(1) STATE MAINTAINED PLANS.—Section 2907 
of the Public Health Service Act (as added by sub-
section (a)) is amended by adding at the end the fol-
lowing: 
‘‘(f) CONTINUED COVERAGE
OF BENEFITS
FOR 
SMALLPOX VACCINE SIDE EFFECTS.—
‘‘(1) IN GENERAL.—In accordance with regula-
tions which the Secretary shall prescribe, each group 
health plan that is maintained by any State that re-
ceives funds under this Act, by any political subdivi-
sion of such State, or by any agency or instrumen-
tality of such State or political subdivision, shall pro-
vide coverage of benefits for side effects resulting 
from covered countermeasures against smallpox at 
the level of such coverage it provided as of Sep-
tember 10, 2001. 
‘‘(2) ENFORCEMENT.—For purposes of section 
2207, the requirement of paragraph (1) is deemed a 
requirement of title XXII.’’. 
(2) PRIVATE PLANS.—
(A) AMENDMENT TO TAX CODE.—
(i) IN
GENERAL.—Paragraph (1) of 
section 4980B(f) of the Internal Revenue 
Code of 1986 is amended by inserting be-
fore the period at the end the following: ‘‘,
and (C) only if the coverage of the side ef-
fects 
from 
covered 
countermeasures 
against smallpox (as such term is defined 
in section 224(p) of the Public Health 
Service Act) is not less than the level of 
coverage provided by the plan as of Sep-
tember 10, 2001’’. 
(ii) 
CONFORMING
AMENDMENTS.—
Section 4980B(f)(1) of such Code is 
amended—
(I) by inserting ‘‘(A)’’ before 
‘‘only if’’ the first place it appears, 
and 
(II) by striking ‘‘and only if’’ and 
inserting ‘‘, (B) only if’’. 
(iii) EFFECTIVE DATE.—The amend-
ments made by this section shall apply to 
covered countermeasures against smallpox 
taken after the date of the enactment of 
this Act. 
(B) AMENDMENT
TO
ERISA.—Section 
609 of the Employee Retirement Income Secu-
rity Act of 1974 (29 U.S.C. 1169) is amend-
ed—
(i) by redesignating subsection (e) as 
subsection (f); and 
(ii) by inserting after subsection (d) 
the following: 
‘‘(e) CONTINUED COVERAGE
OF BENEFITS
FOR 
SMALLPOX VACCINE SIDE EFFECTS.—A group health 
plan shall provide coverage of the side effects from covered 
countermeasures against smallpox (as such term is defined 
in section 224(p) of the Public Health Service Act) at the 
level of coverage provided by the plan as of September 10, 
2001.’’. 
SEC. 4. NATIONAL SMALLPOX VACCINE INJURY COMPENSA-
TION PROGRAM. 
(a) ESTABLISHMENT.—Section 224 of the Public 
Health Service Act (42 U.S.C. 233), as amended by sec-
tion 304(c) of Public Law 107–296 (116 Stat. 2135), is 
amended by adding at the end the following: 
‘‘(q) NATIONAL SMALLPOX VACCINE INJURY COM-
PENSATION PROGRAM.—
‘‘(1) ESTABLISHMENT.—The Secretary shall es-
tablish the National Smallpox Vaccine Injury Com-
pensation Program (referred to in this subsection as 
the ‘Smallpox Program’) under which compensation 
may be paid for injury or death related to the ad-
ministration of any covered countermeasure against 
smallpox. 
‘‘(2) PROCEDURES AND STANDARDS.—The Sec-
retary shall by regulation establish procedures and 
standards applicable to the Smallpox Program that 
follow the procedures and standards applicable 
under the National Vaccine Injury Compensation 
Program established under section 2110, except for 
the following: 
‘‘(A) A person may not file a civil action 
under subsection (p) unless the person has first 
filed a petition for compensation under the 
Smallpox Program under section 2111. 
