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[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 847 Reported in House (RH)]

                                                 Union Calendar No. 321
111th CONGRESS
  2d Session
                                H. R. 847

                  [Report No. 111-560, Parts I and II]

     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.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            February 4, 2009

  Mrs. Maloney (for herself, Mr. Nadler of New York, Mr. King of New 
York, Mr. McMahon, Mr. Rangel, Mr. Ackerman, Mr. Arcuri, Mr. Bishop of 
 New York, Mr. Burgess, Mr. Crowley, Mr. Engel, Mr. Hall of New York, 
 Mr. Higgins, Mr. Himes, Mr. Hinchey, Mr. Israel, Mr. Lee of New York, 
   Mrs. Lowey, Mr. Maffei, Mr. Massa, Mrs. McCarthy of New York, Mr. 
McGovern, Mr. McHugh, Mr. Meeks of New York, Mr. Pascrell, Mr. Serrano, 
  Ms. Sutton, Mr. Tonko, Mr. Towns, Mr. Weiner, Ms. Woolsey, and Ms. 
   Clarke) introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   the Judiciary, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

                             July 22, 2010

  Reported from the Committee on Energy and Commerce with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

                             July 22, 2010

    Additional sponsors: Ms. Berkley, Mr. Gene Green of Texas, Ms. 
  Schakowsky, Mr. Smith of New Jersey, Mr. Connolly of Virginia, Mr. 
  Lance, Mr. Klein of Florida, Mr. Kucinich, Ms. DeLauro, Ms. Lee of 
California, Mr. Lewis of Georgia, Mr. Grijalva, Mr. Bishop of Georgia, 
Mr. Doyle, Mr. Dent, Mr. Murphy of Connecticut, Mr. Holt, Mr. Larson of 
 Connecticut, Mr. Sestak, Mr. Pierluisi, Ms. Slaughter, Ms. Velazquez, 
     Mrs. Dahlkemper, Mr. Etheridge, Mr. Conyers, Mr. Wexler, Mrs. 
  Christensen, Mr. Cohen, Mr. Andrews, Mr. Brady of Pennsylvania, Mr. 
    Schauer, Mr. Garrett of New Jersey, Mr. McCaul, Mr. Hodes, Ms. 
    Schwartz, Mr. Murphy of New York, Mr. Fattah, Mr. Gonzalez, Mr. 
Courtney, Mr. Jones, Mr. Stupak, Mrs. Capps, Ms. Castor of Florida, Mr. 
Sarbanes, Mr. Tim Murphy of Pennsylvania, Mr. Sires, Mr. Lipinski, Mr. 
  Thompson of Mississippi, Mr. Rush, Ms. Baldwin, Mr. Ellsworth, Mr. 
   Carney, Ms. Jackson Lee of Texas, Mr. Neal of Massachusetts, Mr. 
 Patrick J. Murphy of Pennsylvania, Mr. Upton, Mr. Filner, Ms. Harman, 
 Ms. Norton, Mr. Holden, Mr. Cummings, Ms. Shea-Porter, Mr. Rothman of 
    New Jersey, Mrs. Napolitano, Mr. Lynch, Mr. Cao, Mr. Markey of 
Massachusetts, Mr. Nye, Mr. Walz, Ms. McCollum, Mr. Braley of Iowa, Mr. 
 Reichert, Mr. Owens, Mr. Welch, Mr. Davis of Illinois, Ms. Eshoo, Mr. 
Butterfield, Mr. Garamendi, Mr. Baca, Mr. Miller of North Carolina, Mr. 
  Oberstar, Mr. LoBiondo, Ms. Eddie Bernice Johnson of Texas, and Mr. 
                                 Payne

                             July 22, 2010

    Reported from the Committee on the Judiciary with an amendment, 
   committed to the Committee of the Whole House on the State of the 
                    Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                           in boldface roman]
    [For text of introduced bill, see copy of bill as introduced on 
                           February 4, 2009]

_______________________________________________________________________

                                 A BILL

 
     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.

 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

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.
        ``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 WTC-related 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 
                            in New York City.
        ``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.

               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 
        workers 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 screening-eligible 
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 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--
                            ``(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.
            ``(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 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
                    ``(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 WTC-related health conditions that may be available 
                under workers' compensation or other benefit programs 
                for work-related 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
                    ``(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.
    ``(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).
                            ``(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).
            ``(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
                    ``(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 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;
                            ``(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 WTC-related health condition as a 
                        result of exposure to airborne toxins, other 
                        hazards, or adverse conditions resulting 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 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 WTC-RELATED 
              HEALTH CONDITIONS.

    ``(a) WTC-Related Health Condition Defined.--
            ``(1) In general.--For purposes of this title, the term 
        `WTC-related 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--
                            ``(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.
                    ``(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 
                responders.--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 
                WTC-related 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 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.
                    ``(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.
                            ``(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 
                appeal.--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.--
                    ``(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 
                network.--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.--
            ``(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 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).

                        ``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
                                    ``(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 
                                opportunity to appeal such 
                                determination in a manner established 
                                under such process.
                            ``(ii) Written documentation of screening-
                        eligibility.--
                                    ``(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 
        survivors.--
                    ``(A) In general.--The total number of individuals 
                not described in paragraph (1)(A)(i) who may be 
                certified as 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 CERTIFIED-ELIGIBLE 
              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 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 Survivors.--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 certified-eligible 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.--
            ``(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 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 coverage.--
        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 2020 the full contribution amount 
                under this subparagraph shall be equal to 10 percent of 
                the 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.
        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 
        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 Protections.--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) $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, 
                        $672,000,000 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).
                    ``(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.
    ``(b) Mandatory Funds for Monitoring, Initial Health Evaluations, 
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 
        appropriations.--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 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.''.

       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,'' 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.''.

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 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 Removal.--
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) Authority to reinstitute certain lawsuits.--Such 
        section, as so redesignated, is further amended by adding at 
        the end the following new clause:
                            ``(iii) 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 2008, 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.--
                    ``(A) In general.--Notwithstanding any other 
                provision of law, subject to subparagraph (B), 
                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 New York City, 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 thereof, shall not be in an amount that 
                exceeds the sum of the following:
                            ``(i) The amount of funds of the WTC 
                        Captive Insurance Company, including the 
                        cumulative interest.
                            ``(ii) The amount of all available 
                        insurance identified in schedule 2 of the WTC 
                        Captive Insurance Company insurance policy.
                            ``(iii) The amount that is the greater of 
                        New York City's insurance coverage or 
                        $350,000,000. In determining the amount of the 
                        City's insurance coverage for purposes of the 
                        previous sentence, any amount described in 
                        clauses (i) and (ii) shall not be included.
                            ``(iv) The amount of all available 
                        liability insurance coverage maintained by 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.
                            ``(v) The amount of all available liability 
                        insurance coverage maintained by contractors 
                        and subcontractors.
                    ``(B) Exception.--Subparagraph (A) shall not apply 
                to claims or actions based upon conduct held to be 
                intentionally tortious in nature or to acts of gross 
                negligence or other such acts to the extent to which 
                punitive damages are awarded as a result of such 
                conduct or acts.
            ``(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:
                    ``(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.''.

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.
Sec. 2. Findings.
               TITLE I--WORLD TRADE CENTER HEALTH PROGRAM

Sec. 101. World Trade Center Health Program.
             ``TITLE XXX--WORLD TRADE CENTER HEALTH PROGRAM

     ``Subtitle A--Establishment of Program; Advisory and Steering 
                               Committees

        ``Sec. 3001. Establishment of World Trade Center Health Program 
                            within NIOSH.
        ``Sec. 3002. WTC Health Program Scientific/Technical Advisory 
                            Committee.
        ``Sec. 3003. WTC Health Program Steering Committees.
        ``Sec. 3004. Community education and outreach.
        ``Sec. 3005. Uniform data collection.
        ``Sec. 3006. Centers of excellence.
        ``Sec. 3007. Entitlement authorities.
        ``Sec. 3008. Definitions.
 ``Subtitle B--Program of Monitoring, Initial Health Evaluations, and 
                               Treatment

                      ``Part 1--For WTC Responders

        ``Sec. 3011. Identification of eligible WTC responders and 
                            provision of WTC-related monitoring 
                            services.
        ``Sec. 3012. Treatment of certified eligible WTC responders for 
                            WTC-related health conditions.
                      ``Part 2--Community Program

        ``Sec. 3021. Identification and initial health evaluation of 
                            eligible WTC community members.
        ``Sec. 3022. Followup monitoring and treatment of certified 
                            eligible WTC community members for WTC-
                            related health conditions.
        ``Sec. 3023. Followup monitoring and treatment of other 
                            individuals with WTC-related health 
                            conditions.
 ``Part 3--National Arrangement for Benefits for Eligible Individuals 
                            Outside New York

        ``Sec. 3031. National arrangement for benefits for eligible 
                            individuals outside New York.
                 ``Subtitle C--Research Into Conditions

        ``Sec. 3041. Research regarding certain health conditions 
                            related to September 11 terrorist attacks 
                            in New York City.
 ``Subtitle D--Programs of the New York City Department of Health and 
                             Mental Hygiene

