; and (2) by adding at the end the following new subparagraph: (B) Certain remuneration under value-based purchasing arrangements excluded In calculating the manufacturer’s average sales price under this subsection for a drug or biological that is sold under a value-based purchasing arrangement (as defined in section 1927(k)(12)) and with respect to which the manufacturer of such drug or biological has elected to include multiple best price points (as described in section 1927(c)(1)(C)(ii)(VI)) in reporting the best price of such drug under section 1927(b), such manufacturer's average sales price shall not include any amount that is excluded from the calculation of the average manufacturer price of such drug or biological under section 1927(k)(1)(B)(i)(IX). . 4. Guidance on value-based purchasing arrangements for inpatient drugs under Medicaid Not later than 180 days after the date of the enactment of this Act, the Secretary of Health and Human Services shall issue guidance to State Medicaid agencies on the option of entering into a value-based purchasing arrangement (as defined in section 1927(k)(12) of the Social Security Act ( 42 U.S.C. 1396r–8(k)(12) )) with manufacturers for drugs or biological products provided as part of, or as incident to and in the same setting as, inpatient hospital services furnished under a State plan under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ), or under a waiver of such plan, where such drugs or biological products are reimbursed directly and not paid for as part of payment for such inpatient hospital services, including guidance on how multiple States may enter into agreements with one another and with manufacturers which permit the transfer of funds between the participating States so that individuals who reside in a State different from the State in which they receive a drug subject to a value-based purchasing arrangement as an inpatient may be treated as if they received such drug in the State in which they reside. 5. Exception under the antikickback