89–008 

111TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 111–648 

PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 847) TO AMEND THE 

PUBLIC HEALTH SERVICE ACT TO EXTEND AND IMPROVE PROTECTIONS 

AND SERVICES TO INDIVIDUALS DIRECTLY IMPACTED BY THE TERRORIST ATTACK IN NEW YORK CITY ON SEPTEMBER 11, 2001, AND FOR 

OTHER PURPOSES; PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 

2378) TO AMEND TITLE VII OF THE TARIFF ACT OF 1930 TO CLARIFY 

THAT FUNDAMENTAL EXCHANGE-RATE MISALIGNMENT BY ANY FOREIGN NATION IS ACTIONABLE UNDER UNITED STATES COUNTERVAILING AND ANTIDUMPING DUTY LAWS, AND FOR OTHER PURPOSES; 

AND PROVIDING FOR CONSIDERATION OF THE SENATE AMENDMENT TO 

THE BILL (H.R. 2701) TO AUTHORIZE APPROPRIATIONS FOR FISCAL YEAR 

2010 FOR INTELLIGENCE AND INTELLIGENCE-RELATED ACTIVITIES OF 

THE UNITED STATES GOVERNMENT, THE COMMUNITY MANAGEMENT 

ACCOUNT, AND THE CENTRAL INTELLIGENCE AGENCY RETIREMENT 

AND DISABILITY SYSTEM, AND FOR OTHER PURPOSES 

SEPTEMBER 29, 2010.—Referred to the House Calendar and ordered to be printed 

Mr. ARCURI, from the Committee on Rules, 

submitted the following 

R E P O R T 

[To accompany H. Res. 1674] 

The Committee on Rules, having had under consideration House 

Resolution 1674, by a non-record vote, report the same to the 

House with the recommendation that the resolution be adopted. 

SUMMARY OF PROVISIONS OF THE RESOLUTION

The resolution grants a single rule for consideration of (1) H.R. 

847, the ‘‘James Zadroga 9/11 Health and Compensation Act of 

2010, (2) H.R. 2378, the ‘‘Currency Reform for Fair Trade Act,’’ and 

(3) the Senate amendment to H.R. 2701, the ‘‘Intelligence Authorization Act of 2010.’’ 

With respect to H.R. 847, the resolution grants a closed rule providing one hour of debate in the House, with 30 minutes equally 

divided and controlled by the chair and ranking minority member 

of the Committee on Energy and Commerce, 20 minutes equally divided and controlled by the chair and ranking minority member of 

the Committee on the Judiciary, and 10 minutes equally divided 

and controlled by the chair and ranking minority member of the 

Committee on Ways and Means. 


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The resolution waives all points of order against consideration of 

H.R. 847 except those arising under clause 9 or 10 of rule XXI. In 

lieu of the amendments recommended by the Committee on Energy 

and Commerce and the Committee on the Judiciary, the amendment in the nature of a substitute printed in this report shall be 

considered as adopted. The rule provides that the bill, as amended, 

shall be considered as read. The rule waives all points of order 

against the bill, as amended. Finally, the rule provides one motion 

to recommit H.R. 847 with or without instructions. 

With respect to H.R. 2378, the resolution grants a closed rule 

providing one hour of debate in the House equally divided and controlled by the chair and ranking minority member of the Committee on Ways and Means. The rule waives all points of order 

against consideration of the bill except for clauses 9 and 10 of Rule 

XXI. The amendment in the nature of a substitute recommended 

by the Committee on Ways and Means shall be considered as 

adopted and the bill, as amended, shall be considered as read. The 

rule waives all points of order against provisions of the bill, as 

amended. The rule provides one motion to recommit with or without instructions. 

With respect to the Senate amendment to H.R. 2701, the rule 

makes in order a motion offered by the chair of the Permanent Select Committee on Intelligence or his designee that the House concur in the Senate amendment. All points of order against the motion are waived except those arising under clause 10 of rule XXI. 

The motion is debatable for one hour equally divided and controlled 

by the chair and ranking minority member of the Intelligence Committee. The rule provides that the Senate amendment and the motion shall be considered as read. 

EXPLANATION OF WAIVERS

With respect to H.R. 847, the waiver of all points of order against 

consideration of the bill (except those arising under clause 9 or 10 

of rule XXI) includes a waiver of section 303 of the Congressional 

Budget Act (breach of committee spending allocation). The waiver 

of all points of order against the bill includes a waiver of clause 7 

of rule XVI (germaneness) and clause 5 of rule XXI (inclusion of 

provisions on tax not reported by the Committee on Ways and 

Means). 

With respect to H.R. 2378, the waiver of all points of order 

against consideration of the bill (except those arising under clause 

9 or 10 of rule XXI) includes a waiver of clause 4(a) of rule XIII 

(regarding availability of committee report). Although the resolution waives all points of order against the bill, as amended, the 

Committee is not aware of any points of order. The waiver of all 

points of order is prophylactic. 

With respect to the Senate amendment to H.R. 2701, the Committee is not aware of any points of order. The waiver of all points 

of order is prophylactic. 

COMMITTEE VOTES

The results of each record vote on an amendment or motion to 

report, together with the names of those voting for and against, are 

printed below: 


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Rules Committee record vote No. 497 

Date: September 29, 2010. 

Measure: H.R. 847. 

Motion by: Mr. Dreier. 

Summary of motion: To make in order and provide appropriate 

waivers for a substitute amendment offered by the Minority Leader 

or his designee to H.R. 2378, the ‘‘Currency Reform for Fair Trade 

Act.’’ 

Results: Defeated 2–7. 

Vote by Members: McGovern—Nay; Hastings (FL)—Nay; Matsui—Nay; Arcuri—Nay; Pingree—Nay; Polis—Nay; Dreier—Yea; 

Foxx—Yea; Slaughter—Nay. 

Rules Committee record vote No. 498 

Date: September 29, 2010. 

Measure: H.R. 847. 

Motion by: Mr. Dreier. 

Summary of motion: To make in order a motion offered by Rep. 

Hoekstra (MI) to disagree in the Senate amendment to H.R. 2701, 

the ‘‘Intelligence Authorization Act of 2010,’’ and request a conference thereon. 

Results: Defeated 2–7. 

Vote by Members: McGovern—Nay; Hastings (FL)—Nay; Matsui—Nay; Arcuri—Nay; Pingree—Nay; Polis—Nay; Dreier—Yea; 

Foxx—Yea; Slaughter—Nay. 

Rules Committee record vote No. 499 

Date: September 29, 2010. 

Measure: H.R. 847. 

Motion by: Mr. Dreier. 

Summary of motion: To make in order and provide appropriate 

waivers for an amendment in the nature of a substitute by Rep. 

Reichert (WA) and Rep. Poe (TX), #5, which would: (1) strike the 

tax increase used as a pay-for that had been rejected first in H.R. 

3962 and then in H.R. 4849, and was added to H.R. 847 prior to 

consideration of the bill by the House; (2) replace it with the $1.6 

billion remaining money not used for the census, plus the $4.99 billion in rescissions that were contained in the House-adopted 

amendment to H.R. 4899, but were not included in the Senate 

amendment to H.R. 1586; (3) include the language from the PQ to 

H.R. 4785—Requiring the Collection of Unpaid Taxes from Federal 

Employees. 

Results: Defeated 2–7. 

Vote by Members: McGovern—Nay; Hastings (FL)—Nay; Matsui—Nay; Arcuri—Nay; Pingree—Nay; Polis—Nay; Dreier—Yea; 

Foxx—Yea; Slaughter—Nay. 

SUMMARY OF THE AMENDMENT IN THE NATURE OF A SUBSTITUTE TO

H.R. 847 TO BE CONSIDERED AS ADOPTED

The amendment in the nature of a substitute provides $7.4 billion in funding for health claims resulting from the September 11 

terrorist attacks. It amends the Public Health Service Act to establish the World Trade Center Health Program (WTC Program) within the National Institute for Occupational Safety and Health to 


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provide (1) medical monitoring and treatment benefits to eligible 

emergency responders and recovery and cleanup workers (including 

those who are federal employees) who responded to the September 

11, 2001, terrorist attacks; and (2) initial health evaluation, monitoring, and treatment benefits to residents and other building occupants and area workers in New York City who were directly impacted and adversely affected by such attacks. It amends the Air 

Transportation Safety and System Stabilization Act to: (1) make individuals eligible for compensation under the September 11 Victim 

Compensation Fund of 2001 for harm as a result of debris removal; 

(2) extend the deadline for making a claim for compensation for 

physical harm not discovered before the deadline; (3) cap liability 

for claims related to debris removal based on the level of insurance 

available; (4) limit the total payment for compensation for claims 

filed on or after the regulations are updated pursuant to this Act; 

and (5) cap the amount that an individual may charge in connection with a claim under such Act, with exceptions. Finally, it 

amends tax provisions that in some cases allow a U.S. subsidiary 

of a foreign corporation to avoid U.S. withholding tax on payments 

to a related subsidiary in a country that has a tax treaty with the 

United States and changes the timing of estimated corporate tax 

payments. 

TEXT OF THE SUBSTITUTE AMENDMENT TO H.R. 847 TO BE

CONSIDERED AS ADOPTED

Strike all after the enacting clause and insert the following: 

SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

(a) SHORT TITLE.—This Act may be cited as the ‘‘James Zadroga 

9/11 Health and Compensation Act of 2010’’. 

(b) TABLE OF CONTENTS.—The table of contents of this Act is as 

follows: 

Sec. 1. Short title; table of contents. 

TITLE I—WORLD TRADE CENTER HEALTH PROGRAM 

Sec. 101. World Trade Center Health Program. 

‘‘TITLE XXXIII—WORLD TRADE CENTER HEALTH PROGRAM 

‘‘Subtitle A—Establishment of Program; Advisory Committee 

‘‘Sec. 3301. Establishment of World Trade Center Health Program. 

‘‘Sec. 3302. WTC Health Program Scientific/Technical Advisory Committee; 

WTC Health Program Steering Committees. 

‘‘Sec. 3303. Education and outreach. 

‘‘Sec. 3304. Uniform data collection and analysis. 

‘‘Sec. 3305. Clinical Centers of Excellence and Data Centers. 

‘‘Sec. 3306. Definitions. 

‘‘Subtitle B—Program of Monitoring, Initial Health Evaluations, and Treatment 

‘‘PART 1—WTC RESPONDERS

‘‘Sec. 3311. Identification of WTC responders and provision of WTC-related 

monitoring services. 

‘‘Sec. 3312. Treatment of enrolled WTC responders for WTC-related health conditions. 

‘‘Sec. 3313. National arrangement for benefits for eligible individuals outside 

New York. 

‘‘PART 2—WTC SURVIVORS

‘‘Sec. 3321. Identification and initial health evaluation of screening-eligible and 

certified-eligible WTC survivors. 


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‘‘Sec. 3322. Followup monitoring and treatment of certified-eligible WTC survivors for WTC-related health conditions. 

‘‘Sec. 3323. Followup monitoring and treatment of other individuals with WTCrelated health conditions. 

‘‘PART 3—PAYOR PROVISIONS

‘‘Sec. 3331. Payment of claims. 

‘‘Sec. 3332. Administrative arrangement authority. 

‘‘Subtitle C—Research Into Conditions 

‘‘Sec. 3341. Research regarding certain health conditions related to September 

11 terrorist attacks. 

‘‘Sec. 3342. World Trade Center Health Registry. 

‘‘Subtitle D—Funding 

‘‘Sec. 3351. World Trade Center Health Program Fund. 

TITLE II—SEPTEMBER 11TH VICTIM COMPENSATION FUND OF 2001 

Sec. 201. Definitions. 

Sec. 202. Extended and expanded eligibility for compensation. 

Sec. 203. Requirement to update regulations. 

Sec. 204. Limited liability for certain claims. 

Sec. 205. Funding; attorney fees. 

TITLE III—LIMITATION ON TREATY BENEFITS FOR CERTAIN DEDUCTIBLE 

PAYMENTS; TIME FOR PAYMENT OF CORPORATE ESTIMATED TAXES 

Sec. 301. Limitation on treaty benefits for certain deductible payments. 

Sec. 302. Time for payment of corporate estimated taxes. 

TITLE IV—BUDGETARY EFFECTS 

Sec. 401. Compliance with Statutory Pay-As-You-Go Act of 2010. 

TITLE I—WORLD TRADE CENTER 

HEALTH PROGRAM 

SEC. 101. WORLD TRADE CENTER HEALTH PROGRAM. 

The Public Health Service Act is amended by adding at the end 

the following new title: 

‘‘TITLE XXXIII—WORLD TRADE CENTER 

HEALTH PROGRAM 

‘‘Subtitle A—Establishment of Program; 

Advisory Committee 

‘‘SEC. 3301. ESTABLISHMENT OF WORLD TRADE CENTER HEALTH PROGRAM. 

‘‘(a) IN GENERAL.—There is hereby established within the Department of Health and Human Services a program to be known 

as the World Trade Center Health Program, which shall be administered by the WTC Program Administrator, to provide beginning 

on July 1, 2011— 

‘‘(1) medical monitoring and treatment benefits to eligible 

emergency responders and recovery and cleanup workers (including those who are Federal employees) who responded to 

the September 11, 2001, terrorist attacks; and 

‘‘(2) initial health evaluation, monitoring, and treatment benefits to residents and other building occupants and area workVerDate Mar 15 2010 22:29 Sep 29, 2010 Jkt 089008 PO 00000 Frm 00005 Fmt 6659 Sfmt 6602 E:\HR\OC\HR648.XXX HR648

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ers in New York City who were directly impacted and adversely affected by such attacks. 

‘‘(b) COMPONENTS OF PROGRAM.—The WTC Program includes the 

following components: 

‘‘(1) MEDICAL MONITORING FOR RESPONDERS.—Medical monitoring under section 3311, including clinical examinations and 

long-term health monitoring and analysis for enrolled WTC responders who were likely to have been exposed to airborne toxins that were released, or to other hazards, as a result of the 

September 11, 2001, terrorist attacks. 

‘‘(2) INITIAL HEALTH EVALUATION FOR SURVIVORS.—An initial 

health evaluation under section 3321, including an evaluation 

to determine eligibility for followup monitoring and treatment. 

‘‘(3) FOLLOWUP MONITORING AND TREATMENT FOR WTC-RELATED HEALTH CONDITIONS FOR RESPONDERS AND SURVIVORS.— 

Provision under sections 3312, 3322, and 3323 of followup 

monitoring and treatment and payment, subject to the provisions of subsection (d), for all medically necessary health and 

mental health care expenses of an individual with respect to a 

WTC-related health condition (including necessary prescription 

drugs). 

‘‘(4) OUTREACH.—Establishment under section 3303 of an 

education and outreach program to potentially eligible individuals concerning the benefits under this title. 

‘‘(5) CLINICAL DATA COLLECTION AND ANALYSIS.—Collection 

and analysis under section 3304 of health and mental health 

data relating to individuals receiving monitoring or treatment 

benefits in a uniform manner in collaboration with the collection of epidemiological data under section 3342. 

‘‘(6) RESEARCH ON HEALTH CONDITIONS.—Establishment 

under subtitle C of a research program on health conditions resulting from the September 11, 2001, terrorist attacks. 

‘‘(c) NO COST SHARING.—Monitoring and treatment benefits and 

initial health evaluation benefits are provided under subtitle B 

without any deductibles, copayments, or other cost sharing to an 

enrolled WTC responder or certified-eligible WTC survivor. Initial 

health evaluation benefits are provided under subtitle B without 

any deductibles, copayments, or other cost sharing to a screeningeligible WTC survivor. 

