[Congressional Record Volume 156, Number 173 (Wednesday, December 22, 2010)]
[Senate]
[Pages S11039-S11053]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           TEXT OF AMENDMENTS

  SA 4921. Mr. LEVIN (for himself and Mr. McCain) proposed an amendment 
to the bill H.R. 6523, to authorize appropriations for fiscal year 2011 
for military activities of the Department of Defense, for military 
construction, and for defense activities of the Department of Energy, 
to prescribe military personnel strengths for such fiscal year, and for 
other purposes; as follows:

       Strike title XVII and the corresponding table of contents 
     on page 18.
                                 ______
                                 
  SA 4922. Mr. KIRK submitted an amendment intended to be proposed to 
amendment SA 4904 proposed by Mr. Corker to Treaty Doc. 111-5, Treaty 
between the United States of America and the Russian Federation on 
Measures for the Further Reduction and Limitation of Strategic 
Offensive Arms, signed in Prague on April 8, 2010, with Protocol; as 
follows:

       On page 2, after line 19, add the following:
       (2) Missile defense.--It is the understanding of the United 
     States that the advice and consent of the Senate to the New 
     START Treaty is subject to the understanding, which shall be 
     transmitted to the Russian Federation at the time of the 
     exchange of instruments of ratification, stated in the letter 
     transmitted by President Barack Obama to the Majority Leader 
     of the United States Senate on December 18, 2010, the text of 
     which is as follows:

                                              The White House,

                                    Washington, December 18, 2010.
     Hon. Harry M. Reid,
     Majority Leader, U.S. Senate,
     Washington, DC.
       Dear Senator Reid: As the Senate considers the New START 
     Treaty, I want to share with you my views on the issue of 
     missile defense, which has been the subject of much debate in 
     the Senate's review of the Treaty.
       Pursuant to the National Missile Defense Act of 1999 
     (Public Law 106-38), it has long been the policy of the 
     United States to deploy as soon as is technologically 
     possible an effective National Missile Defense system capable 
     of defending the territory of the United States against 
     limited ballistic missile attack, whether accidental, 
     unauthorized, or deliberate. Thirty ground-based interceptors 
     based at Fort Greely, Alaska, and Vandenberg Air Force Base, 
     California, are now defending the nation. All United States 
     missile defense programs--including all phases of the 
     European Phased Adaptive Approach to missile defense (EPAA) 
     and programs to defend United States deployed forces, allies, 
     and partners against regional threats--are consistent with 
     this policy.
       The New START Treaty places no limitations on the 
     development or deployment of our missile defense programs. As 
     the NATO Summit meeting in Lisbon last month underscored, we 
     are proceeding apace with a missile defense system in Europe 
     designed to provide full coverage for NATO members on the 
     continent, as well as deployed U.S. forces, against the 
     growing threat posed by the proliferation of ballistic 
     missiles. The final phase of the system will also augment our 
     current defenses against intercontinental ballistic missiles 
     from Iran targeted against the United States.
       All NATO allies agreed in Lisbon that the growing threat of 
     missile proliferation, and our Article 5 commitment of 
     collective defense, requires that the Alliance develop a 
     territorial missile defense capability. The Alliance further 
     agreed that the EPAA, which I announced in September 2009, 
     will be a crucial contribution to this capability. Starting 
     in 2011, we will begin deploying the first phase of the EPAA, 
     to protect large parts of southern Europe from short- and 
     medium-range ballistic missile threats. In subsequent phases, 
     we will deploy longer-range and more effective land-based 
     Standard Missile-3 (SM-3) interceptors in Romania and Poland 
     to protect Europe against medium- and intermediate-range 
     ballistic missiles. In the final phase, planned for the end 
     of the decade, further upgrades of the SM-3 interceptor will 
     provide an ascent-phase intercept capability to augment our 
     defense of NATO European territory, as well as that of the 
     United States, against future threats of ICBMs launched from 
     Iran.
       The Lisbon decisions represent an historic achievement, 
     making clear that all. NATO allies believe we need an 
     effective territorial missile defense to defend against the 
     threats we face now and in the future., The EPAA represents 
     the right response. At Lisbon, the Alliance also invited the 
     Russian Federation to cooperate on missile defense, which 
     could lead to adding Russian capabilities to those deployed 
     by NATO to enhance our common security against common 
     threats. The Lisbon Summit thus demonstrated that the 
     Alliance's missile defenses can be strengthened by improving 
     NATO-Russian relations.
       This comes even as we have made clear that the system we 
     intend to pursue with Russia will not be a joint system, and 
     it will not in any way limit United States' or NATO's missile 
     defense capabilities. Effective cooperation with Russia could 
     enhance the overall effectiveness and efficiency of our 
     combined territorial missile defenses, and at the same time 
     provide Russia with greater security. Irrespective of how 
     cooperation with Russia develops, the Alliance alone bears 
     responsibility for defending NATO's members, consistent with 
     our Treaty obligations for collective defense. The EPAA and 
     NATO's territorial missile defense capability will allow us 
     to do that.
       In signing the New START Treaty, the Russian Federation 
     issued a statement that expressed its view that the 
     extraordinary events referred to in Article XIV of the Treaty 
     include a ``build-up in the missile defense capabilities of 
     the United States of America such that it would give rise to 
     a threat to the strategic nuclear potential of the Russian 
     Federation.'' Article XIV(3), as you know, gives each Party 
     the right to withdraw from the Treaty if it believes its 
     supreme interests are jeopardized.
       The United States did not and does not agree with the 
     Russian statement, We believe that the continued development 
     and deployment of U.S. missile defense systems, including 
     qualitative and quantitative improvements to such systems, do 
     not and will not threaten the strategic balance with the 
     Russian Federation, and have provided policy and technical 
     explanations to Russia on why we believe that to be the case. 
     Although the United States cannot circumscribe Russia's 
     sovereign rights under Article XIV(3), we believe that the 
     continued improvement and deployment of U.S. missile defense 
     systems do not constitute a basis for questioning the 
     effectiveness and viability of the New START Treaty, and 
     therefore would not give rise to circumstances justifying 
     Russia's withdrawal from the Treaty.
       Regardless of Russia's actions in this regard, as long as I 
     am President, and as long as the Congress provides the 
     necessary funding, the United States will continue to develop 
     and deploy effective missile defenses to protect the United 
     States, our deployed forces, and our allies and partners. My 
     Administration plans to deploy all four phases of the EPAA. 
     While advances of technology or future changes in the threat 
     could modify the details or timing of the later phases of the 
     EPAA--one reason this approach is called ``adaptive''--I will 
     take every action available to me to support the deployment 
     of all four phases.
           Sincerely,
                                                     Barack Obama.
                                 ______
                                 
