I 
110TH CONGRESS 
2D SESSION 
H. R. 7174 
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 
SEPTEMBER 27, 2008 
Mrs. MALONEY of New York (for herself, Mr. NADLER, Mr. FOSSELLA, Mr. 
KING of New York, Mr. RANGEL, Mr. ENGEL, Mr. TOWNS, Mr. WALSH 
of New York, Mr. KUHL of New York, Mr. MCHUGH, Mrs. MCCARTHY 
of New York, Mrs. LOWEY, Mr. HALL of New York, Mr. MCNULTY, Mr. 
HINCHEY, Mr. ISRAEL, Mr. CROWLEY, Mrs. GILLIBRAND, Mr. ARCURI, 
Mr. SHAYS, Mr. SMITH of New Jersey, Ms. SLAUGHTER, Mr. HIGGINS, 
Ms. CLARKE, Mr. SERRANO, Mr. BISHOP of New York, Mr. ACKERMAN, 
and Mr. GARRETT of New Jersey) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committees on the Judiciary and Ways and Means, for a period 
to be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
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. 
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; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘James Zadroga 9/11 Health and Compensation Act of 
2008’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
TITLE I—WORLD TRADE CENTER HEALTH PROGRAM 
Sec. 101. World Trade Center Health Program. 
‘‘TITLE XXX—WORLD TRADE CENTER HEALTH PROGRAM 
‘‘Subtitle A—Establishment of Program; Advisory and Steering Committees 
‘‘Sec. 3001. Establishment of World Trade Center Health Program within 
NIOSH. 
‘‘Sec. 3002. WTC Health Program Scientific/Technical Advisory Com-
mittee. 
‘‘Sec. 3003. WTC Health Program Steering Committees. 
‘‘Sec. 3004. Community education and outreach. 
‘‘Sec. 3005. Uniform data collection. 
‘‘Sec. 3006. Centers of excellence. 
‘‘Sec. 3007. Entitlement authorities. 
‘‘Sec. 3008. Definitions. 
‘‘Subtitle B—Program of Monitoring, Screening, and Treatment 
‘‘PART 1—FOR WTC RESPONDERS 
‘‘Sec. 3011. Identification of eligible WTC responders and provision of 
WTC-related monitoring services. 
‘‘Sec. 3012. Treatment of certified eligible WTC responders for WTC-re-
lated health conditions. 
‘‘PART 2—COMMUNITY PROGRAM 
‘‘Sec. 3021. Identification and screening of eligible WTC community mem-
bers. 
‘‘Sec. 3022. Treatment of certified eligible WTC community members for 
WTC-related health conditions. 
‘‘Sec. 3023. Treatment of other individuals with WTC-related health con-
ditions. 
‘‘PART 3—NATIONAL ARRANGEMENT FOR BENEFITS FOR ELIGIBLE 
INDIVIDUALS OUTSIDE NEW YORK 
‘‘Sec. 3031. National arrangement for benefits for eligible individuals out-
side New York. 
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‘‘Subtitle C—Research Into Conditions 
‘‘Sec. 3041. Research regarding certain health conditions related to Sep-
tember 11 terrorist attacks in New York City. 
‘‘Subtitle D—Programs of the New York City Department of Health and 
Mental Hygiene 
‘‘Sec. 3051. World Trade Center Health Registry. 
‘‘Sec. 3052. Mental health services. 
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 III—REVENUE PROVISIONS 
Subtitle A—Codification of Economic Substance Doctrine 
Sec. 301. Codification of economic substance doctrine. 
Sec. 302. Penalties for underpayments. 
Subtitle B—Prevention of Tax Treaty Exploitation to Evade United States 
Taxation 
Sec. 311. Limitation on treaty benefits for certain deductible payments. 
Subtitle C—Corporate Estimated Taxes 
Sec. 321. Time for payment of corporate estimated taxes. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Thousands of rescue workers who responded 
to the areas devastated by the terrorist attacks of 
September 11, local residents, office and area work-
ers, and school children continue to suffer significant 
medical problems as a result of compromised air 
quality and the release of other toxins from the at-
tack sites. 
(2) In a September 2006 peer-reviewed study 
conducted by the World Trade Center Medical Moni-
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toring Program, of 9,500 World Trade Center re-
sponders, almost 70 percent of World Trade Center 
responders had a new or worsened respiratory symp-
tom that developed during or after their time work-
ing at the World Trade Center; among the respond-
ers who were asymptomatic before 9/11, 61 percent 
developed respiratory symptoms while working at the 
World Trade Center; close to 60 percent still had a 
new or worsened respiratory symptom at the time of 
their examination; one-third had abnormal pul-
monary function tests; and severe respiratory condi-
tions including pneumonia were significantly more 
common in the 6 months after 9/11 than in the 
prior 6 months. 
(3) An April 2006 study documented that, on 
average, a New York City firefighter who responded 
to the World Trade Center has experienced a loss of 
12 years of lung capacity. 
(4) A peer-reviewed study of residents who lived 
near the World Trade Center titled ‘‘The World 
Trade Center Residents’ Respiratory Health Study: 
New Onset Respiratory Symptoms and Pulmonary 
Function’’, found that data demonstrated a three 
fold increase in new-onset, persistent lower res-
piratory symptoms in residents near the former 
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World Trade Center as compared to a control popu-
lation. 
(5) Previous research on the health impacts of 
the devastation caused by the September 11 terrorist 
attacks has shown relationships between the air 
quality from Ground Zero and a host of health im-
pacts, including lower pregnancy rates, higher rates 
of respiratory and lung disorders, and a variety of 
post-disaster mental health conditions (including 
posttraumatic stress disorder) in workers and resi-
dents near Ground Zero. 
(6) A variety of tests conducted by independent 
scientists have concluded that significant WTC con-
tamination settled in indoor environments sur-
rounding the disaster site. The Environmental Pro-
tection Agency’s (EPA) cleanup programs for indoor 
residential spaces, in 2003 and 2005, though lim-
ited, are an acknowledgment that indoor contamina-
tion continued after the WTC attacks. 
(7) At the request of the Department of En-
ergy, the Davis DELTA Group at the University of 
California conducted outdoor dust sampling in Octo-
ber 2001 at Varick and Houston Streets (approxi-
mately 1.2 miles north of Ground Zero) and found 
that the contamination from the World Trade Cen-
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ter ‘‘outdid even the worst pollution from the Ku-
wait oil fields fires’’. Further, the United States Ge-
ological Survey (USGS) reported on November 27, 
2001, that dust samples collected from indoor sur-
faces registered at levels that were ‘‘as caustic as 
liquid drain cleaners’’. 
(8) According to both the EPA’s own Inspector 
General’s (EPA IG) report of August 21, 2003 and 
General Accountability Offices’s (GAO) report of 
September 2007, no comprehensive program has 
ever been conducted in order to characterize the full 
extent of WTC contamination, and therefore the full 
impact of that contamination— geographic or other-
wise—remains unknown. 
(9) Such reports found that there has never 
been a comprehensive program to remediate WTC 
toxins from indoor spaces. Thus, area residents, 
workers and students may continued to be exposed 
to WTC contamination in their homes, workplaces 
and schools. 
(10) Because of the failure to release federally 
appropriated funds for community care, a lack of 
sufficient outreach, the fact that many community 
members are receiving care from physicians outside 
the current City-funded World Trade Center Envi-
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ronmental Health Center program and thus fall out-
side data collection efforts, and other factors, the 
number of community members being treated at the 
World Trade Center Environmental Health Center 
underrepresents the total number in the community 
that have been affected by exposure to Ground Zero 
toxins. 
(11) Research by Columbia University’s Center 
for Children’s Environmental Health has shown neg-
ative health effects on babies born to women living 
within 2 miles of the World Trade Center in the 
month following 9/11. 
(12) Federal funding allocated for the moni-
toring of rescue workers’ health is not sufficient to 
ensure the long-term study of health impacts of Sep-
tember 11. 
(13) A significant portion of those who have de-
veloped health problems as result of exposures to 
airborne toxins or other hazards resulting from the 
September 11, 2001, attacks on the World Trade 
Center have no health insurance, have lost their 
health insurance as a result of the attacks, or have 
inadequate health insurance. 
(14) The Federal program to provide medical 
treatments to those who responded to the September 
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11 aftermath, and who continue to experience health 
problems as a result, was finally established more 
than five years after the attacks, but has no certain 
long-term funding. 
(15) Rescue workers and volunteers seeking 
workers’ compensation have reported that their ap-
plications have been denied, delayed for months, or 
redirected, instead of receiving assistance in a timely 
and supportive manner. 
(16) A February 2007 report released by the 
City of New York estimated that approximately 
410,000 people were the most heavily exposed to the 
environmental hazards and trauma of the September 
11 terrorist attacks. More than 30 percent of the 
Fire Department of the City of New York first re-
sponders were still experiencing some respiratory 
symptoms more than five years after the attacks and 
according to the report, 59 percent of those seen by 
the WTC Environmental Health Center at Bellevue 
Hospital (which serves community members) are 
without insurance and 65 percent have incomes less 
than $15,000 per year. The report also found a need 
to continue and expand mental health services. 
(17) Since the 5th anniversary of the attack 
(September 11, 2006), hundreds of workers a month 
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have been signing up with the monitoring and treat-
ment programs. 
(18) In April 2008, the Department of Health 
and Human Services reported to Congress that in 
fiscal year 2007 11,359 patients received medical 
treatment in the existing WTC Responder Medical 
and Treatment program for WTC-related health 
problems, and that number of responders who need 
treatment and the severity of health problems is ex-
pected to increase. 
(19) The September 11 Victim Compensation 
Fund of 2001 was established to provide compensa-
tion to individuals who were physically injured or 
killed as a result of the terrorist-related aircraft 
crashes of September 11, 2001. 
(20) The deadline for filing claims for com-
pensation under the Victim Compensation Fund was 
December 22, 2003. 
(21) Some individuals did not know they were 
eligible to file claims for compensation for injuries or 
did not know they had suffered physical harm as a 
result of the terrorist-related aircraft crashes until 
after the December 22, 2003, deadline. 
(22) Further research is needed to evaluate 
more comprehensively the extent of the health im-
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pacts of September 11, including research for 
emerging health problems such as cancer, which 
have been predicted. 
(23) Research is needed regarding possible 
treatment for the illnesses and injuries of September 
11. 
(24) The Federal response to medical and fi-
nancial issues arising from the September 11 re-
sponse efforts needs a comprehensive, coordinated 
long-term response in order to meet the needs of all 
the individuals who were exposed to the toxins of 
Ground Zero and are suffering health problems from 
the disaster. 
(25) The failure to extend the appointment of 
Dr. John Howard as Director of the National Insti-
tute for Occupational Safety and Health in July 
2008 is not in the interests of the administration of 
such Institute nor the continued operation of the 
World Trade Center Medical Monitoring and Treat-
ment Program which he has headed, and the Sec-
retary of Health and Human Services should recon-
sider extending such appointment. 
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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 XXX—WORLD TRADE 
CENTER HEALTH PROGRAM 
‘‘Subtitle A—Establishment of Pro-
gram; Advisory and Steering 
Committees 
‘‘SEC. 3001. ESTABLISHMENT OF WORLD TRADE CENTER 
HEALTH PROGRAM WITHIN NIOSH. 
‘‘(a) IN GENERAL.—There is hereby established with-
in the National Institute for Occupational Safety and 
Health a program to be known as the ‘World Trade Center 
Health Program’ (in this title referred to as the ‘WTC 
program’) to provide— 
‘‘(1) medical monitoring and treatment benefits 
to eligible emergency responders and recovery and 
clean-up workers (including those who are Federal 
employees) who responded to the September 11, 
2001, terrorist attacks on the World Trade Center; 
and 
‘‘(2) screening and treatment benefits to resi-
dents and other building occupants and area workers 
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in New York City who were directly impacted and 
adversely affected by such attacks. 
‘‘(b) COMPONENTS OF PROGRAM.—The WTC pro-
gram includes the following components: 
‘‘(1) MEDICAL
MONITORING
FOR
RESPOND-
ERS.—Medical monitoring under section 3011, in-
cluding clinical examinations and long-term health 
monitoring and analysis for individuals 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 on the World 
Trade Center. 
‘‘(2) SCREENING FOR COMMUNITY MEMBERS.— 
Screening under section 3021, including an evalua-
tion to determine eligibility for treatment. 
‘‘(3) TREATMENT
FOR
WTC-RELATED
CONDI-
TIONS
FOR
RESPONDERS
AND
COMMUNITY
MEM-
BERS.—Provision under sections 3012, 3022, and 
3023 of treatment and payment, subject to the pro-
visions of subsection (d), for all medically necessary 
health and mental health care expenses (including 
necessary prescription drugs) of individuals with a 
WTC-related health condition. 
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‘‘(4) OUTREACH.—Establishment under section 
3004 of an outreach program to potentially eligible 
individuals concerning the benefits under this title. 
‘‘(5) UNIFORM DATA COLLECTION.—Collection 
under section 3005 of health and mental health data 
on individuals receiving monitoring or treatment 
benefits, using a uniform system of data collection. 
‘‘(6) RESEARCH ON WTC CONDITIONS.—Estab-
lishment under subtitle C of a research program on 
health conditions resulting from the September 11, 
2001, terrorist attacks on the World Trade Center. 
‘‘(c) NO COST-SHARING.—Monitoring and treatment 
benefits and screening benefits are provided under subtitle 
B without any deductibles, copayments, or other cost-shar-
ing to an eligible WTC responder or any eligible WTC 
community member. 
‘‘(d) PAYOR.— 
‘‘(1) IN GENERAL.—Except as provided in para-
graphs (2) and (3) and section 3012(c)(4), the cost 
of monitoring and treatment benefits and screening 
benefits provided under subtitle B shall be paid for 
by the WTC program. 
‘‘(2) WORKERS’ COMPENSATION
PAYMENT.— 
Payment for treatment under subtitle B of a WTC- 
related condition in an individual that is work-re-
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lated shall be reduced or recouped to the extent that 
the Secretary determines that payment has been 
made, or can reasonably be expected to be made, 
under a workers’ compensation law or plan of the 
United States or a State, or other work-related in-
jury or illness benefit plan of the employer of such 
individual, for such treatment. The provisions of 
clauses (iii), (iv), (v), and (vi) of paragraph (2)(B) 
of section 1862(b) of the Social Security Act (42 
U.S.C. 1395y(b)(2)) and paragraph (3) of such sec-
tion shall apply to the recoupment under this para-
graph of a payment to the WTC program with re-
spect to a workers’ compensation law or plan, or 
other work-related injury or illness plan of the em-
ployer involved, and such individual in the same 
manner as such provisions apply to the reimburse-
ment 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. 
‘‘(3) HEALTH INSURANCE COVERAGE.—In the 
case of an individual who has a WTC-related condi-
tion that is not work-related and has health coverage 
for such condition through any public or private 
health plan, the provisions of section 1862(b) of the 
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Social Security Act (42 U.S.C. 1395y(b)) shall apply 
to such a health plan and such individual in the 
same manner as they apply to a group health plan 
and an individual entitled to benefits under title 
XVIII of such Act pursuant to section 226(a). 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, coinsur-
ance, other cost-sharing, or otherwise, are reimburs-
able under this title to the extent that they are cov-
ered under the WTC program. 
