[Federal Register Volume 78, Number 91 (Friday, May 10, 2013)]
[Proposed Rules]
[Pages 27343-27363]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-11080]


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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: Notice of proposed rulemaking.

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SUMMARY: FMCSA proposes to require certified medical examiners (MEs) 
performing physical examinations on drivers of commercial motor 
vehicles (CMV) 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). In addition, 
MEs would 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 qualified) to FMCSA by close of 
business on the day of the examination. This would include 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). 
Reporting of this information would be accomplished, by completing a 
CMV Driver Medical Examination Results Form, MCSA-5850, via their 
individual password-protected National Registry web account. For 
holders of CDLs and CLPs, FMCSA also proposes to electronically 
transmit driver identification, examination results, and restriction 
information from the National Registry system to the State Driver 
Licensing Agencies (SDLAs). This includes those that have been voided 
by FMCSA because it finds that an ME has certified a driver who does 
not meet the physical certification standards. The Agency would also 
transmit medical variance information (exemptions, skills performance 
evaluation certificates and grandfathered exemptions) for all CMV 
drivers electronically to the SDLAs. Transmission of this information 
would allow authorized State and Federal enforcement officials to be 
able to view the most current and accurate information regarding the 
medical status of the CMV driver, all information on the MEC, and the 
medical variance information (as defined above) to include the issued 
and expiration dates.

DATES: Comments must be received on or before July 9, 2013.

ADDRESSES: You may submit comments identified by Docket Number FMCSA-
2012-0178 using any of the following methods:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the online instructions for submitting comments.
     Mail: Docket Management Facility, U.S. Department of 
Transportation, 1200 New Jersey Avenue SE., West Building, Ground 
Floor, Room W12-140, Washington, DC 20590-0001.
     Hand Delivery or Courier: West Building, Ground Floor, 
Room W12-140, 1200 New Jersey Avenue SE., between 9 a.m. and 5 p.m. 
E.T., Monday through Friday, except Federal holidays.
     Fax: 202-493-2251.
    To avoid duplication, please use only one of these four methods. 
See the ``Public Participation and Request for Comments'' portion of 
the SUPPLEMENTARY INFORMATION section below for instructions on 
submitting comments. Comments received after the comment closing date 
will be included in the docket, and we will consider late comments to 
the extent practicable. FMCSA may, however, issue a final rule at any 
time after the close of the comment period.

FOR FURTHER INFORMATION CONTACT: Elaine Papp, Office of Medical 
Programs, Federal Motor Carrier Safety Administration, 1200 New Jersey 
Avenue SE., Washington, DC 20590-0001, by telephone at (202) 366-4001 
or via email at fmcsamedical@dot.gov. 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 Operations, telephone (202) 366-9826.

SUPPLEMENTARY INFORMATION:

Table of Contents for Preamble

I. Public Participation and Request for Comments
    A. Submitting Comments
    B. Viewing Comments and Documents
    C. 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 Proposed Rule
    A. Overview
    B. Medical Examination Procedures
    C. SDLAs
    D. Drivers
    E. MEs
    F. Motor Carriers
    G. Implementation Date
VII. Section-by-Section
    A. Proposed Changes to Part 383
    B. Proposed Changes to Part 384
    C. Proposed Changes to Part 391
VIII. Regulatory Analyses
    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. 13211 (Energy Supply, Distribution, or Use)
    N. E.O. 13175 (Indian Tribal Governments)
    O. National Technology Transfer and Advancement Act (Technical 
Standards)

I. Public Participation and Request for Comments

    FMCSA encourages you to participate in this rulemaking by 
submitting comments and related materials. All comments received will 
be posted without change to http://www.regulations.gov and will include 
any personal information you provide.

A. Submitting Comments

    If you submit a comment, please include the docket number for this 
rulemaking (FMCSA-2012-0178), indicate the specific section of this 
document to which each comment applies, and provide a reason for each 
suggestion or recommendation. You

[[Page 27344]]

may submit your comments and material online or by fax, mail, or hand 
delivery, but please use only one of these means. FMCSA recommends that 
you include your name and a mailing address, an email address, or a 
phone number in the body of your document so FMCSA can contact you if 
there are questions regarding your submission. To submit your comment 
online, go to http://www.regulations.gov and click on the ``Submit a 
Comment'' box, which will then become highlighted in blue. In the 
``Document Type'' drop-down menu, select ``Proposed Rules,'' insert 
``FMCSA 2011-0178'' in the ``Keyword'' box, and click ``Search.'' When 
the new screen appears, click on ``Submit a Comment'' in the 
``Actions'' column. If you submit your comments by mail or hand 
delivery, submit them in an unbound format, no larger than 8\1/2\ by 11 
inches, suitable for copying and electronic filing. If you submit your 
comments by mail and would like to know that they reached the facility, 
please enclose a stamped, self-addressed postcard or envelope. FMCSA 
will consider all comments and material received during the comment 
period and may change the proposed rule based on your comments.

B. Viewing Comments and Documents

    To view comments, as well as documents mentioned in this preamble, 
available in the docket, go to http://www.regulations.gov and click on 
the ``Read Comments'' box in the upper right-hand side of the screen. 
Then in the ``Keyword'' box, insert ``FMCSA-2012-0178'' and click 
``Search.'' Next, click the ``Open Docket Folder'' in the ``Actions'' 
column. Finally, in the ``Title'' column, click on the document you 
would like to review. If you do not have access to the Internet, you 
may view the docket online by visiting the Docket Management Facility 
in Room W12-140 on the ground floor of the Department of Transportation 
West Building, 1200 New Jersey Avenue SE., Washington, DC 20590, 
between 9 a.m. and 5 p.m. ET, Monday through Friday, except Federal 
holidays.

C. Privacy Act

    Anyone may search the electronic form of all comments received into 
any of our dockets by the name of the individual submitting the comment 
(or of the person signing the comment, if submitted on behalf of an 
association, business, labor union, etc.). You may review DOT's Privacy 
Act Statement for the Federal Docket Management System published in the 
Federal Register on January 17, 2008 (73 FR 3316), or you may visit 
http://www.gpo.gov/fdsys/pkg/FR-2008-01-17/pdf/E8-785.pdf.

II. Executive Summary

A. Purpose and Summary of the Major Provisions

    FMCSA proposes to require certified MEs performing physical 
examinations on drivers of CMV to use a newly developed Medical 
Examination Report (MER) Form, MCSA-5875, in place of the current MER 
Form and to use the prescribed Form MCSA-5876 for the MEC. In addition, 
MEs would 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 qualified) to FMCSA by close of 
business on the day of the examination. This would include all CMV 
drivers who are required to be medically certified to operate in 
interstate commerce, not only those who hold or apply for CLP or CDL. 
Reporting of this information would be accomplished, by completing a 
CMV Driver Medical Examination Results Form, MCSA-5850, via their 
individual password-protected National Registry web account. For 
holders of CDLs and CLPs, FMCSA also proposes to electronically 
transmit driver identification, examination results, and restriction 
information from the National Registry system to the SDLAs. This 
includes those that have been voided by FMCSA because it finds that an 
ME has certified a driver who does not meet the physical certification 
standards. The Agency would also transmit medical variance information 
(exemptions, skills performance evaluation certificates and 
grandfathered exemptions) for all CMV drivers electronically to the 
SDLAs. Transmission of this information would allow authorized State 
and Federal enforcement officials to be able to view the most current 
and accurate information regarding the medical status of the CMV 
driver, all information on the MEC, and the medical variance 
information (as defined above) to include the issued and expiration 
dates.

B. Benefits and Costs

    The estimated economic costs of this proposed rule would not exceed 
the $100 million annual threshold, to be determined ``economically 
significant.'' The only additional cost imposed by the NPRM, would 
result from the ME entering the CMV Driver Medical Examination Results 
(MCSA-5850) data more frequently into the National Registry system. 
This cost is considered minimal in the amount of $455,994, as detailed 
in the Medical Qualifications Requirements Supporting Statement (OMB 
control number 2126-0006).
    The potential estimated benefits are detailed in the table below. 
The revised 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
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                                                                 Million
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Removal of the requirement for employers to verify the MEs         $4.22
 National Registry number for CDL drivers......................
MEC and variance info sent electronically to SDLAs.............     2.17
SDLAs not recording MEC information............................     3.69
                                                                --------
    Total......................................................     10.1
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    The qualitative safety benefits of this rule are difficult to fully 
quantify. However, the Agency believes that the fraud prevention in 
electronic transmission of the MEC and variance information will 
continue to improve safety on public roads. In addition, physical 
qualification standards described in 49 CFR 391.41(b) will be more 
accurately determined for CMV drivers. The new MER Form, MCSA-5875, 
eliminates the advisory criteria (guidance) contained in the current 
MER Form that has been sometimes misinterpreted when applying the 
regulatory standards. Thus, MEs can make more accurate decisions 
regarding the physical qualification of CMV drivers.

III. Abbreviations

APN Advanced Practice Nurses
BLS Bureau of Labor Statistics
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
DC Doctors of Chiropractic
DO Doctor of Osteopathy
DOT U.S. Department of Transportation
DQ Driver Qualification
E-MAIL Electronic Mail
FHWA Federal Highway Administration
FMCSA Federal Motor Carrier Safety Administration
FMCSRs Federal Motor Carrier Safety Regulations
IC Information Collection
ICC Interstate Commerce Commission
IRFA Initial Regulatory Flexibility Analysis
MAP-21 Moving Ahead for Progress in the 21st Century Act
MD Medical Doctor
ME Certified Medical Examiner
MEC Medical Examiner's Certificate

[[Page 27345]]

MER Medical Examiner Report
MCSIA Motor Carrier Safety Improvement Act
MVR Motor Vehicle Record
NLETS National Law Enforcement Telecommunication System
NPRM Notice of Proposed Rulemaking
NRCME National Registry of Certified Medical Examiners
NTSB National Transportation Safety Board
OMB Office of Management and Budget
PA Physician Assistant
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's Licensing Agencies
SPE Skill Performance Evaluation

IV. Legal Basis for the Rulemaking

    The purpose of the principal requirements proposed in this NPRM 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, by close of 
business on the day of the examination by MEs for drivers required to 
have a CDL, would then be promptly and accurately transmitted to the 
SDLAs electronically for entry into the appropriate CDL driver record 
within one business day of receipt from FMCSA. In view of this purpose, 
the legal bases of the two previous final rules also serve as the legal 
basis for this proposed 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 (MCSIA) [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, is 49 U.S.C. 31149, enacted by section 4116(a) of Safe, 
Accountable, Flexible, Efficient Transportation Equity Act: A Legacy 
for Users, Public Law 109-59, 119 Stat. 1726 (Aug. 10, 2005) (SAFETEA-
LU). Brief summaries of the relevant legal bases for the proposed 
requirements in this NPRM are set out below. More detailed discussions 
of the legal basis for each of the previous final rules published in 
2008 and 2012 may be found in their preambles, at 73 FR 73096-73097 and 
77 FR 24105-24106, respectively.

