Bill 111-HR-847 — Government Operations / General
Subject: Health

James Zadroga 9/11 Health and Compensation Act of 2010 - Title I: World Trade Center Health Program - (Sec. 101) Amends the Public Health Service Act to establish the World Trade Center Health Program (WTC Program) within the Department of Health and Human Services (HHS) to provide: (1) medical monitoring and treatment benefits to eligible emergency responders and recovery and cleanup workers (including those who are federal employees) who responded to the September 11, 2001, terrorist attacks; and (2) initial health evaluation, monitoring, and treatment benefits to residents and other building occupants and area workers in New York City who were directly impacted and adversely affected by such attacks. Includes within the WTC Program: (1) medical monitoring, including clinical examinations and long-term health monitoring and analysis for enrolled WTC responders who were likely to have been exposed to airborne toxins that were released, or to other hazards, as a result of the September 11, 2001, terrorist attacks; (2) initial health evaluation, including an evaluation to determine eligibility for follow-up monitoring and treatment; (3) follow-up monitoring and treatment and payment for all medically necessary health and mental health care expenses of an individual with respect to a WTC-related health condition, including necessary prescription drugs; (4) establishment of an education and outreach program to potentially eligible individuals concerning the benefits under this Act; (5) collection and analysis of health and mental health data relating to individuals receiving monitoring or treatment benefits in a uniform manner in collaboration with the collection of epidemiological data; and (6) establishment of a research program on health conditions resulting from the terrorist attacks. Provides monitoring and treatment benefits and initial health evaluation benefits without any cost sharing to an enrolled WTC responder or certified-eligible WTC survivor and provides initial health evaluation benefits without any cost sharing to a screening-eligible WTC survivor. Requires the Inspector General of HHS to develop and implement a program to review: (1) the WTC Program's health care expenditures to detect fraudulent or duplicate billing and payment for inappropriate services; and (2) the WTC Program for unreasonable administrative costs, including with respect to infrastructure, administration, and claims processing. Requires the WTC Program Administrator to: (1) develop and implement a quality assurance program for the monitoring and treatment delivered by Clinical Centers of Excellence and other participating health care providers; (2) submit an annual report to Congress on the operations of this Act for the fiscal year and for the entire period of operation of the WTC Program; and (3) engage in outreach and consultation with relevant stakeholders regarding the implementation and improvement of programs under this Act. Requires the Secretary to notify Congress when enrollments in the WTC Program reach a specified threshold. Directs the WTC Program Administrator to: (1) establish the WTC Health Program Scientific/Technical Advisory Committee to review scientific and medical evidence and to make recommendations to the Administrator on additional WTC Program eligibility criteria and on additional WTC-related health conditions; and (2) consult with the WTC Responders Steering Committee and the WTC Survivors Steering Committee. Requires the WTC Program Administrator to: (1) institute an education and outreach program on the existence and availability of services under the WTC Program; and (2) provide for the uniform collection and analysis of data on the prevalence of WTC-related health conditions and the identification of new WTC-related health conditions. Requires such data to be collected for all individuals provided monitoring or treatment benefits under this Act. Requires the Administrator to enter into contracts with Clinical Centers of Excellence to provide: (1) monitoring and treatment benefits and initial health evaluation benefits; (2) outreach activities to individuals eligible for monitoring and treatment benefits, for initial health evaluations benefits, and for follow-up to individuals who are enrolled in the monitoring program; (3) counseling for benefits, with respect to WTC-related health conditions for eligible individuals; (4) counseling for benefits for WTC-related health conditions that may be available under workers' compensation or other benefits programs for work-related injuries or illnesses, health insurance, disability insurance, or other insurance plans or through public or private social service agencies; (5) translational and interpretive services for program participants who are not English language proficient; and (6) data collection and reporting, including claims data. Requires the Administrator to enter into contracts with qualified data centers to: (1) receive, analyze, and report to the Administrator on data that have been collected and reported by Clinical Centers of Excellence; (2) develop monitoring, initial health evaluation, and treatment protocols; (3) coordinate outreach activities; (4) establish criteria for the credentialing of medical providers participating in the nationwide network of providers; (5) coordinate and administer the activities of the WTC Health Program Steering Committees; and (6) meet periodically with the corresponding Clinical Centers of Excellence to obtain input on the analysis and reporting of data collected and on the development of protocols. Directs the Comptroller General to submit to the relevant congressional committees a report on the feasibility of consolidating data centers into a single data center. Sets forth requirements for Clinical Centers of Excellence, including that such Centers have experience in caring for WTC responders and screening-eligible WTC survivors or have health care providers who have been trained for such care. Requires the Administrator to reimburse a Clinical Center of Excellence for the fixed infrastructure costs of carrying out activities under this Act. Prohibits the Secretary from designating the Director of the National Institute for Occupational Safety and Health or a designee of such Director as the Administrator with respect to payment for initial health evaluation, monitoring, and treatment. Defines and sets forth eligibility requirements for WTC Responders. Establishes a limitation on the number of eligible WTC responders who may be enrolled in the WTC Program. Disqualifies any individual on the terrorist watch list from eligibility as a WTC Responder. Requires the WTC Program to provide monitoring benefits for enrolled WTC responders, including long-term health monitoring and