FDNY Clinic Funding

Apparently from 2016 to 2020, the U. S. Department of the Treasury had been withholding portions of reimbursement payments that were supposed to have been made to the FDNY World Trade Center Health Program, totaling $3.3 Million dollars, under its contract to provide services for 9/11 responders who worked for the FDNY, both Firefighters and EMS personnel.

Thankfully, after several months or denial and resistance, the Trump administration finally agreed to stop withholding the funds and will be releasing what was withheld.

This could not have been done without the work of Rep. Peter King R-NY along with Rep. Carolyn Maloney, D-NY, Senators Kristen Gillibrand and Charles Schumer, Chair of the House Ways and Means Committee, Richard Neal, D-MA, and Chair of the House Energy and Commerce Committee Rank Pallone D-NJ.

Here is the history of this issue.

When FDNY Clinic Director Dr. David Prezant in 2019 first suspected that the program he runs, providing medical treatment for injured and ill FDNY responders who were made ill by the toxins at Ground Zero in the aftermath of 9/11, was not getting its full reimbursement, he attempted to find out why. He first reached out to NIOSH contract office, which runs the World Trade Center Health Program, and they stated that they had approved payment and knew nothing about the shortfall. After further research they found out that funds were being withheld by Treasury but were unclear as to why. After months of asking questions, he was finally given this spreadsheet on March 4th, 2020 by the U.S. Treasury Department without any explanation as to what it meant.

In early March Dr Prezant contacted 911 Health Watch once he knew what was happening.

911 Health Watch reached out to Rep. Peter King (R-NY), one of the sponsors of the Zadroga Act, in March in the hopes that he could find out what the spreadsheet meant and why the program was having its reimbursements for work it had done under contract with the Federal government withheld. After several months of phone calls and emails by Rep King’s staff without an adequate answer, Rep. King wrote to the Treasury Secretary on June 18th, 2020 to ask why this was happening and where at the time the estimated $1.5 million that was owed the program was.

After the letter was sent, Rep. King’s office pursued getting a response to the Congressman’s letter from the Treasury Department. Finally, on August 20th, 2020, Rep. King received a letter from the Treasury Department. According to the Treasury Department’s letter, these funds — now $1.9 million dollars — were being withheld as result of a dispute between the City of New York and the Centers for Medicaid and Medicare Services (CMS) over unrelated funds that CMS says the City of New York owes to the federal government. But they did agree that the money in dispute had nothing to do with the WTC Health Program.

This was clearly outrageous coming after years of effort by a lot of people to get Washington to acknowledge and take responsibility for the treatment of the thousands impacted by the toxins at Ground Zero and to get Washington to provide medical treatment and monitoring to FDNY responders with a range of conditions from cancer to respiratory problems, that these funds were being held hostage in this dispute with the City of New York on Medicare and Medicaid reimbursements under provisions of the Debt Collection Improvement Act (PL 104-134; 31 USC 3701).

Worse still is the fact that the WTC FDNY Health Program did not even know it was happening.

In response, on September 17th, 2020, the bipartisan New York congressional delegation wrote along with the state’s Senators on September 18th to Treasury Secretary Mnuchin, making clear that 9/11 responders should not be held hostage in any unrelated funding dispute and demanding that the funds be released.

The Treasury Department responded to the Delegation and the Senators on September 30th, 2020, again saying that the funds were being withheld due to a dispute between the Federal Government and the City of New York over Medicare and Medicaid reimbursements. But now the amount being withheld had gone up to $3.9 million dollars.

The letter also said that Treasury would “suspend” further offsets, but that a “determination about these accommodations was up to CMS” and that “there are options short of legislation that potentially could protect the FDNY payments from offset.” But in their letter the Treasury Department does not cite any statute or authority for their actions either to withhold the funds or to stop withholding the funds, or what the other “options” that they are exploring with CMS.

In response to the Treasury letter, Rep. King then wrote on October 1st to the Center for Medicare and Medicaid Services Administrator Seema Verna to ask her to take the action suggested by the Treasury to exempt the funds for the World Trade Center Health Program from being withheld in the dispute with the City.

On October 3rd, the Centers for Medicare and Medicaid Services Director, Seema Verma, for the first time responded to the issue with two tweets at @SeemaCMS.

On October 8th 2020, Secretary Mnuchin also for the first time directly responded to the issue with a letter he sent to New York City Mayor Bill DeBlasio.

