; and (B) by inserting before the period at the end the following: , and (IV) pharmacy benefit management services provided by the entity, or provided by a pharmacy benefit manager on behalf of the entity under a contract or other arrangement between the entity and the pharmacy benefit manager, shall comply with the requirements of section 1927(e)(6) . (3) Effective date The amendments made by this subsection apply to contracts between States and managed care entities, other specified entities, or pharmacy benefits managers that are entered into or renewed on or after the date that is 90 days after the date of enactment of this Act. 4. GAO report Not later than 180 days after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on the feasibility and affordability of direct manufacturing by the Federal Government.