‘‘(d) PREVENTING FRAUD AND UNREASONABLE ADMINISTRATIVE

COSTS.— 

‘‘(1) FRAUD.—The Inspector General of the Department of 

Health and Human Services shall develop and implement a 

program to review the WTC Program’s health care expenditures to detect fraudulent or duplicate billing and payment for 

inappropriate services. This title is a Federal health care program (as defined in section 1128B(f) of the Social Security Act) 

and is a health plan (as defined in section 1128C(c) of such 

Act) for purposes of applying sections 1128 through 1128E of 

such Act. 

‘‘(2) UNREASONABLE ADMINISTRATIVE COSTS.—The Inspector 

General of the Department of Health and Human Services 

shall develop and implement a program to review the WTC 

Program for unreasonable administrative costs, including with 


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respect to infrastructure, administration, and claims processing. 

‘‘(e) QUALITY ASSURANCE.—The WTC Program Administrator 

working with the Clinical Centers of Excellence shall develop and 

implement a quality assurance program for the monitoring and 

treatment delivered by such Centers of Excellence and any other 

participating health care providers. Such program shall include— 

‘‘(1) adherence to monitoring and treatment protocols; 

‘‘(2) appropriate diagnostic and treatment referrals for participants; 

‘‘(3) prompt communication of test results to participants; 

and 

‘‘(4) such other elements as the Administrator specifies in 

consultation with the Clinical Centers of Excellence. 

‘‘(f) ANNUAL PROGRAM REPORT.— ‘‘(1) IN GENERAL.—Not later than 6 months after the end of 

each fiscal year in which the WTC Program is in operation, the 

WTC Program Administrator shall submit an annual report to 

the Congress on the operations of this title for such fiscal year 

and for the entire period of operation of the program. 

‘‘(2) CONTENTS INCLUDED IN REPORT.—Each annual report 

under paragraph (1) shall include at least the following: 

‘‘(A) ELIGIBLE INDIVIDUALS.—Information for each clinical program described in paragraph (3)— 

‘‘(i) on the number of individuals who applied for 

certification under subtitle B and the number of such 

individuals who were so certified; 

‘‘(ii) of the individuals who were certified, on the 

number who received monitoring under the program 

and the number of such individuals who received medical treatment under the program; 

‘‘(iii) with respect to individuals so certified who received such treatment, on the WTC-related health conditions for which they were treated; and 

‘‘(iv) on the projected number of individuals who will 

be certified under subtitle B in the succeeding fiscal 

year and the succeeding 10-year period. 

‘‘(B) MONITORING, INITIAL HEALTH EVALUATION, AND

TREATMENT COSTS.—For each clinical program so described— 

‘‘(i) information on the costs of monitoring and initial health evaluation and the costs of treatment and 

on the estimated costs of such monitoring, evaluation, 

and treatment in the succeeding fiscal year; and 

‘‘(ii) an estimate of the cost of medical treatment for 

WTC-related health conditions that have been paid for 

or reimbursed by workers’ compensation, by public or 

private health plans, or by New York City under section 3331. 

‘‘(C) ADMINISTRATIVE COSTS.—Information on the cost of 

administering the program, including costs of program 

support, data collection and analysis, and research conducted under the program. 

‘‘(D) ADMINISTRATIVE EXPERIENCE.—Information on the 

administrative performance of the program, including— 


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‘‘(i) the performance of the program in providing 

timely evaluation of and treatment to eligible individuals; and 

‘‘(ii) a list of the Clinical Centers of Excellence and 

other providers that are participating in the program. 

‘‘(E) SCIENTIFIC REPORTS.—A summary of the findings of 

any new scientific reports or studies on the health effects 

associated with exposure described in section 3306(1), including the findings of research conducted under section 

3341(a). 

‘‘(F) ADVISORY COMMITTEE RECOMMENDATIONS.—A list of 

recommendations by the WTC Scientific/Technical Advisory Committee on additional WTC Program eligibility criteria and on additional WTC-related health conditions and 

the action of the WTC Program Administrator concerning 

each such recommendation. 

‘‘(3) SEPARATE CLINICAL PROGRAMS DESCRIBED.—In paragraph (2), each of the following shall be treated as a separate 

clinical program of the WTC Program: 

‘‘(A) FIREFIGHTERS AND RELATED PERSONNEL.—The benefits provided for enrolled WTC responders described in section 3311(a)(2)(A). 

‘‘(B) OTHER WTC RESPONDERS.—The benefits provided for 

enrolled WTC responders not described in subparagraph 

(A). 

‘‘(C) WTC SURVIVORS.—The benefits provided for screening-eligible WTC survivors and certified-eligible WTC survivors in section 3321(a). 

‘‘(g) NOTIFICATION TO CONGRESS UPON REACHING 80 PERCENT OF

ELIGIBILITY NUMERICAL LIMITS.—The Secretary shall promptly notify the Congress of each of the following: 

‘‘(1) When the number of enrollments of WTC responders 

subject to the limit established under section 3311(a)(4) has 

reached 80 percent of such limit. 

‘‘(2) When the number of certifications for certified-eligible 

WTC survivors subject to the limit established under section 

3321(a)(3) has reached 80 percent of such limit. 

‘‘(h) CONSULTATION.—The WTC Program Administrator shall engage in ongoing outreach and consultation with relevant stakeholders, including the WTC Health Program Steering Committees 

and the Advisory Committee under section 3302, regarding the implementation and improvement of programs under this title. 

‘‘SEC. 3302. WTC HEALTH PROGRAM SCIENTIFIC/TECHNICAL ADVISORY COMMITTEE; WTC HEALTH PROGRAM STEERING 

COMMITTEES. 

‘‘(a) ADVISORY COMMITTEE.— 

‘‘(1) ESTABLISHMENT.—The WTC Program Administrator 

shall establish an advisory committee to be known as the WTC 

Health Program Scientific/Technical Advisory Committee (in 

this subsection referred to as the ‘Advisory Committee’) to review scientific and medical evidence and to make recommendations to the Administrator on additional WTC Program eligibility criteria and on additional WTC-related health conditions. 


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‘‘(2) COMPOSITION.—The WTC Program Administrator shall 

appoint the members of the Advisory Committee and shall include at least— 

‘‘(A) 4 occupational physicians, at least 2 of whom have 

experience treating WTC rescue and recovery workers; 

‘‘(B) 1 physician with expertise in pulmonary medicine; 

‘‘(C) 2 environmental medicine or environmental health 

specialists; 

‘‘(D) 2 representatives of WTC responders; 

‘‘(E) 2 representatives of certified-eligible WTC survivors; 

‘‘(F) an industrial hygienist; 

‘‘(G) a toxicologist; 

‘‘(H) an epidemiologist; and 

‘‘(I) a mental health professional. 

‘‘(3) MEETINGS.—The Advisory Committee shall meet at such 

frequency as may be required to carry out its duties. 

‘‘(4) REPORTS.—The WTC Program Administrator shall provide for publication of recommendations of the Advisory Committee on the public Web site established for the WTC Program. 

‘‘(5) DURATION.—Notwithstanding any other provision of law, 

the Advisory Committee shall continue in operation during the 

period in which the WTC Program is in operation. 

‘‘(6) APPLICATION OF FACA.—Except as otherwise specifically 

provided, the Advisory Committee shall be subject to the Federal Advisory Committee Act. 

‘‘(b) WTC HEALTH PROGRAM STEERING COMMITTEES.— 

‘‘(1) CONSULTATION.—The WTC Program Administrator shall 

consult with 2 steering committees (each in this section referred to as a ‘Steering Committee’) that are established as follows: 

‘‘(A) WTC RESPONDERS STEERING COMMITTEE.—One 

Steering Committee, to be known as the WTC Responders 

Steering Committee, for the purpose of receiving input 

from affected stakeholders and facilitating the coordination 

of monitoring and treatment programs for the enrolled 

WTC responders under part 1 of subtitle B. 

‘‘(B) WTC SURVIVORS STEERING COMMITTEE.—One Steering Committee, to be known as the WTC Survivors Steering Committee, for the purpose of receiving input from affected stakeholders and facilitating the coordination of initial health evaluations, monitoring, and treatment programs for screening-eligible and certified-eligible WTC survivors under part 2 of subtitle B. 

‘‘(2) MEMBERSHIP.— 

‘‘(A) WTC RESPONDERS STEERING COMMITTEE.— 

‘‘(i) REPRESENTATION.—The WTC Responders Steering Committee shall include— 

‘‘(I) representatives of the Centers of Excellence 

providing services to WTC responders; 

‘‘(II) representatives of labor organizations representing firefighters, police, other New York City 

employees, and recovery and cleanup workers who 


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responded to the September 11, 2001, terrorist attacks; and 

‘‘(III) 3 representatives of New York City, 1 of 

whom will be selected by the police commissioner 

of New York City, 1 by the health commissioner 

of New York City, and 1 by the mayor of New 

York City. 

‘‘(ii) INITIAL MEMBERSHIP.—The WTC Responders 

Steering Committee shall initially be composed of 

members of the WTC Monitoring and Treatment Program Steering Committee (as in existence on the day 

before the date of the enactment of this title). 

‘‘(B) WTC SURVIVORS STEERING COMMITTEE.— 

‘‘(i) REPRESENTATION.—The WTC Survivors Steering 

Committee shall include representatives of— 

‘‘(I) the Centers of Excellence providing services 

to screening-eligible and certified-eligible WTC 

survivors; 

‘‘(II) the population of residents, students, and 

area and other workers affected by the September 

11, 2001, terrorist attacks; 

‘‘(III) screening-eligible and certified-eligible 

survivors receiving initial health evaluations, 

monitoring, or treatment under part 2 of subtitle 

B and organizations advocating on their behalf; 

and 

‘‘(IV) New York City. 

‘‘(ii) INITIAL MEMBERSHIP.—The WTC Survivors 

Steering Committee shall initially be composed of 

members of the WTC Environmental Health Center 

Survivor Advisory Committee (as in existence on the 

day before the date of the enactment of this title). 

‘‘(C) ADDITIONAL APPOINTMENTS.—Each Steering Committee may recommend, if approved by a majority of voting 

members of the Committee, additional members to the 

Committee. 

‘‘(D) VACANCIES.—A vacancy in a Steering Committee 

shall be filled by an individual recommended by the Steering Committee. 

‘‘SEC. 3303. EDUCATION AND OUTREACH. 

‘‘The WTC Program Administrator shall institute a program that 

provides education and outreach on the existence and availability 

of services under the WTC Program. The outreach and education 

program— 

‘‘(1) shall include— 

‘‘(A) the establishment of a public Web site with information about the WTC Program; 

‘‘(B) meetings with potentially eligible populations; 

‘‘(C) development and dissemination of outreach materials informing people about the program; and 

‘‘(D) the establishment of phone information services; 

and 

‘‘(2) shall be conducted in a manner intended— 

‘‘(A) to reach all affected populations; and 


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‘‘(B) to include materials for culturally and linguistically 

diverse populations. 

‘‘SEC. 3304. UNIFORM DATA COLLECTION AND ANALYSIS. 

‘‘(a) IN GENERAL.—The WTC Program Administrator shall provide for the uniform collection of data (and analysis of data and 

regular reports to the Administrator) on the prevalence of WTC-related health conditions and the identification of new WTC-related 

health conditions. Such data shall be collected for all individuals 

provided monitoring or treatment benefits under subtitle B and regardless of their place of residence or Clinical Center of Excellence 

through which the benefits are provided. The WTC Program Administrator shall provide, through the Data Centers or otherwise, 

for the integration of such data into the monitoring and treatment 

program activities under this title. 

‘‘(b) COORDINATING THROUGH CENTERS OF EXCELLENCE.—Each 

Clinical Center of Excellence shall collect data described in subsection (a) and report such data to the corresponding Data Center 

for analysis by such Data Center. 

‘‘(c) COLLABORATION WITH WTC HEALTH REGISTRY.—The WTC 

Program Administrator shall provide for collaboration between the 

Data Centers and the World Trade Center Health Registry described in section 3342. 

‘‘(d) PRIVACY.—The data collection and analysis under this section shall be conducted and maintained in a manner that protects 

the confidentiality of individually identifiable health information 

consistent with applicable statutes and regulations, including, as 

applicable, HIPAA privacy and security law (as defined in section 

3009(a)(2)) and section 552a of title 5, United States Code. 

‘‘SEC. 3305. CLINICAL CENTERS OF EXCELLENCE AND DATA CENTERS. 

‘‘(a) IN GENERAL.— 

‘‘(1) CONTRACTS WITH CLINICAL CENTERS OF EXCELLENCE.— 

The WTC Program Administrator shall, subject to subsection 

(b)(1)(B), enter into contracts with Clinical Centers of Excellence (as defined in subsection (b)(1)(A))— 

‘‘(A) for the provision of monitoring and treatment benefits and initial health evaluation benefits under subtitle B; 

‘‘(B) for the provision of outreach activities to individuals 

eligible for such monitoring and treatment benefits, for initial health evaluation benefits, and for followup to individuals who are enrolled in the monitoring program; 

‘‘(C) for the provision of counseling for benefits under 

subtitle B, with respect to WTC-related health conditions, 

for individuals eligible for such benefits; 

‘‘(D) for the provision of counseling for benefits for WTCrelated health conditions that may be available under 

workers’ compensation or other benefit programs for workrelated injuries or illnesses, health insurance, disability insurance, or other insurance plans or through public or private social service agencies and assisting eligible individuals in applying for such benefits; 

‘‘(E) for the provision of translational and interpretive 

services for program participants who are not English language proficient; and 


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‘‘(F) for the collection and reporting of data in accordance 

with section 3304. 

‘‘(2) CONTRACTS WITH DATA CENTERS.— ‘‘(A) IN GENERAL.—The WTC Program Administrator 

shall enter into contracts with Data Centers (as defined in 

subsection (b)(2))— 

‘‘(i) for receiving, analyzing, and reporting to the 

WTC Program Administrator on data, in accordance 

with section 3304, that have been collected and reported to such Data Centers by the corresponding 

Clinical Centers of Excellence under subsection 

(b)(1)(B)(iii); 

‘‘(ii) for the development of monitoring, initial health 

evaluation, and treatment protocols, with respect to 

WTC-related health conditions; 

‘‘(iii) for coordinating the outreach activities conducted under paragraph (1)(B) by each corresponding 

Clinical Center of Excellence; 

‘‘(iv) for establishing criteria for the credentialing of 

medical providers participating in the nationwide network under section 3313; 

‘‘(v) for coordinating and administering the activities 

of the WTC Health Program Steering Committees established under section 3002(b); and 

‘‘(vi) for meeting periodically with the corresponding 

Clinical Centers of Excellence to obtain input on the 

analysis and reporting of data collected under clause 

(i) and on the development of monitoring, initial 

health evaluation, and treatment protocols under 

clause (ii). 

‘‘(B) MEDICAL PROVIDER SELECTION.—The medical providers under subparagraph (A)(iv) shall be selected by the 

WTC Program Administrator on the basis of their experience treating or diagnosing the health conditions included 

in the list of WTC-related health conditions. 

‘‘(C) CLINICAL DISCUSSIONS.—In carrying out subparagraph (A)(ii), a Data Center shall engage in clinical discussions across the WTC Program to guide treatment approaches for individuals with a WTC-related health condition. 

‘‘(D) TRANSPARENCY OF DATA.—A contract entered into 

under this subsection with a Data Center shall require the 

Data Center to make any data collected and reported to 

such Center under subsection (b)(1)(B)(iii) available to 

health researchers and others as provided in the CDC/ 

ATSDR Policy on Releasing and Sharing Data. 

‘‘(3) AUTHORITY FOR CONTRACTS TO BE CLASS SPECIFIC.—A 

contract entered into under this subsection with a Clinical 

Center of Excellence or a Data Center may be with respect to 

one or more class of enrolled WTC responders, screening-eligible WTC survivors, or certified-eligible WTC survivors. 

