Long-Term Care Survey Alert

Published on Sun Oct 14, 2007 PDF

Starting Oct. 1, Medicaid prescriptions are reimbursable by the federal government only if they are written on a non-tamper resistant prescription pad. That's according to a recent letter from the Center for Medicaid and State Operations to state Medicaid directors (read the letter at www.cms.hhs.gov/SMDLdownloads/SMD081707.pdf).

The congressionally enacted requirement applies to all outpatient medications covered by Medicaid, including any over-the-counter medications. The requirement does not apply to electronic or faxed prescriptions or to those communicated to the pharmacy by phone or verbally, according to a Centers for Medicare & Medicaid Services' representative speaking at the Sept. 13, SNF Open Door Forum (ODF).

The act provides exceptions to Medicaid-reimbursed prescriptions in nursing homes and other institutional settings to the extent that the drugs in those setting are not separately reimbursed. When a physician or medical director in a nursing home writes a medication order that goes directly to the pharmacy, that prescription is considered tamper resistant, if the patient had no opportunity to handle the order, according to the SNF ODF.