---
kind: "section"
citation: "42 U.S.C. § 300mm"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300mm"
heading: "Establishment of World Trade Center Health Program"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/300mm"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter XXXI — World Trade Center Health Program"
  - "Part A — Establishment of Program; Advisory Committee"
---

# §300mm. Establishment of World Trade Center Health Program

- (a) **In general—** There is hereby established within the Department of Health and Human [Services](/usc/42/201.md?p=a) a [program](/usc/42/274l–1.md?p=4) to be known as the World Trade Center Health [Program](/usc/42/274l–1.md?p=4), which shall be administered by the [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A), to provide beginning on July 1, 2011—
  - (1) medical monitoring and [treatment](/usc/42/11851.md?p=11) benefits to eligible emergency responders and recovery and cleanup workers (including those who are Federal [employees](/usc/42/300gg–91.md?p=d-5)) who responded to the [September 11, 2001, terrorist attacks](/usc/42/300mm–5.md?p=12); and
  - (2) [initial health evaluation](/usc/42/300mm–5.md?p=6), monitoring, and [treatment](/usc/42/11851.md?p=11) 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](/usc/42/300mm–5.md?p=15) includes the following components:
  - (1) **Medical monitoring for responders—** Medical monitoring under [section 300mm–21 of this title](/usc/42/300mm–21.md), including clinical examinations and long-term health monitoring and analysis for [enrolled WTC responders](/usc/42/300mm–5.md?p=4) 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](/usc/42/300mm–5.md?p=12).
  - (2) **Initial health evaluation for survivors—** An [initial health evaluation](/usc/42/300mm–5.md?p=6) under [section 300mm–31 of this title](/usc/42/300mm–31.md), including an evaluation to determine eligibility for followup monitoring and [treatment](/usc/42/11851.md?p=11).
  - (3) **Followup monitoring and treatment for WTC-related health conditions for responders and survivors—** Provision under sections [300mm–22](/usc/42/300mm–22.md), [300mm–32](/usc/42/300mm–32.md), and [300mm–33](/usc/42/300mm–33.md) of this title of followup monitoring and [treatment](/usc/42/11851.md?p=11) and payment, subject to the provisions of [subsection (d)](#d), for all medically necessary health and mental health care expenses of an individual with respect to a [WTC-related health condition](/usc/42/300mm–5.md?p=17) (including necessary prescription [drugs](/usc/42/11851.md?p=4)).
  - (4) **Outreach—** Establishment under [section 300mm–2 of this title](/usc/42/300mm–2.md) of an education and outreach [program](/usc/42/274l–1.md?p=4) to potentially eligible individuals concerning the benefits under this subchapter.
  - (5) **Clinical data collection and analysis—** Collection and analysis under [section 300mm–3 of this title](/usc/42/300mm–3.md) of health and mental health data relating to individuals receiving monitoring or [treatment](/usc/42/11851.md?p=11) benefits in a uniform manner in collaboration with the collection of epidemiological data under [section 300mm–52 of this title](/usc/42/300mm–52.md).
  - (6) **Research on health conditions—** Establishment under part C of a research [program](/usc/42/274l–1.md?p=4) on health conditions resulting from the [September 11, 2001, terrorist attacks](/usc/42/300mm–5.md?p=12).
- (c) **No cost sharing—** Monitoring and [treatment](/usc/42/11851.md?p=11) benefits and [initial health evaluation](/usc/42/300mm–5.md?p=6) benefits are provided under part B without any deductibles, copayments, or other cost sharing to an [enrolled WTC responder](/usc/42/300mm–5.md?p=4) or [certified-eligible WTC survivor](/usc/42/300mm–5.md?p=2). [Initial health evaluation](/usc/42/300mm–5.md?p=6) benefits are provided under part B without any deductibles, copayments, or other cost sharing to a [screening-eligible WTC survivor](/usc/42/300mm–5.md?p=10).
- (d) **Preventing fraud and unreasonable administrative costs—**
  - (1) **Fraud—** The Inspector General of the Department of Health and Human [Services](/usc/42/201.md?p=a) shall develop and implement a [program](/usc/42/274l–1.md?p=4) to review the [WTC Program](/usc/42/300mm–5.md?p=15)’s health care expenditures to detect fraudulent or duplicate billing and payment for inappropriate [services](/usc/42/201.md?p=a). This subchapter is a Federal health care [program](/usc/42/274l–1.md?p=4) (as defined in [section 1320a–7b(f) of this title](/usc/42/1320a–7b.md?p=f)) and is a health plan (as defined in [section 1320a–7c(c) of this title](/usc/42/1320a–7c.md?p=c)) for purposes of applying sections [1320a–7](/usc/42/1320a–7.md) through [1320a–7e](/usc/42/1320a–7e.md) of this title.