‘‘(4) WORK-RELATED
DESCRIBED.—For the 
purposes of this subsection, a WTC-related condition 
shall be treated as a condition that is work-related 
if— 
‘‘(A) the condition is diagnosed in an eligi-
ble WTC responder, or in an individual who 
qualifies as an eligible WTC community mem-
ber on the basis of being a rescue, recovery, or 
clean-up worker; or 
‘‘(B) with respect to the condition the indi-
vidual has filed and had established a workers’ 
compensation claim. 
‘‘(e) QUALITY ASSURANCE
AND MONITORING
OF 
CLINICAL EXPENDITURES.— 
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‘‘(1) QUALITY
ASSURANCE.—The WTC Pro-
gram Administrator working with the Clinical Cen-
ters of Excellence shall develop and implement a 
quality assurance program for the medical moni-
toring and treatment delivered by such Centers of 
Excellence and any other participating health care 
providers. Such program shall include— 
‘‘(A) adherence to medical monitoring and 
treatment protocols; 
‘‘(B) appropriate diagnostic and treatment 
referrals for participants; 
‘‘(C) prompt communication of test results 
to participants; and 
‘‘(D) such other elements as the Adminis-
trator specifies in consultation with the Clinical 
Centers of Excellence. 
‘‘(2) FRAUD PREVENTION.—The WTC Program 
Administrator shall develop and implement a pro-
gram to review the program’s health care expendi-
tures to detect fraudulent or duplicate billing and 
payment for inappropriate services. Such program 
shall be similar to current methods used in connec-
tion with the Medicare program under title XVIII of 
the Social Security Act. This title is a Federal 
health care program (as defined in section 1128B(f) 
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of such Act) and is a health plan (as defined in sec-
tion 1128C(c) of such Act) for purposes of applying 
sections 1128 through 1128E of such Act. 
‘‘(f) WTC PROGRAM ADMINISTRATION.—The WTC 
program shall be administered by the Director of the Na-
tional Institute for Occupational Safety and Health, or a 
designee of such Director. 
‘‘(g) 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 Admin-
istrator shall submit an annual report to the Con-
gress on the operations of this title for such fiscal 
year and for the entire period of operation of the 
program. 
‘‘(2) CONTENTS OF REPORT.—Each annual re-
port under paragraph (1) shall include the following: 
‘‘(A) ELIGIBLE
INDIVIDUALS.—Informa-
tion for each clinical program described in para-
graph (3)— 
‘‘(i) on the number of individuals who 
applied for certification under subtitle B 
and the number of such individuals who 
were so certified; 
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‘‘(ii) of the individuals who were cer-
tified, on the number who received medical 
monitoring 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. 
‘‘(B) 
MONITORING, 
SCREENING, 
AND 
TREATMENT COSTS.—For each clinical program 
so described— 
‘‘(i) information on the costs of moni-
toring and screening and the costs of treat-
ment and on the estimated costs of such 
monitoring, screening, and treatment in 
the succeeding fiscal year; and 
‘‘(ii) an estimate of the cost of med-
ical treatment for WTC-related conditions 
that have been paid for or reimbursed by 
workers’ compensation, by public or private 
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health plans, or by the City of New York 
under section 3012(c)(4). 
‘‘(C) ADMINISTRATIVE
COSTS.—Informa-
tion on the cost of administering the program, 
including costs of program support, data collec-
tion and analysis, and research conducted under 
the program. 
‘‘(D) ADMINISTRATIVE EXPERIENCE.—In-
formation on the administrative performance of 
the program, including— 
‘‘(i) the performance of the program 
in providing timely evaluation of and treat-
ment to eligible individuals; and 
‘‘(ii) a list of the Clinical Centers of 
Excellence and other providers that are 
participating in the program. 
‘‘(E) SCIENTIFIC
REPORTS.—A summary 
of the findings of any new scientific reports or 
studies on the health effects associated with 
WTC center exposures, including the findings 
of research conducted under section 3041(a). 
‘‘(F) 
ADVISORY
COMMITTEE
REC-
OMMENDATIONS.—A list of recommendations by 
the WTC Scientific/Technical Advisory Com-
mittee on additional WTC program eligibility 
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criteria and on additional WTC-related health 
conditions and the action of the WTC Program 
Administrator 
concerning 
each 
such 
rec-
ommendation. 
‘‘(3) 
SEPARATE
CLINICAL
PROGRAMS
DE-
SCRIBED.—In paragraph (2), each of the following 
shall be treated as a separate clinical program of the 
WTC program: 
‘‘(A) FDNY RESPONDERS.—The benefits 
provided for eligible WTC responders described 
in section 3006(b)(1)(A). 
‘‘(B) OTHER
ELIGIBLE
WTC
RESPOND-
ERS.—The benefits provided for eligible WTC 
responders not described in subparagraph (A). 
‘‘(C) ELIGIBLE
WTC
COMMUNITY
MEM-
BERS.—The benefits provided for eligible WTC 
community members in section 3006(b)(1)(C). 
‘‘(h) NOTIFICATION TO CONGRESS WHEN REACH 80 
PERCENT
OF ELIGIBILITY NUMERICAL LIMITS.—The 
WTC Program Administrator shall promptly notify the 
Congress— 
‘‘(1) when the number of certifications for eligi-
ble WTC responders subject to the limit established 
under section 3011(a)(5) has reached 80 percent of 
such limit; and 
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‘‘(2) when the number of certifications for eligi-
ble WTC community members subject to the limit 
established under section 3021(a)(5) has reached 80 
percent of such limit. 
‘‘(i) GAO REPORT.—The Comptroller General of the 
United States shall submit to the Congress a report on 
the costs of the monitoring and treatment programs pro-
vided under this title. 
‘‘(j) NYC RECOMMENDATIONS.—The City of New 
York may make recommendations to the WTC Program 
Administrator on ways to improve the monitoring and 
treatment programs under this title for both eligible WTC 
responders and eligible WTC community members. 
‘‘SEC. 3002. WTC HEALTH PROGRAM SCIENTIFIC/TECH-
NICAL ADVISORY COMMITTEE. 
‘‘(a) ESTABLISHMENT.—The WTC Program Admin-
istrator shall establish an advisory committee to be known 
as the WTC Health Program Scientific/Technical Advisory 
Committee (in this section referred to as the ‘Advisory 
Committee’) to review scientific and medical evidence and 
to make recommendations to the Administrator on addi-
tional WTC program eligibility criteria and on additional 
WTC-related health conditions. 
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‘‘(b) COMPOSITION.—The WTC Program Adminis-
trator shall appoint the members of the Advisory Com-
mittee and shall include at least— 
‘‘(1) 4 occupational physicians, at least two of 
whom have experience treating WTC rescue and re-
covery workers; 
‘‘(2) 2 environmental medicine or environmental 
health specialists; 
‘‘(3) 2 representatives of eligible WTC respond-
ers; 
‘‘(4) 2 representatives of WTC community 
members; 
‘‘(5) an industrial hygienist; 
‘‘(6) a toxicologist; 
‘‘(7) an epidemiologist; and 
‘‘(8) a mental health professional. 
‘‘(c) MEETINGS.—The Advisory Committee shall 
meet at such frequency as may be required to carry out 
its duties. 
‘‘(d) REPORTS.—The WTC Program Administrator 
shall provide for publication of recommendations of the 
Advisory Committee on the public website established for 
the WTC program. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
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to be appropriated such sums as may be necessary, not 
to exceed $100,000, for each fiscal year beginning with 
fiscal year 2009. 
‘‘(f) DURATION.—Notwithstanding any other provi-
sion of law, the Advisory Committee shall continue in op-
eration during the period in which the WTC program is 
in operation. 
‘‘(g) APPLICATION OF FACA.—Except as otherwise 
specifically provided, the Advisory Committee shall be sub-
ject to the Federal Advisory Committee Act. 
‘‘SEC. 3003. WTC HEALTH PROGRAM STEERING COMMIT-
TEES. 
‘‘(a) ESTABLISHMENT.—The WTC Program Admin-
istrator shall establish two steering committees (each in 
this section referred to as a ‘Steering Committee’) as fol-
lows: 
‘‘(1) 
WTC 
RESPONDERS
STEERING
COM-
MITTEE.—One steering committee, to be known as 
the WTC Responders Steering Committee, for the 
purpose of facilitating the coordination of medical 
monitoring and treatment programs for the eligible 
WTC responders under part 1 of subtitle B. 
‘‘(2) WTC COMMUNITY
PROGRAM
STEERING 
COMMITTEE.—One steering committee, to be known 
as the WTC Community Program Steering Com-
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mittee, for the purpose of facilitating the coordina-
tion of screening and treatment programs for eligible 
WTC community members under part 2 of subtitle 
B. 
‘‘(b) MEMBERSHIP.— 
‘‘(1) INITIAL MEMBERSHIP OF WTC RESPOND-
ERS STEERING COMMITTEE.—The WTC Responders 
Steering Committee shall initially be composed of 
members of the WTC Monitoring and Treatment 
Program Steering Committee (as in existence on the 
day before the date of the enactment of this title). 
In addition, the committee membership shall in-
clude— 
‘‘(A) a representative of the Police Com-
missioner of the City of New York; 
‘‘(B) a representative of the Department of 
Health of the City of New York; 
‘‘(C) a representative of another agency of 
the City of New York, selected by the Mayor of 
New York City, which had a large number of 
non-uniformed City workers who responded to 
the WTC disaster; and 
‘‘(D) three representatives of eligible WTC 
responders; 
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in order that eligible WTC responders constitute half 
the members of the Steering Committee. 
‘‘(2) INITIAL MEMBERSHIP OF WTC COMMUNITY 
PROGRAM STEERING COMMITTEE.— 
‘‘(A) IN GENERAL.—The WTC Community 
Program Steering Committee shall initially be 
composed of members of the WTC Environ-
mental Health Center Community Advisory 
Committee (as in existence on the day before 
the date of the enactment of this title) and shall 
initially have, as voting members, the following: 
‘‘(i) 11 representatives of the affected 
populations of residents, students, area 
workers, and other community members. 
‘‘(ii) The Medical Director of the 
WTC Environmental Health Center. 
‘‘(iii) The Executive Director of the 
WTC Environmental Health Center. 
‘‘(iv) Three physicians, one each rep-
resenting the three WTC Environmental 
Health Center treatment sites of Bellevue 
Hospital Center, Gouverneur Healthcare 
Services, and Elmhurst Hospital Center. 
‘‘(v) Five specialists with WTC re-
lated expertise or experience in treating 
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non-responder WTC diseases, such as a pe-
diatrician, an epidemiologist, a psychiatrist 
or psychologist, an environmental/occupa-
tional specialists or a social worker from a 
WTC Environmental Health Center treat-
ment site, or other relevant specialists. 
‘‘(vi) A representative of the Depart-
ment of Health and Mental Hygiene of the 
City of New York. 
‘‘(B) APPOINTMENTS.— 
‘‘(i) WTC EHC COMMUNITY ADVISORY 
COMMITTEE.—The WTC Environmental 
Health Center Community Advisory Com-
mittee as in existence on the date of the 
enactment of this title shall nominate 
members for positions described in sub-
paragraph (A)(i). 
‘‘(ii) NYC HEALTH
AND
HOSPITALS 
CORPORATION.—The 
New 
York 
City 
Health and Hospitals Corporation shall 
nominate members for positions described 
in clauses (iv) and (v) of subparagraph 
(A). 
‘‘(iii) TIMING.—Nominations under 
clauses (i) and (ii) shall be recommended 
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to the WTC Program Administrator not 
later than 60 days after the date of the en-
actment of this title. 
‘‘(iv) APPOINTMENT.—The WTC Pro-
gram Administrator shall appoint members 
of the WTC Community Program Steering 
Committee not later than 90 days after the 
date of the enactment of this title. 
‘‘(v) GENERAL
REPRESENTATIVES.— 
Of the members appointed under subpara-
graph (A)(i)— 
‘‘(I) the representation shall re-
flect the broad and diverse WTC-af-
fected populations and constituencies 
and the diversity of impacted neigh-
borhoods, including residents, hard-to- 
reach 
populations, 
students, 
area 
workers, school parents, community- 
based 
organizations, 
Community 
Boards, WTC Environmental Health 
Center patients, labor unions, and 
labor advocacy organizations; and 
‘‘(II) no one individual organiza-
tion can have more than one rep-
resentative. 
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‘‘(3) 
ADDITIONAL
APPOINTMENTS.—Each 
Steering Committee may appoint, if approved by a 
majority of voting members of the Committee, addi-
tional members to the Committee. 
‘‘(4) VACANCIES.—A vacancy in a Steering 
Committee shall be filled by the Steering Committee, 
subject to the approval of the WTC Program Ad-
ministrator, so long as— 
‘‘(A) in the case of the WTC Responders 
Steering Committee, the composition of the 
Committee includes representatives of eligible 
WTC responders and representatives of each 
Clinical Center of Excellence and each Coordi-
nating Center of Excellence that serves eligible 
WTC responders and such composition has eli-
gible WTC responders constituting half of the 
membership of the Steering Committee; or 
‘‘(B) in the case of the WTC Community 
Program Steering Committee, the composition 
of the Committee includes representatives of eli-
gible WTC community members and represent-
atives of each Clinical Center of Excellence and 
each Coordinating Center of Excellence that 
serves eligible WTC community members and 
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the nominating process is consistent with para-
graph (2)(B). 
‘‘(5) CO-CHAIRS OF WTC COMMUNITY PROGRAM 
STEERING COMMITTEE.—The WTC Community Pro-
gram Steering Committee shall have two Co-Chairs 
as follows: 
‘‘(A) COMMUNITY/LABOR
CO-CHAIR.—A 
Community/Labor Co-Chair who shall be chosen 
by the community and labor-based members of 
the Steering Committee. 
‘‘(B) ENVIRONMENTAL
HEALTH
CLINIC 
CO-CHAIR.—A WTC Environmental Health 
Clinic Co-Chair who shall be chosen by the 
WTC Environmental Health Center members 
on the Steering Committee. 
‘‘(c) RELATION
TO FACA.—Each Steering Com-
mittee shall not be subject to the Federal Advisory Com-
mittee Act. 
‘‘(d) MEETINGS.—Each Steering Committee shall 
meet at such frequency necessary to carry out its duties, 
but not less than 4 times each calendar year and at least 
two such meetings each year shall be a joint meeting with 
the voting membership of the other Steering Committee 
for the purpose of exchanging information regarding the 
WTC program. 
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‘‘(e) DURATION.—Notwithstanding any other provi-
sion of law, each Steering Committee shall continue in op-
eration during the period in which the WTC program is 
in operation. 
‘‘SEC. 3004. COMMUNITY EDUCATION AND OUTREACH. 
‘‘(a) IN GENERAL.—The WTC Program Adminis-
trator shall institute a program that provides education 
and outreach on the existence and availability of services 
under the WTC program. The outreach and education 
program— 
‘‘(1) shall include— 
‘‘(A) the establishment of a public website 
with information about the WTC program; 
‘‘(B) meetings with potentially eligible pop-
ulations; 
‘‘(C) development and dissemination of 
outreach materials informing people about the 
program; and 
‘‘(D) the establishment of phone informa-
tion services; and 
‘‘(2) shall be conducted in a manner intended— 
‘‘(A) to reach all affected populations; and 
‘‘(B) to include materials for culturally and 
linguistically diverse populations. 
