HR7871119th CongressWALLET

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.

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  • 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.

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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.

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