Coverage & Reimbursement
Welcome to the Coverage & Reimbursement page for the Utah Medicaid Pharmacy Program. Come back often to browse our library of Medicaid Coverage & Reimbursement Policy Manuals and bulletins
Tamper-Resistant Prescription Pad Update:
On April 1, 2008, Utah Medicaid began to phase in TRPPs (Tamper Resistant Prescription Pads) by requiring that all prescriptions comply with one of the three TRPP provisions. Beginning October 1, 2008, all three of the TRPP provisions will be required on prescriptions filled for Medicaid clients. NCPDP in conjunction with CMS has recently issued updated guidance on what tamper resistant characteristics are acceptable to meet TRPP provisions. Medicaid will be sending letters to providers with detailed information in the near future. The full text of the NCPDP letter to prescribers is available through the library at the bottom of this page.
Exceptions to TRPP requirements will be made when a prescription is presented on weekends, holidays, etc. The pharmacy will have 72 hours to contact the physician and indicate on the noncompliant prescription the date, time, and physician’s representative to whom the pharmacist or pharmacy technician spoke.
Remember - the prescriptions that are electronic (those that are faxed, taken over the phone, or transmitted through other electronic means) are not required to be on tamper resistant prescription pads. TRPP requirements apply to all prescriptions hand carried into the pharmacy by the Medicaid client.
Prescriptions paid by Medicaid must continue to comply with all state and federal regulations governing the practice of pharmacy.
Successful implementation of the above requirements will require support of both prescribers and pharmacies. We recognize that the time frame is difficult to meet, but the requirement is a federal law, and we do not have the authority to change it. Please contact the Medicaid Pharmacy team at (801) 538-6293 or (801) 538-6495 if you have any questions.
The documents are provided in Adobe format. If you cannot view a file, please download the free plug-in from the link below.
Click here to view current Medicaid Provider ManualsClick here to view current Medicaid Information Bulletins (MIBs)
| Name | Type | Last Modified |
| CoughColdList.pdf | February 14, 2008 | |
| Medicare Drug Coverage Tip Sheet.pdf | October 04, 2007 | |
| NCPDPletter.doc.DOC | DOC | July 22, 2008 |
| OTC Coverage List.pdf | October 03, 2006 | |
| Table of Covered Triaminic NDCs.pdf | February 14, 2007 | |