[Congressional Bills 111th Congress]
[From the U.S. Government Printing Office]
[H.R. 847 Enrolled Bill (ENR)]
H.R.847
One Hundred Eleventh Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Tuesday,
the fifth day of January, two thousand and ten
An Act
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 Representatives of the
United States of America in Congress assembled,
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 2010''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--WORLD TRADE CENTER HEALTH PROGRAM
Sec. 101. World Trade Center Health Program.
``TITLE XXXIII--WORLD TRADE CENTER HEALTH PROGRAM
``Subtitle A--Establishment of Program; Advisory Committee
``Sec. 3301. Establishment of World Trade Center Health Program.
``Sec. 3302. WTC Health Program Scientific/Technical Advisory
Committee; WTC Health Program Steering Committees.
``Sec. 3303. Education and outreach.
``Sec. 3304. Uniform data collection and analysis.
``Sec. 3305. Clinical Centers of Excellence and Data Centers.
``Sec. 3306. Definitions.
``Subtitle B--Program of Monitoring, Initial Health Evaluations, and
Treatment
``PART 1--WTC Responders
``Sec. 3311. Identification of WTC responders and provision of WTC-
related monitoring services.
``Sec. 3312. Treatment of enrolled WTC responders for WTC-related
health conditions.
``Sec. 3313. National arrangement for benefits for eligible
individuals outside New York.
``PART 2--WTC Survivors
``Sec. 3321. Identification and initial health evaluation of
screening-eligible and certified-eligible WTC survivors.
``Sec. 3322. Followup monitoring and treatment of certified-eligible
WTC survivors for WTC-related health conditions.
``Sec. 3323. Followup monitoring and treatment of other individuals
with WTC-related health conditions.
``PART 3--Payor Provisions
``Sec. 3331. Payment of claims.
``Sec. 3332. Administrative arrangement authority.
``Subtitle C--Research Into Conditions
``Sec. 3341. Research regarding certain health conditions related to
September 11 terrorist attacks.
``Sec. 3342. World Trade Center Health Registry.
``Subtitle D--Funding
``Sec. 3351. World Trade Center Health Program Fund.
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.
Sec. 205. Funding; attorney fees.
TITLE III--REVENUE RELATED PROVISIONS
Sec. 301. Excise tax on foreign procurement.
Sec. 302. Renewal of fees for visa-dependent employers.
TITLE IV--BUDGETARY EFFECTS
Sec. 401. Compliance with Statutory Pay-As-You-Go Act of 2010.
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 XXXIII--WORLD TRADE CENTER HEALTH PROGRAM
``Subtitle A--Establishment of Program; Advisory Committee
``SEC. 3301. ESTABLISHMENT OF WORLD TRADE CENTER HEALTH PROGRAM.
``(a) In General.--There is hereby established within the
Department of Health and Human Services a program to be known as the
World Trade Center Health Program, which shall be administered by the
WTC Program Administrator, to provide beginning on July 1, 2011--
``(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.
``(b) Components of Program.--The WTC Program includes the
following components:
``(1) Medical monitoring for responders.--Medical monitoring
under section 3311, 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 for survivors.--An initial
health evaluation under section 3321, including an evaluation to
determine eligibility for followup monitoring and treatment.
``(3) Followup monitoring and treatment for wtc-related health
conditions for responders and survivors.--Provision under sections
3312, 3322, and 3323 of followup monitoring and treatment and
payment, subject to the provisions of subsection (d), 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) Outreach.--Establishment under section 3303 of an
education and outreach program to potentially eligible individuals
concerning the benefits under this title.
``(5) Clinical data collection and analysis.--Collection and
analysis under section 3304 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 under section 3342.
``(6) Research on health conditions.--Establishment under
subtitle C of a research program on health conditions resulting
from the September 11, 2001, terrorist attacks.
``(c) No Cost Sharing.--Monitoring and treatment benefits and
initial health evaluation benefits are provided under subtitle B
without any deductibles, copayments, or other cost sharing to an
enrolled WTC responder or certified-eligible WTC survivor. Initial
health evaluation benefits are provided under subtitle B without any
deductibles, copayments, or other cost sharing to a screening-eligible
WTC survivor.
``(d) Preventing Fraud and Unreasonable Administrative Costs.--
``(1) Fraud.--The Inspector General of the Department of Health
and Human Services shall develop and implement a program to review
the WTC Program's health care expenditures to detect fraudulent or
duplicate billing and payment for inappropriate services. This
title is a Federal health care program (as defined in section
1128B(f) of the Social Security Act) and is a health plan (as
defined in section 1128C(c) of such Act) for purposes of applying
sections 1128 through 1128E of such Act.
``(2) Unreasonable administrative costs.--The Inspector General
of the Department of Health and Human Services shall develop and
implement a program to review the WTC Program for unreasonable
administrative costs, including with respect to infrastructure,
administration, and claims processing.
``(e) Quality Assurance.--The WTC Program Administrator working
with the Clinical Centers of Excellence shall develop and implement a
quality assurance program for the monitoring and treatment delivered by
such Centers of Excellence and any other participating health care
providers. Such program shall include--
``(1) adherence to monitoring and treatment protocols;
``(2) appropriate diagnostic and treatment referrals for
participants;
``(3) prompt communication of test results to participants; and
``(4) such other elements as the Administrator specifies in
consultation with the Clinical Centers of Excellence.
``(f) 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 Administrator shall submit an annual report to the Congress
on the operations of this title for such fiscal year and for the
entire period of operation of the program.
``(2) Contents included in report.--Each annual report under
paragraph (1) shall include at least the following:
``(A) Eligible individuals.--Information for each clinical
program described in paragraph (3)--
``(i) on the number of individuals who applied for
certification under subtitle B and the number of such
individuals who were so certified;
``(ii) of the individuals who were certified, on the
number who received 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 individuals who will
be certified under subtitle B in the succeeding fiscal year
and the succeeding 10-year period.
``(B) Monitoring, initial health evaluation, and treatment
costs.--For each clinical program so described--
``(i) information on the costs of monitoring and
initial health evaluation and the costs of treatment and on
the estimated costs of such monitoring, evaluation, and
treatment in the succeeding fiscal year; and
``(ii) an estimate of the cost of medical treatment for
WTC-related health conditions that have been paid for or
reimbursed by workers' compensation, by public or private
health plans, or by New York City under section 3331.
``(C) Administrative costs.--Information on the cost of
administering the program, including costs of program support,
data collection and analysis, and research conducted under the
program.
``(D) Administrative experience.--Information on the
administrative performance of the program, including--
``(i) the performance of the program in providing
timely evaluation of and treatment 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 exposure described in section 3306(1),
including the findings of research conducted under section
3341(a).
``(F) Advisory committee recommendations.--A list of
recommendations by the WTC Scientific/Technical Advisory
Committee on additional WTC Program eligibility criteria and on
additional WTC-related health conditions and the action of the
WTC Program Administrator concerning each such recommendation.
``(3) Separate clinical programs described.--In paragraph (2),
each of the following shall be treated as a separate clinical
program of the WTC Program:
``(A) Firefighters and related personnel.--The benefits
provided for enrolled WTC responders described in section
3311(a)(2)(A).
``(B) Other wtc responders.--The benefits provided for
enrolled WTC responders not described in subparagraph (A).
``(C) WTC survivors.--The benefits provided for screening-
eligible WTC survivors and certified-eligible WTC survivors in
section 3321(a).
``(g) Notification to Congress Upon Reaching 80 Percent of
Eligibility Numerical Limits.--The Secretary shall promptly notify the
Congress of each of the following:
``(1) When the number of enrollments of WTC responders subject
to the limit established under section 3311(a)(4) has reached 80
percent of such limit.
``(2) When the number of certifications for certified-eligible
WTC survivors subject to the limit established under section
3321(a)(3) has reached 80 percent of such limit.
``(h) Consultation.--The WTC Program Administrator shall engage in
ongoing outreach and consultation with relevant stakeholders, including
the WTC Health Program Steering Committees and the Advisory Committee
under section 3302, regarding the implementation and improvement of
programs under this title.
``SEC. 3302. WTC HEALTH PROGRAM SCIENTIFIC/TECHNICAL ADVISORY
COMMITTEE; WTC HEALTH PROGRAM STEERING COMMITTEES.
``(a) Advisory Committee.--
``(1) Establishment.--The WTC Program Administrator shall
establish an advisory committee to be known as the WTC Health
Program Scientific/Technical Advisory Committee (in this subsection
referred to as the `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.
``(2) Composition.--The WTC Program Administrator shall appoint
the members of the Advisory Committee and shall include at least--
``(A) 4 occupational physicians, at least 2 of whom have
experience treating WTC rescue and recovery workers;
``(B) 1 physician with expertise in pulmonary medicine;
``(C) 2 environmental medicine or environmental health
specialists;
``(D) 2 representatives of WTC responders;
``(E) 2 representatives of certified-eligible WTC
survivors;
``(F) an industrial hygienist;
``(G) a toxicologist;
``(H) an epidemiologist; and
``(I) a mental health professional.
``(3) Meetings.--The Advisory Committee shall meet at such
frequency as may be required to carry out its duties.
``(4) Reports.--The WTC Program Administrator shall provide for
publication of recommendations of the Advisory Committee on the
public Web site established for the WTC Program.
``(5) Duration.--Notwithstanding any other provision of law,
the Advisory Committee shall continue in operation during the
period in which the WTC Program is in operation.
``(6) Application of faca.--Except as otherwise specifically
provided, the Advisory Committee shall be subject to the Federal
Advisory Committee Act.
``(b) WTC Health Program Steering Committees.--
``(1) Consultation.--The WTC Program Administrator shall
consult with 2 steering committees (each in this section referred
to as a `Steering Committee') that are established as follows:
``(A) WTC responders steering committee.--One Steering
Committee, to be known as the WTC Responders Steering
Committee, for the purpose of receiving input from affected
stakeholders and facilitating the coordination of monitoring
and treatment programs for the enrolled WTC responders under
part 1 of subtitle B.
``(B) WTC survivors steering committee.--One Steering
Committee, to be known as the WTC Survivors Steering Committee,
for the purpose of receiving input from affected stakeholders
and facilitating the coordination of initial health
evaluations, monitoring, and treatment programs for screening-
eligible and certified-eligible WTC survivors under part 2 of
subtitle B.
``(2) Membership.--
``(A) WTC responders steering committee.--
``(i) Representation.--The WTC Responders Steering
Committee shall include--
``(I) representatives of the Centers of Excellence
providing services to WTC responders;
``(II) representatives of labor organizations
representing firefighters, police, other New York City
employees, and recovery and cleanup workers who
responded to the September 11, 2001, terrorist attacks;
and
``(III) 3 representatives of New York City, 1 of
whom will be selected by the police commissioner of New
York City, 1 by the health commissioner of New York
City, and 1 by the mayor of New York City.
``(ii) Initial membership.--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).
``(B) WTC survivors steering committee.--
``(i) Representation.--The WTC Survivors Steering
Committee shall include representatives of--
``(I) the Centers of Excellence providing services
to screening-eligible and certified-eligible WTC
survivors;
``(II) the population of residents, students, and
area and other workers affected by the September 11,
2001, terrorist attacks;
``(III) screening-eligible and certified-eligible
survivors receiving initial health evaluations,
monitoring, or treatment under part 2 of subtitle B and
organizations advocating on their behalf; and
``(IV) New York City.
