Medicaid is a government program. Thus, the government has the right to determine the rules for this program. Requiring that Medicaid prescriptions must be on tamper-resistant paper falls under the regulations for participation in the Medicaid program. However, when it comes to the method used to prescribe medications, state licensure systems that grant physicians the exclusive right to prescribe and pharmacists the exclusive right to dispense prescription medication are protected under Article X of the United States Constitution. Historically, under Article X of the U.S. Constitution, states have the authority to regulate activities that affect the health, safety and welfare of their citizens. In 1889, state licensure systems that granted physicians the exclusive right to prescribe and pharmacists the exclusive right to dispense prescription medication were tested and found valid. In Dent v. West Virginia, 129 U.S. 114 (1889), the Supreme Court denied a due process challenge to a West Virginia medical practice act that required state licensure of physicians. Thus, any regulations as they relate to how physicians prescribe and how pharmacists dispense prescription medication are the responsibility of the states.