Page:United States Statutes at Large Volume 124.djvu/3672

 124 STAT. 3646 PUBLIC LAW 111–347—JAN. 2, 2011 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 Adminis- trator shall establish a program for paying for the medically necessary outpatient prescription pharma- ceuticals 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 pharma- ceutical benefits for participants in the WTC Pro- gram. ‘‘(iii) TREATMENT OF FDNY PARTICIPANTS.—Under such program the Administrator may enter into an agreement with a separate vendor to provide pharma- ceutical 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 Com- merce of the House of Representatives and the Com- mittee 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 METHODOLO- GIES.—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 Clin- ical 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 cer- tified-eligible WTC survivor. ‘‘(2) MONITORING AND INITIAL HEALTH EVALUATION.—The WTC Program Administrator shall reimburse the costs of moni- toring 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 pro- vide for the review of claims for reimbursement or payment Deadline. Reports.