[Federal Register Volume 80, Number 78 (Thursday, April 23, 2015)]
[Rules and Regulations]
[Pages 22789-22825]
[FR Doc No: 2015-09053]

Vol. 80

Thursday,

No. 78

April 23, 2015

Part II

Department of Transportation

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Federal Motor Carrier Safety Administration

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49 CFR Parts 383, 384 and 391

 Medical Examiner's Certification Integration; Final Rule

Federal Register / Vol. 80 , No. 78 / Thursday, April 23, 2015 /
Rules and Regulations

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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

49 CFR Parts 383, 384 and 391

[Docket No. FMCSA-2012-0178]
RIN 2126-AB40

Medical Examiner's Certification Integration

AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.

ACTION: Final rule.

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SUMMARY: FMCSA amends the Federal Motor Carrier Safety Regulations
(FMCSRs) to require certified medical examiners (MEs) performing
physical examinations of commercial motor vehicle (CMV) drivers to use
a newly developed Medical Examination Report (MER) Form, MCSA-5875, in
place of the current MER Form and to use Form MCSA-5876 for the Medical
Examiner's Certificate (MEC); and report results of all CMV drivers'
physical examinations performed (including the results of examinations
where the driver was found not to be qualified) to FMCSA by midnight
(local time) of the next calendar day following the examination. The
reporting of results includes all CMV drivers who are required to be
medically certified to operate in interstate commerce, not only those
who hold or apply for commercial learner's permits (CLP) or commercial
driver's licenses (CDL), and results of any examinations performed in
accordance with the FMCSRs with any applicable State variances (which
will be valid for intrastate operations only). For holders of CLP/CDLs
(interstate and intrastate), FMCSA will electronically transmit driver
identification, examination results, and restriction information from
examinations performed from the National Registry to the State Driver's
Licensing Agencies (SDLAs). The Agency will also transmit medical
variance information for all CMV drivers electronically to the SDLAs.

DATES: Effective on June 22, 2015. See the amendments to 49 CFR parts
383, 384 and 391 for compliance dates.

FOR FURTHER INFORMATION CONTACT: Charles A. Horan, III, Director,
Carrier, Driver, & Vehicle Safety Standards, Federal Motor Carrier
Safety Administration, 1200 New Jersey Avenue SE., Washington, DC
20590-0001, by telephone at<PHONE_NUMBER> or via email at
<EMAIL_ADDRESS>Office hours are from 9 a.m. to 5 p.m. ET, Monday
through Friday, except Federal holidays. If you have questions on
viewing or submitting material to the docket, contact Docket Services,
telephone<PHONE_NUMBER>.

SUPPLEMENTARY INFORMATION:

Table of Contents for Preamble

I. Rulemaking Documents
    A. Availability of Rulemaking Documents
    B. Privacy Act
II. Executive Summary
    A. Purpose and Summary of the Major Provisions
    B. Benefits and Costs
III. Abbreviations
IV. Legal Basis for the Rulemaking
    A. Authority Over Drivers Affected
    B. Authority To Regulate State CDL Programs
    C. Authority To Require Reporting by MEs
V. Background
    A. Medical Certification Requirements as Part of the CDL
    B. National Registry of Certified MEs
    C. MER
VI. Discussion of Comments Received on the Proposed Rule
    A. Overview
    B. Electronic Transmission and Access to MEC Information
    C. Use of Revised Medical Examination Report Form and Medical
Examiner's Certificate
    D. Compliance Date for the States
    E. Coercion
    F. Issues Outside the Scope of This Rulemaking
VII. Section-by-Section Explanation of Changes
    A. Changes to Part 383
    B. Changes to Part 384
    C. Changes to Part 391
    D. Compliance Date
VIII. Regulatory Analyses and Notices
    A. E.O. 12866 (Regulatory Planning and Review and DOT Regulatory
Policies and Procedures as Supplemented by E.O. 13563)
    B. Regulatory Flexibility Act
    C. Assistance for Small Entities
    D. Unfunded Mandates Reform Act of 1995
    E. E.O. 13132 (Federalism)
    F. E.O. 12988 (Civil Justice Reform)
    G. E.O. 13045 (Protection of Children)
    H. E.O. 12630 (Taking of Private Property)
    I. Privacy Impact Assessment
    J. E.O. 12372 (Intergovernmental Review)
    K. Paperwork Reduction Act
    L. National Environmental Policy Act and Clean Air Act
    M. E.O. 12898 Environmental Justice
    N. E.O. 13211 (Energy Supply, Distribution, or Use)
    O. E.O. 13175 (Indian Tribal Governments)
    P. National Technology Transfer and Advancement Act (Technical
Standards)

I. Rulemaking Documents

A. Availability of Rulemaking Documents

    For access to docket FMCSA-2012-0178 to read background documents
and comments received, go to http://www.regulations.gov at any time, or
to U.S. Department of Transportation, Room W12-140, 1200 New Jersey
Avenue SE., Washington, DC 20590, between 9 a.m. and 5 p.m. E.T.,
Monday through Friday, except Federal holidays.

B. Privacy Act

    In accordance with 5 U.S.C. 553(c), DOT solicits comments from the
public to better inform its rulemaking process. DOT posts these
comments, without edit, including any personal information the
commenter provides, to www.regulations.gov, as described in the system
of records notice (DOT/ALL-14 FDMS), which can be reviewed at
www.dot.gov/privacy.

II. Executive Summary

A. Purpose and Summary of the Major Provisions

    The purpose of this final rule is to facilitate the electronic
transmission of MEC information from FMCSA's National Registry to the
SDLAs. This transmission will provide administrative cost savings to
motor carriers, drivers, MEs, and SDLAs. In addition, it will reduce,
to the greatest extent possible, the potential for the submission of
falsified MECs to the States, which are required to post MEC
information to CLP/CDL holders' records accessible via CDLIS. By
ensuring that drivers are medically qualified, FMCSA will decrease the
risk of CMV crashes, attributable in whole or in part, to drivers with
medical conditions that adversely affect their ability to operate a CMV
safely on the Nation's highways.
    The final rule requires certified MEs performing physical
examinations of CMV drivers to use a newly developed MER Form, MCSA-
5875, in place of the current MER Form and to use the Form MCSA-5876
for the MEC. In addition, MEs are required to report results of each
CMV drivers' physical examination, including the results of
examinations where the driver was found not to be qualified, to FMCSA
by midnight local time of the next calendar day following the
examination. This includes all CMV drivers (CDL/CLP and Non-CDL/CLP)
who are required to be medically certified to operate in interstate
commerce and allows, but does not require, MEs to transmit any
information about examinations performed in accordance with the FMCSRs
with any applicable State variances, which will be valid for intrastate
operations only. Examination results will be reported by completing a
CMV Driver Medical Examination Results Form, MCSA-5850, via the ME's
individual password-protected National Registry web account.

    For applicants/holders of CLP/CDLs (interstate and intrastate),
FMCSA will electronically transmit from the National Registry system to
the SDLAs driver identification, examination results, and restriction
information for examinations performed in accordance with the FMCSRs
(49 CFR 391.41-391.49), as well as information about any examinations
reported by the MEs that are performed in accordance with applicable
State variances. This includes examination results that have been
voided by FMCSA because the Agency finds that an ME has certified a
driver who does not meet the interstate physical certification
standards.
    The Agency will also transmit medical variance information \1\ for
all CMV drivers electronically to the SDLAs. Transmission of this
information will allow authorized State and Federal enforcement
officials to view the most current and accurate information regarding
the medical status of the CMV driver, all information on the MEC, any
medical variance information (if applicable), and the issued and
expiration date.
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    \1\ When medical variance information is referenced in this
document it means exemptions, skills performance evaluation
certificates and grandfathered exemptions issued by FMCSA.
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B. Benefits and Costs

    The estimated cost of the final rule is not expected to exceed the
$100 million annual threshold for economic significance. The
modifications to the National Registry system and Commercial Driver's
License Information System (CDLIS) that will allow the Agency to
electronically transmit driver identification, examination results, and
medical variance information from the National Registry system to the
SDLAs, have been estimated to be a one-time rounded cost of
$12,000,000.

                       Summary of Quantified Costs
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SDLA....................................................     $10,000,000
AAMVA...................................................       1,000,000
FMCSA...................................................       1,000,000
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    Total Costs (rounded)...............................      12,000,000
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    The implementation of this rule will result in changes to the
annual paperwork burden hours and costs for the Medical Qualification
Requirements and the Commercial Driver Licensing and Testing Standards
information collections (ICs). As a result, the motor carriers,
drivers, MEs, and SDLAs affected will benefit from a decrease in annual
burden hours and economic expenditures. The estimated cost savings are
$10.16 million annually.
    The potential estimated benefits are detailed in the table below.
The revised Office of Management and Budget (OMB) control numbers 2126-
0006 and 2126-0011 Supporting Statements detail all revisions
associated with the reduced annual paperwork burden hours.

                     Summary of Quantified Benefits
                        [in millions of dollars]
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Motor carriers no longer verify ME National Registry number....    $4.78
MEs no longer handwrite MECs for CLP/CDL applicants/holders....     2.87
CLP/CDL applicants/holders no longer provide MEC to SDLA.......     1.05
SDLAs no longer manually record MEC information................     1.46
                                                                --------
    Total Benefits.............................................    10.16
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III. Abbreviations

AAMVA American Association of Motor Vehicle Administrators
AAMVAnet American Association of Motor Vehicle Administrators Network
Advocates Advocates for Highway and Auto Safety
ATA American Trucking Associations
CAA Clean Air Act
CE Categorical Exclusion
CDL Commercial Driver's License
CDLIS Commercial Driver's License Information System
CLP Commercial Leaner's Permit
CMV Commercial Motor Vehicle
DOT U.S. Department of Transportation
DQ Driver Qualification
FMCSA Federal Motor Carrier Safety Administration
FMCSRs Federal Motor Carrier Safety Regulations
IC Information Collection
ICC Interstate Commerce Commission
MAP-21 Moving Ahead for Progress in the 21st Century Act
ME Certified Medical Examiner
MEC Medical Examiner's Certificate
MER Medical Examination Report
MVR Motor Vehicle Record
NPRM Notice of Proposed Rulemaking
OMB Office of Management and Budget
PIA Privacy Impact Assessment
PII Personally Identifiable Information
PRA Paper Reduction Act
RFA Regulatory Flexibility Act
SAFETEA-LU Safe, Accountable, Flexible, Efficient Transportation Equity
Act: A Legacy for Users
SDLA State Driver Licensing Agencies
SPE Skill Performance Evaluation

IV. Legal Basis for the Rulemaking

    The purpose of this final rule is to modify the requirements
adopted in two earlier final rules issued by FMCSA, 73 FR 73096 (Dec.
1, 2008) and 77 FR 24104 (April 20, 2012), so that the information from
the MEC transmitted to FMCSA after the examination by MEs for drivers
required to have a CDL is promptly and accurately transmitted to the
SDLAs for entry into the appropriate driver record. In view of this
purpose, the legal bases of the two previous final rules also serve as
the legal basis for this final rule. The primary legal basis for the
2008 final rule, Medical Certification Requirements as Part of the
Commercial Driver's License, is section 215 of Motor Carrier Safety
Improvement Act [Pub. L. 106-159, 113 Stat. 1767 (Dec. 9, 1999)] (set
out as a note to 49 U.S.C. 31305). The primary legal basis for the 2012
final rule, National Registry of Certified Medical Examiners (National
Registry), is 49 U.S.C. 31149, enacted by section 4116(a) of the Safe,
Accountable, Flexible, Efficient Transportation Equity Act: A Legacy
for Users, Public Law 109-59, 119 Stat. 1726 (Aug. 10, 2005) (SAFETEA-
LU). Detailed discussions of the legal basis for the 2008 and 2012
final rules appear in their preambles, at 73 FR 73096-73097 and 77 FR
24105-24106, respectively.

A. Authority Over Drivers Affected

1. Drivers Required To Obtain an MEC
    FMCSA is required by statute to establish standards for the
physical qualifications of drivers who operate CMVs in interstate
commerce [49 U.S.C. 31136(a)(3) and 31502(b)]. FMCSA has fulfilled the
statutory mandate of 49 U.S.C. 31136(a)(3) by establishing physical
qualification standards for all drivers covered by these provisions [49
CFR 391.11(b)(4)].\2\ Such drivers must obtain from an ME a
certification stating that the driver is physically qualified [49 CFR
391.41(a), 391.43(g) and (h)]. FMCSA is also required by statute to
ensure that the operation of a CMV does not have a deleterious effect
on the physical condition of the drivers [49 U.S.C. 31136(a)(4)].
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    \2\ There are a few limited exceptions of drivers in 49 CFR
390.3(f) and 391.2.
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    Sec. 32911 of the Moving Ahead for Progress in the 21st Century Act
(MAP-21) (Pub. L. 112-141, 126 Stat. 405, July 6, 2012) added an
additional requirement to ensure that ``an operator of a CMV is not
coerced by a motor carrier, shipper, receiver, or transportation
intermediary to operate a CMV in violation of a regulation

promulgated under this section, or chapter 51 or chapter 313 of this
title'' [49 U.S.C. 31136(a)(5)]. See the discussion below. FMCSA is
also required to consider, to the extent practicable and consistent
with the purposes of the statute, costs and benefits of the rule. 49
U.S.C. 31136(c)(2)(A).
2. Drivers Required To Obtain a CDL
    The authority for FMCSA to require an operator of a CMV to obtain a
CDL rests on the authority found in 49 U.S.C. 31302.

