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CMS to Delay MA Tamper-Resistant Prescription Requirements
September 29, 2007


Both Congressional houses passed legislation early in the week of September 25 to delay implementation of the tamper-resistant prescription pad requirements for handwritten Medicaid (MA) prescriptions found in the US Troop Readiness, Veterans’ Health Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007. Deputy Secretary Michael Nardone, Office of Medical Assistance Programs, sent a letter to the Centers for Medicare and Medicaid Services (CMS) on September 4 expressing deep concern about the October 1 timeframe for implementation given that guidance was issued in August. Some concerns identified included the fact that providers do not have sufficient time to order and receive compliant prescription pads by the deadline or to educate prescribers and staff about the requirements. Individuals may not receive medications if the pharmacy cannot determine that the prescription is tamper-resistant. Pharmacies will be penalized if non-compliant prescriptions are filled. Establishing barriers to access to medications may lead to an increase in costs, rather than the intended cost savings, through increased use of emergency rooms and exacerbation of illnesses. Nationwide, many state agencies and other organizations related their concerns to CMS and to legislators, resulting in the approval of a delay.

The president has not yet signed the Patient and Pharmacy Protection Act of 2007. If signed, implementation of tamper-resistant prescription pad requirements will be delayed until April 1, 2008. Please contact Betty Simmonds with questions.

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