Secretary Mnuchin’s letter agreed with the Delegation that the FDNY should be “made whole” and get their funds, but states, without citing any statute or regulation, that the Federal Government cannot release the funds that it is holding, funds that were to reimburse the FDNY for services undertaken for the WTC Health Program. The letter confirms that Treasury took the money as a hostage in a dispute with the City of New York, but states that somehow it is now the City’s problem to fix it.

In response to the Secretary’s first direct comment on this issue since Rep. King wrote to him in June, House of Representatives Ways and Means Committee Chair, Richard Neal (D-MA) and Energy and Commerce Committee Chair Frank Pallone (D-NJ) wrote to the Treasury Secretary on October 13th, 2020. Their letter asks specifically for the Secretary to explain the legal reasoning behind his determination that he can not release the funds.

Their letter states:

“Treasury appears to have made the decision not to promptly release millions of dollars in reimbursements to FDNY for 9/11 responders despite possessing the statutory authority to do so. As 31 U.S.C. § 3716 specifies regarding such offsets, “The Secretary may exempt other payments from administrative offset under this subsection upon the written request of the head of a payment certifying agency.”

Based on previous Treasury correspondence reviewed by our staffs, Treasury appears to have originally acknowledged such flexibility notwithstanding subsequent statements that it lacked such authority.

When it comes to ensuring 9/11 frontline responders can get the medical treatment and monitoring, they need, any delay that impacts such care is simply intolerable. Accordingly, we respectfully request responses to the following by no later than October 20, 2020:

1) Why does Treasury believe it lacks the authority to release the millions of dollars in reimbursements owed to the FDNY World Trade Center Health Program? Please provide any internal memoranda containing legal analysis justifying this decision.

2) Has Treasury specifically asked CMS to submit a request to exempt the money currently being offset from FDNY? Please describe any consultations or discussions between Treasury and CMS regarding the resolution of such payments being withheld from the FDNY World Trade Center Health Program.”

October 13, 2020 Letter to Secretary Mnuchin by Reps. Neal and Pallone

Here is the statute in question: 31 U.S.C. § 3716(c)(3)(B)

Here is the operative sentence:

… The Secretary may exempt other payments from administrative offset under this subsection upon the written request of the head of a payment certifying agency. A written request for exemption of other payments must provide justification for the exemption under standards prescribed by the Secretary. Such standards shall give due consideration to whether administrative offset would tend to interfere substantially with or defeat the purposes of the payment certifying agency’s program.

31 U.S.C. § 3716(c)(3)(B)

Neither the Treasury Secretary nor the CMS Director has ever over the last few months provided any direct answer as to why they say they cannot under this statute exempt the World Trade Center Health Program and release the funds that were meant for sick and injured FDNY. As you can see over several months, the Administration’s answers change.

Instead of working to fix this, we have a record of evasion and non-answers from the U.S. Treasury Department and CMS since this issue was formally brought to their attention by Rep. King on June 18th, 2020.

Finally on Friday, October 23rd, the Center for Disease Control ( CDC), which houses the WTC Health Program used the Debt Reform law, as had been suggested for several months, and the sent a letter to the Treasury Department requesting that the WTC Health Program be exempt from the Treasury’s offset program, as well as a letter to CMS requesting that approximately $3.3 million be refunded to FDNY for the WTC Health Program payments that have been offset to date.  

The Department of the Treasury approved the exemption request within hours and with Treasury’s approval in hand, CMS has indicated that CDC’s request for a refund to FDNY will be approved and processed as quickly as possible and all the funds that were owed to the FDNY WTC Health Program Clinic will finally be released.

Going forward all the units of the World Trade Center Health Program will now be exempt from being held hostage in a dispute over unrelated debts.

Again, this could not have been done without the work of Rep. Peter King R-NY along with Rep. Carolyn Maloney, D-NY, Senators Kristen Gillibrand and Charles Schumer, Chair of the House Ways and Means Committee, Richard Neal, D-MA, and Chair of the House Energy and Commerce Committee Rank Pallone D-NJ.

