To ensure the quality and security of counterfeit-proof prescription pads provided by the vendor, the vendor must agree to produce a counterfeit-proof prescription pad or blank that meets the minimum specifications listed below:

1. Resist erasures and reproductions.  The blank must be printed on artificial watermarked paper and must be 50# white or other quality approved by the Department.
2. Contain blue or green background ink that resists reproduction. The color must be consistent on every blank and listed on the blank as a security feature.
3. Display the word “VOID” or “ILLEGAL” if the prescription pad is copied. The language used must not obstruct or render illegible any portion of the drug name, quantity or direction for use.
4. Contain the following information (NOTE: Counterfeit-proof blanks may be sold to licensed healthcare practitioners or facilities who print prescriptions using an Electronic Medical Record System):

1. The preprinted name, address, and category of professional licensure of the prescribing practitioner; and
2. A space for the prescribing practitioner’s federal Drug Enforcement Administration registration number for controlled substances.

5. List security features and descriptions on the prescription blanks, preferably on the reverse side, to assist dispensing pharmacists in detecting forgeries. Examples of such feature listings are: the blank resist erasures and alterations, the background color must appear blue (if blue) or green (if green), the words VOID (if void) or ILLEGAL (if illegal) will appear when copied.  Additional security features beyond those required are encouraged, but must be listed on the blank.
6. List a unique tracking identification number for each order which is printed on the front of the blank and readily visible. A unique tracking identification number and the name of the licensed healthcare practitioner or health-care facility that purchased the prescription blank must be maintained by the vendor and available to the Department upon request. The unique tracking identification number must consist of three subsets: (1) a unique alphabetic prefix that readily identifies the vendor, (2) the date of printing, and (3) a batch number. The alpha characters used to identify the vendor will be assigned by the Department and must appear first in the tracking identification number in upper case. The date the blank was printed must immediately follow the vendor’s unique alpha identifier and must be presented in a six character numerical field using the format YRMODY (for example, June 3, 2011, would be coded as 110603). The batch number assigned by the vendor must immediately follow the print date. From left to right, the tracking identification number must appear as alpha prefix, print date, and then batch number, with no blank spaces between subsets. For example, ABC1106030001.
7. Contain no advertisement on the actual prescription blank.  Prescription pads may vary in size and style and contain appropriate advertising on the inside front cover and on alternate sheets within the pad. Advertisements shall be restricted to medically related topics and must be professional in nature.