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  • TAMPER RESISTANT
    Secure Laser Prescription ( Rx ) Paper
    for Doctors, Healthcare Professionals & Medical Clinics
    State of Arizona

    Secure Laser Rx Papers acceptable use in the State of Arizona.

    Micro Format Tamper Resistant Laser Prescription Paper meets and exceeds ALL Medicaid Requirements

    SecureGuard™ Rx Prescription Paper Products meets and exceed the NEW FDA Recommendations

    This site is designed for use by DOCTORS, HEALTHCARE PROFESSIONALS
    and MEDICAL CLINICS

    Varifiable documentation is required to order from this web site.

    The use of Script Paper is controlled by Federal and State Agencies.
    Any attempt to purchase Rx Paper Products by unauthorized persons or by persons providing falsified information will be reported to the proper authorities for prosecution to the full extent of the law.

    Acceptance of any and all orders for Rx Paper Products is at the discretion of the Micro Format Document Security Compliance Team.

    Add an
    Additional Level of Security
    to your prescriptions
    with Tamper Evident
    Security Hologram Labels

    Gold Security Hologram Labels

    Effective November 1, 2012
    All Arizona Medicaid Scripts MUST meet Medicaid Requirements


    MEDICAID REQUIREMENTS


    In an effort to eliminate Prescription Fraud, The Centers for Medicare and Medicaid Services (CMS) implemented a comprehensive tamper resistant Rx Script Program.
    The reason Medicaid requirements were put in place is simply to prevent Medicaid prescription fraud. Medicaid loses millions and millions of dollars annually due to forged or altered prescriptions. By making it harder for patients to alter or forge prescriptions, which affects the sale of illegal drugs, it is anticipated that Medicaid can save a significant amount of money. Every Doctor should be concerned about forged and altered prescriptions since it is their signature that appears on the script. Forged and altered prescriptions affect everyone with higher insurance costs as well as higher state and federal taxes.
    Full compliance with the rules and regulations set forth in the The Centers for Medicare and Medicaid Services (CMS) program is now mandatory.

    All MEDICAID Prescriptions MUST be written on Tamper Resistant Paper.
    To comply, all Medicaid Scripts must contain One or More industry-recognized features from each of THREE CATAGORIES of Security as specified by CMS.

    Micro Format and Secure Guard Prescription Paper Products
    meet and exceed Medicaid Tamper Resistant Requirements for all three categories.

    In addition, Micro Format, Inc., is an approved manufacturer of Secure Prescription Paper
    in every State in which approval is required.

    What are the Medicaid "Tamper Resistant" Prescription Requirements?

    For a prescription to be considered "Tamper Resistant,"
    prescriptions must contain at least one feature in each of three catagories.

    • Category One ~
      One or More industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form.
    • Category Two ~
      One or More industry-recognized features designed to prevent the erasure or modification of information written on a prescription by the prescriber.
    • Category Three ~
      One or More industry-recognized features designed to prevent the use of counterfeit prescription forms.

    How are "Industry-recognized" security features defined and
    what are some of the features that meet the requirements as stated?
    1. Category One
      • Void Pantograph background (Hidden Message Technology)
      • Reverse Rx Symbol
      • Micro Printing
      • Artificial Watermark on back of script
      • Coin Activated Ink
    2. Category Two
      • Colored Shaded Pantograph background
      • Toner Grip Security Coating
      • "Check and Balance" printed features such as
        "quantity" check boxes, and space to indicate
        "number of medications" written on prescription form
    3. Category Three
      • Security Feature Warning Box and Warning Bands
      • Security Back Printing
      • Coin Activated Validation
      • Batch Number identification
      • Secure Rub Color Change Ink
      • Consecutive Numbering
    Rx503 Tamper Resistant Laser Script Paper
    Rx503
    8-1/2" x 11" full sheet
    Tamper Resistant script

    Laser Script Rx503 front
    Front

    Laser Script Rx503 back
    Back

    Item# RX503G
    8.5in. x 11in.
    Green Background Tamper Resistant
    Laser Rx Paper

    Rx503-P2
    to yield 2 scripts (8-1/2" x 5-1/2") when detached)

    Blue Background
    Rx503-P2 (perforated in half)

    Rx503-P2small

    Item# RX503G-P2
    8.5in. x 11in.
    Green Background
    Tamper Resistant
    Laser Rx Paper

    Item# Rx503-P3
    8.5in. x 11in.
    Blue Background
    (perforated to yield 3 scripts (8-1/2" x 3-2/3") when detached)

    Click to Enlarge Rx503-P3
    Click to Enlarge Rx503-P3 image

    Item# Rx503-P4
    8.5in. x 11in.
    Blue Background
    (perforated to yield 4 scripts when detached)

    Click to Enlarge Rx503-P4
    Click to Enlarge Rx503-P4 image


    Item# Rx503-C4
    8.5in. x 11in.
    Blue Background
    (cut into quarters - script size 4-1/4" x 5-1/2")


    Item# Rx503-C2
    8.5in. x 11in.
    Blue Background
    (cut in half - script size 5-1/2" x 8-1/2")


    Item# Rx503-P5
    8.5in. x 11in.
    Blue Background
    Landscape Script in Top Left-Hand Corner of Sheet
    Special Perforated FULL SHEET Prescription Paper
    to yield script one script 5-1/2" x 4-1/4"

    Rx503-P5

    Horizontal perforation 4-1/4" from top edge
    Vertical perforation 5-1/2" from left edge

    Item# Rx503-P6
    Blue Background
    8.5in. x 11in.
    Landscape Script in Bottom Left-Hand Corner of Sheet
    Special Perforated FULL SHEET Prescription Paper
    to yield script one script 5-1/2" x 4-1/4"

    Click to Enlarge Rx503-P6
    Horizontal perforation 4-1/4" from bottom edge
    Vertical perforation 5-1/2" from left edge

    Additional Approved Laser Rx Paper Formats
    Rx510 Laser Script

    8-1/2" x 11"
    with script in top left-hand corner


    Rx510
    SHEET SIZE 8-1/2" x 11"
    Laser Rx Paper

    Detached script size
    4-1/4" x 5-1/2"

    Rx505 Laser Script

    8-1/2" x 11"
    with script in top half of sheet


    Rx505
    SHEET SIZE 8-1/2" x 11"
    Laser Rx Paper

    Detached script size
    5-1/2" x 8-1/2"

    RxEC503 Laser Script

    5-1/2" x 8-1/2" sheet
    2 scripts per sheet over/under

    Tamper Resistant Laser Rx Paper Laser Script Paper
    RxEC503
    NOTE --- This sheet size is 5-1/2" x 8-1/2"
    NOT 8-1/2" x 11"


    For additional information relative to SECURE PRESCRIPTION FORMS,
    contact Micro Format at Support@prescriptionpaper.com


    USA flag - Micro Format, Inc. Micro Format, Inc. is a veteran owned company.
    Micro Format SecureGuard Paper Products are manufactured in the USA from American Made materials.


    Copyright © 2000- Micro Format, Inc., All Rights Reserved

    Micro Format, Inc. 
    830-3 Seton Court ~ Wheeling, IL 60090 
    847/520-4699 FAX 847/520-0197
    800-333-0549