Here are copies of correspondence on the issue:

Documents

March 4, 2020 Response from U.S. Department of Treasury to FDNY Inquiry

June 18, 2020 Letter to Secretary Mnuchin from Congressman Peter King R-NY

August 20th, 2020 Response from Treasury to Rep. King

September 10, 2020 Letter to Secretary Mnuchin from Rep. Peter King

September 17th 2020 New York Congressional Delegation to Secretary Mnuchin

September 18th, 2020 Senators Gillibrand and Schumer Letter to Secretary Mnuchin

September 30th letter to Rep Maloney and House Delegation from Treasury Department responding to their September 17th Letter

September 30th letter to Senators Gillibrand and Schumer from the Treasury Department responding to their September 18th Letter

October 1, 2020 Rep King Letter to CMS Administrator Seema Verma

October 2, 2020 Gillibrand, Schumer letter to Sec. Mnuchin

October 8th 2020 Letter from Sec. Mnuchin to Mayor DeBlasio

October 13, 2020 Letter from Rep. Neal and Pallone to Treasury Secretary

October 23, 2020 CDC Letter to Treasury Department Requesting Exemption for WTC Health Program

October 23, 2020 CDC letter to CMS Requesting Refund

October 23, 2020 Treasury Response to CDC Granting Exemption

October 28th, 2020 Letter from Treasury Secretary Mnuchin to Rep. Peter King

News Clips

Heroes rescued: Millions are restored to FDNY’s World Trade Center health clinics
NY Daily News | October 31, 2020
The clinics are 100% paid for by a Congress grateful to these thousands of selfless public servants who ran to help others and aid our nation under foreign attack. The funding was wrongly dunned with no notice and then took months to restore thanks to the doggedness of Rep. Pete King, who pushed hard since March

Trump administration returns $3.4M taken from ailing 9/11 FDNY program in error
NY Daily News | October 30, 2020
The New York City Fire Department’s World Trade Center Treatment Program just got its pilfered millions back from the Federal Government — $3,363,931.72, to be exact

Statement from Treasury Secretary Steven T. Mnuchin
Treasury.gov | October 29, 2020
“I am delighted that CMS has wired payments to the FDNY refunding the past offsets applied to cover unpaid NYC debts.”

CMS Refunds Withheld Funds Designated for the Fire Department of the City of New York
CMS.gov | October 29, 2020
“We owe an even greater debt to our 9/11 heroes, and our team has worked together with the U.S. Department of Treasury to protect the critical federal funding designated for the World Trade Center Health Program.”

$3.92 Million Restored To FDNY WTC Health Program
CBS2 News at 5 | October 27, 2020

Treasury Department refunds nearly $4 million to FDNY 9/11 first responders health program
CNN | October 26, 2020
The reimbursement appears to resolve an ongoing back-and-forth between New York officials and the federal Treasury Department over the funds previously shorted to the FDNY World Trade Center Health Program.

Doing right by the heroes: The feds finally finally make whole the FDNY WTC health clinics
NY Daily News | October 26, 2020
The immediate parent agency of the WTC Health Program within HHS is the CDC. And on Friday the CDC, yes, the same CDC which tries to protect Americans from coronavirus against an uncaring chief executive, requested Treasury exempt the FDNY money from withholding and Treasury immediately agreed.

Feds to restore millions they took from sick FDNY 9/11 heroes
NY Daily News | October 24, 2020
The Centers for Disease Control and Prevention notified Rep. Pete King (R-Long Island) late Friday that an alphabet soup of federal agencies — including the Treasury Department — will return $3.3 million that was docked from the program.

Treasury withheld nearly $4M from FDNY 9/11 health program
The Hill | October 16, 2020
Treasury Secretary Steven Mnuchin admitted in a letter sent on Oct. 8 to New York City Mayor Bill de Blasio that the department has withheld approximately $3.92 million since 2004 from the New York City Fire Department’s (FDNY) fund for 9/11 first responders.

Treasury Department withheld nearly $4 million from FDNY 9/11 health program, says NYC is responsible for federal debts
CNN | October 15, 2020
Treasury Secretary Steve Mnuchin acknowledged that his department withheld $3.92 million since 2004 from Fire Department of New York first responders suffering from illnesses related to the September 11, 2001, terrorist attacks because of other debts New York City owes the federal government.

Treasury Secretary: City at Fault For Feds Shortchanging WTC Health Fund
The Chief-Leader | October 14, 2020
FDNY, House Dems, Advocates Say He’s Stalling

‘I’m here to say fix it,’ FDNY union head says of nearly $4 million in 9/11 funds diverted by Trump administration
NY Daily News | October 14, 2020
The head of the city firefighters union on Wednesday joined the chorus of voices demanding the Trump Administration restore nearly $4 million siphoned from the NYFD’s 9/11 treatment program.