analysis. Sets forth provisions governing the treatment of WTC responders for WTC-related health conditions. Defines "WTC-related health condition" and lists such health conditions for WTC-responders. Establishes standards for determining whether the terrorist attacks are responsible for a particular health condition. Requires the Administrator to conduct a periodic review of all available scientific and medical evidence to determine if cancer or a certain type of cancer should be added to the applicable list of WTC-related health conditions. Establishes: (1) a process for determinations as to whether to include additional health conditions on the list of WTC-related health conditions; and (2) a certification process for determinations that an enrolled WTC responder has a WTC-related health condition or a condition medically associated with a WTC-related health condition. Directs the Administrator to: (1) reimburse costs for medically necessary treatment for WTC-related health conditions but not at a rate higher than the Office of Worker's Compensation Programs in the Department of Labor would pay; (2) establish a program for paying for the medically necessary outpatient prescription pharmaceuticals prescribed for such conditions; and (3) reimburse the costs of monitoring and the costs of an initial health evaluation. Directs the Comptroller General to report to specified congressional committees as to whether existing federal pharmaceutical purchasing programs can provide pharmaceutical benefits more efficiently and effectively than the WTC Program. Requires the Data Centers to develop medical treatment protocols for the treatment of enrolled WTC responders and certified-eligible WTC survivors for health conditions included in the applicable list of WTC-related health conditions. Provides that such protocols are subject to approval by the Administrator. Requires the WTC Program Administrator to establish a nationwide network of health care providers to provide monitoring and treatment benefits and initial health evaluations to ensure reasonable access to benefits for individuals who are enrolled WTC responders, screening-eligible WTC survivors, or certified-eligible WTC survivors who reside in a state outside the New York metropolitan area. Authorizes the Administrator to enter into an agreement for the provision of services through the facilities of the Department of Veteran Affairs (VA). Directs the Comptroller General to report to specified congressional committees on whether the VA can provide monitoring and treatment services to individuals more efficiently and effectively than the nationwide network of providers established under this Act. Defines "screening-eligible WTC survivor" and establishes eligibility criteria for such survivors. Limits the total number of individuals who may be certified-eligible WTC survivors. Disqualifies any individual on the terrorist watch list from eligibility as a survivor. Requires the WTC Program to provide for an initial health evaluation to determine if a screening-eligible WTC survivor has a WTC-related health conditions and is eligible for follow-up monitoring and treatment benefits under the WTC Program. Lists WTC-related health conditions for certified-eligible WTC survivors. Allows follow-up monitoring and treatment for individuals not otherwise qualified who have been diagnosed with a WTC-related health condition. Limits the amount of benefits that may be provided to all such individuals for any fiscal year. Requires the cost of monitoring and treatment benefits and initial health evaluation benefits to be paid for by the WTC Program from the World Trade Center Health Program Fund. Requires payment for such treatment to be reduced or recouped for work-related conditions to the extent that the Administrator determines the payment has been made or can reasonably be expected to be made under a workers compensation law or plan. Makes the WTC Program a secondary payor for individuals with a public or private health plan. Prohibits payment for monitoring and treatment for individuals who fail to maintain minimum essential coverage, as required. Requires New York City to pay 10% of the costs for the WTC Program through FY2015 and one-ninth of the federal expenditures for FY2016. Requires the WTC Program Administrator to conduct or support: (1) research on physical and mental health conditions that may be related to the terrorist attacks; (2) research on diagnosing WTC-related health conditions in the case of conditions for which there has been diagnostic uncertainty; and (3) research on treating such conditions of such individuals in the case of conditions for which there has been treatment uncertainty. Requires the Administrator to ensure that a registry of victims of the terrorist attacks is maintained. Establishes the World Trade Center Health Program Fund, with funding for the last calendar quarter of FY2011 and for FY2012-FY2015 and additional funding for FY2016 equal to unexpended amounts for previous fiscal years. Sets forth provisions regarding the allocation of such Fund. Title II : September 11th Victim Compensation Fund of 2001 - (Sec. 201) Amends the Air Transportation Safety and System Stabilization Act to revise provisions related to the September 11 Victim Compensation Fund of 2001. Makes individuals eligible for compensation under the Compensation Fund for harm as a result of debris removal. Extends the deadline for making a claim for compensation for physical harm not discovered before the original deadline. (Sec. 204) Caps liability for claims related to debris removal based on the level of insurance available. Allows compensation for claims to be reduced as necessary if insufficient funds are available to pay all claims. Prohibits any declaratory judgment or direct action from being commenced until available funds have been exhausted. (Sec. 205) Terminates the Compensation Fund upon completion of all payments. Authorizes the Special Master to lower attorney fees if the fee limit provides excessive compensation for services rendered. Title III: Revenue Related Provisions - (Sec. 301) Amends the Internal Revenue Code to impose on any foreign person a tax equal to 2% of the amount of any payment received pursuant to a contract with the U.S. government for the provision of goods or services, if such goods are manufactured or produced or such services are provided in any country that is not a party to an international procurement agreement with the United States. Requires the head of each executive agency to take measures necessary to ensure that no funds are disbursed to any foreign contractor in order to reimburse the tax imposed under this title. Title IV: Budgetary Effects - (Sec. 401) Provides for compliance of the budgetary effects of this Act with the Statutory Pay-As-You-Go Act of 2010.