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Tamper-Resistant Prescription Pads/Paper

Due to federal law, the use of tamper-resistant prescription pads/paper is required for all written prescriptions for outpatient drugs, including those for OTC drugs or products, for Medicaid clients.


The following prescriptions are required to be executed on tamper-resistant prescription pads/paper:


  • Written prescriptions for outpatient drugs, including controlled and uncontrolled substances and OTC drugs or products, whenever Medicaid could pay for any portion of the cost of the prescription (including when Medicaid is the secondary payer). 

  • Written prescriptions for outpatient drugs given to Medicaid recipients from an outpatient hospital or independent medical clinic, outpatient psychiatric clinic, outpatient drug and alcohol clinic or psychiatric partial hospitalization clinic, or other situations in which the Medicaid recipient would take the written prescription to an outpatient pharmacy to be filled.


The following prescriptions or situations are exempt from this requirement:


  • Prescriptions transmitted by telephone, by fax or electronically as an e-prescription directly to the pharmacy by the prescriber or prescriber's staff who is authorized to act on the prescriber's behalf.

  • Prescriptions paid for by a managed care entity.

  • When a prescriber administers or provides the drug directly (such as samples) to the patient.

  • Written prescriptions prepared in an institutional setting where the prescriber writes the order into the medical record and then the order is given by medical staff directly to the pharmacy, such that the patient never has the opportunity to handle the written order.

  • Prescriptions written for any medical item, service or equipment that is not considered an outpatient drug.



The law (8.800.11.D) specifies three different characteristics that must be incorporated into the prescription pads/paper and each state has been charged with defining the specific features required by that state in order to comply with the federal requirement.  


General Information

Tamper Resistant FAQs



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