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‘‘(b) PARTNERSHIPS.—To the greatest extent pos-
sible, in carrying out this section, the WTC Program Ad-
ministrator shall enter into partnerships with local govern-
ments and organizations with experience performing out-
reach to the affected populations, including community 
and labor-based organizations. 
‘‘SEC. 3005. UNIFORM DATA COLLECTION. 
‘‘(a) IN GENERAL.—The WTC Program Adminis-
trator shall provide for the uniform collection of data (and 
analysis of data and regular reports to the Administrator) 
on the utilization of monitoring and treatment benefits 
provided to eligible WTC responders and eligible WTC 
community members, the prevalence of WTC-related 
health conditions, and the identification of new WTC-re-
lated medical conditions. Such data shall be collected for 
all individuals provided monitoring or treatment benefits 
under subtitle B and regardless of their place of residence 
or Clinical Center of Excellence through which the benefits 
are provided. 
‘‘(b) COORDINATING THROUGH CENTERS OF EXCEL-
LENCE.—Each Clinical Center of Excellence shall collect 
data described in subsection (a) and report such data to 
the corresponding Coordinating Center of Excellence for 
analysis by such Coordinating Center of Excellence. 
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‘‘(c) PRIVACY.—The data collection and analysis 
under this section shall be conducted in a manner that 
protects the confidentiality of individually identifiable 
health information consistent with applicable legal require-
ments. 
‘‘SEC. 3006. CENTERS OF EXCELLENCE. 
‘‘(a) IN GENERAL.— 
‘‘(1) CONTRACTS WITH CLINICAL CENTERS OF 
EXCELLENCE.—The WTC Program Administrator 
shall enter into contracts with Clinical Centers of 
Excellence specified in subsection (b)(1)— 
‘‘(A) for the provision of monitoring and 
treatment benefits and screening benefits under 
subtitle B; 
‘‘(B) for the provision of outreach activities 
to individuals eligible for such monitoring and 
treatment benefits, for screening benefits, and 
for follow-up to individuals who are enrolled in 
the monitoring program; 
‘‘(C) for the provision of counseling for 
benefits under subtitle B, with respect to WTC- 
related health conditions, for individuals eligible 
for such benefits; and 
‘‘(D) for the provision of counseling for 
benefits for WTC-related health conditions that 
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may be available under Workers’ Compensation 
or other benefit programs for work-related inju-
ries or illnesses, health insurance, disability in-
surance, or other insurance plans or through 
public or private social service agencies and as-
sisting eligible individuals in applying for such 
benefits; 
‘‘(E) for the provision of translational and 
interpretive services as for program participants 
who are not English language proficient; and 
‘‘(F) for the collection and reporting of 
data in accordance with section 3005. 
‘‘(2) CONTRACTS
WITH
COORDINATING
CEN-
TERS
OF
EXCELLENCE.—The WTC Program Ad-
ministrator shall enter into contracts with Coordi-
nating Centers of Excellence specified in subsection 
(b)(2)— 
‘‘(A) for receiving, analyzing, and report-
ing to the WTC Program Administrator on 
data, in accordance with section 3005, that has 
been collected and reported to such Coordi-
nating Centers by the corresponding Clinical 
Centers of Excellence under subsection (d)(3); 
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‘‘(B) for the development of medical moni-
toring, screening, and treatment protocols, with 
respect to WTC-related health conditions; 
‘‘(C) for coordinating the outreach activi-
ties conducted under paragraph (1)(B) by each 
corresponding Clinical Center of Excellence; 
‘‘(D) for establishing criteria for the 
credentialing of medical providers participating 
in the nationwide network under section 3031; 
‘‘(E) for coordinating and administrating 
the activities of the WTC Health Program 
Steering Committees established under section 
3003(a); and 
‘‘(F) for meeting periodically with the cor-
responding Clinical Centers of Excellence to ob-
tain input on the analysis and reporting of data 
collected under subparagraph (A) and on the 
development of medical monitoring, screening, 
and treatment protocols under subparagraph 
(B). 
The medical providers under subparagraph (D) shall 
be selected by the WTC Program Administrator on 
the basis of their experience treating or diagnosing 
the medical conditions included in the list of identi-
fied WTC-related conditions for responders and of 
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with the Fire Department for monitoring 
or treatment of such responders) or any 
other or any other Clinical Center of Ex-
cellence described in subparagraph (B), 
(C), or (D). 
‘‘(B) OTHER ELIGIBLE WTC RESPONDERS 
IN NEW YORK.—With respect to other eligible 
WTC responders who reside in the New York 
Metropolitan area, the Mt. Sinai coordinated 
consortium, Queens College, State University of 
New York at Stony Brook, University of Medi-
cine and Dentistry of New Jersey, and Bellevue 
Hospital. 
‘‘(C) WTC COMMUNITY MEMBERS IN NEW 
YORK.—With respect to eligible WTC commu-
nity members who reside in the New York Met-
ropolitan area, the World Trade Center Envi-
ronmental Health Center at Bellevue Hospital 
and such hospitals or other facilities, including 
but not limited to those within the New York 
City Health and Hospitals Corporation, as are 
identified by the WTC Program Administrator. 
‘‘(D) ALL
ELIGIBLE
WTC
RESPONDERS 
AND ELIGIBLE WTC COMMUNITY MEMBERS.— 
With respect to all eligible WTC responders and 
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eligible WTC community members, such other 
hospitals or other facilities as are identified by 
the WTC Program Administrator. 
The WTC Program Administrator shall limit the 
number of additional Centers of Excellence identified 
under subparagraph (D) to ensure that the partici-
pating centers have adequate experience in the treat-
ment and diagnosis of identified WTC-related med-
ical conditions. 
‘‘(2) 
COORDINATING
CENTER
OF
EXCEL-
LENCE.—In this title, the term ‘Coordinating Center 
of Excellence’ means the following: 
‘‘(A) FOR FDNY RESPONDERS.—With re-
spect to an eligible WTC responder who re-
sponded to the 9/11 attacks as an employee of 
the Fire Department of the City of New York, 
such Fire Department. 
‘‘(B) OTHER WTC RESPONDERS.—With re-
spect to other eligible WTC responders, the Mt. 
Sinai coordinated consortium. 
‘‘(C) WTC
COMMUNITY
MEMBERS.—With 
respect to eligible WTC community members, 
the World Trade Center Environmental Health 
Center at Bellevue Hospital. 
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‘‘(3) CORRESPONDING CENTERS.—In this title, 
a Clinical Center of Excellence and a Coordinating 
Center of Excellence shall be treated as ‘cor-
responding’ to the extent that such Clinical Center 
and Coordinating Center serve the same population 
group. 
‘‘(c) REIMBURSEMENT FOR NON-TREATMENT, NON- 
MONITORING PROGRAM COSTS.—A Clinical or Coordi-
nating Center of Excellence with a contract under this sec-
tion shall be reimbursed for the costs of such Center in 
carrying out the activities described in subsection (a), 
other than those described in subsection (a)(1)(A), subject 
to the provisions of section 3001(d), as follows: 
‘‘(1) CLINICAL
CENTERS
OF
EXCELLENCE.— 
For carrying out subparagraphs (B) through (F) of 
subsection (a)(1)— 
‘‘(A) CLINICAL
CENTER
FOR
FDNY
RE-
SPONDERS IN NEW YORK.—The Clinical Center 
of Excellence for FDNY Responders in New 
York specified in subsection (b)(1)(A) shall be 
reimbursed— 
‘‘(i) in the first year of the contract 
under this section, $600 per certified eligi-
ble WTC responder in the medical treat-
ment program, and $300 per certified eli-
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gible WTC responder in the monitoring 
program; and 
‘‘(ii) in each subsequent contract year, 
subject to paragraph (3), at the rates spec-
ified in this subparagraph for the previous 
contract year adjusted by the WTC Pro-
gram Administrator to reflect the rate of 
medical care inflation during the previous 
contract year. 
‘‘(B) CLINICAL CENTERS SERVING OTHER 
ELIGIBLE WTC RESPONDERS IN NEW YORK.—A 
Clinical Center of Excellence for other WTC re-
sponders in New York specified in subsection 
(b)(1)(B) shall be reimbursed the amounts 
specified in subparagraph (A). 
‘‘(C) CLINICAL
CENTERS
SERVING
WTC 
COMMUNITY
MEMBERS.—A Clinical Center of 
Excellence for eligible WTC community mem-
bers in New York specified in subsection 
(b)(1)(C) shall be reimbursed— 
‘‘(i) in the first year of the contract 
under this section, for each certified eligi-
ble WTC community member in a medical 
treatment program enrolled at a non-hos-
pital-based facility, $600, and for each cer-
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tified eligible WTC community member in 
a medical treatment program enrolled at a 
hospital-based facility, $300; and 
‘‘(ii) in each subsequent contract year, 
subject to paragraph (3), at the rates spec-
ified in this subparagraph for the previous 
contract year adjusted by the WTC Pro-
gram Administrator to reflect the rate of 
medical care inflation during the previous 
contract year. 
‘‘(D) OTHER CLINICAL CENTERS.—A Clin-
ical Center of Excellence or other providers not 
described in a previous subparagraph shall be 
reimbursed at a rate set by the WTC Program 
Administrator. 
‘‘(E) REIMBURSEMENT RULES.—The reim-
bursement provided under subparagraphs (A), 
(B) and (C) shall be made for each certified eli-
gible WTC responder and for each WTC com-
munity member in the WTC program per year 
that the member receives such services, regard-
less of the volume or cost of services required. 
‘‘(2) COORDINATING
CENTERS
OF
EXCEL-
LENCE.—A Coordinating Centers of Excellence spec-
ified in section (a)(2) shall be reimbursed for the 
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provision of services set forth in this section at such 
levels as are established by the WTC Program Ad-
ministrator. 
‘‘(3) REVIEW OF RATES.— 
‘‘(A) INITIAL REVIEW.—Before the end of 
the fifth contract year of the WTC program, 
the WTC Program Administrator shall conduct 
a review to determine whether the reimburse-
ment rates set forth in this subsection provide 
fair and appropriate reimbursement for such 
program services. Based on such review, the 
Administrator may, by rule beginning with the 
sixth contract year, may modify such rates, tak-
ing into account a reasonable and fair rate for 
the services being provided. 
‘‘(B) SUBSEQUENT
REVIEWS.—After the 
sixth contract year, the WTC Program Admin-
istrator shall conduct periodic reviews to deter-
mine whether the reimbursement rates in effect 
under this subsection provide fair and appro-
priate reimbursement for such program serv-
ices. Based upon such a review, the Adminis-
trator may by rule modify such rates, taking 
into account a reasonable and fair rate for the 
services being provided. 
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‘‘(C) GAO 
REVIEW.—The Comptroller 
General of the United States shall review the 
WTC Program Administrator’s determinations 
regarding fair and appropriate reimbursement 
for program services under this paragraph. 
‘‘(d) REQUIREMENTS.—The WTC Program Adminis-
trator shall not enter into a contract with a Clinical Center 
of Excellence under subsection (a)(1) unless— 
‘‘(1) the Center establishes a formal mechanism 
for consulting with and receiving input from rep-
resentatives of eligible populations receiving moni-
toring and treatment benefits under subtitle B from 
such Center; 
‘‘(2) the Center provides for the coordination of 
monitoring and treatment benefits under subtitle B 
with routine medical care provided for the treatment 
of conditions other than WTC-related health condi-
tions; 
‘‘(3) the Center collects and reports to the cor-
responding Coordinating Center of Excellence data 
in accordance with section 3005; 
‘‘(4) the Center has in place safeguards against 
fraud that are satisfactory to the Administrator; 
‘‘(5) the Center agrees to treat or refer for 
treatment all individuals who are eligible WTC re-
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sponders or eligible WTC community members with 
respect to such Center who present themselves for 
treatment of a WTC-related health condition; 
‘‘(6) the Center has in place safeguards to en-
sure the confidentiality of an individual’s individ-
ually identifiable health information, including re-
quiring that such information not be disclosed to the 
individual’s employer without the authorization of 
the individual; 
‘‘(7) the Center provides assurances that the 
amounts paid under subsection (c)(1) are used only 
for costs incurred in carrying out the activities de-
scribed in subsection (a), other than those described 
in subsection (a)(1)(A); and 
‘‘(8) the Center agrees to meet all the other ap-
plicable requirements of this title, including regula-
tions implementing such requirements. 
‘‘SEC. 3007. ENTITLEMENT AUTHORITIES. 
‘‘Subject to section 3012(c)(5), subtitle B constitutes 
budget authority in advance of appropriations Acts and 
represents the obligation of the Federal Government to 
provide for the payment for monitoring, screening, and 
treatment in accordance with such subtitle and section 
3006(c) constitutes such budget authority and represents 
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the obligation of the Federal Government to provide for 
the payment described in such section. 
‘‘SEC. 3008. DEFINITIONS. 
‘‘In this title: 
‘‘(1) The term ‘aggravating’ means, with re-
spect to a health condition, a health condition that 
existed on September 11, 2001, and that, as a result 
of exposure to airborne toxins, any other hazard, or 
any other adverse condition resulting from the Sep-
tember 11, 2001, terrorist attacks on the World 
Trade Center requires medical treatment that is (or 
will be) in addition to, more frequent than, or of 
longer duration than the medical treatment that 
would have been required for such condition in the 
absence of such exposure. 
‘‘(2) The terms ‘certified eligible WTC re-
sponder’ and ‘certified eligible WTC community 
member’ mean an individual who has been certified 
as an eligible WTC responder under section 
3011(a)(4) or an eligible WTC community member 
under section 3021(a)(4), respectively. 
‘‘(3) The terms ‘Clinical Center of Excellence’ 
and ‘Coordinating Center of Excellence’ have the 
meanings given such terms in section 3006(b). 
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‘‘(4) The term ‘current consortium arrange-
ments’ means the arrangements as in effect on the 
date of the enactment of this title between the Na-
tional Institute for Occupational Safety and Health 
and the Mt. Sinai-coordinated consortium and the 
Fire Department of the City of New York. 
‘‘(5) The terms ‘eligible WTC responder’ and 
‘eligible WTC community member’ are defined in 
sections 3011(a) and 3021(a), respectively. 
‘‘(6) The term ‘list of identified WTC-related 
health conditions’ means— 
‘‘(A) for eligible WTC responders, the 
identified WTC-related health condition for eli-
gible WTC responders under section 3012(a)(3) 
or 3012(a)(4); or 
‘‘(B) for eligible WTC community mem-
bers, the identified WTC-related health condi-
tion for WTC community members under sec-
tion 3022(b)(1) or 3022(b)(2). 
‘‘(7) The term ‘Mt.-Sinai-coordinated consor-
tium’ means the consortium coordinated by Mt. 
Sinai hospital in New York City that coordinates the 
monitoring and treatment under the current consor-
tium arrangements for eligible WTC responders 
other than with respect to those covered under the 
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arrangement with the Fire Department of the City 
of New York. 
‘‘(8) The term ‘New York City disaster area’ 
means the area within New York City that is— 
‘‘(A) the area of Manhattan that is south 
of Houston Street; and 
‘‘(B) any block in Brooklyn that is wholly 
or partially contained within a 1.5-mile radius 
of the former World Trade Center site. 
‘‘(9) The term ‘New York metropolitan area’ 
means an area, specified by the WTC Program Ad-
ministrator, within which eligible WTC responders 
and eligible WTC community members who reside in 
such area are reasonably able to access monitoring 
and treatment benefits and screening benefits under 
this title through a Clinical Centers of Excellence 
described in subparagraphs (A), (B), or (C) of sec-
tion 3006(b)(1). 
