Commonwealth of Massachusetts 
Executive Office of Health and Human Services 
Office of Medicaid 
600 Washington Street 
Boston, MA  02111 
www.mass.gov/masshealth 
 


 MassHealth 
 All Provider Bulletin 180 
 September 2008 
 
 

 TO: All Providers Participating in MassHealth 
 
FROM: Tom Dehner, Medicaid Director  
 
 RE: Tamper-Resistant Prescription Update 
  
 
 
 


Background   This bulletin provides important information about compliance with      
the Medicaid tamper-resistant prescription requirements, and expands      upon 
information described in MassHealth All Provider Bulletin 174,      issued April 
2008.  
 
    Currently, a handwritten or computer-generated prescription must contain     
a feature in at least one of the following three characteristic categories to      
be compliant with CMS requirements. By October 1, 2008, handwritten or      
printed prescriptions must contain at least one industry-recognized      feature 
within each of these three categories, to prevent: 
 
     1) unauthorized copying of a completed or blank prescription form; 
 2) the erasure or modification of information written  on the     prescription 
by the prescriber; and 
 3) the use of counterfeit prescription forms. 
 
 No one feature may be counted twice.  
  
 
New Guidance about Computer Generated Prescriptions

CMS’ prior guidance for printed prescriptions generated from EMRs or 
ePrescribing applications stated that special copy-resistant paper would likely 
be required for printed prescriptions to be in compliance as of October 1, 2008. 
CMS has clarified this statement, and is now stating  that while special paper 
may be used to achieve copy resistance, it is  not necessary. EMR or 
ePrescribing-generated prescriptions may be printed on plain paper, and be fully 
compliant with all three categories of tamper resistance, provided they contain 
at least one feature from each of the three categories. 
  
 
Additional Information

CMS is posting educational material for prescribers and pharmacists on      
their Web site at www.cms.hhs.gov, and has updated the document “Top      
Questions about Tamper-Resistant Prescriptions,” to reflect these 
  
   (continued on next page) 
 
 



 



  
 
Additional Information clarifications. MassHealth also posted these questions 
and answers on 
(cont.) our Web site for your convenience at 
http://www.mass.gov/Eeohhs2/docs/masshealth/provlibrary/tprxfaq.pdf. 
 
The National Council for Prescription Drug Programs (NCPDP) issued a letter to 
Medicaid directors regarding industry standards for these features. This 
document is posted at 
http://www.nacds.org/user-
assets/pdfs/gov_affairs/Issues/Tamper_Resist/FinalLtrMedicaidDrtrsTRPP07_17_08.d
oc 
 
All Provider Bulletin 174 (Massachusetts Implementation of Tamper-Resistant 
Prescription Requirements), is posted at 
http://www.mass.gov/Eeohhs2/docs/masshealth/bull_2008/all-174.pdf 
  
 
Questions If you have any questions about the information in this bulletin, 
please contact MassHealth Customer Service at 1-800-841-2900, e-mail your 
inquiry to providersupport@mahealth.net, or fax your inquiry to 617-988-8974. 
.   
 
 


 
 
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