‘‘(4) USE OF COOPERATIVE AGREEMENTS.—Any contract under 

this title between the WTC Program Administrator and a Data 

Center or a Clinical Center of Excellence may be in the form 

of a cooperative agreement. 


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‘‘(b) CENTERS OF EXCELLENCE.— ‘‘(1) CLINICAL CENTERS OF EXCELLENCE.— ‘‘(A) DEFINITION.—For purposes of this title, the term 

‘Clinical Center of Excellence’ means a Center that demonstrates to the satisfaction of the Administrator that the 

Center— 

‘‘(i) uses an integrated, centralized health care provider approach to create a comprehensive suite of 

health services under this title that are accessible to 

enrolled WTC responders, screening-eligible WTC survivors, or certified-eligible WTC survivors; 

‘‘(ii) has experience in caring for WTC responders 

and screening-eligible WTC survivors or includes 

health care providers who have been trained pursuant 

to section 3313(c); 

‘‘(iii) employs health care provider staff with expertise that includes, at a minimum, occupational medicine, environmental medicine, trauma-related psychiatry and psychology, and social services counseling; 

and 

‘‘(iv) meets such other requirements as specified by 

the Administrator. 

‘‘(B) CONTRACT REQUIREMENTS.—The WTC Program Administrator shall not enter into a contract with a Clinical 

Center of Excellence under subsection (a)(1) unless the 

Center agrees to do each of the following: 

‘‘(i) Establish a formal mechanism for consulting 

with and receiving input from representatives of eligible populations receiving monitoring and treatment 

benefits under subtitle B from such Center. 

‘‘(ii) Coordinate monitoring and treatment benefits 

under subtitle B with routine medical care provided 

for the treatment of conditions other than WTC-related health conditions. 

‘‘(iii) Collect and report to the corresponding Data 

Center data in accordance with section 3304(b). 

‘‘(iv) Have in place safeguards against fraud that are 

satisfactory to the Administrator, in consultation with 

the Inspector General of the Department of Health 

and Human Services. 

‘‘(v) Treat or refer for treatment all individuals who 

are enrolled WTC responders or certified-eligible WTC 

survivors with respect to such Center who present 

themselves for treatment of a WTC-related health condition. 

‘‘(vi) Have in place safeguards, consistent with section 3304(c), to ensure the confidentiality of an individual’s individually identifiable health information, 

including requiring that such information not be disclosed to the individual’s employer without the authorization of the individual. 

‘‘(vii) Use amounts paid under subsection (c)(1) only 

for costs incurred in carrying out the activities described in subsection (a), other than those described in 

subsection (a)(1)(A). 


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‘‘(viii) Utilize health care providers with occupational and environmental medicine expertise to conduct physical and mental health assessments, in accordance with protocols developed under subsection 

(a)(2)(A)(ii). 

‘‘(ix) Communicate with WTC responders and 

screening-eligible and certified-eligible WTC survivors 

in appropriate languages and conduct outreach activities with relevant stakeholder worker or community 

associations. 

‘‘(x) Meet all the other applicable requirements of 

this title, including regulations implementing such requirements. 

‘‘(C) TRANSITION RULE TO ENSURE CONTINUITY OF CARE.— The WTC Program Administrator shall to the maximum 

extent feasible ensure continuity of care in any period of 

transition from monitoring and treatment of an enrolled 

WTC responder or certified-eligible WTC survivor by a provider to a Clinical Center of Excellence or a health care 

provider participating in the nationwide network under 

section 3313. 

‘‘(2) DATA CENTERS.—For purposes of this title, the term 

‘Data Center’ means a Center that the WTC Program Administrator determines has the capacity to carry out the responsibilities for a Data Center under subsection (a)(2). 

‘‘(3) CORRESPONDING CENTERS.—For purposes of this title, a 

Clinical Center of Excellence and a Data Center shall be treated as ‘corresponding’ to the extent that such Clinical Center 

and Data Center serve the same population group. 

‘‘(c) PAYMENT FOR INFRASTRUCTURE COSTS.— ‘‘(1) IN GENERAL.—The WTC Program Administrator shall reimburse a Clinical Center of Excellence for the fixed infrastructure costs of such Center in carrying out the activities described in subtitle B at a rate negotiated by the Administrator 

and such Centers. Such negotiated rate shall be fair and appropriate and take into account the number of enrolled WTC 

responders receiving services from such Center under this title. 

‘‘(2) FIXED INFRASTRUCTURE COSTS.—For purposes of paragraph (1), the term ‘fixed infrastructure costs’ means, with respect to a Clinical Center of Excellence, the costs incurred by 

such Center that are not reimbursable by the WTC Program 

Administrator under section 3312(c). 

‘‘SEC. 3306. DEFINITIONS. 

‘‘In this title: 

‘‘(1) The term ‘aggravating’ means, with respect to a health 

condition, a health condition that existed on September 11, 

2001, and that, as a result of exposure to airborne toxins, any 

other hazard, or any other adverse condition resulting from the 

September 11, 2001, terrorist attacks, requires medical treatment that is (or will be) in addition to, more frequent than, or 

of longer duration than the medical treatment that would have 

been required for such condition in the absence of such exposure. 

‘‘(2) The term ‘certified-eligible WTC survivor’ has the meaning given such term in section 3321(a)(2). 


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‘‘(3) The terms ‘Clinical Center of Excellence’ and ‘Data Center’ have the meanings given such terms in section 3305. 

‘‘(4) The term ‘enrolled WTC responder’ means a WTC responder enrolled under section 3311(a)(3). 

‘‘(5) The term ‘initial health evaluation’ includes, with respect to an individual, a medical and exposure history, a physical examination, and additional medical testing as needed to 

evaluate whether the individual has a WTC-related health condition and is eligible for treatment under the WTC Program. 

‘‘(6) The term ‘list of WTC-related health conditions’ means— 

‘‘(A) for WTC responders, the health conditions listed in 

section 3312(a)(3); and 

‘‘(B) for screening-eligible and certified-eligible WTC survivors, the health conditions listed in section 3322(b). 

‘‘(7) The term ‘New York City disaster area’ means the area 

within New York City that is— 

‘‘(A) the area of Manhattan that is south of Houston 

Street; and 

‘‘(B) any block in Brooklyn that is wholly or partially 

contained within a 1.5-mile radius of the former World 

Trade Center site. 

‘‘(8) The term ‘New York metropolitan area’ means an area, 

specified by the WTC Program Administrator, within which 

WTC responders and eligible WTC screening-eligible survivors 

who reside in such area are reasonably able to access monitoring and treatment benefits and initial health evaluation 

benefits under this title through a Clinical Center of Excellence 

described in subparagraphs (A), (B), or (C) of section 

3305(b)(1). 

‘‘(9) The term ‘screening-eligible WTC survivor’ has the 

meaning given such term in section 3321(a)(1). 

‘‘(10) Any reference to ‘September 11, 2001’ shall be deemed 

a reference to the period on such date subsequent to the terrorist attacks at the World Trade Center, Shanksville, Pennsylvania, or the Pentagon, as applicable, on such date. 

‘‘(11) The term ‘September 11, 2001, terrorist attacks’ means 

the terrorist attacks that occurred on September 11, 2001, in 

New York City, in Shanksville, Pennsylvania, and at the Pentagon, and includes the aftermath of such attacks. 

‘‘(12) The term ‘WTC Health Program Steering Committee’ 

means such a Steering Committee established under section 

3302(b). 

‘‘(13) The term ‘WTC Program’ means the Word Trade Center Health Program established under section 3301(a). 

‘‘(14) The term ‘WTC Program Administrator’ means— 

‘‘(A) with respect to paragraphs (3) and (4) of section 

3311(a) (relating to enrollment of WTC responders), section 3312(c) and the corresponding provisions of section 

3322 (relating to payment for initial health evaluation, 

monitoring, and treatment), paragraphs (1)(C), (2)(B), and 

(3) of section 3321(a) (relating to determination or certification of screening-eligible or certified-eligible WTC responders), and part 3 of subtitle B (relating to payor provisions), an official in the Department of Health and Human 

Services, to be designated by the Secretary; and 


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‘‘(B) with respect to any other provision of this title, the 

Director of the National Institute for Occupational Safety 

and Health, or a designee of such Director. 

‘‘(15) The term ‘WTC-related health condition’ is defined in 

section 3312(a). 

‘‘(16) The term ‘WTC responder’ is defined in section 3311(a). 

‘‘(17) The term ‘WTC Scientific/Technical Advisory Committee’ means such Committee established under section 

3302(a). 

‘‘Subtitle B—Program of Monitoring, 

Initial Health Evaluations, and Treatment 

‘‘PART 1—WTC RESPONDERS 

‘‘SEC. 3311. IDENTIFICATION OF WTC RESPONDERS AND PROVISION 

OF WTC-RELATED MONITORING SERVICES. 

‘‘(a) WTC RESPONDER DEFINED.— 

‘‘(1) IN GENERAL.—For purposes of this title, the term ‘WTC 

responder’ means any of the following individuals, subject to 

paragraph (4): 

‘‘(A) CURRENTLY IDENTIFIED RESPONDER.—An individual 

who has been identified as eligible for monitoring under 

the arrangements as in effect on the date of the enactment 

of this title between the National Institute for Occupational Safety and Health and— 

‘‘(i) the consortium coordinated by Mt. Sinai Hospital in New York City that coordinates the monitoring and treatment for enrolled WTC responders 

other than with respect to those covered under the arrangement with the Fire Department of New York 

City; or 

‘‘(ii) the Fire Department of New York City. 

‘‘(B) RESPONDER WHO MEETS CURRENT ELIGIBILITY CRITERIA.—An individual who meets the current eligibility criteria described in paragraph (2). 

‘‘(C) RESPONDER WHO MEETS MODIFIED ELIGIBILITY CRITERIA.—An individual who— 

‘‘(i) performed rescue, recovery, demolition, debris 

cleanup, or other related services in the New York 

City disaster area in response to the September 11, 

2001, terrorist attacks, regardless of whether such 

services were performed by a State or Federal employee or member of the National Guard or otherwise; 

and 

‘‘(ii) meets such eligibility criteria relating to exposure to airborne toxins, other hazards, or adverse conditions resulting from the September 11, 2001, terrorist attacks as the WTC Program Administrator, 

after consultation with the WTC Scientific/Technical 

Advisory Committee, determines appropriate. 

The WTC Program Administrator shall not modify such 

eligibility criteria on or after the date that the number of 

enrollments of WTC responders has reached 80 percent of 


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the limit described in paragraph (4) or on or after the date 

that the number of certifications for certified-eligible WTC 

survivors under section 3321(a)(2)(B) has reached 80 percent of the limit described in section 3321(a)(3). 

‘‘(2) CURRENT ELIGIBILITY CRITERIA.—The eligibility criteria 

described in this paragraph for an individual is that the individual is described in any of the following categories: 

‘‘(A) FIREFIGHTERS AND RELATED PERSONNEL.—The individual— 

‘‘(i) was a member of the Fire Department of New 

York City (whether fire or emergency personnel, active 

or retired) who participated at least one day in the 

rescue and recovery effort at any of the former World 

Trade Center sites (including Ground Zero, Staten Island Landfill, and the New York City Chief Medical 

Examiner’s Office) for any time during the period beginning on September 11, 2001, and ending on July 

31, 2002; or 

‘‘(ii)(I) is a surviving immediate family member of an 

individual who was a member of the Fire Department 

of New York City (whether fire or emergency personnel, active or retired) and was killed at the World 

Trade site on September 11, 2001; and 

‘‘(II) received any treatment for a WTC-related 

health condition described in section 3312(a)(1)(A)(ii) 

(relating to mental health conditions) on or before September 1, 2008. 

‘‘(B) LAW ENFORCEMENT OFFICERS AND WTC RESCUE, RECOVERY, AND CLEANUP WORKERS.—The individual— 

‘‘(i) worked or volunteered onsite in rescue, recovery, 

debris cleanup, or related support services in lower 

Manhattan (south of Canal St.), the Staten Island 

Landfill, or the barge loading piers, for at least 4 

hours during the period beginning on September 11, 

2001, and ending on September 14, 2001, for at least 

24 hours during the period beginning on September 

11, 2001, and ending on September 30, 2001, or for at 

least 80 hours during the period beginning on September 11, 2001, and ending on July 31, 2002; 

‘‘(ii)(I) was a member of the Police Department of 

New York City (whether active or retired) or a member of the Port Authority Police of the Port Authority 

of New York and New Jersey (whether active or retired) who participated onsite in rescue, recovery, debris cleanup, or related services in lower Manhattan 

(south of Canal St.), including Ground Zero, the Staten Island Landfill, or the barge loading piers, for at 

least 4 hours during the period beginning September 

11, 2001, and ending on September 14, 2001; 

‘‘(II) participated onsite in rescue, recovery, debris 

cleanup, or related services in at Ground Zero, the 

Staten Island Landfill, or the barge loading piers, for 

at least one day during the period beginning on September 11, 2001, and ending on July 31, 2002; 


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‘‘(III) participated onsite in rescue, recovery, debris 

cleanup, or related services in lower Manhattan (south 

of Canal St.) for at least 24 hours during the period 

beginning on September 11, 2001, and ending on September 30, 2001; or 

‘‘(IV) participated onsite in rescue, recovery, debris 

cleanup, or related services in lower Manhattan (south 

of Canal St.) for at least 80 hours during the period 

beginning on September 11, 2001, and ending on July 

31, 2002; 

‘‘(iii) was an employee of the Office of the Chief Medical Examiner of New York City involved in the examination and handling of human remains from the 

World Trade Center attacks, or other morgue worker 

who performed similar post-September 11 functions 

for such Office staff, during the period beginning on 

September 11, 2001, and ending on July 31, 2002; 

‘‘(iv) was a worker in the Port Authority Trans-Hudson Corporation Tunnel for at least 24 hours during 

the period beginning on February 1, 2002, and ending 

on July 1, 2002; or 

‘‘(v) was a vehicle-maintenance worker who was exposed to debris from the former World Trade Center 

while retrieving, driving, cleaning, repairing, and 

maintaining vehicles contaminated by airborne toxins 

from the September 11, 2001, terrorist attacks during 

a duration and period described in subparagraph (A). 

‘‘(C) RESPONDERS TO THE SEPTEMBER 11 ATTACKS AT THE

PENTAGON AND SHANKSVILLE, PENNSYLVANIA.—The individual— 

‘‘(i)(I) was a member of a fire or police department 

(whether fire or emergency personnel, active or retired), worked for a recovery or cleanup contractor, or 

was a volunteer; and performed rescue, recovery, demolition, debris cleanup, or other related services at the 

Pentagon site of the terrorist-related aircraft crash of 

September 11, 2001, during the period beginning on 

September 11, 2001, and ending on the date on which 

the cleanup of the site was concluded, as determined 

by the WTC Program Administrator; or 

‘‘(II) was a member of a fire or police department 

(whether fire or emergency personnel, active or retired), worked for a recovery or cleanup contractor, or 

was a volunteer; and performed rescue, recovery, demolition, debris cleanup, or other related services at the 

Shanksville, Pennsylvania, site of the terrorist-related 

aircraft crash of September 11, 2001, during the period beginning on September 11, 2001, and ending on 

the date on which the cleanup of the site was concluded, as determined by the WTC Program Administrator; and 

‘‘(ii) is determined by the WTC Program Administrator to be at an increased risk of developing a WTCrelated health condition as a result of exposure to airborne toxins, other hazards, or adverse conditions reVerDate Mar 15 2010 22:29 Sep 29, 2010 Jkt 089008 PO 00000 Frm 00018 Fmt 6659 Sfmt 6602 E:\HR\OC\HR648.XXX HR648

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sulting from the September 11, 2001, terrorist attacks, 

and meets such eligibility criteria related to such exposures, as the WTC Program Administrator determines 

are appropriate, after consultation with the WTC Scientific/Technical Advisory Committee. 