  SA 4923. Mr. REID (for Mrs. Gillibrand (for herself and Mr. Schumer)) 
proposed an amendment to the bill H.R. 847, to amend the Public Health 
Service Act to extend and improve protections and services to 
individual directly impacted by the terrorist attack in New York City 
on September 11, 2001, and for other purposes; as follows:

       Strike all after the enacting clause and insert the 
     following:

     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.

[[Page S11040]]

``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

[[Page S11041]]

     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

[[Page S11042]]

     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

[[Page S11043]]

     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

[[Page S11044]]

       ``(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.--

[[Page S11045]]

       ``(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

[[Page S11046]]

     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.

[[Page S11047]]

       ``(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.--

[[Page S11048]]

       ``(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

[[Page S11049]]

     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 contra ct 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.''.

[[Page S11050]]

     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

[[Page S11051]]

       (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.
                                 ______
                                 
  SA 4924. Mr. BROWN of Ohio (for himself, Mr. Casey, Mr. Baucus, Mr. 
McCain, and Mr. Kyl) proposed an amendment to the bill H.R. 6517, to 
extend trade adjustment assistance and certain trade preference 
programs, to amend the Harmonized Tariff Schedule of the United States 
to modify temporarily certain rates of duty, and for other purposes; as 
follows:

       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Omnibus 
     Trade Act of 2010''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.

 TITLE I--EXTENSION OF TRADE ADJUSTMENT ASSISTANCE AND HEALTH COVERAGE 
                              IMPROVEMENT

          Subtitle A--Extension of Trade Adjustment Assistance

Sec. 101. Extension of trade adjustment assistance.
Sec. 102. Merit staffing for State administration of trade adjustment 
              assistance.

                Subtitle B--Health Coverage Improvement

Sec. 111. Improvement of the affordability of the credit.
Sec. 112. Payment for the monthly premiums paid prior to commencement 
              of the advance payments of credit.
Sec. 113. TAA recipients not enrolled in training programs eligible for 
              credit.
Sec. 114. TAA pre-certification period rule for purposes of determining 
              whether there is a 63-day lapse in creditable coverage.
Sec. 115. Continued qualification of family members after certain 
              events.
Sec. 116. Extension of COBRA benefits for certain TAA-eligible 
              individuals and PBGC recipients.
Sec. 117. Addition of coverage through voluntary employees' beneficiary 
              associations.
Sec. 118. Notice requirements.