A. Authority Over Drivers Affected

1. Drivers Required to Obtain a MEC
    FMCSA is required by statute to establish standards for the 
physical qualifications of drivers who operate CMVs in interstate 
commerce for non-excepted industries. [49 U.S.C. 31136(a)(3) and 
31502(b)].
    Subject to certain limited industry exceptions,\1\ 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)]. Such drivers must obtain 
from a ME a certification indicating that the driver is physically 
qualified to drive a CMV. [49 CFR 391.41(a), 391.43(g) and (h)]. 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) recently 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 in the Proposed Rule Section 
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).
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    \1\ See 49 CFR 390.3(f) and 391.2.
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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 following 
requirement:

    (1) 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 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. [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 Sec.  
31133(a)(8) to require more frequent and more inclusive reports.\2\ 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.''
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    \2\ The provisions of Sec.  31149(c)(1)(E) have been amended by 
Sec.  32302(c)(1)(A) of Moving Ahead for Progress in the 21st 
Century, Public Law 112-141, 126 Stat. 405 (July 6, 2012) (``MAP-
21'').
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    Authority to implement these various statutory provisions has been 
delegated to the Administrator of FMCSA [49 CFR 1.87(f)].

V. Background

    As stated in the Legal Basis section, this NPRM is a follow-on rule 
to both the National Registry of Certified Medical Examiners (NRCME) 
published on April 20, 2012 (77 FR 2410) and the Medical Certification 
Requirements as Part of the CDL rule (Med-Cert rule) published on 
December 1, 2008 (73 FR 73096). It would also be the third rule of an 
initiative to improve the driver qualification and medical examiner's 
certificate process. A summary of the major relevant provisions of 
those two final rules, outlined in V A and V B, provides the background 
for the proposed rulemaking. In addition, the Agency is also proposing 
substantial revisions to the MER Form and related regulatory 
provisions. A summary of the development of that report is also set 
forth below in V C.

A. Medical Certification Requirements as Part of the CDL

    FMCSA's 2008 final rule, Medical Certification Requirements as Part 
of the Commercial Driver's License [73 FR 73096 (Dec. 1, 2008)] adopted 
a number of regulatory provisions designed to incorporate information 
from the MEC into the Commercial Driver's License Information System 
(CDLIS).

[[Page 27346]]

Subsequent actions of the Agency modified some of the provisions 
adopted in the 2008 final rule [see Medical Certification Requirements 
as Part of the Commercial Driver's License (CDL); Technical, 
Organizational, and Conforming Amendments, 75 FR 28499 (May 21, 2010) 
and Medical Certification Requirements as Part of the Commercial 
Driver's License (CDL), Extension of Certificate Retention 
Requirements, 76 FR 70661 (Nov. 15, 2011)]. Most of the requirements 
established by these actions took effect on January 30, 2012. But some 
requirements affecting CDL drivers and their employers will not take 
effect until January 30, 2014.
    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, 2014. 
As modified by these actions, the essential elements of these CDL and 
CLP medical certification provisions for each of the affected groups 
are summarized below:
1. SDLAs
    The Medical Certification Requirements as Part of the Commercial 
Driver's License Rule requires the States to modify their CDL 
procedures to: (1) Record a CDL or CLP driver'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 MECs from drivers 
operating in non-excepted, interstate commerce who are required by 49 
CFR Part 391 to be medically certified; (3) retain the certificate or a 
copy for 3 years from the date of issuance; (4) post the required 
information from the certificate or a copy onto the CDLIS driver record 
within 10 calendar days; (5) update the medical certification status of 
the CDLIS driver record to show the driver as ``not-certified'' if the 
certification expires; and (6) downgrade the CDL or CLP within 60 days 
of the expiration of the driver's MEC. There are also requirements for 
posting certain information about any medical variances (as defined in 
the SUMMARY section) 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 
Medical Certification Requirements as Part of the Commercial Driver's 
License Rule requires the State to post within 10 calendar days on the 
CDLIS driver record the following information from that driver's MEC: 
(1) ME's name; (2) ME's license or certificate number and the State 
that issued it; (3) expiration date of the MEC; (4) ME's telephone 
number; (5) date of physical examination/issuance of the MEC to the 
driver; (6) National Registry identification number for the ME; (7) 
medical certification status determination (i.e., ``certified'' or 
``not certified''); (8) existence of any medical variance (as defined 
in the SUMMARY section) on the medical certificate (9) any driver 
restrictions; and (10) the date the information is entered on the CDLIS 
driver record.
    In addition to the recordkeeping functions, the SDLA must make the 
driver's medical certification status information electronically 
accessible to authorized State and Federal enforcement officials via 
CDLIS and the National Law Enforcement Telecommunication System 
(NLETS), and to drivers and employers via CDLIS motor vehicle records 
(MVRs). Based on the Medical Certification Requirements as Part of the 
Commercial Driver's License Rule, authorized State and Federal 
enforcement officials will be able to view the most current and 
accurate information regarding the medical status of the CMV driver, 
all information on the MEC, and the medical variance information (as 
defined above) to include the issued and expiration dates.
2. Motor Carriers and Employers
    Motor carriers who employ a CDL driver to operate in non-excepted, 
interstate commerce 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 motor carrier must obtain the CDLIS MVR to verify: (1) The 
driver's self-certification to operate in non-excepted, interstate 
commerce; (2) that a non-excepted, interstate driver has a medical 
certification status of ``certified;'' and, if applicable (3) 
documentation that the driver was issued a medical variance (as defined 
in the SUMMARY section) by FMCSA. After the 15th day, the carrier must 
have obtained a copy of the CDLIS MVR as documentation that the driver 
is medically ``certified'' and retain the MVR in the DQ file. This 
record must be checked annually.
3. Drivers
    All interstate CDL holders subject to the physical qualifications 
standards of 49 CFR part 391 must meet the following requirements:
     Beginning January 30, 2012, 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.
     Beginning January 30, 2012 but not later than January 30, 
2014, all existing CDL holders who do not have a renewal, upgrade or 
transfer issuance must still provide the MEC to the SDLA. Thereafter, 
they must update that information with the SDLA whenever a new 
certificate is issued.
     Beginning on January 30, 2014, these drivers will no 
longer have to use the MEC as proof of his or her certification to 
enforcement personnel or employers, except for the first 15 days after 
issuance,
     Beginning on January 30, 2014, these drivers will no 
longer be allowed to carry the actual MEC after the first 15 days after 
issuance, but must continue to carry any SPE certificate or medical 
exemption document while on duty.
     Beginning on July 8, 2014, the above requirements will 
also apply to CLP holders.
    Non-CDL 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 of Certified Medical Examiners (NRCME) [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. Current regulations require all 
interstate commercial drivers (with certain limited exceptions) to be 
medically examined by an ME (as defined in 49 CFR. 390.5) to determine 
if these drivers meet FMCSA's physical qualification requirements. The 
MEs who conduct such physical examinations 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

[[Page 27347]]

forth in subpart E of part 391 of the FMCSRs.
    The NRCME rule established the National Registry to ensure that all 
MEs who conduct driver medical examinations have been trained on FMCSA 
physical qualifications standards and guidelines. In order to be listed 
on the National Registry, MEs are required to participate in a training 
program from an accredited provider and pass a certification test to 
assess their knowledge of the Agency's physical qualifications 
standards and guidelines and how to apply them to commercial drivers. 
Upon passing this certification test, and meeting the other 
administrative requirements associated with the program, MEs will be 
listed on the National Registry. Once the full compliance date of May 
21, 2014 is reached, the Agency will only consider MECs issued to 
commercial drivers by MEs on the National Registry as valid proof of 
medical certification. The National Registry final rule also addressed 
several of the recommendations from National Transportation Safety 
Board (NTSB) for FMCSA to consider in order to improve the performance 
of MEs and to ensure that CMV drivers meet the physical qualification 
standards of the FMCSRs.\3\
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    \3\ See NTSB Safety Recommendations H-01-17 through H-01-25, 
http://www.ntsb.gov/doclib/recletters/2001/H01_17_25.pdf 
(retrieved Feb. 21, 2012).
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    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 every physical 
examination conducted on both CDL and non-CDL drivers. Beginning on May 
21, 2014, the NRCME rule will require MEs to submit this information 
monthly. The CMV Driver Medical Examination Results Form, MCSA-5850, 
will include almost all of the information on the MEC. The information 
not included on the form includes the ME's name, address, healthcare 
profession, state licensing number, state issued by identifier, 
national registry number and the date the MEC was signed. The 
information listed is not on the form because it is captured by the 
National Registry system upon the ME signing in via their individual 
password-protected National Registry web account. The information from 
the CMV Driver Medical Examination Results Form, MCSA-5850, and the 
information captured by the National Registry system upon the ME 
signing in via their individual password-protected National Registry 
web account will be combined and forwarded from the National Registry 
system to the SDLAs to account for all 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. The form 
and the instructions are presently found in the FMCSRs at 49 CFR 
391.43(f). Between 1940 and 1952, the regulations adopted by one of 
FMCSA's predecessor agencies, the Interstate Commerce Commission (ICC), 
included a ``Standard Physical Examination Form'' and accompanying 
instructions for use by doctors of medicine (the only medical 
practitioners then allowed to perform such examinations), but its use 
was recommended and not compulsory [former 49 CFR 191.4 (1951 ed.)]. In 
1952, the ICC revised the form and the instructions, and revised the 
regulations to require that the MEC ``be based on a physical 
examination made and recorded generally in accordance with the 
following instructions and examination form'' The MER Form and 
instructions were largely unchanged [Qualifications of Employees and 
Safety of Operations, 54 M.C.C. 337 (1952) and former 49 CFR 191.11 
(1952 ed.), 17 FR 4423, 4425-26 (May 15, 1952)].
    The regulations issued by the ICC regarding motor carrier safety 
were adopted by DOT after the transfer of responsibility from the ICC, 
by Public Law 89-670, 80 Stat. 931 (Oct. 15, 1966), and were renumbered 
twice without substantive change [32 FR 17941 (Dec. 15, 1967) and 33 FR 
19729-32 (Dec. 25, 1968)]. In 1970, the Federal Highway Administration 
(FHWA), made the first significant revisions in both the examination 
form and the instructions, which were then, as now, included in 49 CFR. 
391.43 [Qualifications of Drivers, 35 FR 6458 (Apr. 22, 1970)]. Over 
the next 30 years, a number of changes were made, largely as conforming 
changes to reflect revisions in the physical qualification standards or 
the rules for controlled substance testing.
    In 2000, FMCSA issued a final rule adopting both significant 
revisions to the instructions and a completely revised MER Form, both 
of which were substantially in the form in which 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 (i.e., the form will, to the extent possible, include all 
relevant information necessary to conduct the physical examination and 
certification).'' [Physical Qualification of Drivers; Medical 
Examination; Certificate, 65 FR 59363 (Oct. 5, 2000)]. The report was 
expanded to include a recitation of the physical qualification 
standards and to provide space to allow recording of laboratory and 
test data. The MER Form also included a number of advisory criteria 
providing guidelines from the Agency to assist MEs assess 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 revision, the MER Form and the instructions have been revised 
to reflect changes in the standards or advisory guidelines relating to 
hypertension and 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 Proposed Rule

    This NPRM is a follow-on rule to both the National Registry of 
Certified Medical Examiners published on April 20, 2012 (77 FR 2410) 
and the Medical Certification Requirements as Part of the CDL rule 
(Med-Cert rule) published on December 1, 2008 (73 FR 73096). It would 
also be the third component of an initiative to improve the driver 
qualification and medical examiner's certificate process.

