I 
110TH CONGRESS 
1ST SESSION H. R. 1247 
To amend title XVIII of the Social Security Act to provide for comprehensive 
health benefits for the relief of individuals whose health was adversely 
affected by the 9/11 disaster. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 28, 2007 
Mr. NADLER (for himself, Mr. ACKERMAN, Mr. BISHOP of Georgia, Ms. 
CORRINE BROWN of Florida, Mrs. CHRISTENSEN, Ms. CLARKE, Mr. 
CROWLEY, Ms. DELAURO, Mr. ENGEL, Mr. AL GREEN of Texas, Mr. 
GRIJALVA, Mr. HASTINGS of Florida, Mr. HIGGINS, Mr. HINCHEY, Mr. 
HOLT, Mr. ISRAEL, Mr. KUCINICH, Ms. MATSUI, Mrs. MCCARTHY of 
New York, Mr. MEEHAN, Mr. MEEKS of New York, Mr. GEORGE MILLER 
of California, Ms. NORTON, Mr. OBERSTAR, Mr. PASCRELL, Mr. RUSH, 
Mr. SERRANO, Ms. SLAUGHTER, Ms. VELA´ZQUEZ, Mr. WEINER, Mr. 
BISHOP of New York, and Mr. CONYERS) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committee on Ways and Means, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for comprehensive health benefits for the relief of individ-
uals whose health was adversely affected by the 9/11 
disaster. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘9/11 Comprehensive 
Health Benefits Act of 2007’’. 
SEC. 2. MEDICARE-BASED ELIGIBILITY AND BENEFITS FOR 
INDIVIDUALS WITH A 9/11 DISASTER-CON-
NECTED HEALTH CONDITION. 
(a) IN GENERAL.—Title XVIII of the Social Security 
Act is amended by inserting after section 1808 the fol-
lowing new section: 
‘‘BENEFITS FOR INDIVIDUALS WITH A 9/11 DISASTER- 
CONNECTED HEALTH CONDITION 
‘‘SEC. 1809. (a) IN GENERAL.—Every 9/11 impacted 
individual (as defined in subsection (b)(1)(A)) who has a 
9/11 disaster-connected health condition (as defined in 
subsection (b)(2))— 
‘‘(1) is entitled to 9/11-related benefits (as de-
fined in subsection (c)(1)) under this title without 
payment of any premium; and 
‘‘(2) if the individual is not otherwise entitled 
to benefits under part A (or enrolled under part B), 
is eligible to enroll under subsection (d) for benefits 
under parts A, B, and D that are in addition to the 
9/11-related benefits provided under paragraph (1). 
Paragraph (1) shall apply regardless of whether or not 
the individual is otherwise entitled to benefits under part 
A, B, or D. Paragraph (2) shall apply regardless of wheth-
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er the individual is covered under a group health plan or 
otherwise has other health insurance or benefits coverage. 
‘‘(b) ELIGIBILITY.— 
‘‘(1) 9/11 IMPACTED INDIVIDUAL DEFINED.— 
‘‘(A) IN GENERAL.—For purposes of this 
section, the term ‘9/11 impacted individual’ 
means any of the following: 
‘‘(i) EMERGENCY SERVICES OR RES-
CUE
AND
RECOVERY
PERSONNEL.—Any 
emergency services or rescue and recovery 
personnel who responded to the 9/11 New 
York terrorist attacks at any time during 
the period beginning on September 11, 
2001, and ending on August 31, 2002. 
‘‘(ii) INDIVIDUALS EXPOSED TO HAZ-
ARDOUS
SUBSTANCES, POLLUTANTS, OR 
CONTAMINANTS.—Any individual exposed 
in New York City to hazardous substances, 
pollutants, or contaminants released from 
the collapse of the World Trade Center 
that occurred in the 9/11 New York ter-
rorist attacks or from the fires that oc-
curred, or from the handling of resulting 
debris, thereafter. 
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‘‘(iii) 
OTHER
INDIVIDUALS.—Any 
other individual whom the Secretary deter-
mines to be appropriate. 
