Nationwide Provider Network (NPN)

The NPN is different than the Clinical Centers of Excellence (CCEs) based in the New York metropolitan area. Unlike the CCEs, the NPN has no central clinic. Instead, a healthcare delivery company provides a network of individual providers or provider groups nationwide. The organization that currently runs the NPN is Managed Care Advisors (MCA)-Sedgwick.

MCA-Sedgwick oversees the day-to-day operations of the NPN by:

• Building and expanding the available provider network
• Scheduling initial health evaluations, annual monitoring exams, and diagnostic appointments
• Helping to coordinate care and provide case management when necessary
• Submitting WTC-related health condition certification requests to the WTC Health Program
• Maintaining medical records for NPN members
• Operating an NPN-specific call center and online member portal

Since individual doctors and clinicians with their own specialties make up the NPN, you may need to go to more than one provider to receive care for each of your certified WTC-related health conditions.

The NPN provides care outside of the New York metropolitan area. Please note however that the WTC Health Program and the NPN only cover medically necessary healthcare services within the United States and its territories, including the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, the Virgin Islands, American Samoa, and the Trust Territory of the Pacific Islands.

Members in the NPN get the same Program benefits as members that go to the CCEs. How those benefits are administered to members is different (see ‘How does the NPN work?’). But, the benefits are the same.

In a lot of cases, the NPN will make your appointment for you. This helps ensure that the provider is ready to provide your WTC-related care, has your membership information, and knows how to bill the Program properly.

Learn more about how to schedule an appointment with the NPN.

Unlike members that go to a CCE, members of the NPN get an NPN member ID card from MCA-Sedgwick. The card identifies a WTC Health Program member to a provider that may otherwise not see any other Program members.

NPN members should show their NPN ID card every time they see a provider for a WTC-related service. The card provides important member benefit and billing details for the provider and their staff.

If you do not have an NPN member ID card, please contact MCA-Sedgwick at 1-800-416-2898. You can also download a temporary NPN ID card through the NPN Member Portal .

While MCA-Sedgwick handles day-to-day NPN operations, both the NPN and the CCEs are overseen by the federal government. The Administrator of WTC Health Program and federal Program staff are in the National Institute for Occupational Safety and Health (NIOSH). NIOSH is part of the Centers for Disease Control and Prevention (CDC) in the U.S. Department of Health and Human Services (HHS).

Newly enrolled WTC Health Program members outside of the New York metropolitan area are automatically assigned to the NPN. The NPN is listed on their official Program enrollment welcome letter. MCA-Sedgwick then follows up with a welcome packet.

Existing members at a CCE may wish to transfer into the NPN when moving out of the New York metropolitan area. Detailed information on how to transfer into the NPN is on the Transferring Clinics page.

No. WTC Health Program members, whether in the NPN or at a CCE, should never receive a bill for WTC-related services received through the Program. This includes copays and deductibles.

As an NPN member, if you receive a bill for a WTC-related service by mistake, do not pay it. Call MCA-Sedgwick at 1-800-416-2898 or submit the bill through the NPN Member Portal .

You should also not pay any copays at your WTC-related appointments. If a provider asks you to pay a copay, have them call MCA-Sedgwick at 1-800-416-2898 or the WTC Health Program call center at 1-888-982-4748.

Please note: you might receive an Explanation of Benefits (EOB) from your NPN provider or, for Survivors, your primary health insurance. This document explains the WTC-related medical claim and the associated costs. An EOB is not a bill. The Program is not able to control who sends an EOB to you. If you are unsure about what you received, please contact MCA-Sedgwick or the WTC Health Program call center.

The NPN Member Portal is a convenient online self-serve option provided by MCA-Sedgwick. It allows you to access information about your WTC Health Program NPN benefits and information. Use of the portal is  optional.

Features of MCA-Sedgwick’s NPN Member Portal include:

• ability to upload medical records
• online versions of key NPN forms
• messaging or live chatting the MCA-Sedgwick Member Services team

If you want to register for the portal or need to verify or give the NPN your current email address, please call 1-800-416-2898.