                 TITLE II--ANDEAN TRADE PREFERENCES ACT

Sec. 201. Extension of Andean Trade Preference Act.

                           TITLE III--OFFSETS

Sec. 301. Customs user fees.
Sec. 302. Time for payment of corporate estimated taxes.

                      TITLE IV--BUDGETARY EFFECTS

Sec. 401. Compliance with PAYGO.

 TITLE I--EXTENSION OF TRADE ADJUSTMENT ASSISTANCE AND HEALTH COVERAGE 
                              IMPROVEMENT

          Subtitle A--Extension of Trade Adjustment Assistance

     SEC. 101. EXTENSION OF TRADE ADJUSTMENT ASSISTANCE.

       (a) In General.--Section 1893(a) of the Trade and 
     Globalization Adjustment Assistance Act of 2009 (Public Law 
     111-5; 123 Stat.

[[Page S11052]]

     422) is amended by striking ``January 1, 2011'' each place it 
     appears and inserting ``Febrary 13, 2011''.
       (b) Application of Prior Law.--Section 1893(b) of the Trade 
     and Globalization Adjustment Assistance Act of 2009 (Public 
     Law 111-5; 123 Stat. 422 (19 U.S.C. 2271 note prec.)) is 
     amended to read as follows:
       ``(b) Application of Prior Law.--Chapters 2, 3, 4, 5, and 6 
     of title II of the Trade Act of 1974 (19 U.S.C. 2271 et seq.) 
     shall be applied and administered beginning February 13, 
     2011, as if the amendments made by this subtitle (other than 
     part VI) had never been enacted, except that in applying and 
     administering such chapters--
       ``(1) section 245 of that Act shall be applied and 
     administered by substituting `February 12, 2012' for 
     `December 31, 2007';
       ``(2) section 246(b)(1) of that Act shall be applied and 
     administered by substituting `February 12, 2012' for `the 
     date that is 5 years' and all that follows through `State';
       ``(3) section 256(b) of that Act shall be applied and 
     administered by substituting `the 1-year period beginning 
     February 13, 2011, and ending February 12. 2012,' for `each 
     of fiscal years 2003 through 2007, and $4,000,000 for the 3-
     month period beginning on October 1, 2007,';
       ``(4) section 298(a) of that Act shall be applied and 
     administered by substituting `the 1-year period beginning 
     February 13, 2011, and ending February 12. 2012,' for `each 
     of the fiscal years' and all that follows through `October 1, 
     2007'; and
       ``(5) subject to subsection (a)(2), section 285 of that Act 
     shall be applied and administered--
       ``(A) in subsection (a), by substituting `February 12, 
     2011' for `December 31, 2007' each place it appears; and
       ``(B) by applying and administering subsection (b) as if it 
     read as follows:
       `` `(b) Other Assistance.--
       `` `(1) Assistance for firms.--
       `` `(A) In general.--Except as provided in subparagraph 
     (B), assistance may not be provided under chapter 3 after 
     February 12, 2012.
       `` `(B) Exception.--Notwithstanding subparagraph (A), any 
     assistance approved under chapter 3 on or before February 12, 
     2012, may be provided--
       `` `(i) to the extent funds are available pursuant to such 
     chapter for such purpose; and
       `` `(ii) to the extent the recipient of the assistance is 
     otherwise eligible to receive such assistance.
       `` `(2) Farmers.--
       `` `(A) In general.--Except as provided in subparagraph 
     (B), assistance may not be provided under chapter 6 after 
     February 12, 2012.
       `` `(B) Exception.--Notwithstanding subparagraph (A), any 
     assistance approved under chapter 6 on or before February 12, 
     2012, may be provided--
       `` `(i) to the extent funds are available pursuant to such 
     chapter for such purpose; and
       `` `(ii) to the extent the recipient of the assistance is 
     otherwise eligible to receive such assistance.'.''.
       (c) Conforming Amendments.--
       (1) Section 236(a)(2)(A) of the Trade Act of 1974 (19 
     U.S.C. 2296(a)(2)(A)) is amended to read as follows:
       ``(2)(A) The total amount of payments that may be made 
     under paragraph (1) shall not exceed--
       ``(i) $575,000,000 for fiscal year 2010; and
