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
(a) In general. Section 1128B(b)(3) of the Social Security Act (42 U.S.C. 1320a–7b(b)(3)) is amended—
(1) in subparagraph (J), by moving the left margin of such subparagraph 2 ems to the left;
(2) in subparagraph (K)—
(A) by moving the left margin of such subparagraph 2 ems to the left; and
(B) by striking and at the end;
(3) in subparagraph (L)(iii), by striking the period and inserting ; and; and
(4) by adding at the end the following new subparagraph:
(M) any remuneration provided by a manufacturer or third party on behalf of a manufacturer to a State under a value-based purchasing arrangement (as defined in section 1927(k)(12)) under a State plan under title XIX (or waiver of such plan) in the case a patient fails to achieve outcomes or measures defined in such arrangement following the administration of a covered outpatient drug (as defined in section 1927(k)(2)).
(b) Rulemaking. Not later than 180 days after the date of the enactment of this Act, the Inspector General of the Department of Health and Human Services shall through rulemaking implement the amendments made by this section.