Section 7 AAC 120.114 - Tamper-resistant prescription requirements(a) If a covered outpatient drug under 7 AAC 120.110(b) and payable under Medicaid is not prescribed by electronic transmission in accordance with 12 AAC 52.490 or by verbal communication, the prescription for that drug must be submitted on tamper-resistant paper or on plain paper with tamper-resistant features generated through an electronic medical record practice system in order to be paid by the department. Each prescription form must contain the prescriber's National Provider Identifier (NPI) number under 45 C.F.R. 162.402 - 162.414. (b) The requirements in (a) of this section do not apply to a (1) prescription for which retroactive Medicaid eligibility has been determined under 7 AAC 100.072, except for refills that are filled after the retroactive eligibility determination date; or (2) prescription prepared in an institutional pharmacy, if the prescriber writes the prescription into the medical record, the medical staff gives the order directly to the institutional pharmacy, and the patient does not handle or have the opportunity to handle the prescription; in this paragraph, "institutional pharmacy" has the meaning given in 12 AAC 52.995(a). (c) The tamper-resistant paper or tamper-resistant printing required under (a) of this section must include at least one industry-recognized feature designed to prevent unauthorized copying of a completed prescription, at least one industry-recognized feature designed to prevent the erasure or modification of information written on the prescription by the prescriber, and at least one industry-recognized feature designed to prevent the use of counterfeit prescription forms. Anyone feature may not be used more than once for proof of tamper resistance. (d) Industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form include (1) high-security watermarks on the reverse side of blank prescriptions; (2) thermochromic ink that changes color or disappears when warmed; (4) "void", "copy", or "illegal" pantographs, with or without a reverse prescription; (5) microprinting with a font size of 0.5 point or less; (6) prismatic printing; and (e) Industry-recognized features designed to prevent erasure or modification of information written on the prescription by the prescriber include tamper-resistant background ink that shows erasures or attempts to change written information in accordance with any of the following techniques: (1) toner anchorage used to complicate the removal of toner; (2) chemical stains used to reveal chemical eradication attempts against ink or toner; (3) laid lines used to reveal cut-paste attempts on an item; (4) chemical reactive inks used to reveal washing attacks; (5) overcoatings, laminates, and varnishes used to secure written content on the item; (6) erasable ink backgrounds used to reveal attempts at ink and toner removal;(7) borders and fill characters used to complicate attempts to add-on extra information;(8) on-item encodation techniques, bar codes, and patterns used to validate item content; (9) quantity check-off boxes. (f) Industry-recognized features designed to prevent the use of counterfeit prescription forms include (1) serially numbered blanks; (2) duplicate or triplicate blanks; (3) thermochromic ink that changes color or disappears when warmed; (4) color-shifting ink that changes color when viewed from different angles; and (5) security features and descriptions listed on the prescription. (g) The department will pay a provider for filling a prescription that does not comply with (a) - (f) of this section if the pharmacy verifies the authenticity of the prescription by (1) contacting the prescriber or prescriber's representative; and (2) documenting on the prescription form (A) the name of the prescriber or prescriber's representative who verified the prescription; and (B) the date the prescription was verified. (h) Failure to comply with (a) - (g) of this section may result in a finding of an overpayment that may be recouped by the department during pre- or postpayment audit or review.Eff. 5/18/2014, Register 210, July 2014Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040