B. Authority To Regulate State CDL Programs

    FMCSA, in accordance with 49 U.S.C. 31311 and 31314, has authority
to prescribe procedures and requirements for the States to observe in
order to issue CDLs [see, generally, 49 CFR part 384]. In particular,
under section 31314, in order to avoid loss of funds apportioned from
the Highway Trust Fund, each State shall comply with the requirement
that the State shall adopt and carry out a program for testing and
ensuring the fitness of individuals to operate commercial motor
vehicles consistent with the minimum standards prescribed by FMCSA
under section 31305(a) of Title 49 U.S.C. 49 U.S.C. 31311(a)(1). See
also 49 CFR 384.201.

C. Authority To Require Reporting by MEs

    FMCSA has authority under 49 U.S.C. 31133(a)(8) and 31149(c)(1)(E)
to require MEs on the National Registry to obtain information from CMV
drivers regarding their physical health, to record and retain the
results of the physical examinations of CMV drivers and to require
frequent reporting of the information contained on all of the MECs they
issue. Section 31133(a)(8) gives the Agency broad administrative powers
(specifically ``to prescribe recordkeeping and reporting
requirements'') to assist in ensuring motor carrier safety and driver
health. [Sen. Report No. 98-424 at 9 (May 2, 1984)]. Section
31149(c)(1)(E) authorizes a requirement for electronic reporting of
certain specific information by MEs, including applicant names and
numerical identifiers as determined by the FMCSA Administrator. Section
31149(c)(1)(E) sets minimum monthly reporting requirements for MEs and
does not preclude the exercise by the Agency of its broad authority
under section 31133(a)(8) to require more frequent and more inclusive
reports. In addition to the general rulemaking authority in 49 U.S.C.
31136(a), the Secretary of Transportation is specifically authorized by
section 31149(e) to ``issue such regulations as may be necessary to
carry out this section.''
    Authority to implement these various statutory provisions has been
delegated to the Administrator of FMCSA [49 CFR 1.87(f)].

V. Background

    On May 10, 2013, FMCSA published the Medical Examiner's
Certification Integration notice of proposed rulemaking (NPRM) (78 FR
27343). The public comment period for the NPRM closed on July 9, 2013.
This final rule, as stated in the Legal Basis section, is a follow-on
rule to both the Medical Certification Requirements as Part of the CDL
rule (Med-Cert) final rule published on December 1, 2008 (73 FR 73096)
and the National Registry of Certified Medical Examiners (National
Registry) final rule published on April 20, 2012 (77 FR 2410). It is
the third rule of an initiative to improve the driver qualification and
medical examiner's certification process.

A. Medical Certification Requirements as Part of the CDL

    FMCSA's 2008 Med-Cert final rule, [73 FR 73096 (Dec. 1, 2008)]
adopted a number of regulatory provisions designed to incorporate
information from the MEC into CDLIS. Subsequent actions of the Agency
modified some of the provisions adopted in the 2008 final rule [see
Med-Cert; Technical, Organizational, and Conforming Amendments, 75 FR
28499 (May 21, 2010)]. Most of the requirements established by these
actions took effect on January 30, 2012. But some requirements
affecting CDL holders and their employers did not take effect until
January 30, 2015.
    In addition, FMCSA established new uniform requirements for CLPs in
the final rule published May 9, 2011, Commercial Driver's License
Testing and Commercial Learner's Permit Standards [76 FR 26854]. As a
result, the medical certification requirements of the 2008 final rule
will apply to applicants and holders of CLPs beginning on July 8, 2015
[78 FR 17875, 17882 (Mar. 25, 2013), amending 49 CFR 384.301(f)]. As
modified by these actions, the essential elements of these CLP/CDL
medical certification provisions for each of the affected groups are
summarized below:
1. SDLAs
    The Med-Cert rule mainly requires the States to modify their CDL
procedures to: (1) Record a CLP/CDL applicant's/holder's self-
certification regarding type of driving (e.g., interstate (non-excepted
or excepted) and intrastate (non-excepted or excepted) on the CDLIS
driver record); (2) require submission of the original or copy of the
MEC from a driver operating in non-excepted, interstate commerce who is
required by 49 CFR part 391 to be medically certified; (3) post the
required information from the certificate or a copy onto the CDLIS
driver record within 10 calendar days; (4) update the medical
certification status of the CDLIS driver record to show the driver as
``not-certified'' if the certification expires; and (5) downgrade the
CLP/CDL within 60 days of the expiration of the driver's MEC. There are
also requirements for posting certain information about any medical
variances issued to the driver on the CDLIS driver record.
    If the driver certifies that he or she expects to drive in
interstate commerce and is not driving exclusively for one of the
industries excepted from the requirements of 49 CFR part 391, the Med-
Cert rule requires the State to post the driver's information, within
10 calendar days on the CDLIS driver record. In addition to the
recordkeeping requirements, the SDLA must make the driver's medical
certification status information electronically accessible to
authorized State and Federal enforcement officials and to drivers and
employers via CDLIS motor vehicle records (MVRs).
    Today's final rule provides a cost-effective tool to support the
States in implementing the Med-Cert rule and reduce to the greatest
extent possible the need for State personnel to spend time manually
entering information from paper copies of the medical certificates. The
rule also helps ensure that the medical certificates being uploaded are
valid.
2. Motor Carriers and Employers
    Motor carriers who employ a CDL holder subject to the physical
qualifications requirements under 49 CFR part 391 must place the
driver's current CDLIS MVR documenting the driver's medical
certification status in the driver's qualification (DQ) file before
allowing the driver to operate a CMV. The MEC that the driver provided
to the SDLA may be used for this purpose for up to 15 days from the
date the certificate was issued by the ME. The CDLIS MVR will be used
to verify the driver has the necessary medical certification and the
results placed in the DQ file.
3. Drivers.
    All interstate CDL holders subject to the physical qualifications
standards of

49 CFR part 391 must meet the following requirements:
     All drivers applying for an initial, renewal, upgrade or
transfer of a CDL must provide the MEC to the SDLA, and update that
information whenever a new certificate is issued.
     All existing CDL holders who do not have a renewal,
upgrade or transfer issuance must still provide the MEC to the SDLA.
They must update that information with the SDLA whenever a new
certificate is issued.
     Beginning on January 30, 2015, these drivers no longer
have to use the MEC as proof of their medical certification to
enforcement personnel or employers, except for the first 15 days after
issuance.
     Beginning on January 30, 2015, these drivers are no longer
required to carry the actual MEC after the first 15 days after
issuance, but must continue to carry any Skills Performance Evaluation
(SPE) certificate or medical exemption document while on duty.
     Beginning on July 8, 2015, the above requirements will
also apply to CLP holders.
    Non-CDL/CLP holders subject to the physical qualifications
standards of 49 CFR part 391 will continue to be required to carry the
original or a copy of the MEC and any SPE certificate or medical
exemption document while on duty.

B. National Registry of Certified MEs

    In 2012, FMCSA issued a final rule establishing the National
Registry [77 FR 24104 (Apr. 20, 2012)]. This rule established training
and testing requirements for medical professionals who conduct the
medical certification examinations of interstate CMV drivers. The
compliance date for the National Registry final rule was May 21, 2014.
Therefore, as to medical certifications issued on or after that date,
the Agency considers valid only those MECs that were issued by MEs
listed on the National Registry on the date of issuance. MECs that were
issued prior to the May 21, 2014 compliance date, however, are
considered valid until the MECs expiration date provided by the ME.
    The MEs who conduct medical examinations of CMV drivers must retain
copies of the MER Forms of all drivers they examine and certify. The
MER Form lists the specific results of the various medical tests and
assessments used to determine if a driver meets the physical
qualification standards set forth in 49 CFR part 391, subpart E.
    One of the administrative requirements for being listed on the
National Registry is for the ME to submit a CMV Driver Medical
Examination Results Form, MCSA-5850, to FMCSA for each physical
examination conducted on both CLP/CDL and non-CDL holders. MEs are
required to submit this information monthly. The CMV Driver Medical
Examination Results Form, MCSA-5850, has undergone minor editorial
changes to be more user friendly and includes most of the information
on the MEC.

C. MER

    The current version of the MER Form and the instructions and
requirements for its use have evolved over a number of years. In 2000,
FMCSA issued a final rule adopting significant revisions to the
instructions and MER Form, much as they appear today in 49 CFR
391.43(f). The purpose of the revisions was to organize the form to:
``(1) Gain simplicity and efficiency; (2) reflect current medical
terminology and examination components; and (3) be a self-contained
document. . . .'' [Physical Qualification of Drivers; Medical
Examination; Certificate, 65 FR 59363 (Oct. 5, 2000)]. The MER Form
also included a number of advisory criteria providing Agency guidelines
to assist MEs in assessing a driver's physical qualifications. FMCSA
noted that ``These guidelines are strictly advisory and were
established after consultation with physicians, States and industry
representatives.'' (65 FR 59364).
    Since the 2000 revisions, the MER Form and the instructions have
been revised only to reflect changes in the advisory guidelines
relating to hypertension and standards for the use of Schedule I drugs
[Motor Carrier Safety Regulations; Miscellaneous Technical Amendments,
68 FR 56199 (Sep. 30, 2003) and Harmonizing Schedule I Drug
Requirements, 77 FR 4479 (Jan. 30, 2012) and 77 FR 10391 (Feb. 22,
2012)].

VI. Discussion of Comments Received on the Proposed Rule

A. Overview of Comments

    In response to the May 2013 NPRM, FMCSA received 67 comments. The
majority of the commenters were State agencies (from Alabama,
California, Colorado, Delaware, Georgia, Illinois, Kentucky, Maryland,
Missouri, Montana, Nebraska, New York, Ohio, Oregon, Utah, Virginia,
and Wisconsin) and individuals, many of whom identified themselves as
healthcare professionals. Among other commenters were the following:
Five healthcare provider professional associations including the
American Academy of Physician Assistants (AAPA) and the American
College of Occupational and Environmental Medicine (ACOEM); four
trucking/industry associations including the American Association of
Motor Vehicle Administrators (AAMVA) and the American Trucking
Associations, Inc. (ATA); seven motor carriers including Landstar
Transportation Logistics, Inc.; Schneider National, Inc.; the County of
Los Angeles, CA; Concentra Health Services jointly with U.S.
HealthWorks Medical Group; and Advocates for Highway and Auto Safety
(Advocates).
    The first area of comment involved the proposal for electronic
transmission of CMV drivers' MEC information to the SDLAs, and related
issues. The second involved the proposed revisions and handling of the
MER Form, MCSA-5875 and, to a lesser extent, the minor changes to the
MEC, Form MCSA-5876. A third area of comment involved provisions that
would invalidate a driver's current MEC when the driver fails a new
physical examination. Lastly, a number of commenters raised issues that
were beyond the scope of the proposals in the NPRM. These comments will
be briefly summarized with an explanation as to why the issues raised
are not within the scope of this proceeding.
    Although no commenters explicitly expressed support for the
proposed rule in its entirety, 17 were in support of various provisions
of the rule. Five commenters explicitly opposed the proposed rule.
Twenty-nine commenters provided recommendations, voiced concerns, or
were opposed to specific parts of the proposed rule, such as
identification of the system that will be used for the electronic
transmission of MEC data to the SDLAs, transmission of data for all CMV
drivers not just CLP/CDL applicants/holders, transmission of data for
those drivers operating in intrastate commerce, daily reporting
requirements for MEs, and new form requirements. Nine commenters
expressed serious concerns over specific requirements that they believe
would be detrimental to stakeholders, such as increased costs, creating
potential shortages of certified MEs, prohibiting drivers from carrying
their MEC as a means of proving their medical qualification, and the
implementation date for SDLAs. Seven others commented on issues that
are outside the scope of this rulemaking.
    The following sections provide details regarding specific issues
raised by the commenters.