‘‘(10) Any reference to ‘September 11, 2001’ 
shall be deemed a reference to the period on such 
date subsequent to the terrorist attacks on the 
World Trade Center on such date. 
‘‘(11) The term ‘September 11, 2001, terrorist 
attacks on the World Trade Center’ means the ter-
rorist attacks that occurred on September 11, 2001, 
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in New York City and includes the aftermath of 
such attacks. 
‘‘(12) The term ‘WTC Health Program Steer-
ing Committee’ means such a Steering Committee 
established under section 3003. 
‘‘(13) The term ‘WTC Program Administrator’ 
means the individual responsible under section 
3001(f) for the administration of the WTC program. 
‘‘(14) The term ‘WTC-related health condition’ 
is defined in section 3012(a). 
‘‘(15) The term ‘WTC Scientific/Technical Ad-
visory Committee’ means such Committee estab-
lished under section 3002. 
‘‘Subtitle 
B—Program 
of 
Moni-
toring, Screening, and Treat-
ment 
‘‘PART 1—FOR WTC RESPONDERS 
‘‘SEC. 3011. IDENTIFICATION OF ELIGIBLE WTC RESPOND-
ERS AND PROVISION OF WTC-RELATED MONI-
TORING SERVICES. 
‘‘(a) ELIGIBLE WTC RESPONDER DEFINED.— 
‘‘(1) IN GENERAL.—For purposes of this title, 
the term ‘eligible WTC responder’ means any of the 
following individuals, subject to paragraph (5): 
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‘‘(A) 
CURRENTLY
IDENTIFIED
RE-
SPONDER.—An individual who has been identi-
fied as eligible for medical monitoring under the 
current consortium arrangements (as defined in 
section 3008(4)). 
‘‘(B) RESPONDER WHO MEETS CURRENT 
ELIGIBILITY
CRITERIA.—An individual who 
meets the current eligibility criteria described in 
paragraph (2). 
‘‘(C) RESPONDER WHO MEETS MODIFIED 
ELIGIBILITY CRITERIA.—An individual who— 
‘‘(i) performed rescue, recovery, demo-
lition, debris cleanup, or other related serv-
ices in the New York City disaster area in 
response to the September 11, 2001, ter-
rorist attacks on the World Trade Center, 
regardless of whether such services were 
performed by a State or Federal employee 
or member of the National Guard or other-
wise; and 
‘‘(ii) meets such eligibility criteria re-
lating to exposure to airborne toxins, other 
hazards, or adverse conditions resulting 
from the September 11, 2001, terrorist at-
tacks on the World Trade Center as the 
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WTC Program Administrator, after con-
sultation with the WTC Responders Steer-
ing Committee and the WTC Scientific/ 
Technical Advisory Committee, determines 
appropriate. 
The WTC Program Administrator shall not 
modify such eligibility criteria on or after the 
date that the number of certifications for eligi-
ble responders has reached 80 percent of the 
limit described in paragraph (5) or on or after 
the date that the number of certifications for el-
igible community members has reached 80 per-
cent 
of 
the 
limit 
described 
in 
section 
3021(a)(5). 
‘‘(2) CURRENT
ELIGIBILITY
CRITERIA.—The 
eligibility criteria described in this paragraph for an 
individual is that the individual is described in either 
of the following categories: 
‘‘(A) FIRE FIGHTERS AND RELATED PER-
SONNEL.—The individual— 
‘‘(i) was a member of the Fire De-
partment of the City of New York (wheth-
er fire or emergency personnel, active or 
retired) who participated at least one day 
in the rescue and recovery effort at any of 
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the former World Trade sites (including 
Ground Zero, Staten Island land fill, and 
the NYC Chief Medical Examiner’s office) 
for any time during the period beginning 
on September 11, 2001, and ending on 
July 31, 2002; or 
‘‘(ii)(I) is a surviving immediate fam-
ily member of an individual who was a 
member of the Fire Department of the 
City of New York (whether fire or emer-
gency personnel, active or retired) and was 
killed at the World Trade site on Sep-
tember 11, 2001; and 
‘‘(II) received any treatment for a 
WTC-related mental health condition de-
scribed in section 3012(a)(1)(B) on or be-
fore September 1, 2008. 
‘‘(B) LAW ENFORCEMENT OFFICERS AND 
WTC
RESCUE, 
RECOVERY, 
AND
CLEAN-UP 
WORKERS.—The individual— 
‘‘(i) worked or volunteered on-site in 
rescue, recovery, debris-cleanup or related 
support services in lower Manhattan (south 
of Canal St.), the Staten Island Landfill, 
or the barge loading piers, for at least 4 
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hours during the period beginning on Sep-
tember 11, 2001, and ending on Sep-
tember 14, 2001, for at least 24 hours 
during the period beginning on September 
11, 2001, and ending on September 30, 
2001, or for at least 80 hours during the 
period beginning on September 11, 2001, 
and ending on July 31, 2002; 
‘‘(ii)(I) was a member of the Police 
Department of the City of New York 
(whether active or retired) or a member of 
the Port Authority Police of the Port Au-
thority of New York and New Jersey 
(whether active or retired) who partici-
pated on-site in rescue, recovery, debris 
clean-up, or related services in lower Man-
hattan (south of Canal St.), including 
Ground Zero, the Staten Island Landfill or 
the barge loading piers, for at least 4 
hours during the period beginning Sep-
tember 11, 2001, and ending on Sep-
tember 14, 2001; 
‘‘(II) participated on-site in rescue, 
recovery, debris clean-up, or related serv-
ices in at Ground Zero, the Staten Island 
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Landfill or the barge loading piers, for at 
least one day during the period beginning 
on September 11, 2001, and ending on 
July 31, 2002; 
‘‘(III) participated on-site in rescue, 
recovery, debris clean-up, or related serv-
ices in lower Manhattan (south of Canal 
St.) for at least 24 hours during the period 
beginning on September 11, 2001, and 
ending on September 30, 2001; 
‘‘(IV) participated on-site in rescue, 
recovery, debris clean-up, or related serv-
ices in lower Manhattan (south of Canal 
St.) for at least 80 hours during the period 
beginning on September 11, 2001, and 
ending on July 31, 2002; 
‘‘(iii) was an employee of the Office of 
the Chief Medical Examiner of the City of 
New York involved in the examination and 
handling of human remains from the 
World Trade Center attacks, or other 
morgue worker who performed similar 
post-September 11 functions for such Of-
fice staff, during the period beginning on 
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September 11, 2001 and ending on July 
31, 2002; 
‘‘(iv) was a worker in the Port Au-
thority Trans-Hudson Corporation tunnel 
for at least 24 hours during the period be-
ginning on February 1, 2002, and ending 
on July 1, 2002; or 
‘‘(v) was a vehicle-maintenance worker 
who was exposed to debris from the former 
World Trade Center while retrieving, driv-
ing, cleaning, repairing, and maintaining 
vehicles contaminated by airborne toxins 
from the September 11, 2001, terrorist at-
tacks on the World Trade Center during a 
duration and period described in subpara-
graph (A). 
‘‘(3) APPLICATION PROCESS.—The WTC Pro-
gram Administrator in consultation with the Coordi-
nating Centers of Excellence shall establish a proc-
ess for individuals, other than eligible WTC respond-
ers described in paragraph (1)(A), to apply to be de-
termined to be eligible WTC responders. Under such 
process— 
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‘‘(A) there shall be no fee charged to the 
applicant for making an application for such 
determination; 
‘‘(B) the Administrator shall make a deter-
mination on such an application not later than 
60 days after the date of filing the application; 
and 
‘‘(C) an individual who is determined not 
to be an eligible WTC responder shall have an 
opportunity to appeal such determination before 
an administrative law judge in a manner estab-
lished under such process. 
‘‘(4) CERTIFICATION.— 
‘‘(A) IN GENERAL.—In the case of an indi-
vidual who is described in paragraph (1)(A) or 
who is determined under paragraph (3) (con-
sistent with paragraph (5)) to be an eligible 
WTC responder, the WTC Program Adminis-
trator shall provide an appropriate certification 
of such fact and of eligibility for monitoring 
and treatment benefits under this part. The Ad-
ministrator shall make determinations of eligi-
bility relating to an applicant’s compliance with 
this title, including the verification of informa-
tion submitted in support of the application, 
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‘‘(5) NUMERICAL
LIMITATION
ON
ELIGIBLE 
WTC RESPONDERS.— 
‘‘(A) IN GENERAL.—The total number of 
individuals not described in subparagraph (C) 
who may qualify as eligible WTC responders for 
purposes of this title, and be certified as eligible 
WTC responders under paragraph (4), shall not 
exceed 15,000, subject to adjustment under 
paragraph (6), of which no more than 2,500 
may be individuals certified based on modified 
eligibility criteria established under paragraph 
(1)(C). In applying the previous sentence, any 
individual who at any time so qualifies as an el-
igible WTC responder shall be counted against 
such numerical limitation. 
‘‘(B) PROCESS.—In implementing subpara-
graph (A), the WTC Program Administrator 
shall— 
‘‘(i) limit the number of certifications 
provided under paragraph (4) in accord-
ance with such subparagraph; and 
‘‘(ii) provide priority in such certifi-
cations in the order in which individuals 
apply for a determination under paragraph 
(3). 
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‘‘(C) CURRENTLY
IDENTIFIED
RESPOND-
ERS NOT COUNTED.—Individuals described in 
this subparagraph are individuals who are de-
scribed in paragraph (1)(A). 
‘‘(6) POTENTIAL ADJUSTMENT IN NUMERICAL 
LIMITATIONS DEPENDENT UPON ACTUAL SPENDING 
RELATIVE TO ESTIMATED SPENDING.— 
‘‘(A) INITIAL
CALCULATION
FOR
FISCAL 
YEARS 2009 THROUGH 2011.—If the WTC Pro-
gram Administrator determines as of December 
1, 2011, that the WTC expenditure-to-CBO-es-
timate percentage (as defined in subparagraph 
(D)(iii)) for fiscal years 2009 through 2011 
does not exceed 90 percent, then, effective Jan-
uary 1, 2012, the WTC Program Administrator 
may increase the numerical limitation under 
paragraph (5)(A), the numerical limitation 
under section 3021(a)(5), or both, by a number 
of percentage points not to exceed the number 
of percentage points specified in subparagraph 
(C) for such period of fiscal years. 
‘‘(B) SUBSEQUENT CALCULATION FOR FIS-
CAL YEARS 2009 THROUGH 2015.—If the Sec-
retary determines as of December 1, 2015, that 
the WTC expenditure-to-CBO-estimate percent-
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ages for fiscal years 2009 through 2015 and for 
fiscal years 2012 through 2015 do not exceed 
90 percent, then, effective January 1, 2015, the 
WTC Program Administrator may increase the 
numerical limitation under paragraph (5)(A), 
the 
numerical 
limitation 
under 
section 
3021(a)(5), or both, as in effect after the appli-
cation of subparagraph (A), by a number of 
percentage points not to exceed twice the lesser 
of— 
‘‘(i) the number of percentage points 
specified in subparagraph (C) for fiscal 
years 2009 through 2012, or 
‘‘(ii) the number of percentage points 
specified in subparagraph (C) for fiscal 
years 2012 through 2015. 
‘‘(C) MAXIMUM PERCENTAGE INCREASE IN 
NUMERICAL LIMITATIONS FOR PERIOD OF FIS-
CAL YEARS.—The number of percentage points 
specified in this clause for a period of fiscal 
years is— 
‘‘(i) 100 percentage points, multiplied 
by 
‘‘(ii) one minus a fraction the numer-
ator of which is the net Federal WTC 
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spending for such period, and the denomi-
nator of which is the CBO WTC spending 
estimate for such period. 
‘‘(D) DEFINITIONS.—For purposes of this 
paragraph: 
‘‘(i) NET FEDERAL SPENDING.—The 
term ‘net Federal WTC spending’ means, 
with respect to a period of fiscal years, the 
net Federal spending under this title for 
such fiscal years. 
‘‘(ii) CBO 
WTC
SPENDING
ESTI-
MATE.—The term ‘CBO WTC spending es-
timate’ means, with respect to— 
‘‘(I) fiscal years 2009 through 
2011, $900,000,000; 
‘‘(II) fiscal years 2012 through 
2015, $1,890,000,000; and 
‘‘(III) fiscal years 2009 through 
2015, the sum of the amounts speci-
fied in subclauses (I) and (II). 
‘‘(iii) WTC EXPENDITURE-TO-CBO-ES-
TIMATE
PERCENTAGE.—The term ‘WTC 
expenditure-to-estimate percentage’ means, 
with respect to a period of fiscal years, the 
ratio (expressed as a percentage) of— 
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‘‘(I) the net Federal WTC spend-
ing for such period, to 
‘‘(II) the CBO WTC spending es-
timate for such period. 
‘‘(b) MONITORING BENEFITS.— 
‘‘(1) IN GENERAL.—In the case of an eligible 
WTC responder under section 3011(a)(4) (other 
than one described in subsection (a)(2)(A)(ii)), the 
WTC program shall provide for monitoring benefits 
that include medical monitoring consistent with pro-
tocols approved by the WTC Program Administrator 
and including clinical examinations and long-term 
health monitoring and analysis. In the case of an eli-
gible WTC responder who is an active member of 
the Fire Department of the City of New York, the 
responder shall receive such benefits as part of the 
individual’s periodic company medical exams. 
‘‘(2) PROVISION OF MONITORING BENEFITS.— 
The monitoring benefits under paragraph (1) shall 
be provided through the Clinical Center of Excel-
lence for the type of individual involved or, in the 
case of an individual residing outside the New York 
metropolitan area, under an arrangement under sec-
tion 3031. 
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‘‘SEC. 3012. TREATMENT OF CERTIFIED ELIGIBLE WTC RE-
SPONDERS FOR WTC-RELATED HEALTH CON-
DITIONS. 
‘‘(a) WTC–RELATED
HEALTH
CONDITION
DE-
FINED.— 
‘‘(1) IN GENERAL.—For purposes of this title, 
the term ‘WTC-related health condition’ means— 
‘‘(A) an illness or health condition for 
which exposure to airborne toxins, any other 
hazard, or any other adverse condition resulting 
from the September 11, 2001, terrorist attacks 
on the World Trade Center, based on an exam-
ination by a medical professional with experi-
ence in treating or diagnosing the medical con-
ditions included in the applicable list of identi-
fied WTC-related conditions, is substantially 
likely to be a significant factor in aggravating, 
contributing to, or causing the illness or health 
condition, as determined under paragraph (2); 
or 
‘‘(B) a mental health condition for which 
such attacks, based on an examination by a 
medical professional with experience in treating 
or diagnosing the medical conditions included in 
the applicable list of identified WTC-related 
conditions, is substantially likely be a signifi-
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cant factor in aggravating, contributing to, or 
causing the condition, as determined under 
paragraph (2). 
In the case of an eligible WTC responder described 
in section 3011(a)(2)(A)(ii), such term only includes 
the mental health condition described in subpara-
graph (B). 
‘‘(2) DETERMINATION.—The determination of 
whether the September 11, 2001, terrorist attacks 
on the World Trade Center were substantially likely 
to be a significant factor in aggravating, contrib-
uting to, or causing an individual’s illness or health 
condition shall be made based on an assessment of 
the following: 
‘‘(A) The individual’s exposure to airborne 
toxins, any other hazard, or any other adverse 
condition resulting from the terrorist attacks. 