       ``(ii) $66,500,000 for the 6-week period beginning January 
     1, 2011, and ending February 12, 2011.''.
       (2) Section 245(a) of the Trade Act of 1974 (19 U.S.C. 
     2317(a)) is amended by striking ``December 31, 2010'' and 
     inserting ``February 12, 2011''.
       (3) Section 246(b)(1) of the Trade Act of 1974 (19 U.S.C. 
     2318(b)(1)) is amended by striking ``December 31, 2010'' and 
     inserting ``February 12, 2011''.
       (4) Section 255(a) of the Trade Act of 1974 (19 U.S.C. 
     2345(a)) is amended--
       (A) in the first sentence to read as follows: ``There are 
     authorized to be appropriated to the Secretary to carry out 
     the provisions of this chapter $50,000,000 for fiscal year 
     2010 and $5,800,000 for the 6-week period beginning January 
     1, 2011, and ending February 12, 2011.''; and
       (B) in paragraph (1), by striking ``December 31, 2010'' and 
     inserting ``February 12, 2011''.
       (5) Section 275(f) of the Trade Act of 1974 (19 U.S.C. 
     2371d(f)) is amended by striking ``2011'' and inserting ``and 
     annually thereafter''.
       (6) Section 276(c)(2) of the Trade Act of 1974 (19 U.S.C. 
     2371e(c)(2)) is amended to read as follows:
       ``(2) Funds to be used.--Of the funds appropriated pursuant 
     to section 277(c), the Secretary may make available, to 
     provide grants to eligible communities under paragraph (1), 
     not more than--
       ``(A) $25,000,000 for fiscal year 2010; and
       ``(B) $2,900,000 for the 6-week period beginning January 1, 
     2011, and ending February 12, 2011.''.
       (7) Section 277(c) of the Trade Act of 1974 (19 U.S.C. 
     2371f(c)) is amended--
       (A) by amending paragraph (1) to read as follows:
       ``(1) In general.--There are authorized to be appropriated 
     to the Secretary to carry out this subchapter--
       ``(A) $150,000,000 for fiscal year 2010; and
       ``(B) $17,3000 for the 6-week period beginning January 1, 
     2011 and ending February 12, 2011.''; and
       (B) in paragraph (2)(A), by striking ``December 31, 2010'' 
     and inserting ``February 12, 2011''.
       (8) Section 278(e) of the Trade Act of 1974 (19 U.S.C. 
     2372(e)) is amended by striking ``2011'' and inserting ``and 
     annually thereafter''.
       (9) Section 279A(h)(2) of the Trade Act of 1974 (19 U.S.C. 
     2373(h)(2)) is amended by striking ``2011'' and inserting 
     ``and annually thereafter''.
       (10) Section 279B(a) of the Trade Act of 1974 (19 U.S.C. 
     2373a(a)) is amended to read as follows:
       ``(a) In General.--
       ``(1) Authorization.--There are authorized to be 
     appropriated to the Secretary of Labor to carry out the 
     Sector Partnership Grant program under section 279A--
       ``(A) $40,000,000 for fiscal year 2010; and
       ``(B) $4,600,000 for the 6-week period beginning January 1, 
     2011, and ending February 12, 2011.
       ``(2) Availability of appropriations.--Funds appropriated 
     pursuant to this section shall remain available until 
     expended.''.
       (11) Section 285 of the Trade Act of 1974 (19 U.S.C. 2271 
     note) is amended--
       (A) by striking ``December 31, 2010'' each place it appears 
     and inserting ``February 12, 2011''; and
       (B) in subsection (a)(2)(A), by inserting ``pursuant to 
     petitions filed under section 221 before February 12, 2011'' 
     after ``title''.
       (12) Section 298(a) of the Trade Act of 1974 (19 U.S.C. 
     2401g(a)) is amended by striking ``$90,000,000 for each of 
     the fiscal years 2009 and 2010, and $22,500,000 for the 
     period beginning October 1, 2010, and ending December 31, 
     2010'' and inserting ``$10,400,000 for the 6-week period 
     beginning January 1, 2011, and ending February 12, 2011''.
       (13) The table of contents for the Trade Act of 1974 is 
     amended by striking the item relating to section 235 and 
     inserting the following:

``Sec. 235. Employment and case management services.''.
       (d) Effective Date.--The amendments made by this section 
     shall take effect on January 1, 2011.