  - (2) **Unreasonable administrative costs—** The Inspector General of the Department of Health and Human [Services](/usc/42/201.md?p=a) shall develop and implement a [program](/usc/42/274l–1.md?p=4) to review the [WTC Program](/usc/42/300mm–5.md?p=15) for unreasonable administrative costs, including with respect to infrastructure, administration, and claims processing.
- (e) **Quality assurance—** The [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) working with the Clinical Centers of Excellence shall develop and implement a quality assurance [program](/usc/42/274l–1.md?p=4) for the monitoring and [treatment](/usc/42/11851.md?p=11) delivered by such Centers of Excellence and any other participating [health care providers](/usc/42/300aa–33.md?p=1). Such [program](/usc/42/274l–1.md?p=4) shall include—
  - (1) adherence to monitoring and [treatment](/usc/42/11851.md?p=11) protocols;
  - (2) appropriate diagnostic and [treatment](/usc/42/11851.md?p=11) referrals for [participants](/usc/42/300gg–91.md?p=d-11);
  - (3) prompt communication of test results to [participants](/usc/42/300gg–91.md?p=d-11); and
  - (4) such other elements as the [Administrator](/usc/42/300bb–8.md?p=4) 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](/usc/42/300mm–5.md?p=15) is in operation, the [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) shall submit an annual report to the Congress on the operations of this subchapter for such fiscal year and for the entire period of operation of the [program](/usc/42/274l–1.md?p=4).
  - (2) **Contents included in report—** Each annual report under [paragraph (1)](#f-1) shall include at least the following:
    - (A) **Eligible individuals—** Information for each clinical [program](/usc/42/274l–1.md?p=4) described in [paragraph (3)](#f-3)—
      - (i) on the number of individuals who applied for certification under part 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](/usc/42/274l–1.md?p=4) and the number of such individuals who received medical [treatment](/usc/42/11851.md?p=11) under the [program](/usc/42/274l–1.md?p=4);
      - (iii) with respect to individuals so certified who received such [treatment](/usc/42/11851.md?p=11), on the [WTC-related health conditions](/usc/42/300mm–5.md?p=17) for which they were treated; and
      - (iv) on the projected number of individuals who will be certified under part B in the succeeding fiscal year and the succeeding 10-year period.
    - (B) **Monitoring, initial health evaluation, and treatment costs—** For each clinical [program](/usc/42/274l–1.md?p=4) so described—
      - (i) information on the costs of monitoring and [initial health evaluation](/usc/42/300mm–5.md?p=6) and the costs of [treatment](/usc/42/11851.md?p=11) and on the estimated costs of such monitoring, evaluation, and [treatment](/usc/42/11851.md?p=11) in the succeeding fiscal year; and
      - (ii) an estimate of the cost of medical [treatment](/usc/42/11851.md?p=11) for [WTC-related health conditions](/usc/42/300mm–5.md?p=17) that have been paid for or reimbursed by workers’ compensation, by public or private health plans, or by New York City under [section 300mm–41 of this title](/usc/42/300mm–41.md).
    - (C) **Administrative costs—** Information on the cost of administering the [program](/usc/42/274l–1.md?p=4), including costs of [program](/usc/42/274l–1.md?p=4) support, data collection and analysis, and research conducted under the [program](/usc/42/274l–1.md?p=4).
    - (D) **Administrative experience—** Information on the administrative performance of the [program](/usc/42/274l–1.md?p=4), including—
      - (i) the performance of the [program](/usc/42/274l–1.md?p=4) in providing timely evaluation of and [treatment](/usc/42/11851.md?p=11) to eligible individuals; and
      - (ii) a list of the Clinical Centers of Excellence and other [providers](/usc/42/299b–21.md?p=8) that are participating in the [program](/usc/42/274l–1.md?p=4).
    - (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 300mm–5(1) of this title](/usc/42/300mm–5.md?p=1), including the findings of research conducted under subsection (a) or (c) of [section 300mm–51 of this title](/usc/42/300mm–51.md).
    - (F) **Advisory Committee recommendations—** A list of recommendations by the [WTC Scientific/Technical Advisory Committee](/usc/42/300mm–5.md?p=19) on additional [WTC Program](/usc/42/300mm–5.md?p=15) eligibility criteria and on additional [WTC-related health conditions](/usc/42/300mm–5.md?p=17) and the action of the [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) concerning each such recommendation.
  - (3) **Separate clinical programs described—** In [paragraph (2)](#f-2), each of the following shall be treated as a separate clinical [program](/usc/42/274l–1.md?p=4) of the [WTC Program](/usc/42/300mm–5.md?p=15):