‘‘(B) EMERGENCY
SERVICES
OR
RESCUE 
AND
RECOVERY
PERSONNEL
INCLUDED.—For 
purposes of this paragraph, the term ‘emer-
gency services personnel or rescue and recovery 
personnel’ includes any of the following: 
‘‘(i) A Federal, State, or city employee 
who responded to the 9/11 New York ter-
rorist attacks. 
‘‘(ii) An individual who, as a worker 
or volunteer, was involved in clean-up, re-
pair, or infrastructure restoration activities 
related to the 9/11 New York terrorist at-
tacks. 
‘‘(iii) An individual participating in a 
search and rescue team, or who assisted in 
the recovery of human remains, after the 
9/11 New York terrorist attacks. 
‘‘(iv) Any other relief or rescue worker 
who the Secretary determines to be appro-
priate. 
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‘‘(C) PRESUMPTION
OF
EXPOSURE
TO 
HAZARDOUS
SUBSTANCES, 
POLLUTANTS, 
OR 
CONTAMINANTS.— 
‘‘(i) 
IN
GENERAL.—An 
individual 
shall be treated as described in subpara-
graph (A)(ii) if the individual resided, 
owned a business, was employed, or at-
tended school, child care, or adult day care 
in a building that was exposed to haz-
ardous substances, pollutants, or contami-
nants released from the collapse of the 
World Trade Center that occurred during 
such attacks on or after September 11, 
2001 or from the fires that occurred, or 
from the handling of resulting debris, 
thereafter. 
‘‘(ii) TREATMENT
OF
BUILDINGS.— 
For purposes of clause (i), any building in 
Manhattan, Brooklyn, Queens, Staten Is-
land, or Northern New Jersey (as delin-
eated by the Secretary) shall be treated as 
being described in such clause if there is 
evidence that the building was exposed to 
hazardous substances, pollutants, or con-
taminants released from the collapse of the 
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World Trade Center or from the fires that 
occurred thereafter at any time during the 
period beginning on September 11, 2001, 
and ending on December 31, 2001. 
‘‘(2) 9/11 DISASTER-CONNECTED HEALTH CON-
DITION DEFINED.— 
‘‘(A) IN GENERAL.—For purposes of this 
section, the term ‘9/11 disaster-connected 
health condition’ means an adverse health con-
dition (including the exacerbation of a pre-exist-
ing health condition), which also may be an ad-
verse mental health condition, that, in the judg-
ment of a qualified medical practitioner (includ-
ing a therapist in the case of an adverse mental 
health condition), can reasonably be considered 
to be associated with exposure to the 9/11 New 
York terrorist attacks. 
‘‘(B) 9/11 NEW YORK TERRORIST ATTACKS 
DEFINED.—For purposes of this section, the 
term ‘9/11 New York terrorist attacks’ means 
the terrorist attacks that occurred on Sep-
tember 11, 2001, in New York City, New York. 
‘‘(C) TREATMENT
OF
ADVERSE
MENTAL 
HEALTH
CONDITION.—For purposes of sub-
paragraph (A), an individual shall be considered 
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to have a 9/11 disaster-connected health condi-
tion if the individual has an adverse emotional 
or psychological health impact that— 
‘‘(i) has been formally diagnosed by a 
qualified medical practitioner or therapist; 
and 
‘‘(ii) can be reasonably considered, in 
the judgment of such practitioner or thera-
pist, to be associated with exposure to the 
9/11 New York terrorist attacks. 
‘‘(3) CRITERIA.—Not later than 30 days after 
the date of establishment of the Consortium estab-
lished under section 3 of the 9/11 Comprehensive 
Health Benefits Act of 2007, the Secretary, in con-
sultation with such Consortium, shall initially de-
velop standardized criteria for medical practitioners 
to consult with for assistance in their determination 
of whether an individual has a 9/11 disaster-con-
nected health condition consistent with this sub-
section. The Secretary shall periodically review such 
criteria and may, from time to time and in consulta-
tion with the Consortium, modify such criteria as 
the Secretary determines appropriate. 
‘‘(4) APPEALS PROCESS.—The Secretary shall 
specify a process for the appeal of a determination 
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that an individual is not eligible for benefits under 
this section. Such process shall be consistent with 
the process under section 1869 for the appeal of a 
determination that an individual is entitled to bene-
fits under parts A and B. 
