I'm pleased to reintroduce my bipartisan MVP Act to expand access to innovative, lifesaving treatments for vulnerable Americans with rare diseases. This transformative legislation would give states the flexibility to offer high-cost therapies for rare diseases without raising taxes or cutting other state programs.
Brett Guthrie will expand access to innovative, lifesaving treatments for vulnerable Americans with rare diseases by advancing the Medicaid VBPs for Patients Act and value-based Medicaid purchasing agreements.
Occurrences
Evidence
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CMS finalized a rule to support state flexibility to enter value-based purchasing arrangements with manufacturers, including Medicaid, effective March 1, 2021 with some provisions effective January 1, 2022.
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Current regulation defines a value-based purchasing arrangement as one intended to align pricing or payments to observed or expected therapeutic or clinical value, including evidence-based or outcomes-based measures.
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Current regulation states that if a manufacturer offers a VBP arrangement to all states, best price may include varying best price points for a single dosage form and strength because of that arrangement.
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Congress.gov lists Brett Guthrie as Representative for Kentucky District 2 in the 111th-119th Congresses and shows his sponsored legislation and member activity records.
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H.R.1 became Public Law 119-21 on July 4, 2025. Its health title includes extensive Medicaid provisions such as eligibility redeterminations, provider tax limits, work requirements, cost sharing, HCBS waivers, and rural health funding; the page contains no matching text for value-based purchasing.
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The House vote on concurring in the Senate amendment to H.R.1 passed 218-214. Brett Guthrie, Republican of Kentucky, voted Aye.
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GovInfo lists H.R. 7871 in the 119th Congress as the Medicaid VBPs for Patients Act, sponsored by Brett Guthrie, with last action on March 9, 2026: introduced in the House and referred to the Committees on Energy and Commerce and Ways and Means. The full title would amend title XIX to codify value-based purchasing arrangements under Medicaid and related price-reporting reforms.
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Guthrie's official House office announced that he introduced the Medicaid VBPs for Patients Act with bipartisan cosponsors. The release says the bill would let states voluntarily enter value-based purchasing agreements tied to patient outcomes and would modernize the Medicaid Drug Rebate Program by allowing multiple best prices for these therapies.
Assessments
Guthrie materially advanced the promised policy in the relevant federal office context by sponsoring and introducing H.R. 7871, the Medicaid VBPs for Patients Act, in the 119th Congress. However, the available official status shows the bill was only introduced and referred to House committees, with no enactment or implemented expansion of Medicaid value-based purchasing access for rare-disease treatments. Existing CMS VBP regulations predate this promise and do not establish Guthrie's delivery of the named Act. This is a serious legislative effort, but the promised outcome was not delivered.
Current CMS Medicaid drug rebate regulations do support value-based purchasing arrangements and allow multiple best-price points when manufacturers offer VBP arrangements to all states, so the underlying Medicaid VBP policy mechanism exists. However, the evidence does not show that Brett Guthrie sponsored, wrote, enacted, or materially advanced a Medicaid VBPs for Patients Act, and the major 119th Congress Medicaid law cited did not include the promised VBP rare-disease policy. Because the policy exists through CMS rulemaking rather than demonstrated Guthrie delivery of the named promise, this merits partial credit rather than full delivery.