        ``Sec. 3051. World Trade Center Health Registry.
        ``Sec. 3052. Mental health services.
       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.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Thousands of rescue workers who responded to the areas 
        devastated by the terrorist attacks of September 11, local 
        residents, office and area workers, and school children 
        continue to suffer significant medical problems as a result of 
        compromised air quality and the release of other toxins from 
        the attack sites.
            (2) In a September 2006 peer-reviewed study conducted by 
        the World Trade Center Medical Monitoring Program, of 9,500 
        World Trade Center responders, almost 70 percent of World Trade 
        Center responders had a new or worsened respiratory symptom 
        that developed during or after their time working at the World 
        Trade Center; among the responders who were asymptomatic before 
        9/11, 61 percent developed respiratory symptoms while working 
        at the World Trade Center; close to 60 percent still had a new 
        or worsened respiratory symptom at the time of their 
        examination; one-third had abnormal pulmonary function tests; 
        and severe respiratory conditions including pneumonia were 
        significantly more common in the 6 months after 9/11 than in 
        the prior 6 months.
            (3) An April 2006 study documented that, on average, a New 
        York City firefighter who responded to the World Trade Center 
        has experienced a loss of 12 years of lung capacity.
            (4) A peer-reviewed study of residents who lived near the 
        World Trade Center titled ``The World Trade Center Residents' 
        Respiratory Health Study: New Onset Respiratory Symptoms and 
        Pulmonary Function'', found that data demonstrated a three-fold 
        increase in new-onset, persistent lower respiratory symptoms in 
        residents near the former World Trade Center as compared to a 
        control population.
            (5) Previous research on the health impacts of the 
        devastation caused by the September 11 terrorist attacks has 
        shown relationships between the air quality from Ground Zero 
        and a host of health impacts, including lower pregnancy rates, 
        higher rates of respiratory and lung disorders, and a variety 
        of post-disaster mental health conditions (including 
        posttraumatic stress disorder) in workers and residents near 
        Ground Zero.
            (6) A variety of tests conducted by independent scientists 
        have concluded that significant WTC contamination settled in 
        indoor environments surrounding the disaster site. The 
        Environmental Protection Agency's (EPA) cleanup programs for 
        indoor residential spaces, in 2003 and 2005, though limited, 
        are an acknowledgment that indoor contamination continued after 
        the WTC attacks.
            (7) At the request of the Department of Energy, the Davis 
        DELTA Group at the University of California conducted outdoor 
        dust sampling in October 2001 at Varick and Houston Streets 
        (approximately 1.2 miles north of Ground Zero) and found that 
        the contamination from the World Trade Center ``outdid even the 
        worst pollution from the Kuwait oil fields fires''. Further, 
        the United States Geological Survey (USGS) reported on November 
        27, 2001, that dust samples collected from indoor surfaces 
        registered at levels that were ``as caustic as liquid drain 
        cleaners''.
            (8) According to both the EPA's own Inspector General's 
        (EPA IG) report of August 21, 2003 and General Accountability 
        Offices's (GAO) report of September 2007, no comprehensive 
        program has ever been conducted in order to characterize the 
        full extent of WTC contamination, and therefore the full impact 
        of that contamination--geographic or otherwise--remains 
        unknown.
            (9) Such reports found that there has never been a 
        comprehensive program to remediate WTC toxins from indoor 
        spaces. Thus, area residents, workers and students may continue 
        to be exposed to WTC contamination in their homes, workplaces 
        and schools.
            (10) Because of the failure to release federally 
        appropriated funds for community care, a lack of sufficient 
        outreach, the fact that many community members are receiving 
        care from physicians outside the current City-funded World 
        Trade Center Environmental Health Center program and thus fall 
        outside data collection efforts, and other factors, the number 
        of community members being treated at the World Trade Center 
        Environmental Health Center underrepresents the total number in 
        the community that have been affected by exposure to Ground 
        Zero toxins.
            (11) Research by Columbia University's Center for 
        Children's Environmental Health has shown negative health 
        effects on babies born to women living within 2 miles of the 
        World Trade Center in the month following 9/11.
            (12) Federal funding allocated for the monitoring of rescue 
        workers' health is not sufficient to ensure the long-term study 
        of health impacts of September 11.
            (13) A significant portion of those who have developed 
        health problems as result of exposures to airborne toxins or 
        other hazards resulting from the September 11, 2001, attacks on 
        the World Trade Center have no health insurance, have lost 
        their health insurance as a result of the attacks, or have 
        inadequate health insurance.
            (14) The Federal program to provide medical treatments to 
        those who responded to the September 11 aftermath, and who 
        continue to experience health problems as a result, was finally 
        established more than five years after the attacks, but has no 
        certain long-term funding.
            (15) Rescue workers and volunteers seeking workers' 
        compensation have reported that their applications have been 
        denied, delayed for months, or redirected, instead of receiving 
        assistance in a timely and supportive manner.
            (16) A February 2007 report released by the City of New 
        York estimated that approximately 410,000 people were the most 
        heavily exposed to the environmental hazards and trauma of the 
        September 11 terrorist attacks. More than 30 percent of the 
        Fire Department of the City of New York first responders were 
        still experiencing some respiratory symptoms more than five 
        years after the attacks and according to the report, 59 percent 
        of those seen by the WTC Environmental Health Center at 
        Bellevue Hospital (which serves community members) are without 
        insurance and 65 percent have incomes less than $15,000 per 
        year. The report also found a need to continue and expand 
        mental health services.
            (17) Since the 5th anniversary of the attack (September 11, 
        2006), hundreds of workers a month have been signing up with 
        the monitoring and treatment programs.
            (18) In April 2008, the Department of Health and Human 
        Services reported to Congress that in fiscal year 2007 11,359 
        patients received medical treatment in the existing WTC 
        Responder Medical and Treatment program for WTC-related health 
        problems, and that number of responders who need treatment and 
        the severity of health problems is expected to increase.
            (19) The September 11 Victim Compensation Fund of 2001 was 
        established to provide compensation to individuals who were 
        physically injured or killed as a result of the terrorist-
        related aircraft crashes of September 11, 2001.
            (20) The deadline for filing claims for compensation under 
        the Victim Compensation Fund was December 22, 2003.
            (21) Some individuals did not know they were eligible to 
        file claims for compensation for injuries or did not know they 
        had suffered physical harm as a result of the terrorist-related 
        aircraft crashes until after the December 22, 2003, deadline.
            (22) Further research is needed to evaluate more 
        comprehensively the extent of the health impacts of September 
        11, including research for emerging health problems such as 
        cancer, which have been predicted.
            (23) Research is needed regarding possible treatment for 
        the illnesses and injuries of September 11.
            (24) The Federal response to medical and financial issues 
        arising from the September 11 response efforts needs a 
        comprehensive, coordinated long-term response in order to meet 
        the needs of all the individuals who were exposed to the toxins 
        of Ground Zero and are suffering health problems from the 
        disaster.
            (25) The failure to extend the appointment of Dr. John 
        Howard as Director of the National Institute for Occupational 
        Safety and Health in July 2008 is not in the interests of the 
        administration of such Institute nor the continued operation of 
        the World Trade Center Medical Monitoring and Treatment Program 
        which he has headed, and the Secretary of Health and Human 
        Services should reconsider extending such appointment.

               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 XXX--WORLD TRADE CENTER HEALTH PROGRAM

     ``Subtitle A--Establishment of Program; Advisory and Steering 
                               Committees

``SEC. 3001. ESTABLISHMENT OF WORLD TRADE CENTER HEALTH PROGRAM WITHIN 
              NIOSH.

    ``(a) In General.--There is hereby established within the National 
Institute for Occupational Safety and Health a program to be known as 
the `World Trade Center Health Program' (in this title referred to as 
the `WTC program') to provide--
            ``(1) medical monitoring and treatment benefits to eligible 
        emergency responders and recovery and clean-up workers 
        (including those who are Federal employees) who responded to 
        the September 11, 2001, terrorist attacks on the World Trade 
        Center; 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.
    ``(b) Components of Program.--The WTC program includes the 
following components:
            ``(1) Medical monitoring for responders.--Medical 
        monitoring under section 3011, including clinical examinations 
        and long-term health monitoring and analysis for individuals 
        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 on the World Trade 
        Center.
            ``(2) Initial health evaluation for community members.--An 
        initial health evaluation under section 3021, including an 
        evaluation to determine eligibility for followup monitoring and 
        treatment.
            ``(3) Follow-up monitoring and treatment for wtc-related 
        conditions for responders and community members.--Provision 
        under sections 3012, 3022, and 3023 of follow-up monitoring and 
        treatment and payment, subject to the provisions of subsection 
        (d), for all medically necessary health and mental health care 
        expenses (including necessary prescription drugs) of 
        individuals with a WTC-related health condition.
            ``(4) Outreach.--Establishment under section 3004 of an 
        outreach program to potentially eligible individuals concerning 
        the benefits under this title.
            ``(5) Uniform data collection.--Collection under section 
        3005 of health and mental health data on individuals receiving 
        monitoring or treatment benefits, using a uniform system of 
        data collection.
            ``(6) Research on wtc conditions.--Establishment under 
        subtitle C of a research program on health conditions resulting 
        from the September 11, 2001, terrorist attacks on the World 
        Trade Center.
    ``(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 
eligible WTC responder or any eligible WTC community member.
    ``(d) Payor.--
            ``(1) In general.--Except as provided in paragraphs (2) and 
        (3), the cost of monitoring and treatment benefits and initial 
        health evaluation benefits provided under subtitle B shall be 
        paid for by the WTC program.
            ``(2) Workers' compensation payment.--
                    ``(A) In general.--Except as provided in 
                subparagraph (B), payment for treatment under subtitle 
                B of a WTC-related condition in an individual that is 
                work-related shall be reduced or recouped to the extent 
                that the Secretary 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 
                or a State, 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 (42 U.S.C. 1395y(b)(2)) and 
                paragraph (3) of such section shall apply to the 
                recoupment under this paragraph 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.
                    ``(B) Exception.--If the WTC Program Administrator 
                certifies that the City of New York has contributed the 
                matching contribution required under section 3006(a)(3) 
                for a 12-month period (specified by the WTC Program 
                Administrator), subparagraph (A) shall not apply for 
                that 12-month period with respect to a workers' 
                compensation law or plan, including line of duty 
                compensation, to which the City is obligated to make 
                payments.
            ``(3) Health insurance coverage.--
                    ``(A) In general.--In the case of an individual who 
                has a WTC-related condition that is not work-related 
                and has health coverage for such condition through any 
                public or private health plan, the provisions of 
                section 1862(b) of the Social Security Act (42 U.S.C. 
                1395y(b)) shall apply to such a health plan and such 
                individual in the same manner as they apply to a group 
                health plan and an individual entitled to benefits 
                under title XVIII of such Act pursuant to section 
                226(a). 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.
                    ``(B) Recovery by individual providers.--Nothing in 
                subparagraph (A) 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.
            ``(4) Work-related described.--For the purposes of this 
        subsection, a WTC-related condition shall be treated as a 
        condition that is work-related if--
                    ``(A) the condition is diagnosed in an eligible WTC 
                responder, or in an individual who qualifies as an 
                eligible WTC community member on the basis of being a 
                rescue, recovery, or clean-up worker; or
                    ``(B) 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.
    ``(e) Quality Assurance and Monitoring of Clinical Expenditures.--
            ``(1) Quality assurance.--The WTC Program Administrator 
        working with the Clinical Centers of Excellence shall develop 
        and implement a quality assurance program for the medical 
        monitoring and treatment delivered by such Centers of 
        Excellence and any other participating health care providers. 
        Such program shall include--
                    ``(A) adherence to medical monitoring and treatment 
                protocols;
                    ``(B) appropriate diagnostic and treatment 
                referrals for participants;
                    ``(C) prompt communication of test results to 
                participants; and
                    ``(D) such other elements as the Administrator 
                specifies in consultation with the Clinical Centers of 
                Excellence.
            ``(2) Fraud prevention.--The WTC Program Administrator 
        shall develop and implement a program to review the program's 
        health care expenditures to detect fraudulent or duplicate 
        billing and payment for inappropriate services. Such program 
        shall be similar to current methods used in connection with the 
        Medicare program under title XVIII of the Social Security Act. 
        This title is a Federal health care program (as defined in 
        section 1128B(f) of such 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.
    ``(f) WTC Program Administration.--The WTC program shall be 
administered by the Director of the National Institute for Occupational 
Safety and Health, or a designee of such Director.
    ``(g) 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 of report.--Each annual report under 
        paragraph (1) shall include 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 medical 
                        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.
                    ``(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 conditions that have 
                        been paid for or reimbursed by workers' 
                        compensation, by public or private health 
                        plans, or by the City of New York under section 
                        3012(c)(4).
                    ``(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--
                            ``(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 WTC center 
                exposures, including the findings of research conducted 
                under section 3041(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) FDNY responders.--The benefits provided for 
                eligible WTC responders described in section 
                3006(b)(1)(A).
                    ``(B) Other eligible wtc responders.--The benefits 
                provided for eligible WTC responders not described in 
                subparagraph (A).
                    ``(C) Eligible wtc community members.--The benefits 
                provided for eligible WTC community members in section 
                3006(b)(1)(C).
    ``(h) Notification to Congress When Reach 80 Percent of Eligibility 
Numerical Limits.--The WTC Program Administrator shall promptly notify 
the Congress--
            ``(1) when the number of certifications for eligible WTC 
        responders subject to the limit established under section 
        3011(a)(5) has reached 80 percent of such limit; and
            ``(2) when the number of certifications for eligible WTC 
        community members subject to the limit established under 
        section 3021(a)(5) has reached 80 percent of such limit.
    ``(i) GAO Report.--Not later than 3 years after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit to the Congress a report on the costs of the monitoring 
and treatment programs provided under this title.
    ``(j) NYC Recommendations.--The City of New York may make 
recommendations to the WTC Program Administrator on ways to improve the 
monitoring and treatment programs under this title for both eligible 
WTC responders and eligible WTC community members.

