Page:United States Statutes at Large Volume 124.djvu/3680

 124 STAT. 3654 PUBLIC LAW 111–347—JAN. 2, 2011 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 para- graph (1) shall be construed as requiring an entity providing monitoring and treatment under this title to seek reimburse- ment under a health plan with which the entity has no contract for reimbursement. ‘‘(3) MAINTENANCE OF REQUIRED MINIMUM ESSENTIAL COV- ERAGE.—No payment may be made for monitoring and treat- ment 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 sub- section (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 sec- tion 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 subpara- graph (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 con- tract, with respect to the last calendar quarter of fiscal Applicability.