A. Overview

    FMCSA proposes that MEs be required to report the results of all 
completed commercial drivers' physical examinations to FMCSA by close 
of business on the day the examination is conducted, by completing a 
CMV Driver Medical Examination Results Form, MCSA-5850, via their 
individual password-protected National Registry web account. The report 
would include the results of examinations where the driver was found to 
be qualified, not qualified and where the ME would indicate that the 
determination was pending. When the driver was determined to be not 
qualified, all previous certificates issued to the driver would be 
deemed invalid. FMCSA would then transmit all of the information from 
the MEC electronically from the National Registry system to the SDLAs 
for CLP and CDL holders only. FMCSA anticipates delivering the 
information to the SDLA the next business day after receipt. It also 
proposes to transmit to the SDLAs

[[Page 27348]]

information about MECs for CDL and CLP drivers that have been 
invalidated because a subsequent examination has found that the driver 
is not physically qualified. The SDLAs would then record the driver's 
status on the CDLIS driver record as ``not certified'' and begin the 
process of downgrading the CDL in accordance with existing procedures. 
In addition, the Agency would transmit medical variance information (as 
defined in the SUMMARY section) for all interstate CMV drivers 
electronically to the SDLAs.
    For interstate CMV drivers required to have CDLs or CLPs (after 
July 8, 2014), FMCSA would then be able to promptly transmit to the 
SDLAs the drivers' MEC information for entry on the State-managed CDL 
driver records. For physically qualified non-CDL drivers, the ME will 
continue to issue a paper MEC, Form MCSA-5876. The ME has the option to 
either fill in the MEC by hand or to generate an electronically 
populated copy if the examination information is submitted to the 
National Registry system at the time of the examination.
    FMCSA proposes that the MEs allow and encourage all drivers to 
review their information on the CMV Driver Medical Examination Results 
Form, MCSA-5850. This review would reduce data entry errors that will 
be transmitted to the National Registry and then to the States 
potentially hindering delivery of the medical certification information 
to the intended CDLIS driver record.
    The medical variance information would originate with FMCSA. A 
medical variance (as defined in the SUMMARY section) is issued by FMCSA 
to a driver who would otherwise not meet the physical qualification 
standards in 49 CFR 391.41(b). See proposed 49 CFR 
383.73(o)(1)(i)(B)(8), and (o)(2) and (3). FMCSA would transmit this 
medical variance information for all CMV (both CDL and non-CDL) drivers 
electronically to the appropriate SDLAs whenever FMCSA issues, renews, 
or rescinds a medical variance. FMCSA proposes to require the SDLAs to 
update CDLIS driver records each business day with medical variance 
information (as defined in the SUMMARY section) transmitted from FMCSA 
for CLP and CDL drivers. This will allow the most current information 
about the medical status of CDL drivers to be made available promptly 
and accurately.
    FMCSA will also forward information to the SDLAs when FMCSA voids a 
MEC issued to a driver required to have a CDL or CLP. Under the 
authority granted by 49 U.S.C. 31149(c)(2), FMCSA may void a 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 medical examiner has falsely claimed to 
have completed training in physical and medical examination 
standards.'' Some examples of circumstances in which the driver does 
not meet the applicable standards that might trigger such action by the 
Agency could include, but would not be limited to, when a driver has 
falsified or omitted disclosing potentially disqualifying medical 
information to the ME at the time of the examination or when a ME has 
not applied correctly the physical qualification standards in deciding 
that the driver was physically qualified. The Agency is developing 
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.
    Before voiding the MEC, 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 the action should not be taken. If the decision is made to 
void the driver's certificate, FMCSA would notify the driver. If the 
driver holds a CDL or CLP, notification would be transmitted by FMCSA 
to the driver's SDLA through the National Registry, and the SDLA would 
change the CDL or CLP driver's medical status to ``not certified'' and 
notify the driver of the action taken.

B. Medical Examination Procedures

    FMCSA proposes 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. New 
versions of the Instructions for Performing and Recording Physical 
Examinations will be published in FMCSA guidance documents.
    FMCSA also proposes to require MEs to begin using a newly developed 
MER Form, MCSA-5875, in place of the current MER Form. This form was 
developed by FMCSA in consultation with health care practitioners that 
are familiar with performing driver medical examinations. The use of 
the proposed form would be required, and is being submitted for the 
necessary approvals under the Paperwork Reduction Act, 44 U.S.C. 3501-
21. The proposed MER Form, MCSA-5875, would make the information 
collected on driver health history more comprehensive, streamline the 
format, strengthen the efficiency of frequently used clinical processes 
and tools for performing driver physical examinations, expand the ME 
determination section, add a statement for the ME signature, add a 
National Registry Number, and add a section for amending the ME 
determination.
    The revised MER Form, MCSA-5875, would no longer include 
information about the driver's role, a listing of physical 
qualification standards for drivers, detailed instructions for 
performing the examination, and the medical advisory criteria. 
Information about the driver's role, detailed guidance about performing 
the examination, and the medical advisory criteria would be published 
in FMCSA guidance documents. The physical qualification standards are 
published in the FMCSRs. Both will be covered in training required for 
an ME to be listed on the National Registry.
    The MER Form, MCSA-5875, would expand the ME determination section 
by eliminating the ``Temporarily Disqualified'' option and adding a 
``Pending Determination'' option to defer a decision temporarily for up 
to 45 days, if the ME requires additional information to make a 
determination of whether or not the driver was qualified. The form 
would also add a place for an ME to amend the certification decision if 
the driver did not require a completely new examination. FMCSA would 
consider any CMV Driver Medical Examination Results Form, MCSA-5850, 
displaying a ``Pending Determination'' status as an incomplete 
examination. This information will be submitted and stored only in the 
National Registry system. If the disposition of the pending examination 
is not updated by the ME before the 45 day expiration date, FMCSA would 
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 invalidated examination information in the National 
Registry System.

C. SDLAs

    SDLAs would no longer require CLP and CDL holders and applicants to 
provide their MECs or accept medical

[[Page 27349]]

variance documents (as defined in the SUMMARY section) from CLP and CDL 
drivers required to have a medical variance. The SDLA would receive 
information about CDL and CLP drivers determined to be physically 
qualified electronically from FMCSA, as well as information about 
drivers whose MECs have been invalidated because the driver has been 
determined to be not physically qualified as a result of a subsequent 
examination. The SDLAs would be required to update CLP and CDL driver 
records with medical certification information within one business day 
of receipt from FMCSA. In addition, the SDLAs would be required to 
update driver medical variance information (for CDL and CLP drivers) 
within one business day of receipt from FMCSA.

D. Drivers

    Drivers who are required to have a CDL or a CLP would no longer be 
required to provide either their MECs or any medical variance documents 
(as defined in the SUMMARY section) to the SDLA. FMCSA would provide 
that information to the SDLA electronically. CDL or CLP drivers would 
no longer be required to carry a valid MEC while 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 CDL 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. The electronic record of the driver's 
medical certification would be the only valid evidence that the driver 
was physically qualified. Non-CDL drivers will continue to be required 
to carry the original, or a copy, of the MEC. All CMV drivers would 
however be required to carry any relevant medical variance documents 
(as defined in the SUMMARY section).
    FMCSA does not believe this proposed rule would result in any 
operator of a CMV being coerced to violate any other safety 
regulations, because the proposed rule is entirely designed to enhance 
compliance with the physical qualification requirements applicable to 
all CMV drivers. Indeed, by providing MEC information and medical 
variance information (as defined in the SUMMARY section) directly to 
the SDLAs, FMCSA will eliminate the opportunity for drivers to provide 
fraudulent documents to their SDLAs and the opportunity for motor 
carriers, shippers, receivers, or transportation intermediaries to 
coerce them to do so. In addition, CDL MEC information will be 
transmitted to the SDLAs only for drivers certified by an ME listed on 
the National Registry, thereby eliminating the possibility of motor 
carriers coercing drivers to operate without a valid MEC.

E. MEs

    MEs would complete the new MER Form, MCSA 5875, when performing 
driver physical examinations, based on FMCSA regulations and advisory 
criteria published by FMCSA. They would be required to report results 
of all driver physical examinations, including those who failed to meet 
the FMCSA physical qualification standards and those who are pending 
further evaluation before the physical qualification determination is 
made, to FMCSA by close of business the same day by completing a CMV 
Driver Medical Examination Results Form, MCSA-5850, via their 
individual password-protected National Registry web account. MEs would 
allow and encourage all drivers to review their information on the CMV 
Driver Medical Examination Results Form, MCSA-5850 to ensure the 
driver's personal information (name, address, driver's license number, 
etc.) are correct. The prompt and complete reporting to FMCSA by the 
MEs of the medical certification information will enable this 
information (for CMV drivers required to have a CDL or CLP) to be 
transmitted expeditiously to the SDLAs for posting on the CDLIS driver 
record for the driver involved. This will ensure that complete, up-to-
date and accurate information about the medical certification status of 
such drivers is available to State and federal enforcement personnel, 
SDLAs, employers, drivers and others who rely on this information to 
ascertain whether a driver is in compliance with the applicable 
physical qualification standards and is able to operate a CMV safely. 
If the ME determined the non-CDL driver was physically qualified, they 
would complete the MEC, Form MCSA-5876, obtain the driver's signature, 
and provide the certificate to the driver (and a copy to the employer, 
if requested to do so).
    In addition, FMCSA proposes to require all MEs to notify FMCSA if 
they have not performed any driver physical examinations during the 
previous month. The compliance date for this provision would coincide 
with the effective date of the final rule to enable FMCSA to monitor ME 
compliance with reporting requirements.

F. Motor Carriers

    Motor carriers would no longer be required to verify the National 
Registry Number of the ME who issued a MEC to a driver required to have 
a CDL or a CLP by accessing the public information available on the 
National Registry. All certification information for such drivers would 
be provided to the SDLAs and posted as part of the driver record only 
by MEs listed on the National Registry. Motor carriers would still be 
required to obtain each driver's driver record from the SDLA which 
licensed the driver. The motor carrier would verify that the driver's 
status is ``medically certified'' and that the driver has the 
documentation for all medical variances (as defined in the SUMMARY 
section) noted on the MEC. For any CMV drivers who are not required to 
have a CDL, motor carriers would still have to verify that the ME was 
listed on the National Registry.
    For drivers required to have a CDL or a CLP, motor carriers would 
no longer be permitted to rely on an original or copy of a MEC in the 
DQ file for the first 15 days after it is issued. The motor carrier 
would obtain the driver's medical information as part of the CDLIS MVR 
from the SDLA.

