204 
‘‘(c) PAYMENT FOR INITIAL HEALTH EVALUA-
TION, 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 reim-
burse costs for medically necessary 
treatment under this title for WTC-re-
lated 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 es-
tablish a program for paying for 
the 
medically 
necessary 
out-
patient 
prescription 
pharma-
ceuticals prescribed under this 
title for WTC-related conditions 
through one or more contracts 
with outside vendors. 
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205 
‘‘(ii) 
COMPETITIVE
BIDDING.— 
Under such program the Adminis-
trator shall— 
‘‘(I) select one or more ap-
propriate vendors through a 
Federal competitive bid proc-
ess; and 
‘‘(II) select the lowest bid-
der (or bidders) meeting the 
requirements 
for 
providing 
pharmaceutical benefits for 
participants in the WTC pro-
gram. 
‘‘(iii) TREATMENT OF FDNY PAR-
TICIPANTS.—Under such program 
the Administrator may enter se-
lect a separate vendor to provide 
pharmaceutical benefits to cer-
tified eligible WTC responders for 
whom the Clinical Center of Ex-
cellence is described in section 
3006(b)(1)(A) if such an arrange-
ment is deemed necessary and 
beneficial to the program by the 
WTC Program Administrator. 
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206 
‘‘(C) 
OTHER
TREATMENT.—For 
treatment not covered under a pre-
ceding subparagraph, the WTC Pro-
gram 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 Adminis-
trator. 
‘‘(3) ADMINISTRATIVE ARRANGEMENT AU-
THORITY.—The WTC Program Adminis-
trator may enter into arrangements with 
other government agencies, insurance 
companies, or other third-party adminis-
trators to provide for timely and accurate 
processing of claims under this section. 
‘‘(4) CLAIMS PROCESSING SUBJECT TO AP-
PROPRIATIONS.—The payment by the WTC 
Program Administrator for the proc-
essing of claims under this title is limited 
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207 
to the amounts provided in advance in 
appropriations Acts. 
‘‘(d) MEDICAL TREATMENT PROTOCOLS.— 
‘‘(1) DEVELOPMENT.—The Coordinating 
Centers of Excellence shall develop med-
ical treatment protocols for the treatment 
of certified eligible WTC responders and 
certified eligible WTC community mem-
bers 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 Com-
mittees. 
‘‘PART 2—COMMUNITY PROGRAM 
‘‘SEC. 3021. IDENTIFICATION AND INITIAL HEALTH EVALUA-
TION OF ELIGIBLE WTC COMMUNITY MEM-
BERS. 
‘‘(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 
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208 
WTC-related health condition and is de-
scribed in any of the following subpara-
graphs: 
‘‘(A) CURRENTLY
IDENTIFIED
COM-
MUNITY
MEMBER.—An individual, in-
cluding 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
CRI-
TERIA.—An individual who is not an 
eligible WTC responder and meets 
such eligibility criteria relating to ex-
posure to airborne toxins, other haz-
ards, or adverse conditions resulting 
from the September 11, 2001, terrorist 
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209 
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 certifi-
cations for eligible community members 
has reached 80 percent of the limit de-
scribed 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 fol-
lowing subparagraphs: 
‘‘(A) A person who was present in 
the New York City disaster area in 
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