B. Electronic Transmission and Access to MEC Information

1. System To Be Used for Data Transfer
    FMCSA proposed to electronically transmit driver identification,
examination results, and restriction information from the National
Registry system to the SDLAs for CLP/CDL applicants/holders. Many
commenters were concerned that the system FMCSA plans to use to
transfer the MEC information electronically to the SDLAs was not
identified. AAMVA, many States, and other commenters suggested FMCSA
consider using the existing CDLIS platform because it is a proven,
secure system that on a daily basis successfully moves large amounts of
data between States. It is their opinion that it would be easier to
create a new message type in CDLIS that allows the MEC information to
be transmitted than it would be to develop a new system, and would not
require manual entry of data. They recommended that all fields have
defined formats/standards and, if standards already exist in CDLIS and
are included in the CDLIS MVR that is available to carriers and
drivers, FMCSA use those. Many of these commenters stated that without
the system being identified, there was not enough information to make a
full assessment of the technical and cost impact. Some commenters were
also concerned about how information would be made available to
employers, drivers and other users, such as enforcement personnel. The
ATA suggested that FMCSA design the system so that, if a State
consents, MEs can simultaneously and instantaneously report results to
both the National Registry and the driver's MVR in CDLIS and other
relevant systems.
    There were also comments addressing the length of time that the
SDLAs would have to update the records, ranging from real time updates
to three days or longer. Werner Enterprises, Inc. expressed concern for
how the proposed system would work on a practical level and suggested
that the timeframe for FMCSA to transmit the MEC information to the
SDLA be mandated as the next day.
FMCSA Response
    Although the Agency had long recognized the benefits of using the
CDLIS platform, the Agency did not discuss this plan in the preamble to
the NPRM. The intent of the rulemaking was not to specify the platform,
but to explain that the Agency made a preliminary determination that it
was feasible to collect MEC information from MEs on a daily basis, and
that the more frequent submission of the examination results would
facilitate the timely transmission of information to the SDLAs. The
Agency now agrees that CDLIS is the appropriate and most cost-effective
means of implementing the requirements of this final rule, as many of
the commenters urged. When it is implemented, FMCSA will receive and
process the MEC information from the MEs, and then the data for CDL
drivers will be electronically transmitted through the AAMVAnet
communications system to the SDLAs. Once received, the SDLAs will be
able to automatically populate the individual CDLIS driver records with
the MEC information. The fields for this information have already been
created and established in the CDLIS record as a result of the
implementation of the 2008 Med-Cert final rule. The development of this
electronic transfer of MEC information from the National Registry
through the AAMVAnet communications system to the CDLIS driver records
will be a joint effort of FMCSA, AAMVA and the SDLAs.
    While there will be one-time costs incurred by the SDLAs to
implement this secure transmission of MEC information, SDLAs should see
a reduction in staff time and costs in the elimination of manual input
of this MEC information over time.
2. Transmission of MEC Information for CLP/CDL Applicants/Holders Only
    For applicants/holders of CLP/CDLs, FMCSA proposed to transmit
driver identification, examination results, and restriction information
electronically from the National Registry system to the SDLAs. Many
commenters were opposed the continued use of paper MECs for non-CLP/CDL
applicants/holders. Several commenters believe FMCSA should require the
posting of the MEC for non-CLP/CDL applicants/holders to a database
similar to CDLIS. For example, the ATA suggested that FMCSA examine the
benefits of requiring SDLAs to furnish MEC information to all CMV
drivers, including those who require medical certification but do not
require a CDL.
    The American College of Occupational and Environmental Medicine
(ACOEM) indicated that placing the responsibility on the ME to keep
track of whether they are required to submit the results of the
examination (CLP/CDL applicants/holders) or issue a paper MEC (those
who require the MEC but do not require a CDL) could be confusing,
especially for the intrastate CLP/CDL holders. They also stated that
the proposed rule extends the burden on the MEs with more frequent
submissions and tracking of different requirements for inter/intrastate
or CLP/CDL/non-CLP/CDL holders, not to mention the excepted or non-
excepted drivers.
    Oregon's Driver and Motor Vehicle Services expressed a similar
concern that errors occurring in the transmission of the information to
the National Registry will result in inaccuracies that will prevent the
National Registry from transmitting the data successfully to the
correct State. They suggested that a process be added for States to
access the National Registry through a password-protected web account
to locate the MEC for a particular driver. They stated that the ability
to pull the MEC information could resolve the concerns for those States
with statutes that require an MEC. They also suggested, as an
alternative, that the National Registry provide a ``help desk''
function that would receive requests for MECs, search for a driver, and
mark the record so the system can transmit the MEC information to a
particular State.
FMCSA Response
    FMCSA generally agrees with the suggestions. However, there are
practical technical and statutory limitations that shaped the direction
of the Agency's proposal.
    FMCSA will electronically transmit MEC information from the
National Registry to the SDLAs only for CLP/CDL applicants/holders
because there is currently no IT system platform comparable to CDLIS
for non-CLP/CDL applicants/holders, and the Agency does not have
statutory authority to impose requirements on SDLAs concerning
licensing of non-CLP/CDL applicants/holders. The 1986 legislation
concerning the Federal CDL program does not provide the Agency with
authority to cover non-CDL issues. Therefore, the Agency has no
alternative but to focus on the electronic exchange of information
between the National Registry and the SDLAs and retain requirements for
paper MECs for non-CLP/CDL applicants/holders.
    While some commenters expressed concern about placing a burden on
MEs by having two different methods of processing MEC information for
CLP/CDL applicants/holders versus non-CLP/CDL applicants/holders, FMCSA
does not believe there is a burden on MEs. MEs need only focus on
accurately documenting the results of the examination completely and
accurately by completing the CMV Driver Medical Examination Results
Form, MCSA-5850, via their individual password-protected National
Registry account, following every examination. As long as

the information is complete and accurate, the FMCSA will take full
responsibility for the electronic transmission of the MEC information
to the SDLAs. Nothing in this rulemaking prohibits MEs from providing
each driver with a copy of the MEC at the completion of the
examination, so all drivers could carry a copy with them if the driver
believes it is necessary. Drivers whose MEC information was transmitted
electronically will have the added benefit of no longer being required
to present proof directly to the SDLA. But the only official record of
the CDL driver's physical qualifications will be the CDLIS driver
record.
    FMCSA acknowledges that there will be situations where the SDLA may
need to pull MEC information from the National Registry for a driver,
as indicated by the comments from Oregon's Driver and Motor Vehicle
Services. The FMCSA is committed to putting into place a push-pull
system for transmission of information between the National Registry
and the SDLAs. Under this system the information could be loaded
automatically onto drivers' records, but the SDLAs could also query the
National Registry and pull or download the MEC information for drivers
who had not yet obtained their CLP/CDL at the time of the medical
examination.
3. Daily Submission of CMV Driver Medical Examination Results Form,
MCSA-5850
    FMCSA proposed that MEs be required to report results of all
completed commercial drivers' physical examinations, including the
results of examinations where the driver was found not to be physically
qualified, to the National Registry system by close of business (COB)
on the day of the examination.
    Many commenters were opposed to the daily submission of the CMV
Driver Medical Examination Results Form, MCSA-5850 because they believe
that daily submission will place administrative and cost burdens on MEs
and the medical practice that may result in fewer MEs willing to become
certified. Some commenters believed that additional resources,
technology, and staff may be required to meet this proposed
requirement. Several commenters suggested that FMCSA allow
significantly more time to report results and allow various methods of
submission and a reduction in reporting requirements.
    Southern Company believes that COB reporting is unrealistic and
stated in detail how their MEs have estimated that the new requirements
would increase their administrative costs by 20-25% per physical.
Schneider National, Inc. would like FMCSA to reconsider the extent to
which the cost of exams would increase with the daily reporting
requirement. It asserts that the cost of this increase will be more
than the $18.00 assumption used for additional administrative worker
time.
    The Owner Operated Independent Drivers Association (OOIDA) asks the
Agency to take into account certain factors that will increase the
costs of the medical certification process to drivers: The costs
associated with there being fewer MEs under the new system due to daily
reporting requirements and the increased costs of those MEs being
passed on to the driver.
    Werner Enterprises stated that they were concerned by the lack of a
clearly defined deadline for FMCSA to deliver the information to the
SDLA. They suggested it be defined as the next business day. ATA
supports daily reporting, but suggested time zone considerations be
made for downloads and batch submissions. Several commenters requested
that FMCSA provide a means to allow the data to be automatically
uploaded from a computer, stating that this would significantly improve
their ability to meet the requirements and support FMCSA, the drivers,
and the States.
    On the other hand, AAMVA and its membership (some of whom commented
separately) stated that it is imperative for the SDLA to receive the
MEC information by no later than COB on the day of the exam. They
stated that without this requirement, roadside inspectors would not be
able to verify that a driver is medically certified and there would be
a tremendous impact on the ability of the SDLA to make an informed and
accurate determination on the medical status of their commercial
driving constituency.
    Many recommendations were made for modifying the reporting
timeline, such as separate submission deadlines for those that are not
qualified versus those that are qualified, a phase-in approach for all
qualification statuses, and submission deadlines based on length of
certification. One commenter, Southern Company, suggested that the
current medical certification reporting process of the ME sending the
MEC information to the SDLA be retained for efficiency purposes.
FMCSA Response
    After careful consideration of the comments received on this issue,
the Agency has modified the proposed daily reporting requirement. In
this final rule, MEs will be required to report results of all CMV
drivers' physical examinations performed, including the results of
examinations where the driver was found not to be physically qualified,
to FMCSA by midnight (local time) of the next calendar day following
the examination, instead of the proposed same-day reporting
requirement. FMCSA disagrees with commenters who claim that the
requirement to report exam results more quickly will increase the cost
of that task. This requirement will not increase the time needed to
transmit the form. MEs are encouraged to allow drivers to review the
information that will be transmitted to FMCSA so as to reduce data
errors and to ensure that, for CLP/CDL applicants/holders, the
information is promptly and accurately recorded on the driver record.
    The current process requires the ME to provide the MEC to the CLP/
CDL applicant/holder, who in turn must provide the information to the
SDLA, a requirement that was adopted in 2008 and which became fully
implemented on January 30, 2015. 79 FR 2377 (Jan. 14, 2014). The
purpose of this final rule is to replace that procedure with a
procedure for electronic transmission of the MEC information from the
MEs to FMCSA and then from FMCSA to the SDLAs. FMCSA will develop its
systems so that, when fully implemented in three years, they will
ensure prompt transmission of the MEC information from FMCSA to the
SDLAs for CLP/CDL applicants/holders. This should greatly improve the
timeliness and accuracy of the CDLIS driver record. Even though the
information for non-CDL holders will be reported to the National
Registry, such drivers still need to be issued a paper MEC, Form MCSA-
5876 by the ME if the driver is physically qualified. Contrary to
Southern Company's comment, there is no national system for MEs to send
MEC information to the SDLA.
    Finally, FMCSA believes that concerns about the number of MEs
listed on the National Registry are no longer warranted. As of January
5, 2015, there were more than 39,160 certified healthcare professionals
on the National Registry, and the Agency had received the results
concerning more than 2.8 million physical examinations conducted
between May 21, 2014 and December 31, 2014.
4. Carrier To Obtain MEC as Part of MVR From SDLA
    FMCSA proposed retaining the requirements for motor carriers to
obtain the CLP/CDL holders' medical information as part of the CDLIS
MVR from the SDLA originally imposed