Such exposure shall be— 
‘‘(i) 
evaluated 
and 
characterized 
through the use of a standardized, popu-
lation appropriate questionnaire approved 
by the Director of the National Institute 
for Occupational Safety and Health; and 
‘‘(ii) assessed and documented by a 
medical professional with experience in 
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treating or diagnosing medical conditions 
included on the list of identified WTC-re-
lated conditions. 
‘‘(B) The type of symptoms and temporal 
sequence of symptoms. Such symptoms shall 
be— 
‘‘(i) assessed through the use of a 
standardized, population appropriate med-
ical questionnaire approved by Director of 
the National Institute for Occupational 
Safety and Health and a medical examina-
tion; and 
‘‘(ii) diagnosed and documented by a 
medical professional described in subpara-
graph (A)(ii). 
‘‘(3) 
LIST
OF
IDENTIFIED
WTC-RELATED 
HEALTH CONDITIONS FOR CERTIFIED ELIGIBLE WTC 
RESPONDERS.—For purposes of this title, the term 
‘identified WTC-related health condition for eligible 
WTC responders’ means any of the following health 
conditions: 
‘‘(A) AERODIGESTIVE DISORDERS.— 
‘‘(i) Interstitial lung diseases. 
‘‘(ii) Chronic respiratory disorder- 
fumes/vapors. 
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‘‘(iii) Asthma. 
‘‘(iv) Reactive airways dysfunction 
syndrome (RADS). 
‘‘(v) WTC-exacerbated chronic ob-
structive pulmonary disease (COPD). 
‘‘(vi) Chronic cough syndrome. 
‘‘(vii) Upper airway hyperreactivity. 
‘‘(viii) Chronic rhinosinusitis. 
‘‘(ix) Chronic nasopharyngitis. 
‘‘(x) Chronic laryngitis. 
‘‘(xi) Gastro-esophageal reflux dis-
order (GERD). 
‘‘(xii) Sleep apnea exacerbated by or 
related to a condition described in a pre-
vious clause. 
‘‘(B) MENTAL HEALTH CONDITIONS.— 
‘‘(i) Post traumatic stress disorder 
(PTSD). 
‘‘(ii) Major depressive disorder. 
‘‘(iii) Panic disorder. 
‘‘(iv) Generalized anxiety disorder. 
‘‘(v) Anxiety disorder (not otherwise 
specified). 
‘‘(vi) Depression (not otherwise speci-
fied). 
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‘‘(vii) Acute stress disorder. 
‘‘(viii) Dysthymic disorder. 
‘‘(ix) Adjustment disorder. 
‘‘(x) Substance abuse. 
‘‘(xi) V codes (treatments not specifi-
cally related to psychiatric disorders, such 
as marital problems, parenting problems 
etc.), secondary to another identified 
WTC-related health condition for WTC eli-
gible responders. 
‘‘(C) MUSCULOSKELETAL DISORDERS.— 
‘‘(i) Low back pain. 
‘‘(ii) Carpal tunnel syndrome (CTS). 
‘‘(iii) Other musculoskeletal disorders. 
‘‘(4) APPLICATION FOR RECOMMENDATION TO 
CONGRESS
OF
ADDITIONAL
IDENTIFIED
WTC-RE-
LATED HEALTH CONDITIONS FOR ELIGIBLE WTC RE-
SPONDERS.— 
‘‘(A) APPLICATION.—Any individual or or-
ganization can apply to the WTC Program Ad-
ministrator for an illness or health condition 
not described in paragraph (3) to be added to 
the list of identified WTC-related conditions for 
eligible WTC responders. 
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‘‘(B) REVIEW.—The WTC Program Ad-
ministrator shall establish a public process for 
receiving public input and comments on any ap-
plication under subparagraph (A). 
‘‘(C) CONSIDERATIONS.—In making deter-
minations on such applications, the WTC Pro-
gram Administrator shall take into account the 
findings and recommendations of Clinical Cen-
ters of Excellence published in peer reviewed 
journals in the determination of whether an ad-
ditional illness or health condition, such as can-
cer, should be added to the list of identified 
WTC-related health conditions for eligible WTC 
responders. 
‘‘(D) CONSULTATION.—The WTC Pro-
gram Administrator shall consult with the WTC 
Responders Steering Committee and the WTC 
Scientific/Technical 
Advisory 
Committee 
in 
making a determination on whether an addi-
tional health condition should be added to the 
list of identified WTC-related conditions for eli-
gible WTC responders. 
‘‘(E) RECOMMENDATION TO CONGRESS.— 
The WTC Program Administrator shall rec-
ommend to Congress the addition of an illness 
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or health condition to the list of identified 
WTC-related health conditions for eligible WTC 
responders if, based on a review of the evidence 
and consultations conducted under subpara-
graphs (B), (C), and (D), the Administrator de-
termines that exposure to airborne toxins, other 
hazards, or other adverse conditions resulting 
from the September 11, 2001, terrorist attacks 
on the World Trade Center is substantially like-
ly to be a significant factor in aggravating, con-
tributing to, or causing the illness or health 
condition. 
‘‘(b) COVERAGE OF TREATMENT FOR WTC-RELATED 
HEALTH CONDITIONS.— 
‘‘(1) DETERMINATION BASED ON AN IDENTI-
FIED WTC-RELATED HEALTH CONDITION FOR CER-
TIFIED ELIGIBLE WTC RESPONDERS.— 
‘‘(A) IN GENERAL.—If a physician at a 
Clinical Center of Excellence that is providing 
monitoring benefits under section 3011 for a 
certified eligible WTC responder determines 
that the responder has an identified WTC-re-
lated health condition, and the physician makes 
a clinical determination that exposure to air-
borne toxins, other hazards, or adverse condi-
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tions resulting from the 9/11 terrorist attacks is 
substantially likely to be a significant factor in 
aggravating, contributing to, or causing the 
condition— 
‘‘(i) the physician shall promptly 
transmit such determination to the WTC 
Program Administrator and provide the 
Administrator with the medical facts sup-
porting such determination; and 
‘‘(ii) on and after the date of such 
transmittal and subject to subparagraph 
(B), the WTC program shall provide for 
payment under subsection (c) for medically 
necessary treatment for such condition. 
‘‘(B) 
REVIEW; 
CERTIFICATION; 
AP-
PEALS.— 
‘‘(i) REVIEW.—A Federal employee 
designated by the WTC Program Adminis-
trator shall review determinations made 
under subparagraph (A) of a WTC-related 
health condition. 
‘‘(ii) CERTIFICATION.—The Adminis-
trator shall provide a certification of such 
condition based upon reviews conducted 
under clause (i). Such a certification shall 
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be provided unless the Administrator de-
termines that the responder’s condition is 
not an identified WTC-related health con-
dition or that exposure to airborne toxins, 
other hazards, or adverse conditions result-
ing from the 9/11 terrorist attacks is not 
substantially likely to be a significant fac-
tor in significantly aggravating, contrib-
uting to, or causing the condition. 
‘‘(iii) APPEAL PROCESS.—The Admin-
istrator shall provide a process for the ap-
peal of determinations under clause (ii) be-
fore an administrative law judge. 
‘‘(2) DETERMINATION BASED ON OTHER WTC- 
RELATED HEALTH CONDITION.— 
‘‘(A) IN GENERAL.—If a physician at a 
Clinical Center of Excellence determines pursu-
ant to subsection (a) that the certified eligible 
WTC responder has a WTC-related health con-
dition that is not an identified WTC-related 
health condition for eligible WTC responders— 
‘‘(i) the physician shall promptly 
transmit such determination to the WTC 
Program Administrator and provide the 
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Administrator with the facts supporting 
such determination; and 
‘‘(ii) on and after the date of such 
transmittal and pending a determination 
by the Administrator under subparagraph 
(B), and subject to paragraph (6), the 
WTC program shall provide for payment 
under subsection (c) for medically nec-
essary treatment for such condition. 
‘‘(B) REVIEW; CERTIFICATION.— 
‘‘(i) USE OF PHYSICIAN PANEL.—The 
WTC Program Administrator shall provide 
for the review of each determination made 
under subparagraph (A)(i) of a WTC-re-
lated health condition to be made by a 
physician panel with appropriate expertise 
appointed by the WTC Program Adminis-
trator. Such a panel shall make rec-
ommendations to the Administrator on the 
evidence supporting such determination. 
‘‘(ii) REVIEW OF RECOMMENDATIONS 
OF PANEL; CERTIFICATION.—The Adminis-
trator, based on such recommendations 
shall determine whether or not the condi-
tion is a WTC-related health condition 
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and, if it is, provide for a certification 
under paragraph (1)(B)(ii) of coverage of 
such condition. The Administrator shall 
provide a process for the appeal of deter-
minations that the responder’s condition is 
not a WTC-related health condition before 
an administrative law judge. 
‘‘(3) REQUIREMENT OF MEDICAL NECESSITY.— 
‘‘(A) IN
GENERAL.—In providing treat-
ment for a WTC-health condition, a physician 
shall provide treatment that is medically nec-
essary and in accordance with medical protocols 
established under subsection (d). 
‘‘(B) 
MEDICALLY
NECESSARY
STAND-
ARD.—For the purpose of this title, health care 
services shall be treated as medically necessary 
for an individual if a physician, exercising pru-
dent clinical judgment, would consider the serv-
ices to be medically necessary for the individual 
for the purpose of evaluating, diagnosing, or 
treating an illness, injury, disease or its symp-
toms, and that are— 
‘‘(i) in accordance with the generally 
accepted standards of medical practice; 
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‘‘(ii) clinically appropriate, in terms of 
type, frequency, extent, site, and duration, 
and considered effective for the individual’s 
illness, injury, or disease; and 
‘‘(iii) not primarily for the conven-
ience of the patient or physician, or an-
other physician, and not more costly than 
an alternative service or sequence of serv-
ices at least as likely to produce equivalent 
therapeutic or diagnostic results as to the 
diagnosis or treatment of the individual’s 
illness, injury, or disease. 
‘‘(C) DETERMINATION
OF
MEDICAL
NE-
CESSITY.— 
‘‘(i) REVIEW
OF
MEDICAL
NECES-
SITY.—As part of the reimbursement pay-
ment process under subsection (c), the 
WTC Program Administrator shall review 
claims for reimbursement for the provision 
of medical treatment to determine if such 
treatment is medically necessary. 
‘‘(ii) WITHHOLDING OF PAYMENT FOR 
MEDICALLY UNNECESSARY TREATMENT.— 
The Administrator may withhold such pay-
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ment for treatment that the Administrator 
determines is not medically necessary. 
‘‘(iii) REVIEW
OF
DETERMINATIONS 
OF
MEDICAL
NECESSITY.—The Adminis-
trator shall provide a process for providers 
to appeal a determination under clause (ii) 
that medical treatment is not medically 
necessary. Such appeals shall be reviewed 
through the use of a physician panel with 
appropriate expertise. 
‘‘(4) SCOPE OF TREATMENT COVERED.— 
‘‘(A) IN
GENERAL.—The scope of treat-
ment covered under such paragraphs includes 
services of physicians and other health care pro-
viders, diagnostic and laboratory tests, prescrip-
tion drugs, inpatient and outpatient hospital 
services, and other medically necessary treat-
ment. 
‘‘(B) PHARMACEUTICAL COVERAGE.—With 
respect to ensuring coverage of medically nec-
essary outpatient prescription drugs, such drugs 
shall be provided, under arrangements made by 
the WTC Program Administrator, directly 
through participating Clinical Centers of Excel-
lence or through one or more outside vendors. 
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‘‘(5) PROVISION OF TREATMENT PENDING CER-
TIFICATION.—In the case of a certified eligible WTC 
responder who has been determined by an examining 
physician under subsection (b)(1) to have an identi-
fied WTC-related health condition, but for whom a 
certification of the determination has not yet been 
made by the WTC Program Administrator, medical 
treatment may be provided under this subsection, 
subject to paragraph (6), until the Administrator 
makes a decision on such certification. Medical 
treatment provided under this paragraph shall be 
considered to be medical treatment for which pay-
ment may be made under subsection (c). 
‘‘(6) PRIOR APPROVAL PROCESS FOR NON-CER-
TIFIED
NON-EMERGENCY
INPATIENT
HOSPITAL 
SERVICES.—Non-emergency inpatient hospital serv-
ices for a WTC-related health condition identified by 
an examining physician under paragraph (b)(1) that 
is not certified under paragraph (1)(B)(ii) is not 
covered unless the services have been determined to 
be medically necessary and approved through a proc-
ess established by the WTC Program Administrator. 
Such process shall provide for a decision on a re-
quest for such services within 15 days of the date 
of receipt of the request. The WTC Administrator 
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shall provide a process for the appeal of a decision 
that the services are not medically necessary. 
‘‘(c) PAYMENT FOR MEDICAL MONITORING, SCREEN-
ING, AND TREATMENT OF WTC-RELATED HEALTH CON-
DITIONS.— 
‘‘(1) MEDICAL TREATMENT.— 
‘‘(A) USE
OF
FECA
PAYMENT
RATES.— 
Subject to subparagraph (B), the WTC Pro-
gram Administrator shall reimburse costs for 
medically necessary treatment under this title 
for WTC-related health conditions according to 
the payment rates that would apply to the pro-
vision of such treatment and services by the fa-
cility under the Federal Employees Compensa-
tion Act. 
‘‘(B) PHARMACEUTICALS.— 
‘‘(i) IN
GENERAL.—The WTC Pro-
gram Administrator shall establish a pro-
gram for paying for the medically nec-
essary outpatient prescription pharma-
ceuticals prescribed under this title for 
WTC-related conditions through one or 
more contracts with outside vendors. 
‘‘(ii) COMPETITIVE BIDDING.—Under 
such program the Administrator shall— 
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‘‘(I) select one or more appro-
priate vendors through a Federal com-
petitive bid process; and 
‘‘(II) select the lowest bidder (or 
bidders) meeting the requirements for 
providing pharmaceutical benefits for 
participants in the WTC program. 
‘‘(iii) TREATMENT OF FDNY PARTICI-
PANTS.—Under such program the Admin-
istrator may enter select a separate vendor 
to provide pharmaceutical benefits to cer-
tified eligible WTC responders for whom 
the Clinical Center of Excellence is de-
scribed in section 3006(b)(1)(A) if such an 
arrangement is deemed necessary and ben-
eficial to the program by the WTC Pro-
gram Administrator. 
‘‘(C) OTHER TREATMENT.—For treatment 
not covered under a preceding subparagraph, 
the WTC Program Administrator shall des-
ignate a reimbursement rate for each such serv-
ice. 
‘‘(2) MEDICAL MONITORING AND SCREENING.— 
The WTC Program Administrator shall reimburse 
the costs of medical monitoring and the costs of 
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screening provided under this title at a rate set by 
the Administrator. 