G. Implementation Date

    In order to allow sufficient time for the SDLAs and FMCSA to 
develop and implement the necessary changes in their information 
systems to accomplish the proposed changes, FMCSA proposes to require 
that most of the proposed rules would take effect three years after the 
effective date of the final rule. The provisions requiring: (1) MEs to 
notify FMCSA if they have not performed any driver physical 
examinations during the previous month; (2) MEs to use the new MER 
Form, MCSA-5875; (3) the State to post the medical variance information 
(as defined in the SUMMARY section) provided by FMCSA, including the 
dates of issuance and expiration, to the CDLIS driver record within 1 
business day of receipt for CLP and CDL drivers; (4) the State to 
update the medical status to ``not certified' when the medical 
certification is voided by FMCSA; and (5) MEs to use the prescribed 
form for the MEC would go into effect on the effective date of the 
final rule.
    FMCSA proposes that beginning [INSERT DATE 3 YEARS AFTER THE 
EFFECTIVE DATE OF THE FINAL RULE], MEs be required to report the 
results of all commercial drivers' physical examinations to FMCSA by

[[Page 27350]]

close of business on the day the examination is conducted (instead of 
once a month), by completing a CMV Driver Medical Examination Results 
Form, MCSA-5850, via their individual password-protected National 
Registry web account. FMCSA would then transmit all of the information 
from the MEC electronically from the National Registry system to the 
SDLAs for CLP and CDL holders only. FMCSA is proposing 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. 
However, if the Agency finds that the States are ready earlier than 
expected the Agency may decide to shorten the proposed period and make 
this requirement before three years after the effective date.

VII. Section-by-Section

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

A. Proposed Changes to Part 383

    Part 383 contains the requirements for CLPs and CDLs. With certain 
exceptions, the rules in this part apply to every person who operates a 
CMV in interstate, foreign or intrastate commerce, to all employers of 
such persons, and to all States.
    Section 383.71(h). FMCSA proposes to change the requirement of a 
CLP or CDL applicant or holder who is required to obtain a MEC (no 
number assigned) from providing the State with an original or copy of 
the MEC (no number assigned) to FMCSA providing the State with the 
electronic MEC information.
    Section 383.73(a)-(b). FMCSA proposes to change the requirement 
that the State must post the MEC (no number assigned) received from the 
CLP or CDL applicant or holder to the CDLIS driver record to the State 
posting the electronic MEC information received from FMCSA.
    Section 383.73(o). FMCSA proposes to change the State requirement 
of posting the original or copy of the MEC (no number assigned) 
information to the CDLIS driver record within 10 calendar days after 
receipt to the posting of the electronic MEC, Form MCSA-5876, 
information to the CDLIS driver record within 1 business day after 
receiving the electronic information from FMCSA. The proposal would 
also add 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, it must change the driver's status on the CDLIS 
record to ``not certified'' and begin the process for downgrading the 
CDL or CLP. FMCSA also proposes to change the requirement that the 
State retain an original or copy of the MEC (no number assigned) for 3 
years to a requirement that it retain an electronic record of the MEC, 
Form MCSA-5876, information for 3 years.
    While the American Association of Motor Vehicle Administration's 
``Commercial Driver's License Information System State Procedures 
Manual,'' Release 5.2.0, February 2011 requires the State to post the 
medical variance information (as defined in the SUMMARY section) 
provided by FMCSA, including the dates of issuance and expiration, and 
was previously incorporated by reference in Sec.  384.105 of this 
chapter, FMCSA proposes to also include this requirement in paragraph 
(o) along with the MEC, Form MCSA-5876, information posting requirement 
as a reminder to the States. This proposed requirement would be 
effective immediately because States are already required to post this 
information. FMCSA also proposes to reduce the time the State has to 
post the medical variance information (as defined in the SUMMARY 
section) received from FMCSA to the CDLIS driver record from within 10 
calendar days to 1 business day of receipt since the information will 
be sent electronically.
    FMCSA proposes a new requirement that the State must also update 
the medical status to ``not certified' when the medical certification 
is voided by FMCSA.

B. Proposed Changes to Part 384

    Part 384 contains the requirements to ensure that the States comply 
with the provisions of section 12009(a) of the Commercial Motor Vehicle 
Safety Act of 1986 (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 22 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 proposes an administrative amendment to this 
section to include driver medical certification recordkeeping 
requirements for CLP applicants in Part 383.
    Section 384.301. FMCSA proposes to amend 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 
new legislation and modify State systems to comply with the new 
requirements, including CDLIS. New paragraph (i) would specify the 3 
year compliance date for States.

C. Proposed 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 proposes 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). The rule would eliminate the 
requirement for the motor carrier to verify and document in the DQ file 
that a CDL driver was certified by an ME listed on the National 
Registry. Employers will no longer need to verify that the driver 
examination was performed by an ME listed on the National Registry by 
FMCSA, because that information will be sent to the SDLAs from the 
National Registry. Motor carriers will still be required to meet this 
requirement for non-CDL drivers.
    Section 391.41(a)(2). 3 years after the effective date of the final 
rule, FMCSA proposes to eliminate the provision allowing drivers 
required to have a CDL or a CLP to carry a current MEC (no number 
assigned) for 15 days.
    Section 391.43. FMCSA proposes eliminating the Instructions for 
Performing and Recording Physical Examinations section in Sec.  
391.43(f) to eliminate redundant or unnecessary requirements. The 
Instructions section contains information found elsewhere in FMCSA 
guidance and information that health care practitioners must be 
knowledgeable of in order to be licensed, registered or certified by 
their States to perform physical examinations. FMCSA proposes revising 
the MER Form in Sec.  391.43(f) to make the driver's health history 
information more comprehensive, streamline the format, strengthen the 
efficiency of frequently used clinical processes and tools for 
performing driver physical examinations, expand the ME determination 
section, add a statement for ME signature, add a National Registry 
Number, and add a section for amending the ME determination.
    FMCSA proposes in 391.43(g)(2) that, beginning 3 years after the 
effective date of the final rule, MEs would no longer

[[Page 27351]]

be required to provide the MEC, Form MCSA-5876, to drivers required to 
have a CDL or CLP (and their employers) because the MEC information 
would be promptly and accurately transmitted electronically to the 
SDLAs for entry on the CDLIS driver record. But the ME would still 
provide the MEC, Form MCSA-5876, to non-CDL drivers (and requesting 
employers), as currently required.
    FMCSA proposes to insert two new paragraphs in 49 CFR 391.43(g). 
The first one, new paragraph (g)(3), would require 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 would then invalidate any MECs 
previously issued to the driver that are contained in the Agency's 
records. The second one would require 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 valid and the driver will be required 
to obtain a new examination in order to obtain a MEC, Form MCSA-5876.
    FMCSA proposes in 391.43(g)(5)(A)(ii) (renumbered from (g)(3) 
because of the two new paragraphs proposed above) 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 the close of the same business day. As indicated above, 
FMCSA may shorten this period if the States are ready before 3 years to 
begin receiving medical certification for drivers required to have a 
CDL or CLP.
    FMCSA proposes in 391.43(g)(5)(B) to 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 proposes to revise 391.43(h) to require MEs to use the MEC, 
Form MCSA-5876, and will seek approval under the Paperwork Reduction 
Act for its use. (See the Regulatory Analysis section below.) Only 
minor editorial edits have been made to the form for clarity. The 
information required to be entered on the certificate is unchanged from 
the information required under the current regulation.
    Section 391.45. FMCSA proposes to add a new paragraph at the end of 
this section that would require 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 391.43(g)(3).
    Section 391.51. FMCSA proposes in 391.51(b)(7) to eliminate the 
exception that allows the motor carrier to use a MEC (no number 
assigned) as proof of medical certification in the DQ file, because 
States would be required to load medical certification information into 
the driver's record within one business day of receipt from FMCSA.

VIII. Regulatory Analyses

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

    FMCSA has determined this proposed 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 estimated cost of the proposed 
rule is not expected to exceed the $100 million annual threshold for 
economic significance. The Agency expects this proposed rule to 
generate net cost savings because of reduced annual paperwork burden 
hours compared to the current information collection activity (IC). The 
motor carriers and SDLAs affected will benefit from a decrease in 
annual burden hours and economic expenditures that will more than 
offset the burden increase for MEs.
    FMCSA proposes to transmit MEC information electronically from the 
National Registry system to the SDLAs for CLP and CDL drivers. The 
Agency will also transmit medical variance information (as defined in 
the SUMMARY section) for all CMV drivers electronically to the SDLAs.
    The MEC information would originate with the ME. The ME would 
perform a driver physical examination and record the results on a MER 
Form, MCSA-5875. The ME would enter the MEC information on to the CMV 
Driver Medical Examination Results Form, MCSA-5850, and submit it to 
the National Registry via the ME's password-protected web account by 
close of business the same day. For CMV drivers required to have CDLs 
or (after July 8, 2014) CLPs, FMCSA would then be able to promptly 
transmit to the SDLAs the drivers' MEC information for entry on the 
CDLIS driver records.
1. Summary of Estimated Costs
    The Agency expects this proposed rule to generate net cost savings 
because of the reduced annual paperwork burden hours on the current IC. 
The additional cost this proposed rule would impose would result from 
the ME entering the CMV Driver Medical Examination Results Form, MCSA-
5850, data more frequently into the National Registry System, as 
detailed in the revised Medical Qualifications Requirements Supporting 
Statement (Office of Management and Budget (OMB) Control Number 2126-
0006) posted in the docket. This annual cost is very minimal in the 
amount of $455,994 (25,333 additional data entry annual burden hours x 
$18.00 per hour (includes benefits) for ME administrative personnel to 
perform data entry.) Another potential cost may be SDLAs' IT upgrades 
to connect to the National Registry database; however, the Agency is 
unable to estimate and quantify that potential cost at this time. The 
cost savings will be in the form of saving efficiencies through the 
electronic transmission of information.
2. Summary of Estimated Benefits
    Potential quantifiable estimated benefits, as detailed in the 
revised Medical Qualification Requirements and the Commercial Driver 
Licensing and Test Standards (OMB control number 2126-0011) Supporting 
Statements-posted in the docket include: (1) Employers would no longer 
be required to verify the ME's National Registry number for CDL driver 
examinations because only MEs listed on the National Registry will be 
able to forward MEC information to the National Registry. MEs will 
encourage drivers to review and correct MEC information to ensure 
accurate information is recorded. This will result in $4.22 million in 
a cost savings to employers (221,904 annual burden hours x $19.00 per 
hour (including benefits)); (2) CMV drivers will save time by not 
having to provide their MEC to the SDLAs. By sending the MEC and 
variance information (as defined in the SUMMARY section) electronically 
FMCSA is creating a cost savings for drivers of $2.17 million 
(4,623,000 MECs x $0.47 postage to