‘‘(B) After filing a petition under section 
2111, a person may elect to instead bring a 
civil action under subsection (p) if the person 
would be authorized under clause (i) or (ii) of 
section 2111(a)(2)(A) and under section 2121 
to elect to bring a civil action. 
‘‘(C) 
Notwithstanding 
section 
2111(c)(1)(A), a person who did not receive a 
covered countermeasure against smallpox or 
any other substance administered for the pre-
vention or treatment of smallpox (including 
vaccinia virus) may receive compensation under
the Smallpox Program if the person was injured 
as a result of contact with another person who 
received such a countermeasure or substance. 
‘‘(D) Section 2111(c)(1)(D) (requiring pe-
titioner to demonstrate death, residual effects 
for more than 6 months, or inpatient hos-
pitalization and surgical intervention) shall not 
apply. 
‘‘(E) Notwithstanding section 2115(a)(2), 
in the event of a death related to the adminis-
tration of vaccinia virus or other substance or 
medication administered for the purpose of pre-
venting or treating smallpox (including any cov-
ered countermeasure against smallpox), com-
pensation under the Smallpox Program shall in-
clude an award for the estate of the deceased 
of $850,000, in addition to any other com-
pensation to which the petitioner is entitled 
under this section. 
‘‘(3) VACCINE INJURY TABLE.—
‘‘(A) INCLUSION.—For purposes of receiv-
ing compensation under the Smallpox Program, 
the Vaccine Injury Table under section 2114 is 
deemed to include the following table of inju-
ries, disabilities, illnesses, conditions, and
deaths resulting from the administration of the 
smallpox vaccine, and the time period in which 
the first symptom or manifestation of onset or 
of significant aggravation of such injuries, dis-
abilities, illnesses, conditions, and deaths is to 
occur after administration of vaccinia virus or 
other substance or medication administered for 
the purpose of preventing or treating smallpox 
(including a covered countermeasure against 
smallpox):
‘‘Adverse event: 
Time period for first symptom or mani-
festation of onset or of significant aggra-
vation after administration of vaccinia 
virus or other substance or medication 
administered for the purpose of pre-
venting or treating smallpox (including a 
covered countermeasure against small-
pox): 
A. Anaphylaxis or anaphylactic shock .........
0–4 hours 
B. Eczema vaccinatum (including in a con-
tact case) ..................................................
any 
C. Accidental inoculation (including in a 
contact case) ............................................
any 
D. Progressive vaccinia ................................
any 
E. Encephalopathy (or encephalitis) ...........
0–21 days 
F. Stevens-Johnson syndrome .....................
3–21 days 
G. Generalized vaccinia ...............................
0–60 days 
H. Any acute complication or sequela (in-
cluding death) of an illness, disability, in-
jury, or condition referred to above which 
illness, disability, injury, or condition 
arose within the time period prescribed ..
Not applicable 
‘‘(B) RULE
OF
CONSTRUCTION.—Section 
13632 (a)(3) of Public Law 103–66 (107 Stat. 
646) (making revisions by Secretary to the Vac-
cine Injury Table effective on the effective date 
of a corresponding tax) shall not be construed 
to apply to the revision to the Vaccine Injury 
Table made by this paragraph.
‘‘(4) PROHIBITION.—The Secretary may not 
provide any compensation under the Smallpox Pro-
gram for any minor scarring or minor local reaction. 
‘‘(5) APPLICATION.—The Smallpox Program 
applies to any injury or death associated with the 
administration of any covered countermeasure on or 
after November 25, 2002. 
‘‘(6) REIMBURSEMENT.—Notwithstanding para-
graph (4), the Secretary may reimburse under this 
section an employer who seeks reimbursement pur-
suant to section 2904. 
‘‘(7) SPECIAL MASTERS.—
‘‘(A) HIRING.—In accordance with section 
2112, the judges of the United States Claims 
Court shall appoint a sufficient number of spe-
cial masters to address claims for compensation 
under this subsection. 
