; and (B) by striking and after the semicolon at the end; (2) in subclause (K)— (A) by moving the left margin of such subparagraph 2 ems to the left; and (B) by striking the period at the end and inserting ; and ; and (3) by adding at the end the following new subparagraph: (L) any remuneration provided by a manufacturer or third party on behalf of a manufacturer to a plan under a value-based purchasing arrangement (as defined in section 1927(k)(12)) in the case a patient fails to achieve outcomes or measures defined in such arrangement following the administration of a covered outpatient drug (as defined in section 1927(k)(2)). . 7. GAO study and report on use of value-based purchasing arrangements (a) Study The Comptroller General of the United States shall conduct a study on the extent to which value-based purchasing arrangements (as defined in section 1927(k)(12) of the Social Security Act ( 42 U.S.C. 1396r–8(k)(12) ) facilitate patient access to covered outpatient drugs, improve patient outcomes, lower overall health system costs, and lower costs for patients in Federal health care programs. In conducting such study, the Comptroller General shall— (1) study the impact of this Act on— (A) access to transformative therapies, including rare disease gene therapies, generally; (B) mitigating socioeconomic disparities in accessing covered outpatient drugs sold under value-based purchasing arrangements through its requirement that State Medicaid programs have access to the same value-based purchasing arrangement pricing structure that are available in the commercial market for such drugs; and (C) the Medicaid drug rebate program under section 1927 of the Social Security Act ( 42 U.S.C. 1396r–8 ), the 340B drug pricing program under section 340B of the Public Health Service Act ( 42 U.S.C. 256b ), and part B of title XVIII of the Social Security Act ( 42 U.S.C. 1395j et seq. ), including compliance with such programs