``(ii) Initial membership.--The WTC Survivors Steering
Committee shall initially be composed of members of the WTC
Environmental Health Center Survivor Advisory Committee (as
in existence on the day before the date of the enactment of
this title).
``(C) Additional appointments.--Each Steering Committee may
recommend, if approved by a majority of voting members of the
Committee, additional members to the Committee.
``(D) Vacancies.--A vacancy in a Steering Committee shall
be filled by an individual recommended by the Steering
Committee.
``SEC. 3303. EDUCATION AND OUTREACH.
``The WTC Program Administrator 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 Web site with
information about the WTC Program;
``(B) meetings with potentially eligible populations;
``(C) development and dissemination of outreach materials
informing people about the program; and
``(D) the establishment of phone information 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.
``SEC. 3304. UNIFORM DATA COLLECTION AND ANALYSIS.
``(a) In General.--The WTC Program Administrator shall provide for
the uniform collection of data, including claims data (and analysis of
data and regular reports to the Administrator) on the prevalence of
WTC-related health conditions and the identification of new WTC-related
health 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. The WTC Program Administrator
shall provide, through the Data Centers or otherwise, for the
integration of such data into the monitoring and treatment program
activities under this title.
``(b) Coordinating Through Centers of Excellence.--Each Clinical
Center of Excellence shall collect data described in subsection (a) and
report such data to the corresponding Data Center for analysis by such
Data Center.
``(c) Collaboration With WTC Health Registry.--The WTC Program
Administrator shall provide for collaboration between the Data Centers
and the World Trade Center Health Registry described in section 3342.
``(d) Privacy.--The data collection and analysis under this section
shall be conducted and maintained in a manner that protects the
confidentiality of individually identifiable health information
consistent with applicable statutes and regulations, including, as
applicable, HIPAA privacy and security law (as defined in section
3009(a)(2)) and section 552a of title 5, United States Code.
``SEC. 3305. CLINICAL CENTERS OF EXCELLENCE AND DATA CENTERS.
``(a) In General.--
``(1) Contracts with clinical centers of excellence.--The WTC
Program Administrator shall, subject to subsection (b)(1)(B), enter
into contracts with Clinical Centers of Excellence (as defined in
subsection (b)(1)(A))--
``(A) for the provision of monitoring and treatment
benefits and initial health evaluation benefits under subtitle
B;
``(B) for the provision of outreach activities to
individuals eligible for such monitoring and treatment
benefits, for initial health evaluation benefits, and for
followup 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;
``(D) for the provision of counseling for benefits for WTC-
related health conditions that may be available under workers'
compensation or other benefit programs for work-related
injuries or illnesses, health insurance, disability insurance,
or other insurance plans or through public or private social
service agencies and assisting eligible individuals in applying
for such benefits;
``(E) for the provision of translational and interpretive
services for program participants who are not English language
proficient; and
``(F) for the collection and reporting of data, including
claims data, in accordance with section 3304.
``(2) Contracts with data centers.--
``(A) In general.--The WTC Program Administrator shall
enter into contracts with one or more Data Centers (as defined
in subsection (b)(2))--
``(i) for receiving, analyzing, and reporting to the
WTC Program Administrator on data, in accordance with
section 3304, that have been collected and reported to such
Data Centers by the corresponding Clinical Centers of
Excellence under subsection (b)(1)(B)(iii);
``(ii) for the development of monitoring, initial
health evaluation, and treatment protocols, with respect to
WTC-related health conditions;
``(iii) for coordinating the outreach activities
conducted under paragraph (1)(B) by each corresponding
Clinical Center of Excellence;
``(iv) for establishing criteria for the credentialing
of medical providers participating in the nationwide
network under section 3313;
``(v) for coordinating and administering the activities
of the WTC Health Program Steering Committees established
under section 3002(b); and
``(vi) for meeting periodically with the corresponding
Clinical Centers of Excellence to obtain input on the
analysis and reporting of data collected under clause (i)
and on the development of monitoring, initial health
evaluation, and treatment protocols under clause (ii).
``(B) Medical provider selection.--The medical providers
under subparagraph (A)(iv) shall be selected by the WTC Program
Administrator on the basis of their experience treating or
diagnosing the health conditions included in the list of WTC-
related health conditions.
``(C) Clinical discussions.--In carrying out subparagraph
(A)(ii), a Data Center shall engage in clinical discussions
across the WTC Program to guide treatment approaches for
individuals with a WTC-related health condition.
``(D) Transparency of data.--A contract entered into under
this subsection with a Data Center shall require the Data
Center to make any data collected and reported to such Center
under subsection (b)(1)(B)(iii) available to health researchers
and others as provided in the CDC/ATSDR Policy on Releasing and
Sharing Data.
``(3) Authority for contracts to be class specific.--A contract
entered into under this subsection with a Clinical Center of
Excellence or a Data Center may be with respect to one or more
class of enrolled WTC responders, screening-eligible WTC survivors,
or certified-eligible WTC survivors.
``(4) Use of cooperative agreements.--Any contract under this
title between the WTC Program Administrator and a Data Center or a
Clinical Center of Excellence may be in the form of a cooperative
agreement.
``(5) Review on feasibility of consolidating data centers.--Not
later than July 1, 2011, the Comptroller General of the United
States shall submit to the Committee on Energy and Commerce of the
House of Representatives and the Committee on Health, Education,
Labor, and Pensions of the Senate a report on the feasibility of
consolidating Data Centers into a single Data Center.
``(b) Centers of Excellence.--
``(1) Clinical centers of excellence.--
``(A) Definition.--For purposes of this title, the term
`Clinical Center of Excellence' means a Center that
demonstrates to the satisfaction of the Administrator that the
Center--
``(i) uses an integrated, centralized health care
provider approach to create a comprehensive suite of health
services under this title that are accessible to enrolled
WTC responders, screening-eligible WTC survivors, or
certified-eligible WTC survivors;
``(ii) has experience in caring for WTC responders and
screening-eligible WTC survivors or includes health care
providers who have been trained pursuant to section
3313(c);
``(iii) employs health care provider staff with
expertise that includes, at a minimum, occupational
medicine, environmental medicine, trauma-related psychiatry
and psychology, and social services counseling; and
``(iv) meets such other requirements as specified by
the Administrator.
``(B) Contract requirements.--The WTC Program Administrator
shall not enter into a contract with a Clinical Center of
Excellence under subsection (a)(1) unless the Center agrees to
do each of the following:
``(i) Establish a formal mechanism for consulting with
and receiving input from representatives of eligible
populations receiving monitoring and treatment benefits
under subtitle B from such Center.
``(ii) Coordinate monitoring and treatment benefits
under subtitle B with routine medical care provided for the
treatment of conditions other than WTC-related health
conditions.
``(iii) Collect and report to the corresponding Data
Center data, including claims data, in accordance with
section 3304(b).
``(iv) Have in place safeguards against fraud that are
satisfactory to the Administrator, in consultation with the
Inspector General of the Department of Health and Human
Services.
``(v) Treat or refer for treatment all individuals who
are enrolled WTC responders or certified-eligible WTC
survivors with respect to such Center who present
themselves for treatment of a WTC-related health condition.
``(vi) Have in place safeguards, consistent with
section 3304(c), to ensure the confidentiality of an
individual's individually identifiable health information,
including requiring that such information not be disclosed
to the individual's employer without the authorization of
the individual.
``(vii) Use amounts paid under subsection (c)(1) only
for costs incurred in carrying out the activities described
in subsection (a), other than those described in subsection
(a)(1)(A).
``(viii) Utilize health care providers with
occupational and environmental medicine expertise to
conduct physical and mental health assessments, in
accordance with protocols developed under subsection
(a)(2)(A)(ii).
``(ix) Communicate with WTC responders and screening-
eligible and certified-eligible WTC survivors in
appropriate languages and conduct outreach activities with
relevant stakeholder worker or community associations.
``(x) Meet all the other applicable requirements of
this title, including regulations implementing such
requirements.
``(C) Transition rule to ensure continuity of care.--The
WTC Program Administrator shall to the maximum extent feasible
ensure continuity of care in any period of transition from
monitoring and treatment of an enrolled WTC responder or
certified-eligible WTC survivor by a provider to a Clinical
Center of Excellence or a health care provider participating in
the nationwide network under section 3313.
``(2) Data centers.--For purposes of this title, the term `Data
Center' means a Center that the WTC Program Administrator
determines has the capacity to carry out the responsibilities for a
Data Center under subsection (a)(2).
``(3) Corresponding centers.--For purposes of this title, a
Clinical Center of Excellence and a Data Center shall be treated as
`corresponding' to the extent that such Clinical Center and Data
Center serve the same population group.
``(c) Payment for Infrastructure Costs.--
``(1) In general.--The WTC Program Administrator shall
reimburse a Clinical Center of Excellence for the fixed
infrastructure costs of such Center in carrying out the activities
described in subtitle B at a rate negotiated by the Administrator
and such Centers. Such negotiated rate shall be fair and
appropriate and take into account the number of enrolled WTC
responders receiving services from such Center under this title.
``(2) Fixed infrastructure costs.--For purposes of paragraph
(1), the term `fixed infrastructure costs' means, with respect to a
Clinical Center of Excellence, the costs incurred by such Center
that are not otherwise reimbursable by the WTC Program
Administrator under section 3312(c) for patient evaluation,
monitoring, or treatment but which are needed to operate the WTC
program such as the costs involved in outreach to participants or
recruiting participants, data collection and analysis, social
services for counseling patients on other available assistance
outside the WTC program, and the development of treatment
protocols. Such term does not include costs for new construction or
other capital costs.
``(d) GAO Analysis.--Not later than July 1, 2011, the Comptroller
General shall submit to the Committee on Energy and Commerce of the
House of Representatives and the Committee on Health, Education, Labor,
and Pensions of the Senate an analysis on whether Clinical Centers of
Excellence with which the WTC Program Administrator enters into a
contract under this section have financial systems that will allow for
the timely submission of claims data for purposes of section 3304 and
subsections (a)(1)(F) and (b)(1)(B)(iii).
``SEC. 3306. DEFINITIONS.
``In this title:
``(1) The term `aggravating' means, with respect 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 September
11, 2001, terrorist attacks, 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 term `certified-eligible WTC survivor' has the
meaning given such term in section 3321(a)(2).
``(3) The terms `Clinical Center of Excellence' and `Data
Center' have the meanings given such terms in section 3305.
``(4) The term `enrolled WTC responder' means a WTC responder
enrolled under section 3311(a)(3).
``(5) The term `initial health evaluation' includes, with
respect to an individual, a medical and exposure history, a
physical examination, and additional medical testing as needed to
evaluate whether the individual has a WTC-related health condition
and is eligible for treatment under the WTC Program.
``(6) The term `list of WTC-related health conditions' means--
``(A) for WTC responders, the health conditions listed in
section 3312(a)(3); and
``(B) for screening-eligible and certified-eligible WTC
survivors, the health conditions listed in section 3322(b).
``(7) 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.