[[Page 27352]]

SDLAs); \4\ (3) SDLAs would save 205,333 annual burden hours of 
administrative time recording MEC information for not having to attend 
to the driver above, resulting in $3.69 million (205,333 annual burden 
hours x $18.00 per hour (including benefits)) in cost savings. As a 
result, this proposed rule will generate $10.1 million in overall cost 
savings.
---------------------------------------------------------------------------

    \4\ OMB control number 2126-0011 Medical Qualification 
Requirements due to expire July 31, 2015. The number of medical 
certificates 4,623,000 issued per year by MEs x $0.47 ($0.05 copy + 
$0.42 postage) = $2,172,180.
---------------------------------------------------------------------------

    Although the safety benefits of this rule are difficult to fully 
quantify, the Agency believes that the fraud prevention in electronic 
transmission of MEC and medical variance information (as defined in the 
SUMMARY section) will continue to improve safety on public roads. 
Continuing to leave the responsibility to drivers would create a 
potential for fraud, as it would provide an opportunity for the driver 
to forge or alter the MEC or medical variance information (as defined 
in the SUMMARY section). Prompt and complete reporting to FMCSA by the 
MEs would allow the information to be transmitted expeditiously to the 
SDLAs for posting on the CDLIS driver record for CDL and CLP drivers. 
As a result, up-to-date and accurate information concerning the medical 
certification status of such drivers would 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, by using the new MER Form, MCSA-5875, FMCSA believes that 
MEs will be able to determine more correctly whether CMV drivers meet 
the physical qualification standards contained in 49 CFR 391.41(b). The 
MER Form, MCSA-5875, removes the advisory criteria (guidance) contained 
in the current form that has been sometimes confused with regulatory 
standards; contains evaluation tools that align more precisely with the 
qualification standards and the Agency's advisory criteria and 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 form will help ensure that the physical 
condition of CMV operators is adequate to enable them to operate CMVs 
safely. Because the implementation of the National Registry program is 
just beginning, FMCSA does not have sufficient data at this time to 
quantify the expected safety benefits from adoption of the new 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.\5\ 
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.
---------------------------------------------------------------------------

    \5\ Regulatory Flexibility Act (5 U.S.C. 601 et seq.) see 
National Archives at http://www.archives.gov/federal-register/laws/regulatory-flexibility/601.html
---------------------------------------------------------------------------

    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 proposed rule is not expected to have a significant 
economic impact on a substantial number of small entities. 
Consequently, I certify that the proposed action would not have a 
significant economic impact on a substantial number of small entities.
    An Initial Regulatory Flexibility Analysis (IRFA), which must 
accompany this NPRM, must include six components. See 5 U.S.C. 603(b) 
and (c). The Agency has listed these components and addresses each 
section with regard to this NPRM.
    1. A description of the reason why action by the Agency is being 
considered.
    In order to alleviate manual entry of data by the SDLAs and to 
provide authorized State and Federal enforcement officials the most 
current and accurate information regarding the medical status of the 
CMV driver, FMCSA proposes to require MEs to begin using a newly 
developed MER Form, MCSA-5875, in place of the current MER Form. In 
addition, MEs would be required to report results of all driver 
physical examinations to FMCSA by close of business the day the 
examination is conducted by completing a CMV Driver Medical Examination 
Results Form, MCSA-5850, via their individual password-protected 
National Registry web account. FMCSA also proposes to transmit 
information from the MEC electronically from the National Registry to 
the SDLAs for CMV drivers who hold or apply for CLPs or CDLs and are 
required to be medically certified. It is also transmitting medical 
variance information (as defined in the SUMMARY section) for such 
drivers electronically to the SDLAs.
    2. A succinct statement of the objectives of, and legal basis why 
action by the Agency is being considered.
    The Agency's Medical Examiner's Certification Integration Rule is a 
follow-on rule that strengths and modifies the rules adopted in both 
the National Registry of Certified Medical Examiners published on April 
20, 2012 (77 FR 2410) and the Medical Certification Requirements as 
Part of the CDL rule (Med-Cert rule) published on December 1, 2008 (73 
FR 73096). It proposes to expedite transmission of the medical 
examination information to FMCSA by MEs, FMCSA would then promptly and 
accurately transmitted this information to the SDLAs electronically 
(for drivers required to have a CDL) to be entered into the appropriate 
CDLIS driver records. This rule is the third element of an initiative 
to improve the driver qualification and medical examiner certificate 
process. In addition, electronic transmission of the information will 
improve safety on public roads by decreasing the risk of fraud by CMV 
drivers and providing authorized State/Federal enforcement officials 
access to current and accurate medical status of CMV drivers during 
inspections.
    3. A description and, where feasible, an estimate of the number of 
small entities to which the proposed rule would apply.
    States have distinctive guidelines on who can perform physical 
examinations of commercial drivers, which vary among states for the 
purpose of certifying or non-certifying CDL drivers for this proposal, 
Federal regulations enable any of the following health-care 
professionals, including others, to conduct the CMV driver examination 
provided they are licensed, registered, or certified by the State(s) to 
conduct physical examinations: Medical Doctor (MD), Doctor of 
Osteopathy (DO), Physician Assistant (PA), Advanced Practice Nurses 
(APN) and Doctors of Chiropractic (DC). Once a year the Department of 
Labor's Bureau of Labor Statistics (BLS) publishes total annual 
employment figures based on their National Occupational Employment and 
Wage Estimates.\6\ Therefore, the Agency

[[Page 27353]]

estimates that this rule would impact approximately 40,000 health-care 
professionals expected to be listed on the National Registry. (see 
National Registry of Certified Medical Examiners 77 FR 24104, April 20, 
2012).
---------------------------------------------------------------------------

    \6\ U.S. Department of Labor, Bureau of Labor Statistics (BLS). 
May 2008 National Occupational Employment and Wage Estimates. 
Available online at http://www.bls.gov/oes/current/_oesnat.htm#b29-0000. 2008.
---------------------------------------------------------------------------

    The Small Business Administration's threshold to qualify as a small 
business fluctuates between $10 million or less in revenue for 
physician-owned businesses to $7 million in revenue for APN and PA 
owned companies. As such, FMCSA considers all of the medical 
professionals as small entities.
    4. A description of the projected reporting, recordkeeping, and 
other compliance requirements of the proposed rule, including an 
estimate of the classes of small entities that will be subject to 
requirements and the type of professional skills necessary for 
preparation of the report or record.
    The ME will be required to fill out the MER Form, MCSA-5875, with 
examination findings and the CMV Driver Medical Examination Results 
Form, MCSA-5850, with the driver examination results. The skills 
required to fill out these forms are basic office and computer 
proficiency skills.
    5. Identification, to the extent practicable, of all relevant 
Federal rules that may duplicate, overlap, or conflict with the 
proposed rule.
    The Agency did not identify any Federal rules that duplicate, 
overlap or conflict with the rule.
    6. A description of any significant alternatives to the proposed 
rule which minimize any significant impacts on small entities.
    The Agency did not identify any significant alternatives to the 
rule that could lessen the burden on small entities without 
compromising its goals or the Agency's statutory mandate. Because small 
businesses are such a large part of the demographic the Agency 
regulates, providing alternatives to small businesses for non-
compliance with FMCSA regulations or providing alternative compliance 
options is not feasible and not consistent with sound public policy.

C. Assistance for Small Entities

    In accordance with section 213(a) of the Small Business Regulatory 
Enforcement Fairness Act of 1996, FMCSA wants to assist small entities 
in understanding this proposed rule so that they can better evaluate 
its effects on themselves and participate in the rulemaking initiative. 
If the proposed rule would affect your small business, organization, or 
governmental jurisdiction and you have questions concerning its 
provisions or options for compliance; please consult the FMCSA point of 
contact, Elaine Papp, listed in the FOR FURTHER INFORMATION CONTACT 
section of this proposed 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 regarding 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 proposed rule would have very minimal costs that would 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 $143.1 
million (which is the value of $100 million in 2010 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 proposal 
would not have substantial direct costs on or for States, nor would 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 proposed 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 proposed 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 proposed 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

    Section 522 of title I of division H of the Consolidated 
Appropriations Act, 2005, enacted December 8, 2004 (Pub. L. 108-447, 
118 Stat. 2809, 3268, 5 U.S.C. 552a note), requires the Agency to 
conduct a privacy impact assessment (PIA) of a regulation that will 
affect the privacy of individuals. This rule does require the 
collection of personally identifiable information (PII). 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 proposed 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.

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 NPRM contains the following new IC requirements. As required 
by the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3507(d)), FMCSA 
submitted the information requirements associated with the proposal to 
the OMB for its

[[Page 27354]]

review. This proposed 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.
    Once the National Registry is implemented beginning May 21, 2014, 
as discussed in the final rule (77 FR 24104; April 21, 2012), MEs will 
start to electronically submit MEC information to the National Registry 
on a monthly basis. The Medical Examiner's Certification Integration 
Rule proposes that the information be submitted by the ME at the close 
of business the day the examination is conducted as opposed to 
submitting monthly batched reports. In addition, it proposes that FMCSA 
will electronically transmit examination information to the SDLAs, 
providing more accurate and timely delivery of information to update 
CDLIS driver records and for safety enforcement purposes. The 
requirements imposed on CMV drivers and employers for this IC are being 
considered. The estimate of the number of CMV drivers (respondents) 
covered by this IC includes both interstate drivers subject to the 
FMCSRs and intrastate drivers subject to compatible State regulations. 
Although Federal regulations do not require States to comply with the 
medical requirements in the FMCSRs, most States do mirror the Federal 
requirements. 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 extreme risks to the 
public.
    FMCSA analyzed this rule and determined that its implementation 
will decrease the currently approved IC burden hours covered by OMB 
Control No. 2126-006, titled ``Medical Qualification Requirements,'' 
and OMB Control No. 2126-0011, titled ``Commercial Driver Licensing and 
Test Standards.'' The Table below captures the current and future 
paperwork burden hours associated with the two approved supporting 
statements. A detailed analysis of each IC activity can be found in the 
Supporting Statements attachments, which are in the public docket for 
this rulemaking.