House Committees demand answers after feds divert nearly $4M from 9/11 FDNY treatment fund
NY Daily News | October 13, 2020
Both Treasury and CMS officials acknowledged that the ailing firefighters and paramedics in the program should not be punished over unrelated debts. But they have not come up with a federal solution.

Neal, Pallone Blast Treasury Department for Withholding Millions from 9/11 Health Fund
House Ways & Means Committee | October 13, 2020
“Heroic frontline responders courageously put their lives on the line on 9/11. The Administration should do everything within in its power to ensure that firefighters who still face health challenges due to the toxins they encountered at Ground Zero can get the care they deserve.”

NYC should replace 9/11 funds erroneously taken by Treasury: Mnuchin tells de Blasio
NY Daily News | October 9, 2020
Mnuchin sent a letter to Mayor De Blasio on Thursday saying that the city should make up the shortfall. And if the city doesn’t pay up, Mnuchin threatened to take other federal healthcare funding meant for New York, and give that to the fire department instead.

Trump officials admit diverting 9/11 treatment funds was wrong, but stall returning $4M
NY Daily News | October 8, 2020
The money was taken in bits and pieces by the Treasury Department since 2016 to pay down a still-unexplained Medicare debt purportedly owed by the city that has nothing to do with the Fire Department.

Feds must return funds to 9/11 program
Newsday | October 6, 2020
Just when we thought these battles were over, here we are again.

Pete King’s search for FDNY health program funding
Newsday | October 5, 2020
King’s White House connection on the issue is Andrew Giuliani – son to former Mayor Rudy Giuliani – who works in the Office of Public Liaison.

Schumer, Gillibrand demand Treasury Dept. returns $3.7 million to FDNY 9/11 treatment program
NY Daily News | October 2, 2020
Mnuchin’s Treasury Department informed members of Congress this week that the offsets were stopping. Now Sens. Chuck Schumer and Kirsten Gillibrand are telling Mnuchin that’s not enough.

9/11 heroes deserve better
NY Daily News | October 2, 2020
You don’t rob from the heroes of 9/11. Mnuchin and Verma must fix this now.

Trump administration will not take additional money from FDNY’s 9/11 treatment program; unclear if $3.7M will be returned
NY Daily News | October 1, 2020
The federal agency began docking payments meant to care for ill firefighters and EMTs back in 2016 in a move that was never explained to the FDNY’s World Trade Center Treatment program.

‘It’s their f—ing job to make sure that the FDNY gets the money’: NY lawmakers furious that Treasury took funds from 9/11 health care
NY Daily News | September 18, 2020
The U.S. Treasury Department has claimed for a week that it was bound by law to take millions of dollars away from the New York City Fire Department’s treatment fund, but a review by the Daily News and by lawmakers irate over the vanishing dollars found that is not the case.

Maloney, Nadler, King Lead NY Delegation in Urging Sec. Mnuchin to Immediately Make FDNY Health Program Whole
Rep. Carolyn Maloney | September 17, 2020
“We are deeply concerned to learn that your Department, without any apparent notice to the FDNY World Trade Center Health Program, has been withholding part of the clinics’ reimbursement for several years.”

N.Y. congressional delegation demands Trump administration restore 9/11 health funds to FDNY
NY Daily News | September 17, 2020
New York’s congressional delegation joined Thursday in demanding that Treasury Secretary Steven Mnuchin “immediately” restore millions of dollars that the Trump administration has withheld from the FDNY’s 9/11 health care program.

‘Unacceptable’: N.Y. Republicans rebuke Trump administration for defunding FDNY 9/11 program as rest of GOP silent
NY Daily News | September 16, 2020
Most of New York’s congressional Republicans broke party ranks this week and condemned the Trump administration for stripping millions of dollars from the FDNY’s 9/11 health care program.

Trump administration admits defunding FDNY’s 9/11 healthcare program
NY Daily News | September 11, 2020
The Trump administration admitted Friday to stripping millions of dollars from an FDNY fund that foots healthcare bills for 9/11 survivors and promised to try to put an end to the heartless practice.

Trump Administration Secretly Withheld Millions from FDNY 9/11 Health Program
NY Daily News | September 10, 2020
The Trump administration has secretly siphoned nearly $4 million away from a program that tracks and treats FDNY firefighters and medics suffering from 9/11 related illnesses, the Daily News has learned.

Page revised 11/2/2020