``(8) The term `New York metropolitan area' means an area,
specified by the WTC Program Administrator, within which WTC
responders and eligible WTC screening-eligible survivors who reside
in such area are reasonably able to access monitoring and treatment
benefits and initial health evaluation benefits under this title
through a Clinical Center of Excellence described in subparagraphs
(A), (B), or (C) of section 3305(b)(1).
``(9) The term `screening-eligible WTC survivor' has the
meaning given such term in section 3321(a)(1).
``(10) Any reference to `September 11, 2001' shall be deemed a
reference to the period on such date subsequent to the terrorist
attacks at the World Trade Center, Shanksville, Pennsylvania, or
the Pentagon, as applicable, on such date.
``(11) The term `September 11, 2001, terrorist attacks' means
the terrorist attacks that occurred on September 11, 2001, in New
York City, in Shanksville, Pennsylvania, and at the Pentagon, and
includes the aftermath of such attacks.
``(12) The term `WTC Health Program Steering Committee' means
such a Steering Committee established under section 3302(b).
``(13) The term `WTC Program' means the Word Trade Center
Health Program established under section 3301(a).
``(14)(A) The term `WTC Program Administrator' means--
``(i) subject to subparagraph (B), with respect to
paragraphs (3) and (4) of section 3311(a) (relating to
enrollment of WTC responders), section 3312(c) and the
corresponding provisions of section 3322 (relating to payment
for initial health evaluation, monitoring, and treatment,
paragraphs (1)(C), (2)(B), and (3) of section 3321(a) (relating
to determination or certification of screening-eligible or
certified-eligible WTC responders), and part 3 of subtitle B
(relating to payor provisions), an official in the Department
of Health and Human Services, to be designated by the
Secretary; and
``(ii) with respect to any other provision of this title,
the Director of the National Institute for Occupational Safety
and Health, or a designee of such Director.
``(B) In no case may the Secretary designate under subparagraph
(A)(i) the Director of the National Institute for Occupational
Safety and Health or a designee of such Director with respect to
section 3322 (relating to payment for initial health evaluation,
monitoring, and treatment).
``(15) The term `WTC-related health condition' is defined in
section 3312(a).
``(16) The term `WTC responder' is defined in section 3311(a).
``(17) The term `WTC Scientific/Technical Advisory Committee'
means such Committee established under section 3302(a).
``Subtitle B--Program of Monitoring, Initial Health Evaluations, and
Treatment
``PART 1--WTC RESPONDERS
``SEC. 3311. IDENTIFICATION OF WTC RESPONDERS AND PROVISION OF WTC-
RELATED MONITORING SERVICES.
``(a) WTC Responder Defined.--
``(1) In general.--For purposes of this title, the term `WTC
responder' means any of the following individuals, subject to
paragraph (4):
``(A) Currently identified responder.--An individual who
has been identified as eligible for monitoring under the
arrangements as in effect on the date of the enactment of this
title between the National Institute for Occupational Safety
and Health and--
``(i) the consortium coordinated by Mt. Sinai Hospital
in New York City that coordinates the monitoring and
treatment for enrolled WTC responders other than with
respect to those covered under the arrangement with the
Fire Department of New York City; or
``(ii) the Fire Department of New York City.
``(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, demolition, debris
cleanup, or other related services in the New York City
disaster area in response to the September 11, 2001,
terrorist attacks, regardless of whether such services were
performed by a State or Federal employee or member of the
National Guard or otherwise; and
``(ii) meets such eligibility criteria relating to
exposure to airborne toxins, other hazards, or adverse
conditions resulting from the September 11, 2001, terrorist
attacks as the WTC Program Administrator, after
consultation with 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 enrollments of
WTC responders has reached 80 percent of the limit described in
paragraph (4) or on or after the date that the number of
certifications for certified-eligible WTC survivors under
section 3321(a)(2)(B) has reached 80 percent of the limit
described in section 3321(a)(3).
``(2) Current eligibility criteria.--The eligibility criteria
described in this paragraph for an individual is that the
individual is described in any of the following categories:
``(A) Firefighters and related personnel.--The individual--
``(i) was a member of the Fire Department of New York
City (whether fire or emergency personnel, active or
retired) who participated at least one day in the rescue
and recovery effort at any of the former World Trade Center
sites (including Ground Zero, Staten Island Landfill, and
the New York City 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 family member of an
individual who was a member of the Fire Department of New
York City (whether fire or emergency personnel, active or
retired) and was killed at the World Trade site on
September 11, 2001; and
``(II) received any treatment for a WTC-related health
condition described in section 3312(a)(1)(A)(ii) (relating
to mental health conditions) on or before September 1,
2008.
``(B) Law enforcement officers and wtc rescue, recovery,
and cleanup workers.--The individual--
``(i) worked or volunteered onsite 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 hours during the
period beginning on September 11, 2001, and ending on
September 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 New
York City (whether active or retired) or a member of the
Port Authority Police of the Port Authority of New York and
New Jersey (whether active or retired) who participated
onsite in rescue, recovery, debris cleanup, or related
services in lower Manhattan (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 September 11, 2001, and ending on September 14,
2001;
``(II) participated onsite in rescue, recovery, debris
cleanup, or related services at Ground Zero, the Staten
Island 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 onsite in rescue, recovery, debris
cleanup, or related services 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; or
``(IV) participated onsite in rescue, recovery, debris
cleanup, or related services 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 New York City 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 Office staff,
during the period beginning on September 11, 2001, and
ending on July 31, 2002;
``(iv) was a worker in the Port Authority Trans-Hudson
Corporation Tunnel for at least 24 hours during the period
beginning 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, driving, cleaning, repairing, and maintaining
vehicles contaminated by airborne toxins from the September
11, 2001, terrorist attacks during a duration and period
described in subparagraph (A).
``(C) Responders to the september 11 attacks at the
pentagon and shanksville, pennsylvania.--The individual--
``(i)(I) was a member of a fire or police department
(whether fire or emergency personnel, active or retired),
worked for a recovery or cleanup contractor, or was a
volunteer; and performed rescue, recovery, demolition,
debris cleanup, or other related services at the Pentagon
site of the terrorist-related aircraft crash of September
11, 2001, during the period beginning on September 11,
2001, and ending on the date on which the cleanup of the
site was concluded, as determined by the WTC Program
Administrator; or
``(II) was a member of a fire or police department
(whether fire or emergency personnel, active or retired),
worked for a recovery or cleanup contractor, or was a
volunteer; and performed rescue, recovery, demolition,
debris cleanup, or other related services at the
Shanksville, Pennsylvania, site of the terrorist-related
aircraft crash of September 11, 2001, during the period
beginning on September 11, 2001, and ending on the date on
which the cleanup of the site was concluded, as determined
by the WTC Program Administrator; and
``(ii) is determined by the WTC Program Administrator
to be at an increased risk of developing a WTC-related
health condition as a result of exposure to airborne
toxins, other hazards, or adverse conditions resulting from
the September 11, 2001, terrorist attacks, and meets such
eligibility criteria related to such exposures, as the WTC
Program Administrator determines are appropriate, after
consultation with the WTC Scientific/Technical Advisory
Committee.
``(3) Enrollment process.--
``(A) In general.--The WTC Program Administrator shall
establish a process for enrolling WTC responders in the WTC
Program. Under such process--
``(i) WTC responders described in paragraph (1)(A)
shall be deemed to be enrolled in such Program;
``(ii) subject to clause (iii), the Administrator shall
enroll in such program individuals who are determined to be
WTC responders;
``(iii) the Administrator shall deny such enrollment to
an individual if the Administrator determines that the
numerical limitation in paragraph (4) on enrollment of WTC
responders has been met;
``(iv) there shall be no fee charged to the applicant
for making an application for such enrollment;
``(v) the Administrator shall make a determination on
such an application not later than 60 days after the date
of filing the application; and
``(vi) an individual who is denied enrollment in such
Program shall have an opportunity to appeal such
determination in a manner established under such process.
``(B) Timing.--
``(i) Currently identified responders.--In accordance
with subparagraph (A)(i), the WTC Program Administrator
shall enroll an individual described in paragraph (1)(A) in
the WTC Program not later than July 1, 2011.
``(ii) Other responders.--In accordance with
subparagraph (A)(ii) and consistent with paragraph (4), the
WTC Program Administrator shall enroll any other individual
who is determined to be a WTC responder in the WTC Program
at the time of such determination.
``(4) Numerical limitation on eligible wtc responders.--
``(A) In general.--The total number of individuals not
described in paragraph (1)(A) or (2)(A)(ii) who may be enrolled
under paragraph (3)(A)(ii) shall not exceed 25,000 at any time,
of which no more than 2,500 may be individuals enrolled based
on modified eligibility criteria established under paragraph
(1)(C).
``(B) Process.--In implementing subparagraph (A), the WTC
Program Administrator shall--
``(i) limit the number of enrollments made under
paragraph (3)--
``(I) in accordance with such subparagraph; and
``(II) to such number, as determined by the
Administrator based on the best available information
and subject to amounts available under section 3351,
that will ensure sufficient funds will be available to
provide treatment and monitoring benefits under this
title, with respect to all individuals who are enrolled
through the end of fiscal year 2020; and
``(ii) provide priority (subject to paragraph
(3)(A)(i)) in such enrollments in the order in which
individuals apply for enrollment under paragraph (3).
``(5) Disqualification of individuals on terrorist watch
list.--No individual who is on the terrorist watch list maintained
by the Department of Homeland Security shall qualify as an eligible
WTC responder. Before enrolling any individual as a WTC responder
in the WTC Program under paragraph (3), the Administrator, in
consultation with the Secretary of Homeland Security, shall
determine whether the individual is on such list.
``(b) Monitoring Benefits.--
``(1) In general.--In the case of an enrolled WTC responder
(other than one described in subsection (a)(2)(A)(ii)), the WTC
Program shall provide for monitoring benefits that include
monitoring consistent with protocols approved by the WTC Program
Administrator and including clinical examinations and long-term
health monitoring and analysis. In the case of an enrolled WTC
responder who is an active member of the Fire Department of New
York City, 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 Excellence for the type of individual involved or, in the
case of an individual residing outside the New York metropolitan
area, under an arrangement under section 3313.
``SEC. 3312. TREATMENT OF ENROLLED WTC RESPONDERS FOR WTC-RELATED
HEALTH CONDITIONS.
``(a) WTC-Related Health Condition Defined.--
``(1) In general.--For purposes of this title, the term `WTC-
related health condition' means a condition that--
``(A)(i) is 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, based on an examination by a medical
professional with experience in treating or diagnosing the
health conditions included in the applicable list of WTC-
related health 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
``(ii) is a mental health condition for which such attacks,
based on an examination by a medical professional with
experience in treating or diagnosing the health conditions
included in the applicable list of WTC-related health
conditions, is substantially likely to be a significant factor
in aggravating, contributing to, or causing the condition, as
determined under paragraph (2); and
``(B) is included in the applicable list of WTC-related
health conditions or--
``(i) with respect to a WTC responder, is provided
certification of coverage under subsection (b)(2)(B)(iii);
or
``(ii) with respect to a screening-eligible WTC
survivor or certified-eligible WTC survivor, is provided
certification of coverage under subsection (b)(2)(B)(iii),
as applied under section 3322(a).