     SEC. 102. MERIT STAFFING FOR STATE ADMINISTRATION OF TRADE 
                   ADJUSTMENT ASSISTANCE.

       (a) In General.--Notwithstanding section 618.890(b) of 
     title 20, Code of Federal Regulations, or any other provision 
     of law, the single transition deadline for implementing the 
     merit-based State personnel staffing requirements contained 
     in section 618.890(a) of title 20, Code of Federal 
     Regulations, shall not be earlier than February 12, 2011.
       (b) Effective Date.--This section shall take effect on 
     December 14, 2010.

                Subtitle B--Health Coverage Improvement

     SEC. 111. IMPROVEMENT OF THE AFFORDABILITY OF THE CREDIT.

       (a) In General.--Section 35(a) of the Internal Revenue Code 
     of 1986 is amended by striking ``January 1, 2011'' and 
     inserting ``February 13, 2011''.
       (b) Conforming Amendment.--Section 7527(b) of such Code is 
     amended by striking ``January 1, 2011'' and inserting 
     ``February 13, 2011''.
       (c) Effective Date.--The amendments made by this section 
     shall apply to coverage months beginning after December 31, 
     2010.

     SEC. 112. PAYMENT FOR THE MONTHLY PREMIUMS PAID PRIOR TO 
                   COMMENCEMENT OF THE ADVANCE PAYMENTS OF CREDIT.

       (a) In General.--Section 7527(e) of the Internal Revenue 
     Code of 1986 is amended by striking ``January 1, 2011'' and 
     inserting ``February 13, 2011''.
       (b) Effective Date.--The amendment made by this section 
     shall apply to coverage months beginning after December 31, 
     2010.

     SEC. 113. TAA RECIPIENTS NOT ENROLLED IN TRAINING PROGRAMS 
                   ELIGIBLE FOR CREDIT.

       (a) In General.--Section 35(c)(2)(B) of the Internal 
     Revenue Code of 1986 is amended by striking ``January 1, 
     2011'' and inserting ``February 13, 2011''.
       (b) Effective Date.--The amendment made by this section 
     shall apply to coverage months beginning after December 31, 
     2010.

     SEC. 114. TAA PRE-CERTIFICATION PERIOD RULE FOR PURPOSES OF 
                   DETERMINING WHETHER THERE IS A 63-DAY LAPSE IN 
                   CREDITABLE COVERAGE.

       (a) IRC Amendment.--Section 9801(c)(2)(D) of the Internal 
     Revenue Code of 1986 is amended by striking ``January 1, 
     2011'' and inserting ``February 13, 2011''.
       (b) ERISA Amendment.--Section 701(c)(2)(C) of the Employee 
     Retirement Income Security Act of 1974 (29 U.S.C. 
     1181(c)(2)(C)) is amended by striking ``January 1, 2011'' and 
     inserting ``February 13, 2011''.
       (c) PHSA Amendment.--Section 2701(c)(2)(C) of the Public 
     Health Service Act (as in effect for plan years beginning 
     before January 1, 2014) is amended by striking ``January 1, 
     2011'' and inserting ``February 13, 2011''.
       (d) Effective Date.--The amendments made by this section 
     shall apply to plan years beginning after December 31, 2010.

     SEC. 115. CONTINUED QUALIFICATION OF FAMILY MEMBERS AFTER 
                   CERTAIN EVENTS.

       (a) In General.--Section 35(g)(9) of the Internal Revenue 
     Code of 1986, as added by section 1899E(a) of the American 
     Recovery and Reinvestment Tax Act of 2009 (relating to 
     continued qualification of family members after certain 
     events), is amended by striking ``January 1, 2011'' and 
     inserting ``February 13, 2011''.

[[Page S11053]]

       (b) Conforming Amendment.--Section 173(f)(8) of the 
     Workforce Investment Act of 1998 (29 U.S.C. 2918(f)(8)) is 
     amended by striking ``January 1, 2011'' and inserting 
     ``February 13, 2011''.
       (c) Effective Date.--The amendments made by this section 
     shall apply to months beginning after December 31, 2010.

     SEC. 116. EXTENSION OF COBRA BENEFITS FOR CERTAIN TAA-
                   ELIGIBLE INDIVIDUALS AND PBGC RECIPIENTS.