‘‘(3) ADMINISTRATIVE ARRANGEMENT AUTHOR-
ITY.—The WTC Program Administrator 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) PARTICIPATION
BY
NEW
YORK
CITY
IN 
MONITORING
AND
TREATMENT
PROGRAM
AND 
COSTS.— 
‘‘(A) IN
GENERAL.—In order for New 
York City, any agency or Department thereof, 
or the New York City Health and Hospitals 
Corporation to qualify for a contract for the 
provision of monitoring and treatment benefits 
and other services under section 3006, New 
York City is required to contribute a matching 
amount of 10 percent of the amount of the cov-
ered monitoring and treatment payment (as de-
fined in subparagraph (B)). Such matching 
amount shall be reduced by any payment made 
by New York City, its agencies or departments 
under a workers’ compensation plan or other 
work-related injury of illness benefit plan for 
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covered treatment benefits as provided for in 
section 3001(d)(2). 
‘‘(B) COVERED MONITORING AND TREAT-
MENT PAYMENT DEFINED.—For the purposes 
of this paragraph, the term ‘covered monitoring 
and treatment payment’ means payment under 
paragraphs (1) and (2), including under such 
paragraph as applied under section 3021(b), 
3022(a), and 3023, and reimbursement under 
3006(c) for items and services furnished by a 
Clinical Center of Excellence or Coordinating 
Center of Excellence, and providers designated 
by the WTC Program under Section 3031, 
after the application of paragraphs (2) and (3) 
of section 3001 (d). 
‘‘(C) PAYMENT OF NEW YORK CITY SHARE 
OF MONITORING AND TREATMENT COSTS.—The 
WTC Program Administrator shall bill the 
amount specified in subparagraph (A) directly 
to New York City. 
‘‘(D) ENFORCEMENT OF NEW YORK CITY 
SHARE
OF
MONITORING
AND
TREATMENT 
COSTS.—To the extent that New York City fails 
to pay its share of the monitoring and treat-
ment costs on a timely basis, the Administrator 
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shall reduce the reimbursement for all screen-
ing, monitoring, treatment, and administration 
in a proportional amount, that when applied 
will make up for the shortfall in payment by 
New York City. 
‘‘(5) CLAIMS PROCESSING SUBJECT TO APPRO-
PRIATIONS.—The payment by the WTC Program 
Administrator for the processing of claims under 
this title is limited to the amounts provided in ad-
vance in appropriations Acts. 
‘‘(d) MEDICAL TREATMENT PROTOCOLS.— 
‘‘(1) DEVELOPMENT.—The Coordinating Cen-
ters of Excellence shall develop medical treatment 
protocols for the treatment of certified eligible WTC 
responders and certified eligible WTC community 
members for identified WTC-related health condi-
tions. 
‘‘(2) APPROVAL.—The WTC Program Adminis-
trator shall approve the medical treatment protocols, 
in consultation with the WTC Health Program 
Steering Committees. 
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‘‘PART 2—COMMUNITY PROGRAM 
‘‘SEC. 3021. IDENTIFICATION AND SCREENING OF ELIGIBLE 
WTC COMMUNITY MEMBERS. 
‘‘(a) ELIGIBLE WTC COMMUNITY MEMBER DE-
FINED.— 
‘‘(1) IN GENERAL.—In this title, the term ‘eligi-
ble WTC community member’ means, subject to 
paragraph (3), an individual who is not an eligible 
WTC responder and is described in any of the fol-
lowing subparagraphs: 
‘‘(A) A person who was present in the New 
York City disaster area in the dust or dust 
cloud on September 11, 2001. 
‘‘(B) A person who worked, resided or at-
tended school, child care or adult day care in 
the New York City disaster area for— 
‘‘(i) at least four days during the 4- 
month period beginning on September 11, 
2001, and ending on January 10, 2002; or 
‘‘(ii) at least 30 days during the pe-
riod beginning on September 11, 2001, 
and ending on July 31, 2002. 
‘‘(C) Any person who worked as a clean-up 
worker or performed maintenance work in the 
New York City disaster area during the 4- 
month period described in subparagraph (B)(i) 
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and had extensive exposure to WTC dust as a 
result of such work. 
‘‘(D) A person who was deemed eligible to 
receive a grant from the Lower Manhattan De-
velopment Corporation Residential Grant Pro-
gram, who possessed a lease for a residence or 
purchased a residence in the New York City 
disaster area, and who resided in such residence 
during the period beginning on September 11, 
2001, and ending on May 31, 2003. 
‘‘(E) A person whose place of employ-
ment— 
‘‘(i) at any time during the period be-
ginning on September 11, 2001, and end-
ing on May 31, 2003, was in the New 
York City disaster area; and 
‘‘(ii) was deemed eligible to receive a 
grant from the Lower Manhattan Develop-
ment Corporation WTC Small Firms At-
traction and Retention Act program or 
other government incentive program de-
signed to revitalize the Lower Manhattan 
economy after the September 11, 2001, 
terrorist attacks on the World Trade Cen-
ter. 
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‘‘(F) A person who was receiving treat-
ment as of the date of the enactment of this 
title at the World Trade Center Environmental 
Health Center operated by the New York City 
Health and Hospitals Corporation. 
‘‘(2) ELIGIBILITY
CRITERIA.—In establishing 
eligibility criteria for purposes of subparagraphs (A) 
through (F) of paragraph (1) and for purposes of 
section 3011(a)(1)(C)(ii), the WTC Program Admin-
istrator shall— 
‘‘(A) take into account the period, and, to 
the extent feasible, intensity, of exposure to air-
borne toxins, other hazard, or other adverse 
condition; 
‘‘(B) base such criteria on best available 
evidence of exposure and related adverse health 
effects; and 
‘‘(C) consult with the WTC Community 
Program Steering Committee, Coordinating 
Centers of Excellence described in section 
3006(b)(1)(C), and affected populations. 
The Administrator shall first establish such criteria 
not later than 90 days after the date of the enact-
ment of this title. The Administrator shall not mod-
ify such criteria on or after the date that the num-
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ber of certifications for eligible community members 
has reached 80 percent of the limit described in 
paragraph (5) or on or after the date that the num-
ber of certifications for eligible responders has 
reached 80 percent of the limit described in section 
3021(a)(5). 
‘‘(3) APPLICATION PROCESS.—The WTC Pro-
gram Administrator in consultation with the Coordi-
nating Centers of Excellence shall establish a proc-
ess for individuals to be determined eligible WTC 
community member. Under such process— 
‘‘(A) there shall be no fee charged to the 
applicant for making an application for such 
determination; 
‘‘(B) the Administrator shall make a deter-
mination on such an application not later than 
60 days after the date of filing the application; 
and 
‘‘(C) an individual who is determined not 
to be an eligible WTC community member shall 
have an opportunity to appeal such determina-
tion before an administrative law judge in a 
manner established under such process. 
‘‘(4) CERTIFICATION.— 
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‘‘(A) IN GENERAL.—In the case of an indi-
vidual who is determined under paragraph (3) 
and consistent with paragraph (5) to be an eli-
gible WTC community member, the WTC Pro-
gram Administrator shall provide an appro-
priate certification of such fact and of eligibility 
for treatment benefits under this part. The Ad-
ministrator shall make determinations of eligi-
bility relating to an applicant’s compliance with 
this title, including the verification of informa-
tion submitted in support of the application and 
shall not deny such a certification to an indi-
vidual unless the Administrator determines 
that— 
‘‘(i) based on the application sub-
mitted, the individual does not meet the 
eligibility criteria; or 
‘‘(ii) the numerical limitation on eligi-
ble WTC community members set forth in 
paragraph (5) has been met. 
‘‘(B) TIMING.— 
‘‘(i) CURRENTLY IDENTIFIED COMMU-
NITY MEMBERS.—In the case of an indi-
vidual who is described in paragraph 
(1)(F), the WTC Program Administrator 
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shall provide the certification under sub-
paragraph (A) not later than 60 days after 
the date of the enactment of this title. 
‘‘(ii) OTHER MEMBERS.—In the case 
of another individual who is determined 
under paragraph (3) and consistent with 
paragraph (5) to be an eligible WTC com-
munity member, the WTC Program Ad-
ministrator shall provide the certification 
under subparagraph (A) at the time of 
such determination. 
‘‘(5) NUMERICAL
LIMITATION
ON
ELIGIBLE 
WTC COMMUNITY MEMBERS.— 
‘‘(A) IN GENERAL.—The total number of 
individuals not described in subparagraph (C) 
who may qualify as eligible WTC community 
members for purposes of this title, and be cer-
tified as eligible WTC community members 
under paragraph (4), shall not exceed 15,000. 
In applying the previous sentence, any indi-
vidual who at any time so qualifies as an eligi-
ble WTC community member shall be counted 
against such numerical limitation. 
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‘‘(B) PROCESS.—In implementing subpara-
graph (A), the WTC Program Administrator 
shall— 
‘‘(i) limit the number of certifications 
provided under paragraph (4) in accord-
ance with such subparagraph; and 
‘‘(ii) provide priority in such certifi-
cations in the order in which individuals 
apply for a determination under paragraph 
(3). 
‘‘(C) INDIVIDUALS CURRENTLY RECEIVING 
TREATMENT
NOT
COUNTED.—Individuals de-
scribed in this subparagraph are individuals 
who, before the date of the enactment of this 
title, have received treatment for an identified 
WTC-related condition for eligible WTC com-
munity members at the World Trade Center 
Environmental Health Center at Bellevue Hos-
pital Center, Gouverneur Health Care Services, 
or Elmhurst Hospital Center. 
‘‘(D) REPORT
TO
CONGRESS
IF
NUMER-
ICAL
LIMITATION
TO
BE
REACHED.—If the 
WTC Program Administrator determines that 
the number of individuals subject to the numer-
ical limitation of subparagraph (A) is likely to 
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exceed such numerical limitation, the Adminis-
trator shall submit to Congress a report on 
such determination. Such report shall include 
an estimate of the number of such individuals 
in excess of such numerical limitation and of 
the additional expenditures that would result 
under this title if such numerical limitation 
were removed. 
‘‘(b) SCREENING TO DETERMINE ELIGIBILITY FOR 
TREATMENT.— 
‘‘(1) IN GENERAL.—In the case of a certified el-
igible WTC community member, the WTC program 
shall provide for screening to determine if the mem-
ber has a WTC-related health condition and are eli-
gible for treatment under the WTC program. 
Screening protocols shall be approved by the WTC 
Program Administrator, in consultation with the 
World Trade Center Environmental Health Center 
at Bellevue Hospital and the WTC Community Pro-
gram Steering Committee. 
‘‘(2) SCREENING
PROVIDERS.—The screening 
described in paragraph (1) shall be provided through 
a Clinical Center of Excellence with respect to the 
individual involved. 
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‘‘(3) LIMITATION ON SCREENING BENEFITS.— 
Benefits for screening under this part for an eligible 
WTC community member shall consist only of a sin-
gle medical screening consistent with screening pro-
tocols described in paragraph (1). Nothing in this 
paragraph shall be construed as preventing such an 
individual from seeking additional medical screening 
at the expense of the individual. 
‘‘SEC. 3022. TREATMENT OF CERTIFIED ELIGIBLE WTC 
COMMUNITY MEMBERS FOR WTC-RELATED 
HEALTH CONDITIONS. 
‘‘(a) IN GENERAL.—Subject to subsection (b), the 
provisions of section 3012 shall apply to the treatment of 
WTC-related health conditions for certified eligible WTC 
community members in the same manner as such provi-
sions apply to the treatment of identified WTC-related 
health conditions for certified eligible WTC responders. 
‘‘(b) LIST OF IDENTIFIED WTC-RELATED HEALTH 
CONDITIONS FOR WTC COMMUNITY MEMBERS.— 
‘‘(1) IDENTIFIED WTC-RELATED HEALTH CON-
DITIONS FOR WTC COMMUNITY MEMBERS.—For pur-
poses of this title, the term ‘identified WTC-related 
health conditions for WTC community members’ 
means any of the following health conditions: 
‘‘(A) AERODIGESTIVE DISORDERS.— 
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‘‘(i) Interstitial lung diseases. 
‘‘(ii) Chronic respiratory disorder— 
fumes/vapors. 
‘‘(iii) Asthma. 
‘‘(iv) Reactive airways dysfunction 
syndrome (RADS). 
‘‘(v) WTC-exacerbated chronic ob-
structive pulmonary disease (COPD). 
‘‘(vi) Chronic cough syndrome. 
‘‘(vii) Upper airway hyperreactivity. 
‘‘(viii) Chronic rhinosinusitis. 
‘‘(ix) Chronic nasopharyngitis. 
‘‘(x) Chronic laryngitis. 
‘‘(xi) Gastro-esophageal reflux dis-
order (GERD). 
‘‘(xii) Sleep apnea exacerbated by or 
related to a condition described in a pre-
vious clause. 
‘‘(B) MENTAL HEALTH CONDITIONS.— 
‘‘(i) Post traumatic stress disorder 
(PTSD). 
‘‘(ii) Major depressive disorder. 
‘‘(iii) Panic disorder. 
‘‘(iv) Generalized anxiety disorder. 
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‘‘(v) Anxiety disorder (not otherwise 
specified). 
‘‘(vi) Depression (not otherwise speci-
fied). 
‘‘(vii) Acute stress disorder. 
‘‘(viii) Dysthymic disorder. 
‘‘(ix) Adjustment disorder. 
‘‘(x) Substance abuse. 
‘‘(xi) V codes (treatments not specifi-
cally related to psychiatric disorders, such 
as marital problems, parenting problems 
etc.), secondary to another identified 
WTC-related health condition for WTC 
community members. 
‘‘(2) APPLICATION FOR RECOMMENDATION TO 
CONGRESS
OF
ADDITIONAL
IDENTIFIED
WTC-RE-
LATED HEALTH CONDITIONS FOR WTC COMMUNITY 
MEMBERS.—The provisions of paragraph (4) of sec-
tion 3012(a) shall apply with respect to a rec-
ommendation to Congress of an addition to the list 
of identified WTC-related conditions for eligible 
WTC community members under paragraph (1) in 
the same manner as such provisions apply to a rec-
ommendation to Congress of the addition to the list 
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of identified WTC-related conditions for eligible 
WTC responders under section 3012(a)(3). 
‘‘SEC. 3023. TREATMENT OF OTHER INDIVIDUALS WITH 
WTC-RELATED HEALTH CONDITIONS. 
‘‘(a) IN GENERAL.—Subject to subsection (c), the 
provisions of section 3022 shall apply to the treatment of 
WTC-related health conditions for eligible WTC commu-
nity members in the case of individuals described in sub-
section (b) in the same manner as such provisions apply 
to the treatment of WTC-related health conditions for 
WTC community members. 
‘‘(b) INDIVIDUALS DESCRIBED.—An individual de-
scribed in this subsection is an individual who, regardless 
of location of residence— 
‘‘(1) is not a eligible WTC responder or an eli-
gible WTC community member; and 
‘‘(2) is diagnosed at a Clinical Center of Excel-
lence (with respect to an eligible WTC community 
member) with an identified WTC-related health con-
dition for WTC community members. 
‘‘(c) LIMITATION.— 
‘‘(1) IN GENERAL.—The WTC Program Admin-
istrator shall limit benefits for any fiscal year under 
subsection (a) in a manner so that payments under 
this section for such fiscal year do not exceed the 
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amount specified in paragraph (2) for such fiscal 
year. 
‘‘(2) LIMITATION.—The amount specified in 
this paragraph for— 
‘‘(A) fiscal year 2009 is $20,000,000; or 
‘‘(B) a succeeding fiscal year is the 
amount specified in this paragraph for the pre-
vious fiscal year increased by the annual per-
centage increase in the medical care component 
of the consumer price index for all urban con-
sumers. 