In the case of a WTC responder described in section
3311(a)(2)(A)(ii) (relating to a surviving immediate family member
of a firefighter), such term does not include an illness or health
condition described in subparagraph (A)(i).
``(2) Determination.--The determination under paragraph (1) or
subsection (b) of whether the September 11, 2001, terrorist attacks
were substantially likely to be a significant factor in
aggravating, contributing 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, population-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 treating or diagnosing
health conditions included on the list of WTC-related
health 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 medical questionnaire approved by
the Director of the National Institute for Occupational
Safety and Health and a medical examination; and
``(ii) diagnosed and documented by a medical
professional described in subparagraph (A)(ii).
``(3) List of health conditions for wtc responders.--The list
of health conditions for WTC responders consists of the following:
``(A) Aerodigestive disorders.--
``(i) Interstitial lung diseases.
``(ii) Chronic respiratory disorder--fumes/vapors.
``(iii) Asthma.
``(iv) Reactive airways dysfunction syndrome (RADS).
``(v) WTC-exacerbated chronic obstructive pulmonary
disease (COPD).
``(vi) Chronic cough syndrome.
``(vii) Upper airway hyperreactivity.
``(viii) Chronic rhinosinusitis.
``(ix) Chronic nasopharyngitis.
``(x) Chronic laryngitis.
``(xi) Gastroesophageal reflux disorder (GERD).
``(xii) Sleep apnea exacerbated by or related to a
condition described in a previous clause.
``(B) Mental health conditions.--
``(i) Posttraumatic stress disorder (PTSD).
``(ii) Major depressive disorder.
``(iii) Panic disorder.
``(iv) Generalized anxiety disorder.
``(v) Anxiety disorder (not otherwise specified).
``(vi) Depression (not otherwise specified).
``(vii) Acute stress disorder.
``(viii) Dysthymic disorder.
``(ix) Adjustment disorder.
``(x) Substance abuse.
``(C) Musculoskeletal disorders for certain wtc
responders.--In the case of a WTC responder described in
paragraph (4), a condition described in such paragraph.
``(D) Additional conditions.--Any cancer (or type of
cancer) or other condition added, pursuant to paragraph (5) or
(6), to the list under this paragraph.
``(4) Musculoskeletal disorders.--
``(A) In general.--For purposes of this title, in the case
of a WTC responder who received any treatment for a WTC-related
musculoskeletal disorder on or before September 11, 2003, the
list of health conditions in paragraph (3) shall include:
``(i) Low back pain.
``(ii) Carpal tunnel syndrome (CTS).
``(iii) Other musculoskeletal disorders.
``(B) Definition.--The term `WTC-related musculoskeletal
disorder' means a chronic or recurrent disorder of the
musculoskeletal system caused by heavy lifting or repetitive
strain on the joints or musculoskeletal system occurring during
rescue or recovery efforts in the New York City disaster area
in the aftermath of the September 11, 2001, terrorist attacks.
``(5) Cancer.--
``(A) In general.--The WTC Program Administrator shall
periodically conduct a review of all available scientific and
medical evidence, including findings and recommendations of
Clinical Centers of Excellence, published in peer-reviewed
journals to determine if, based on such evidence, cancer or a
certain type of cancer should be added to the applicable list
of WTC-related health conditions. The WTC Program Administrator
shall conduct the first review under this subparagraph not
later than 180 days after the date of the enactment of this
title.
``(B) Proposed regulations and rulemaking.--Based on the
periodic reviews under subparagraph (A), if the WTC Program
Administrator determines that cancer or a certain type of
cancer should be added to such list of WTC-related health
conditions, the WTC Program Administrator shall propose
regulations, through rulemaking, to add cancer or the certain
type of cancer to such list.
``(C) Final regulations.--Based on all the available
evidence in the rulemaking record, the WTC Program
Administrator shall make a final determination of whether
cancer or a certain type of cancer should be added to such list
of WTC-related health conditions. If such a determination is
made to make such an addition, the WTC Program Administrator
shall by regulation add cancer or the certain type of cancer to
such list.
``(D) Determinations not to add cancer or certain types of
cancer.--In the case that the WTC Program Administrator
determines under subparagraph (B) or (C) that cancer or a
certain type of cancer should not be added to such list of WTC-
related health conditions, the WTC Program Administrator shall
publish an explanation for such determination in the Federal
Register. Any such determination to not make such an addition
shall not preclude the addition of cancer or the certain type
of cancer to such list at a later date.
``(6) Addition of health conditions to list for wtc
responders.--
``(A) In general.--Whenever the WTC Program Administrator
determines that a proposed rule should be promulgated to add a
health condition to the list of health conditions in paragraph
(3), the Administrator may request a recommendation of the
Advisory Committee or may publish such a proposed rule in the
Federal Register in accordance with subparagraph (D).
``(B) Administrator's options after receipt of petition.--
In the case that the WTC Program Administrator receives a
written petition by an interested party to add a health
condition to the list of health conditions in paragraph (3),
not later than 60 days after the date of receipt of such
petition the Administrator shall--
``(i) request a recommendation of the Advisory
Committee;
``(ii) publish a proposed rule in the Federal Register
to add such health condition, in accordance with
subparagraph (D);
``(iii) publish in the Federal Register the
Administrator's determination not to publish such a
proposed rule and the basis for such determination; or
``(iv) publish in the Federal Register a determination
that insufficient evidence exists to take action under
clauses (i) through (iii).
``(C) Action by advisory committee.--In the case that the
Administrator requests a recommendation of the Advisory
Committee under this paragraph, with respect to adding a health
condition to the list in paragraph (3), the Advisory Committee
shall submit to the Administrator such recommendation not later
than 60 days after the date of such request or by such date
(not to exceed 180 days after such date of request) as
specified by the Administrator. Not later than 60 days after
the date of receipt of such recommendation, the Administrator
shall, in accordance with subparagraph (D), publish in the
Federal Register a proposed rule with respect to such
recommendation or a determination not to propose such a
proposed rule and the basis for such determination.
``(D) Publication.--The WTC Program Administrator shall,
with respect to any proposed rule under this paragraph--
``(i) publish such proposed rule in accordance with
section 553 of title 5, United States Code; and
``(ii) provide interested parties a period of 30 days
after such publication to submit written comments on the
proposed rule.
The WTC Program Administrator may extend the period described
in clause (ii) upon a finding of good cause. In the case of
such an extension, the Administrator shall publish such
extension in the Federal Register.
``(E) Interested party defined.--For purposes of this
paragraph, the term `interested party' includes a
representative of any organization representing WTC responders,
a nationally recognized medical association, a Clinical or Data
Center, a State or political subdivision, or any other
interested person.
``(b) Coverage of Treatment for WTC-Related Health Conditions.--
``(1) Determination for enrolled wtc responders based on a wtc-
related health condition.--
``(A) In general.--If a physician at a Clinical Center of
Excellence that is providing monitoring benefits under section
3311 for an enrolled WTC responder makes a determination that
the responder has a WTC-related health condition that is in the
list in subsection (a)(3) and that exposure to airborne toxins,
other hazards, or adverse conditions resulting from the
September 1, 2001, 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 supporting 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; appeals.--
``(i) Review.--A Federal employee designated by the WTC
Program Administrator shall review determinations made
under subparagraph (A).
``(ii) Certification.--The Administrator shall provide
a certification of such condition based upon reviews
conducted under clause (i). Such a certification shall be
provided unless the Administrator determines that the
responder's condition is not a WTC-related health condition
in the list in subsection (a)(3) or that exposure to
airborne toxins, other hazards, or adverse conditions
resulting from the September 1, 2001, terrorist attacks is
not substantially likely to be a significant factor in
aggravating, contributing to, or causing the condition.
``(iii) Appeal process.--The Administrator shall
establish, by rule, a process for the appeal of
determinations under clause (ii).
``(2) Determination based on medically associated wtc-related
health conditions.--
``(A) In general.--If a physician at a Clinical Center of
Excellence determines pursuant to subsection (a) that the
enrolled WTC responder has a health condition described in
subsection (a)(1)(A) that is not in the list in subsection
(a)(3) but which is medically associated with a WTC-related
health condition--
``(i) the physician shall promptly transmit such
determination to the WTC Program Administrator and provide
the Administrator with the facts supporting such
determination; and
``(ii) the Administrator shall make a determination
under subparagraph (B) with respect to such physician's
determination.
``(B) Procedures for review, certification, and appeal.--
The WTC Program Administrator shall, by rule, establish
procedures for the review and certification of physician
determinations under subparagraph (A). Such rule shall provide
for--
``(i) the timely review of such a determination by a
physician panel with appropriate expertise for the
condition and recommendations to the WTC Program
Administrator;
``(ii) not later than 60 days after the date of the
transmittal under subparagraph (A)(i), a determination by
the WTC Program Administrator on whether or not the
condition involved is described in subsection (a)(1)(A) and
is medically associated with a WTC-related health
condition;
``(iii) certification in accordance with paragraph
(1)(B)(ii) of coverage of such condition if determined to
be described in subsection (a)(1)(A) and medically
associated with a WTC-related health condition; and
``(iv) a process for appeals of determinations relating
to such conditions.
``(C) Inclusion in list of health conditions.--If the WTC
Program Administrator provides certification under subparagraph
(B)(iii) for coverage of a condition, the Administrator may,
pursuant to subsection (a)(6), add the condition to the list in
subsection (a)(3).
``(D) Conditions already declined for inclusion in list.--
If the WTC Program Administrator publishes a determination
under subsection (a)(6)(B) not to include a condition in the
list in subsection (a)(3), the WTC Program Administrator shall
not provide certification under subparagraph (B)(iii) for
coverage of the condition. In the case of an individual who is
certified under subparagraph (B)(iii) with respect to such
condition before the date of the publication of such
determination the previous sentence shall not apply.
``(3) Requirement of medical necessity.--
``(A) In general.--In providing treatment for a WTC-related
health condition, a physician or other provider shall provide
treatment that is medically necessary and in accordance with
medical treatment protocols established under subsection (d).
``(B) Regulations relating to medical necessity.--For the
purpose of this title, the WTC Program Administrator shall
issue regulations specifying a standard for determining medical
necessity with respect to health care services and prescription
pharmaceuticals, a process for determining whether treatment
furnished and pharmaceuticals prescribed under this title meet
such standard (including any prior authorization requirement),
and a process for appeal of a determination under subsection
(c)(3).
``(4) Scope of treatment covered.--
``(A) In general.--The scope of treatment covered under
this subsection includes services of physicians and other
health care providers, diagnostic and laboratory tests,
prescription drugs, inpatient and outpatient hospital services,
and other medically necessary treatment.
``(B) Pharmaceutical coverage.--With respect to ensuring
coverage of medically necessary outpatient prescription drugs,
such drugs shall be provided, under arrangements made by the
WTC Program Administrator, directly through participating
Clinical Centers of Excellence or through one or more outside
vendors.
``(C) Transportation expenses for nationwide network.--The
WTC Program Administrator may provide for necessary and
reasonable transportation and expenses incident to the securing
of medically necessary treatment through the nationwide network
under section 3313 involving travel of more than 250 miles and
for which payment is made under this section in the same manner
in which individuals may be furnished necessary and reasonable
transportation and expenses incident to services involving
travel of more than 250 miles under regulations implementing
section 3629(c) of the Energy Employees Occupational Illness
Compensation Program Act of 2000 (title XXXVI of Public Law
106-398; 42 U.S.C. 7384t(c)).