``SEC. 3002. WTC HEALTH PROGRAM SCIENTIFIC/TECHNICAL ADVISORY 
              COMMITTEE.

    ``(a) Establishment.--The WTC Program Administrator shall establish 
an advisory committee to be known as the WTC Health Program Scientific/
Technical Advisory Committee (in this section 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.
    ``(b) Composition.--The WTC Program Administrator shall appoint the 
members of the Advisory Committee and shall include at least--
            ``(1) 4 occupational physicians, at least two of whom have 
        experience treating WTC rescue and recovery workers;
            ``(2) 1 physician with expertise in pulmonary medicine;
            ``(3) 2 environmental medicine or environmental health 
        specialists;
            ``(4) 2 representatives of eligible WTC responders;
            ``(5) 2 representatives of WTC community members;
            ``(6) an industrial hygienist;
            ``(7) a toxicologist;
            ``(8) an epidemiologist; and
            ``(9) a mental health professional.
    ``(c) Meetings.--The Advisory Committee shall meet at such 
frequency as may be required to carry out its duties.
    ``(d) Reports.--The WTC Program Administrator shall provide for 
publication of recommendations of the Advisory Committee on the public 
website established for the WTC program.
    ``(e) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary, not to exceed $100,000, for each fiscal year 
beginning with fiscal year 2009.
    ``(f) 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.
    ``(g) Application of FACA.--Except as otherwise specifically 
provided, the Advisory Committee shall be subject to the Federal 
Advisory Committee Act.

``SEC. 3003. WTC HEALTH PROGRAM STEERING COMMITTEES.

    ``(a) Establishment.--The WTC Program Administrator shall establish 
two steering committees (each in this section referred to as a 
`Steering Committee') as follows:
            ``(1) WTC responders steering committee.--One steering 
        committee, to be known as the WTC Responders Steering 
        Committee, for the purpose of facilitating the coordination of 
        medical monitoring and treatment programs for the eligible WTC 
        responders under part 1 of subtitle B.
            ``(2) WTC community program steering committee.--One 
        steering committee, to be known as the WTC Community Program 
        Steering Committee, for the purpose of facilitating the 
        coordination of initial health evaluations, monitoring, and 
        treatment programs for eligible WTC community members under 
        part 2 of subtitle B.
    ``(b) Membership.--
            ``(1) Initial membership of wtc responders steering 
        committee.--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). In 
        addition, the committee membership shall include--
                    ``(A) a representative of the Police Commissioner 
                of the City of New York;
                    ``(B) a representative of the Department of Health 
                of the City of New York;
                    ``(C) a representative of another agency of the 
                City of New York, selected by the Mayor of New York 
                City, which had a large number of non-uniformed City 
                workers who responded to the WTC disaster; and
                    ``(D) three representatives of eligible WTC 
                responders;
        in order that eligible WTC responders constitute half the 
        members of the Steering Committee.
            ``(2) Initial membership of wtc community program steering 
        committee.--
                    ``(A) In general.--The WTC Community Program 
                Steering Committee shall initially be composed of 
                members of the WTC Environmental Health Center 
                Community Advisory Committee (as in existence on the 
                day before the date of the enactment of this title) and 
                shall initially have, as voting members, the following:
                            ``(i) 11 representatives of the affected 
                        populations of residents, students, area 
                        workers, and other community members.
                            ``(ii) The Medical Director of the WTC 
                        Environmental Health Center.
                            ``(iii) The Executive Director of the WTC 
                        Environmental Health Center.
                            ``(iv) Three physicians, one each 
                        representing the three WTC Environmental Health 
                        Center treatment sites of Bellevue Hospital 
                        Center, Gouverneur Healthcare Services, and 
                        Elmhurst Hospital Center.
                            ``(v) Five specialists with WTC related 
                        expertise or experience in treating non-
                        responder WTC diseases, such as a pediatrician, 
                        an epidemiologist, a psychiatrist or 
                        psychologist, an environmental/occupational 
                        specialists or a social worker from a WTC 
                        Environmental Health Center treatment site, or 
                        other relevant specialists.
                            ``(vi) A representative of the Department 
                        of Health and Mental Hygiene of the City of New 
                        York.
                    ``(B) Appointments.--
                            ``(i) WTC ehc community advisory 
                        committee.--The WTC Environmental Health Center 
                        Community Advisory Committee as in existence on 
                        the date of the enactment of this title shall 
                        nominate members for positions described in 
                        subparagraph (A)(i).
                            ``(ii) NYC health and hospitals 
                        corporation.--The New York City Health and 
                        Hospitals Corporation shall nominate members 
                        for positions described in clauses (iv) and (v) 
                        of subparagraph (A).
                            ``(iii) Timing.--Nominations under clauses 
                        (i) and (ii) shall be recommended to the WTC 
                        Program Administrator not later than 60 days 
                        after the date of the enactment of this title.
                            ``(iv) Appointment.--The WTC Program 
                        Administrator shall appoint members of the WTC 
                        Community Program Steering Committee not later 
                        than 90 days after the date of the enactment of 
                        this title.
                            ``(v) General representatives.--Of the 
                        members appointed under subparagraph (A)(i)--
                                    ``(I) the representation shall 
                                reflect the broad and diverse WTC-
                                affected populations and constituencies 
                                and the diversity of impacted 
                                neighborhoods, including residents, 
                                hard-to-reach populations, students, 
                                area workers, school parents, 
                                community-based organizations, 
                                Community Boards, WTC Environmental 
                                Health Center patients, labor unions, 
                                and labor advocacy organizations; and
                                    ``(II) no one individual 
                                organization can have more than one 
                                representative.
            ``(3) Additional appointments.--Each Steering Committee may 
        appoint, if approved by a majority of voting members of the 
        Committee, additional members to the Committee.
            ``(4) Vacancies.--A vacancy in a Steering Committee shall 
        be filled by the Steering Committee, subject to the approval of 
        the WTC Program Administrator, so long as--
                    ``(A) in the case of the WTC Responders Steering 
                Committee, the composition of the Committee includes 
                representatives of eligible WTC responders and 
                representatives of each Clinical Center of Excellence 
                and each Coordinating Center of Excellence that serves 
                eligible WTC responders and such composition has 
                eligible WTC responders constituting half of the 
                membership of the Steering Committee; or
                    ``(B) in the case of the WTC Community Program 
                Steering Committee, the composition of the Committee 
                includes representatives of eligible WTC community 
                members and representatives of each Clinical Center of 
                Excellence and each Coordinating Center of Excellence 
                that serves eligible WTC community members and the 
                nominating process is consistent with paragraph (2)(B).
            ``(5) Co-chairs of wtc community program steering 
        committee.--The WTC Community Program Steering Committee shall 
        have two Co-Chairs as follows:
                    ``(A) Community/Labor co-chair.--A Community/Labor 
                Co-Chair who shall be chosen by the community and 
                labor-based members of the Steering Committee.
                    ``(B) Environmental health clinic co-chair.--A WTC 
                Environmental Health Clinic Co-Chair who shall be 
                chosen by the WTC Environmental Health Center members 
                on the Steering Committee.
    ``(c) Relation to FACA.--Each Steering Committee shall not be 
subject to the Federal Advisory Committee Act.
    ``(d) Meetings.--Each Steering Committee shall meet at such 
frequency necessary to carry out its duties, but not less than 4 times 
each calendar year and at least two such meetings each year shall be a 
joint meeting with the voting membership of the other Steering 
Committee for the purpose of exchanging information regarding the WTC 
program.
    ``(e) Duration.--Notwithstanding any other provision of law, each 
Steering Committee shall continue in operation during the period in 
which the WTC program is in operation.