‘‘(3) ENROLLMENT PROCESS.— ‘‘(A) IN GENERAL.—The WTC Program Administrator 

shall establish a process for enrolling WTC responders in 

the WTC Program. Under such process— 

‘‘(i) WTC responders described in paragraph (1)(A) 

shall be deemed to be enrolled in such Program; 

‘‘(ii) subject to clause (iii), the Administrator shall 

enroll in such program individuals who are determined to be WTC responders; 

‘‘(iii) the Administrator shall deny such enrollment 

to an individual if the Administrator determines that 

the numerical limitation in paragraph (4) on enrollment of WTC responders has been met; 

‘‘(iv) there shall be no fee charged to the applicant 

for making an application for such enrollment; 

‘‘(v) the Administrator shall make a determination 

on such an application not later than 60 days after the 

date of filing the application; and 

‘‘(vi) an individual who is denied enrollment in such 

Program shall have an opportunity to appeal such determination in a manner established under such process. 

‘‘(B) TIMING.— ‘‘(i) CURRENTLY IDENTIFIED RESPONDERS.—In accordance with subparagraph (A)(i), the WTC Program Administrator shall enroll an individual described in 

paragraph (1)(A) in the WTC Program not later than 

July 1, 2011. 

‘‘(ii) OTHER RESPONDERS.—In accordance with subparagraph (A)(ii) and consistent with paragraph (4), 

the WTC Program Administrator shall enroll any 

other individual who is determined to be a WTC responder in the WTC Program at the time of such determination. 

‘‘(4) NUMERICAL LIMITATION ON ELIGIBLE WTC RESPONDERS.— 

‘‘(A) IN GENERAL.—The total number of individuals not 

described in paragraph (1)(A) or (2)(A)(ii) who may be enrolled under paragraph (3)(A)(ii) shall not exceed 25,000 at 

any time, of which no more than 2,500 may be individuals 

enrolled based on modified eligibility criteria established 

under paragraph (1)(C). 

‘‘(B) PROCESS.—In implementing subparagraph (A), the 

WTC Program Administrator shall— 

‘‘(i) limit the number of enrollments made under 

paragraph (3)— 

‘‘(I) in accordance with such subparagraph; and 

‘‘(II) to such number, as determined by the Administrator based on the best available information and subject to amounts available under section 3351, that will ensure sufficient funds will be 


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available to provide treatment and monitoring 

benefits under this title, with respect to all individuals who are enrolled through the end of fiscal 

year 2020; and 

‘‘(ii) provide priority (subject to paragraph (3)(A)(i)) 

in such enrollments in the order in which individuals 

apply for enrollment under paragraph (3). 

‘‘(5) DISQUALIFICATION OF INDIVIDUALS ON TERRORIST WATCH

LIST.—No individual who is on the terrorist watch list maintained by the Department of Homeland Security shall qualify 

as an eligible WTC responder. Before enrolling any individual 

as a WTC responder in the WTC Program under paragraph (3), 

the Administrator, in consultation with the Secretary of Homeland Security, shall determine whether the individual is on 

such list. 

‘‘(b) MONITORING BENEFITS.— ‘‘(1) IN GENERAL.—In the case of an enrolled WTC responder 

(other than one described in subsection (a)(2)(A)(ii)), the WTC 

Program shall provide for monitoring benefits that include 

monitoring consistent with protocols approved by the WTC 

Program Administrator and including clinical examinations 

and long-term health monitoring and analysis. In the case of 

an enrolled WTC responder who is an active member of the 

Fire Department of New York City, the responder shall receive 

such benefits as part of the individual’s periodic company medical exams. 

‘‘(2) PROVISION OF MONITORING BENEFITS.—The monitoring 

benefits under paragraph (1) shall be provided through the 

Clinical Center of Excellence for the type of individual involved 

or, in the case of an individual residing outside the New York 

metropolitan area, under an arrangement under section 3313. 

‘‘SEC. 3312. TREATMENT OF ENROLLED WTC RESPONDERS FOR WTCRELATED HEALTH CONDITIONS. 

‘‘(a) WTC-RELATED HEALTH CONDITION DEFINED.— 

‘‘(1) IN GENERAL.—For purposes of this title, the term ‘WTCrelated health condition’ means a condition that— 

‘‘(A)(i) is an illness or health condition for which exposure to airborne toxins, any other hazard, or any other adverse condition resulting from the September 11, 2001, terrorist attacks, based on an examination by a medical professional with experience in treating or diagnosing the 

health conditions included in the applicable list of WTC-related health conditions, is substantially likely to be a significant factor in aggravating, contributing to, or causing 

the illness or health condition, as determined under paragraph (2); or 

‘‘(ii) is a mental health condition for which such attacks, 

based on an examination by a medical professional with 

experience in treating or diagnosing the health conditions 

included in the applicable list of WTC-related health conditions, is substantially likely to be a significant factor in aggravating, contributing to, or causing the condition, as determined under paragraph (2); and 

‘‘(B) is included in the applicable list of WTC-related 

health conditions or— 


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‘‘(i) with respect to a WTC responder, is provided 

certification of coverage under subsection (b)(2)(B)(iii); 

or 

‘‘(ii) with respect to a screening-eligible WTC survivor or certified-eligible WTC survivor, is provided 

certification of coverage under subsection (b)(2)(B)(iii), 

as applied under section 3322(a). 

In the case of a WTC responder described in section 

3311(a)(2)(A)(ii) (relating to a surviving immediate family 

member of a firefighter), such term does not include an illness 

or health condition described in subparagraph (A)(i). 

‘‘(2) DETERMINATION.—The determination under paragraph 

(1) or subsection (b) of whether the September 11, 2001, terrorist attacks were substantially likely to be a significant factor in aggravating, contributing to, or causing an individual’s 

illness or health condition shall be made based on an assessment of the following: 

‘‘(A) The individual’s exposure to airborne toxins, any 

other hazard, or any other adverse condition resulting 

from the terrorist attacks. Such exposure shall be— 

‘‘(i) evaluated and characterized through the use of 

a standardized, population-appropriate questionnaire 

approved by the Director of the National Institute for 

Occupational Safety and Health; and 

‘‘(ii) assessed and documented by a medical professional with experience in treating or diagnosing health 

conditions included on the list of WTC-related health 

conditions. 

‘‘(B) The type of symptoms and temporal sequence of 

symptoms. Such symptoms shall be— 

‘‘(i) assessed through the use of a standardized, population-appropriate medical questionnaire approved by 

the Director of the National Institute for Occupational 

Safety and Health and a medical examination; and 

‘‘(ii) diagnosed and documented by a medical professional described in subparagraph (A)(ii). 

‘‘(3) LIST OF HEALTH CONDITIONS FOR WTC RESPONDERS.—The 

list of health conditions for WTC responders consists of the following: 

‘‘(A) AERODIGESTIVE DISORDERS.— 

‘‘(i) Interstitial lung diseases. 

‘‘(ii) Chronic respiratory disorder—fumes/vapors. 

‘‘(iii) Asthma. 

‘‘(iv) Reactive airways dysfunction syndrome 

(RADS). 

‘‘(v) WTC-exacerbated chronic obstructive pulmonary 

disease (COPD). 

‘‘(vi) Chronic cough syndrome. 

‘‘(vii) Upper airway hyperreactivity. 

‘‘(viii) Chronic rhinosinusitis. 

‘‘(ix) Chronic nasopharyngitis. 

‘‘(x) Chronic laryngitis. 

‘‘(xi) Gastroesophageal reflux disorder (GERD). 

‘‘(xii) Sleep apnea exacerbated by or related to a condition described in a previous clause. 


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‘‘(B) MENTAL HEALTH CONDITIONS.— ‘‘(i) Posttraumatic stress disorder (PTSD). 

‘‘(ii) Major depressive disorder. 

‘‘(iii) Panic disorder. 

‘‘(iv) Generalized anxiety disorder. 

‘‘(v) Anxiety disorder (not otherwise specified). 

‘‘(vi) Depression (not otherwise specified). 

‘‘(vii) Acute stress disorder. 

‘‘(viii) Dysthymic disorder. 

‘‘(ix) Adjustment disorder. 

‘‘(x) Substance abuse. 

‘‘(C) MUSCULOSKELETAL DISORDERS FOR CERTAIN WTC RE- SPONDERS.—In the case of a WTC responder described in 

paragraph (4), a condition described in such paragraph. 

‘‘(D) ADDITIONAL CONDITIONS.—Any cancer (or type of 

cancer) or other condition added, pursuant to paragraph 

(5) or (6), to the list under this paragraph. 

‘‘(4) MUSCULOSKELETAL DISORDERS.— ‘‘(A) IN GENERAL.—For purposes of this title, in the case 

of a WTC responder who received any treatment for a 

WTC-related musculoskeletal disorder on or before September 11, 2003, the list of health conditions in paragraph 

(3) shall include: 

‘‘(i) Low back pain. 

‘‘(ii) Carpal tunnel syndrome (CTS). 

‘‘(iii) Other musculoskeletal disorders. 

‘‘(B) DEFINITION.—The term ‘WTC-related musculoskeletal disorder’ means a chronic or recurrent disorder of 

the musculoskeletal system caused by heavy lifting or repetitive strain on the joints or musculoskeletal system occurring during rescue or recovery efforts in the New York 

City disaster area in the aftermath of the September 11, 

2001, terrorist attacks. 

‘‘(5) CANCER.— 

‘‘(A) IN GENERAL.—The WTC Program Administrator 

shall periodically conduct a review of all available scientific and medical evidence, including findings and recommendations of Clinical Centers of Excellence, published 

in peer-reviewed journals to determine if, based on such 

evidence, cancer or a certain type of cancer should be 

added to the applicable list of WTC-related health conditions. The WTC Program Administrator shall conduct the 

first review under this subparagraph not later than 180 

days after the date of the enactment of this title. 

‘‘(B) PROPOSED REGULATIONS AND RULEMAKING.—Based 

on the periodic reviews under subparagraph (A), if the 

WTC Program Administrator determines that cancer or a 

certain type of cancer should be added to such list of WTCrelated health conditions, the WTC Program Administrator 

shall propose regulations, through rulemaking, to add cancer or the certain type of cancer to such list. 

‘‘(C) FINAL REGULATIONS.—Based on all the available 

evidence in the rulemaking record, the WTC Program Administrator shall make a final determination of whether 

cancer or a certain type of cancer should be added to such 


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list of WTC-related health conditions. If such a determination is made to make such an addition, the WTC Program 

Administrator shall by regulation add cancer or the certain 

type of cancer to such list. 

‘‘(D) DETERMINATIONS NOT TO ADD CANCER OR CERTAIN

TYPES OF CANCER.—In the case that the WTC Program Administrator determines under subparagraph (B) or (C) that 

cancer or a certain type of cancer should not be added to 

such list of WTC-related health conditions, the WTC Program Administrator shall publish an explanation for such 

determination in the Federal Register. Any such determination to not make such an addition shall not preclude 

the addition of cancer or the certain type of cancer to such 

list at a later date. 

‘‘(6) ADDITION OF HEALTH CONDITIONS TO LIST FOR WTC RESPONDERS.— 

‘‘(A) IN GENERAL.—Whenever the WTC Program Administrator determines that a proposed rule should be promulgated to add a health condition to the list of health conditions in paragraph (3), the Administrator may request a 

recommendation of the Advisory Committee or may publish such a proposed rule in the Federal Register in accordance with subparagraph (D). 

‘‘(B) ADMINISTRATOR’S OPTIONS AFTER RECEIPT OF PETITION.—In the case that the WTC Program Administrator 

receives a written petition by an interested party to add a 

health condition to the list of health conditions in paragraph (3), not later than 60 days after the date of receipt 

of such petition the Administrator shall— 

‘‘(i) request a recommendation of the Advisory Committee; 

‘‘(ii) publish a proposed rule in the Federal Register 

to add such health condition, in accordance with subparagraph (D); 

‘‘(iii) publish in the Federal Register the Administrator’s determination not to publish such a proposed rule 

and the basis for such determination; or 

‘‘(iv) publish in the Federal Register a determination 

that insufficient evidence exists to take action under 

clauses (i) through (iii). 

‘‘(C) ACTION BY ADVISORY COMMITTEE.—In the case that 

the Administrator requests a recommendation of the Advisory Committee under this paragraph, with respect to adding a health condition to the list in paragraph (3), the Advisory Committee shall submit to the Administrator such 

recommendation not later than 60 days after the date of 

such request or by such date (not to exceed 180 days after 

such date of request) as specified by the Administrator. 

Not later than 60 days after the date of receipt of such recommendation, the Administrator shall, in accordance with 

subparagraph (D), publish in the Federal Register a proposed rule with respect to such recommendation or a determination not to propose such a proposed rule and the 

basis for such determination. 


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‘‘(D) PUBLICATION.—The WTC Program Administrator 

shall, with respect to any proposed rule under this paragraph— 

‘‘(i) publish such proposed rule in accordance with 

section 553 of title 5, United States Code; and 

‘‘(ii) provide interested parties a period of 30 days 

after such publication to submit written comments on 

the proposed rule. 

The WTC Program Administrator may extend the period 

described in clause (ii) upon a finding of good cause. In the 

case of such an extension, the Administrator shall publish 

such extension in the Federal Register. 

‘‘(E) INTERESTED PARTY DEFINED.—For purposes of this 

paragraph, the term ‘interested party’ includes a representative of any organization representing WTC responders, a nationally recognized medical association, a Clinical 

or Data Center, a State or political subdivision, or any 

other interested person. 

‘‘(b) COVERAGE OF TREATMENT FOR WTC-RELATED HEALTH CONDITIONS.— 

‘‘(1) DETERMINATION FOR ENROLLED WTC RESPONDERS BASED

ON A WTC-RELATED HEALTH CONDITION.— 

‘‘(A) IN GENERAL.—If a physician at a Clinical Center of 

Excellence that is providing monitoring benefits under section 3311 for an enrolled WTC responder makes a determination that the responder has a WTC-related health 

condition that is in the list in subsection (a)(3) and that exposure to airborne toxins, other hazards, or adverse conditions resulting from the September 1, 2001, terrorist attacks is substantially likely to be a significant factor in aggravating, contributing to, or causing the condition— 

‘‘(i) the physician shall promptly transmit such determination to the WTC Program Administrator and 

provide the Administrator with the medical facts supporting such determination; and 

‘‘(ii) on and after the date of such transmittal and 

subject to subparagraph (B), the WTC Program shall 

provide for payment under subsection (c) for medically 

necessary treatment for such condition. 

‘‘(B) REVIEW; CERTIFICATION; APPEALS.— 

‘‘(i) REVIEW.—A Federal employee designated by the 

WTC Program Administrator shall review determinations made under subparagraph (A). 

‘‘(ii) CERTIFICATION.—The Administrator shall provide a certification of such condition based upon reviews conducted under clause (i). Such a certification 

shall be provided unless the Administrator determines 

that the responder’s condition is not a WTC-related 

health condition in the list in subsection (a)(3) or that 

exposure to airborne toxins, other hazards, or adverse 

conditions resulting from the September 1, 2001, terrorist attacks is not substantially likely to be a significant factor in aggravating, contributing to, or causing 

the condition. 


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‘‘(iii) APPEAL PROCESS.—The Administrator shall establish, by rule, a process for the appeal of determinations under clause (ii). 