``(5) Provision of treatment pending certification.--With
respect to an enrolled WTC responder for whom a determination is
made by an examining physician under paragraph (1) or (2), but for
whom the WTC Program Administrator has not yet determined whether
to certify the determination, the WTC Program Administrator may
establish by rule a process through which the Administrator may
approve the provision of medical treatment under this subsection
(and payment under subsection (c)) with respect to such responder
and such responder's WTC-related health condition (under such terms
and conditions as the Administrator may provide) until the
Administrator makes a decision on whether to certify the
determination.
``(c) Payment for Initial Health Evaluation, Monitoring, and
Treatment of WTC-Related Health Conditions.--
``(1) Medical treatment.--
``(A) Use of feca payment rates.--
``(i) In general.--Subject to clause (ii):
``(I) Subject to subparagraphs (B) and (C), the WTC
Program 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 provision of such
treatment and services by the facility under the
Federal Employees Compensation Act.
``(II) For treatment not covered under subclause
(i) or subparagraph (B), the WTC Program Administrator
shall establish by regulation a reimbursement rate for
such treatment.
``(ii) Exception.--In no case shall payments for
products or services under clause (i) be made at a rate
higher than the Office of Worker's Compensation Programs in
the Department Labor would pay for such products or
services rendered at the time such products or services
were provided.
``(B) Pharmaceuticals.--
``(i) In general.--The WTC Program Administrator shall
establish a program for paying for the medically necessary
outpatient prescription pharmaceuticals prescribed under
this title for WTC-related health conditions through one or
more contracts with outside vendors.
``(ii) Competitive bidding.--Under such program the
Administrator shall--
``(I) select one or more appropriate vendors
through a Federal competitive 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 participants.--Under such
program the Administrator may enter into an agreement with
a separate vendor to provide pharmaceutical benefits to
enrolled WTC responders for whom the Clinical Center of
Excellence is described in section 3305 if such an
arrangement is deemed necessary and beneficial to the
program by the WTC Program Administrator.
``(iv) Pharmaceuticals.--Not later than July 1, 2011,
the Comptroller General of the United States shall submit
to the Committee on Energy and Commerce of the House of
Representatives and the Committee on Health, Education,
Labor, and Pensions of the Senate a report on whether
existing Federal pharmaceutical purchasing programs can
provide pharmaceutical benefits more efficiently and
effectively than through the WTC program.
``(C) Improving quality and efficiency through modification
of payment amounts and methodologies.--The WTC Program
Administrator may modify the amounts and methodologies for
making payments for initial health evaluations, monitoring, or
treatment, if, taking into account utilization and quality data
furnished by the Clinical Centers of Excellence under section
3305(b)(1)(B)(iii), the Administrator determines that a
bundling, capitation, pay for performance, or other payment
methodology would better ensure high quality and efficient
delivery of initial health evaluations, monitoring, or
treatment to an enrolled WTC responder, screening-eligible WTC
survivor, or certified-eligible WTC survivor.
``(2) Monitoring and initial health evaluation.--The WTC
Program Administrator shall reimburse the costs of monitoring and
the costs of an initial health evaluation provided under this title
at a rate set by the Administrator by regulation.
``(3) Determination of medical necessity.--
``(A) Review of medical necessity and protocols.--As part
of the process for reimbursement or payment under this
subsection, the WTC Program Administrator shall provide for the
review of claims for reimbursement or payment for the provision
of medical treatment to determine if such treatment is
medically necessary and in accordance with medical treatment
protocols established under subsection (d).
``(B) Withholding of payment for medically unnecessary
treatment.--The Administrator shall withhold such reimbursement
or payment for treatment that the Administrator determines is
not medically necessary or is not in accordance with such
medical treatment protocols.
``(d) Medical Treatment Protocols.--
``(1) Development.--The Data Centers shall 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.
``(2) Approval.--The medical treatment protocols developed
under paragraph (1) shall be subject to approval by the WTC Program
Administrator.
``SEC. 3313. NATIONAL ARRANGEMENT FOR BENEFITS FOR ELIGIBLE INDIVIDUALS
OUTSIDE NEW YORK.
``(a) In General.--In order to ensure reasonable access to benefits
under this subtitle for individuals who are enrolled WTC responders,
screening-eligible WTC survivors, or certified-eligible WTC survivors
and who reside in any State, as defined in section 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 initial health evaluations near
such individuals' areas of residence in such States. Nothing in this
subsection shall be construed as preventing such individuals from being
provided such monitoring and treatment benefits or initial health
evaluation through any Clinical Center of Excellence.
``(b) Network Requirements.--Any health care provider participating
in the network under subsection (a) shall--
``(1) meet criteria for credentialing established by the Data
Centers;
``(2) follow the monitoring, initial health evaluation, and
treatment protocols developed under section 3305(a)(2)(A)(ii);
``(3) collect and report data in accordance with section 3304;
and
``(4) meet such fraud, quality assurance, and other
requirements as the WTC Program Administrator establishes,
including sections 1128 through 1128E of the Social Security Act,
as applied by section 3301(d).
``(c) Training and Technical Assistance.--The WTC Program
Administer may provide, including through contract, for the provision
of training and technical assistance to health care providers
participating in the network under subsection (a).
``(d) Provision of Services Through the VA.--
``(1) In general.--The WTC Program Administrator may enter into
an agreement with the Secretary of Veterans Affairs for the
Secretary to provide services under this section through facilities
of the Department of Veterans Affairs.
``(2) National program.--Not later than July 1, 2011, the
Comptroller General of the United States shall submit to the
Committee on Energy and Commerce of the House of Representatives
and the Committee on Health, Education, Labor, and Pensions of the
Senate a report on whether the Department of Veterans Affairs can
provide monitoring and treatment services to individuals under this
section more efficiently and effectively than through the
nationwide network to be established under subsection (a).
``PART 2--WTC SURVIVORS
``SEC. 3321. IDENTIFICATION AND INITIAL HEALTH EVALUATION OF SCREENING-
ELIGIBLE AND CERTIFIED-ELIGIBLE WTC SURVIVORS.
``(a) Identification of Screening-Eligible WTC Survivors and
Certified-Eligible WTC Survivors.--
``(1) Screening-eligible wtc survivors.--
``(A) Definition.--In this title, the term `screening-
eligible WTC survivor' means, subject to subparagraph (C) and
paragraph (3), an individual who is described in any of the
following clauses:
``(i) Currently identified survivor.--An individual,
including a WTC responder, who has been identified as
eligible for medical treatment and monitoring by the WTC
Environmental Health Center as of the date of enactment of
this title.
``(ii) Survivor who meets current eligibility
criteria.--An individual who is not a WTC responder, for
purposes of the initial health evaluation under subsection
(b), claims symptoms of a WTC-related health condition and
meets any of the current eligibility criteria described in
subparagraph (B).
``(iii) Survivor who meets modified eligibility
criteria.--An individual who is not a WTC responder, for
purposes of the initial health evaluation under subsection
(b), claims symptoms of a WTC-related health condition and
meets such eligibility criteria relating to exposure to
airborne toxins, other hazards, or adverse conditions
resulting from the September 11, 2001, terrorist attacks as
the WTC Administrator determines, after consultation with
the Data Centers described in section 3305 and the WTC
Scientific/Technical Advisory Committee and WTC Health
Program Steering Committees under section 3302.
The Administrator shall not modify such criteria under clause
(iii) on or after the date that the number of certifications
for certified-eligible WTC survivors under paragraph (2)(B) has
reached 80 percent of the limit described in paragraph (3) or
on or after the date that the number of enrollments of WTC
responders has reached 80 percent of the limit described in
section 3311(a)(4).
``(B) Current eligibility criteria.--The eligibility
criteria described in this subparagraph for an individual are
that the individual is described in any of the following
clauses:
``(i) A person who was present in the New York City
disaster area in the dust or dust cloud on September 11,
2001.
``(ii) A person who worked, resided, or attended
school, childcare, or adult daycare in the New York City
disaster area for--
``(I) at least 4 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 period beginning
on September 11, 2001, and ending on July 31, 2002.
``(iii) Any person who worked as a cleanup worker or
performed maintenance work in the New York City disaster
area during the 4-month period described in subparagraph
(B)(i) and had extensive exposure to WTC dust as a result
of such work.
``(iv) A person who was deemed eligible to receive a
grant from the Lower Manhattan Development Corporation
Residential Grant Program, 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.
``(v) A person whose place of employment--
``(I) at any time during the period beginning on
September 11, 2001, and ending 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 Development Corporation WTC Small
Firms Attraction and Retention Act program or other
government incentive program designed to revitalize the
lower Manhattan economy after the September 11, 2001,
terrorist attacks.
``(C) Application and determination process for screening
eligibility.--
``(i) In general.--The WTC Program Administrator in
consultation with the Data Centers shall establish a
process for individuals, other than individuals described
in subparagraph (A)(i), to be determined to be screening-
eligible WTC survivors. Under such process--
``(I) there shall be no fee charged to the
applicant for making an application for such
determination;
``(II) the Administrator shall make a determination
on such an application not later than 60 days after the
date of filing the application;
``(III) the Administrator shall make such a
determination relating to an applicant's compliance
with this title and shall not determine that an
individual is not so eligible or deny written
documentation under clause (ii) to such individual
unless the Administrator determines that--
``(aa) based on the application submitted, the
individual does not meet the eligibility criteria;
or
``(bb) the numerical limitation on
certifications of certified-eligible WTC survivors
set forth in paragraph (3) has been met; and
``(IV) an individual who is determined not to be a
screening-eligible WTC survivor shall have an
opportunity to appeal such determination in a manner
established under such process.
``(ii) Written documentation of screening-
eligibility.--
``(I) In general.--In the case of an individual who
is described in subparagraph (A)(i) or who is
determined under clause (i) (consistent with paragraph
(3)) to be a screening-eligible WTC survivor, the WTC
Program Administrator shall provide an appropriate
written documentation of such fact.
``(II) Timing.--
``(aa) Currently identified survivors.--In the
case of an individual who is described in
subparagraph (A)(i), the WTC Program Administrator
shall provide the written documentation under
subclause (I) not later than July 1, 2011.
``(bb) Other members.--In the case of another
individual who is determined under clause (i) and
consistent with paragraph (3) to be a screening-
eligible WTC survivor, the WTC Program
Administrator shall provide the written
documentation under subclause (I) at the time of
such determination.
``(2) Certified-eligible wtc survivors.--
``(A) Definition.--The term `certified-eligible WTC
survivor' means, subject to paragraph (3), a screening-eligible
WTC survivor who the WTC Program Administrator certifies under
subparagraph (B) to be eligible for followup monitoring and
treatment under this part.
``(B) Certification of eligibility for monitoring and
treatment.--
``(i) In general.--The WTC Program Administrator shall
establish a certification process under which the
Administrator shall provide appropriate certification to
screening-eligible WTC survivors who, pursuant to the
initial health evaluation under subsection (b), are
determined to be eligible for followup monitoring and
treatment under this part.