``SEC. 3004. COMMUNITY EDUCATION AND OUTREACH.

    ``(a) In General.--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 website 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
                    ``(B) to include materials for culturally and 
                linguistically diverse populations.
    ``(b) Partnerships.--To the greatest extent possible, in carrying 
out this section, the WTC Program Administrator shall enter into 
partnerships with local governments and organizations with experience 
performing outreach to the affected populations, including community 
and labor-based organizations.

``SEC. 3005. UNIFORM DATA COLLECTION.

    ``(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 utilization of monitoring and 
treatment benefits provided to eligible WTC responders and eligible WTC 
community members, the prevalence of WTC-related health conditions, and 
the identification of new WTC-related medical 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.
    ``(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 Coordinating Center of Excellence 
for analysis by such Coordinating Center of Excellence.
    ``(c) Privacy.--The data collection and analysis under this section 
shall be conducted in a manner that protects the confidentiality of 
individually identifiable health information consistent with applicable 
legal requirements.

``SEC. 3006. CENTERS OF EXCELLENCE.

    ``(a) In General.--
            ``(1) Contracts with clinical centers of excellence.--The 
        WTC Program Administrator shall enter into contracts with 
        Clinical Centers of Excellence specified in subsection (b)(1)--
                    ``(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 follow-up 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 WTC-related health conditions that may be available 
                under Workers' Compensation or other benefit programs 
                for work-related 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 as for program participants who 
                are not English language proficient; and
                    ``(F) for the collection and reporting of data in 
                accordance with section 3005.
            ``(2) Contracts with coordinating centers of excellence.--
        The WTC Program Administrator shall enter into contracts with 
        Coordinating Centers of Excellence specified in subsection 
        (b)(2)--
                    ``(A) for receiving, analyzing, and reporting to 
                the WTC Program Administrator on data, in accordance 
                with section 3005, that has been collected and reported 
                to such Coordinating Centers by the corresponding 
                Clinical Centers of Excellence under subsection (d)(3);
                    ``(B) for the development of medical monitoring, 
                initial health evaluation, and treatment protocols, 
                with respect to WTC-related health conditions;
                    ``(C) for coordinating the outreach activities 
                conducted under paragraph (1)(B) by each corresponding 
                Clinical Center of Excellence;
                    ``(D) for establishing criteria for the 
                credentialing of medical providers participating in the 
                nationwide network under section 3031;
                    ``(E) for coordinating and administrating the 
                activities of the WTC Health Program Steering 
                Committees established under section 3003(a); and
                    ``(F) for meeting periodically with the 
                corresponding Clinical Centers of Excellence to obtain 
                input on the analysis and reporting of data collected 
                under subparagraph (A) and on the development of 
                medical monitoring, initial health evaluation, and 
                treatment protocols under subparagraph (B).
        The medical providers under subparagraph (D) shall be selected 
        by the WTC Program Administrator on the basis of their 
        experience treating or diagnosing the medical conditions 
        included in the list of identified WTC-related conditions for 
        responders and of identified WTC-related conditions for 
        community members.
            ``(3) Required participation by new york city in monitoring 
        and treatment program and costs.--
                    ``(A) In general.--In order for New York City, any 
                agency or Department thereof, or the New York City 
                Health and Hospitals Corporation to qualify for a 
                contract for the provision of monitoring and treatment 
                benefits and other services under section 3006, New 
                York City is required to contribute a matching amount 
                of 10 percent of the amount of the covered monitoring 
                and treatment payment (as defined in subparagraph (B)).
                    ``(B) Covered monitoring and treatment payment 
                defined.--For the purposes of this paragraph, the term 
                `covered monitoring and treatment payment' means 
                payment under paragraphs (1) and (2), including under 
                such paragraph as applied under section 3021(b), 
                3022(a), and 3023, and reimbursement under 3006(c) for 
                items and services furnished by a Clinical Center of 
                Excellence or Coordinating Center of Excellence, and 
                providers designated by the WTC Program under section 
                3031, after the application of paragraphs (2) and (3) 
                of section 3001 (d).
                    ``(C) Payment of new york city share of monitoring 
                and treatment costs.--The WTC Program Administrator 
                shall--
                            ``(i) bill the amount specified in 
                        subparagraph (A) directly to New York City; and
                            ``(ii) certify periodically, for purposes 
                        of section 3001(d)(2), whether or not New York 
                        City has paid the amount so billed.
                    ``(D) Limitation on required amount.--In no case is 
                New York City required under this paragraph to 
                contribute more than a total of $500,000,000 over any 
                10-year period.
    ``(b) Centers of Excellence Defined.--
            ``(1) Clinical center of excellence.--In this title, the 
        term `Clinical Center of Excellence' means the following:
                    ``(A) For fdny responders.--With respect to an 
                eligible WTC responder who responded to the 9/11 
                attacks as an employee of the Fire Department of the 
                City of New York and who--
                            ``(i) is an active employee of such 
                        Department--
                                    ``(I) with respect to monitoring, 
                                such Fire Department; and
                                    ``(II) with respect to treatment, 
                                such Fire Department (or such entity as 
                                has entered into a contract with the 
                                Fire Department for treatment of such 
                                responders) or any other Clinical 
                                Center of Excellence described in 
                                subparagraph (B), (C), or (D); or
                            ``(ii) is not an active employee of such 
                        Department, such Fire Department (or such 
                        entity as has entered into a contract with the 
                        Fire Department for monitoring or treatment of 
                        such responders) or any other or any other 
                        Clinical Center of Excellence described in 
                        subparagraph (B), (C), or (D).
                    ``(B) Other eligible wtc responders.--With respect 
                to other eligible WTC responders, whether or not they 
                reside in the New York Metropolitan area, the Mt. Sinai 
                coordinated consortium, Queens College, State 
                University of New York at Stony Brook, University of 
                Medicine and Dentistry of New Jersey, and Bellevue 
                Hospital.
                    ``(C) WTC community members.--With respect to 
                eligible WTC community members, whether or not they 
                reside in the New York Metropolitan area, the World 
                Trade Center Environmental Health Center at Bellevue 
                Hospital and such hospitals or other facilities, 
                including but not limited to those within the New York 
                City Health and Hospitals Corporation, as are 
                identified by the WTC Program Administrator.
                    ``(D) All eligible wtc responders and eligible wtc 
                community members.--With respect to all eligible WTC 
                responders and eligible WTC community members, such 
                other hospitals or other facilities as are identified 
                by the WTC Program Administrator.
        The WTC Program Administrator shall limit the number of 
        additional Centers of Excellence identified under subparagraph 
        (D) to ensure that the participating centers have adequate 
        experience in the treatment and diagnosis of identified WTC-
        related medical conditions.
            ``(2) Coordinating center of excellence.--In this title, 
        the term `Coordinating Center of Excellence' means the 
        following:
                    ``(A) For fdny responders.--With respect to an 
                eligible WTC responder who responded to the 9/11 
                attacks as an employee of the Fire Department of the 
                City of New York, such Fire Department.
                    ``(B) Other wtc responders.--With respect to other 
                eligible WTC responders, the Mt. Sinai coordinated 
                consortium.
                    ``(C) Wtc community members.--With respect to 
                eligible WTC community members, the World Trade Center 
                Environmental Health Center at Bellevue Hospital.
            ``(3) Corresponding centers.--In this title, a Clinical 
        Center of Excellence and a Coordinating Center of Excellence 
        shall be treated as `corresponding' to the extent that such 
        Clinical Center and Coordinating Center serve the same 
        population group.
    ``(c) Reimbursement for Non-treatment, Non-monitoring Program 
Costs.--A Clinical or Coordinating Center of Excellence with a contract 
under this section shall be reimbursed for the costs of such Center in 
carrying out the activities described in subsection (a), other than 
those described in subsection (a)(1)(A), subject to the provisions of 
section 3001(d), as follows:
            ``(1) Clinical centers of excellence.--For carrying out 
        subparagraphs (B) through (F) of subsection (a)(1)--
                    ``(A) Clinical center for fdny responders in new 
                york.--The Clinical Center of Excellence for FDNY 
                Responders in New York specified in subsection 
                (b)(1)(A) shall be reimbursed--
                            ``(i) in the first year of the contract 
                        under this section, $600 per certified eligible 
                        WTC responder in the medical treatment program, 
                        and $300 per certified eligible WTC responder 
                        in the monitoring program; and
                            ``(ii) in each subsequent contract year, 
                        subject to paragraph (3), at the rates 
                        specified in this subparagraph for the previous 
                        contract year adjusted by the WTC Program 
                        Administrator to reflect the rate of medical 
                        care inflation during the previous contract 
                        year.
                    ``(B) Clinical centers serving other eligible wtc 
                responders in new york.--A Clinical Center of 
                Excellence for other WTC responders in New York 
                specified in subsection (b)(1)(B) shall be reimbursed 
                the amounts specified in subparagraph (A).
                    ``(C) Clinical centers serving wtc community 
                members.--A Clinical Center of Excellence for eligible 
                WTC community members in New York specified in 
                subsection (b)(1)(C) shall be reimbursed--
                            ``(i) in the first year of the contract 
                        under this section, for each certified eligible 
                        WTC community member in a medical treatment 
                        program enrolled at a non-hospital-based 
                        facility, $600, and for each certified eligible 
                        WTC community member in a medical treatment 
                        program enrolled at a hospital-based facility, 
                        $300; and
                            ``(ii) in each subsequent contract year, 
                        subject to paragraph (3), at the rates 
                        specified in this subparagraph for the previous 
                        contract year adjusted by the WTC Program 
                        Administrator to reflect the rate of medical 
                        care inflation during the previous contract 
                        year.
                    ``(D) Other clinical centers.--A Clinical Center of 
                Excellence or other providers not described in a 
                previous subparagraph shall be reimbursed at a rate set 
                by the WTC Program Administrator.
                    ``(E) Reimbursement rules.--The reimbursement 
                provided under subparagraphs (A), (B) and (C) shall be 
                made for each certified eligible WTC responder and for 
                each WTC community member in the WTC program per year 
                that the member receives such services, regardless of 
                the volume or cost of services required.
            ``(2) Coordinating centers of excellence.--A Coordinating 
        Centers of Excellence specified in section (a)(2) shall be 
        reimbursed for the provision of services set forth in this 
        section at such levels as are established by the WTC Program 
        Administrator.
            ``(3) Review of rates.--
                    ``(A) Initial review.--Before the end of the third 
                contract year of the WTC program, the WTC Program 
                Administrator shall conduct a review to determine 
                whether the reimbursement rates set forth in this 
                subsection provide fair and appropriate reimbursement 
                for such program services. Based on such review, the 
                Administrator may, by rule beginning with the fourth 
                contract year, may modify such rates, taking into 
                account a reasonable and fair rate for the services 
                being provided.
                    ``(B) Subsequent reviews.--After the fourth 
                contract year, the WTC Program Administrator shall 
                conduct periodic reviews to determine whether the 
                reimbursement rates in effect under this subsection 
                provide fair and appropriate reimbursement for such 
                program services. Based upon such a review, the 
                Administrator may by rule modify such rates, taking 
                into account a reasonable and fair rate for the 
                services being provided.
                    ``(C) GAO review.--The Comptroller General of the 
                United States shall review the WTC Program 
                Administrator's determinations regarding fair and 
                appropriate reimbursement for program services under 
                this paragraph.
    ``(d) Requirements.--The WTC Program Administrator shall not enter 
into a contract with a Clinical Center of Excellence under subsection 
(a)(1) unless--
            ``(1) the Center establishes 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;
            ``(2) the Center provides for the coordination of 
        monitoring and treatment benefits under subtitle B with routine 
        medical care provided for the treatment of conditions other 
        than WTC-related health conditions;
            ``(3) the Center collects and reports to the corresponding 
        Coordinating Center of Excellence data in accordance with 
        section 3005;
            ``(4) the Center has in place safeguards against fraud that 
        are satisfactory to the Administrator;
            ``(5) the Center agrees to treat or refer for treatment all 
        individuals who are eligible WTC responders or eligible WTC 
        community members with respect to such Center who present 
        themselves for treatment of a WTC-related health condition;
            ``(6) the Center has in place safeguards 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;
            ``(7) the Center provides assurances that the amounts paid 
        under subsection (c)(1) are used only for costs incurred in 
        carrying out the activities described in subsection (a), other 
        than those described in subsection (a)(1)(A); and
            ``(8) the Center agrees to meet all the other applicable 
        requirements of this title, including regulations implementing 
        such requirements.

