; and (2) by adding at the end the following new clause: (ii) Negotiated prices at point-of-sale (I) In general Negotiated prices for covered part D drugs described in clause (i), including all price negotiated concessions, shall be provided at the point-of-sale of the covered part D drug. If the negotiated price, including all negotiated price concessions, is not possible to calculate at the point-of-sale, an approximate negotiated price (as established by the Secretary) shall be used under the prescription drug plan or MA–PD plan. (II) Approximate negotiated price In determining an approximate negotiated price for a covered part D drug under subclause (I), the Secretary shall ensure that— (aa) such price reflects the estimated negotiated price that is based on the previous year’s negotiated price concessions negotiated under the plan for all or similar covered part D drugs or is based on such other factors as the Secretary may determine appropriate; and (bb) the use of such price does not prevent the use of value-based contracts between drug manufacturers, PDP sponsors, MA organizations, and pharmacies. . (b) Effective date The amendment made by subsection (a) shall apply to plan years beginning on or after January 1, 2019.