                                Current and Future Information Collection Burdens
----------------------------------------------------------------------------------------------------------------
                                                                                                 Proposed annual
                                                                Currently     Future change in  burden hours for
                     OMB Approvals No.                       approved annual    annual burden   IC activities in
                                                              burden hours          hours          year 4 and
                                                                                                subsequent years
----------------------------------------------------------------------------------------------------------------
2126-0006.................................................         2,130,702         (196,571)         1,934,131
2126-0011.................................................         1,682,582         (205,333)         1,423,249
                                                           -----------------------------------------------------
    Totals................................................         3,813,284         (401,904)         3,357,380
----------------------------------------------------------------------------------------------------------------

    2126-0006 Medical Qualification Requirements.
    This IC is currently due to expire on July 31, 2015. This revision 
is due to the Agency's development of the rules proposed in this NPRM. 
It proposes to change the State requirement of posting the original or 
copy of the MEC information to the CDLIS driver record within 10 
calendar days of receipt to the posting of the electronic MEC 
information to the CDLIS driver record within 1 business day. In 
addition, the proposed rule would eliminate the requirement for the CMV 
drivers to provide their MEC to their SDLAs. It would also eliminate 
the requirement for motor carriers to verify that their CDL drivers 
were certified by an ME on the National Registry.
    The current and proposed IC activities imposed on the MEs and motor 
carriers over the first 3 years of implementing the proposed electronic 
transmission of MEC information from the ME to the SDLAs would remain 
unchanged. This would allow time for those States that need to pass 
legislation and for all States to make the necessary system upgrades, 
before the proposed electronic transmission of MEC information from the 
ME, through the National Registry System, to the SDLA for update on the 
CDLIS driver's record will be implemented in each State and the 
District of Columbia. The table below details the IC activities 
incurred by the ME and motor carriers for the current and proposed 
first 3 years, along with IC activities in Year 4 and subsequent years.

----------------------------------------------------------------------------------------------------------------
                                                                                                Proposed  annual
                                                                              Proposed  annual    burden  hours
   Current and proposed IC activities for MEs and motor         Currently       burden  hours        for IC
                         carriers                            approved annual     for the  IC      activities in
                                                              burden hours     activities  in     year 4th and
                                                                               first 3  years   subsequent years
----------------------------------------------------------------------------------------------------------------
MER, Medical Examination Results Form, and the MEC........         1,695,000         1,695,000         1,695,000
Resolution of Medical Conflict............................                11                11                11
SPE.......................................................               192               192               192
Vision Exemption..........................................               727               727               727
Diabetes Exemption........................................               600               600               600
ME Application............................................             1,111             1,111             1,111
ME Test Results...........................................             1,111             1,111             1,111
CMV Driver Examination Data...............................           123,575           123,575           148,908
MER and MEC Copies........................................               175               175               175
Verification of National Registry Number..................           308,200           308,200            86,296
                                                           -----------------------------------------------------
    Total Burden Hours....................................         2,130,702         2,130,702         1,934,131
----------------------------------------------------------------------------------------------------------------


[[Page 27355]]

    FMCSA estimates that the number of times per year that respondents 
would provide CMV driver examination results information would increase 
from a minimum of 12 times per year to an average of 50 times per year. 
MEs would file 4,623,000 MECs per year (unchanged). It is projected 
that 40,000 MEs (unchanged) will be needed to perform the 4,623,000 CMV 
driver medical examinations required annually. The transmission of CMV 
driver examination information will require approximately 71,858 hours 
of ME administrative personnel time on a yearly basis [40,000 
registered MEs x 1 minute/60 minutes to file a report x 50 reports per 
year + 4,623,000 reports x 30 seconds/3600 seconds to enter each 
driver's examination data elements = 71,858 hours]. This is an increase 
of 25,333 burden hours per year.
    In addition, verification for CDL drivers will not be required, 
because FMCSA will provide medical certification information to the 
states only from MEs who are listed on the National Registry. Motor 
carriers will verify the National Registry Number for an estimated 
1,294,440 non-CDL drivers who are medically certified per year (a 
decrease from 4,623,000 CDL and non-CDL drivers medically certified per 
year). It is estimated it will take motor carrier administrative 
personnel 4 minutes to verify the National Registry Number, write a 
note regarding the verification, and file the note in the DQ file, so 
this will require approximately 86,296 hours of administrative 
personnel time on a yearly basis [1,294,440 verifications x 4 minutes/
60 minutes per verification = 86,296 hours]. This is a decrease of 
221,904 annual burden hours per year.
    FMCSA estimates that the Medical Examiner's Certification 
Integration Rule would decrease the total estimated annual time burden 
to respondents for Medical Qualifications by 196,571 hours [(221,904) 
fewer hours for verification of non-CDL National Registry Number minus 
25,333 additional hours to enter driver examination data elements]. The 
Medical Examiner's Certification Integration Rule would result in a 
total annual time burden to respondents for all medical requirement 
components of an estimated 1, 934,131 hours (2,130,702 current hours 
minus 196,571 fewer hours).
    2126-0011 Commercial Driver Licensing and Test Standards. This IC 
is currently due to expire on August 31, 2014. This IC supports the DOT 
Strategic Goal of Safety by requiring that CLP and CDL holders driving 
CMVs subject to part 391 are properly licensed according to all 
applicable Federal requirements. The information being collected 
ensures that CLP and CDL holders are qualified to hold a CLP or CDL to 
operate CMVs, and that States are administering their CDL programs in 
compliance with the Federal requirements.
    As proposed, the MEC and medical variance information (as defined 
in the SUMMARY section) for CLP and CDL drivers would be transmitted 
electronically by FMCSA to the SDLA and posted to the CLP or CDL 
holder's CDLIS driver record. This would eliminate the need for the 
driver to carry a paper copy of the MEC and to physically provide a 
copy to his/her SDLA. Therefore, there would be no change in the total 
annual burden hours during the first 3 years. However, during these 3 
years there will be a one-time cost that each State and the District of 
Columbia will need to expend to make updates to their systems to 
accommodate the development of the capability to electronically receive 
and post medical certification and medical variance information (as 
defined in the SUMMARY section) from FMCSA and to the CDLIS driver 
record. The information technology necessary to carry out these 
transactions are still in the early development stage. Therefore, FMCSA 
cannot make any cost estimates at this time. FMCSA welcomes any 
comments on estimated costs to develop this capability.
    Starting in the 4th and subsequent years, there would be a proposed 
decrease in total annual burden hours due to the implementation of the 
new program change. With medical certification and medical variance 
information (as defined in the SUMMARY section) being sent 
electronically to the SDLA by FMCSA to post to the CDLIS driver record, 
the annual burden hours for the SDLA to manually post the medical 
certification and medical variance information to the CDLIS driver 
record will be reduced from 205,333 hours to 0 hours based on the 
medical variance information being electronically sent through the 
National Registry to the SDLA by FMCSA and electronically posted to the 
CDLIS driver record. If the medical variance information (as defined in 
the SUMMARY section) continues to be sent by email there would be 
minimal burden hours associated with this task therefore, FMCSA has not 
attempted to quantify it. The following table summarizes the annual 
information collection burden hours for current and proposed IC 
activities for the first 3 years and the subsequent years. As discussed 
above, the currently approved total annual burden of 1,628,582 hours 
for the first 3 years remains unchanged. The decrease in proposed total 
annual burden of 205,333 hours in subsequent years is due to the 
program changes from implementing the new requirement.

----------------------------------------------------------------------------------------------------------------
                                                                                                Proposed  annual
                                                                              Proposed  annual    burden  hours
   Current and proposed IC activities for States and CDL        Currently       burden  hours        for IC
                          drivers                            approved annual     for the  IC      activities in
                                                              burden hours     activities  in     year 4th and
                                                                               first 3  years   subsequent years
----------------------------------------------------------------------------------------------------------------
State recording of medical examiner's certification and              205,333           205,333                 0
 medical variance information on CDLIS driver record......
State recording of the self-certification of CMV operation             3,984             3,984             3,984
 on CDLIS driver record...................................
State verification of the medical certification status of              2,593             2,593             2,593
 all interstate CDL holders...............................
Driver to notify employer of convictions/disqualifications           640,000           640,000           640,000
Driver to complete previous employment paperwork..........           403,200           403,200           403,200
States to complete compliance certification documents.....             1,632             1,632             1,632
States to complete compliance review documents............             2,400             2,400             2,400
Data/document checks and CDLIS recordkeeping..............           212,224           212,224           212,224
Drivers to complete the CLP/CDL application...............            48,000            48,000            48,000
CDL tests recordkeeping...................................            84,000            84,000            84,000
Knowledge and skills test examiner certification..........            25,216            25,216            25,216
Skills test examiner monitoring and auditing..............                 0                 0                 0
                                                           -----------------------------------------------------

[[Page 27356]]

 
    Total Burden Hours....................................         1,628,582         1,628,582         1,423,249
----------------------------------------------------------------------------------------------------------------

L. National Environmental Policy Act and Clean Air Act

    FMCSA analyzed this NPRM for the purpose of the National 
Environmental Policy Act of 1969 (42 U.S.C. 4321 et seq.) and 
determined this action is categorically excluded from further analysis 
and documentation in an environmental assessment or environmental 
impact statement under FMCSA Order 5610.1(69 FR 9680, March 1, 2004), 
Appendix 2, paragraph (s)(7) and paragraph (t)(2). The Categorical 
Exclusion (CE) in paragraph (b) covers administrative or editorial 
changes; (s)(7) covers requirements for State-issued commercial license 
documentation; and paragraph (t)(2) addresses regulations that assure 
States have the appropriate information systems and procedures 
concerning CDL qualifications. The proposals in this rule are covered 
by these two CEs and the proposed action does not have any effect on 
the quality of the environment. The CE determination is available for 
inspection or copying in the Regulations.gov Web site listed under 
ADDRESSES. FMCSA also analyzed this rule under the Clean Air Act, as 
amended (CAA), section 176(c) (42 U.S.C. 7401 et seq.), and 
implementing regulations promulgated by the Environmental Protection 
Agency. Approval of this action is exempt from the CAA's general 
conformity requirement since it does not affect direct or indirect 
emissions of criteria pollutants.

M. E.O. 13211 (Energy Supply, Distribution, or Use)

    FMCSA has analyzed this proposed rule under E.O. 13211, Actions 
Concerning Regulations That Significantly Affect Energy Supply, 
Distribution, or Use. The Agency has determined that it is not a 
``significant energy action'' under that order because it is not a 
``significant regulatory action'' likely to have a significant adverse 
effect on the supply, distribution, or use of energy. Therefore, it 
does not require a Statement of Energy Effects under E.O. 13211.

N. E.O. 13175 (Indian Tribal Governments)

    This rule does not have tribal implications under E.O. 13175, 
Consultation and Coordination with Indian Tribal Governments, because 
it does not have a substantial direct effect on one or more Indian 
tribes, on the relationship between the Federal Government and Indian 
tribes, or on the distribution of power and responsibilities between 
the Federal Government and Indian tribes.

O. National Technology Transfer and Advancement Act (Technical 
Standards)

    The National Technology Transfer and Advancement Act (NTTAA) (15 
U.S.C. 272 note) directs agencies to use voluntary consensus standards 
in their regulatory activities unless the agency provides Congress, 
through OMB, with an explanation of why using these standards would be 
inconsistent with applicable law or otherwise impractical. Voluntary 
consensus standards (e.g., specifications of materials, performance, 
design, or operation; test methods; sampling procedures; and related 
management systems practices) are standards that are developed or 
adopted by voluntary consensus standards bodies. This rule does not use 
technical standards. Therefore, we did not consider the use of 
voluntary consensus standards.