``SEC. 3007. ENTITLEMENT AUTHORITIES.

    ``Subject to subsections (b)(4)(C) and (c)(5) of section 3012, 
subtitle B constitutes budget authority in advance of appropriations 
Acts and represents the obligation of the Federal Government to provide 
for the payment for monitoring, initial health evaluations, and 
treatment in accordance with such subtitle and section 3006(c) 
constitutes such budget authority and represents the obligation of the 
Federal Government to provide for the payment described in such 
section.

``SEC. 3008. 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 on the World Trade 
        Center 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 terms `certified eligible WTC responder' and 
        `certified eligible WTC community member' mean an individual 
        who has been certified as an eligible WTC responder under 
        section 3011(a)(4) or an eligible WTC community member under 
        section 3021(a)(4), respectively.
            ``(3) The terms `Clinical Center of Excellence' and 
        `Coordinating Center of Excellence' have the meanings given 
        such terms in section 3006(b).
            ``(4) The term `current consortium arrangements' means the 
        arrangements as in effect on the date of the enactment of this 
        title between the National Institute for Occupational Safety 
        and Health and the Mt. Sinai-coordinated consortium and the 
        Fire Department of the City of New York.
            ``(5) The terms `eligible WTC responder' and `eligible WTC 
        community member' are defined in sections 3011(a) and 3021(a), 
        respectively.
            ``(6) 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.
            ``(7) The term `list of identified WTC-related health 
        conditions' means--
                    ``(A) for eligible WTC responders, the identified 
                WTC-related health condition for eligible WTC 
                responders under section 3012(a)(3) or 3012(a)(4); or
                    ``(B) for eligible WTC community members, the 
                identified WTC-related health condition for WTC 
                community members under section 3022(b)(1) or 
                3022(b)(2).
            ``(8) The term `Mt.-Sinai-coordinated consortium' means the 
        consortium coordinated by Mt. Sinai hospital in New York City 
        that coordinates the monitoring and treatment under the current 
        consortium arrangements for eligible WTC responders other than 
        with respect to those covered under the arrangement with the 
        Fire Department of the City of New York.
            ``(9) 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.
            ``(10) The term `New York metropolitan area' means an area, 
        specified by the WTC Program Administrator, within which 
        eligible WTC responders and eligible WTC community members 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 Centers of Excellence 
        described in subparagraphs (A), (B), or (C) of section 
        3006(b)(1).
            ``(11) Any reference to `September 11, 2001' shall be 
        deemed a reference to the period on such date subsequent to the 
        terrorist attacks on the World Trade Center on such date.
            ``(12) The term `September 11, 2001, terrorist attacks on 
        the World Trade Center' means the terrorist attacks that 
        occurred on September 11, 2001, in New York City and includes 
        the aftermath of such attacks.
            ``(13) The term `WTC Health Program Steering Committee' 
        means such a Steering Committee established under section 3003.
            ``(14) The term `WTC Program Administrator' means the 
        individual responsible under section 3001(f) for the 
        administration of the WTC program.
            ``(15) The term `WTC-related health condition' is defined 
        in section 3012(a).
            ``(16) The term `WTC Scientific/Technical Advisory 
        Committee' means such Committee established under section 3002.

 ``Subtitle B--Program of Monitoring, Initial Health Evaluations, and 
                               Treatment

                      ``PART 1--FOR WTC RESPONDERS

``SEC. 3011. IDENTIFICATION OF ELIGIBLE WTC RESPONDERS AND PROVISION OF 
              WTC-RELATED MONITORING SERVICES.