``(ii) Timing.--
``(I) Currently identified survivors.--In the case
of an individual who is described in paragraph
(1)(A)(i), the WTC Program Administrator shall provide
the certification under clause (i) not later than July
1, 2011.
``(II) Other members.--In the case of another
individual who is determined under clause (i) to be
eligible for followup monitoring and treatment, the WTC
Program Administrator shall provide the certification
under such clause at the time of such determination.
``(3) Numerical limitation on certified-eligible wtc
survivors.--
``(A) In general.--The total number of individuals not
described in paragraph (1)(A)(i) who may be certified as
certified-eligible WTC survivors under paragraph (2)(B) shall
not exceed 25,000 at any time.
``(B) Process.--In implementing subparagraph (A), the WTC
Program Administrator shall--
``(i) limit the number of certifications provided under
paragraph (2)(B)--
``(I) in accordance with such subparagraph; and
``(II) to such number, as determined by the
Administrator based on the best available information
and subject to amounts made available under section
3351, that will ensure sufficient funds will be
available to provide treatment and monitoring benefits
under this title, with respect to all individuals
receiving such certifications through the end of fiscal
year 2020; and
``(ii) provide priority in such certifications in the
order in which individuals apply for a determination under
paragraph (2)(B).
``(4) Disqualification of individuals on terrorist watch
list.--No individual who is on the terrorist watch list maintained
by the Department of Homeland Security shall qualify as a
screening-eligible WTC survivor or a certified-eligible WTC
survivor. Before determining any individual to be a screening-
eligible WTC survivor under paragraph (1) or certifying any
individual as a certified eligible WTC survivor under paragraph
(2), the Administrator, in consultation with the Secretary of
Homeland Security, shall determine whether the individual is on
such list.
``(b) Initial Health Evaluation To Determine Eligibility for
Followup Monitoring or Treatment.--
``(1) In general.--In the case of a screening-eligible WTC
survivor, the WTC Program shall provide for an initial health
evaluation to determine if the survivor has a WTC-related health
condition and is eligible for followup monitoring and treatment
benefits under the WTC Program. Initial health evaluation protocols
under section 3305(a)(2)(A)(ii) shall be subject to approval by the
WTC Program Administrator.
``(2) Initial health evaluation providers.--The initial health
evaluation described in paragraph (1) shall be provided through a
Clinical Center of Excellence with respect to the individual
involved.
``(3) Limitation on initial health evaluation benefits.--
Benefits for an initial health evaluation under this part for a
screening-eligible WTC survivor shall consist only of a single
medical initial health evaluation consistent with initial health
evaluation protocols described in paragraph (1). Nothing in this
paragraph shall be construed as preventing such an individual from
seeking additional medical initial health evaluations at the
expense of the individual.
``SEC. 3322. FOLLOWUP MONITORING AND TREATMENT OF CERTIFIED-ELIGIBLE
WTC SURVIVORS FOR WTC-RELATED HEALTH CONDITIONS.
``(a) In General.--Subject to subsection (b), the provisions of
sections 3311 and 3312 shall apply to followup monitoring and treatment
of WTC-related health conditions for certified-eligible WTC survivors
in the same manner as such provisions apply to the monitoring and
treatment of WTC-related health conditions for enrolled WTC responders.
``(b) List of WTC-Related Health Conditions for Survivors.--The
list of health conditions for screening-eligible WTC survivors and
certified-eligible WTC survivors consists of the following:
``(1) Aerodigestive disorders.--
``(A) Interstitial lung diseases.
``(B) Chronic respiratory disorder--fumes/vapors.
``(C) Asthma.
``(D) Reactive airways dysfunction syndrome (RADS).
``(E) WTC-exacerbated chronic obstructive pulmonary disease
(COPD).
``(F) Chronic cough syndrome.
``(G) Upper airway hyperreactivity.
``(H) Chronic rhinosinusitis.
``(I) Chronic nasopharyngitis.
``(J) Chronic laryngitis.
``(K) Gastroesophageal reflux disorder (GERD).
``(L) Sleep apnea exacerbated by or related to a condition
described in a previous clause.
``(2) Mental health conditions.--
``(A) Posttraumatic stress disorder (PTSD).
``(B) Major depressive disorder.
``(C) Panic disorder.
``(D) Generalized anxiety disorder.
``(E) Anxiety disorder (not otherwise specified).
``(F) Depression (not otherwise specified).
``(G) Acute stress disorder.
``(H) Dysthymic disorder.
``(I) Adjustment disorder.
``(J) Substance abuse.
``(3) Additional conditions.--Any cancer (or type of cancer) or
other condition added to the list in section 3312(a)(3) pursuant to
paragraph (5) or (6) of section 3312(a), as such provisions are
applied under subsection (a) with respect to certified-eligible WTC
survivors.
``SEC. 3323. FOLLOWUP MONITORING AND TREATMENT OF OTHER INDIVIDUALS
WITH WTC-RELATED HEALTH CONDITIONS.
``(a) In General.--Subject to subsection (c), the provisions of
section 3322 shall apply to the followup monitoring and treatment of
WTC-related health conditions in the case of individuals described in
subsection (b) in the same manner as such provisions apply to the
followup monitoring and treatment of WTC-related health conditions for
certified-eligible WTC survivors.
``(b) Individuals Described.--An individual described in this
subsection is an individual who, regardless of location of residence--
``(1) is not an enrolled WTC responder or a certified-eligible
WTC survivor; and
``(2) is diagnosed at a Clinical Center of Excellence with a
WTC-related health condition for certified-eligible WTC survivors.
``(c) Limitation.--
``(1) In general.--The WTC Program Administrator 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 amount specified in paragraph (2) for such fiscal year.
``(2) Limitation.--The amount specified in this paragraph for--
``(A) the last calendar quarter of fiscal year 2011 is
$5,000,000;
``(B) fiscal year 2012 is $20,000,000; or
``(C) a succeeding fiscal year is the amount specified in
this paragraph for the previous fiscal year increased by the
annual percentage increase in the medical care component of the
consumer price index for all urban consumers.
``PART 3--PAYOR PROVISIONS
``SEC. 3331. PAYMENT OF CLAIMS.
``(a) In General.--Except as provided in subsections (b) and (c),
the cost of monitoring and treatment benefits and initial health
evaluation benefits provided under parts 1 and 2 of this subtitle shall
be paid for by the WTC Program from the World Trade Center Health
Program Fund.
``(b) Workers' Compensation Payment.--
``(1) In general.--Subject to paragraph (2), payment for
treatment under parts 1 and 2 of this subtitle of a WTC-related
health condition of an individual that is work-related shall be
reduced or recouped to the extent that the WTC Program
Administrator 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, a State, or a locality, or other
work-related injury 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 and paragraphs (3) and (4) of such section
shall apply to the recoupment under this subsection of a payment to
the WTC Program (with respect to a workers' compensation law or
plan, or other work-related injury or illness plan of the employer
involved, and such individual) in the same manner as such
provisions apply to the reimbursement of a payment under section
1862(b)(2) of such Act to the Secretary (with respect to such a law
or plan and an individual entitled to benefits under title XVIII of
such Act) except that any reference in such paragraph (4) to
payment rates under title XVIII of the Social Security Act shall be
deemed a reference to payment rates under this title.
``(2) Exception.--Paragraph (1) shall not apply for any
quarter, with respect to any workers' compensation law or plan,
including line of duty compensation, to which New York City is
obligated to make payments, if, in accordance with terms specified
under the contract under subsection (d)(1)(A), New York City has
made the full payment required under such contract for such
quarter.
``(3) Rules of construction.--Nothing in this title shall be
construed to affect, modify, or relieve any obligations under a
worker's compensation law or plan, other work-related injury or
illness benefit plan of an employer, or any health insurance plan.
``(c) Health Insurance Coverage.--
``(1) In general.--In the case of an individual who has a WTC-
related health condition that is not work-related and has health
coverage for such condition through any public or private health
plan (including health benefits under title XVIII, XIX, or XXI of
the Social Security Act) the provisions of section 1862(b) of the
Social Security Act shall apply to such a health plan and such
individual in the same manner as they apply to group health plan
and an individual entitled to benefits under title XVIII of such
Act pursuant to section 226(a) of such Act. Any costs for items and
services covered under such plan that are not reimbursed by such
health plan, due to the application of deductibles, copayments,
coinsurance, other cost sharing, or otherwise, are reimbursable
under this title to the extent that they are covered under the WTC
Program. The program under this title shall not be treated as a
legally liable party for purposes of applying section 1902(a)(25)
of the Social Security Act.
``(2) Recovery by individual providers.--Nothing in paragraph
(1) shall be construed as requiring an entity providing monitoring
and treatment under this title to seek reimbursement under a health
plan with which the entity has no contract for reimbursement.
``(3) Maintenance of required minimum essential coverage.--No
payment may be made for monitoring and treatment under this title
for an individual for a month (beginning with July 2014) if with
respect to such month the individual--
``(A) is an applicable individual (as defined in subsection
(d) of section 5000A of Internal Revenue Code of 1986) for whom
the exemption under subsection (e) of such section does not
apply; and
``(B) is not covered under minimum essential coverage, as
required under subsection (a) of such section.
``(d) Required Contribution by New York City in Program Costs.--
``(1) Contract requirement.--
``(A) In general.--No funds may be disbursed from the World
Trade Center Health Program Fund under section 3351 unless New
York City has entered into a contract with the WTC Program
Administrator under which New York City agrees, in a form and
manner specified by the Administrator, to pay the full
contribution described in subparagraph (B) in accordance with
this subsection on a timely basis, plus any interest owed
pursuant to subparagraph (E)(i). Such contract shall specify
the terms under which New York City shall be considered to have
made the full payment required for a quarter for purposes of
subsection (b)(2).
``(B) Full contribution amount.--Under such contract, with
respect to the last calendar quarter of fiscal year 2011 and
each calendar quarter in fiscal years 2012 through 2015 the
full contribution amount under this subparagraph shall be equal
to 10 percent of the expenditures in carrying out this title
for the respective quarter and with respect to calendar
quarters in fiscal year 2016, such full contribution amount
shall be equal to \1/9\ of the Federal expenditures in carrying
out this title for the respective quarter.
``(C) Satisfaction of payment obligation.--The payment
obligation under such contract may not be satisfied through any
of the following:
``(i) An amount derived from Federal sources.
``(ii) An amount paid before the date of the enactment
of this title.
``(iii) An amount paid to satisfy a judgment or as part
of a settlement related to injuries or illnesses arising
out of the September 11, 2001, terrorist attacks.
``(D) Timing of contribution.--The payment obligation under
such contract for a calendar quarter in a fiscal year shall be
paid not later than the last day of the second succeeding
calendar quarter.
``(E) Compliance.--
``(i) Interest for late payment.--If New York City
fails to pay to the WTC Program Administrator pursuant to
such contract the amount required for any calendar quarter
by the day specified in subparagraph (D), interest shall
accrue on the amount not so paid at the rate (determined by
the Administrator) based on the average yield to maturity,
plus 1 percentage point, on outstanding municipal bonds
issued by New York City with a remaining maturity of at
least 1 year.
``(ii) Recovery of amounts owed.--The amounts owed to
the WTC Program Administrator under such contract shall be
recoverable by the United States in an action in the same
manner as payments made under title XVIII of the Social
Security Act may be recoverable in an action brought under
section 1862(b)(2)(B)(iii) of such Act.