‘‘(2) DETERMINATION BASED ON MEDICALLY ASSOCIATED WTC- RELATED HEALTH CONDITIONS.— ‘‘(A) IN GENERAL.—If a physician at a Clinical Center of 

Excellence determines pursuant to subsection (a) that the 

enrolled WTC responder has a health condition described 

in subsection (a)(1)(A) that is not in the list in subsection 

(a)(3) but which is medically associated with a WTC-related health condition— 

‘‘(i) the physician shall promptly transmit such determination to the WTC Program Administrator and 

provide the Administrator with the facts supporting 

such determination; and 

‘‘(ii) the Administrator shall make a determination 

under subparagraph (B) with respect to such physician’s determination. 

‘‘(B) PROCEDURES FOR REVIEW, CERTIFICATION, AND AP- PEAL.—The WTC Program Administrator shall, by rule, establish procedures for the review and certification of physician determinations under subparagraph (A). Such rule 

shall provide for— 

‘‘(i) the timely review of such a determination by a 

physician panel with appropriate expertise for the condition and recommendations to the WTC Program Administrator; 

‘‘(ii) not later than 60 days after the date of the 

transmittal under subparagraph (A)(i), a determination by the WTC Program Administrator on whether 

or not the condition involved is described in subsection 

(a)(1)(A) and is medically associated with a WTC-related health condition; 

‘‘(iii) certification in accordance with paragraph 

(1)(B)(ii) of coverage of such condition if determined to 

be described in subsection (a)(1)(A) and medically associated with a WTC-related health condition; and 

‘‘(iv) a process for appeals of determinations relating 

to such conditions. 

‘‘(C) INCLUSION IN LIST OF HEALTH CONDITIONS.—If the 

WTC Program Administrator provides certification under 

subparagraph (B)(iii) for coverage of a condition, the Administrator may, pursuant to subsection (a)(6), add the 

condition to the list in subsection (a)(3). 

‘‘(D) CONDITIONS ALREADY DECLINED FOR INCLUSION IN

LIST.—If the WTC Program Administrator publishes a determination under subsection (a)(6)(B) not to include a condition in the list in subsection (a)(3), the WTC Program 

Administrator shall not provide certification under subparagraph (B)(iii) for coverage of the condition. In the case 

of an individual who is certified under subparagraph 

(B)(iii) with respect to such condition before the date of the 

publication of such determination the previous sentence 

shall not apply. 

‘‘(3) REQUIREMENT OF MEDICAL NECESSITY.— 


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‘‘(A) IN GENERAL.—In providing treatment for a WTC-related health condition, a physician or other provider shall 

provide treatment that is medically necessary and in accordance with medical treatment protocols established 

under subsection (d). 

‘‘(B) REGULATIONS RELATING TO MEDICAL NECESSITY.— For the purpose of this title, the WTC Program Administrator shall issue regulations specifying a standard for determining medical necessity with respect to health care 

services and prescription pharmaceuticals, a process for 

determining whether treatment furnished and pharmaceuticals prescribed under this title meet such standard 

(including any prior authorization requirement), and a 

process for appeal of a determination under subsection 

(c)(3). 

‘‘(4) SCOPE OF TREATMENT COVERED.— ‘‘(A) IN GENERAL.—The scope of treatment covered under 

this subsection includes services of physicians and other 

health care providers, diagnostic and laboratory tests, prescription drugs, inpatient and outpatient hospital services, 

and other medically necessary treatment. 

‘‘(B) PHARMACEUTICAL COVERAGE.—With respect to ensuring coverage of medically necessary outpatient prescription drugs, such drugs shall be provided, under arrangements made by the WTC Program Administrator, directly 

through participating Clinical Centers of Excellence or 

through one or more outside vendors. 

‘‘(C) TRANSPORTATION EXPENSES FOR NATIONWIDE NET- WORK.—The WTC Program Administrator may provide for 

necessary and reasonable transportation and expenses incident to the securing of medically necessary treatment 

through the nationwide network under section 3313 involving travel of more than 250 miles and for which payment is made under this section in the same manner in 

which individuals may be furnished necessary and reasonable transportation and expenses incident to services involving travel of more than 250 miles under regulations 

implementing section 3629(c) of the Energy Employees Occupational Illness Compensation Program Act of 2000 (title 

XXXVI of Public Law 106–398; 42 U.S.C. 7384t(c)). 

‘‘(5) PROVISION OF TREATMENT PENDING CERTIFICATION.— 

With respect to an enrolled WTC responder for whom a determination is made by an examining physician under paragraph 

(1) or (2), but for whom the WTC Program Administrator has 

not yet determined whether to certify the determination, the 

WTC Program Administrator may establish by rule a process 

through which the Administrator may approve the provision of 

medical treatment under this subsection (and payment under 

subsection (c)) with respect to such responder and such responder’s WTC-related health condition (under such terms and 

conditions as the Administrator may provide) until the Administrator makes a decision on whether to certify the determination. 

‘‘(c) PAYMENT FOR INITIAL HEALTH EVALUATION, MONITORING, 

AND TREATMENT OF WTC-RELATED HEALTH CONDITIONS.— 


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‘‘(1) MEDICAL TREATMENT.— ‘‘(A) USE OF FECA PAYMENT RATES.—Subject to subparagraphs (B) and (C), the WTC Program Administrator shall 

reimburse costs for medically necessary treatment under 

this title for WTC-related health conditions according to 

the payment rates that would apply to the provision of 

such treatment and services by the facility under the Federal Employees Compensation Act. For treatment not covered under the previous sentence or subparagraph (B), the 

WTC Program Administrator shall establish by regulation 

a reimbursement rate for such treatment. 

‘‘(B) PHARMACEUTICALS.— ‘‘(i) IN GENERAL.—The WTC Program Administrator 

shall establish a program for paying for the medically 

necessary outpatient prescription pharmaceuticals prescribed under this title for WTC-related health conditions through one or more contracts with outside vendors. 

‘‘(ii) COMPETITIVE BIDDING.—Under such program 

the Administrator shall— 

‘‘(I) select one or more appropriate vendors 

through a Federal competitive bid process; and 

‘‘(II) select the lowest bidder (or bidders) meeting the requirements for providing pharmaceutical 

benefits for participants in the WTC Program. 

‘‘(iii) TREATMENT OF FDNY PARTICIPANTS.—Under 

such program the Administrator may enter into an 

agreement with a separate vendor to provide pharmaceutical benefits to enrolled WTC responders for whom 

the Clinical Center of Excellence is described in section 3305 if such an arrangement is deemed necessary 

and beneficial to the program by the WTC Program 

Administrator. 

‘‘(C) IMPROVING QUALITY AND EFFICIENCY THROUGH MODIFICATION OF PAYMENT AMOUNTS AND METHODOLOGIES.— The WTC Program Administrator may modify the amounts 

and methodologies for making payments for initial health 

evaluations, monitoring, or treatment, if, taking into account utilization and quality data furnished by the Clinical 

Centers of Excellence under section 3305(b)(1)(B)(iii), the 

Administrator determines that a bundling, capitation, pay 

for performance, or other payment methodology would better ensure high quality and efficient delivery of initial 

health evaluations, monitoring, or treatment to an enrolled 

WTC responder, screening-eligible WTC survivor, or certified-eligible WTC survivor. 

‘‘(2) MONITORING AND INITIAL HEALTH EVALUATION.—The 

WTC Program Administrator shall reimburse the costs of monitoring and the costs of an initial health evaluation provided 

under this title at a rate set by the Administrator by regulation. 

‘‘(3) DETERMINATION OF MEDICAL NECESSITY.— ‘‘(A) REVIEW OF MEDICAL NECESSITY AND PROTOCOLS.—As 

part of the process for reimbursement or payment under 

this subsection, the WTC Program Administrator shall 


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provide for the review of claims for reimbursement or payment for the provision of medical treatment to determine 

if such treatment is medically necessary and in accordance 

with medical treatment protocols established under subsection (d). 

‘‘(B) WITHHOLDING OF PAYMENT FOR MEDICALLY UNNECESSARY TREATMENT.—The Administrator shall withhold 

such reimbursement or payment for treatment that the 

Administrator determines is not medically necessary or is 

not in accordance with such medical treatment protocols. 

‘‘(d) MEDICAL TREATMENT PROTOCOLS.— 

‘‘(1) DEVELOPMENT.—The Data Centers shall develop medical 

treatment protocols for the treatment of enrolled WTC responders and certified-eligible WTC survivors for health conditions included in the applicable list of WTC-related health conditions. 

‘‘(2) APPROVAL.—The medical treatment protocols developed 

under paragraph (1) shall be subject to approval by the WTC 

Program Administrator. 

‘‘SEC. 3313. NATIONAL ARRANGEMENT FOR BENEFITS FOR ELIGIBLE 

INDIVIDUALS OUTSIDE NEW YORK. 

‘‘(a) IN GENERAL.—In order to ensure reasonable access to benefits under this subtitle for individuals who are enrolled WTC responders, screening-eligible WTC survivors, or certified-eligible 

WTC survivors and who reside in any State, as defined in section 

2(f), outside the New York metropolitan area, the WTC Program 

Administrator shall establish a nationwide network of health care 

providers to provide monitoring and treatment benefits and initial 

health evaluations near such individuals’ areas of residence in such 

States. Nothing in this subsection shall be construed as preventing 

such individuals from being provided such monitoring and treatment benefits or initial health evaluation through any Clinical 

Center of Excellence. 

‘‘(b) NETWORK REQUIREMENTS.—Any health care provider participating in the network under subsection (a) shall— 

‘‘(1) meet criteria for credentialing established by the Data 

Centers; 

‘‘(2) follow the monitoring, initial health evaluation, and 

treatment protocols developed under section 3305(a)(2)(A)(ii); 

‘‘(3) collect and report data in accordance with section 3304; 

and 

‘‘(4) meet such fraud, quality assurance, and other requirements as the WTC Program Administrator establishes, including sections 1128 through 1128E of the Social Security Act, as 

applied by section 3301(d). 

‘‘(c) TRAINING AND TECHNICAL ASSISTANCE.—The WTC Program 

Administer may provide, including through contract, for the provision of training and technical assistance to health care providers 

participating in the network under subsection (a). 


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‘‘PART 2—WTC SURVIVORS 

‘‘SEC. 3321. IDENTIFICATION AND INITIAL HEALTH EVALUATION OF 

SCREENING-ELIGIBLE AND CERTIFIED-ELIGIBLE WTC 

SURVIVORS. 

‘‘(a) IDENTIFICATION OF SCREENING-ELIGIBLE WTC SURVIVORS

AND CERTIFIED-ELIGIBLE WTC SURVIVORS.— 

‘‘(1) SCREENING-ELIGIBLE WTC SURVIVORS.— 

‘‘(A) DEFINITION.—In this title, the term ‘screening-eligible WTC survivor’ means, subject to subparagraph (C) and 

paragraph (3), an individual who is described in any of the 

following clauses: 

‘‘(i) CURRENTLY IDENTIFIED SURVIVOR.—An individual, including a WTC responder, who has been 

identified as eligible for medical treatment and monitoring by the WTC Environmental Health Center as of 

the date of enactment of this title. 

‘‘(ii) SURVIVOR WHO MEETS CURRENT ELIGIBILITY CRITERIA.—An individual who is not a WTC responder, 

for purposes of the initial health evaluation under subsection (b), claims symptoms of a WTC-related health 

condition and meets any of the current eligibility criteria described in subparagraph (B). 

‘‘(iii) SURVIVOR WHO MEETS MODIFIED ELIGIBILITY

CRITERIA.—An individual who is not a WTC responder, 

for purposes of the initial health evaluation under subsection (b), claims symptoms of a WTC-related health 

condition and meets such eligibility criteria relating to 

exposure to airborne toxins, other hazards, or adverse 

conditions resulting from the September 11, 2001, terrorist attacks as the WTC Administrator determines, 

after consultation with the Data Centers described in 

section 3305 and the WTC Scientific/Technical Advisory Committee and WTC Health Program Steering 

Committees under section 3302. 

The Administrator shall not modify such criteria under 

clause (iii) on or after the date that the number of certifications for certified-eligible WTC survivors under paragraph (2)(B) has reached 80 percent of the limit described 

in paragraph (3) or on or after the date that the number 

of enrollments of WTC responders has reached 80 percent 

of the limit described in section 3311(a)(4). 

‘‘(B) CURRENT ELIGIBILITY CRITERIA.—The eligibility criteria described in this subparagraph for an individual are 

that the individual is described in any of the following 

clauses: 

‘‘(i) A person who was present in the New York City 

disaster area in the dust or dust cloud on September 

11, 2001. 

‘‘(ii) A person who worked, resided, or attended 

school, childcare, or adult daycare in the New York 

City disaster area for— 

‘‘(I) at least 4 days during the 4-month period 

beginning on September 11, 2001, and ending on 

January 10, 2002; or 


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‘‘(II) at least 30 days during the period beginning on September 11, 2001, and ending on July 

31, 2002. 

‘‘(iii) Any person who worked as a cleanup worker or 

performed maintenance work in the New York City 

disaster area during the 4-month period described in 

subparagraph (B)(i) and had extensive exposure to 

WTC dust as a result of such work. 

‘‘(iv) A person who was deemed eligible to receive a 

grant from the Lower Manhattan Development Corporation Residential Grant Program, who possessed a 

lease for a residence or purchased a residence in the 

New York City disaster area, and who resided in such 

residence during the period beginning on September 

11, 2001, and ending on May 31, 2003. 

‘‘(v) A person whose place of employment— 

‘‘(I) at any time during the period beginning on 

September 11, 2001, and ending on May 31, 2003, 

was in the New York City disaster area; and 

‘‘(II) was deemed eligible to receive a grant from 

the Lower Manhattan Development Corporation 

WTC Small Firms Attraction and Retention Act 

program or other government incentive program 

designed to revitalize the lower Manhattan economy after the September 11, 2001, terrorist attacks. 

‘‘(C) APPLICATION AND DETERMINATION PROCESS FOR

SCREENING ELIGIBILITY.— 

‘‘(i) IN GENERAL.—The WTC Program Administrator 

in consultation with the Data Centers shall establish 

a process for individuals, other than individuals described in subparagraph (A)(i), to be determined to be 

screening-eligible WTC survivors. Under such process— 

‘‘(I) there shall be no fee charged to the applicant for making an application for such determination; 

‘‘(II) the Administrator shall make a determination on such an application not later than 60 days 

after the date of filing the application; 

‘‘(III) the Administrator shall make such a determination relating to an applicant’s compliance 

with this title and shall not determine that an individual is not so eligible or deny written documentation under clause (ii) to such individual unless the Administrator determines that— 

‘‘(aa) based on the application submitted, 

the individual does not meet the eligibility criteria; or 

‘‘(bb) the numerical limitation on certifications of certified-eligible WTC survivors set 

forth in paragraph (3) has been met; and 

‘‘(IV) an individual who is determined not to be 

a screening-eligible WTC survivor shall have an 


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opportunity to appeal such determination in a 

manner established under such process. 

‘‘(ii) WRITTEN DOCUMENTATION OF SCREENING-ELIGI- BILITY.— 

‘‘(I) IN GENERAL.—In the case of an individual 

who is described in subparagraph (A)(i) or who is 

determined under clause (i) (consistent with paragraph (3)) to be a screening-eligible WTC survivor, 

the WTC Program Administrator shall provide an 

appropriate written documentation of such fact. 

‘‘(II) TIMING.— ‘‘(aa) CURRENTLY IDENTIFIED SURVIVORS.— In the case of an individual who is described 

in subparagraph (A)(i), the WTC Program Administrator shall provide the written documentation under subclause (I) not later than 

July 1, 2011. 

‘‘(bb) OTHER MEMBERS.—In the case of another individual who is determined under 

clause (i) and consistent with paragraph (3) to 

be a screening-eligible WTC survivor, the 

WTC Program Administrator shall provide 

the written documentation under subclause (I) 

at the time of such determination. 