through the 2008 Med-Cert final rule. Barton Solvents, Inc. pointed out
that they currently request MVRs twice a year and review all drivers'
records during those two periods. They stated that the proposed rule
would break up the requests such that MVRs would be requested
individually after the examination and annually thereafter and that the
administration of this change will require several more hours of staff
time for tracking and making the requests. They requested that FMCSA
consider removing the proposed requirement for employers to obtain the
MVR and have it placed into the driver qualification (DQ) file within
15 days, and return to the current requirement of an annual review. On
the other hand, ATA fully supports FMCSA's proposed decision to allow
motor carriers to use a driver's MVR containing medical qualification
information to demonstrate compliance with the motor carrier's driver
medical qualification monitoring requirement. Wisconsin's Department of
Transportation recommended that the system allow the physician to print
results of the exam and to email or eFax results to the driver. They
questioned how the doctor would be notifying the driver that she/he has
failed, how the driver/employer knows what that means, and if FMCSA is
planning on notifying drivers when their medical certification is due
to expire and/or expires.
FMCSA Response
    FMCSA understands the concerns underlying Barton Solvents' request
to modify the current requirement so that the MVR only be obtained and
placed in the DQ file once a year at a time determined by the employer.
But the current requirement under 49 CFR 391.25(a) was established
because the MEC or medical variance provided by the driver may expire
before a new MVR is obtained if it is only requested once a year. This
would leave the employer without proof for the DQ file to verify the
medical qualification of the driver. The employer's business practices
need to be modified so that the MVR is obtained by the employer each
time a new physical examination is taken and at least annually between
examinations to be in compliance with the driver qualification
requirements in 49 CFR 391.11(b)(4) and 391.41(a).
    In response to Wisconsin's comments, the driver can request and
receive any additional information and documents (including copies of
the MER and the MEC). But the official record of the driver's
qualifications (for CLP/CDL applicants/holders) will be the information
transmitted to FMCSA by the ME and then transmitted by FMCSA to the
SDLA for entry on the driver record. Non-CDL holders, of course, will
still have to be provided a signed copy of the MEC in accordance with
49 CFR 391.43. Finally, it is the driver's responsibility to ensure
that, if required to have a valid MEC, they obtain a new one before the
previous one expires. FMCSA will not be providing any notice to drivers
about upcoming expiration dates. A CLP/CDL holder who allows the MEC to
expire without obtaining a new one will, in due course, be notified by
the SDLA that the CLP/CDL will be downgraded.
5. Carrying a Paper MEC While on Duty
    FMCSA proposed that CLP/CDL holders would no longer be required to
carry a valid MEC while on duty operating a CMV, even during the first
15 days after it is issued because the MEC information would be
electronically transmitted from the ME to the National Registry system
by close of business on the day of the examination. FMCSA would then
promptly transmit the information from the National Registry system to
the SDLAs electronically for entry into the appropriate CDLIS driver
record. The MEC information would be posted to the driver's record, by
the SDLA, within one business day of receiving the information from
FMCSA.
    Several commenters were opposed to CLP/CDL holders no longer being
allowed or required to carry a paper MEC. They suggested we use the
language ``no longer required'' instead of ``not permitted.''
    Some commenters were concerned about the effect of the length of
time it might take for the information to be posted by the SDLAs on the
CDLIS driver record, and urged that the Agency retain the current 15-
day period during which the paper MEC would be valid. On the other
hand, ATA supports use of the language ``no longer required to carry
MEC.'' But it suggested FMCSA design the system to transmit to the
National Registry and the driver's MVR at the same time.
    Schneider National, Inc. pointed out that the MEC serves as the
driver's reminder as to when his/her certification expires; without
this they will need to call the ME, carrier or SLDA and ask when the
physical expires. They expressed their concern for the administrative
burden and costs this would cause. Schneider recommended any ``pending
decision'' be sent to the SLDA as ``not certified,'' then if no action
is taken, no additional transmission or change of status is needed. If
the driver resolves the issue and is certified, then upon receipt of
that status FMCSA would communicate a status of ``certified.'' Other
commenters suggested we retain the ``temporarily disqualified'' as an
outcome on the MER Form, MCSA-5875, and New York's Department of Motor
Vehicles asked that FMCSA clarify the State's responsibility when the
driver is reported by the ME as ``pending determination.''
FMCSA Response
    FMCSA's intent in promulgating this final rule is to eliminate the
need for CLP/CDL holders to carry a paper MEC as proof of being
medically qualified and to reduce fraudulent activity involved in the
issuance and forging of these documents in a paper format. For CDL
holders (and later for CLP holders), this requirement was established
in the Med-Cert final rule, although the requirement to have a paper
MEC while on duty was extended to January 30, 2015 because a few States
have not yet implemented the changes necessary to comply with that rule
[Med-Cert, Extension of Certificate Retention Requirements, 76 FR 70661
(Nov. 15, 2011); and Med-Cert, Extension of Certificate Retention
Requirements, 79 FR 2377 (Jan. 14, 2014)]. FMCSA acknowledges that
giving the ME until midnight (local time) of the next calendar day to
submit the MCSA-5850 to the National Registry will require extra
outreach to the drivers to encourage them not to wait until the last
minute to renew their medical certification. This outreach will be in
addition to general outreach to and training for drivers, employers and
law enforcement to become comfortable with this new method of proving
medical qualification. The electronic record of the driver's medical
certification will be the only valid evidence that the CLP/CDL holder
was physically qualified. Therefore, even if the CLP/CDL holder chooses
to carry a paper MEC, it will not be considered valid evidence of
medical qualification. As first established by the Med-Cert final rule,
the purpose of eliminating the paper MEC for CLP/CDL holders is to
provide current and accurate information and to reduce fraud. Non- CLP/
CDL holders will continue to be required to carry the original, or a
copy, of the MEC while on duty. All CMV drivers will still be required
to carry any relevant medical variance documents.
    FMCSA disagrees with Schneider's recommendation to forward any
pending determination to the SDLAs as not certified. The pending
determination category represents a situation where the ME needs
additional

medical information to determine if a driver is medically qualified.
When pending determination is selected, the driver may still drive
until his/her existing MEC expires or the ME makes a qualification
decision. This information will be submitted and stored only in the
National Registry system. It will not be transmitted to the SDLAs. In
addition, it would not be appropriate to forward this information as
``not certified'' because a determination has not been made. If it was
forwarded as ``not certified'', the SDLA will be required to enter
``not certified'' on the driver's CDL and to begin the process of
downgrading. If the disposition of the pending determination is not
updated by the ME before the 45 day expiration date, FMCSA will notify
the ME and the driver in writing that the examination is no longer
valid and that the driver is required to be re-examined. FMCSA will
retain the incomplete examination information in the National Registry
System. If the driver is not medically qualified at the time of the
exam, ``not qualified'' should be selected by the ME. This will apply
at all times when a driver is not medically qualified including when a
driver has a temporary and/or treatable disqualifying condition that
may later be resolved enabling the driver to again be medically
qualified or when a driver has not completed the recommended waiting
period. FMCSA will use this to audit/check for irregularities in
information transmitted to the National Registry (e.g., two or more
conflicting certification statuses submitted).
    It should also be pointed out that the CMV Driver Medical
Examination Results Form, MCSA-5850 clearly states that the results of
all examinations conducted by the ME, including incomplete and failed
examinations must be reported to FMCSA. However, the Agency does not
have the authority to require a driver to complete the physical
examination by a certified ME. The driver is able to stop the exam at
any time but all exams, including those that are incomplete will be
reported by the certified ME to the National Registry.
6. Transmission of MEC Information for Interstate Drivers Only
    FMCSA proposed to transfer MEC information to the SDLAs only for
those CLP/CDL applicants/holders that are required to be medically
certified to operate a CMV transporting property or passengers in
interstate commerce.
    Commenters objected to FMCSA transmitting MEC information for only
interstate drivers and were concerned that no consideration has been
given for intrastate drivers that are subject to the FMCSRs. Many,
including 10 of the 17 States that commented, suggested that FMCSA
electronically transmit MEC information for all CMV drivers, including
those that drive exclusively in intrastate commerce. The Colorado
Department of Revenue/CDL Unit and AAMVA, like many others, requested
clarification on whether it is the intent of FMCSA to send MEC
information for interstate CLP/CDL applicants/holders only. They
strongly objected to the process excluding intrastate drivers and
stated that this exclusion will require the SDLAs to develop two
different processes for receiving and entering MEC information. They
believe that having two separate processes will be confusing to those
law enforcement agencies that do not deal with CDL issues on a regular
basis. The Colorado Department of Revenue/CDL Unit pointed out that
while they understand that FMCSA does not regulate intrastate drivers,
Motor Carrier Safety Assistance Program (MCSAP) States are required to
treat intrastate drivers the same as interstate and suggested that
FMCSA do the same. The Colorado Department of Revenue/CDL Unit also
requested clarification on the use of the ``intrastate-only flag'' on
the CMV Driver Medical Examination Results Form, MCSA-5850,
specifically whether the driver would be certifying to inter or
intrastate driving, and whether MCSA-5850 forms marked intrastate-only
would be transmitted from the National Registry to the SDLAs.
    Georgia's Department of Driver Services recommended that FMCSA
consider designating any driver whose medical certification is sent
electronically from an ME to the SDLAs be designated by default to be
self-certified as non-excepted interstate. Georgia's Department of
Driver Services believes that this designation is logical because any
driver who obtains a medical certification believes that he or she is
non-excepted. They stated that each SDLA could impose intrastate-only
restrictions if such are applicable to a specific driver. Oregon Driver
and Motor Vehicle Services suggested that FMCSA develop a process that
includes a way for each State to select which of its drivers should
have MECs forwarded and have the ability to change that selection if
necessary, send all MEC information regardless of driving type, or
develop a way for States to access and retrieve the data directly from
the National Registry.
    ACOEM suggested that the final rule make it clear that the driver
is responsible for correctly notifying the ME of the category into
which the driver falls--interstate/intrastate and excepted/non-
excepted. They stated that placing the responsibility on the ME to keep
track of whether the ME is required to submit the results of the
examination (for CDL holders) or to issue an MEC (for those who require
an MEC but do not require a CDL) could be burdensome and confusing,
especially as to intrastate CDL holders. In ACOEM's opinion,
documentation requirements should not fall on the ME. ACOEM also
suggested that FMCSA develop a process to address situations where a
driver obtained an MEC prior to applying for a CDL, or where CDL was
checked on the MER but the driver does not have a CDL. ATA suggested
that FMCSA educate MEs about the differences between interstate and
intrastate drivers, as well as those that are required to have a CDL
and those that do not.
FMCSA Response
    The NPRM proposed that FMCSA would send MEC information to the
SDLAs only for those CLP/CDL applicants/holders who are required to be
medically qualified to operate in interstate commerce. In response to
the States' comments, however, the final rule has been expanded not
just to include transmittal of MEC information from all examinations
performed in accordance with the FMCSRs (49 CFR 391.41-49 CFR 391.49),
but also to allow (but not require) MEs to transmit information about
examinations performed in accordance with the FMCSRs with any
applicable State variances. See 49 CFR 391.43(g)(5)(i)(B) below.
    In general, States receiving MCSAP grants are required to adopt and
apply to intrastate CMV drivers, physical qualification standards that
are identical to or have the same effect as those applicable to
interstate CMV drivers, (49 CFR 350.101, 350.105 (definition of
compatible or compatibility) and 350.201(a)). A majority of States have
adopted compatible physical qualification standards, and a
certification that a driver has met those standards would be valid for
both interstate and intrastate operations. But a minority of States, as
permitted by the regulations governing MCSAP grants in 49 CFR
350.341(h)(1) and (2), have variances from the interstate standards
that are only valid for drivers operating in intrastate commerce.
    Moreover, States that have adopted such variances for intrastate
drivers have the option of setting up their own registry of MEs
qualified to apply those standards or to use MEs listed on the

