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) Study. The Comptroller General of the United States shall conduct a study on the extent to which value-based purchasing arrangements (as defined in section 1927(k)(12) of the Social Security Act (42 U.S.C. 1396r–8(k)(12))) facilitate patient access to covered outpatient drugs, improve patient outcomes, lower overall health system costs, and lower costs for patients in Federal health care programs. In conducting such study, the Comptroller General shall—
(1) study the impact of this Act on—
(A) access to transformative therapies, including rare disease gene therapies, generally;
(B) mitigating socioeconomic disparities in accessing covered outpatient drugs sold under value-based purchasing arrangements through its requirement that State Medicaid programs have access to the same value-based purchasing arrangement pricing structure that are available in the commercial market for such drugs;
(C) the Medicaid drug rebate program under section 1927 of the Social Security Act (42 U.S.C. 1396r–8), the 340B drug pricing program under section 340B of the Public Health Service Act (42 U.S.C. 256b), and part B of title XVIII of the Social Security Act (42 U.S.C. 1395j et seq.), including compliance with such programs;
(D) expenditures under State Medicaid programs; and
(E) prices for such drugs under the Medicaid program in States that do not enter into such arrangements;
(2) analyze all the types of value-based purchasing arrangement pricing structures, which structures are working well (as measured by price and ease of implementing), and which need improvement; and
(3) study the potential long-term savings for States that enter into such arrangements under State Medicaid programs.
(b) Report. Not later than June 30, 2029, the Comptroller General of the United States shall submit to Congress a report containing the results of the study conducted under subsection (a).