MVP Act
- Bill Number
- H.R. 7871
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-03-09: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-07-01T08:09:02Z
AI-Generated Summary
Purpose of the Legislation This bill, known as the Medicaid VBPs for Patients Act or MVP Act, aims to codify value-based purchasing arrangements (VBPs) in the Medicaid program. These arrangements tie drug payments to patient outcomes or measures. It also updates price reporting rules for such arrangements in Medicaid and Medicare, provides guidance for inpatient drug use, creates a safe harbor under the Anti-Kickback Statute, and requires a study on their effects.
Key Provisions Outlined
- Codifying Multiple Best Prices: Amends Medicaid law to allow manufacturers to report multiple best price points for a single drug dosage under a VBP, but only if the arrangement is offered to all states.
- Changes to Average Manufacturer Price (AMP): Excludes certain refunds, rebates, or payment adjustments triggered by unmet patient outcomes from the AMP calculation for drugs sold under VBPs. Adds a rule for installment payments in VBPs to treat the full price as paid upfront.
- Medicare Average Sales Price (ASP): Excludes amounts already removed from AMP calculations when determining ASP for drugs under VBPs that use multiple best prices.
- Inpatient Drug Guidance: Requires the Department of Health and Human Services to issue guidance within 180 days on using VBPs for inpatient hospital drugs, including options for multi-state agreements to handle patients receiving care out of state.
- Anti-Kickback Statute Exception: Creates a new safe harbor allowing manufacturers to provide remuneration to states under Medicaid VBPs when patients do not meet defined outcomes.
- GAO Study: Directs the Government Accountability Office to study VBP impacts on drug access, outcomes, costs, and compliance, with a report due by June 30, 2029.
Significant Changes to Existing Law Introduced
- Updates section 1927 of the Social Security Act to define VBPs by referencing existing federal regulations and permit multiple best prices.
- Revises AMP and ASP calculation rules to account for outcome-based payments and installments.
- Adds a specific exception to the Anti-Kickback Statute (section 1128B) for VBP-related payments.
- These changes build on current Medicaid rebate and Medicare pricing frameworks without altering core program structures.
Potential Impacts
- On Government Agencies: Requires rulemaking by HHS within 180 days and implementation by the HHS Inspector General; mandates guidance for state Medicaid agencies and a GAO study that could affect program oversight and spending.
- On Citizens: May improve access to high-cost or transformative drugs, such as gene therapies, by linking payments to results and requiring equal access for Medicaid programs.
- On International Relations: No direct effects identified.
- Overall, the changes could alter how states and manufacturers negotiate drug prices while maintaining compliance with existing rebate programs.
Main Stakeholders Affected
- State Medicaid agencies and programs.
- Pharmaceutical manufacturers.
- Patients in Medicaid and Medicare, especially those using drugs under VBPs.
- The Department of Health and Human Services and its Office of Inspector General.
- The Government Accountability Office.
- Providers and entities involved in the 340B drug pricing program.
Notable Legal, Constitutional, or Political Implications
- Introduces targeted exceptions to the Anti-Kickback Statute, which could affect fraud and abuse enforcement in outcome-based drug deals.
- Relies on regulatory definitions and requires agency rulemaking, potentially raising questions about administrative authority.
- The bill was introduced on a bipartisan basis, focusing on expanding VBP options without broader program reforms.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (16)
Rep. Auchincloss, Jake [D-MA-4], Rep. Miller-Meeks, Mariannette [R-IA-1], Rep. Joyce, John [R-PA-13], Rep. Peters, Scott H. [D-CA-50], Rep. Davis, Donald G. [D-NC-1], Rep. Mullin, Kevin [D-CA-15], Rep. Ivey, Glenn [D-MD-4], Rep. Van Duyne, Beth [R-TX-24], Rep. Carter, Earl L. "Buddy" [R-GA-1], Rep. Dunn, Neal P. [R-FL-2], Rep. Cammack, Kat [R-FL-3], Rep. Lieu, Ted [D-CA-36], Rep. Kelly, Mike [R-PA-16], Rep. Meuser, Daniel [R-PA-9], Rep. Balderson, Troy [R-OH-12], Rep. Bilirakis, Gus M. [R-FL-12]
Recent Actions
- 2026-03-09: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-03-09: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-03-09: Introduced in House
- 2026-03-09: Introduced in House
Bill Versions
- Medicaid VBPs for Patients Act — issued 2026-03-09 — PDF (10 pages)