‘‘(B) BUDGET AUTHORITY.—There are ap-
propriated to carry out this paragraph such 
sums as may be necessary for fiscal year 2003 
and each fiscal year thereafter. This subpara-
graph constitutes budget authority in advance 
of appropriations and represents the obligation 
of the Federal Government.
‘‘(8) COVERED
COUNTERMEASURE.—For pur-
poses of this subsection, the terms ‘covered counter-
measure’ and ‘covered countermeasure against 
smallpox’ have the meanings given to those terms in 
subsection (p)(7)(A). 
‘‘(9) FUNDING.—Compensation made under the 
Smallpox Program shall be made from the same 
source of funds as payments made under subsection 
(p).’’. 
(b) RELATION TO FEDERAL TORT CLAIMS ACT.—
Paragraph (3) of section 224(p) of the Public Health 
Service Act (42 U.S.C. 233(p)) is amended to read as fol-
lows: 
‘‘(3) EXHAUSTION; EXCLUSIVITY.—
‘‘(A) NATIONAL
SMALLPOX
VACCINE
IN-
JURY
COMPENSATION
PROGRAM.—A person 
may not bring a claim under this subsection un-
less the person has first filed a petition for 
compensation under the program established 
under subsection (q) and made a proper elec-
tion under sections 2111(a)(2)(A) and 2121. 
‘‘(B) EXCLUSIVITY.—Except for filing a 
petition for compensation under the program 
established under subsection (q), the remedy 
provided by subsection (a) shall be exclusive of
any other civil action or proceeding for any 
claim or suit this subsection encompasses, dur-
ing the effective period of a declaration by the 
Secretary under paragraph (2)(A).’’. 
(c) PERSONS SUSCEPTIBLE TO VACCINE-RELATED 
INJURY.—Subsection (b) of section 2114 of the Public 
Health Service Act (42 U.S.C. 300aa–14) is amended by 
adding at the end the following: 
‘‘(5) A petitioner shall be considered to have 
suffered an injury related to the administration of a 
covered countermeasure even if the petitioner might 
not have suffered the injury absent an infection, dis-
ease, or other condition that made him or her more 
susceptible to the injury.’’. 
SEC. 5. TECHNICAL MODIFICATION. 
(a) CIRCUMSTANCES
IN WHICH PRESUMPTION
IN 
CASES
OF ACCIDENTAL VACCINIA INOCULATION AP-
PLIES.—Section 224(p)(2)(C)(ii)(II) of the Public Health 
Service Act (42 U.S.C. 233(p)(2)(C)(ii)(II)) is amended 
by striking ‘‘resides or has resided with’’ and inserting 
‘‘has had close contact with’’. 
(b) COVERED
COUNTERMEASURE.—Subparagraph 
(A) of section 224(p)(7) of the Public Health Service Act 
(42 U.S.C. 233(p)(7)(A)) is amended to read as follows:
‘‘(A) COVERED
COUNTERMEASURE.—The 
term ‘covered countermeasure’, or ‘covered 
countermeasure against smallpox’, means a sub-
stance specified in a declaration under para-
graph (2) that is—
‘‘(i) a substance used to prevent or 
treat smallpox (including vaccinia or an-
other vaccine); or 
‘‘(ii) a substance (including vaccinia 
immune globulin and cidofovir) used to 
control or treat the adverse effects of 
vaccinia inoculation or administration of 
any other countermeasure against small-
pox.’’. 
(c) COVERED PERSON.—Section 224(p)(7)(B)(ii) of 
the 
Public 
Health 
Service 
Act 
(42 
U.S.C. 
233(p)(7)(B)(ii)) is amended to read as follows: 
‘‘(ii) a health care entity, a State, or 
a political subdivision of a State under 
whose auspices such countermeasure was 
administered;’’. 
(d) EFFECTIVE DATE.—This section shall take effect 
as of November 25, 2002 (the date of enactment of the
Homeland Security Act of 2002 (Pub. L. 107–296; 116 
Stat. 2135)).
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