World Trade Center Health Program: administrator's plans for evaluating clinics' capabilities to provide required data

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DIANE Publishing, 2011 - 33 pages
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This report discusses the briefing presented to congressional staff on June 30, 2011 regarding the James Zadroga 9/11 Health and Compensation Act of 2010 (Zadroga Act). The Zadroga Act requires GAO to report by July 1, 2011, on whether the Clinical Centers of Excellence (CCE) under contract with the World Trade Center Health Program (WTCHP) Administrator have financial systems that allow for the timely submission of health care claims data as envisioned by the act. Beginning on July 1, 2011, the WTCHP is to provide medical services to responders and survivors of the September 11, 2001, terrorist attacks through contracted medical facilities known as CCEs in the New York City/New Jersey metropolitan area and a nationwide network of providers. In addition to providing medical services, the WTCHP is required to collect, report, and analyze data, including health care claims data; perform research on World Trade Center-related health conditions; and establish an outreach program. The Secretary of Health and Human Services designated the Director of the National Institute for Occupational Safety and Health (NIOSH) as the WTCHP Administrator. The Administrator is responsible, as specified by the Zadroga Act, for all provisions of the act not related to payments for eligible health care claims. As discussed with the committees, our objective was to describe the WTCHP Administrator's plans and processes for determining whether the CCEs' financial systems can provide timely and accurate health care claims data as required by the Zadroga Act. Accordingly, the briefing focused on the (1) Centers for Disease Control and Prevention (CDC)/NIOSH schedule for awarding contracts to CCEs, (2) health care claims data requirements for the CCEs and planned procedures, and (3) Administrator's plans for evaluating each CCE system's health care claims data capabilities during and after the award of the contracts.

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