    - (A) **Firefighters and related personnel—** The benefits provided for [enrolled WTC responders](/usc/42/300mm–5.md?p=4) described in [section 300mm–21(a)(2)(A) of this title](/usc/42/300mm–21.md?p=a-2-A).
    - (B) **Other WTC responders—** The benefits provided for [enrolled WTC responders](/usc/42/300mm–5.md?p=4) not described in [subparagraph (A)](#f-3-A).
    - (C) **WTC survivors—** The benefits provided for [screening-eligible WTC survivors](/usc/42/300mm–5.md?p=10) and [certified-eligible WTC survivors](/usc/42/300mm–5.md?p=2) in [section 300mm–31(a) of this title](/usc/42/300mm–31.md?p=a).
- (g) **Notification to Congress upon reaching 80 percent of eligibility numerical limits—** The [Secretary](/usc/42/201.md?p=c) shall promptly notify the Congress of each of the following:
  - (1) When the number of enrollments of [WTC responders](/usc/42/300mm–5.md?p=18) subject to the limit established under [section 300mm–21(a)(4) of this title](/usc/42/300mm–21.md?p=a-4) has reached 80 percent of such limit.
  - (2) When the number of certifications for [certified-eligible WTC survivors](/usc/42/300mm–5.md?p=2) subject to the limit established under [section 300mm–31(a)(3) of this title](/usc/42/300mm–31.md?p=a-3) has reached 80 percent of such limit.
- (h) **Consultation—** The [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) shall engage in ongoing outreach and consultation with relevant stakeholders, including the [WTC Health Program Steering Committees](/usc/42/300mm–5.md?p=14) and the [Advisory Committee](/usc/42/17061.md?p=2) under [section 300mm–1 of this title](/usc/42/300mm–1.md), regarding the implementation and improvement of [programs](/usc/42/274l–1.md?p=4) under this subchapter.
- (i) **GAO studies—**
  - (1) **Report—** Not later than 18 months after December 18, 2015, the [Comptroller General](/usc/42/300x–64.md?p=b-1) 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 that assesses, with respect to the [WTC Program](/usc/42/300mm–5.md?p=15), the effectiveness of each of the following:
    - (A) The quality assurance [program](/usc/42/274l–1.md?p=4) developed and implemented under [subsection (e)](#e).
    - (B) The procedures for providing certifications of coverage of conditions as [WTC-related health conditions](/usc/42/300mm–5.md?p=17) for [enrolled WTC responders](/usc/42/300mm–5.md?p=4) under [section 300mm–22(b)(2)(B)(iii) of this title](/usc/42/300mm–22.md?p=b-2-B-iii) and for [screening-eligible WTC survivors](/usc/42/300mm–5.md?p=10) and [certified-eligible WTC survivors](/usc/42/300mm–5.md?p=2) under such section as applied under [section 300mm–32(a) of this title](/usc/42/300mm–32.md?p=a).
    - (C) Any action under the [WTC Program](/usc/42/300mm–5.md?p=15) to ensure appropriate payment (including the avoidance of improper payments), including determining the extent to which individuals enrolled in the [WTC Program](/usc/42/300mm–5.md?p=15) are eligible for workers compensation or sources of health coverage, ascertaining the liability of such compensation or sources of health coverage, and making recommendations for ensuring effective and efficient coordination of benefits for individuals enrolled in the [WTC Program](/usc/42/300mm–5.md?p=15) that does not place an undue burden on such individuals.
  - (2) **Subsequent assessments—** Not later than 6 years and 6 months after December 18, 2015, and every 5 years thereafter through fiscal year 2042, the [Comptroller General](/usc/42/300x–64.md?p=b-1) of the United States shall—
    - (A) consult the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate on the objectives in assessing the [WTC Program](/usc/42/300mm–5.md?p=15); and
    - (B) prepare and submit to such Committees a report that assesses the [WTC Program](/usc/42/300mm–5.md?p=15) for the applicable reporting period, including the objectives described in [subparagraph (A)](#i-2-A).
- (j) **Regulations—** The [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) is authorized to promulgate such [regulations](/usc/42/201.md?p=d) as the [Administrator](/usc/42/300bb–8.md?p=4) determines necessary to administer this subchapter.
- (k) **Termination—** The [WTC Program](/usc/42/300mm–5.md?p=15) shall terminate on October 1, 2090.

## Source credit

(July 1, 1944, ch. 373, title XXXIII, § 3301, as added Pub. L. 111–347, title I, § 101, Jan. 2, 2011, 124 Stat. 3624; amended Pub. L. 114–113, div. O, title III, § 302(b), Dec. 18, 2015, 129 Stat. 2998; Pub. L. 117–328, div. FF, title VII, § 7702(c), Dec. 29, 2022, 136 Stat. 5967.)

## Notes

### Editorial Notes

### Amendments

2022—Subsec. (f)(2)(E). Pub. L. 117–328 substituted “subsection (a) or (c) of section 300mm–51 of this title” for “section 300mm–51(a) of this title”.

2015—Subsecs. (i) to (k). Pub. L. 114–113 added subsecs. (i) to (k).