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WTC Program (with respect to a workers’ compensa-
tion law or plan, or other work-related injury or ill-
ness plan of the employer involved, and such indi-
vidual) 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.—
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‘‘(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 condi-
tion through any public or private health plan (in-
cluding 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 man-
ner as they apply to group health plan and an indi-
vidual 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 re-
quiring an entity providing monitoring and treat-
ment under this title to seek reimbursement under a
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health plan with which the entity has no contract for 
reimbursement. 
‘‘(3) MAINTENANCE OF REQUIRED MINIMUM ES-
SENTIAL COVERAGE.—No payment may be made for 
monitoring and treatment under this title for an in-
dividual 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 essen-
tial 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 dis-
bursed from the World Trade Center Health Pro-
gram 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
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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 2015 the 
full contribution amount under this subpara-
graph shall be equal to 10 percent of the expendi-
tures in carrying out this title for the respective 
quarter and with respect to calendar quarters in 
fiscal year 2016, such full contribution amount 
shall be equal to 1⁄9 of the Federal expenditures 
in carrying out this title for the respective quar-
ter. 
‘‘(C) SATISFACTION
OF
PAYMENT
OBLIGA-
TION.—The payment obligation under such con-
tract may not be satisfied through any of the fol-
lowing: 
‘‘(i) An amount derived from Federal 
sources.
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‘‘(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 pay-
ment obligation under such contract for a cal-
endar 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 cal-
endar quarter by the day specified in sub-
paragraph (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.
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‘‘(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 ac-
tion 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 Pro-
gram 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 esti-
mate of such amount of the required contribution 
at the beginning of such quarter and with an up-
dated estimate of such amount at the beginning 
of each of the subsequent 2 quarters; 
‘‘(B) bill such amount directly to New York 
City; and
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‘‘(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 adjust-
ment and reconciliation based upon actual expendi-
tures 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 work-
ers’ compensation law or plan of the United States or
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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 ar-
rangements with other government agencies, insurance com-
panies, 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 CON-
DITIONS RELATED TO SEPTEMBER 11 TER-
RORIST ATTACKS. 
‘‘(a) IN GENERAL.—With respect to individuals, in-
cluding enrolled WTC responders and certified-eligible WTC 
survivors, receiving monitoring or treatment under subtitle 
B, the WTC Program Administrator shall conduct or sup-
port— 
‘‘(1) research on physical and mental health con-
ditions 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 condi-
tions for which there has been diagnostic uncertainty; 
and
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‘‘(3) research on treating WTC-related health 
conditions of such individuals, in the case of condi-
tions for which there has been treatment uncertainty. 
The Administrator may provide such support through con-
tinuation and expansion of research that was initiated be-
fore 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 sub-
section (a)(1) shall include epidemiologic and other research 
studies on WTC-related health conditions or emerging con-
ditions— 
‘‘(1) among enrolled WTC responders and cer-
tified-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 pop-
ulations, to identify potential for long-term adverse 
health effects in less exposed populations. 
‘‘(c) CONSULTATION.—The WTC Program Adminis-
trator 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 protec-
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tions 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 at-
tacks, 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 Reg-
istry 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 Pro-
gram Fund (referred to in this section as the ‘Fund’). 
‘‘(2) FUNDING.—Out of any money in the Treas-
ury not otherwise appropriated, there shall be depos-
ited into the Fund for each of fiscal years 2012 
through 2016 (and the last calendar quarter of fiscal 
year 2011)—
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‘‘(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 fis-
cal year (initially based on estimates, sub-
ject to subsequent reconciliation based on 
actual expenditures); or 
‘‘(ii)(I) $71,000,000 for the last cal-
endar 
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, and 
$431,000,000 for fiscal year 2015; and 
‘‘(II) subject to paragraph (4), an ad-
ditional amount for fiscal year 2016 from 
unexpended amounts for previous fiscal 
years; 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 dis-
bursed from the Fund unless New York City has 
entered into a contract with the WTC Program 
Administrator under section 3331(d)(1).
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‘‘(B) BREACH OF CONTRACT.—In the case of 
a failure to pay the amount so required under 
the contract— 
‘‘(i) the amount is recoverable under 
subparagraph (E)(ii) of such section; 
‘‘(ii) such failure shall not affect the 
disbursement of amounts from the Fund; 
and 
‘‘(iii) the Federal share described in 
paragraph (2)(A) shall not be increased by 
the amount so unpaid. 
‘‘(4) AGGREGATE LIMITATION ON FUNDING BE-
GINNING WITH FISCAL YEAR 2016.—Beginning with 
fiscal year 2016, in no case shall the share of Federal 
funds deposited into the Fund under paragraph (2) 
for such fiscal year and previous fiscal years and 
quarters exceed the sum of the amounts specified in 
paragraph (2)(A)(ii)(I). 
‘‘(b) MANDATORY FUNDS FOR MONITORING, INITIAL 
HEALTH EVALUATIONS, TREATMENT, AND CLAIMS PROC-
ESSING.— 
‘‘(1) IN GENERAL.—The amounts deposited into 
the Fund under subsection (a)(2) shall be available, 
without further appropriation, consistent with para-
graph (2) and subsection (c), to carry out subtitle B
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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 avail-
able from the Fund for such purpose. 
‘‘(3) LIMITATION ON AUTHORIZATION FOR FUR-
THER 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