Washington – Millions of Medicaid patients and their pharmacists could be in for a nasty surprise Oct. 1.
A tiny provision tucked into a spending bill for Iraq requires that prescriptions for Medicaid patients be written on “tamper-resistant” pads. But most doctors do not use such pads.
The law is designed to make it harder for patients to obtain controlled drugs illegally and easier for the government to save money. The quick start date leaves little time to educate doctors and pharmacists.
“Our members are absolutely flabbergasted that they’re going to be put on the hook for denying prescriptions if something is not on a tamper-proof pad,” said Paul Kelly, vice president of government affairs for the National Association of Chain Drug Stores. “Our biggest fear is the negative impact this could have on patient care and access to prescriptions.”
Pharmacists’ groups have asked lawmakers and the Centers for Medicare and Medicaid Services to delay putting the law in place.
Steve Hahn, a spokesman for the centers, said the agency has no plans now to change the Oct. 1 date. In the interim, it is consulting with health-care providers and preparing guidance on how to comply with the law.
Several states already require tamper-proof prescription pads, Hahn noted. But health- care providers in those states often had more than a year to prepare, Kelly said. New York, for example, had 18 months.
In this instance, many doctors are not even aware of the law.
“The implementation timetable is too short to educate prescribing physicians about the new law and is also likely too short to produce and distribute the enormous quantity of new prescription pads that will be needed,” said Dr. Edward Langston, chairman of the board of trustees for the American Medical Association.
The tamper-resistant pads often contain a chemical that reveals when efforts have been made to alter them. For example, the heat from a copier may cause the word void to appear. Sometimes, the pads contain serial numbers that are entered into a computer by the pharmacist so that they can be matched against a doctor’s order.