National Registry who have knowledge of such variances. See 49 CFR
350.341(h)(3) and the explanation in the National Registry final rule
at 77 FR at 24109-24110 and 24120. To the extent States with variances
from the physical qualification standards choose to require
examinations of intrastate drivers to be conducted by MEs on the
National Registry, FMCSA is modifying the provisions of proposed 49 CFR
391.43(g)(5)(i)(B) to allow information about such examinations to be
reported to the National Registry for transmission to the appropriate
SDLA.
    The FMCSA cannot take any responsibility for determining whether
the MEC information for a driver who declares that he or she will
operate a CMV only in intrastate commerce meets State medical
qualification requirements. For this reason, FMCSA is modifying all of
the medical forms to make it clear whether an ME is examining and
issuing an MEC to a driver under the interstate physical qualification
standards applicable to all interstate and most intrastate drivers, or
under a set of standards that also includes applicable State variances
from the interstate physical qualification standards. Ultimately, after
the certification information for CLP/CDL holders has been transmitted
to the SDLAs, it will be the responsibility of those States with
variances to determine through their own procedures whether the State
variances have been properly applied for drivers who have self-
certified in accordance with 49 CFR 383.71(b)(1) that they are
operating intrastate-only and are subject to the State standards.
    As discussed in a previous response, MEs will be receiving training
and outreach regarding non-CLP/CDL holders who will need a paper copy
of the MEC, Form MCSA-5876. In regard to MEs having to make a decision
on who is excepted from the MEC requirements, FMCSA does not believe
this decision needs to be made by the ME. Anyone taking a physical
examination will be assumed to be non-excepted and in need of an MEC.
CMV drivers excepted from the physical qualification requirements will
not need to obtain an MEC.
7. Transfer of Medical Variance Information
    FMCSA proposed to electronically transmit medical variance
information for all interstate CMV drivers to the SDLAs.
    Commenters were concerned about the transmission of medical
variance information for all CMV drivers. The Colorado Department of
Revenue/CDL Unit and AAMVA requested that FMCSA clarify how the SDLAs
will receive this information for non-CDL holders and what they would
be expected to do with the information. The Nebraska Department of
Motor Vehicles stated that specific transmission requirements should be
identified and that currently the transmission of medical variance
information is not always timely. They requested that medical variance
information be transmitted through the National Driver Registry and
that it be done by COB on the day of the exam. ATA suggested that FMCSA
initiate a pilot project to examine whether medical variance
information can also be transferred from paper certificates carried by
a driver to electronic transmission. Oregon's Driver and Motor Vehicle
Services questioned how, without knowing whether a variance might be
approved, an ME knows whether a patient is physically qualified. They
suggested instructions be provided for how to proceed when checking
``qualified . . . only when accompanied by.''
FMCSA Response
    Medical variance information for all CLP/CDL holders will be
electronically transmitted from the National Registry to the SDLAs.
FMCSA will input approved exemption information and approved SPE
certificates. This information will then be promptly transmitted to the
appropriate SDLA. Because the status of a variance may or may not be
known at the time of the medical examination, we cannot provide a
specific timeframe in which the variance information will be
transmitted to the SLDA. Non-CLP/CDL applicants/holders variance
information will continue to be electronically transmitted through
encrypted email to the SDLAs. The SDLAs will use medical variance
information of non-CLP/CDL applicants/holders for verifying the
validity of medical variance documents provided by drivers and for
informational purposes.
    For those CMV drivers who are applying for an exemption or SPE for
the first time, the medical examination results will be held in the
National Registry system until the variance is approved. At that time,
the medical examination results and variance information will be
promptly transmitted to the appropriate SDLA. Grandfathered exemption
information will be inputted into the National Registry and promptly
transmitted to the appropriate SDLA. However, FMCSA and the SDLAs will
also be able to query the system to retrieve grandfathered exemption
information. All CMV drivers are required to carry any relevant medical
variance documents.
    When MEs select the ``qualified . . . only when accompanied by . .
.'' option on the CMV Driver Medical Examination Results Form, MCSA-
5850; MER Form, MCSA-5875; and/or the MEC, Form MCSA-5876, they are
certifying that the driver is physically qualified with the specified
waiver/exemption or SPE. It is up to the driver to obtain the waiver/
exemption or SPE. In this case, the MEC is not valid unless accompanied
by the waiver/exemption or SPE.
8. Voiding the MEC
    OOIDA pointed out that the NPRM did not elaborate on or provide
regulatory language for the process of voiding an MEC and questioned
the lack of detail for the procedures that FMCSA would use to void an
MEC. OOIDA recommended that in order to protect drivers from having
their MEC incorrectly voided and careers harmed, no final rule should
be issued until such a procedure is proposed, the public is given an
opportunity to comment, and provisions are written into the final rule.
Schneider National, Inc. commented that FMCSA proposed a new
requirement that the State must also update the medical status to ``not
certified'' when the medical certification is voided by FMCSA.
Schneider National, Inc. requested that this requirement be changed to
require the State to post on the CDLIS driver record a status of
``invalid'' rather than ``not certified'' in the cases of an
invalidated MEC. Schneider National, Inc. also requested more detail on
the procedures that FMCSA would follow.
FMCSA Response
    As explained in both the National Registry final rule (77 FR at
24108) and in the NPRM in this rulemaking (78 FR at 27348), under the
authority granted by 49 U.S.C. 31149(c)(2), FMCSA may void an MEC
issued to a CMV driver if it finds either that an ME has issued a
certificate to a driver ``who fails to meet the applicable standards at
the time of the examination'' or ``that a ME has falsely claimed to
have completed training in physical and medical examination
standards.'' FMCSA has implemented this authority on a case-by-case
basis as appropriate to the circumstances. The Agency has developed
internal processes for evaluating the validity of certificates in the
wide variety of possible situations where such review appears to be
appropriate under the statutory

standard. This will include review of the data submitted by MEs to the
National Registry system, as well as complaints, field investigations,
crash reports and other sources. FMCSA will provide the affected driver
a notice of the proposed action and an opportunity either to obtain a
new MEC, if appropriate, or to provide the Agency with any legal or
factual reasons why a new medical certificate should not be required
before voiding the MEC. If the decision is made to void the driver's
certificate, FMCSA will notify the driver. If the driver holds a CLP/
CDL, notification will be electronically transmitted by FMCSA to the
driver's SDLA through the National Registry, and the SDLA will change
the CLP/CDL holder's medical status to ``not certified'' within 10 days
and notify the driver of the action taken.

C. Use of Revised MER Form and MEC

    FMCSA proposed to require certified ME performing physical
examinations of CMV drivers to use a newly developed MER Form, MCSA-
5875, in place of the current MER Form and to use Form MCSA-5876 for
the MEC. Both forms will be prescribed for mandatory use.
    While many commenters supported the changes to the MER Form, MCSA-
5875, many also raised a number of different issues related to this
form. Each of those issues is discussed below. The only comments
received regarding the revised and prescribed MEC, Form MCSA-5876, were
suggestions to add a CLP indication and to remove the intrastate-only
selection. Both issues are discussed below.
Collection of Driver Health Information
    OOIDA stated that NPRM did not attempt either to make a connection
between the new questions and the driver medical qualification
requirements or to otherwise justify their adoption into the medical
certification form. They stated that FMCSA does not have the authority
to make such changes to the MER without describing its authority to do
so, and without dealing with the privacy implications of the proposal.
    Several other commenters raised questions about the need and
relevance of some of the information about the drivers' health history
requested on the revised MER. ATA expressed its concern about removing
the instructions from the MER Form, MCSA-5875 without replacing them
with documentation to distinguish between guidance and regulation and
that removing the reference to guidance undermines the distinction
between the two.
    Many other commenters made recommendations for modifying the MER
Form, MCSA-5875. For example, AAMVA and others suggested we include a
CLP box in addition to the CDL box on the MER Form, MCSA-5875 for
clarification purposes and to avoid the possibility of a driver
applying for a CLP not checking the CDL box and their MEC information
not being forwarded to the SDLA. The Delaware Division of Motor
Vehicles and others suggested that we remove the intrastate-only
option, contending that all MEC information should be submitted to the
National Registry and sent to the SDLAs.
FMCSA Response
    FMCSA believes its statutory authority for this rulemaking, as
provided in the legal basis section, is clear. The Agency has ample
legal authority to adopt recordkeeping requirements needed to implement
the proposed rule, and it may adopt these ancillary provisions as part
of the same rulemaking. The Agency does not believe it is necessary to
articulate the separate statutory authority for each specific change to
the form.
    FMCSA notes that proposed changes to IC burdens are covered through
its actions to comply with the Paperwork Reduction Act. To the extent
that the proposed changes would affect the estimated paperwork burden,
the Agency discusses those matters and seeks public comment on the
burden and associated costs of the recordkeeping requirement.
    With regard to privacy of medical information, FMCSA does not
collect details of drivers' medical history. This information is
collected to facilitate the completion of a thorough examination by the
ME and an appropriate assessment whether the driver meets the physical
qualifications standards. The MEs are responsible for maintaining the
MER, but they are not required to submit those reports to FMCSA absent
a request from the Agency or its State partners in association with an
investigation or audit. FMCSA emphasizes that the driver health history
questions, including those that have been added, are specifically
linked to the physical qualification standards set out in 49 CFR
391.41(b).
    The section for the driver's signature has been revised to read as
follows in order to emphasize the importance of providing complete and
accurate responses:

    I certify that the above information is accurate and complete. I
understand that inaccurate, false or missing information may
invalidate the examination and my Medical Examiner's Certificate,
that submission of fraudulent or intentionally false information is
a violation of 49 CFR 390.35, and that submission of fraudulent or
intentionally false information may subject me to civil or criminal
penalties under 49 CFR 390.37 and 49 CFR 386 Appendices A and B.

    The Agency proposed to remove the Instructions for Performing and
Recording Physical Examinations from 49 CFR 391.43(f), because FMCSA
recognizes that MEs, who have been licensed, certified, or registered
in accordance with applicable State laws and regulations to perform
physical examinations thereby possess the knowledge, skills, and
abilities to perform physical examinations, and do not need general
instructions in performing and recording physical examinations. The
Agency proposed to publish new versions of the instructions in FMCSA
guidance documents. To eliminate redundant or unnecessary requirements,
the instructions have been removed from 49 CFR 391.43(f).
    The Agency also proposed to remove the information about the
driver's role, a listing of physical qualification standards for
drivers, detailed instructions to the medical examiner, and the medical
advisory criteria from the newly developed MER Form, MCSA-5875, and to
publish them in FMCSA guidance documents. Because the majority is
information that healthcare practitioners must be knowledgeable of in
order to be licensed, registered or certified by their States to
perform physical examinations, this material has been removed from the
newly developed MER Form, MCSA-5875. The Agency recognizes that MEs
frequently refer to the guidance in the medical advisory criteria when
determining if a driver meets the physical qualification standards,
however, is therefore publishing the medical advisory criteria without
substantive change as an appendix to 49 CFR part 391, instead of in the
MER Form, MCSA-5875. In addition, brief instructions for completing the
MER Form, MCSA-5875, are included as part of the revised form.
    For clarification purposes, an entry for CLP has been added with
the entry for CDL on the CMV Driver Medical Examination Results Form,
MCSA-5850; MER Form, MCSA-5875; and the MEC, Form MCSA-5876 has been
changed from a box that reads ``CDL, YES or NO'' to a box that reads
``CLP/CDL Applicant/Holder, YES or NO.'' These changes should cover all
possibilities for a person who is

applying for, or is a holder of, a CLP or CDL, and should eliminate the
possibility that a driver who is applying for a CLP overlooks checking
the CDL box, which could result in MEC information not being forwarded
to the SDLA.
    The intrastate-only option on the CMV Driver Medical Examination
Results Form, MCSA-5850; MER Form, MCSA-5875; and the MEC, Form MCSA-
5876 has been removed and replaced with two certification options (1)
driver certified in accordance with the FMCSRs (49 CFR 391.41-391.49)
and (2) driver certified in accordance with the FMCSRs with any
applicable State variances (which will only be valid for intrastate
operations). This has been done in order to implement the Agency's
decision explained above to facilitate the transmission of driver
information for both interstate and intrastate operations, while
clearly differentiating on the relevant documentation which standards
(interstate or intrastate) are involved.
1. Privacy Act Compliance and Privacy Impact Assessment (PIA)
    OOIDA stated in its comments that the PIA was not published until
July 2013 and contains no greater discussion concerning the content of
the revised MER form than does the NPRM. OOIDA commented that the
proposed expansion of the information about a driver's personal health
history requested and recorded on a new MER greatly increases the
opportunity for such personal information to be distributed and used by
those without an interest in safety and for purposes other than driver
safety. OOIDA stated that the NPRM described the Privacy Act
requirements as not applicable to the MER because the proposed rule
does not require the government's collection of personally identifiable
information (PII). OOIDA explained that this is not exactly true
because this rule greatly expands the amount of information that the
government collects or otherwise has access to under existing rules,
and that by changing the universe of MER information used by other
rules, any privacy analysis performed when those rules were promulgated
would be out-of-date under the proposed rule. OOIDA stated that FMCSA
must now examine, under the Privacy Act, each of its rules that permit
or require the government to obtain and review the new MERs. It asked
if the answers to these questions will be stored and have some impact
on the driver in the future.
FMCSA Response
    There has been and will be adequate opportunity for public
awareness of, and in some respects for public comment on, the privacy
interests affected by this final rule. The Agency, in conjunction with
the Department's Chief Information Office, has prepared and made
available a PIA.\3\ The PIA is prepared in accordance with Section
522(a)(5) of the Fiscal Year 2005 Omnibus Appropriations Act, Pub. L.
108-447, 118 Stat. 3268 (Dec. 8, 2004).\4\ The PIA provides a detailed
explanation of the privacy interests involved in the entire National
Registry program. It sets out the careful and thorough steps FMCSA and
the Department have taken and will take to protect those interests,
while at the same time carrying out the statutory directives to ensure
that CMV drivers are physically qualified and can operate safely and
that operation of a CMV does not have a deleterious effect on their
health.\5\
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    \3\ Available at http://www.regulations.gov/#!documentDetail;D=FMCSA-2012-0178-0039.
    \4\ Set out as a note to 5 U.S.C. 552a, the Privacy Act, 5
U.S.C. 552a.
    \5\ 49 U.S.C. 31136(a)(3) and (4).
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    However, because of the unexpected delays in making the PIA
available in the rulemaking docket in support of the NPRM, FMCSA
published a Notice of Availability advising interested members of the
public that there was an additional, limited opportunity for comment on
the privacy issues involved in the proposed rules until June 11, 2014.
79 FR 30062 (May 27, 2014).\6\
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    \6\ http://www.regulations.gov/#!documentDetail;D=FMCSA-2012-
0178-0075
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    The Agency provided this opportunity to comment on the possible
impact of the rules proposed in the NPRM on the protection of privacy
of information used in determining the physical qualifications of CMV
drivers, in light of the evaluation by the Agency and the Department of
the protection of privacy of information set out in the PIA. In
response to the May 27, 2014, Notice of Availability, FMCSA received
two comments. One comment was from a driver stating that the National
Registry was making his job more difficult. The other comment was from
a medical office commenting on the submission requirements and
suggesting edits to the MER Form, MCSA-5875. Both comments received
were considered to be outside the scope of the PIA because neither
comment addressed the protection of privacy of information collected.
They were nevertheless considered as late-filed comments to the NPRM,
consistent with the Agency's policy to consider, to the extent
practicable, comments received after the close of a routine comment
period under 5 U.S.C. 553(c).
2. Paperwork Reduction Act Compliance
    ATA suggested that FMCSA publish an IC request to examine the
appropriateness of the amendments and investigate other potential
additions or subtractions to the MER Form, MCSA-5875.
FMCSA Response
    As required by the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C.
3507(d)), FMCSA submitted the information collection requirements
associated with the proposed rule, including the newly developed MER
Form, MCSA-5875, to OMB for its review. The final rule has a decrease
in annual paperwork burden hours (401,904 hours) as detailed in OMB
control number 2126-0011 Commercial Driver Licensing and Test Standards
and 2126-0006 Medical Qualification Requirements Supporting Statements
in the docket. FMCSA analyzed this rule and determined that its
implementation will decrease the currently approved IC burden hours
covered by both of these control numbers. A detailed analysis of each
IC activity can be found in the Supporting Statements attachments,
which are in the public docket for this rulemaking. The Agency believes
that the burden has not increased from what is currently being
collected on the MER Form, MCSA-5875 and is not a new collection of
information but is replacing the current MER being used by MEs. Much of
the same information is being collected, just in a different format.
3. Cost Impacts of Revised Form
    Southern Company stated that increasing reporting requirements on
the MER Form, MCSA 5875, will have costly impacts and that form changes
need to be evaluated in conjunction with the registration and
certification of MEs on the National Registry and pending medical
examination guideline changes for MEs. They indicated that together
these rules will prove very costly, confusing, and disruptive to their
company, the energy industry and the trucking industry. They stated
that the expanded set of questions on medical history will increase
direct and indirect costs of the exam because the driver will need 30-
45 more minutes to complete the medical history and the ME will have to
discuss the answers with the driver, increasing the total time for the