‘‘(5) TREATMENT OF NONRESIDENTS AND UN-
DOCUMENTED
ALIENS.—Nothing in this section 
shall be construed as making an individual ineligible 
for benefits under this section because the individual 
is not a resident of New York or the United States 
or because the individual is an alien or is not au-
thorized to reside in the United States. Nothing in 
this paragraph shall be construed to provide for any 
benefits under this title for items and services fur-
nished outside the United States, except as may oth-
erwise be authorized under this title. 
‘‘(c) 9/11-RELATED BENEFITS DEFINED.— 
‘‘(1) IN GENERAL.—For purposes of this sec-
tion, the term ‘9/11-related benefits’ means benefits 
under parts A, B, and D for the treatment of any 
9/11 disaster-related health condition, subject to the 
following modifications with respect to such treat-
ment: 
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‘‘(A) NO COST-SHARING.—No deductibles, 
coinsurance, copayments, or other cost-sharing 
shall be applicable. 
‘‘(B) ELIMINATION
OF
DAY
OR
DOLLAR 
LIMITATIONS.—Any day or dollar limitations on 
coverage with respect to such treatment, includ-
ing such limitations under sections 1812, 
1833(g), and 1860D–2(b)(3), shall not be ap-
plicable. 
‘‘(2) ENTITLEMENT WITHOUT PREMIUMS.—An 
individual entitled to 9/11-related benefits under this 
section is deemed to be entitled to benefits under 
parts A, B, and D with respect to such 9/11-related 
benefits without requirement for payment for any 
premium. The entitlement to such benefits shall 
begin on the date that the individual is determined 
to be eligible for such benefits, but in no case before 
the date of the enactment of this section. 
‘‘(3) RELATION TO PART C.—Except in the case 
of an individual enrolled under part A or B under 
subsection (d) or otherwise, 9/11-related benefits are 
not available through enrollment in a Medicare Ad-
vantage plan under part C. 
‘‘(d) ENROLLMENT OPTION FOR ADDITIONAL MEDI-
CARE BENEFITS.— 
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‘‘(1) IN GENERAL.—With respect to the enroll-
ment option described in subsection (a)(2), an eligi-
ble individual may enroll under part A or B (or 
both), and under part D, in a manner and form pre-
scribed in regulations. Such regulations shall provide 
for continuous open enrollment for such individuals. 
‘‘(2) PREMIUMS.— 
‘‘(A) IN GENERAL.—Except as provided in 
this paragraph, the premium for enrollment 
under part A under this subsection shall be the 
same as the premium established under sub-
section (d) of section 1818 for enrollment under 
such section, subject to any reduction provided 
under such subsection. 
‘‘(B) ELIMINATION
OF
PREMIUM
BASED 
ON
QUARTERS
OF
COVERAGE.—No premium 
shall be imposed under subparagraph (A) in the 
case of an individual if the individual would be 
entitled, based solely on the number of quarters 
of coverage under title II, to benefits under 
part A under section 226(a), 226(b), or 226A. 
‘‘(C) NO LATE ENROLLMENT PENALTY.— 
An individual enrolling under part A, B, or D 
under this subsection shall not be subject to 
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any late enrollment penalty, including under 
sections 1839(b) and 1860D–13(b). 
‘‘(3) ENROLLMENT UNDER PARTS B AND D.— 
For purposes of parts B and D, in the case of an 
individual eligible to enroll under this subsection, the 
individual’s initial enrollment period under such 
parts shall be treated as beginning on the date of 
such eligibility and having no end date. 
‘‘(4) COVERAGE.— 
‘‘(A) IN
GENERAL.—The period (in this 
subsection referred to as a ‘coverage period’) 
during which an individual enrolled under this 
subsection is entitled to benefits under the re-
spective part shall begin on the first day of the 
first month that begins at least 15 days after 
the date of the individual’s enrollment under 
such part. 
‘‘(B) TERMINATION.—An individual’s cov-
erage period under this subsection under a part 
shall continue until the individual’s enrollment 
under such part is terminated as follows: 
‘‘(i) As of the month following the 
month in which the individual files notice 
that the individual no longer wishes to be 
enrolled in the part under this subsection. 
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