‘‘(2) CERTIFIED-ELIGIBLE WTC SURVIVORS.— ‘‘(A) DEFINITION.—The term ‘certified-eligible WTC survivor’ means, subject to paragraph (3), a screening-eligible 

WTC survivor who the WTC Program Administrator certifies under subparagraph (B) to be eligible for followup 

monitoring and treatment under this part. 

‘‘(B) CERTIFICATION OF ELIGIBILITY FOR MONITORING AND

TREATMENT.— 

‘‘(i) IN GENERAL.—The WTC Program Administrator 

shall establish a certification process under which the 

Administrator shall provide appropriate certification 

to screening-eligible WTC survivors who, pursuant to 

the initial health evaluation under subsection (b), are 

determined to be eligible for followup monitoring and 

treatment under this part. 

‘‘(ii) TIMING.— 

‘‘(I) CURRENTLY IDENTIFIED SURVIVORS.—In the 

case of an individual who is described in paragraph (1)(A)(i), the WTC Program Administrator 

shall provide the certification under clause (i) not 

later than July 1, 2011. 

‘‘(II) OTHER MEMBERS.—In the case of another 

individual who is determined under clause (i) to 

be eligible for followup monitoring and treatment, 

the WTC Program Administrator shall provide the 

certification under such clause at the time of such 

determination. 

‘‘(3) NUMERICAL LIMITATION ON CERTIFIED-ELIGIBLE WTC SUR- VIVORS.— 

‘‘(A) IN GENERAL.—The total number of individuals not 

described in paragraph (1)(A)(i) who may be certified as 


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certified-eligible WTC survivors under paragraph (2)(B) 

shall not exceed 25,000 at any time. 

‘‘(B) PROCESS.—In implementing subparagraph (A), the 

WTC Program Administrator shall— 

‘‘(i) limit the number of certifications provided under 

paragraph (2)(B)— 

‘‘(I) in accordance with such subparagraph; and 

‘‘(II) to such number, as determined by the Administrator based on the best available information and subject to amounts made available under 

section 3351, that will ensure sufficient funds will 

be available to provide treatment and monitoring 

benefits under this title, with respect to all individuals receiving such certifications through the 

end of fiscal year 2020; and 

‘‘(ii) provide priority in such certifications in the 

order in which individuals apply for a determination 

under paragraph (2)(B). 

‘‘(4) DISQUALIFICATION OF INDIVIDUALS ON TERRORIST WATCH

LIST.—No individual who is on the terrorist watch list maintained by the Department of Homeland Security shall qualify 

as a screening-eligible WTC survivor or a certified-eligible 

WTC survivor. Before determining any individual to be a 

screening-eligible WTC survivor under paragraph (1) or certifying any individual as a certified eligible WTC survivor under 

paragraph (2), the Administrator, in consultation with the Secretary of Homeland Security, shall determine whether the individual is on such list. 

‘‘(b) INITIAL HEALTH EVALUATION TO DETERMINE ELIGIBILITY FOR

FOLLOWUP MONITORING OR TREATMENT.— ‘‘(1) IN GENERAL.—In the case of a screening-eligible WTC 

survivor, the WTC Program shall provide for an initial health 

evaluation to determine if the survivor has a WTC-related 

health condition and is eligible for followup monitoring and 

treatment benefits under the WTC Program. Initial health 

evaluation protocols under section 3305(a)(2)(A)(ii) shall be 

subject to approval by the WTC Program Administrator. 

‘‘(2) INITIAL HEALTH EVALUATION PROVIDERS.—The initial 

health evaluation described in paragraph (1) shall be provided 

through a Clinical Center of Excellence with respect to the individual involved. 

‘‘(3) LIMITATION ON INITIAL HEALTH EVALUATION BENEFITS.— 

Benefits for an initial health evaluation under this part for a 

screening-eligible WTC survivor shall consist only of a single 

medical initial health evaluation consistent with initial health 

evaluation protocols described in paragraph (1). Nothing in this 

paragraph shall be construed as preventing such an individual 

from seeking additional medical initial health evaluations at 

the expense of the individual. 

‘‘SEC. 3322. FOLLOWUP MONITORING AND TREATMENT OF CERTIFIEDELIGIBLE WTC SURVIVORS FOR WTC-RELATED HEALTH 

CONDITIONS. 

‘‘(a) IN GENERAL.—Subject to subsection (b), the provisions of sections 3311 and 3312 shall apply to followup monitoring and treatment of WTC-related health conditions for certified-eligible WTC 


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survivors in the same manner as such provisions apply to the monitoring and treatment of WTC-related health conditions for enrolled 

WTC responders. 

‘‘(b) LIST OF WTC-RELATED HEALTH CONDITIONS FOR SUR- VIVORS.—The list of health conditions for screening-eligible WTC 

survivors and certified-eligible WTC survivors consists of the following: 

‘‘(1) AERODIGESTIVE DISORDERS.— ‘‘(A) Interstitial lung diseases. 

‘‘(B) Chronic respiratory disorder—fumes/vapors. 

‘‘(C) Asthma. 

‘‘(D) Reactive airways dysfunction syndrome (RADS). 

‘‘(E) WTC-exacerbated chronic obstructive pulmonary 

disease (COPD). 

‘‘(F) Chronic cough syndrome. 

‘‘(G) Upper airway hyperreactivity. 

‘‘(H) Chronic rhinosinusitis. 

‘‘(I) Chronic nasopharyngitis. 

‘‘(J) Chronic laryngitis. 

‘‘(K) Gastroesophageal reflux disorder (GERD). 

‘‘(L) Sleep apnea exacerbated by or related to a condition 

described in a previous clause. 

‘‘(2) MENTAL HEALTH CONDITIONS.— 

‘‘(A) Posttraumatic stress disorder (PTSD). 

‘‘(B) Major depressive disorder. 

‘‘(C) Panic disorder. 

‘‘(D) Generalized anxiety disorder. 

‘‘(E) Anxiety disorder (not otherwise specified). 

‘‘(F) Depression (not otherwise specified). 

‘‘(G) Acute stress disorder. 

‘‘(H) Dysthymic disorder. 

‘‘(I) Adjustment disorder. 

‘‘(J) Substance abuse. 

‘‘(3) ADDITIONAL CONDITIONS.—Any cancer (or type of cancer) 

or other condition added to the list in section 3312(a)(3) pursuant to paragraph (5) or (6) of section 3312(a), as such provisions are applied under subsection (a) with respect to certifiedeligible WTC survivors. 

‘‘SEC. 3323. FOLLOWUP MONITORING AND TREATMENT OF OTHER INDIVIDUALS WITH WTC-RELATED HEALTH CONDITIONS. 

‘‘(a) IN GENERAL.—Subject to subsection (c), the provisions of section 3322 shall apply to the followup monitoring and treatment of 

WTC-related health conditions in the case of individuals described 

in subsection (b) in the same manner as such provisions apply to 

the followup monitoring and treatment of WTC-related health conditions for certified-eligible WTC survivors. 

‘‘(b) INDIVIDUALS DESCRIBED.—An individual described in this 

subsection is an individual who, regardless of location of residence— 

‘‘(1) is not an enrolled WTC responder or a certified-eligible 

WTC survivor; and 

‘‘(2) is diagnosed at a Clinical Center of Excellence with a 

WTC-related health condition for certified-eligible WTC survivors. 

‘‘(c) LIMITATION.— 


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‘‘(1) IN GENERAL.—The WTC Program Administrator shall 

limit benefits for any fiscal year under subsection (a) in a manner so that payments under this section for such fiscal year do 

not exceed the amount specified in paragraph (2) for such fiscal 

year. 

‘‘(2) LIMITATION.—The amount specified in this paragraph 

for— 

‘‘(A) the last calendar quarter of fiscal year 2011 is $5,000,000; ‘‘(B) fiscal year 2012 is $20,000,000; or 

‘‘(C) a succeeding fiscal year is the amount specified in 

this paragraph for the previous fiscal year increased by the 

annual percentage increase in the medical care component 

of the consumer price index for all urban consumers. 

‘‘PART 3—PAYOR PROVISIONS 

‘‘SEC. 3331. PAYMENT OF CLAIMS. 

‘‘(a) IN GENERAL.—Except as provided in subsections (b) and (c), 

the cost of monitoring and treatment benefits and initial health 

evaluation benefits provided under parts 1 and 2 of this subtitle 

shall be paid for by the WTC Program from the World Trade Center Health Program Fund. 

‘‘(b) WORKERS’ COMPENSATION PAYMENT.— ‘‘(1) IN GENERAL.—Subject to paragraph (2), payment for 

treatment under parts 1 and 2 of this subtitle of a WTC-related health condition of an individual that is work-related 

shall be reduced or recouped to the extent that the WTC Program Administrator determines that payment has been made, 

or can reasonably be expected to be made, under a workers’ 

compensation law or plan of the United States, a State, or a 

locality, or other work-related injury or illness benefit plan of 

the employer of such individual, for such treatment. The provisions of clauses (iii), (iv), (v), and (vi) of paragraph (2)(B) of section 1862(b) of the Social Security Act and paragraphs (3) and 

(4) of such section shall apply to the recoupment under this 

subsection of a payment to the WTC Program (with respect to 

a workers’ compensation law or plan, or other work-related injury or illness plan of the employer involved, and such individual) in the same manner as such provisions apply to the reimbursement of a payment under section 1862(b)(2) of such Act 

to the Secretary (with respect to such a law or plan and an individual entitled to benefits under title XVIII of such Act) except that any reference in such paragraph (4) to payment rates 

under title XVIII of the Social Security Act shall be deemed a 

reference to payment rates under this title. 

‘‘(2) EXCEPTION.—Paragraph (1) shall not apply for any quarter, with respect to any workers’ compensation law or plan, including line of duty compensation, to which New York City is 

obligated to make payments, if, in accordance with terms specified under the contract under subsection (d)(1)(A), New York 

City has made the full payment required under such contract 

for such quarter. 

‘‘(3) RULES OF CONSTRUCTION.—Nothing in this title shall be 

construed to affect, modify, or relieve any obligations under a 


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worker’s compensation law or plan, other work-related injury 

or illness benefit plan of an employer, or any health insurance 

plan. 

‘‘(c) HEALTH INSURANCE COVERAGE.— ‘‘(1) IN GENERAL.—In the case of an individual who has a 

WTC-related health condition that is not work-related and has 

health coverage for such condition through any public or private health plan (including health benefits under title XVIII, 

XIX, or XXI of the Social Security Act) the provisions of section 

1862(b) of the Social Security Act shall apply to such a health 

plan and such individual in the same manner as they apply to 

group health plan and an individual entitled to benefits under 

title XVIII of such Act pursuant to section 226(a) of such Act. 

Any costs for items and services covered under such plan that 

are not reimbursed by such health plan, due to the application 

of deductibles, copayments, coinsurance, other cost sharing, or 

otherwise, are reimbursable under this title to the extent that 

they are covered under the WTC Program. The program under 

this title shall not be treated as a legally liable party for purposes of applying section 1902(a)(25) of the Social Security Act. 

‘‘(2) RECOVERY BY INDIVIDUAL PROVIDERS.—Nothing in paragraph (1) shall be construed as requiring an entity providing 

monitoring and treatment under this title to seek reimbursement under a health plan with which the entity has no contract for reimbursement. 

‘‘(3) MAINTENANCE OF REQUIRED MINIMUM ESSENTIAL COV- ERAGE.—No payment may be made for monitoring and treatment under this title for an individual for a month (beginning 

with July 2014) if with respect to such month the individual— 

‘‘(A) is an applicable individual (as defined in subsection 

(d) of section 5000A of Internal Revenue Code of 1986) for 

whom the exemption under subsection (e) of such section 

does not apply; and 

‘‘(B) is not covered under minimum essential coverage, 

as required under subsection (a) of such section. 

‘‘(d) REQUIRED CONTRIBUTION BY NEW YORK CITY IN PROGRAM

COSTS.— 

‘‘(1) CONTRACT REQUIREMENT.— ‘‘(A) IN GENERAL.—No funds may be disbursed from the 

World Trade Center Health Program Fund under section 

3351 unless New York City has entered into a contract 

with the WTC Program Administrator under which New 

York City agrees, in a form and manner specified by the 

Administrator, to pay the full contribution described in 

subparagraph (B) in accordance with this subsection on a 

timely basis, plus any interest owed pursuant to subparagraph (E)(i). Such contract shall specify the terms under 

which New York City shall be considered to have made the 

full payment required for a quarter for purposes of subsection (b)(2). 

‘‘(B) FULL CONTRIBUTION AMOUNT.—Under such contract, 

with respect to the last calendar quarter of fiscal year 

2011 and each calendar quarter in fiscal years 2012 

through 2018 the full contribution amount under this subparagraph shall be equal to 10 percent of the expenditures 


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in carrying out this title for the respective quarter and 

with respect to calendar quarters in fiscal years 2019 and 

2020, such full contribution amount shall be equal to 1⁄9 of 

the Federal expenditures in carrying out this title for the 

respective quarter. 

‘‘(C) SATISFACTION OF PAYMENT OBLIGATION.—The payment obligation under such contract may not be satisfied 

through any of the following: 

‘‘(i) An amount derived from Federal sources. 

‘‘(ii) An amount paid before the date of the enactment of this title. 

‘‘(iii) An amount paid to satisfy a judgment or as 

part of a settlement related to injuries or illnesses 

arising out of the September 11, 2001, terrorist attacks. 

‘‘(D) TIMING OF CONTRIBUTION.—The payment obligation 

under such contract for a calendar quarter in a fiscal year 

shall be paid not later than the last day of the second succeeding calendar quarter. 

‘‘(E) COMPLIANCE.— 

‘‘(i) INTEREST FOR LATE PAYMENT.—If New York City 

fails to pay to the WTC Program Administrator pursuant to such contract the amount required for any calendar quarter by the day specified in subparagraph 

(D), interest shall accrue on the amount not so paid at 

the rate (determined by the Administrator) based on 

the average yield to maturity, plus 1 percentage point, 

on outstanding municipal bonds issued by New York 

City with a remaining maturity of at least 1 year. 

‘‘(ii) RECOVERY OF AMOUNTS OWED.— The amounts 

owed to the WTC Program Administrator under such 

contract shall be recoverable by the United States in 

an action in the same manner as payments made 

under title XVIII of the Social Security Act may be recoverable in an action brought under section 

1862(b)(2)(B)(iii) of such Act. 

‘‘(F) DEPOSIT IN FUND.—The WTC Program Administer 

shall deposit amounts paid under such contract into the 

World Trade Center Health Program Fund under section 

3351. 

‘‘(2) PAYMENT OF NEW YORK CITY SHARE OF MONITORING AND

TREATMENT COSTS.—With respect to each calendar quarter for 

which a contribution is required by New York City under the 

contract under paragraph (1), the WTC Program Administrator 

shall— 

‘‘(A) provide New York City with an estimate of such 

amount of the required contribution at the beginning of 

such quarter and with an updated estimate of such 

amount at the beginning of each of the subsequent 2 quarters; 

‘‘(B) bill such amount directly to New York City; and 

‘‘(C) certify periodically, for purposes of this subsection, 

whether or not New York City has paid the amount so 

billed. 


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Such amount shall initially be estimated by the WTC Program 

Administrator and shall be subject to adjustment and reconciliation based upon actual expenditures in carrying out this title. 

‘‘(3) RULE OF CONSTRUCTION.—Nothing in this subsection 

shall be construed as authorizing the WTC Administrator, with 

respect to a fiscal year, to reduce the numerical limitation 

under section 3311(a)(4) or 3321(a)(3) for such fiscal year if 

New York City fails to comply with paragraph (1) for a calendar quarter in such fiscal year. 