office visit. They stated that this warrants more time to analyze the
economic impact since this would potentially increase the trucking
industry's costs significantly as well and negatively impact the
nation's economy. They suggested that this regulatory action should be
combined with the related rule changes as mentioned above and proposed
for comments.
FMCSA Response
    The newly developed MER Form, MCSA-5875, contains much of the same
information being collected on the current MER, but in a different
format, and thus is not considered a new collection of information.
Therefore, the burden has not increased from what is currently being
collected on the MER. In addition, all questions on the MER Form, MCSA-
5875, can be specifically linked to provisions of 49 CFR 391.41,
physical qualifications for drivers, or to ensuring that there is no
negative or deleterious effect on the driver's health making it more
difficult to drive a CMV safely. FMCSA does not consider the questions
on the revised MER Form, MCSA-5875, to be long or onerous for the
driver to complete. The time spent to fill out the form or to complete
the exam will not increase to the extent that the commenter suggests.

D. Compliance Date for States

    FMCSA proposed that beginning 3 years after the effective date of
the final rule, FMCSA would electronically transmit all of the
information on the MEC from the National Registry system to the SDLAs
for CLP/CDL applicants/holders only. FMCSA proposed this date based on
its estimate of when all States will have the information technology
systems in place to receive the information from the National Registry.
    Several commenters were concerned that three years is not enough
time for the States to come into compliance. Oregon's Driver and Motor
Vehicle Services (Oregon) stated that three years is not enough time
for implementation because the mechanism for sending the information to
the States has not yet been determined. Oregon commented that if FMCSA
decides to use CDLIS, development of the system requirements will take
at least a year, leaving two years or less for the States to do the
work needed to comply. The State questioned why FMCSA would choose to
build in guaranteed noncompliance by most, if not all by requiring the
States to come into compliance within 3 years. They suggested that
FMCSA delay the final rule until the technical details have been
coordinated.
    California's Department of Motor Vehicles (California) agreed that
three years is not enough time to complete all necessary program
changes. California pointed out that many States are not able to
implement rules within three years of being published as final, due in
part to receiving technical specifications 18-24 months after the
effective date, leaving the States a year or less to perform system
analysis and programming. They also pointed out that competing
resources with existing State-mandated projects and laws is an issue
for them. They suggested that FMCSA delay implementation for five
years.
    Delaware's Division of Motor Vehicles (Delaware) stated that
shortening the proposed date would be problematic. Delaware explained
that the State has to propose and pass legislation, fund programming,
conduct examiner training, complete structured testing, etc., all while
maintaining regular operations. The State indicated that changes are
prioritized and must have established timelines. They stated that
shortening the deadline will hinder an SDLA's ability to properly
manage its priorities. They recommended FMCSA retain a hard date for
implementation.
    Schneider National, Inc. (Schneider) stated that without a
consistent implementation date for all parties, the driver will be
unsure as to whether the ME will submit the information on the MEC to
the SDLA. If changes have not been implemented, drivers must continue
to use a paper copy of the MEC to ensure they remain in compliance.
Schneider pointed out that there is no language to hold the ME
accountable to tell drivers if the information would be communicated
electronically or if the driver needs to deliver a paper copy to the
SDLA.
    On the other hand, Advocates recommended that the Agency set an
earlier date for compliance. They stated that one year should be
sufficient but certainly no more than 18 months.
    New York's Department of Motor Vehicles (New York) stated that
another potential cost may be SDLA upgrades to connect to the National
Registry database; however the Agency is unable to estimate and
quantify at this time. New York asked if States would be able to apply
for a CDLPI grant. Several commenters questioned the date beginning on
July 8, 2014, if the driver has a CLP and has certified that he or she
expects to operate in interstate commerce that the driver has a valid
MEC and any required medical variances. They believe this date should
be July 8, 2015, based on the extension granted for the Commercial
Driver's License Testing and Commercial Learner's Permit Standards.
FMCSA Response
    While several commenters voiced concern that three years is not
enough time for States to come into compliance with these new
requirements because the mechanism for sending the medical
certification information to the States has yet to be determined, the
Agency believes it is sufficient time because the decision has now been
made that CDLIS will be the mechanism for sending the medical
certification information from the National Registry to the SDLAs.
California's Department of Motor Vehicles and several other commenters
based their concern in part on the past history of receiving technical
specifications 18-24 months after the effective date of the final rule,
leaving the States a year or less to perform system analysis and
programming. FMCSA is working to get these technical specifications to
the States sooner than in the past. Therefore, FMCSA has decided to
keep the State compliance date at three years from the effective date
of the final rule, as proposed in the NPRM. Some commenters
misunderstood the Agency's intent regarding the compliance date and
thought that we were considering different dates for each State based
on when they would have the information technology systems in place to
receive the information from the National Registry. The Agency was
simply pointing out that if all the States were ready earlier than
three years from the effective date of the final rule that we would
consider shortening the compliance date. The State compliance date will
be unified as suggested by Schneider and will be three years from the
effective date of the final rule.

E. Coercion

    No comments were received suggesting that the proposed rule would
result in any operator of a CMV being coerced to violate any of the
safety regulations issued pursuant to 49 U.S.C. 31136. The rule is
intended to enhance compliance with the physical qualification
requirements applicable to all CMV drivers. As noted in the NPRM, by
providing MEC information and medical variance information directly to
the SDLAs, FMCSA will reduce to the greatest extent possible the
coercion of drivers to operate with invalid or improper medical
certificate.

F. Issues Outside of the Scope of This Rulemaking

    A number of respondents submitted comments on topics that were
either

outside the scope of what was proposed in the NPRM or were based on a
misunderstanding of what the Agency proposed in this rulemaking. Most
of these comments relate to the 2008 final rule, in Med-Cert and the
2012 final rule, in National Registry. Many comments raised issues that
either were actually raised (and previously addressed) or should have
been raised during the proceedings that resulted in the two previous
final rules.
FMCSA Response
    One comment outside the scope of what was proposed in the NPRM
concerned the lost time and money associated with MEs being required to
go through training and be tested to be listed on the National
Registry. The training and testing that is required is part of the
National Registry of Certified Medical Examiners final rule that was
published on April 20, 2012. Full compliance with the National Registry
final rule took effect on May 21, 2014. Therefore, all CMV drivers
(both CDL and non-CDL) are now required to obtain an examination and
MEC from an ME listed on the National Registry.
1. Fraud and How the SDLA Will Be Notified
    The Colorado Department of Revenue/CDL Unit questioned whether
FMCSA expects the SDLA to take a false statement disqualification
action, assuredly as contained in 49 CFR 383.73(j), when FMCSA
determines that an individual has falsified potentially disqualifying
medical information. They also questioned how FMCSA would notify the
SDLA of possible fraud and how much information will be disclosed to
the SDLA to allow them to take the false statement disqualification.
FMCSA Response
    Although this is not a matter within the scope of this rulemaking,
it is an important point that needs explanation. As explained in the
2008 final rule and subsequent technical amendments in Med-Cert, the
provisions of 49 CFR 383.73(j) regarding penalties for false
information submitted by CLP/CDL applicants/holders require SDLAs--not
FMCSA--to take the actions specified in section 383.73(j) when the
State determines that an applicant has falsified medical information.
If FMCSA review of MEC information finds a CLP/CDL holder has falsified
information in the course of obtaining the MEC, FMCSA may void the MEC
and will then notify the SDLA. The SDLA should then notify the CLP/CDL
holder of the ``not certified' status and begin the process for the
downgrading of the CLP/CDL as set out in 49 CFR 383.73(o)(4)(i). The
SDLA can also take any of the actions set out in section 383.73(j).
2. Safety Benefits
    One driver stated that there are no proven safety benefits to
submitting private medical information to the Federal government and
for making the medical doctors go through training on driver fitness
and join another federally run program so they can be on the approved
list.
FMCSA Response
    FMCSA is required by statute to establish and maintain the National
Registry, and it did so in the final rule published in 2012. 49 U.S.C.
31136(a)(3) and 31149. The benefits of that program were thoroughly
discussed and explained in that final rule. Further consideration of
them in this proceeding is not warranted. The Agency is not requiring
the submission of private medical information, only the MEC, which
serves as proof the driver meets the physical qualifications standards.
Drivers have long been required to present the MEC during roadside
inspections, and employers have long been required to maintain a copy
of the MEC in DQ files. The private medical information is contained on
the MER which continues to be maintained by the healthcare
professional. While FMCSA and employers may request access to the MER,
the Agency does not intend to request the document except as part of an
investigation or audit.
3. MERs
    ATA suggested that after a medical examiner uploads medical
qualification information for a driver holding a medically downgraded
CDL, FMCSA should require SDLAs to automatically return that driver's
license to interstate status. ATA stated that they hope that any
forthcoming employer notification system FMCSA might develop will
account for this process by eliminating needless paperwork for carriers
maintaining DQ files that must be renewed upon a medical certificate's
expiration. They suggested that the Agency examine ways to incorporate
medical status monitoring into any forthcoming employer notification
system authorized under section 32303 of MAP-21 instead of forcing a
carrier to request additional reports every time the date on a driver's
medical qualification changes.
    Schneider National, Inc. recommended that the language be changed
to allow the motor carrier to continue to require drivers to provide a
copy of their MEC and Form MCSA-5876. They stated that they have a
third party vendor that ensures the drivers are disclosing all their
known medical conditions and they also compare the prior physical (if
available) to the new physical to identify any errors or issues. They
pointed out that 15-20% of driver physicals require them to send the
driver back to the clinic, either due to the driver failing to disclose
all relevant medical information on the form or because of a clinic
error.
FMCSA Response
    This rule will not require MEs to inform drivers' employers and
provide the motor carrier a copy of a driver's MER Form, MCSA-5875,
when a driver completes a medical examination. For MEs to provide the
motor carrier employer with a copy of the MER Form, MCSA-5875, there
will need to be an agreement between the driver and employer, often as
a condition of employment.
    Under Sec.  391.43(g)(2), if the ME finds that the person examined
is physically qualified to operate a CMV in accordance with Sec.
391.41(b), he or she must complete a certificate in the form prescribed
in paragraph (h) of this section and furnish the original to the person
who was examined. The examiner must provide a copy to a prospective or
current employing motor carrier who requests it. Under Sec.  391.43(i),
each original (paper or electronic) completed MER Form, MCSA-5875 and a
copy or electronic version of each MEC, Form MCSA-5876 must be retained
on file at the office of the ME for at least 3 years from the date of
examination. The ME must make all records and information in these
files available to an authorized representative of FMCSA or an
authorized Federal, State, or local enforcement agency representative,
within 48 hours after the request is made.
    When the SDLA receives notification of medical qualification
information for a driver with a CDL downgraded for medical
qualification reasons, the driver's medical status should be updated to
``certified'' and the CDL status updated to ``licensed.'' An SDLA may
have additional requirements.

VII. Section-by-Section Explanation of Changes

    This section includes a summary of the regulatory changes made in
49 CFR parts, 383, 384 and 391 organized by section number.