``(F) Deposit in fund.--The WTC Program Administer shall
deposit amounts paid under such contract into the World Trade
Center Health Program Fund under section 3351.
``(2) Payment of new york city share of monitoring and
treatment costs.--With respect to each calendar quarter for which a
contribution is required by New York City under the contract under
paragraph (1), the WTC Program Administrator shall--
``(A) provide New York City with an estimate of such amount
of the required contribution at the beginning of such quarter
and with an updated estimate of such amount at the beginning of
each of the subsequent 2 quarters;
``(B) bill such amount directly to New York City; and
``(C) certify periodically, for purposes of this
subsection, whether or not New York City has paid the amount so
billed.
Such amount shall initially be estimated by the WTC Program
Administrator and shall be subject to adjustment and reconciliation
based upon actual expenditures in carrying out this title.
``(3) Rule of construction.--Nothing in this subsection shall
be construed as authorizing the WTC Administrator, with respect to
a fiscal year, to reduce the numerical limitation under section
3311(a)(4) or 3321(a)(3) for such fiscal year if New York City
fails to comply with paragraph (1) for a calendar quarter in such
fiscal year.
``(e) Work-Related Described.--For the purposes of this section, a
WTC-related health condition shall be treated as a condition that is
work-related if--
``(1) the condition is diagnosed in an enrolled WTC responder,
or in an individual who qualifies as a certified-eligible WTC
survivor on the basis of being a rescue, recovery, or cleanup
worker; or
``(2) with respect to the condition the individual has filed
and had established a claim under a workers' compensation law or
plan of the United States or a State, or other work-related injury
or illness benefit plan of the employer of such individual.
``SEC. 3332. ADMINISTRATIVE ARRANGEMENT AUTHORITY.
``The WTC Program Administrator may enter into arrangements with
other government agencies, insurance companies, or other third-party
administrators to provide for timely and accurate processing of claims
under sections 3312, 3313, 3322, and 3323.
``Subtitle C--Research Into Conditions
``SEC. 3341. RESEARCH REGARDING CERTAIN HEALTH CONDITIONS RELATED TO
SEPTEMBER 11 TERRORIST ATTACKS.
``(a) In General.--With respect to individuals, including enrolled
WTC responders and certified-eligible WTC survivors, receiving
monitoring or treatment under 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 uncertainty; and
``(3) research on treating WTC-related health conditions of
such individuals, in the case of conditions for which there has
been treatment uncertainty.
The Administrator may provide such support through continuation and
expansion of research that was initiated before the date of the
enactment of this title and through the World Trade Center Health
Registry (referred to in section 3342), through a Clinical Center of
Excellence, or through a Data Center.
``(b) Types of Research.--The research under subsection (a)(1)
shall include epidemiologic and other research studies on WTC-related
health conditions or emerging conditions--
``(1) among enrolled WTC responders and certified-eligible WTC
survivors under treatment; and
``(2) in sampled populations outside the New York City disaster
area in Manhattan as far north as 14th Street and in Brooklyn,
along with control populations, to identify potential for long-term
adverse health effects in less exposed populations.
``(c) Consultation.--The WTC Program Administrator shall carry out
this section in consultation with the WTC Scientific/Technical Advisory
Committee.
``(d) Application of Privacy and Human Subject Protections.--The
privacy and human subject protections applicable to research conducted
under this section shall not be less than such protections applicable
to research conducted or funded by the Department of Health and Human
Services.
``SEC. 3342. WORLD TRADE CENTER HEALTH REGISTRY.
``For the purpose of ensuring ongoing data collection relating to
victims of the September 11, 2001, terrorist attacks, the WTC Program
Administrator shall ensure that a registry of such victims is
maintained that is at least as comprehensive as the World Trade Center
Health Registry maintained under the arrangements in effect as of April
20, 2009, with the New York City Department of Health and Mental
Hygiene.
``Subtitle D--Funding
``SEC. 3351. WORLD TRADE CENTER HEALTH PROGRAM FUND.
``(a) Establishment of Fund.--
``(1) In general.--There is established a fund to be known as
the World Trade Center Health Program Fund (referred to in this
section as the `Fund').
``(2) Funding.--Out of any money in the Treasury not otherwise
appropriated, there shall be deposited into the Fund for each of
fiscal years 2012 through 2016 (and the last calendar quarter of
fiscal year 2011)--
``(A) the Federal share, consisting of an amount equal to
the lesser of--
``(i) 90 percent of the expenditures in carrying out
this title for the respective fiscal year (initially based
on estimates, subject to subsequent reconciliation based on
actual expenditures); or
``(ii)(I) $71,000,000 for the last calendar quarter of
fiscal year 2011, $318,000,000 for fiscal year 2012,
$354,000,000 for fiscal year 2013, $382,000,000 for fiscal
year 2014, and $431,000,000 for fiscal year 2015; and
``(II) subject to paragraph (4), an additional amount
for fiscal year 2016 from unexpended amounts for previous
fiscal years; plus
``(B) the New York City share, consisting of the amount
contributed under the contract under section 3331(d).
``(3) Contract requirement.--
``(A) In general.--No funds may be disbursed from the Fund
unless New York City has entered into a contract with the WTC
Program Administrator under section 3331(d)(1).
``(B) Breach of contract.--In the case of a failure to pay
the amount so required under the contract--
``(i) the amount is recoverable under subparagraph
(E)(ii) of such section;
``(ii) such failure shall not affect the disbursement
of amounts from the Fund; and
``(iii) the Federal share described in paragraph (2)(A)
shall not be increased by the amount so unpaid.
``(4) Aggregate limitation on funding beginning with fiscal
year 2016.--Beginning with fiscal year 2016, in no case shall the
share of Federal funds deposited into the Fund under paragraph (2)
for such fiscal year and previous fiscal years and quarters exceed
the sum of the amounts specified in paragraph (2)(A)(ii)(I).
``(b) Mandatory Funds for Monitoring, Initial Health Evaluations,
Treatment, and Claims Processing.--
``(1) In general.--The amounts deposited into the Fund under
subsection (a)(2) shall be available, without further
appropriation, consistent with paragraph (2) and subsection (c), to
carry out subtitle B and sections 3302(a), 3303, 3304, 3305(a)(2),
3305(c), 3341, and 3342.
``(2) Limitation on mandatory funding.--This title does not
establish any Federal obligation for payment of amounts in excess
of the amounts available from the Fund for such purpose.
``(3) Limitation on authorization for further appropriations.--
This title does not establish any authorization for appropriation
of amounts in excess of the amounts available from the Fund under
paragraph (1).
``(c) Limits on Spending for Certain Purposes.--Of the amounts made
available under subsection (b)(1), not more than each of the following
amounts may be available for each of the following purposes:
``(1) Surviving immediate family members of firefighters.--For
the purposes of carrying out subtitle B with respect to WTC
responders described in section 3311(a)(2)(A)(ii)--
``(A) for the last calendar quarter of fiscal year 2011,
$100,000;
``(B) for fiscal year 2012, $400,000; and
``(C) for each subsequent fiscal year, the amount specified
under this paragraph for the previous fiscal year increased by
the percentage increase in the consumer price index for all
urban consumers (all items; United States city average) as
estimated by the Secretary for the 12-month period ending with
March of the previous year.
``(2) WTC health program scientific/technical advisory
committee.--For the purpose of carrying out section 3302(a)--
``(A) for the last calendar quarter of fiscal year 2011,
$25,000;
``(B) for fiscal year 2012, $100,000; and
``(C) for each subsequent fiscal year, the amount specified
under this paragraph for the previous fiscal year increased by
the percentage increase in the consumer price index for all
urban consumers (all items; United States city average) as
estimated by the Secretary for the 12-month period ending with
March of the previous year.
``(3) Education and outreach.--For the purpose of carrying out
section 3303--
``(A) for the last calendar quarter of fiscal year 2011,
$500,000;
``(B) for fiscal year 2012, $2,000,000; and
``(C) for each subsequent fiscal year, the amount specified
under this paragraph for the previous fiscal year increased by
the percentage increase in the consumer price index for all
urban consumers (all items; United States city average) as
estimated by the Secretary for the 12-month period ending with
March of the previous year.
``(4) Uniform data collection.--For the purpose of carrying out
section 3304 and for reimbursing Data Centers (as defined in
section 3305(b)(2)) for the costs incurred by such Centers in
carrying out activities under contracts entered into under section
3305(a)(2)--
``(A) for the last calendar quarter of fiscal year 2011,
$2,500,000;
``(B) for fiscal year 2012, $10,000,000; and
``(C) for each subsequent fiscal year, the amount specified
under this paragraph for the previous fiscal year increased by
the percentage increase in the consumer price index for all
urban consumers (all items; United States city average) as
estimated by the Secretary for the 12-month period ending with
March of the previous year.
``(5) Research regarding certain health conditions.--For the
purpose of carrying out section 3341--
``(A) for the last calendar quarter of fiscal year 2011,
$3,750,000;
``(B) for fiscal year 2012, $15,000,000; and
``(C) for each subsequent fiscal year, the amount specified
under this paragraph for the previous fiscal year increased by
the percentage increase in the consumer price index for all
urban consumers (all items; United States city average) as
estimated by the Secretary for the 12-month period ending with
March of the previous year.
``(6) World trade center health registry.--For the purpose of
carrying out section 3342--
``(A) for the last calendar quarter of fiscal year 2011,
$1,750,000;
``(B) for fiscal year 2012, $7,000,000; and
``(C) for each subsequent fiscal year, the amount specified
under this paragraph for the previous fiscal year increased by
the percentage increase in the consumer price index for all
urban consumers (all items; United States city average) as
estimated by the Secretary for the 12-month period ending with
March of the previous year.''.
TITLE II--SEPTEMBER 11TH VICTIM 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, and payments
made pursuant to the settlement of a civil action described in
section 405(c)(3)(C)(iii)'' after ``September 11, 2001'';
(2) by inserting after paragraph (6) the following new
paragraphs and redesignating subsequent paragraphs accordingly:
``(7) Contractor and subcontractor.--The term `contractor and
subcontractor' means any contractor or subcontractor (at any tier
of a subcontracting relationship), including any general
contractor, construction manager, prime contractor, consultant, or
any parent, subsidiary, associated or allied company, affiliated
company, corporation, firm, organization, or joint venture thereof
that participated in debris removal at any 9/11 crash site. Such
term shall not include 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, direct or indirect.
``(8) Debris removal.--The term `debris removal' means rescue
and recovery efforts, removal of debris, cleanup, remediation, and
response during the immediate aftermath of the terrorist-related
aircraft crashes of September 11, 2001, with respect to a 9/11
crash site.'';
(3) by inserting after paragraph (10), as so redesignated, the
following new paragraph and redesignating the subsequent paragraphs
accordingly:
``(11) Immediate aftermath.--The term `immediate aftermath'
means any period beginning with the terrorist-related aircraft
crashes of September 11, 2001, and ending on May 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, Pentagon site, and
Shanksville, Pennsylvania site;
``(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 demonstrable 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 occurred, 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 Debris 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 removal during
the immediate aftermath'' after ``September 11, 2001'';
(2) in clause (ii), by inserting ``or debris removal during the
immediate aftermath'' after ``crashes''; and
(3) in clause (iii), by inserting ``or debris removal 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 promulgated
under section 407(a).