‘‘PART 3—NATIONAL ARRANGEMENT FOR BENE-
FITS FOR ELIGIBLE INDIVIDUALS OUTSIDE 
NEW YORK 
‘‘SEC. 3031. NATIONAL ARRANGEMENT FOR BENEFITS FOR 
ELIGIBLE INDIVIDUALS OUTSIDE NEW YORK. 
‘‘(a) IN GENERAL.—In order to ensure reasonable ac-
cess to benefits under this subtitle for individuals who are 
eligible WTC responders or eligible WTC community 
members and who reside in any State, as defined in sec-
tion 2(f), outside the New York metropolitan area, the 
WTC Program Administrator shall establish a nationwide 
network of health care providers to provide monitoring 
and treatment benefits and screening near such individ-
uals’ areas of residence in such States. Nothing in this 
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subsection shall be construed as preventing such individ-
uals from being provided such monitoring and treatment 
benefits or screening through a Clinical Center of Excel-
lence. 
‘‘(b) NETWORK REQUIREMENTS.—Any health care 
provider participating in the network under subsection (a) 
shall— 
‘‘(1) meet criteria for credentialing established 
by the Coordinating Centers of Excellence; 
‘‘(2) follow the monitoring, screening, and 
treatment 
protocols 
developed 
under 
section 
3006(a)(2)(B); 
‘‘(3) collect and report data in accordance with 
section 3005; and 
‘‘(4) meet such fraud, quality assurance, and 
other requirements as the WTC Program Adminis-
trator establishes. 
‘‘Subtitle C—Research Into 
Conditions 
‘‘SEC. 3041. RESEARCH REGARDING CERTAIN HEALTH CON-
DITIONS RELATED TO SEPTEMBER 11 TER-
RORIST ATTACKS IN NEW YORK CITY. 
‘‘(a) IN GENERAL.—With respect to individuals, in-
cluding eligible WTC responders and eligible WTC com-
munity members, receiving monitoring or treatment under 
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subtitle B, the WTC Program Administrator shall conduct 
or support— 
‘‘(1) research on physical and mental health 
conditions 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 
conditions for which there has been diagnostic un-
certainty; and 
‘‘(3) research on treating WTC-related health 
conditions of such individuals, in the case of condi-
tions for which there has been treatment uncer-
tainty. 
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 3051), through a Clinical Center of Excellence, or 
through a Coordinating Center of Excellence. 
‘‘(b) TYPES
OF RESEARCH.—The research under 
subsection (a)(1) shall include epidemiologic and other re-
search studies on WTC-related conditions or emerging 
conditions— 
‘‘(1) among WTC responders and community 
members under treatment; and 
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‘‘(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 
populations, to identify potential for long-term ad-
verse health effects in less exposed populations. 
‘‘(c) CONSULTATION.—The WTC Program Adminis-
trator shall carry out this section in consultation with the 
WTC Health Program Steering Committees and the WTC 
Scientific/Technical Advisory Committee. 
‘‘(d) APPLICATION OF PRIVACY AND HUMAN SUB-
JECT PROTECTIONS.—The privacy and human subject 
protections applicable to research conducted under this 
section shall not be less than such protections applicable 
to research otherwise conducted by the National Institutes 
of Health. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated $15,000,000 for each fiscal year, in 
addition to any other authorizations of appropriations that 
are available for such purpose. 
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‘‘Subtitle D—Programs of the New 
York City Department of Health 
and Mental Hygiene 
‘‘SEC. 3051. WORLD TRADE CENTER HEALTH REGISTRY. 
‘‘(a) PROGRAM EXTENSION.—For the purpose of en-
suring on-going data collection for victims of the Sep-
tember 11, 2001, terrorist attacks on the World Trade 
Center, the WTC Program Administrator, shall extend 
and expand the arrangements in effect as of January 1, 
2008, with the New York City Department of Health and 
Mental Hygiene that provide for the World Trade Center 
Health Registry. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated $7,000,000 for each fis-
cal year to carry out this section. 
‘‘SEC. 3052. MENTAL HEALTH SERVICES. 
‘‘(a) IN GENERAL.—The WTC Program Adminis-
trator may make grants to the New York City Department 
of Health and Mental Hygiene to provide mental health 
services to address mental health needs relating to the 
September 11, 2001, terrorist attacks on the World Trade 
Center. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated $8,500,000 for each fis-
cal year to carry out this section.’’. 
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TITLE II—SEPTEMBER 11TH VIC-
TIM COMPENSATION FUND OF 
2001 
SEC. 201. DEFINITIONS. 
Section 402 of the Air Transportation Safety and 
System Stabilization Act (49 U.S.C. 40101 note) is 
amended— 
(1) in paragraph (6) by inserting ‘‘, or debris 
removal, including under the World Trade Center 
Health Program established under section 3001 of 
the Public Health Service Act,’’ after ‘‘September 
11, 2001’’; 
(2) by inserting after paragraph (6) the fol-
lowing new paragraphs and redesignating subse-
quent paragraphs accordingly: 
‘‘(7) CONTRACTOR AND SUBCONTRACTOR.—The 
term ‘contractor and subcontractor’ means any con-
tractor or subcontractor (at any tier of a subcon-
tracting relationship), including any general con-
tractor, construction manager, prime contractor, 
consultant, or any parent, subsidiary, associated or 
allied company, affiliated company, corporation, 
firm, organization, or joint venture thereof that par-
ticipated in debris removal at any 9/11 crash site. 
Such term shall not include any entity, including the 
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Port Authority of New York and New Jersey, with 
a property interest in the World Trade Center, on 
September 11, 2001, whether fee simple, leasehold 
or easement, direct or indirect. 
‘‘(8) DEBRIS REMOVAL.—The term ‘debris re-
moval’ means rescue and recovery efforts, removal of 
debris, cleanup, remediation, and response during 
the immediate aftermath of the terrorist-related air-
craft crashes of September 11, 2001, with respect to 
a 9/11 crash site.’’; 
(3) by inserting after paragraph (10), as so re-
designated, the following new paragraph and redes-
ignating the subsequent paragraphs accordingly: 
‘‘(11) IMMEDIATE AFTERMATH.—The term ‘im-
mediate aftermath’ means any period beginning with 
the terrorist-related aircraft crashes of September 
11, 2001, and ending on August 30, 2002.’’; and 
(4) by adding at the end the following new 
paragraph: 
‘‘(14) 9/11 CRASH SITE.—The term ‘9/11 crash 
site’ means— 
‘‘(A) the World Trade Center site, Pen-
tagon site, and Shanksville, Pennsylvania site; 
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‘‘(B) the buildings or portions of buildings 
that were destroyed as a result of the terrorist- 
related aircraft crashes of September 11, 2001; 
‘‘(C) any area contiguous to a site of such 
crashes that the Special Master determines was 
sufficiently close to the site that there was a de-
monstrable risk of physical harm resulting from 
the impact of the aircraft or any subsequent 
fire, explosions, or building collapses (including 
the immediate area in which the impact oc-
curred, fire occurred, portions of buildings fell, 
or debris fell upon and injured individuals); and 
‘‘(D) any area related to, or along, routes 
of debris removal, such as barges and Fresh 
Kills.’’. 
SEC. 202. EXTENDED AND EXPANDED ELIGIBILITY FOR 
COMPENSATION. 
(a) INFORMATION ON LOSSES RESULTING FROM DE-
BRIS REMOVAL INCLUDED
IN CONTENTS
OF CLAIM 
FORM.—Section 405(a)(2)(B) of the Air Transportation 
Safety and System Stabilization Act (49 U.S.C. 40101 
note) is amended— 
(1) in clause (i), by inserting ‘‘, or debris re-
moval during the immediate aftermath’’ after ‘‘Sep-
tember 11, 2001’’; and 
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100 
(2) in clause (ii), by inserting ‘‘or debris re-
moval during the immediate aftermath’’ after 
‘‘crashes’’. 
(3) in clause (iii), by inserting ‘‘or debris re-
moval during the immediate aftermath’’ after 
‘‘crashes’’. 
(b) EXTENSION OF DEADLINE FOR CLAIMS UNDER 
SEPTEMBER 11TH VICTIM COMPENSATION FUND
OF 
2001.—Section 405(a)(3) of such Act is amended to read 
as follows: 
‘‘(3) LIMITATION.— 
‘‘(A) IN GENERAL.—Except as provided by 
subparagraph (B), no claim may be filed under 
paragraph (1) after the date that is 2 years 
after the date on which regulations are promul-
gated under section 407(a). 
‘‘(B) EXCEPTION.—A claim may be filed 
under paragraph (1), in accordance with sub-
section (c)(3)(A)(i), by an individual (or by a 
personal representative on behalf of a deceased 
individual) during the period beginning on the 
date on which the regulations are updated 
under section 407(b) and ending on December 
22, 2031.’’. 
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101 
(c) REQUIREMENTS
FOR FILING CLAIMS DURING 
EXTENDED FILING PERIOD.—Section 405(c)(3) of such 
Act is amended— 
(1) by redesignating subparagraphs (A) and 
(B) as subparagraphs (B) and (C), respectively; and 
(2) by inserting before subparagraph (B), as so 
redesignated, the following new subparagraph: 
‘‘(A) REQUIREMENTS FOR FILING CLAIMS 
DURING EXTENDED FILING PERIOD.— 
‘‘(i) TIMING REQUIREMENTS FOR FIL-
ING CLAIMS.—An individual (or a personal 
representative on behalf of a deceased indi-
vidual) may file a claim during the period 
described in subsection (a)(3)(B) as fol-
lows: 
‘‘(I) In the case that the Special 
Master 
determines 
the 
individual 
knew (or reasonably should have 
known) before the date specified in 
clause (iii) that the individual suffered 
a physical harm at a 9/11 crash site 
as a result of the terrorist-related air-
craft crashes of September 11, 2001, 
or as a result of debris removal, and 
that the individual knew (or should 
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102 
have known) before such specified 
date that the individual was eligible to 
file a claim under this title, the indi-
vidual may file a claim not later than 
the date that is 2 years after such 
specified date. 
‘‘(II) In the case that the Special 
Master determines the individual first 
knew (or reasonably should have 
known) on or after the date specified 
in clause (iii) that the individual suf-
fered such a physical harm or that the 
individual first knew (or should have 
known) on or after such specified date 
that the individual was eligible to file 
a claim under this title, the individual 
may file a claim not later than the 
last day of the 2-year period begin-
ning on the date the Special Master 
determines the individual first knew 
(or should have known) that the indi-
vidual both suffered from such harm 
and was eligible to file a claim under 
this title. 
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103 
‘‘(ii) OTHER
ELIGIBILITY
REQUIRE-
MENTS
FOR
FILING
CLAIMS.—An indi-
vidual may file a claim during the period 
described in subsection (a)(3)(B) only if— 
‘‘(I) the individual was treated by 
a medical professional for suffering 
from a physical harm described in 
clause (i)(I) within a reasonable time 
from the date of discovering such 
harm; and 
‘‘(II) the individual’s physical 
harm is verified by contemporaneous 
medical records created by or at the 
direction of the medical professional 
who provided the medical care. 
‘‘(iii) DATE
SPECIFIED.—The date 
specified in this clause is the date on which 
the regulations are updated under section 
407(a).’’. 
(d) CLARIFYING APPLICABILITY TO ALL 9/11 CRASH 
SITES.—Section 405(c)(2)(A)(i) of such Act is amended 
by striking ‘‘or the site of the aircraft crash at Shanksville, 
Pennsylvania’’ and inserting ‘‘the site of the aircraft crash 
at Shanksville, Pennsylvania, or any other 9/11 crash 
site’’. 
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104 
(e) INCLUSION
OF PHYSICAL HARM RESULTING 
FROM DEBRIS REMOVAL.—Section 405(c) of such Act is 
amended in paragraph (2)(A)(ii), by inserting ‘‘or debris 
removal’’ after ‘‘air crash’’. 
(f) LIMITATIONS ON CIVIL ACTIONS.— 
(1) APPLICATION
TO
DAMAGES
RELATED
TO 
DEBRIS
REMOVAL.—Clause 
(i) 
of 
section 
405(c)(3)(C) of such Act, as redesignated by sub-
section (c), is amended by inserting ‘‘, or for dam-
ages arising from or related to debris removal’’ after 
‘‘September 11, 2001’’. 
(2) PENDING ACTIONS.—Clause (ii) of such sec-
tion, as so redesignated, is amended to read as fol-
lows: 
‘‘(ii) PENDING ACTIONS.—In the case 
of an individual who is a party to a civil 
action described in clause (i), such indi-
vidual may not submit a claim under this 
title— 
‘‘(I) during the period described 
in subsection (a)(3)(A) unless such in-
dividual withdraws from such action 
by the date that is 90 days after the 
date on which regulations are promul-
gated under section 407(a); and 
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105 
‘‘(II) during the period described 
in subsection (a)(3)(B) unless such in-
dividual withdraws from such action 
by the date that is 90 days after the 
date on which the regulations are up-
dated under section 407(b).’’. 
(3) AUTHORITY
TO
REINSTITUTE
CERTAIN 
LAWSUITS.—Such section, as so redesignated, is fur-
ther amended by adding at the end the following 
new clause: 
‘‘(iii) AUTHORITY
TO
REINSTITUTE 
CERTAIN
LAWSUITS.—In the case of a 
claimant who was a party to a civil action 
described in clause (i), who withdrew from 
such action pursuant to clause (ii), and 
who is subsequently determined to not be 
an eligible individual for purposes of this 
subsection, such claimant may reinstitute 
such action without prejudice during the 
90-day period beginning after the date of 
such ineligibility determination.’’. 
SEC. 203. REQUIREMENT TO UPDATE REGULATIONS. 
Section 407 of the Air Transportation Safety and 
System Stabilization Act (49 U.S.C. 40101 note) is 
amended— 
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106 
(1) by striking ‘‘Not later than’’ and inserting 
‘‘(a) IN GENERAL.—Not later than’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(b) UPDATED REGULATIONS.—Not later than 90 
days after the date of the enactment of the James Zadroga 
9/11 Health and Compensation Act of 2008, the Special 
Master shall update the regulations promulgated under 
subsection (a) to the extent necessary to comply with the 
provisions of title II of such Act.’’. 
SEC. 204. LIMITED LIABILITY FOR CERTAIN CLAIMS. 
Section 408(a) of the Air Transportation Safety and 
System Stabilization Act (49 U.S.C. 40101 note) is 
amended by adding at the end the following new para-
graphs: 
‘‘(4) LIABILITY FOR CERTAIN CLAIMS.— 
‘‘(A) IN GENERAL.—Notwithstanding any 
other provision of law, subject to subparagraph 
(B), liability for all claims and actions (includ-
ing claims or actions that have been previously 
resolved, that are currently pending, and that 
may be filed through December 22, 2031) for 
compensatory damages, contribution or indem-
nity, or any other form or type of relief, arising 
from or related to debris removal, against the 
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107 
City of New York, any entity (including the 
Port Authority of New York and New Jersey) 
with a property interest in the World Trade 
Center on September 11, 2001 (whether fee 
simple, leasehold or easement, or direct or indi-
rect) and any contractors and subcontractors 
thereof, shall not be in an amount that exceeds 
the sum of the following: 
‘‘(i) The amount of funds of the WTC 
Captive Insurance Company, including the 
cumulative interest. 
‘‘(ii) The amount of all available in-
surance identified in schedule 2 of the 
WTC Captive Insurance Company insur-
ance policy. 
