Tamperproof prescriptions

On May 27, 2007, Congress enacted regulations requiring the use of tamper-resistant prescription pads. This primarily affects patients covered by state Medicaid programs.

Following several meetings internally, with state agencies and with professional organizations, BIDMC elected to use tamper proof paper stock in printers which produce electronic prescriptions (not e-prescribing, which is exempt from the regulation). The new stock will be used to write all prescriptions, regardless of payer/insurer and contains the features proposed by MassHealth as "standards" for Tamper-Resistant Prescription Pads:

It has a greenish hue.

It is perforated (twice) so that up to three prescriptions can be printed on one sheet.

When photocopied, the word "VOID" will appear in multiple locations.

The backside has Rx icons printed in thermochromic ink. This means the icon will disappear when rubbed with your finger and then reappear when you stop.

We're implementing this in two phases. From April 1, 2008 to October 1, 2008, we can still use plain paper, but we've modified prescription printing as permitted by the new regulation :

“Quantity Border and Fill (for computer generated prescriptions on paper only), i.e. Quantities are surrounded by special characters such as an asterisk to prevent alteration; e.g. QTY **50** and Value may also be expressed as text, e.g. (Fifty), (optional).”

“Refill Border and Fill (for computer generated prescriptions on paper only), i.e. Refill quantities are surrounded by special characters such as an asterisk to prevent alteration; e.g. QTY **5** and Value may also be expressed as text, e.g. (FIVE), (optional).”

Here is a link to an example of our new printed prescriptions. This is live now.

We're also providing a Notice to Dispensing Pharmacies which we're attaching to prescriptions.

By October 1, 2008, we'll replace all plain paper with the tamperproof paper as required by the regulation.

This has been an effort requiring coordination among IT, providers, administration, pharmacies, and government. It's been quite complex and we're hopeful that our planning, communication, and phased implementation effort will be successful.