A. Changes to Part 383

    Part 383 contains the requirements for CLP/CDLs. With certain
exceptions, the rules in this part apply to every person

required to possess a CLP/CDL to operate a CMV in commerce, to all
employers of such persons, and to all States.
    Section 383.71(h). FMCSA changes the requirement of a CDL/CLP
applicant/holder from providing the State with an original or copy of
their MEC (previous edition) to FMCSA providing the State with the
electronic MEC information beginning three years after the effective
date of this final rule.
    Section 383.73(a)-(b). Three years after the effective date of the
final rule, FMCSA will change the requirement that the State must post
the MEC (previous edition) received from the CLP/CDL applicant or
holder to the CDLIS driver record to the State posting the electronic
MEC information received from FMCSA.
    Section 383.73(o). Three years after the effective date of the
final rule, FMCSA will change the requirement that the State post the
original or copy of the MEC (previous edition) information to the CDLIS
driver record within 10 calendar days after receipt to a requirement
that the State post the electronic MEC, Form MCSA-5876, information to
the CDLIS driver record within 1 business day after receiving the
electronic information from FMCSA. The final rule also adds a
requirement that, when the SDLA receives information that a driver's
MEC has been invalidated because the driver has been found to be not
physically qualified in a subsequent examination by an ME on the
National Registry, the SDLA must change the driver's status on the
CDLIS record to ``not certified'' and begin the process for downgrading
the CLP/CDL. FMCSA also changes the requirement that the State retain
an original or copy of the MEC (previous edition) for 3 years to a
requirement that it retain an electronic record of the MEC information,
Form MCSA-5876, for 3 years.
    Paragraph (o) also requires the States to post the medical variance
information provided by FMCSA, including the dates of issuance and
expiration, along with the MEC, Form MCSA-5876, information. This
variance information posting requirement was previously incorporated by
reference in Sec.  384.107 of this chapter from AAMVA's ``Commercial
Driver's License Information System State Procedures Manual,'' Release
<IP_ADDRESS>, August 2013. This requirement will be effective immediately
because States are already required to post this information. FMCSA
also reduces the time the State has to post the medical variance
information received from FMCSA to the CDLIS driver record from within
10 calendar days to 1 business day from the date of receipt because the
information will be sent and posted electronically. FMCSA also added a
new requirement that the State must update the medical status to ``not
certified' when the medical certification is voided by FMCSA.

B. Changes to Part 384

    Part 384 contains the requirements that the States comply with the
provisions of section 49 U.S.C. 31311(a). Part 384 includes the minimum
standards for the actions States must take to be in substantial
compliance with each of the 25 requirements of 49 U.S.C. 31311(a),
establishes procedures for FMCSA determinations of State compliance,
and specifies the consequences of State noncompliance.
    Section 384.234. FMCSA added an administrative amendment to this
section to include driver medical certification recordkeeping
requirements for CLP applicants in Part 383.
    Section 384.301. FMCSA amended this section by adding a new
paragraph (i). FMCSA has always given the States 3 years after the
effective date of any new rule to come into substantial compliance with
new CDL requirements. This allows the States time to pass any necessary
legislation and to modify State systems to comply with the new
requirements, including CDLIS. New paragraph (i) would specify the 3
year compliance date for States.

C. Changes to Part 391

    Part 391 establishes minimum qualifications for persons who drive
CMVs. The requirements in this part also establish minimum duties of
motor carriers with respect to the qualifications of their drivers.
    Section 391.23(m)(2)(i)(A). FMCSA made an editorial change to
eliminate an erroneous reference to Sec.  383.71(a)(1)(ii) and to add a
reference to 383.71(b)(1)(ii), which describes the four types of self-
certifications.
    Section 391.23(m)(2)(i)(B). Three years after the effective date of
the final rule FMCSA will eliminate the requirement for the motor
carrier to verify and document in the DQ file that a CDL holder was
certified by an ME listed on the National Registry. Employers will no
longer need to verify the examination and ME listing, because that
information will be sent to the SDLAs through CDLIS from the National
Registry. Motor carriers will still be required to meet this
requirement for non-CDL holders.
    Section 391.41(a)(2). Three years after the effective date of the
final rule, FMCSA will eliminate the provision requiring drivers
required to have a CLP/CDL to carry a current MEC (previous edition)
for 15 days.
    Section 391.43. FMCSA removed the Instructions for Performing and
Recording Physical Examinations section in Sec.  391.43(f) to eliminate
redundant or unnecessary requirements.
    Beginning 3 years after the effective date of the final rule, FMCSA
will eliminate in Sec.  391.43(g)(2) the requirement that MEs provide
the MEC, Form MCSA-5876, to drivers required to have a CLP/CDL (and to
their employers), because the MEC information will be promptly and
accurately transmitted electronically to the SDLAs for entry on the
CDLIS driver record. But the ME must still provide the MEC, Form MCSA-
5876, to non-CDL drivers and requesting employers, as currently
required.
    FMCSA inserts two new paragraphs in Sec.  391.43(g). The first,
paragraph (g)(3), requires the ME to inform the driver if a
determination has been made that the driver is not physically
qualified, and that this information will be reported to FMCSA. Upon
receiving this report, FMCSA will invalidate any MECs previously issued
to the driver that are contained in the Agency's records and will
electronically transmit this report to the appropriate SDLA. The second
new paragraph, (g)(4), requires the ME to inform the driver if the
determination of whether the driver is physically qualified requires
additional information or further examination. This pending status will
remain in effect for 45 days, and will be reported to FMCSA. If the
examination is not completed within the 45-day period, the examination
will be no longer be valid and the driver will be required to obtain a
new examination in order to obtain a MEC, Form MCSA-5876.
    In Sec.  391.43(g)(5)(i)(B) (renumbered from (g)(3) because of the
two new paragraphs above), FMCSA requires that, beginning 3 years after
the effective date of the final rule, the ME must report results of all
commercial drivers' physical examinations to FMCSA by completing a CMV
Driver Medical Examination Results Form, MCSA-5850, via the ME's
individual password-protected National Registry web account by midnight
(local time) of the next calendar day. MEs are required to report the
results of all examinations conducted in accordance with the physical
qualification standards in 49 CFR part 391, subpart E that apply to CMV
drivers engaged in interstate operations. In addition, as a convenience
to those States that have variances from those standards for

drivers operating intrastate, the rule allows MEs to transmit such
information to the National Registry, if required by the States
involved, for eventual transmittal to the SDLAs.
    In Sec.  391.43(g)(5)(ii), FMCSA will require MEs to report to
FMCSA whenever the ME does not complete any driver medical examinations
during the preceding 30 days, beginning on the effective date of the
final rule.
    FMCSA revises Sec.  391.43(h) to require MEs to use the MEC, Form
MCSA-5876. The form has been modified to require the ME to indicate
whether the driver is being certified as qualified in accordance with
either the standards applicable to all interstate drivers or any State
standards for intrastate drivers that have variances from the Federal
standards in effect. This replaces the designation that the driver is
either interstate or intrastate. Other minor editorial edits have been
made to the form for clarity. The other information required to be
entered on the certificate is unchanged from the information required
under the current regulation.
    Section 391.45. FMCSA has decided that when a driver has been
determined to not be physically qualified, any previous MECs issued to
a driver will be deemed invalid as explained above regarding Sec.
391.43(g)(3). FMCSA has added a new paragraph at the end of this
section that requires a driver to be medically examined and certified
before operating a CMV after previous certifications have been
invalidated because of a driver not being physically qualified under
the provisions of proposed new Sec.  391.43(g)(3).
    Section 391.51. In Sec.  391.51(b)(7), FMCSA has eliminated the
exception that allows the motor carrier to use an MEC (previous
edition) as proof of medical certification for CLP/CDL holders in the
DQ file, because States will be required to record medical
certification information in driver's record automatically upon receipt
from FMCSA.
    Appendix to Part 391. FMCSA has added medical advisory criteria as
an Appendix at the end of this section. The advisory criteria (which
are recommendations for use by MEs) are reproduced without substantive
change from the advisory criteria currently included in the MER. FMCSA
recognizes that some of these advisory criteria should be updated or
revised. However, such substantive changes should not be made without
notice and opportunity for public comment. FMCSA intends to seek public
comment on revisions to the advisory criteria as promptly as feasible
to bring them up to current standards.

D. Compliance Date

    In order to allow sufficient time for the SDLAs and FMCSA to
develop and implement necessary information system changes, most of the
final rule provisions will take effect three years after the effective
date of the final rule. The provisions requiring MEs to notify FMCSA if
they have not performed any driver physical examinations during the
previous month and the State to update the medical status to ``not
certified' when the medical certification is voided by FMCSA under the
authority of 49 U.S.C. 31149(c)(2) will go into effect on the effective
date of the final rule. To allow sufficient time for the certified MEs
to make the necessary adjustments to their business requirements, the
provisions requiring MEs to use the new MER Form, MCSA-5875 and MEs to
use the prescribed Form MCSA-5876 for the MEC will go into effect six
months after the effective date of the final rule.
    Beginning June 22, 2018, MEs will be required to report the results
of all commercial drivers' physical examinations to FMCSA by midnight
(local time) of the next calendar day following the examination, by
completing a CMV Driver Medical Examination Results Form, MCSA-5850,
via their individual password-protected National Registry web account.
For CLP/CDL applicants/holders, FMCSA will electronically transmit
driver identification, examination results, and restriction information
from the National Registry system to the SDLAs, as well as information
about MECs invalidated under new 49 CFR 391.43(g)(3) and 391.45(d).
FMCSA will also electronically transmit medical variance information
for all CMV drivers to the SDLAs. SDLAs will be required to post the
medical variance information provided by FMCSA, including the dates of
issuance and expiration, to the CDLIS driver record within 1 business
day of receipt for CDL/CLP holders.

VIII. Regulatory Analyses and Notices

A. E.O. 12866 (Regulatory Planning and Review and DOT Regulatory
Policies and Procedures as Supplemented by E.O. 13563)

    FMCSA has determined that this final rule is not a significant
regulatory action within the meaning of Executive Order (E.O.) 12866,
as supplemented by E.O. 13563 (76 FR 3821, January 21, 2011), and is
also not significant within the meaning of DOT regulatory policies and
procedures (DOT Order 2100.5 dated May 22, 1980; 44 FR 11034, February
26, 1979) because it is not expected to generate substantial
congressional or public interest. The impact of the final rule is
estimated to be $12 million in up-front costs and $10.16 million in
annual savings, so the rule's impact is not expected to exceed the $100
million annual threshold for economic significance. The purpose of the
principal requirements established in the final rule is to modify the
requirements adopted in two previous rules so that the driver
identification, examination results, and restriction information for
CLP/CDL holders is electronically transmitted by a certified ME listed
on the National Registry to the FMCSA by midnight (local time) of the
next calendar day after the examination, and then electronically
transmitted by FMCSA within one business day to the SDLA for entry into
the appropriate driver record.
1. Summary of Estimated Costs
    FMCSA is not able to quantify the benefits of ensuring that CMV
drivers are medically qualified and of reducing the falsification of
medical certification by drivers. The revised medical forms will not
take significantly longer to complete than the previous versions. They
contain much of the same information being collected on the current
MER, but in a different format. The requirement that CMV driver medical
examination results be transmitted to FMCSA by midnight (local time) of
the next calendar day following the exam is not expected to increase
the burden on the ME or their staff, because the total time required to
transmit each form does not increase based on when the form is
completed and transmitted.
    FMCSA expects there will be costs for the SDLAs to modify their
systems to accept transmission of MEC and variance information from the
National Registry system. FMCSA and the AAMVA, which facilitates the
maintenance of driver data and communication with the SDLAs, also need
to update their systems and test the connections between databases.
FMCSA estimates the costs of these efforts by using estimates that were
made for previous efforts. The SDLAs (51 separate entities) will
perform tasks similar to (but likely smaller in scope than) their
efforts to comply with FMCSA CDL records requirements. Estimates for
that included $6,147,000 for input and inquiry screens, $1,564,000 for
an expanded database, $1,665,000 for systems and user acceptance
testing, and $590,000 for testing their links with AAMVA. This