‘‘(iii) The amount that is the greater 
of the City of New York’s insurance cov-
erage or $350,000,000. In determining the 
amount of the City’s insurance coverage 
for purposes of the previous sentence, any 
amount described in clauses (i) and (ii) 
shall not be included. 
‘‘(iv) The amount of all available li-
ability insurance coverage maintained by 
any entity, including the Port Authority of 
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108 
New York and New Jersey, with a prop-
erty interest in the World Trade Center, 
on September 11, 2001, whether fee sim-
ple, leasehold or easement, or direct or in-
direct. 
‘‘(v) The amount of all available liabil-
ity insurance coverage maintained by con-
tractors and subcontractors. 
‘‘(B) 
EXCEPTION.—Subparagraph 
(A) 
shall not apply to claims or actions based upon 
conduct held to be intentionally tortious in na-
ture or to acts of gross negligence or other such 
acts to the extent to which punitive damages 
are awarded as a result of such conduct or acts. 
‘‘(5) PRIORITY
OF
CLAIMS
PAYMENTS.—Pay-
ments to plaintiffs who obtain a settlement or judg-
ment with respect to a claim or action to which 
paragraph (4)(A) applies, shall be paid solely from 
the following funds in the following order: 
‘‘(A) The funds described in clause (i) or 
(ii) of paragraph (4)(A). 
‘‘(B) If there are no funds available as de-
scribed in clause (i) or (ii) of paragraph (4)(A), 
the funds described in clause (iii) of such para-
graph. 
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109 
‘‘(C) If there are no funds available as de-
scribed in clause (i), (ii), or (iii) of paragraph 
(4)(A), the funds described in clause (iv) of 
such paragraph. 
‘‘(D) If there are no funds available as de-
scribed in clause (i),(ii), (iii), or (iv) of para-
graph (4)(A), the funds described in clause (v) 
of such paragraph. 
‘‘(6) DECLARATORY JUDGMENT ACTIONS AND 
DIRECT ACTION.—Any party to a claim or action to 
which paragraph (4)(A) applies may, with respect to 
such claim or action, either file an action for a de-
claratory judgment for insurance coverage or bring 
a direct action against the insurance company in-
volved.’’. 
TITLE III—REVENUE 
PROVISIONS 
Subtitle A—Codification of 
Economic Substance Doctrine 
SEC. 301. CODIFICATION OF ECONOMIC SUBSTANCE DOC-
TRINE. 
(a) IN GENERAL.—Section 7701 of the Internal Rev-
enue Code of 1986 is amended by redesignating subsection 
(p) as subsection (q) and by inserting after subsection (o) 
the following new subsection: 
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110 
‘‘(p) CLARIFICATION
OF
ECONOMIC
SUBSTANCE 
DOCTRINE.— 
‘‘(1) APPLICATION OF DOCTRINE.—In the case 
of any transaction to which the economic substance 
doctrine is relevant, such transaction shall be treated 
as having economic substance only if— 
‘‘(A) the transaction changes in a mean-
ingful way (apart from Federal income tax ef-
fects) the taxpayer’s economic position, and 
‘‘(B) the taxpayer has a substantial pur-
pose (apart from Federal income tax effects) 
for entering into such transaction. 
‘‘(2) SPECIAL RULE WHERE TAXPAYER RELIES 
ON PROFIT POTENTIAL.— 
‘‘(A) IN
GENERAL.—The potential for 
profit of a transaction shall be taken into ac-
count in determining whether the requirements 
of subparagraphs (A) and (B) of paragraph (1) 
are met with respect to the transaction only if 
the present value of the reasonably expected 
pre-tax profit from the transaction is substan-
tial in relation to the present value of the ex-
pected net tax benefits that would be allowed if 
the transaction were respected. 
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111 
‘‘(B) TREATMENT OF FEES AND FOREIGN 
TAXES.—Fees and other transaction expenses 
and foreign taxes shall be taken into account as 
expenses in determining pre-tax profit under 
subparagraph (A). 
‘‘(3) STATE AND LOCAL TAX BENEFITS.—For 
purposes of paragraph (1), any State or local income 
tax effect which is related to a Federal income tax 
effect shall be treated in the same manner as a Fed-
eral income tax effect. 
‘‘(4) FINANCIAL ACCOUNTING BENEFITS.—For 
purposes of paragraph (1)(B), achieving a financial 
accounting benefit shall not be taken into account as 
a purpose for entering into a transaction if such 
transaction results in a Federal income tax benefit. 
‘‘(5) DEFINITIONS AND SPECIAL RULES.—For 
purposes of this subsection— 
‘‘(A) ECONOMIC SUBSTANCE DOCTRINE.— 
The term ‘economic substance doctrine’ means 
the common law doctrine under which tax bene-
fits under subtitle A with respect to a trans-
action are not allowable if the transaction does 
not have economic substance or lacks a business 
purpose. 
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112 
‘‘(B) EXCEPTION FOR PERSONAL TRANS-
ACTIONS OF INDIVIDUALS.—In the case of an 
individual, paragraph (1) shall apply only to 
transactions entered into in connection with a 
trade or business or an activity engaged in for 
the production of income. 
‘‘(C) OTHER
COMMON
LAW
DOCTRINES 
NOT
AFFECTED.—Except as specifically pro-
vided in this subsection, the provisions of this 
subsection shall not be construed as altering or 
supplanting any other rule of law, and the re-
quirements of this subsection shall be construed 
as being in addition to any such other rule of 
law. 
‘‘(D) DETERMINATION OF APPLICATION OF 
DOCTRINE NOT AFFECTED.—The determination 
of whether the economic substance doctrine is 
relevant to a transaction shall be made in the 
same manner as if this subsection had never 
been enacted. 
‘‘(6) REGULATIONS.—The Secretary shall pre-
scribe such regulations as may be necessary or ap-
propriate to carry out the purposes of this sub-
section. Such regulations may include exemptions 
from the application of this subsection.’’. 
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113 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to transactions entered into after 
the date of the enactment of this Act. 
SEC. 302. PENALTIES FOR UNDERPAYMENTS. 
(a) PENALTY FOR UNDERPAYMENTS ATTRIBUTABLE 
TO TRANSACTIONS LACKING ECONOMIC SUBSTANCE.— 
(1) IN
GENERAL.—Subsection (b) of section 
6662 of the Internal Revenue Code of 1986 is 
amended by inserting after paragraph (5) the fol-
lowing new paragraph: 
‘‘(6) Any disallowance of claimed tax benefits 
by reason of a transaction lacking economic sub-
stance (within the meaning of section 7701(p)) or 
failing to meet the requirements of any similar rule 
of law.’’. 
(2) INCREASED PENALTY FOR NONDISCLOSED 
TRANSACTIONS.—Section 6662 of such Code is 
amended by adding at the end the following new 
subsection: 
‘‘(i) INCREASE IN PENALTY IN CASE OF NONDIS-
CLOSED NONECONOMIC SUBSTANCE TRANSACTIONS.— 
‘‘(1) IN GENERAL.—To the extent that a por-
tion of the underpayment to which this section ap-
plies is attributable to one or more nondisclosed non-
economic substance transactions, subsection (a) shall 
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114 
be applied with respect to such portion by sub-
stituting ‘40 percent’ for ‘20 percent’. 
‘‘(2) 
NONDISCLOSED
NONECONOMIC
SUB-
STANCE TRANSACTIONS.—For purposes of this sub-
section, the term ‘nondisclosed noneconomic sub-
stance transaction’ means any portion of a trans-
action described in subsection (b)(6) with respect to 
which the relevant facts affecting the tax treatment 
are not adequately disclosed in the return nor in a 
statement attached to the return. 
‘‘(3) 
SPECIAL
RULE
FOR
AMENDED
RE-
TURNS.—Except as provided in regulations, in no 
event shall any amendment or supplement to a re-
turn of tax be taken into account for purposes of 
this subsection if the amendment or supplement is 
filed after the earlier of the date the taxpayer is first 
contacted by the Secretary regarding the examina-
tion of the return or such other date as is specified 
by the Secretary.’’. 
(3) CONFORMING AMENDMENT.—Subparagraph 
(B) of section 6662A(e)(2) of such Code is amend-
ed— 
(A) by striking ‘‘section 6662(h)’’ and in-
serting ‘‘subsection (h) or (i) of section 6662’’, 
and 
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115 
(B) 
by 
striking 
‘‘GROSS
VALUATION 
MISSTATEMENT PENALTY’’ in the heading and 
inserting 
‘‘CERTAIN
INCREASED
UNDER-
PAYMENT PENALTIES’’. 
(b) REASONABLE CAUSE EXCEPTION NOT APPLICA-
BLE TO NONECONOMIC SUBSTANCE TRANSACTIONS, TAX 
SHELTERS, AND CERTAIN LARGE CORPORATIONS.—Sub-
section (c) of section 6664 of such Code is amended— 
(1) by redesignating paragraphs (2) and (3) as 
paragraphs (3) and (4), respectively, 
(2) by striking ‘‘paragraph (2)’’ in paragraph 
(4), as so redesignated, and inserting ‘‘paragraph 
(3)’’, and 
(3) by inserting after paragraph (1) the fol-
lowing new paragraph: 
‘‘(2) EXCEPTION
FOR
NONECONOMIC
SUB-
STANCE TRANSACTIONS, TAX SHELTERS, AND CER-
TAIN LARGE CORPORATIONS.—Paragraph (1) shall 
not apply— 
‘‘(A) to any portion of an underpayment 
which is attributable to one or more tax shelters 
(as defined in section 6662(d)(2)(C)) or trans-
actions described in section 6662(b)(6), and 
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116 
‘‘(B) to any taxpayer if such taxpayer is a 
specified large corporation (as defined in section 
6662(d)(2)(D)(ii)).’’. 
(c) APPLICATION
OF PENALTY
FOR ERRONEOUS 
CLAIM FOR REFUND OR CREDIT TO NONECONOMIC SUB-
STANCE TRANSACTIONS.—Section 6676 of such Code is 
amended by redesignating subsection (c) as subsection (d) 
and inserting after subsection (b) the following new sub-
section: 
‘‘(c) NONECONOMIC
SUBSTANCE
TRANSACTIONS 
TREATED AS LACKING REASONABLE BASIS.—For pur-
poses of this section, any excessive amount which is attrib-
utable to any transaction described in section 6662(b)(6) 
shall not be treated as having a reasonable basis.’’. 
(d) SPECIAL UNDERSTATEMENT REDUCTION RULE 
FOR CERTAIN LARGE CORPORATIONS.— 
(1) IN
GENERAL.—Paragraph (2) of section 
6662(d) of such Code is amended by adding at the 
end the following new subparagraph: 
‘‘(D) SPECIAL REDUCTION RULE FOR CER-
TAIN LARGE CORPORATIONS.— 
‘‘(i) IN GENERAL.—In the case of any 
specified large corporation— 
‘‘(I) subparagraph (B) shall not 
apply, and 
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117 
‘‘(II) the amount of the under-
statement under subparagraph (A) 
shall be reduced by that portion of the 
understatement which is attributable 
to any item with respect to which the 
taxpayer has a reasonable belief that 
the tax treatment of such item by the 
taxpayer is more likely than not the 
proper tax treatment of such item. 
‘‘(ii) SPECIFIED
LARGE
CORPORA-
TION.— 
‘‘(I) IN GENERAL.—For purposes 
of this subparagraph, the term ‘speci-
fied large corporation’ means any cor-
poration with gross receipts in excess 
of $100,000,000 for the taxable year 
involved. 
‘‘(II) AGGREGATION
RULE.—All 
persons treated as a single employer 
under section 52(a) shall be treated as 
one person for purposes of subclause 
(I).’’. 
(2) CONFORMING AMENDMENT.—Subparagraph 
(C) of section 6662(d)(2) of such Code is amended 
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118 
by striking ‘‘Subparagraph (B)’’ and inserting ‘‘Sub-
paragraphs (B) and (D)(i)(II)’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
Subtitle 
B—Prevention 
of 
Tax 
Treaty Exploitation to Evade 
United States Taxation 
SEC. 311. LIMITATION ON TREATY BENEFITS FOR CERTAIN 
DEDUCTIBLE PAYMENTS. 
(a) IN GENERAL.—Section 894 (relating to income 
affected by treaty) is amended by adding at the end the 
following new subsection: 
‘‘(d) LIMITATION ON TREATY BENEFITS FOR CER-
TAIN DEDUCTIBLE PAYMENTS.— 
‘‘(1) IN GENERAL.—In the case of any deduct-
ible related-party payment, any withholding tax im-
posed under chapter 3 (and any tax imposed under 
subpart A or B of this part) with respect to such 
payment may not be reduced under any treaty of the 
United States unless any such withholding tax would 
be reduced under a treaty of the United States if 
such payment were made directly to the foreign par-
ent corporation. 
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119 
‘‘(2) 
DEDUCTIBLE
RELATED-PARTY
PAY-
MENT.—For purposes of this subsection, the term 
‘deductible related-party payment’ means any pay-
ment made, directly or indirectly, by any person to 
any other person if the payment is allowable as a de-
duction under this chapter and both persons are 
members of the same foreign controlled group of en-
tities. 
‘‘(3) FOREIGN CONTROLLED GROUP OF ENTI-
TIES.—For purposes of this subsection— 
‘‘(A) IN
GENERAL.—The term ‘foreign 
controlled group of entities’ means a controlled 
group of entities the common parent of which 
is a foreign corporation. 
‘‘(B) CONTROLLED GROUP OF ENTITIES.— 
The term ‘controlled group of entities’ means a 
controlled group of corporations as defined in 
section 1563(a)(1), except that— 
‘‘(i) ‘more than 50 percent’ shall be 
substituted for ‘at least 80 percent’ each 
place it appears therein, and 
‘‘(ii) the determination shall be made 
without regard to subsections (a)(4) and 
(b)(2) of section 1563. 
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A partnership or any other entity (other than a 
corporation) shall be treated as a member of a 
controlled group of entities if such entity is con-
trolled 
(within 
the 
meaning 
of 
section 
954(d)(3)) by members of such group (includ-
ing any entity treated as a member of such 
group by reason of this sentence). 
‘‘(4) FOREIGN
PARENT
CORPORATION.—For 
purposes of this subsection, the term ‘foreign parent 
corporation’ means, with respect to any deductible 
related-party payment, the common parent of the 
foreign controlled group of entities referred to in 
paragraph (3)(A). 
‘‘(5) REGULATIONS.—The Secretary may pre-
scribe such regulations or other guidance as are nec-
essary or appropriate to carry out the purposes of 
this subsection, including regulations or other guid-
ance which provide for— 
‘‘(A) the treatment of two or more persons 
as members of a foreign controlled group of en-
tities if such persons would be the common par-
ent of such group if treated as one corporation, 
and 
‘‘(B) the treatment of any member of a 
foreign controlled group of entities as the com-
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121 
mon parent of such group if such treatment is 
appropriate taking into account the economic 
relationships among such entities.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to payments made after the date 
of the enactment of this Act. 
Subtitle C—Corporate Estimated 
Taxes 
SEC. 321. TIME FOR PAYMENT OF CORPORATE ESTIMATED 
TAXES. 
The percentage under subparagraph (C) of section 
401(1) of the Tax Increase Prevention and Reconciliation 
Act of 2005 in effect on the date of the enactment of this 
Act is increased by 5 percentage points. 
Æ 
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