       (a) ERISA Amendments.--
       (1) PBGC recipients.--Section 602(2)(A)(v) of the Employee 
     Retirement Income Security Act of 1974 (29 U.S.C. 
     1162(2)(A)(v)) is amended by striking ``December 31, 2010'' 
     and inserting ``February 12, 2011''.
       (2) TAA-eligible individuals.--Section 602(2)(A)(vi) of 
     such Act (29 U.S.C. 1162(2)(A)(vi)) is amended by striking 
     ``December 31, 2010'' and inserting ``February 12, 2011''.
       (b) IRC Amendments.--
       (1) PBGC recipients.--Section 4980B(f)(2)(B)(i)(V) of the 
     Internal Revenue Code of 1986 is amended by striking 
     ``December 31, 2010'' and inserting ``February 12, 2011''.
       (2) TAA-eligible individuals.--Section 
     4980B(f)(2)(B)(i)(VI) of such Code is amended by striking 
     ``December 31, 2010'' and inserting ``February 12, 2011''.
       (c) PHSA Amendments.--Section 2202(2)(A)(iv) of the Public 
     Health Service Act (42 U.S.C. 300bb-2(2)(A)(iv)) is amended 
     by striking ``December 31, 2010'' and inserting ``February 
     12, 2011''.
       (d) Effective Date.--The amendments made by this section 
     shall apply to periods of coverage which would (without 
     regard to the amendments made by this section) end on or 
     after December 31, 2010.

     SEC. 117. ADDITION OF COVERAGE THROUGH VOLUNTARY EMPLOYEES' 
                   BENEFICIARY ASSOCIATIONS.

       (a) In General.--Section 35(e)(1)(K) of the Internal 
     Revenue Code of 1986 is amended by striking ``January 1, 
     2011'' and inserting ``February 13, 2012''.
       (b) Effective Date.--The amendment made by this section 
     shall apply to coverage months beginning after December 31, 
     2010.

     SEC. 118. NOTICE REQUIREMENTS.

       (a) In General.--Section 7527(d)(2) of the Internal Revenue 
     Code of 1986 is amended by striking ``January 1, 2011'' and 
     inserting ``February 13, 2011''.
       (b) Effective Date.--The amendment made by this section 
     shall apply to certificates issued after December 31, 2010.

                 TITLE II--ANDEAN TRADE PREFERENCES ACT

     SEC. 201. EXTENSION OF ANDEAN TRADE PREFERENCE ACT.

       (a) Extension.--Section 208(a)(1) of the Andean Trade 
     Preference Act (19 U.S.C. 3206(a)(1)) is amended to read as 
     follows:
       ``(1) remain in effect--
       ``(A) with respect to Colombia after February 12, 2011; and
       ``(B) with respect to Peru after December 31, 2010;''.
       (b) Ecuador.--Section 208(a)(2) of the Andean Trade 
     Preference Act (19 U.S.C. 3206(a)(2)) is amended by striking 
     ``December 31, 2010'' and inserting ``February 12, 2011''.
       (c) Treatment of Certain Apparel Articles.--Section 
     204(b)(3)(E)(ii)(II) of the Andean Trade Preference Act (19 
     U.S.C. 3203(b)(3)) is amended (ii)(II), by striking 
     ``December 31, 2010'' and inserting ``February 12, 2011''.
       (d) Annual Report.--Section 203(f)(1) of the Andean Trade 
     Preference Act (19 U.S.C. 3202(f)(1)) is amended by striking 
     ``every 2 years'' and inserting ``annually''.

                           TITLE III--OFFSETS

     SEC. 301. CUSTOMS USER FEES.

       Section 13031(j)(3) of the Consolidated Omnibus Budget 
     Reconciliation Act of 1985 (19 U.S.C. 58c(j)(3)) is amended--
       (1) in subparagraph (A), by striking ``September 30, 2019'' 
     and inserting ``January 7, 2020''; and
       (2) in subparagraph (B)(i), by striking ``September 30, 
     2019'' and inserting ``January 14, 2020''.

     SEC. 302. TIME FOR PAYMENT OF CORPORATE ESTIMATED TAXES.

       The percentage under paragraph (2) of section 561 of the 
     Hiring Incentives to Restore Employment Act in effect on the 
     date of the enactment of this Act is increased by 4.5 
     percentage points.

                      TITLE IV--BUDGETARY EFFECTS

     SEC. 401. COMPLIANCE WITH PAYGO.

       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.

                          ____________________