totals $9,966,000 for all SDLAs \7\. Additionally, FMCSA and AAMVA must
expend funds to connect and test the links between their databases--an
estimated $1,000,000 will be necessary in each case. The total
expenditures needed to create and test the links between databases will
therefore be $11,966,000.
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    \7\ OMB Control Number 2126-0011 Supporting Statement:
Commercial Driver Licensing and Testing Standards, approved 1/12/
2015.
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2. Summary of Estimated Benefits
    Potential quantifiable estimated benefits, as detailed in the
revised Medical Qualification Requirements (OMB control number 2126-
0006) and the Commercial Driver Licensing and Test Standards (OMB
control number 2126-0011) Supporting Statements, posted in the docket,
include: (1) Employers of drivers will no longer be required to verify
the ME's National Registry number for CDL holder examinations because
only MEs listed on the National Registry will be able to forward MEC
information to the National Registry. This will result in 251,695 fewer
annual burden hours (from 308,200 hours to 56,505 hours) and an annual
cost savings of $4.78 million (from $5,855,800 to $1,073,595); (2) ME's
will no longer need to handwrite the MEC for CLP/CDL applicants/holders
because the information will be electronically transmitted by the ME to
the National Registry and from the National Registry to the SDLAs,
resulting in an annual time savings of 32,303 hours (from 77,050 hours
to 44,747 hours) and an annual cost savings of $2.87 million (from
$6,857,450 to $3,982,483), while decreasing the MEs paperwork and
administrative burdens; (3) CLP/CDL applicants/holders will save time
because they are no longer required to provide their MEC to the SDLAs
as proof of medical certification. By electronically transmitting the
MEC information and variance information (as defined in the SUMMARY
section), FMCSA is creating a cost savings for drivers of $1.05 million
(1,940,000 MECs x $0.54 postage plus one copy to SDLAs); (4) SDLAs will
save 81,000 annual burden hours of administrative time recording MEC
information for not having to attend to the driver above, resulting in
$1.46 million (81,000 annual burden hours x $18.00 per hour) in cost
savings. As a result, this final rule will generate a maximum $10.16
million in overall annual cost savings. This estimate is the greatest
possible amount, and includes the assumption that all intrastate
drivers who can take advantage of using MEs on the National Registry
will.
    The Agency believes that the fraud prevention in electronic
transmission of MEC and medical variance information will continue to
improve safety on public roads. Currently, there is potential for
fraud, as drivers have the opportunity to forge or alter the MEC or
medical variance information. More frequent reporting of CMV driver
medical examination results to FMCSA by the MEs will allow the
information to be promptly transmitted to the SDLAs for posting on the
CDLIS driver record for CLP/CDL applicants/holders. As a result, up-to-
date and accurate information concerning the medical certification
status of these drivers will be available to State and Federal
enforcement personnel, SDLAs, employers, drivers, and others who rely
on this information to determine whether a driver is in compliance with
the applicable physical qualification standards.
    Lastly, FMCSA believes that use of the revised MER Form, MCSA-5875,
will assist MEs in accurately determining whether CMV drivers meet the
physical qualification standards contained in 49 CFR 391.41(b). The MER
Form, MCSA-5875, has been streamlined for efficiency and contains
evaluation tools that more precisely align with the qualification
standards and the Agency's advisory criteria, and the revised MER Form
presents those tools using a systematic physical examination approach
similar to standards of clinical practice. When combined with the
expected improvement in ME qualifications and performance under the
National Registry program, the new MER Form will help ensure that the
physical condition of CMV drivers is adequate to enable them to safely
operate a CMV. The National Registry has only recently reached its
compliance date; therefore, FMCSA does not have sufficient data at this
time to quantify the expected safety benefits from adoption of the
revised MER Form, MCSA-5875.

B. Regulatory Flexibility Act

    The Regulatory Flexibility Act of 1980 (5 U.S.C. 601 et seq.)
requires Federal agencies to consider the effects of the regulatory
action on small business and other small entities and to minimize any
significant economic impact. The term ``small entities'' comprises
small businesses and not-for-profit organizations that are
independently owned and operated and are not dominant in their fields,
and governmental jurisdictions with populations of less than 50,000.
Accordingly, DOT policy requires an analysis of the impact of all
regulations on small entities, and mandates that agencies strive to
lessen any adverse effects on these businesses.
    Under the Regulatory Flexibility Act (RFA), as amended by the Small
Business Regulatory Enforcement Fairness Act of 1996 (Pub. L. 104-121,
110 Stat. 857), the final rule is not expected to have a significant
economic impact on a substantial number of small entities.
Consequently, I certify that the proposed action will not have a
significant economic impact on a substantial number of small entities.
    The NPRM for this rule contained a detailed Initial Regulatory
Flexibility Analysis which described the reasons for this action and
its objective. The 39,160 \8\ MEs who are currently certified and will
be impacted by this rule are considered to be small business entities.
However, the changes to the requirements on those MEs are small and
should not have any negative economic impact on them. The changes to
the required medical forms (CMV Driver Medical Examination Results
Form, MCSA-5850, MER Form, MCSA-5875 and the MEC, Form MCSA-5876) are
not expected to increase the burden on any ME, nor is the requirement
that the CMV driver medical examination results be submitted by
midnight (local time) of the next calendar day following the exam.
---------------------------------------------------------------------------

    \8\ 39,160 MEs certified and listed on the National Registry as
of January 5, 2015.
---------------------------------------------------------------------------

C. Assistance for Small Entities

    Under section 213(a) of the Small Business Regulatory Enforcement
Fairness Act of 1996, FMCSA wants to assist small entities in
understanding the effects of this final rule. While the Agency believes
that the rule will adversely affect few, if any, small businesses,
organizations, or governmental jurisdictions, any questions concerning
its provisions or options for compliance should be directed to, the
FMCSA personnel listed in the FOR FURTHER INFORMATION CONTACT section
of the final rule.
    Small businesses may send comments on the actions of Federal
employees who enforce or otherwise determine compliance with Federal
regulations to the Small Business Administration's Small Business and
Agriculture Regulatory Enforcement Ombudsman and the Regional Small
Business Regulatory Fairness Boards. The Ombudsman evaluates these
actions annually and rates each agency's responsiveness to small
business. If you wish to comment on actions by

employees of FMCSA, call 1-888-REG-FAIR (1-888-734-3247). DOT has a
policy ensuring the rights of small entities to regulatory enforcement
fairness and an explicit policy against retaliation for exercising
these rights.

D. Unfunded Mandates Reform Act of 1995

    This final rule will impose costs that do not exceed the threshold
nor impose an unfunded Federal mandate, as defined by the Unfunded
Mandates Reform Act of 1995 (2 U.S.C. 1532 et seq.), that will result
in the expenditure by State, local, and tribal governments, in the
aggregate, or by the private sector, of $151 million (which is the
value of $100 million in 2012 after adjusting for inflation) or more in
any 1 year.

E. E.O. 13132 (Federalism)

    A rule has implications for Federalism under Section 1(a) of
Executive Order 13132 if it has ``substantial direct effects on the
States, on the relationship between the national government and the
States, or on the distribution of power and responsibilities among the
various levels of government.'' FMCSA has determined that this final
rule will not have substantial direct costs on or for States, nor will
it limit the policymaking discretion of States. Nothing in this
document preempts any State law or regulation. Therefore, this rule
does not have sufficient federalism implications to warrant the
preparation of a federalism assessment.

F. E.O. 12988 (Civil Justice Reform)

    This final rule meets applicable standards in sections 3(a) and
3(b)(2) of E.O. 12988, Civil Justice Reform, to minimize litigation,
eliminates ambiguity, and reduce burden.

G. E.O. 13045 (Protection of Children)

    E.O. 13045, Protection of Children from Environmental Health Risks
and Safety Risks (62 FR 19885, Apr. 23, 1997), requires agencies
issuing ``economically significant'' rules, if the regulation also
concerns an environmental health or safety risk that an agency has
reason to believe may disproportionately affect children, to include an
evaluation of the regulation's environmental health and safety effects
on children. The Agency determined this final rule is not economically
significant. Therefore, no analysis of the impacts on children is
required. In any event, the Agency does not anticipate that this
regulatory action could in any respect present an environmental or
safety risk that could disproportionately affect children.

H. E.O. 12630 (Taking of Private Property)

    FMCSA reviewed this final rule in accordance with E.O. 12630,
Governmental Actions and Interference with Constitutionally Protected
Property Rights, and has determined it will not effect a taking of
private property or otherwise have taking implications.

I. Privacy Impact Assessment

    FMCSA conducted a PIA of this rule as required by section 522(a)(5)
of division H of the FY 2005 Omnibus Appropriations Act, Public Law
108-447, 118 Stat. 3268 (Dec. 8, 2004). The assessment considered
impacts of the final rule on the privacy of information in an
identifiable form and related matters. The final rule would impact the
handling of PII. FMCSA has evaluated the risks and effects the
rulemaking might have on collecting, storing, and sharing PII and has
evaluated protections and alternative information handling processes in
developing the final rule in order to mitigate potential privacy risks.
The supporting PIA, available for review in the docket, gives a full
and complete explanation of FMCSA practices for protecting PII in
general and specifically in relation to this final rule.
    The Privacy Act (5 U.S.C. 552a) applies only to Federal agencies
and any non-Federal agency which receives records contained in a system
of records from a Federal agency for use in a matching program. FMCSA
and the Department will be publishing, with request for comment, a
revised system of records notice that will cover the collections of
information that are affected by this final rule and covered by the
Privacy Act.

J. E.O. 12372 (Intergovernmental Review)

    The regulations implementing E.O. 12372 regarding intergovernmental
consultation on Federal programs and activities do not apply to this
program.

K. Paperwork Reduction Act

    This final rule contains the following new IC requirements. As
required by the Paperwork Reduction Act of 1995 (44 U.S.C. 3507(d)),
FMCSA submitted the information requirements associated with the
proposal to the OMB for its review. The Medical Qualification
Requirements Supporting Statement, OMB control number 2126-0006 has
been revised primarily due to the Agency's promulgation of this final
rule. However, it has also been revised to provide new and updated data
to the currently approved IC that is not a result of this final rule.
As a result of this update which includes several IC program changes
such as the inclusion of a time burden for the driver to complete the
health history section of the MER, a correction to the calculation for
the National Registry regarding the time for entering and submitting
MCSA-5850s, and the Agency's decision to grant hearing and seizure
exemptions, there is an increase from the current approved annual
paperwork burden hours of 503,000 hours (2,130,702 hours to 2,633,702).
As a result of this final rule, the annual burden hours will remain the
same during the first 3 years of implementation of the final rule but
will decrease by 283,998 hours (2,633,702 hours to 2,349,704 hours)
during the 4th and subsequent years after the compliance date.
Therefore, this rule has a decrease in annual paperwork burden hours of
364,998 hours (81,000 + 283,998) as detailed in OMB control number
2126-0011 Commercial Driver Licensing and Test Standards and 2126-0006
Medical Qualification Requirements Supporting Statements in the docket.
    As discussed in the National Registry final rule (77 FR 24104;
April 21, 2012), MEs have started to electronically submit MEC
information to the National Registry on a monthly basis. The Medical
Examiner's Certification Integration NPRM proposed that the information
be submitted by the ME by close of business the day the examination is
conducted, as opposed to submitting monthly. The final rule slightly
relaxes that standard by requiring MEs to report results of all CMV
drivers' physical examinations performed (including the results of
examinations where the driver was found not to be qualified) to FMCSA
by midnight (local time) of the next calendar day following the
examination. The final rule requires FMCSA to electronically transmit
driver identification, examination results, and restriction information
for CLP/CDL applicants/holders, from the National Registry system to
the SDLAs, providing more accurate and timely delivery of MEC
information to update CDLIS driver records and for safety enforcement
purposes. In addition, the final rule requires FMCSA to electronically
transmit medical variance information for all CMV drivers
electronically to the SDLAs.
    Close tracking and monitoring of certification activities and
medical results are crucial to reducing fraudulent efforts of a subset
of CDL applicants. Some CDL drivers avoid following the proper
guidelines to

become medically qualified, posing safety risks to the public.
    While the NPRM proposed to send MEC information to the SDLAs only
for CLP/CDL applicants/holders who are required to be medically
qualified to operate in interstate commerce, the final rule has been
expanded to include MEC information from examinations performed in
accordance with the FMCSRs (49 CFR 391.41- 391.49), as well as allowing
(but not requiring) to include those performed in accordance with
applicable State standards. The National Registry final rule requires
certified MEs to report to FMCSA the results of each medical
examination of CMV drivers who are required to be medically qualified
to operate in interstate commerce. If intrastate CMV drivers are
subject to differing but compatible State regulations, the Agency
anticipates that these drivers likely will use certified MEs on the
National Registry for their medical qualification examinations. FMCSA
recognizes that using the entire intrastate CMV driver population may
be a high estimation, but we have used this conservatively high burden
estimation since the Agency doesn't have an exact number, and there is
nothing to preclude intrastate CMV drivers from being examined by a
certified ME listed on the National Registry.
2126-0006 Medical Qualification Requirements
    This IC is currently due to expire on July 31, 2015. On December
16, 2014, FMCSA published a Federal Register notice (79 FR 74804)
requesting public comment to revisions made to this IC. The comment
period closed on February 17, 2015. The publication of this IC as part
of the Medical Examiner's Certification Integration final rule serves
as a withdrawal of the notice for comment and replaces the previous
ICR. This revision is primarily due to the Agency's promulgation of
this final rule. However, as discussed above, this IC is also being
revised to provide new and updated data to the currently approved IC
and replaces the Federal Register notice that was previously published
for comment. The principal purpose of this final rule is to modify the
requirements adopted in two previous rules so that (1) the driver
identification, examination results, and restriction information for
CLP/CDL applicants/holders is electronically transmitted to the FMCSA