List of Subjects

49 CFR Part 383

    Administrative practice and procedure, Alcohol abuse, Drug abuse, 
Highway safety, Incorporation by reference, Motor carriers.

49 CFR Part 384

    Administrative practice and procedure, Alcohol abuse, Drug abuse, 
Highway safety, Incorporation by reference, Motor carriers.

49 CFR Part 391

    Alcohol abuse, Drug abuse, Drug testing, Highway safety, Motor 
carriers, Reporting and recordkeeping requirements, Safety, 
Transportation.
    For the reasons stated in the preamble, FMCSA proposes to amend 
title 49 CFR, Code of Federal Regulations, chapter III, to read as 
follows:

PART 383--COMMERCIAL DRIVER'S LICENSE STANDARDS; REQUIREMENTS AND 
PENALTIES

0
1. The authority citation for part 383 continues to read as follows:

    Authority:  49 U.S.C. 521, 31136, 31301 et seq., and 31502; 
secs. 214 and 215, Pub. L. 106-159, 113 Stat. 1748, 1766, 1767; sec. 
4140, Pub. L. 109-59, 119 Stat. 1144, 1746; and 49 CFR 1.87.

0
2. Amend Sec.  383.71 by revising paragraphs (h)(1) and (3) to read as 
follows:


Sec.  383.71  Driver application and certification procedures.

    (h) * * *
    (1) New CLP and CDL applicants. (i) Before [INSERT DATE 3 YEARS 
AFTER THE EFFECTIVE DATE OF THE FINAL RULE], a new CLP or CDL applicant 
who certifies that he/she will operate CMVs in non-excepted, interstate 
commerce must provide the State with an original or copy (as required 
by the State) of a medical examiner's certificate prepared by a medical 
examiner, as defined in 49 CFR 390.5, and the State will post a medical 
qualifications status of ``certified'' on the CDLIS driver record for 
the driver;
    (ii) On or after [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF 
THE FINAL RULE], a new CLP or CDL applicant who certifies that he/she 
will operate CMVs in non-excepted, interstate commerce must be 
medically examined and certified in accordance with 49 CFR 391.43 as 
medically qualified to operate a CMV by a medical examiner, as defined 
in 49 CFR 390.5. Upon receiving an electronic copy of the medical 
examiner's certificate from FMCSA, the State will post a medical 
qualifications status of ``certified'' on the CDLIS driver record for 
the driver; * * *
    (3) Maintaining the medical certification status of ``certified.'' 
(i) In order to maintain a medical certification status of 
``certified,'' before [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF 
THE FINAL RULE], a CLP or CDL holder who

[[Page 27357]]

certifies that he/she will operate CMVs in non-excepted, interstate 
commerce must provide the State with an original or copy (as required 
by the State) of each subsequently issued medical examiner's 
certificate;
    (ii) In order to maintain a medical certification status of 
``certified,'' on or after [INSERT DATE 3 YEARS AFTER THE EFFECTIVE 
DATE OF THE FINAL RULE], a CLP or CDL holder who certifies that he/she 
will operate CMVs in non-excepted, interstate commerce must continue to 
be medically examined and certified in accordance with 49 CFR 391.43 as 
physically qualified to operate a commercial motor vehicle by a medical 
examiner, as defined in 49 CFR 390.5. FMCSA will provide the State with 
an electronic copy of the medical examiner's certificate information 
for all subsequent medical examinations in which the driver has been 
deemed qualified.
0
3. Amend Sec.  383.73 by revising paragraphs (a)(2)(vii), (b)(5), 
(o)(1), (o)(2), (o)(3) and (o)(4) to read as follows:


Sec.  383.73  State procedures.

    (a) * * *
    (2) * * *
    (vii)(A) Before [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF 
THE FINAL RULE], for drivers who certified their type of driving 
according to Sec.  383.71(b)(1)(ii)(A) (non-excepted interstate) and, 
if the CLP applicant submits a current medical examiner's certificate, 
date-stamp the medical examiner's certificate, and post all required 
information from the medical examiner's certificate to the CDLIS driver 
record in accordance with paragraph (o) of this section.
    (B) On or after [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF 
THE FINAL RULE], for drivers who certified their type of driving 
according to Sec.  383.71(b)(1)(ii)(A) (non-excepted interstate) and, 
if FMCSA provides current medical examiner's certificate information 
electronically, post all required information matching the medical 
examiner's certificate to the CDLIS driver record in accordance with 
paragraph (o) of this section.
    (b) * * *
    (5)(i) Before [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF THE 
FINAL RULE], for drivers who certified their type of driving according 
to Sec.  383.71(b)(1)(ii)(A) (non-excepted interstate) and, if the CDL 
holder submits a current medical examiner's certificate, date-stamp the 
medical examiner's certificate and post all required information from 
the medical examiner's certificate to the CDLIS driver record in 
accordance with paragraph (o) of this section.
    (ii) On or after [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF 
THE FINAL RULE], for drivers who certified their type of driving 
according to Sec.  383.71(b)(1)(ii)(A) (non-excepted interstate) and, 
if FMCSA provides current medical examiner's certificate information 
electronically, post all required information matching the medical 
examiner's certificate to the CDLIS driver record in accordance with 
paragraph (o) of this section.
* * * * *
    (o) Medical recordkeeping -- (1)(i) Status of CDL holder. Before 
[INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF THE FINAL RULE], for 
each operator of a commercial motor vehicle required to have a CLP or 
CDL, the current licensing State must:
    (A) Post the driver's self-certification of type of driving under 
Sec.  383.71(b)(1)(ii) to the CDLIS driver record;
    (B) Post the information from the medical examiner's certificate 
within 10 calendar days to the CDLIS driver record, including:
    (1) Medical examiner's name;
    (2) Medical examiner's telephone number;
    (3) Date of medical examiner's certificate issuance;
    (4) Medical examiner's license number and the State that issued it;
    (5) Medical examiner's National Registry identification number;
    (6) The indicator of medical certification status, i.e., 
``certified'' or ``not-certified'';
    (7) Expiration date of the medical examiner's certificate;
    (8) Existence of any medical variance on the medical examiner's 
certificate, such as an exemption, SPE certification, or grandfather 
provisions;
    (9) Any restrictions (e.g., corrective lenses, hearing aid, 
required to have possession of an exemption letter or SPE certificate 
while on-duty, etc.); and
    (10) Date the medical examiner's certificate information was posted 
to the CDLIS driver record; and
    (C) Post the medical variance information within 10 calendar days 
to the CDLIS driver record, including:
    (1) Date of medical variance issuance; and
    (2) Expiration date of medical variance;
    (D) Retain the original or a copy of the medical examiner's 
certificate of any driver required to provide documentation of physical 
qualification for 3 years beyond the date the certificate was issued.
    (ii) Status of CDL holder. On or after [INSERT DATE 3 YEARS AFTER 
THE EFFECTIVE DATE OF THE FINAL RULE], for each operator of a 
commercial motor vehicle required to have a CLP or CDL, the current 
licensing State must:
    (A) Post the driver's self-certification of type of driving under 
49 CFR 383.71(b)(1)(ii) to the CDLIS driver record;
    (B) Post the information from the medical examiner's certificate 
within 1 business day to the CDLIS driver record, including:
    (1) Medical examiner's name;
    (2) Medical examiner's telephone number;
    (3) Date of medical examiner's certificate issuance;
    (4) Medical examiner's license number and the State that issued it;
    (5) Medical examiner's National Registry identification number;
    (6) The indicator of medical certification status, i.e., 
``certified'' or ``not-certified'';
    (7) Expiration date of the medical examiner's certificate;
    (8) Existence of any medical variance on the medical examiner's 
certificate, such as an exemption, Skill Performance Evaluation (SPE) 
certification, or grandfather provisions;
    (9) Any restrictions (e.g., corrective lenses, hearing aid, 
required to have possession of an exemption letter or SPE certificate 
while on-duty, etc.); and
    (10) Date the medical examiner's certificate information was posted 
to the CDLIS driver record;
    (C) Post the medical variance information within 1 business day to 
the CDLIS driver record, including:
    (1) Date of medical variance issuance; and
    (2) Expiration date of medical variance;
    (D)(1) Retain the electronic record of the medical examiner's 
certificate information for any driver required to have documentation 
of physical qualification for 3 years beyond the date the certificate 
was issued.
    (2)(i) Status update. Until the day before [INSERT DATE 3 YEARS 
AFTER THE EFFECTIVE DATE OF THE FINAL RULE], the State must, within 10 
calendar days of the driver's medical examiner's certificate or medical 
variance expiring, the medical variance being rescinded or the medical 
examiner's certificate being voided by FMCSA, update the medical 
certification status of that driver as ``not certified.''
    (ii) Beginning [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE

[[Page 27358]]

OF THE FINAL RULE], the State must, within 10 calendar days of the 
driver's medical examiner's certificate or medical variance expiring, 
the medical examiner's certificate becoming invalid, the medical 
variance being rescinded or the medical examiner's certificate being 
voided by FMCSA, update the medical certification status of that driver 
as ``not certified.''
    (3) Variance update. (i) Before [INSERT DATE 3 YEARS AFTER THE 
EFFECTIVE DATE OF THE FINAL RULE], within 10 calendar days of receiving 
information from FMCSA regarding issuance or renewal of a medical 
variance for a driver, the State must update the CDLIS driver record to 
include the medical variance information provided by FMCSA.
    (ii) On or after [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF 
THE FINAL RULE], within 1 business day of electronically receiving 
medical variance information from FMCSA regarding the issuance or 
renewal of a medical variance for a driver, the State must update the 
CDLIS driver record to include the medical variance information 
provided by FMCSA.
    (4) Downgrade. (i) if a driver's medical certification or medical 
variance expires, or FMCSA notifies the State that a medical 
certification or medical variance was removed or rescinded, the State 
must:
    (A)(1) Before [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF THE 
FINAL RULE] notify the CLP or CDL holder of his/her CLP or CDL ``not-
certified'' medical certification status and that the CMV privileges 
will be removed from the CLP or CDL unless the driver submits a current 
medical examiner's certificate and/or medical variance, or changes his/
her self-certification to driving only in excepted or intrastate 
commerce (if permitted by the State);
    (2) On or after [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF 
THE FINAL RULE] notify the CLP or CDL holder of his/her CLP or CDL 
``not-certified'' medical certification status and that the CMV 
privileges will be removed from the CLP or CDL unless the driver has 
been medically examined and certified in accordance with 49 CFR 391.43 
as physically qualified to operate a commercial motor vehicle by a 
medical examiner, as defined in 49 CFR 390.5 of this chapter, or the 
driver changes his/her self-certification to driving only in excepted 
or intrastate commerce (if permitted by the State).
    (B) [Reserved]
    (ii) [Reserved]
* * * * *

PART 384--STATE COMPLIANCE WITH COMMERCIAL DRIVER'S LICENSE PROGRAM

0
5. The authority citation for part 384 continues to read as follows:

    Authority:  49 U.S.C. 31136, 31301, et seq., and 31502; secs. 
103 and 215, Pub. L. 106-159, 113 Stat. 1748, 1753, 1767; and 49 CFR 
1.87.

