The MVP Act amends Medicaid and Medicare drug pricing rules to expand value-based purchasing arrangements, where manufacturers can adjust drug payments based on patient outcomes. The bill allows manufacturers to offer different pricing points for the same drug if they make the arrangement available to all states, and clarifies how these outcome-based rebates and refunds are calculated in determining drug prices for payment purposes. The legislation applies to drug manufacturers selling through Medicaid and Medicare, as well as state Medicaid agencies that can now negotiate these outcome-based deals for both outpatient and inpatient drugs. Within 180 days of enactment, federal health agencies must issue guidance and regulations implementing these changes and clarifying how the arrangements comply with anti-kickback laws. The Government Accountability Office must study the impact of these arrangements on drug access, patient outcomes, and costs by June 30, 2028.