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Tamper Proof Prescription Pads

New Law Only Affects Medications Prescribed to Medi-Cal Patients

Effective April 1, 2008, a new federal regulation requires that tamper-resistant prescription pads be used for all covered outpatient drugs prescribed to Medi-Cal patients (i.e. discharge and outpatient prescriptions). To be considered tamper-resistant, a prescription pad must contain at least one of the following characteristics:

  1. One or more industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form;

  2. One or more industry-recognized features designed to prevent the erasure or modification of information written on the prescription by the prescriber;
  3. One or more industry-recognized features designed to prevent the use of counterfeit prescription forms.
Tamper-resistant prescriptions have been required in California when prescribing scheduled medications since Jan. 1, 2005. Since these tamper-resistant prescription pads exceed the federal requirements above, they can be used on all prescriptions written for Medi-Cal patients.

However, this new law will have a significant impact on medical trainees who are not yet licensed and so cannot get their own individualized tamper-resistant prescription pads.

Pharmacy has worked with Reprographics to print generic tamper-resistant prescription pads for these trainees to use for discharge prescriptions and in outpatient areas that do not have Centricity (arrangements have been made to use tamper-resistant paper with Centricity in ACC). These pads do not meet the California standards for the prescription of scheduled medications (narcotics, benzodiazepines, etc.), and so can only used for non-scheduled medications prescribed for Medi-Cal patients.

The GME Office will be assisting Pharmacy in the distribution of these pads to training programs.

The Pharmacy advises that physicians can still telephone or fax prescriptions for Medi-Cal patients. Only paper prescriptions need to be on tamper-resistant forms.

  • Physicians who already have their individual tamper-resistant prescription pads should use it for all written discharge and outpatient prescriptions for Medi-Cal patients starting April 1.
  • Physicians (i.e., housestaff) who do not have their individual tamper-resistant prescription pads should use the generic tamper-resistant pads provided by GME for all written discharge and outpatient prescriptions for Medi-Cal patients. Note: these generic pads do not meet the security requirements for prescribing controlled substances in California and should not be used for such.

For information on receiving the generic pads for the housestaff, please contact Ellen W. Green, Director of Medical Education, or Brian Taylor at (310) 423-2126.