    ``(a) Eligible WTC Responder Defined.--
            ``(1) In general.--For purposes of this title, the term 
        `eligible WTC responder' means any of the following 
        individuals, subject to paragraph (5):
                    ``(A) Currently identified responder.--An 
                individual who has been identified as eligible for 
                medical monitoring under the current consortium 
                arrangements (as defined in section 3008(4)).
                    ``(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 on the World Trade Center, 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 on 
                        the World Trade Center as the WTC Program 
                        Administrator, after consultation with the WTC 
                        Responders Steering Committee and 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 certifications for eligible responders has 
                reached 80 percent of the limit described in paragraph 
                (5) or on or after the date that the number of 
                certifications for eligible community members has 
                reached 80 percent of the limit described in section 
                3021(a)(5).
            ``(2) Current eligibility criteria.--The eligibility 
        criteria described in this paragraph for an individual is that 
        the individual is described in either of the following 
        categories:
                    ``(A) Fire fighters and related personnel.--The 
                individual--
                            ``(i) was a member of the Fire Department 
                        of the City of New York (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 sites (including Ground Zero, Staten 
                        Island land fill, and the NYC 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 the City of New York 
                        (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 mental health condition described in 
                        section 3012(a)(1)(B) on or before September 1, 
                        2008.
                    ``(B) Law enforcement officers and wtc rescue, 
                recovery, and clean-up workers.--The individual--
                            ``(i) worked or volunteered on-site 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 the City of New York (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 on-site in rescue, recovery, 
                        debris clean-up, 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 on-site in rescue, 
                        recovery, debris clean-up, 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;
                            ``(III) participated on-site in rescue, 
                        recovery, debris clean-up, 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 on-site in rescue, 
                        recovery, debris clean-up, 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 the City of New 
                        York 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 on the 
                        World Trade Center during a duration and period 
                        described in subparagraph (A).
            ``(3) Application process.--The WTC Program Administrator 
        in consultation with the Coordinating Centers of Excellence 
        shall establish a process for individuals, other than eligible 
        WTC responders described in paragraph (1)(A), to apply to be 
        determined to be eligible WTC responders. Under such process--
                    ``(A) there shall be no fee charged to the 
                applicant for making an application for such 
                determination;
                    ``(B) the Administrator shall make a determination 
                on such an application not later than 60 days after the 
                date of filing the application; and
                    ``(C) an individual who is determined not to be an 
                eligible WTC responder shall have an opportunity to 
                appeal such determination before an administrative law 
                judge in a manner established under such process.
            ``(4) Certification.--
                    ``(A) In general.--In the case of an individual who 
                is described in paragraph (1)(A) or who is determined 
                under paragraph (3) (consistent with paragraph (5)) to 
                be an eligible WTC responder, the WTC Program 
                Administrator shall provide an appropriate 
                certification of such fact and of eligibility for 
                monitoring and treatment benefits under this part. The 
                Administrator shall make determinations of eligibility 
                relating to an applicant's compliance with this title, 
                including the verification of information submitted in 
                support of the application, and shall not deny such a 
                certification to an individual unless the Administrator 
                determines that--
                            ``(i) based on the application submitted, 
                        the individual does not meet the eligibility 
                        criteria; or
                            ``(ii) the numerical limitation on eligible 
                        WTC responders set forth in paragraph (5) has 
                        been met.
                    ``(B) Timing.--
                            ``(i) Currently identified responders.--In 
                        the case of an individual who is described in 
                        paragraph (1)(A), the WTC Program Administrator 
                        shall provide the certification under 
                        subparagraph (A) not later than 60 days after 
                        the date of the enactment of this title.
                            ``(ii) Other responders.--In the case of 
                        another individual who is determined under 
                        paragraph (3) and consistent with paragraph (5) 
                        to be an eligible WTC responder, the WTC 
                        Program Administrator shall provide the 
                        certification under subparagraph (A) at the 
                        time of the determination.
            ``(5) Numerical limitation on eligible wtc responders.--
                    ``(A) In general.--The total number of individuals 
                not described in subparagraph (C) who may qualify as 
                eligible WTC responders for purposes of this title, and 
                be certified as eligible WTC responders under paragraph 
                (4), shall not exceed 15,000, subject to adjustment 
                under paragraph (6), of which no more than 2,500 may be 
                individuals certified based on modified eligibility 
                criteria established under paragraph (1)(C). In 
                applying the previous sentence, any individual who at 
                any time so qualifies as an eligible WTC responder 
                shall be counted against such numerical limitation.
                    ``(B) Process.--In implementing subparagraph (A), 
                the WTC Program Administrator shall--
                            ``(i) limit the number of certifications 
                        provided under paragraph (4) in accordance with 
                        such subparagraph; and
                            ``(ii) provide priority in such 
                        certifications in the order in which 
                        individuals apply for a determination under 
                        paragraph (3).
                    ``(C) Currently identified responders not 
                counted.--Individuals described in this subparagraph 
                are individuals who are described in paragraph (1)(A).
            ``(6) Potential adjustment in numerical limitations 
        dependent upon actual spending relative to estimated 
        spending.--
                    ``(A) Initial calculation for fiscal years 2009 
                through 2011.--If the WTC Program Administrator 
                determines as of December 1, 2011, that the WTC 
                expenditure-to-CBO-estimate percentage (as defined in 
                subparagraph (D)(iii)) for fiscal years 2009 through 
                2011 does not exceed 90 percent, then, effective 
                January 1, 2012, the WTC Program Administrator may 
                increase the numerical limitation under paragraph 
                (5)(A), the numerical limitation under section 
                3021(a)(5), or both, by a number of percentage points 
                not to exceed the number of percentage points specified 
                in subparagraph (C) for such period of fiscal years.
                    ``(B) Subsequent calculation for fiscal years 2009 
                through 2015.--If the Secretary determines as of 
                December 1, 2015, that the WTC expenditure-to-CBO-
                estimate percentages for fiscal years 2009 through 2015 
                and for fiscal years 2012 through 2015 do not exceed 90 
                percent, then, effective January 1, 2015, the WTC 
                Program Administrator may increase the numerical 
                limitation under paragraph (5)(A), the numerical 
                limitation under section 3021(a)(5), or both, as in 
                effect after the application of subparagraph (A), by a 
                number of percentage points not to exceed twice the 
                lesser of--
                            ``(i) the number of percentage points 
                        specified in subparagraph (C) for fiscal years 
                        2009 through 2012, or
                            ``(ii) the number of percentage points 
                        specified in subparagraph (C) for fiscal years 
                        2012 through 2015.
                    ``(C) Maximum percentage increase in numerical 
                limitations for period of fiscal years.--The number of 
                percentage points specified in this clause for a period 
                of fiscal years is--
                            ``(i) 100 percentage points, multiplied by
                            ``(ii) one minus a fraction the numerator 
                        of which is the net Federal WTC spending for 
                        such period, and the denominator of which is 
                        the CBO WTC spending estimate under this title 
                        for such period.
                    ``(D) Definitions.--For purposes of this paragraph:
                            ``(i) Net federal spending.--The term `net 
                        Federal WTC spending' means, with respect to a 
                        period of fiscal years, the net Federal 
                        spending under this title for such fiscal 
                        years.
                            ``(ii) CBO wtc spending estimate under this 
                        title.--The term `CBO WTC medical spending 
                        estimate under this title' means, with respect 
                        to--
                                    ``(I) fiscal years 2009 through 
                                2011, $900,000,000;
                                    ``(II) fiscal years 2012 through 
                                2015, $1,890,000,000; and
                                    ``(III) fiscal years 2009 through 
                                2015, the sum of the amounts specified 
                                in subclauses (I) and (II).
                            ``(iii) WTC expenditure-to-cbo-estimate 
                        percentage.--The term `WTC expenditure-to-
                        estimate percentage' means, with respect to a 
                        period of fiscal years, the ratio (expressed as 
                        a percentage) of--
                                    ``(I) the net Federal WTC spending 
                                for such period, to
                                    ``(II) the CBO WTC spending 
                                estimate under this title for such 
                                period.
    ``(b) Monitoring Benefits.--
            ``(1) In general.--In the case of an eligible WTC responder 
        under section 3011(a)(4) (other than one described in 
        subsection (a)(2)(A)(ii)), the WTC program shall provide for 
        monitoring benefits that include medical 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 eligible WTC responder who is 
        an active member of the Fire Department of the City of New 
        York, 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 
        3031.

``SEC. 3012. TREATMENT OF CERTIFIED ELIGIBLE WTC RESPONDERS FOR WTC-
              RELATED HEALTH CONDITIONS.

