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February 2014
Use tamper-resistant prescription pads, paper

Recent retail pharmacy audits by the Department of Social Services (DSS) reveal non-compliance with the federally mandated Medicaid requirement for using tamper-resistant prescription pads and paper for all written or printed prescriptions. DSS and other agencies began enforcing this requirement in 2008.

The Connecticut Hospital Association (CHA) notes that to avoid audit deficiencies, every prescription given to a patient in a printed form must comply with the tamper-resistant prescription requirements. To comply, a handwritten or computer-generated (and then printed) prescription must contain at least one feature from all three categories below. (No feature may be used more than once to fulfill each category requirement.)

One or more industry-recognized feature designed to prevent the:

  • Unauthorized copying of a completed or blank prescription
  • Erasure or modification of information written on the prescription by the prescriber
  • Use of counterfeit prescriptions

The tamper-resistant pad or paper requirement does not apply to e-prescriptions when sent electronically, but does apply when an e-prescription is not sent electronically and is printed instead. Additionally, any e-prescription printed and not sent electronically must be physically signed for the prescription to be valid, even though it would have had an e-signature had it been sent electronically.

The requirement also does not apply to faxed prescriptions, telephoned prescriptions and emergency fill (when a prescriber provides a compliant written prescription within 72 hours after the emergency fill).

If you have any questions, please contact Marielle Daniels, manager, Patient Care Regulation, CHA, by email ( or call (203) 294-7256.

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