H.R. 7871
MVP Act
Sponsor: Brett Guthrie
Official summary
Written by the Congressional Research Service.
Medicaid VBPs for Patients Act or the MVP Act
This bill provides statutory authority for regulations that allow for the use of varying best price points under value-based purchasing arrangements for purposes of the Medicaid Drug Rebate Program. (Value-based purchasing arrangements refer to arrangements in which the price of a drug is linked to clinical outcomes; such arrangements are particularly used for new high-cost treatments, such as gene therapies.)
The Government Accountability Office must study the impact of value-based purchasing arrangements on federal health care programs, including with respect to the bill's changes.
Additionally, the bill (1) exempts sales of drugs that are made under value-based purchasing arrangements from calculations of the manufacturer average sales price for purposes of payments under Medicare medical services, if the manufacturer reports multiple best prices under Medicaid in accordance with the bill's changes; and (2) requires the Centers for Medicare & Medicaid Services to issue guidance on how state Medicaid programs may cover drugs in inpatient settings via value-based purchasing arrangements.
Text of the bill
Section 1847A(c)(3) of the Social Security Act (42 U.S.C. 1395w–3a(c)(3)) is amended—
(1) by striking In calculating and inserting the following:
(A) In general. Subject to subparagraph (B), in calculating
; and
(2) by adding at the end the following new subparagraph:
(B) Certain remuneration under value-based purchasing arrangements excluded. In calculating the manufacturer’s average sales price under this subsection for a drug or biological that is sold under a value-based purchasing arrangement (as defined in section 1927(k)(12)) and with respect to which the manufacturer of such drug or biological has elected to include multiple best price points (as described in section 1927(c)(1)(C)(ii)(VI)) in reporting the best price of such drug under section 1927(b), such manufacturer's average sales price shall not include any amount that is excluded from the calculation of the average manufacturer price of such drug or biological under section 1927(k)(1)(B)(i)(IX).