0
6. Revise Sec.  384.234 to read as follows:


Sec.  384.234  Driver medical certification recordkeeping.

    The State must meet the medical certification recordkeeping 
requirements of Sec. Sec.  383.73(a)(2)(vii), (b)(5), (c)(8), (d)(8), 
(e)(6) and (o) of this chapter.
0
7. Amend Sec.  384.301 by adding a new paragraph (i) to read as 
follows:


Sec.  384.301  Substantial compliance--general requirements.

* * * * *
    (i) A State must come into substantial compliance with the 
requirements of subpart B of this part and part 383 of this chapter in 
effect as of [INSERT THE EFFECTIVE DATE OF THE FINAL RULE] as soon as 
practical, but, unless otherwise specifically provided in this part, 
not later than [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF THE 
FINAL RULE].

PART 391--QUALIFICATIONS OF DRIVERS AND LONGER COMBINATION (LCV) 
DRIVER INSTRUCTORS

0
8. The authority citation for part 391 will continue to read as 
follows:

    Authority: 49 U.S.C. 504, 508, 31133, 31136, and 31502; sec. 
4007(b), Pub. L. 102-240, 105 Stat, 1914, 2152; sec. 114, Pub. L. 
103-311, 108 Stat. 1673, 1677; sec. 215, Pub. L. 106-159, 113 Stat. 
1748, 1767; and 49 CFR 1.87.
0
9. Amend Sec.  391.23 by revising paragraph (m)(2) to read as follows:


Sec.  391.23  Investigation and inquiries.

* * * * *
    (m) * * *
    (2) Exception. For drivers required to have a commercial driver's 
license under part 383 of this chapter:
    (i) Beginning January 30, 2014, using the CDLIS motor vehicle 
record obtained from the current licensing State, the motor carrier 
must verify and document in the driver qualification file the following 
information before allowing the driver to operate a CMV:
    (A) The type of operation the driver self-certified that he or she 
will perform in accordance with Sec.  383.71(b)(1)(ii) of this chapter.
    (B) (1) Beginning on May 21, 2014, and ending on [INSERT THE 
EFFECTIVE DATE OF THE FINAL RULE], that the driver was certified by a 
medical examiner listed on the National Registry of Certified Medical 
Examiners as of the date of medical examiner's certificate issuance.
    (2) Beginning on [INSERT THE EFFECTIVE DATE OF THE FINAL RULE], if 
the driver has certified under paragraph (m)(2)(i)(A) of this section 
that he or she expects to operate in interstate commerce, that the 
driver has a valid medical examiner's certificate and any required 
medical variances.
    (3) Beginning on July 8, 2014, if the driver has a commercial 
learner's permit and has certified under paragraph (m)(2)(i)(A) of this 
section that he or she expects to operate in interstate commerce that 
the driver has a valid medical examiner's certificate and any required 
medical variances.
    (C) Exception. Until [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE 
OF THE FINAL RULE], if the driver provided the motor carrier with a 
copy of the current medical examiner's certificate that was submitted 
to the State in accordance with Sec.  383.73(a)(5) of this chapter, the 
motor carrier may use a copy of that medical examiner's certificate as 
proof of the driver's medical certification for up to 15 days after the 
date it was issued.
    (ii) [Reserved]
0
10. Amend Sec.  391.41 by revising paragraph (a)(2)(i) to read as 
follows:


Sec.  391.41  Physical qualifications for drivers.

    (a) * * *
    (2) CDL exception. (i) (A) Beginning January 30, 2014 and ending on 
the day before [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF THE 
FINAL RULE], a driver required to have a commercial driver's license 
under part 383 of this chapter, and who submitted a current medical 
examiner's certificate to the State in accordance with 49 CFR 383.71(h) 
documenting that he or she meets the physical qualification 
requirements of this part, no longer needs to carry on his or her 
person the medical examiner's certificate specified at Sec.  391.43(h), 
or a copy, for more than 15 days after the date it was issued as valid 
proof of medical certification.
    (B) Beginning on [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF 
THE FINAL RULE], a driver required to have a commercial driver's 
license or a commercial learner's permit under 49 CFR part 383, and who 
has a current medical examiner's certificate documenting that he or she 
meets the physical qualification requirements of this part, is no 
longer permitted to carry on his or her person the medical

[[Page 27359]]

examiner's certificate specified at Sec.  391.43(h).
* * * * *
0
11. Amend Sec.  391.43 by revising paragraphs (f), (g)(2), (g)(3) and 
(h), and adding paragraph (g)(4) and (g)(5), to read as follows:


Sec.  391.43  Medical examination; certificate of physical examination.

* * * * *
    (f) The medical examination shall be performed, and its results 
shall be recorded on the Medical Examination Report set out below
[GRAPHIC] [TIFF OMITTED] TP10MY13.009


[[Page 27360]]


[GRAPHIC] [TIFF OMITTED] TP10MY13.010


[[Page 27361]]


[GRAPHIC] [TIFF OMITTED] TP10MY13.011

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    (g) * * *
    (2) (i) Until the day before [INSERT DATE 3 YEARS AFTER THE 
EFFECTIVE DATE OF THE FINAL RULE], if the medical examiner finds that 
the person examined is physically qualified to operate a commercial 
motor vehicle 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.
    (ii) Beginning [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF THE 
FINAL RULE], if the medical examiner identifies that the person 
examined will not be operating a commercial motor vehicle that requires 
a commercial driver's license or a commercial learner's permit and 
finds that the driver is physically qualified to operate a commercial 
motor vehicle 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.
    (3) Beginning [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF THE 
FINAL RULE], if the medical examiner finds that the person examined is 
not physically qualified to operate a commercial motor vehicle in 
accordance with Sec.  391.41(b), he or she must inform the person 
examined that

[[Page 27362]]

he or she is not physically qualified, and that this information will 
be reported to FMCSA. All medical examiner's certificates previously 
issued to the person are not valid and no longer satisfy the 
requirements of Sec.  391.41(a).
    (4) Beginning [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF THE 
FINAL RULE], if the medical examiner finds that the determination of 
whether the person examined is physically qualified to operate a 
commercial motor vehicle in accordance with Sec.  391.41(b) should be 
delayed pending the receipt of additional information or the conduct of 
further examination in order for the medical examiner make such 
determination, he or she must inform the person examined that the 
additional information must be provided or the further examination 
completed within 45 days, and that the pending status of the 
examination will be reported to FMCSA.
    (5)(i)(A) Once every calendar month, beginning May 21, 2014 and 
ending on [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF THE FINAL 
RULE], the medical examiner must electronically transmit to the 
Director, Office of Carrier, Driver and Vehicle Safety Standards, via a 
secure Web account on the National Registry, a completed CMV Driver 
Medical Examination Results Form, MCSA-5850, Medical Examiner 
Submission of CMV Driver Medical Examination Results. The Form must 
include all information specified for each medical examination 
conducted during the previous month for any driver who is required to 
be examined by a medical examiner listed on the National Registry of 
Certified Medical Examiners.
    (B) Beginning [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF THE 
FINAL RULE] by close of business on each day during which the medical 
examiner completes a medical examination for any driver who is required 
to be examined by a medical examiner listed on the National Registry of 
Certified Medical Examiners the medical examiner must electronically 
transmit the Director, Office of Carrier, Driver and Vehicle Safety 
Standards, via a secure FMCSA-designated Web site, a completed CMV 
Driver Medical Examination Results Form, MCSA-5850, Medical Examiner 
Submission of CMV Driver Medical Examination. The Form must include all 
information specified for each medical examination conducted for each 
driver.
    (ii) Beginning on May 21, 2014, if the medical examiner does not 
perform a medical examination of any driver who is required to be 
examined by a medical examiner listed on the National Registry of 
Certified Medical Examiners during any calendar month, the medical 
examiner must report that fact to FMCSA, via a secure FMCSA-designated 
Web site, by the close of business on the last day of such month.
    (h) The medical examiner's certificate shall be completed in 
accordance with the following Form MCSA-5876, Medical Examiner's 
Certificate.
[GRAPHIC] [TIFF OMITTED] TP10MY13.012

* * * * *
0
12. Amend Sec.  391.45 by revising paragraphs (b)(2) and (c), and 
adding new paragraph (d) to read as follows:


Sec.  391.45  Persons who must be medically examined and certified.

* * * * *
    (b) * * *
    (2) Any driver authorized to operate a commercial motor vehicle 
only with an exempt intracity zone pursuant to Sec.  391.62, or only by 
operation of the exemption in Sec.  391.64, if such driver has not been 
medically examined and certified as qualified to drive in such zone 
during the preceding 12 months;
    (c) Any driver whose ability to perform his/her normal duties has 
been

[[Page 27363]]

impaired by a physical or mental injury or disease; and
    (d) Beginning [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF THE 
FINAL RULE], any person found by a medical examiner not to be 
physically qualified to operate a commercial motor vehicle under the 
provisions of paragraph (g)(3) of Sec.  391.43.
0
13. Amend Sec.  391.51 by revising paragraphs (b)(7)(i) and (ii), and 
(b)(9) to read as follows:


Sec.  391.51  General requirements for driver qualification files.

* * * * *
    (b) * * *
    (7)(i) The medical examiner's certificate as required by Sec.  
391.43(g) or a legible copy of the certificate.
    (ii) Exception. For CDL holders, beginning January 30, 2012, if the 
CDLIS motor vehicle record contains medical certification status 
information, the motor carrier employer must meet this requirement by 
obtaining the CDLIS motor vehicle record defined at Sec.  384.105 of 
this chapter. That record must be obtained from the current licensing 
State and placed in the driver qualification file. After January 30, 
2014 a non-excepted, interstate CDL holder without medical 
certification status information on the CDLIS motor vehicle record is 
designated ``not-certified'' to operate a CMV in interstate commerce. 
After January 30, 2014 and until [INSERT DATE 3 YEARS AFTER THE 
EFFECTIVE DATE OF THE FINAL RULE], a motor carrier may use a copy of 
the driver's current medical examiner's certificate that was submitted 
to the State for up to 15 days from the date it was issued as proof of 
medical certification.
* * * * *
    (9) (i) For drivers not required to have a CDL, a note relating to 
verification of medical examiner listing on the National Registry of 
Certified Medical Examiners required by Sec.  391.23(m)(1).
    (ii) Until [INSERT DATE 3 YEARS AFTER THE EFFECTIVE DATE OF THE 
FINAL RULE], for drivers required to have a CDL, a note relating to 
verification of medical examiner listing on the National Registry of 
Certified Medical Examiners required by Sec.  391.23(m)(2).
* * * * *

    Issued under the authority delegated in 49 CFR 1.87 on: May 2, 
2013.
Anne S. Ferro,
Administrator.
[FR Doc. 2013-11080 Filed 5-9-13; 8:45 am]
BILLING CODE P