; (B) in clause (v), by striking at the end the period and inserting ; and ; (C) by inserting after clause (v) the following new clause: (vi) in conjunction with reporting required under clause (i), in the case of a covered outpatient drug that is sold under a value-based purchasing arrangement (as defined in subsection (k)(12)) made available by the manufacturer to a State plan— (I) the pricing structure for such drug based on pre-defined outcomes or measures specified in such value-based purchasing arrangement; and (II) the best price for such covered outpatient drug outside of a value-based purchasing arrangement, which in the event such drug is sold exclusively through such an arrangement, means the lowest price available net of any discounts or offsets that are unrelated to a refund, rebate, reimbursement, free item, withholding, or repayment made under a value-based purchasing arrangement for such drug. ; and (D) by adding at the end of the flush left matter at the end the following new sentence: Information reported with respect to a rebate period under clause (i)(I) relating to average manufacturer price and clause (i)(II) relating to best price shall be updated for such rebate period if, subsequent to the date such information was reported, cumulative discounts, rebates, or other arrangements adjust such average price actually realized or best price available to the extent that such cumulative discounts, rebates, or other arrangements are not excluded under this section from the determination of average manufacturer price or best price. (2) Rules of construction Nothing in the amendments made by paragraph (1) shall be construed as— (A) requiring— (i) a State to enter into a value-based purchasing arrangement with a manufacturer for a covered outpatient drug; or (ii) a manufacturer to enter into a value-based purchasing arrangement with a State for a covered outpatient drug; (B) prohibiting a manufacturer from treating a value-based purchasing arrangement as a bundled sale