42 C.F.R. § 88.6

Current through October 31, 2024
Section 88.6 - Enrollment decision-WTC responders
(a)Enrollment priority. The WTC Health Program will prioritize applications in the order in which they are received.
(b)Enrollment eligibility. The WTC Health Program will decide if the applicant meets the eligibility criteria provided in § 88.4 .
(c)Denial of enrollment.
(1) The WTC Health Program will deny enrollment if the applicant fails to meet the applicable eligibility requirements.
(2) The WTC Health Program may deny enrollment of a responder who is otherwise eligible and qualified if the Act's numerical limitations for newly enrolled responders have been met.
(i) No more than the number of WTC responders specified in the Act, as amended, other than those enrolled pursuant to §§ 88.3 , 88.4(a)(1)(ii) , 88.4(b)(1)(iv) through (vi) , and 88.4(c)(1)(iv) through (vi) , may be enrolled at any time.
(ii) No more than 500 WTC responders meeting the eligibility criteria in §§ 88.4(b)(1)(iv) through (vi) and 88.4(c)(1)(iv) through (vi) may be enrolled at any time.
(iii) The Administrator of the WTC Health Program may decide, based on the best available evidence, that sufficient funds are available under the Act to provide treatment and monitoring only for individuals who are already enrolled as WTC responders at that time.
(3) No individual who is determined to be a positive match to the terrorist watch list maintained by the Federal government may qualify to be enrolled or be determined to be eligible for the WTC Health Program.
(d)Notification of enrollment decision.
(1) The WTC Health Program will decide if the applicant meets the current eligibility criteria for WTC responders in § 88.4 and is qualified, and notify the applicant of the enrollment decision in writing within 60 calendar days of the date of receipt of the application. The 60-day time period will not include any days during which the applicant is correcting deficiencies in the application or supporting documentation.
(2) If the WTC Health Program decides that an applicant is denied enrollment, the written notification will include an explanation, as appropriate, for the decision to deny enrollment and inform the applicant of the right to appeal the initial denial of eligibility and provide instructions on how to file an appeal.

42 C.F.R. §88.6

81 FR 90938 , Dec. 15, 2016, as amended at 89 FR 73601 , Sept. 11, 2024
81 FR 90938 , 1/17/2017; as amended at 89 FR 73601 , 9/11/2024