‘‘(e) WORK-RELATED DESCRIBED.—For the purposes of this section, a WTC-related health condition shall be treated as a condition 

that is work-related if— 

‘‘(1) the condition is diagnosed in an enrolled WTC responder, or in an individual who qualifies as a certified-eligible 

WTC survivor on the basis of being a rescue, recovery, or 

cleanup worker; or 

‘‘(2) with respect to the condition the individual has filed and 

had established a claim under a workers’ compensation law or 

plan of the United States or a State, or other work-related injury or illness benefit plan of the employer of such individual. 

‘‘SEC. 3332. ADMINISTRATIVE ARRANGEMENT AUTHORITY. 

‘‘The WTC Program Administrator may enter into arrangements 

with other government agencies, insurance companies, or other 

third-party administrators to provide for timely and accurate processing of claims under sections 3312, 3313, 3322, and 3323. 

‘‘Subtitle C—Research Into Conditions 

‘‘SEC. 3341. RESEARCH REGARDING CERTAIN HEALTH CONDITIONS 

RELATED TO SEPTEMBER 11 TERRORIST ATTACKS. 

‘‘(a) IN GENERAL.—With respect to individuals, including enrolled 

WTC responders and certified-eligible WTC survivors, receiving 

monitoring or treatment under subtitle B, the WTC Program Administrator shall conduct or support— 

‘‘(1) research on physical and mental health conditions that 

may be related to the September 11, 2001, terrorist attacks; 

‘‘(2) research on diagnosing WTC-related health conditions of 

such individuals, in the case of conditions for which there has 

been diagnostic uncertainty; and 

‘‘(3) research on treating WTC-related health conditions of 

such individuals, in the case of conditions for which there has 

been treatment uncertainty. 

The Administrator may provide such support through continuation 

and expansion of research that was initiated before the date of the 

enactment of this title and through the World Trade Center Health 

Registry (referred to in section 3342), through a Clinical Center of 

Excellence, or through a Data Center. 

‘‘(b) TYPES OF RESEARCH.—The research under subsection (a)(1) 

shall include epidemiologic and other research studies on WTC-related health conditions or emerging conditions— 

‘‘(1) among enrolled WTC responders and certified-eligible 

WTC survivors under treatment; and 

‘‘(2) in sampled populations outside the New York City disaster area in Manhattan as far north as 14th Street and in 


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Brooklyn, along with control populations, to identify potential 

for long-term adverse health effects in less exposed populations. 

‘‘(c) CONSULTATION.—The WTC Program Administrator shall 

carry out this section in consultation with the WTC Scientific/Technical Advisory Committee. 

‘‘(d) APPLICATION OF PRIVACY AND HUMAN SUBJECT PROTEC- TIONS.—The privacy and human subject protections applicable to 

research conducted under this section shall not be less than such 

protections applicable to research conducted or funded by the Department of Health and Human Services. 

‘‘SEC. 3342. WORLD TRADE CENTER HEALTH REGISTRY. 

‘‘For the purpose of ensuring ongoing data collection relating to 

victims of the September 11, 2001, terrorist attacks, the WTC Program Administrator shall ensure that a registry of such victims is 

maintained that is at least as comprehensive as the World Trade 

Center Health Registry maintained under the arrangements in effect as of April 20, 2009, with the New York City Department of 

Health and Mental Hygiene. 

‘‘Subtitle D—Funding 

‘‘SEC. 3351. WORLD TRADE CENTER HEALTH PROGRAM FUND. 

‘‘(a) ESTABLISHMENT OF FUND.— ‘‘(1) IN GENERAL.—There is established a fund to be known 

as the World Trade Center Health Program Fund (referred to 

in this section as the ‘Fund’). 

‘‘(2) FUNDING.—Out of any money in the Treasury not otherwise appropriated, there shall be deposited into the Fund for 

each of fiscal years 2012 through 2020 (and the last calendar 

quarter of fiscal year 2011)— 

‘‘(A) the Federal share, consisting of an amount equal to 

the lesser of— 

‘‘(i) 90 percent of the expenditures in carrying out 

this title for the respective fiscal year (initially based 

on estimates, subject to subsequent reconciliation 

based on actual expenditures); or 

‘‘(ii)(I) $71,000,000 for the last calendar quarter of 

fiscal year 2011, $318,000,000 for fiscal year 2012, 

$354,000,000 for fiscal year 2013, $382,000,000 for fiscal year 2014, $431,000,000 for fiscal year 2015, 

$481,000,000 for fiscal year 2016, $537,000,000 for fiscal year 2017, $601,000,000 for fiscal year 2018, and 

$173,000,000 for fiscal year 2019; and 

‘‘(II) subject to paragraph (4), an additional 

$499,000,000 for fiscal year 2019 and $743,000,000 for 

fiscal year 2020; plus 

‘‘(B) the New York City share, consisting of the amount 

contributed under the contract under section 3331(d). 

‘‘(3) CONTRACT REQUIREMENT.— 

‘‘(A) IN GENERAL.—No funds may be disbursed from the 

Fund unless New York City has entered into a contract 

with the WTC Program Administrator under section 

3331(d)(1). 


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‘‘(B) BREACH OF CONTRACT.— In the case of a failure to 

pay the amount so required under the contract— 

‘‘(i) the amount is recoverable under subparagraph 

(E)(ii) of such section; 

‘‘(ii) such failure shall not affect the disbursement of 

amounts from the Fund; and 

‘‘(iii) the Federal share described in paragraph (2)(A) 

shall not be increased by the amount so unpaid. 

‘‘(4) AGGREGATE LIMITATION ON FUNDING BEGINNING WITH

FISCAL YEAR 2019.—Beginning with fiscal year 2019, in no case 

shall the share of Federal funds deposited into the Fund under 

paragraph (2) for such fiscal year and previous fiscal years and 

quarters exceed the sum of the amounts specified in paragraph 

(2)(A)(ii)(I). 

‘‘(b) MANDATORY FUNDS FOR MONITORING, INITIAL HEALTH EVAL- UATIONS, TREATMENT, AND CLAIMS PROCESSING.— ‘‘(1) IN GENERAL.—The amounts deposited into the Fund 

under subsection (a)(2) shall be available, without further appropriation, consistent with paragraph (2) and subsection (c), 

to carry out subtitle B and sections 3302(a), 3303, 3304, 

3305(a)(2), 3305(c), 3341, and 3342. 

‘‘(2) LIMITATION ON MANDATORY FUNDING.—This title does 

not establish any Federal obligation for payment of amounts in 

excess of the amounts available from the Fund for such purpose. 

‘‘(3) LIMITATION ON AUTHORIZATION FOR FURTHER APPROPRIA- TIONS.—This title does not establish any authorization for appropriation of amounts in excess of the amounts available from 

the Fund under paragraph (1). 

‘‘(c) LIMITS ON SPENDING FOR CERTAIN PURPOSES.—Of the 

amounts made available under subsection (b)(1), not more than 

each of the following amounts may be available for each of the following purposes: 

‘‘(1) SURVIVING IMMEDIATE FAMILY MEMBERS OF FIREFIGHTERS.—For the purposes of carrying out subtitle B with respect to WTC responders described in section 

3311(a)(2)(A)(ii)— 

‘‘(A) for the last calendar quarter of fiscal year 2011, $100,000; 

‘‘(B) for fiscal year 2012, $400,000; and 

‘‘(C) for each subsequent fiscal year, the amount specified under this paragraph for the previous fiscal year increased by the percentage increase in the consumer price 

index for all urban consumers (all items; United States 

city average) as estimated by the Secretary for the 12- 

month period ending with March of the previous year. 

‘‘(2) WTC HEALTH PROGRAM SCIENTIFIC/TECHNICAL ADVISORY

COMMITTEE.—For the purpose of carrying out section 3302(a)— 

‘‘(A) for the last calendar quarter of fiscal year 2011, 

$25,000; 

‘‘(B) for fiscal year 2012, $100,000; and 

‘‘(C) for each subsequent fiscal year, the amount specified under this paragraph for the previous fiscal year increased by the percentage increase in the consumer price 

index for all urban consumers (all items; United States 


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city average) as estimated by the Secretary for the 12- 

month period ending with March of the previous year. 

‘‘(3) EDUCATION AND OUTREACH.—For the purpose of carrying 

out section 3303— 

‘‘(A) for the last calendar quarter of fiscal year 2011, 

$500,000; 

‘‘(B) for fiscal year 2012, $2,000,000; and 

‘‘(C) for each subsequent fiscal year, the amount specified under this paragraph for the previous fiscal year increased by the percentage increase in the consumer price 

index for all urban consumers (all items; United States 

city average) as estimated by the Secretary for the 12- 

month period ending with March of the previous year. 

‘‘(4) UNIFORM DATA COLLECTION.—For the purpose of carrying out section 3304 and for reimbursing Data Centers (as 

defined in section 3305(b)(2)) for the costs incurred by such 

Centers in carrying out activities under contracts entered into 

under section 3305(a)(2)— 

‘‘(A) for the last calendar quarter of fiscal year 2011, 

$2,500,000; 

‘‘(B) for fiscal year 2012, $10,000,000; and 

‘‘(C) for each subsequent fiscal year, the amount specified under this paragraph for the previous fiscal year increased by the percentage increase in the consumer price 

index for all urban consumers (all items; United States 

city average) as estimated by the Secretary for the 12- 

month period ending with March of the previous year. 

‘‘(5) RESEARCH REGARDING CERTAIN HEALTH CONDITIONS.— 

For the purpose of carrying out section 3341— 

‘‘(A) for the last calendar quarter of fiscal year 2011, 

$3,750,000; 

‘‘(B) for fiscal year 2012, $15,000,000; and 

‘‘(C) for each subsequent fiscal year, the amount specified under this paragraph for the previous fiscal year increased by the percentage increase in the consumer price 

index for all urban consumers (all items; United States 

city average) as estimated by the Secretary for the 12- 

month period ending with March of the previous year. 

‘‘(6) WORLD TRADE CENTER HEALTH REGISTRY.—For the purpose of carrying out section 3342— 

‘‘(A) for the last calendar quarter of fiscal year 2011, 

$1,750,000; 

‘‘(B) for fiscal year 2012, $7,000,000; and 

‘‘(C) for each subsequent fiscal year, the amount specified under this paragraph for the previous fiscal year increased by the percentage increase in the consumer price 

index for all urban consumers (all items; United States 

city average) as estimated by the Secretary for the 12- 

month period ending with March of the previous year.’’. 


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TITLE II—SEPTEMBER 11TH VICTIM 

COMPENSATION FUND OF 2001 

SEC. 201. DEFINITIONS. 

Section 402 of the Air Transportation Safety and System Stabilization Act (49 U.S.C. 40101 note) is amended— 

(1) in paragraph (6) by inserting ‘‘, or debris removal, including under the World Trade Center Health Program established 

under section 3001 of the Public Health Service Act, and payments made pursuant to the settlement of a civil action described in section 405(c)(3)(C)(iii)’’ after ‘‘September 11, 2001’’; 

(2) by inserting after paragraph (6) the following new paragraphs and redesignating subsequent paragraphs accordingly: 

‘‘(7) CONTRACTOR AND SUBCONTRACTOR.—The term ‘contractor and subcontractor’ means any contractor or subcontractor (at any tier of a subcontracting relationship), including 

any general contractor, construction manager, prime contractor, consultant, or any parent, subsidiary, associated or allied company, affiliated company, corporation, firm, organization, or joint venture thereof that participated in debris removal at any 9/11 crash site. Such term shall not include any 

entity, including the Port Authority of New York and New Jersey, with a property interest in the World Trade Center, on 

September 11, 2001, whether fee simple, leasehold or easement, direct or indirect. 

‘‘(8) DEBRIS REMOVAL.—The term ‘debris removal’ means rescue and recovery efforts, removal of debris, cleanup, remediation, and response during the immediate aftermath of the terrorist-related aircraft crashes of September 11, 2001, with respect to a 9/11 crash site.’’; 

(3) by inserting after paragraph (10), as so redesignated, the 

following new paragraph and redesignating the subsequent 

paragraphs accordingly: 

‘‘(11) IMMEDIATE AFTERMATH.—The term ‘immediate aftermath’ means any period beginning with the terrorist-related 

aircraft crashes of September 11, 2001, and ending on August 

30, 2002.’’; and 

(4) by adding at the end the following new paragraph: 

‘‘(14) 9/11 CRASH SITE.—The term ‘9/11 crash site’ means— 

‘‘(A) the World Trade Center site, Pentagon site, and 

Shanksville, Pennsylvania site; 

‘‘(B) the buildings or portions of buildings that were destroyed as a result of the terrorist-related aircraft crashes 

of September 11, 2001; 

‘‘(C) any area contiguous to a site of such crashes that 

the Special Master determines was sufficiently close to the 

site that there was a demonstrable risk of physical harm 

resulting from the impact of the aircraft or any subsequent 

fire, explosions, or building collapses (including the immediate area in which the impact occurred, fire occurred, portions of buildings fell, or debris fell upon and injured individuals); and 

‘‘(D) any area related to, or along, routes of debris removal, such as barges and Fresh Kills.’’. 


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SEC. 202. EXTENDED AND EXPANDED ELIGIBILITY FOR COMPENSATION. 

(a) INFORMATION ON LOSSES RESULTING FROM DEBRIS REMOVAL

INCLUDED IN CONTENTS OF CLAIM FORM.—Section 405(a)(2)(B) of 

the Air Transportation Safety and System Stabilization Act (49 

U.S.C. 40101 note) is amended— 

(1) in clause (i), by inserting ‘‘, or debris removal during the 

immediate aftermath’’ after ‘‘September 11, 2001’’; 

(2) in clause (ii), by inserting ‘‘or debris removal during the 

immediate aftermath’’ after ‘‘crashes’’; and 

(3) in clause (iii), by inserting ‘‘or debris removal during the 

immediate aftermath’’ after ‘‘crashes’’. 

(b) EXTENSION OF DEADLINE FOR CLAIMS UNDER SEPTEMBER

11TH VICTIM COMPENSATION FUND OF 2001.—Section 405(a)(3) of 

such Act is amended to read as follows: 

‘‘(3) LIMITATION.— 

‘‘(A) IN GENERAL.—Except as provided by subparagraph 

(B), no claim may be filed under paragraph (1) after the 

date that is 2 years after the date on which regulations are 

promulgated under section 407(a). 

‘‘(B) EXCEPTION.—A claim may be filed under paragraph 

(1), in accordance with subsection (c)(3)(A)(i), by an individual (or by a personal representative on behalf of a deceased individual) during the period beginning on the date 

on which the regulations are updated under section 407(b) 

and ending on December 22, 2031.’’. 

(c) REQUIREMENTS FOR FILING CLAIMS DURING EXTENDED FILING

PERIOD.—Section 405(c)(3) of such Act is amended— 

(1) by redesignating subparagraphs (A) and (B) as subparagraphs (B) and (C), respectively; and 

(2) by inserting before subparagraph (B), as so redesignated, 

the following new subparagraph: 

‘‘(A) REQUIREMENTS FOR FILING CLAIMS DURING EXTENDED FILING PERIOD.— 

‘‘(i) TIMING REQUIREMENTS FOR FILING CLAIMS.—An 

individual (or a personal representative on behalf of a 

deceased individual) may file a claim during the period described in subsection (a)(3)(B) as follows: 

‘‘(I) In the case that the Special Master determines the individual knew (or reasonably should 

have known) before the date specified in clause 

(iii) that the individual suffered a physical harm 

at a 9/11 crash site as a result of the terrorist-related aircraft crashes of September 11, 2001, or as 

a result of debris removal, and that the individual 

knew (or should have known) before such specified 

date that the individual was eligible to file a claim 

under this title, the individual may file a claim 

not later than the date that is 2 years after such 

specified date. 

