MVP Act
Sponsored By: Senator Markwayne Mullin
Introduced
Summary
Value-based purchasing arrangements for drugs. This bill would let Medicaid use different "best price" points when drug payments are tied to patient outcomes and it would change how manufacturers report prices and how Medicare counts some outcome-based payments.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 2 benefits, 0 costs, 2 mixed.
New drug pricing and rebate rules
If enacted, this would change how drug makers report prices to Medicaid and Medicare for value-based deals. Outcome-triggered refunds, rebates, reimbursements, or withheld payments would count toward the Average Manufacturer Price during the rebate period. For installment payment deals, the full price would count as if paid in the first installment for rebate purposes. A manufacturer could report multiple best-price points for the same drug only if it offers the arrangement to all States. The HHS Secretary must write rules within 180 days.
Guidance for states on inpatient drug payments
If enacted, the HHS Secretary would give states guidance within 180 days on value-based deals for drugs used with inpatient hospital care when the drug is paid for directly. The guidance must address how multiple States can enter agreements and transfer funds. That would let a patient treated outside their home State be treated administratively as if they received the drug in their State of residence.
Allow states to get outcome-based drug payments
If enacted, the bill would add an exception to the federal Anti-Kickback Statute. This would let a drug maker—or a third party on its behalf—pay a State under a value-based purchasing deal when a patient fails to meet agreed outcomes after getting a covered outpatient drug. The rule would apply to State Medicaid plans and waivers. The HHS Inspector General must issue implementing rules within 180 days.
GAO study on value-based drug purchasing
If enacted, the Comptroller General would study how value-based drug deals affect access, outcomes, and overall costs. The study would analyze effects on rare gene therapies, disparities, interactions with Medicaid rebates, the 340B and Medicare Part B programs, pricing structures, and possible long-term State savings. GAO must report to Congress by June 30, 2029.
Sponsors & CoSponsors
Sponsor
Markwayne Mullin
OK • R
Cosponsors
Maggie Hassan
NH • D
Sponsored 5/7/2025
Tim Scott
SC • R
Sponsored 5/7/2025
Roll Call Votes
No roll call votes available for this bill.
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