    ``(a) WTC-Related Health Condition Defined.--
            ``(1) In general.--For purposes of this title, the term 
        `WTC-related health condition' means--
                    ``(A) 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 on the World Trade Center, 
                based on an examination by a medical professional with 
                experience in treating or diagnosing the medical 
                conditions included in the applicable list of 
                identified WTC-related 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
                    ``(B) a mental health condition for which such 
                attacks, based on an examination by a medical 
                professional with experience in treating or diagnosing 
                the medical conditions included in the applicable list 
                of identified WTC-related conditions, is substantially 
                likely be a significant factor in aggravating, 
                contributing to, or causing the condition, as 
                determined under paragraph (2).
        In the case of an eligible WTC responder described in section 
        3011(a)(2)(A)(ii), such term only includes the mental health 
        condition described in subparagraph (B).
            ``(2) Determination.--The determination of whether the 
        September 11, 2001, terrorist attacks on the World Trade Center 
        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 medical conditions included on the 
                        list of identified WTC-related 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 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 identified wtc-related health conditions for 
        certified eligible wtc responders.--For purposes of this title, 
        the term `identified WTC-related health condition for eligible 
        WTC responders' means any of the following health conditions:
                    ``(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) Gastro-esophageal reflux disorder 
                        (GERD).
                            ``(xii) Sleep apnea exacerbated by or 
                        related to a condition described in a previous 
                        clause.
                    ``(B) Mental health conditions.--
                            ``(i) Post traumatic 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.
                            ``(xi) V codes (treatments not specifically 
                        related to psychiatric disorders, such as 
                        marital problems, parenting problems etc.), 
                        secondary to another identified WTC-related 
                        health condition for WTC eligible responders.
                    ``(C) Musculoskeletal disorders.--
                            ``(i) Low back pain.
                            ``(ii) Carpal tunnel syndrome (CTS).
                            ``(iii) Other musculoskeletal disorders.
            ``(4) Addition of identified wtc-related health conditions 
        for eligible wtc responders.--
                    ``(A) In general.--The WTC Program Administrator 
                may promulgate regulations to add an illness or health 
                condition not described in paragraph (3) to be added to 
                the list of identified WTC-related conditions for 
                eligible WTC responders. In promulgating such 
                regulations, the Secretary shall provide for notice and 
                opportunity for a public hearing and at least 90 days 
                of public comment. In promulgating such regulations, 
                the WTC Program Administrator shall take into account 
                the findings and recommendations of Clinical Centers of 
                Excellence published in peer reviewed journals in the 
                determination of whether an additional illness or 
                health condition, such as cancer, should be added to 
                the list of identified WTC-related health conditions 
                for eligible WTC responders.
                    ``(B) Petitions.--Any person (including the WTC 
                Health Program Scientific/Technical Advisory Committee) 
                may petition the WTC Program Administrator to propose 
                regulations described in subparagraph (A). Unless 
                clearly frivolous, or initiated by such Committee, any 
                such petition shall be referred to such Committee for 
                its recommendations. Following--
                            ``(i) receipt of any recommendation of the 
                        Committee; or
                            ``(ii) 180 days after the date of the 
                        referral to the Committee,
                whichever occurs first, the WTC Program Administrator 
                shall conduct a rulemaking proceeding on the matters 
                proposed in the petition or publish in the Federal 
                Register a statement of reasons for not conducting such 
                proceeding.
                    ``(C) Effectiveness.--Any addition under 
                subparagraph (A) of an illness or health condition 
                shall apply only with respect to applications for 
                benefits under this title which are filed after the 
                effective date of such regulation.
                    ``(D) Role of advisory committee.--Except with 
                respect to a regulation recommended by the WTC Health 
                Program Scientific/Technical Advisory Committee), the 
                WTC Program Administrator may not propose a regulation 
                under this paragraph, unless the Administrator has 
                first provided to the Committee a copy of the proposed 
                regulation, requested recommendations and comments by 
                the Committee, and afforded the Committee at least 90 
                days to make such recommendations.
    ``(b) Coverage of Treatment for WTC-Related Health Conditions.--
            ``(1) Determination based on an identified wtc-related 
        health condition for certified eligible wtc responders.--
                    ``(A) In general.--If a physician at a Clinical 
                Center of Excellence that is providing monitoring 
                benefits under section 3011 for a certified eligible 
                WTC responder determines that the responder has an 
                identified WTC-related health condition, and the 
                physician makes a clinical determination that exposure 
                to airborne toxins, other hazards, or adverse 
                conditions resulting from the 9/11 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) of a WTC-related health 
                        condition.
                            ``(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 an identified WTC-
                        related health condition or that exposure to 
                        airborne toxins, other hazards, or adverse 
                        conditions resulting from the 9/11 terrorist 
                        attacks is not substantially likely to be a 
                        significant factor in significantly 
                        aggravating, contributing to, or causing the 
                        condition.
                            ``(iii) Appeal process.--The Administrator 
                        shall provide a process for the appeal of 
                        determinations under clause (ii) before an 
                        administrative law judge.
            ``(2) Determination based on other wtc-related health 
        condition.--
                    ``(A) In general.--If a physician at a Clinical 
                Center of Excellence determines pursuant to subsection 
                (a) that the certified eligible WTC responder has a 
                WTC-related health condition that is not an identified 
                WTC-related health condition for eligible WTC 
                responders--
                            ``(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) Review; certification.--
                            ``(i) Use of physician panel.--With respect 
                        to each determination relating to a WTC-related 
                        health condition transmitted under subparagraph 
                        (A)(i), the WTC Program Administrator shall 
                        provide for the review of the condition to be 
                        made by a physician panel with appropriate 
                        expertise appointed by the WTC Program 
                        Administrator. Such a panel shall make 
                        recommendations to the Administrator on the 
                        evidence supporting such determination.
                            ``(ii) Review of recommendations of panel; 
                        certification.--The Administrator, based on 
                        such recommendations shall determine, within 60 
                        days after the date of the transmittal under 
                        subparagraph (A)(i), whether or not the 
                        condition is a WTC-related health condition 
                        and, if it is, provide for a certification 
                        under paragraph (1)(B)(ii) of coverage of such 
                        condition. The Administrator shall provide a 
                        process for the appeal of determinations that 
                        the responder's condition is not a WTC-related 
                        health condition before an administrative law 
                        judge.
            ``(3) Requirement of medical necessity.--
                    ``(A) In general.--In providing treatment for a 
                WTC-health condition, a physician shall provide 
                treatment that is medically necessary and in accordance 
                with medical protocols established under subsection 
                (d).
                    ``(B) Medically necessary standard.--For the 
                purpose of this title, health care services shall be 
                treated as medically necessary for an individual if a 
                physician, exercising prudent clinical judgment, would 
                consider the services to be medically necessary for the 
                individual for the purpose of evaluating, diagnosing, 
                or treating an illness, injury, disease or its 
                symptoms, and that are--
                            ``(i) in accordance with the generally 
                        accepted standards of medical practice;
                            ``(ii) clinically appropriate, in terms of 
                        type, frequency, extent, site, and duration, 
                        and considered effective for the individual's 
                        illness, injury, or disease; and
                            ``(iii) not primarily for the convenience 
                        of the patient or physician, or another 
                        physician, and not more costly than an 
                        alternative service or sequence of services at 
                        least as likely to produce equivalent 
                        therapeutic or diagnostic results as to the 
                        diagnosis or treatment of the individual's 
                        illness, injury, or disease.
                    ``(C) Determination of medical necessity.--
                            ``(i) Review of medical necessity.--As part 
                        of the reimbursement payment process under 
                        subsection (c), the WTC Program Administrator 
                        shall review claims for reimbursement for the 
                        provision of medical treatment to determine if 
                        such treatment is medically necessary.
                            ``(ii) Withholding of payment for medically 
                        unnecessary treatment.--The Administrator may 
                        withhold such payment for treatment that the 
                        Administrator determines is not medically 
                        necessary.
                            ``(iii) Review of determinations of medical 
                        necessity.--The Administrator shall provide a 
                        process for providers to appeal a determination 
                        under clause (ii) that medical treatment is not 
                        medically necessary. Such appeals shall be 
                        reviewed through the use of a physician panel 
                        with appropriate expertise.
            ``(4) Scope of treatment covered.--
                    ``(A) In general.--The scope of treatment covered 
                under such paragraphs 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.--To the extent 
                provided in advance in appropriations Acts, the WTC 
                Program Administrator may provide for necessary and 
                reasonable transportation and expenses incident to the 
                securing of medically necessary treatment 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.--In the 
        case of a certified eligible WTC responder who has been 
        determined by an examining physician under subsection (b)(1) to 
        have an identified WTC-related health condition, but for whom a 
        certification of the determination has not yet been made by the 
        WTC Program Administrator, medical treatment may be provided 
        under this subsection, subject to paragraph (6), until the 
        Administrator makes a decision on such certification. Medical 
        treatment provided under this paragraph shall be considered to 
        be medical treatment for which payment may be made under 
        subsection (c).
            ``(6) Prior approval process for non-certified non-
        emergency inpatient hospital services.--Non-emergency inpatient 
        hospital services for a WTC-related health condition identified 
        by an examining physician under paragraph (b)(1) that is not 
        certified under paragraph (1)(B)(ii) is not covered unless the 
        services have been determined to be medically necessary and 
        approved through a process established by the WTC Program 
        Administrator. Such process shall provide for a decision on a 
        request for such services within 15 days of the date of receipt 
        of the request. The WTC Administrator shall provide a process 
        for the appeal of a decision that the services are not 
        medically necessary.
    ``(c) Payment for Initial Health Evaluation, Medical Monitoring, 
and Treatment of WTC-Related Health Conditions.--
            ``(1) Medical treatment.--
                    ``(A) Use of feca payment rates.--Subject to 
                subparagraph (B), 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.
                    ``(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 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 
                        select a separate vendor to provide 
                        pharmaceutical benefits to certified eligible 
                        WTC responders for whom the Clinical Center of 
                        Excellence is described in section 
                        3006(b)(1)(A) if such an arrangement is deemed 
                        necessary and beneficial to the program by the 
                        WTC Program Administrator.
                    ``(C) Other treatment.--For treatment not covered 
                under a preceding subparagraph, the WTC Program 
                Administrator shall designate a reimbursement rate for 
                each such service.
            ``(2) Medical monitoring and initial health evaluation.--
        The WTC Program Administrator shall reimburse the costs of 
        medical monitoring and the costs of an initial health 
        evaluation provided under this title at a rate set by the 
        Administrator.
            ``(3) 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 this section.
            ``(4) Claims processing subject to appropriations.--The 
        payment by the WTC Program Administrator for the processing of 
        claims under this title is limited to the amounts provided in 
        advance in appropriations Acts.
    ``(d) Medical Treatment Protocols.--
            ``(1) Development.--The Coordinating Centers of Excellence 
        shall develop medical treatment protocols for the treatment of 
        certified eligible WTC responders and certified eligible WTC 
        community members for identified WTC-related health conditions.
            ``(2) Approval.--The WTC Program Administrator shall 
        approve the medical treatment protocols, in consultation with 
        the WTC Health Program Steering Committees.

                      ``PART 2--COMMUNITY PROGRAM

``SEC. 3021. IDENTIFICATION AND INITIAL HEALTH EVALUATION OF ELIGIBLE 
              WTC COMMUNITY MEMBERS.

