IB 
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) in-
troduced the following bill; which was referred to the Committee on En-
ergy 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. VELA´ZQUEZ, Mrs. DAHLKEMPER, Mr. ETHERIDGE, Mr. 
CONYERS, Mr. WEXLER, Mrs. CHRISTENSEN, Mr. COHEN, Mr. AN-
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DREWS, 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. ROTH-
MAN of New Jersey, Mrs. NAPOLITANO, Mr. LYNCH, Mr. CAO, Mr. MAR-
KEY 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, com-
mitted 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. 
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Be it enacted by the Senate and House of Representa-
tives 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. 
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‘‘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 Sep-
tember 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 Adminis-
trator, to provide beginning on July 1, 2011— 
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‘‘(1) medical monitoring and treatment benefits 
to eligible emergency responders and recovery and 
cleanup workers (including those who are Federal em-
ployees) who responded to the September 11, 2001, 
terrorist attacks; and 
‘‘(2) initial health evaluation, monitoring, and 
treatment benefits to residents and other building oc-
cupants and area workers in New York City who were 
directly impacted and adversely affected by such at-
tacks. 
‘‘(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 moni-
toring 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
SUR-
VIVORS.—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
RE-
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SPONDERS 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 re-
spect to a WTC-related health condition (including 
necessary prescription drugs). 
‘‘(4) OUTREACH.—Establishment under section 
3303 of an education and outreach program to poten-
tially eligible individuals concerning the benefits 
under this title. 
‘‘(5) CLINICAL
DATA
COLLECTION
AND
ANAL-
YSIS.—Collection and analysis under section 3304 of 
health and mental health data relating to individuals 
receiving monitoring or treatment benefits in a uni-
form manner in collaboration with the collection of 
epidemiological data under section 3342. 
‘‘(6) RESEARCH ON HEALTH CONDITIONS.—Es-
tablishment 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 cer-
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tified-eligible WTC survivor. Initial health evaluation bene-
fits are provided under subtitle B without any deductibles, 
copayments, or other cost sharing to a screening-eligible 
WTC survivor. 
‘‘(d) PREVENTING FRAUD AND UNREASONABLE AD-
MINISTRATIVE COSTS.— 
‘‘(1) FRAUD.—The Inspector General of the De-
partment of Health and Human Services shall de-
velop and implement a program to review the WTC 
Program’s health care expenditures to detect fraudu-
lent or duplicate billing and payment for inappro-
priate services. This title is a Federal health care pro-
gram (as defined in section 1128B(f) of the Social Se-
curity Act) and is a health plan (as defined in section 
1128C(c) of such Act) for purposes of applying sec-
tions 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 unreason-
able administrative costs, including with respect to 
infrastructure, administration, and claims processing. 
‘‘(e) QUALITY ASSURANCE.—The WTC Program Ad-
ministrator working with the Clinical Centers of Excellence 
shall develop and implement a quality assurance program 
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for the monitoring and treatment delivered by such Centers 
of Excellence and any other participating health care pro-
viders. Such program shall include— 
‘‘(1) adherence to monitoring and treatment pro-
tocols; 
‘‘(2) appropriate diagnostic and treatment refer-
rals 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 Adminis-
trator 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)— 
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‘‘(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 cer-
tified, on the number who received moni-
toring 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 indi-
viduals who will be certified under subtitle 
B in the succeeding fiscal year and the suc-
ceeding 10-year period. 
‘‘(B) MONITORING, INITIAL HEALTH EVAL-
UATION, AND TREATMENT COSTS.—For each clin-
ical program so described— 
‘‘(i) information on the costs of moni-
toring 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 
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