were technologically feasible, easy for pharmacists to identify, and inexpensive for physicians to purchase. Two weeks after the meeting, NCPDP produced a final document outlining the suggested security features. According to Jamgochian, most states now specify what security features will be accepted, based primarily on the NCPDP recommendations. With the guidance of NCPDP, states are cohering around a set of agreed-upon rules. For example, most states agree that a “void” pantograph on the pad is an accepted security feature. When a prescription is copied or scanned, the word “void” emerges in the background. Most states also require an Rx pad to have a list of its security features to help pharmacists quickly identify compliant pads and examine the security features. As the states prepared for the April 1st implementation date, they have also undertaken an outreach effort to physicians, pharmacists, and consumers. “We are doing what we can on the educational side and in coordination with state Medicaid directors,” Jamgochian told Drug Topics. There still is significant variation from state to state. The South Carolina Medical Association, for example, has decided to endorse Standard Register as a preferrred vendor. California, for example, lists 11 accepted security features, while Texas has five and Maine has only four accepted features. To help pharmacists and physicians keep track of state regulations, the National Association of State Medicaid Directors has pledged to keep a clearinghouse for state requirements at www.nasmd. org/issues/TRPP.asp. http://www.drugtopics.com http://www.nasmd.org/issues/TRPP.asp http://www.nasmd.org/issues/TRPP.asp

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Drug Topics - March 14, 2008 Contents Latebreakers Letters: Students Need Grounding in Chemistry Pharmacy Directors Wary of Heparin Shortages Some E-prescribing Standards are Ready to Go, Others are Not News Briefs Nanotechnology: Big Stakes in a Small World Pay for Performance is Coming to Pharmacy Patient Safety Organizations Still Very Much in Planning Stage Reconciling Medications in Specialty Patients Poses More Challenges Pharmacy Outsourcing Still Much in Use by Hospitals Studied Extensively, New Drug-Eluting Stent Said to be Very Safe Prevention is Key in Treating C. Difficile Infections E-prescribing Grows in Massachusetts, but Other States Lag Behind Active Metabolite Gives New Life to Antidepressant NSAIDS not Recommended for Long-term Use in Osteoarthritis This Time R.Ph.s and States Are Ready for Tamper-Resistant Rx Pads Cardinal Caught Between DEA and Pharmacies over Diversion Control Medicating Kids: Still More Questions than Answers Schnucks Pharmacy: Drug Topics' Chain of the Year Panel Will Ask for a System for R.Ph. Practice Across State Lines FDA Safety Page: How to use Fentora Safely The Shining OTC/HBC Stars of 2007 Take a Look at These OTCs for Eye Health Technology Update: Google Offers a Sneak Peak at its Electronic Records Initiative Recent Advancements in HIV/AIDS Treatment New Products Advertisers Index Classified Viewpoint: Are State Boards of Pharmacy Abusing Their Power?

Drug Topics - April 14, 2008

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