    ``(a) Eligible WTC Community Member Defined.--
            ``(1) In general.--In this title, the term `eligible WTC 
        community member' means, subject to paragraphs (3) and (5), an 
        individual who claims symptoms of a WTC-related health 
        condition and is described in any of the following 
        subparagraphs:
                    ``(A) Currently identified community member.--An 
                individual, including an eligible WTC responder, who 
                has been identified as eligible for medical treatment 
                or monitoring by the WTC Environmental Health Center as 
                of the date of enactment of this title.
                    ``(B) Community member who meets current 
                eligibility criteria.--An individual who is not an 
                eligible WTC responder and meets any of the current 
                eligibility criteria described in a subparagraph of 
                paragraph (2).
                    ``(C) Community member who meets modified 
                eligibility criteria.--An individual who is not an 
                eligible WTC responder and meets such eligibility 
                criteria relating to exposure to airborne toxins, other 
                hazards, or adverse conditions resulting from the 
                September 11, 2001, terrorist attacks on the World 
                Trade Center as the WTC Administrator determines 
                eligible, after consultation with the WTC Community 
                Program Steering Committee, Coordinating Centers of 
                Excellence described in section 3006(b)(1)(C), and the 
                WTC Scientific/Technical Advisory Committee.
        The Administrator shall not modify such criteria under 
        subparagraph (C) on or after the date that the number of 
        certifications for eligible community members has reached 80 
        percent of the limit described in paragraph (5) or on or after 
        the date that the number of certifications for eligible 
        responders has reached 80 percent of the limit described in 
        section 3021(a)(5).
            ``(2) Current eligibility criteria.--The eligibility 
        criteria described in this paragraph for an individual are that 
        the individual is described in any of the following 
        subparagraphs:
                    ``(A) A person who was present in the New York City 
                disaster area in the dust or dust cloud on September 
                11, 2001.
                    ``(B) A person who worked, resided or attended 
                school, child care or adult day care in the New York 
                City disaster area for--
                            ``(i) at least four days during the 4-month 
                        period beginning on September 11, 2001, and 
                        ending on January 10, 2002; or
                            ``(ii) at least 30 days during the period 
                        beginning on September 11, 2001, and ending on 
                        July 31, 2002.
                    ``(C) Any person who worked as a clean-up 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.
                    ``(D) 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.
                    ``(E) 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 on the World Trade 
                        Center.
            ``(3) Application process.--The WTC Program Administrator 
        in consultation with the Coordinating Centers of Excellence 
        shall establish a process for individuals, other than 
        individuals described in paragraph (1)(A), to be determined 
        eligible WTC community member. Under such process--
                    ``(A) there shall be no fee charged to the 
                applicant for making an application for such 
                determination;
                    ``(B) the Administrator shall make a determination 
                on such an application not later than 60 days after the 
                date of filing the application; and
                    ``(C) an individual who is determined not to be an 
                eligible WTC community member shall have an opportunity 
                to appeal such determination before an administrative 
                law judge in a manner established under such process.
            ``(4) Certification.--
                    ``(A) In general.--In the case of an individual who 
                is described in paragraph (1)(A) or who is determined 
                under paragraph (3) (consistent with paragraph (5)) to 
                be an eligible WTC community member, the WTC Program 
                Administrator shall provide an appropriate 
                certification of such fact and of eligibility for 
                followup monitoring and treatment benefits under this 
                part. The Administrator shall make determinations of 
                eligibility relating to an applicant's compliance with 
                this title, including the verification of information 
                submitted in support of the application and shall not 
                deny such a certification to an individual unless the 
                Administrator determines that--
                            ``(i) based on the application submitted, 
                        the individual does not meet the eligibility 
                        criteria; or
                            ``(ii) the numerical limitation on 
                        certification of eligible WTC community members 
                        set forth in paragraph (5) has been met.
                    ``(B) Timing.--
                            ``(i) Currently identified community 
                        members.--In the case of an individual who is 
                        described in paragraph (1)(A), the WTC Program 
                        Administrator shall provide the certification 
                        under subparagraph (A) not later than 60 days 
                        after the date of the enactment of this title.
                            ``(ii) Other members.--In the case of 
                        another individual who is determined under 
                        paragraph (3) and consistent with paragraph (5) 
                        to be an eligible WTC community member, the WTC 
                        Program Administrator shall provide the 
                        certification under subparagraph (A) at the 
                        time of such determination.
            ``(5) Numerical limitation on certification of eligible wtc 
        community members.--
                    ``(A) In general.--The total number of individuals 
                not described in subparagraph (C) who may be certified 
                as eligible WTC community members under paragraph (4) 
                shall not exceed 15,000. In applying the previous 
                sentence, any individual who at any time so qualifies 
                as an eligible WTC community member shall be counted 
                against such numerical limitation.
                    ``(B) Process.--In implementing subparagraph (A), 
                the WTC Program Administrator shall--
                            ``(i) limit the number of certifications 
                        provided under paragraph (4) in accordance with 
                        such subparagraph; and
                            ``(ii) provide priority in such 
                        certifications in the order in which 
                        individuals apply for a determination under 
                        paragraph (4).
                    ``(C) Individuals currently receiving treatment not 
                counted.--Individuals described in this subparagraph 
                are individuals who--
                            ``(i) are described in paragraph (1)(A); or
                            ``(ii) before the date of the enactment of 
                        this title, have received monitoring or 
                        treatment at the World Trade Center 
                        Environmental Health Center at Bellevue 
                        Hospital Center, Gouverneur Health Care 
                        Services, or Elmhurst Hospital Center.
                The New York City Health and Hospitals Corporation 
                shall, not later than 6 months after the date of 
                enactment of this title, enter into arrangements with 
                the Mt. Sinai Data and Clinical Coordination Center for 
                the reporting of medical data concerning eligible WTC 
                responders described in paragraph (1)(A), as determined 
                by the WTC Program Administrator and consistent with 
                applicable Federal and State laws and regulations 
                relating to confidentiality of individually 
                identifiable health information.
                    ``(D) Report to congress if numerical limitation to 
                be reached.--If the WTC Program Administrator 
                determines that the number of individuals subject to 
                the numerical limitation of subparagraph (A) is likely 
                to exceed such numerical limitation, the Administrator 
                shall submit to Congress a report on such 
                determination. Such report shall include an estimate of 
                the number of such individuals in excess of such 
                numerical limitation and of the additional expenditures 
                that would result under this title if such numerical 
                limitation were removed.
    ``(b) Initial Health Evaluation To Determine Eligibility for 
Followup Monitoring or Treatment.--
            ``(1) In general.--In the case of a certified eligible WTC 
        community member, the WTC program shall provide for an initial 
        health evaluation to determine if the member has a WTC-related 
        health condition and is eligible for followup monitoring and 
        treatment benefits under the WTC program. Initial health 
        evaluation protocols shall be approved by the WTC Program 
        Administrator, in consultation with the World Trade Center 
        Environmental Health Center at Bellevue Hospital and the WTC 
        Community Program Steering Committee.
            ``(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 initial health evaluation under this part for an 
        eligible WTC community member 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. 3022. FOLLOWUP MONITORING AND TREATMENT OF CERTIFIED ELIGIBLE 
              WTC COMMUNITY MEMBERS FOR WTC-RELATED HEALTH CONDITIONS.

    ``(a) In General.--Subject to subsection (b), the provisions of 
sections 3011 and 3012 shall apply to followup monitoring and treatment 
of WTC-related health conditions for certified eligible WTC community 
members in the same manner as such provisions apply to the monitoring 
and treatment of identified WTC-related health conditions for certified 
eligible WTC responders, except that such monitoring shall only be 
available to those certified as eligible for treatment under this 
title. Under section 3006(a)(3), the City of New York is required to 
contribute a share of the costs of such treatment.
    ``(b) List of Identified WTC-related Health Conditions for WTC 
Community Members.--
            ``(1) Identified wtc-related health conditions for wtc 
        community members.--For purposes of this title, the term 
        `identified WTC-related health conditions for WTC community 
        members' means any of the following health conditions:
                    ``(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) Gastro-esophageal reflux disorder 
                        (GERD).
                            ``(xii) Sleep apnea exacerbated by or 
                        related to a condition described in a previous 
                        clause.
                    ``(B) Mental health conditions.--
                            ``(i) Post traumatic 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.
                            ``(xi) V codes (treatments not specifically 
                        related to psychiatric disorders, such as 
                        marital problems, parenting problems etc.), 
                        secondary to another identified WTC-related 
                        health condition for WTC community members.
            ``(2) Additions to identified wtc-related health conditions 
        for wtc community members.--The provisions of paragraph (4) of 
        section 3012(a) shall apply with respect to an addition to the 
        list of identified WTC-related conditions for eligible WTC 
        community members under paragraph (1) in the same manner as 
        such provisions apply to an addition to the list of identified 
        WTC-related conditions for eligible WTC responders under 
        section 3012(a)(3).

``SEC. 3023. FOLLOWUP MONITORING AND TREATMENT OF OTHER INDIVIDUALS 
              WITH WTC-RELATED HEALTH CONDITIONS.

    ``(a) In General.--Subject to subsection (c), the provisions of 
section 3022 shall apply to the followup monitoring and treatment of 
WTC-related health conditions for eligible WTC community members 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 WTC community members. Under section 
3006(a)(3), the City of New York is required to contribute a share of 
the costs of such monitoring and treatment.
    ``(b) Individuals Described.--An individual described in this 
subsection is an individual who, regardless of location of residence--
            ``(1) is not a eligible WTC responder or an eligible WTC 
        community member; and
            ``(2) is diagnosed at a Clinical Center of Excellence (with 
        respect to an eligible WTC community member) with an identified 
        WTC-related health condition for WTC community members.
    ``(c) Limitation.--
            ``(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) fiscal year 2009 is $20,000,000; or
                    ``(B) 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--NATIONAL ARRANGEMENT FOR BENEFITS FOR ELIGIBLE INDIVIDUALS 
                            OUTSIDE NEW YORK

``SEC. 3031. 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 eligible WTC responders or 
eligible WTC community members 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 
        Coordinating Centers of Excellence;
            ``(2) follow the monitoring, initial health evaluation, and 
        treatment protocols developed under section 3006(a)(2)(B);
            ``(3) collect and report data in accordance with section 
        3005; and
            ``(4) meet such fraud, quality assurance, and other 
        requirements as the WTC Program Administrator establishes.

                 ``Subtitle C--Research Into Conditions

``SEC. 3041. RESEARCH REGARDING CERTAIN HEALTH CONDITIONS RELATED TO 
              SEPTEMBER 11 TERRORIST ATTACKS IN NEW YORK CITY.

    ``(a) In General.--With respect to individuals, including eligible 
WTC responders and eligible WTC community members, 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 3051), through a Clinical Center of 
Excellence, or through a Coordinating Center of Excellence.
    ``(b) Types of Research.--The research under subsection (a)(1) 
shall include epidemiologic and other research studies on WTC-related 
conditions or emerging conditions--
            ``(1) among WTC responders and community members under 
        treatment; and
            ``(2) in sampled populations outside the New York City 
        disaster area in Manhattan as far north as 14th Street and in 
        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 Health Program Steering 
Committees and the WTC Scientific/Technical Advisory Committee.
    ``(d) Application of Privacy and Human Subject Protections.--The 
privacy and human subject protections applicable to research conducted 
under this section shall not be less than such protections applicable 
to research otherwise conducted by the National Institutes of Health.
    ``(e) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $15,000,000 
for each fiscal year, in addition to any other authorizations of 
appropriations that are available for such purpose.

 ``Subtitle D--Programs of the New York City Department of Health and 
                             Mental Hygiene

``SEC. 3051. WORLD TRADE CENTER HEALTH REGISTRY.

    ``(a) Program Extension.--For the purpose of ensuring on-going data 
collection for victims of the September 11, 2001, terrorist attacks on 
the World Trade Center, the WTC Program Administrator, shall extend and 
expand the arrangements in effect as of January 1, 2008, with the New 
York City Department of Health and Mental Hygiene that provide for the 
World Trade Center Health Registry.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated $7,000,000 for each fiscal year to carry out this section.

``SEC. 3052. MENTAL HEALTH SERVICES.

    ``(a) In General.--The WTC Program Administrator may make grants to 
the New York City Department of Health and Mental Hygiene to provide 
mental health services to address mental health needs relating to the 
September 11, 2001, terrorist attacks on the World Trade Center.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated $8,500,000 for each fiscal year to carry out this 
section.''.

       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'' 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.''.

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 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 Removal.--
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) Authority to reinstitute certain lawsuits.--Such 
        section, as so redesignated, is further amended by adding at 
        the end the following new clause:
                            ``(iii) 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 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 subsection (d), not later than'';
            (2) in subsection (b), by striking ``This title'' and 
        inserting ``Subject to subsection (d), this title''; and
            (3) by adding at the end the following new subsections:
    ``(d) Limitation.--The total payment of amounts 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.
    ``(e) Attorney Fees.--
            ``(1) In general.--Notwithstanding any contract, and except 
        as provided in paragraph (2), 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) 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) 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.''.
                                                 Union Calendar No. 321

111th CONGRESS

  2d Session

                               H. R. 847

                  [Report No. 111-560, Parts I and II]

_______________________________________________________________________

                                 A BILL

     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.

_______________________________________________________________________

                             July 22, 2010

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
```