MVP Act
Sponsored By: Representative Guthrie
Introduced
Summary
This bill would codify and expand Medicaid value-based purchasing arrangements, letting states and drug makers use multiple “best price” tiers and bundled-sales rules to tie payments to patient outcomes. It would also change how Medicaid and Medicare calculate drug prices and add a new Anti-Kickback Statute safe harbor for payments to States under these arrangements.
Show full summary
- States and Medicaid programs would get clearer authority to run VBPs, use multiple best-price points for the same drug strength, and treat those deals as bundled sales. The bill directs guidance on inpatient drugs and allows inter-State fund transfers so patients treated outside their home State can be treated as if in their home State.
- Drug manufacturers would have to include outcome-triggered rebates, refunds, and free goods from VBPs when reporting Average Manufacturer Price for Medicaid. The bill adds special rules for installment payments that treat the full aggregate price as paid in the first installment for reporting, and it excludes VBP remuneration from Medicare average sales price when a multiple best-price election is used. HHS must issue implementing rules within 180 days.
- The bill creates an Anti-Kickback Statute safe harbor for VBPs that provide remuneration to States and requires HHS’s Inspector General to publish implementing rules within 180 days. It also orders a Government Accountability Office study, with a final report due June 30, 2029, on access to transformative therapies, socioeconomic disparities, interactions with the Medicaid drug rebate program and 340B, Part B prices, and potential long-term state savings.
Your PRIA Score
Personalized for You
How does this bill affect your finances?
Sign up for a PRIA Policy Scan to see your personalized alignment score for this bill and every other piece of legislation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
3 provisions identified: 1 benefits, 0 costs, 2 mixed.
Changes to Medicaid and Medicare drug pricing
If enacted, this would change how drug makers and programs report prices and rebates for value-based purchasing (VBP) drug deals. A manufacturer could report multiple "best price" points for the same drug only if it offers the VBP to all States. For drugs sold under a VBP, Medicaid price calculations (AMP) would include refunds, rebates, reimbursements, free goods, or payment withholdings triggered when patients do not meet outcomes. Medicare's average sales price (ASP) calculations would exclude the same amounts the bill excludes from AMP when the manufacturer elects multiple best price points. The Secretary must write rules to implement the AMP changes within 180 days after enactment.
New safe harbor for Medicaid VBP payments
If enacted, this would add an exception to the federal Anti-Kickback law for payments a drug maker (or third party for the maker) gives a State under a value-based purchasing arrangement when a patient fails to meet outcome goals. The exception would cover VBP payments under a State Medicaid plan or waiver. The HHS Inspector General must issue rules to implement the new safe harbor within 180 days after enactment.
Guidance on inpatient Medicaid drug deals
If enacted, HHS would issue guidance to State Medicaid agencies within 180 days on using VBPs for drugs given with inpatient hospital care when those drugs are paid for separately. The guidance would explain how multiple States can agree with each other and with manufacturers to transfer funds. This would let a patient treated in a different State be treated as if they received the drug in their home State for billing and payment purposes.
Sponsors & CoSponsors
Sponsor
Guthrie
KY • R
Cosponsors
Auchincloss
MA • D
Sponsored 3/9/2026
Miller-Meeks
IA • R
Sponsored 3/9/2026
Joyce (PA)
PA • R
Sponsored 3/9/2026
Peters
CA • D
Sponsored 3/9/2026
Davis (NC)
NC • D
Sponsored 3/9/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.govTake It Personal
Get Your Personalized Policy View
Start a Free Government Policy Watch to see how policy affects your household, then upgrade to PRIA Full Coverage for year-round monitoring.
Already have an account? Sign in