What does Preamble of HR 7871 do?

This bill, formally titled 'To amend title XIX of the Social Security Act to codify value-based purchasing arrangements under the Medicaid program and reforms related to price reporting under such arrangements, and for other purposes,' aims to modify the Medicaid program. The bill intends to codify value-based purchasing arrangements within the Medicaid program. It also proposes reforms related to price reporting under these arrangements.

What does SHORT TITLE. of HR 7871 do?

This bill is formally titled the Medicaid VBPs for Patients Act.

What does CODIFYING VALUE-BASED PURCHASING ARRANGEMENTS UNDER MEDICAID of HR 7871 do?

This section amends Section 1927(c)(1)(C)(ii) of the Social Security Act to allow for multiple best price points for a single drug under a value-based purchasing arrangement, provided the manufacturer offers such an arrangement to all states. It clarifies that manufacturers can treat value-based purchasing arrangements as bundled sales. This section amends Section 1927(k)(1) of the Social Security Act to define Average Manufacturer Price, including refunds, rebates, or withholding of payments triggered by patient outcomes under value-based purchasing arrangements. It establishes a special rule for determining the price of drugs sold under value-based purchasing arrangements where payment is made in installments. The Secretary of Health and Human Services must implement these amendments through rulemaking within 180 days of the Act's enactment. This section defines 'value-based purchasing arrangement' by referencing Section 447.502 of Title 42 of the Code of Federal Regulations (or any successor regulation).

What does CALCULATION OF AVERAGE SALES PRICE UNDER MEDICARE. of HR 7871 do?

This section amends Section 1847A(c)(3) of the Social Security Act. The amendment introduces a new subparagraph (B) to address the calculation of a manufacturer's average sales price. The new subparagraph excludes certain remuneration from the average sales price calculation for drugs or biologicals sold under value-based purchasing arrangements. This exclusion applies if the manufacturer has elected to include multiple best price points. The excluded amounts are those also excluded from the calculation of the average manufacturer price under section 1927(k)(1)(B)(i)(IX).

What does GUIDANCE ON VALUE-BASED PURCHASING ARRANGEMENTS FOR INPATIENT of HR 7871 do?

This section requires the Secretary of Health and Human Services to issue guidance to State Medicaid agencies regarding value-based purchasing arrangements for inpatient drugs. The guidance concerns arrangements between State Medicaid agencies and manufacturers for drugs or biological products used in inpatient hospital services. The guidance must address how multiple States can enter into agreements and transfer funds to ensure individuals receive appropriate treatment regardless of the state where they reside. The arrangements apply to drugs or biological products reimbursed directly and not included in payment for inpatient hospital services.

What does EXCEPTION UNDER THE ANTIKICKBACK STATUTE. of HR 7871 do?

This section amends Section 1128B(b)(3) of the Social Security Act. The amendments involve adjustments to subparagraphs (J), (K), and (L)(iii) including moving left margins and striking text. A new subparagraph (M) is added, exempting certain remuneration provided by manufacturers or third parties to states under value-based purchasing arrangements. This exemption applies when a patient fails to achieve outcomes or measures defined in the arrangement following the administration of a covered outpatient drug. The Inspector General of the Department of Health and Human Services must implement these amendments through rulemaking within 180 days of the Act's enactment.

What does GAO STUDY AND REPORT ON USE OF VALUE-BASED PURCHASING of HR 7871 do?

This section mandates a study by the Comptroller General of the United States regarding value-based purchasing arrangements. The study will assess how these arrangements impact patient access to covered outpatient drugs, patient outcomes, and health system costs. Specific areas of focus include access to transformative therapies, socioeconomic disparities in drug access, and compliance with existing drug pricing programs (Medicaid rebate, 340B, and Medicare Part B). The study will also analyze different value-based purchasing arrangement pricing structures and identify areas for improvement. The Comptroller General will examine potential long-term savings for states participating in these arrangements under Medicaid. A report detailing the study's findings must be submitted to Congress by June 30, 2029.

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MVP Act — HR. 7871

Last updated: 3/9/2026 · Introduced: 3/9/2026

Author: Brett Guthrie (R-KY)

TL;DR (AI)

This bill modifies the Medicaid program to codify value-based purchasing arrangements, allowing manufacturers to offer multiple best price points if offered to all states.
It clarifies how Average Manufacturer Price is calculated, including refunds and rebates tied to patient outcomes under value-based purchasing arrangements, and excludes certain remuneration from the Average Sales Price calculation under Medicare.
The bill requires the Secretary of Health and Human Services to issue guidance to state Medicaid agencies on value-based purchasing arrangements for inpatient drugs and exempts certain payments under these arrangements from the Anti-Kickback Statute.

119th Congressin committeeS. 1637(In Committee)Official page

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Includes provisions on preamble, short title., and 5 more.

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