‘‘(II) In the case that the Special Master determines the individual first knew (or reasonably 

should have known) on or after the date specified 

in clause (iii) that the individual suffered such a 

physical harm or that the individual first knew (or 


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should have known) on or after such specified date 

that the individual was eligible to file a claim 

under this title, the individual may file a claim 

not later than the last day of the 2-year period beginning on the date the Special Master determines 

the individual first knew (or should have known) 

that the individual both suffered from such harm 

and was eligible to file a claim under this title. 

‘‘(ii) OTHER ELIGIBILITY REQUIREMENTS FOR FILING

CLAIMS.—An individual may file a claim during the period described in subsection (a)(3)(B) only if— 

‘‘(I) the individual was treated by a medical professional for suffering from a physical harm described in clause (i)(I) within a reasonable time 

from the date of discovering such harm; and 

‘‘(II) the individual’s physical harm is verified by 

contemporaneous medical records created by or at 

the direction of the medical professional who provided the medical care. 

‘‘(iii) DATE SPECIFIED.—The date specified in this 

clause is the date on which the regulations are updated under section 407(a).’’. 

(d) CLARIFYING APPLICABILITY TO ALL 9/11 CRASH SITES.—Section 405(c)(2)(A)(i) of such Act is amended by striking ‘‘or the site 

of the aircraft crash at Shanksville, Pennsylvania’’ and inserting 

‘‘the site of the aircraft crash at Shanksville, Pennsylvania, or any 

other 9/11 crash site’’. 

(e) INCLUSION OF PHYSICAL HARM RESULTING FROM DEBRIS RE- MOVAL.—Section 405(c) of such Act is amended in paragraph 

(2)(A)(ii), by inserting ‘‘or debris removal’’ after ‘‘air crash’’. 

(f) LIMITATIONS ON CIVIL ACTIONS.— (1) APPLICATION TO DAMAGES RELATED TO DEBRIS REMOVAL.— 

Clause (i) of section 405(c)(3)(C) of such Act, as redesignated 

by subsection (c), is amended by inserting ‘‘, or for damages 

arising from or related to debris removal’’ after ‘‘September 11, 

2001’’. 

(2) PENDING ACTIONS.—Clause (ii) of such section, as so redesignated, is amended to read as follows: 

‘‘(ii) PENDING ACTIONS.—In the case of an individual 

who is a party to a civil action described in clause (i), 

such individual may not submit a claim under this 

title— 

‘‘(I) during the period described in subsection 

(a)(3)(A) unless such individual withdraws from 

such action by the date that is 90 days after the 

date on which regulations are promulgated under 

section 407(a); and 

‘‘(II) during the period described in subsection 

(a)(3)(B) unless such individual withdraws from 

such action by the date that is 90 days after the 

date on which the regulations are updated under 

section 407(b).’’. 

(3) SETTLED ACTIONS; AUTHORITY TO REINSTITUTE CERTAIN

LAWSUITS.—Such section, as so redesignated, is further amended by adding at the end the following new clauses: 


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‘‘(iii) SETTLED ACTIONS.—In the case of an individual 

who settled a civil action described in clause (i), such 

individual may not submit a claim under this title unless such action was commenced after December 22, 

2003, and a release of all claims in such action was 

tendered prior to the date on which the James 

Zadroga 9/11 Health and Compensation Act of 2010 

was enacted. 

‘‘(iv) AUTHORITY TO REINSTITUTE CERTAIN LAWSUITS.—In the case of a claimant who was a party to 

a civil action described in clause (i), who withdrew 

from such action pursuant to clause (ii), and who is 

subsequently determined to not be an eligible individual for purposes of this subsection, such claimant 

may reinstitute such action without prejudice during 

the 90-day period beginning after the date of such ineligibility determination.’’. 

SEC. 203. REQUIREMENT TO UPDATE REGULATIONS. 

Section 407 of the Air Transportation Safety and System Stabilization Act (49 U.S.C. 40101 note) is amended— 

(1) by striking ‘‘Not later than’’ and inserting ‘‘(a) IN GENERAL.—Not later than’’; and 

(2) by adding at the end the following new subsection: 

‘‘(b) UPDATED REGULATIONS.—Not later than 90 days after the 

date of the enactment of the James Zadroga 9/11 Health and Compensation Act of 2010, the Special Master shall update the regulations promulgated under subsection (a) to the extent necessary to 

comply with the provisions of title II of such Act.’’. 

SEC. 204. LIMITED LIABILITY FOR CERTAIN CLAIMS. 

Section 408(a) of the Air Transportation Safety and System Stabilization Act (49 U.S.C. 40101 note) is amended by adding at the 

end the following new paragraphs: 

‘‘(4) LIABILITY FOR CERTAIN CLAIMS.—Notwithstanding any 

other provision of law, liability for all claims and actions (including claims or actions that have been previously resolved, 

that are currently pending, and that may be filed through December 22, 2031) for compensatory damages, contribution or 

indemnity, or any other form or type of relief, arising from or 

related to debris removal, against the City of New York, any 

entity (including the Port Authority of New York and New Jersey) with a property interest in the World Trade Center on 

September 11, 2001 (whether fee simple, leasehold or easement, or direct or indirect) and any contractors and subcontractors, shall not be in an amount that exceeds the sum of 

the following, as may be applicable: 

‘‘(A) The amount of funds of the WTC Captive Insurance 

Company, including the cumulative interest. 

‘‘(B) The amount of all available insurance identified in 

schedule 2 of the WTC Captive Insurance Company insurance policy. 

‘‘(C) As it relates to the limitation of liability of the City 

of New York, the amount that is the greater of the City 

of New York’s insurance coverage or $350,000,000. In determining the amount of the City’s insurance coverage for 


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purposes of the previous sentence, any amount described 

in clauses (i) and (ii) shall not be included. 

‘‘(D) As it relates to the limitation of liability of any entity, including the Port Authority of New York and New Jersey, with a property interest in the World Trade Center on 

September 11, 2001 (whether fee simple, leasehold or easement, or direct or indirect), the amount of all available liability insurance coverage maintained by any such entity. 

‘‘(E) As it relates to the limitation of liability of any individual contractor or subcontractor, the amount of all available liability insurance coverage maintained by such contractor or subcontractor on September 11, 2001. 

‘‘(5) PRIORITY OF CLAIMS PAYMENTS.—Payments to plaintiffs 

who obtain a settlement or judgment with respect to a claim 

or action to which paragraph (4)(A) applies, shall be paid solely 

from the following funds in the following order, as may be applicable: 

‘‘(A) The funds described in clause (i) or (ii) of paragraph 

(4)(A). 

‘‘(B) If there are no funds available as described in 

clause (i) or (ii) of paragraph (4)(A), the funds described in 

clause (iii) of such paragraph. 

‘‘(C) If there are no funds available as described in 

clause (i), (ii), or (iii) of paragraph (4)(A), the funds described in clause (iv) of such paragraph. 

‘‘(D) If there are no funds available as described in 

clause (i), (ii), (iii), or (iv) of paragraph (4)(A), the funds described in clause (v) of such paragraph. 

‘‘(6) DECLARATORY JUDGMENT ACTIONS AND DIRECT ACTION.— Any party to a claim or action to which paragraph (4)(A) applies may, with respect to such claim or action, either file an 

action for a declaratory judgment for insurance coverage or 

bring a direct action against the insurance company involved.’’. 

SEC. 205. FUNDING; ATTORNEY FEES. 

Section 406 of the Air Transportation Safety and System Stabilization Act (49 U.S.C. 40101 note) is amended— 

(1) in subsection (a), by striking ‘‘Not later than’’ and inserting ‘‘Subject to the limitations under subsection (d), not later 

than’’; 

(2) in subsection (b)— 

(A) by inserting ‘‘in the amounts provided under subsection (d)(1)’’ after ‘‘appropriations Acts’’; and 

(B) by inserting ‘‘subject to the limitations under subsection (d)’’ before the period; and 

(3) by adding at the end the following new subsections: 

‘‘(d) LIMITATION.— 

‘‘(1) IN GENERAL.—The total amount of Federal funds paid 

for compensation under this title, with respect to claims filed 

on or after the date on which the regulations are updated 

under section 407(b), shall not exceed $8,400,000,000. Of such 

amounts, $4,200,000,000 shall be available to pay such claims 

during the 10-year period beginning on such date and 

$4,200,000,000 shall be available to pay such claims after such 

period. 

‘‘(2) PRO-RATION AND PAYMENT OF REMAINING CLAIMS.— 


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‘‘(A) IN GENERAL.—With respect to the one-year period 

beginning on the date on which the first payment is made 

under this title for claims filed pursuant to the regulations 

updated under section 407(b), the Special Master shall examine the total number of such claims paid during such 

period and the amounts of the payments made for such 

claims to project the total number and amount of claims 

expected to be paid under this title during the 10-year period described in paragraph (1). If, based on such projection, the Special Master determines that there will be insufficient funds available under paragraph (1) to pay such 

claims during such 10-year period, beginning on the first 

day following such one-year period, the Special Master 

shall ratably reduce the amount of compensation due 

claimants under this title in a manner to ensure, to the extent possible, that— 

‘‘(i) all claimants who, before application of the limitation under the second sentence of paragraph (1), 

would have been determined to be entitled to a payment under this title during such 10-year period, receive a payment during such period; and 

‘‘(ii) the total amount of all such payments made 

during such 10-year period do not exceed the amount 

available under the second sentence of paragraph (1) 

to pay claims during such period. 

‘‘(B) PAYMENT OF REMAINDER OF CLAIM AMOUNTS.—In 

any case in which the amount of a claim is ratably reduced 

pursuant to subparagraph (A), on or after the first day 

after the 10-year period described in paragraph (1), the 

Special Master shall pay to the claimant the amount that 

is equal to the difference between— 

‘‘(i) the amount that the claimant would have been 

paid under this title during such period without regard to the limitation under the second sentence of 

paragraph (1) applicable to such period; and 

‘‘(ii) the amount the claimant was paid under this 

title during such period. 

‘‘(e) ATTORNEY FEES.— ‘‘(1) IN GENERAL.—Notwithstanding any contract, and except 

as provided in paragraphs (2) and (3), the representative of an 

individual may not charge, for services rendered in connection 

with the claim of an individual under this title, more than 10 

percent of an award made under this title on such claim. 

‘‘(2) LIMITATION.— 

‘‘(A) IN GENERAL.—Except as provided in subparagraph 

(B), in the case of an individual who was charged a legal 

fee in connection with the settlement of a civil action described in section 405(c)(3)(C)(iii), the representative of 

the individual may not charge any amount for compensation for services rendered in connection with a claim filed 

under this title. 

‘‘(B) EXCEPTION.—If the legal fee charged in connection 

with the settlement of a civil action described in section 

405(c)(3)(C)(iii) of an individual is less than 10 percent of 

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dividual through such settlement and the claim of the individual under this title, the representative of such individual may charge an amount for compensation for services rendered in connection with such claim under this 

title to the extent that such amount charged is not more 

than— 

‘‘(i) 10 percent of such aggregate amount, minus 

‘‘(ii) the total amount of all legal fees charged for 

services rendered in connection with such settlement. 

‘‘(3) EXCEPTION.—With respect to a claim made on behalf of 

an individual for whom a lawsuit was filed in the Southern 

District of New York prior to January 1, 2009, in the event 

that the representative believes in good faith that the fee limit 

set by paragraph (1) or (2) will not provide adequate compensation for services rendered in connection with such claim because of the substantial amount of legal work provided on behalf of the claimant (including work performed before the enactment of this legislation), application for greater compensation may be made to the Special Master. Upon such application, the Special Master may, in his or her discretion, award 

as reasonable compensation for services rendered an amount 

greater than that allowed for in paragraph (1). Such fee award 

will be final, binding, and non-appealable.’’. 

TITLE III—LIMITATION ON TREATY 

BENEFITS FOR CERTAIN DEDUCTIBLE 

PAYMENTS; TIME FOR PAYMENT OF 

CORPORATE ESTIMATED TAXES 

SEC. 301. LIMITATION ON TREATY BENEFITS FOR CERTAIN DEDUCTIBLE PAYMENTS. 

(a) IN GENERAL.—Section 894 of the Internal Revenue Code of 

1986 (relating to income affected by treaty) is amended by adding 

at the end the following new subsection: 

‘‘(d) LIMITATION ON TREATY BENEFITS FOR CERTAIN DEDUCTIBLE

PAYMENTS.— 

‘‘(1) IN GENERAL.—In the case of any deductible related-party 

payment, any withholding tax imposed under chapter 3 (and 

any tax imposed under subpart A or B of this part) with respect to such payment may not be reduced under any treaty 

of the United States unless any such withholding tax would be 

reduced under a treaty of the United States if such payment 

were made directly to the foreign parent corporation. 

‘‘(2) DEDUCTIBLE RELATED-PARTY PAYMENT.—For purposes of 

this subsection, the term ‘deductible related-party payment’ 

means any payment made, directly or indirectly, by any person 

to any other person if the payment is allowable as a deduction 

under this chapter and both persons are members of the same 

foreign controlled group of entities. 

‘‘(3) FOREIGN CONTROLLED GROUP OF ENTITIES.—For purposes 

of this subsection— 


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‘‘(A) IN GENERAL.—The term ‘foreign controlled group of 

entities’ means a controlled group of entities the common 

parent of which is a foreign corporation. 

‘‘(B) CONTROLLED GROUP OF ENTITIES.—The term ‘controlled group of entities’ means a controlled group of corporations as defined in section 1563(a)(1), except that— 

‘‘(i) ‘more than 50 percent’ shall be substituted for 

‘at least 80 percent’ each place it appears therein, and 

‘‘(ii) the determination shall be made without regard 

to subsections (a)(4) and (b)(2) of section 1563. 

A partnership or any other entity (other than a corporation) shall be treated as a member of a controlled group of 

entities if such entity is controlled (within the meaning of 

section 954(d)(3)) by members of such group (including any 

entity treated as a member of such group by reason of this 

sentence). 

‘‘(4) FOREIGN PARENT CORPORATION.—For purposes of this 

subsection, the term ‘foreign parent corporation’ means, with 

respect to any deductible related-party payment, the common 

parent of the foreign controlled group of entities referred to in 

paragraph (3)(A). 

‘‘(5) REGULATIONS.—The Secretary may prescribe such regulations or other guidance as are necessary or appropriate to 

carry out the purposes of this subsection, including regulations 

or other guidance which provide for— 

‘‘(A) the treatment of two or more persons as members 

of a foreign controlled group of entities if such persons 

would be the common parent of such group if treated as 

one corporation, and 

‘‘(B) the treatment of any member of a foreign controlled 

group of entities as the common parent of such group if 

such treatment is appropriate taking into account the economic relationships among such entities.’’. 

(b) EFFECTIVE DATE.—The amendment made by this section shall 

apply to payments made after the date of the enactment of this 

Act. 

SEC. 302. TIME FOR PAYMENT OF CORPORATE ESTIMATED TAXES. 

The percentage under paragraph (2) of section 561 of the Hiring 

Incentives to Restore Employment Act in effect on the date of the 

enactment of this Act is increased by 3 percentage points. 

TITLE IV—BUDGETARY EFFECTS 

SEC. 401. COMPLIANCE WITH STATUTORY PAY-AS-YOU-GO ACT OF 2010. 

The budgetary effects of this Act, for the purpose of complying 

with the Statutory Pay-As-You-Go-Act of 2010, shall be determined 

by reference to the latest statement titled ‘‘Budgetary Effects of 

PAYGO Legislation’’ for this Act, submitted for printing in the Congressional Record by the Chairman of the House Budget Committee, provided that such statement has been submitted prior to 

the vote on passage. 

Æ 


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