New prescription law to take effect

Prescription cheaters beware. As of April 1, all Medicaid prescriptions must be written on tamper-resistant pads.

The move could save taxpayers up to $355 million in the next decade, according to the Congressional Budget Office.

After a six-month delay of the initial enforcement date, Oct. 1 2007, most in the medical community seem well-prepared for the switch.

"There's no indication they're not ready for the change," said Jeff Stensland, director of public information for the state's Medicaid agency.

Judi Bucknam, manager of Medical University of South Carolina's 20 adult medical surgical clinics, said that the whole hospital will go over to the tamper-resistant prescription pads Tuesday.

Before, prescriptions were written on regular laser jet printer paper, she said. A ream of regular paper runs about $6, she said. The new paper costs $64 a ream.

Where that money will come from is not clear. "The cost has to be taken in by somebody," she said.

Under the law, three industry standards must be applied. To prevent unauthorized copying, the paper can have watermarks, a micro-printed border or use thermochromatic ink, which disappears when rubbed.

To ensure against modification, background ink will show if someone tries to erase.

Finally, to prevent the production of counterfeit prescriptions, paper can be sequentially numbered, or again, micro-printed borders or thermochromatic ink can be used.

Only one of the three requirements must be met by April 1 and all three by Oct. 1, but many are making the complete change now, Bucknam said. The new rules do not apply to prescriptions given over the phone, by fax or electronically.

Dr. Marshall Newton of West Ashley said his office, like many, gets prescription pads for free through a mail order system. For years, he's selected the tamper-resistant option.

"I would think most doctors are ready for this," Newton said.

But where the enforcement will play out is at the pharmacist's counter. The pharmacist would not be reimbursed unless the prescription is written on tamper-resistant paper, said Dr. Wayne Weart, professor of pharmacy and family medicine at MUSC.

"The pharmacist would have to call the doctor's office and get a telephone prescription," Weart said. "It puts in a hassle factor that costs the pharmacy more time and effort."