``(B) Exception.--A claim may be filed under paragraph (1),
in accordance with subsection (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
the date that is 5 years after the date on which such
regulations are updated.''.
(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 filing claims.--An
individual (or a personal representative on behalf of a
deceased individual) may file a claim during the period
described in subsection (a)(3)(B) as follows:
``(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
aircraft crashes of September 11, 2001, or as a result
of debris removal, and that the individual knew (or
should have known) before 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 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 suffered 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 beginning on the date
the Special Master determines the individual first knew
(or should have known) that the individual both
suffered from such harm and was eligible to file a
claim under this title.
``(ii) Other eligibility requirements for filing
claims.--An individual 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''.
(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
subsection (c), is amended by inserting ``, or for damages arising
from or related to debris removal'' after ``September 11, 2001''.
(2) Pending actions.--Clause (ii) of such section, as so
redesignated, is amended to read as follows:
``(ii) Pending actions.--In the case of an individual
who is a party to a civil action described in clause (i),
such individual may not submit a claim under this title--
``(I) during the period described in subsection
(a)(3)(A) unless such individual withdraws from such
action by the date that is 90 days after the date on
which regulations are promulgated under section 407(a);
and
``(II) during the period described in subsection
(a)(3)(B) unless such individual withdraws from such
action by the date that is 90 days after the date on
which the regulations are updated under section
407(b).''.
(3) Settled actions.--Such section, as so redesignated, is
further amended by adding at the end the following new clause:
``(iii) Settled actions.--In the case of an individual
who settled a civil action described in clause (i), such
individual may not submit a claim under this title unless
such action was commenced after December 22, 2003, and a
release of all claims in such action was tendered prior to
the date on which the James Zadroga 9/11 Health and
Compensation Act of 2010 was enacted.''.
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--
(1) by striking ``Not later than'' and inserting ``(a) In
General.--Not later than''; and
(2) by adding at the end the following new subsection:
``(b) Updated Regulations.--Not later than 180 days after the date
of the enactment of the James Zadroga 9/11 Health and Compensation Act
of 2010, 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 paragraphs:
``(4) Liability for certain claims.--Notwithstanding any other
provision of law, liability for all claims and actions (including
claims or actions that have been previously resolved, that are
currently pending, and that may be filed) for compensatory damages,
contribution or indemnity, or any other form or type of relief,
arising from or related to debris removal, against the 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 indirect) and any contractors and subcontractors, shall
not be in an amount that exceeds the sum of the following, as may
be applicable:
``(A) The amount of funds of the WTC Captive Insurance
Company, including the cumulative interest.
``(B) The amount of all available insurance identified in
schedule 2 of the WTC Captive Insurance Company insurance
policy.
``(C) As it relates to the limitation of liability of the
City of New York, the amount that is the greater of the City of
New York's insurance coverage or $350,000,000. In determining
the amount of the City's insurance coverage for purposes of the
previous sentence, any amount described in subparagraphs (A)
and (B) shall not be included.
``(D) As it relates to the limitation of liability of 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 indirect), the amount of all available liability
insurance coverage maintained by any such entity.
``(E) As it relates to the limitation of liability of any
individual contractor or subcontractor, the amount of all
available liability insurance coverage maintained by such
contractor or subcontractor on September 11, 2001.
``(5) Priority of claims payments.--Payments to plaintiffs who
obtain a settlement or judgment with respect to a claim or action
to which paragraph (4) applies, shall be paid solely from the
following funds in the following order, as may be applicable:
``(A) The funds described in subparagraph (A) or (B) of
paragraph (4).
``(B) If there are no funds available as described in
subparagraph (A) or (B) of paragraph (4), the funds described
in subparagraph (C) of such paragraph.
``(C) If there are no funds available as described in
subparagraph (A), (B), or (C) of paragraph (4), the funds
described in subparagraph (D) of such paragraph.
``(D) If there are no funds available as described in
subparagraph (A), (B), (C), or (D) of paragraph (4), the funds
described in subparagraph (E) of such paragraph.
``(6) Declaratory judgment actions and direct action.--Any
claimant to a claim or action to which paragraph (4) applies may,
with respect to such claim or action, either file an action for a
declaratory judgment for insurance coverage or bring a direct
action against the insurance company involved, except that no such
action for declaratory judgment or direct action may be commenced
until after the funds available in subparagraph (A), (B), (C), and
(D) of paragraph (5) have been exhausted consistent with the order
described in such paragraph for payment.''.
SEC. 205. FUNDING; ATTORNEY FEES.
Section 406 of the Air Transportation Safety and System
Stabilization Act (49 U.S.C. 40101 note) is amended--
(1) in subsection (a), by striking ``Not later than'' and
inserting ``Subject to the limitations under subsection (d), not
later than'';
(2) in subsection (b)--
(A) by inserting ``in the amounts provided under subsection
(d)(1)'' after ``appropriations Acts''; and
(B) by inserting ``subject to the limitations under
subsection (d)'' before the period; and
(3) by adding at the end the following new subsections:
``(d) Limitation.--
``(1) In general.--The total amount of Federal funds paid for
compensation under this title, with respect to claims filed on or
after the date on which the regulations are updated under section
407(b), shall not exceed $2,775,000,000. Of such amounts, not to
exceed $875,000,000 shall be available to pay such claims during
the 5-year period beginning on such date.
``(2) Pro-ration and payment of remaining claims.--
``(A) In general.--The Special Master shall ratably reduce
the amount of compensation due claimants under this title in a
manner to ensure, to the extent possible, that--
``(i) all claimants who, before application of the
limitation under the second sentence of paragraph (1),
would have been determined to be entitled to a payment
under this title during such 5-year period, receive a
payment during such period; and
``(ii) the total amount of all such payments made
during such 5-year period do not exceed the amount
available under the second sentence of paragraph (1) to pay
claims during such period.
``(B) Payment of remainder of claim amounts.--In any case
in which the amount of a claim is ratably reduced pursuant to
subparagraph (A), on or after the first day after the 5-year
period described in paragraph (1), but in no event later than 1
year after such 5-year period, the Special Master shall pay to
the claimant the amount that is equal to the difference
between--
``(i) the amount that the claimant would have been paid
under this title during such period without regard to the
limitation under the second sentence of paragraph (1)
applicable to such period; and
``(ii) the amount the claimant was paid under this
title during such period.
``(C) Termination.--Upon completion of all payments
pursuant to this subsection, the Victim's Compensation Fund
shall be permanently closed.
``(e) Attorney Fees.--
``(1) In general.--Notwithstanding any contract, the
representative of an individual may not charge, for services
rendered in connection with the claim of an individual under this
title, more than 10 percent of an award made under this title on
such claim.
``(2) Limitation.--
``(A) In general.--Except as provided in subparagraph (B),
in the case of an individual who was charged a legal fee in
connection with the settlement of a civil action described in
section 405(c)(3)(C)(iii), the representative of the individual
may not charge any amount for compensation for services
rendered in connection with a claim filed under this title.
``(B) Exception.--If the legal fee charged in connection
with the settlement of a civil action described in section
405(c)(3)(C)(iii) of an individual is less than 10 percent of
the aggregate amount of compensation awarded to such individual
through such settlement, the representative of such individual
may charge an amount for compensation for services rendered to
the extent that such amount charged is not more than--
``(i) 10 percent of such aggregate amount through the
settlement, minus
``(ii) the total amount of all legal fees charged for
services rendered in connection with such settlement.
``(3) Discretion to lower fee.--In the event that the special
master finds that the fee limit set by paragraph (1) or (2)
provides excessive compensation for services rendered in connection
with such claim, the Special Master may, in the discretion of the
Special Master, award as reasonable compensation for services
rendered an amount lesser than that permitted for in paragraph
(1).''.
TITLE III--REVENUE RELATED PROVISIONS
SEC. 301. EXCISE TAX ON CERTAIN FOREIGN PROCUREMENT.
(a) Imposition of Tax.--
(1) In general.--Subtitle D of the Internal Revenue Code of
1986 is amended by adding at the end the following new chapter:
``CHAPTER 50--FOREIGN PROCUREMENT
``Sec. 5000C. Imposition of tax on certain foreign procurement.
``SEC. 5000C. IMPOSITION OF TAX ON CERTAIN FOREIGN PROCUREMENT.
``(a) Imposition of Tax.--There is hereby imposed on any foreign
person that receives a specified Federal procurement payment a tax
equal to 2 percent of the amount of such specified Federal procurement
payment.
``(b) Specified Federal Procurement Payment.--For purposes of this
section, the term `specified Federal procurement payment' means any
payment made pursuant to a contract with the Government of the United
States for--
``(1) the provision of goods, if such goods are manufactured or
produced in any country which is not a party to an international
procurement agreement with the United States, or
``(2) the provision of services, if such services are provided
in any country which is not a party to an international procurement
agreement with the United States.
``(c) Foreign Person.--For purposes of this section, the term
`foreign person' means any person other than a United States person.
``(d) Administrative Provisions.--
``(1) Withholding.--The amount deducted and withheld under
chapter 3 shall be increased by the amount of tax imposed by this
section on such payment.
``(2) Other administrative provisions.--For purposes of
subtitle F, any tax imposed by this section shall be treated as a
tax imposed by subtitle A.''.
(2) Clerical amendment.--The table of chapters for subtitle D
of the Internal Revenue Code of 1986 is amended by adding at the
end the following new item:
``Chapter 50--Foreign Procurement''.
(3) Effective date.--The amendments made by this subsection
shall apply to payments received pursuant to contracts entered into
on and after the date of the enactment of this Act.
(b) Prohibition on Reimbursement of Fees.--
(1) In general.--The head of each executive agency shall take
any and all measures necessary to ensure that no funds are
disbursed to any foreign contractor in order to reimburse the tax
imposed under section 5000C of the Internal Revenue Code of 1986.
(2) Annual review.--The Administrator for Federal Procurement
Policy shall annually review the contracting activities of each
executive agency to monitor compliance with the requirements of
paragraph (1).
(3) Executive agency.--For purposes of this subsection, the
term ``executive agency'' has the meaning given the term in section
4 of the Office of Federal Procurement Policy Act (41 U.S.C. 403).
(c) Application.--This section and the amendments made by this
section shall be applied in a manner consistent with United States
obligations under international agreements.
SEC. 302. RENEWAL OF FEES FOR VISA-DEPENDENT EMPLOYERS.
Subsections (a), (b), and (c) of section 402 of Public Law 111-230
are amended by striking ``2014'' each place that such appears and
inserting ``2015''.
TITLE IV--BUDGETARY EFFECTS
SEC. 401. COMPLIANCE WITH STATUTORY PAY-AS-YOU-GO ACT OF 2010.
The budgetary effects of this Act, for the purpose of complying
with the Statutory Pay-As-You-Go Act of 2010, shall be determined by
reference to the latest statement titled ``Budgetary Effects of PAYGO
Legislation'' for this Act, submitted for printing in the Congressional
Record by the Chairman of the Senate Budget Committee, provided that
such statement has been submitted prior to the vote on passage.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.