NCPA Statement About CMS' Tamper Resistant Pad Guidelines For Pharmacies Under The Medicaid Program

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Pharmacy / Pharmacist
Article Date: 23 Aug 2007 - 1:00 PST

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In response to CMS' letter, National Community Pharmacists Association (NCPA) Executive Vice President and CEO Bruce Roberts, RPh, issued the following statement:

"Everybody agrees with the goal of eliminating Medicaid prescription drug fraud. Everyday community pharmacists do everything possible to address this problem. However, the tamper resistant pad law if not properly implemented, creates unnecessary hardships for community pharmacies who are trying to ensure their patients get the medications they need. As a result of input from organizations such as NCPA and also from Congress, last week CMS sought to clarify some of community pharmacies' concerns.

"The use of tamper resistant pads will not apply to e-prescriptions, faxed prescriptions, prescriptions conveyed by telephone, or when a managed care entity pays. Each of these allowances takes into account the reality of how prescriptions are transmitted to our pharmacies. If this action had not been taken pharmacies would have been placed in an untenable position of having to refuse to fill legitimate prescriptions.

"CMS has now put the onus on State Medicaid agencies to create their own criteria for how the law will be implemented in their respective states. By October 1, these agencies must have one of the following options in place. Their providers must be directed to use tamper resistant pads that contain a feature to prevent copying of completed or blank prescription forms; or a feature to prevent the erasing or altering of written prescription information; or a feature to prevent the creation of counterfeit prescription forms. Whichever remaining two features aren't in place six weeks from now must be incorporated by October 1, 2008. NCPA encourages State Medicaid directors to start an immediate education program for both doctors and pharmacists in their state so patients will continue to get their prescriptions filled without any delay.

"We also encourage State Medicaid directors to address the fact that the federal law does not require doctors to use tamper resistant pads. Obviously, State Medicaid directors need to mandate their use by doctors so their prescriptions get filled by pharmacies.

"While the guidance that CMS issued is a start, in order for pharmacies, patients and doctors to have a smooth transition, State Medicaid directors need to act swiftly meet all of their obligations to the affected parties."

Before CMS issued their guidelines, NCPA sent them a letter on July 24 that made recommendations for how to effectively implement the provision by emphasizing any procedure must ensure patients will continue to receive their medications in a timely manner. On July 26, another letter with those sentiments was signed and sent to CMS by 78 members of Congress. NCPA also sent a letter to all of the State Medicaid agencies on August 14 explaining both their concerns and suggestions about how to proceed going forward.

- NCPA letter to CMS
- Congress letter to CMS
- NCPA letter to State Medicaid Agencies

The National Community Pharmacists Association, founded in 1898, represents the nation's community pharmacists, including the owners of more than 23,000 pharmacies. The nation's independent pharmacies, independent pharmacy franchises, and independent chains dispense nearly half of the nation's retail prescription medicines. For more information go to http://www.ncpanet.org.

The Centers for Medicare & Medicaid Services (CMS) provided guidance in a letter to State Medicaid agencies about the implementation of the tamper resistant prescription pads provision for pharmacies on Friday, August 16. The tamper provision-created to limit Medicaid fraud-was part of the Iraq Appropriations Bill that was signed into law on May 25 and begins on October 1.

http://www.cms.hhs.gov/