OIG releases audit of National Registry for medical examiners

January 15, 2021

Greg Grisolano

|

The Federal Motor Carrier Safety Administration “has not fully met oversight requirements as it rebuilds the National Registry of Certified Medical Examiners.”

That’s both the title and the key takeaway of a new report from the U.S. Department of Transportation’s Office of Inspector General. Released on Jan. 13, the report says “a lengthy outage” of the National Registry website and resulting backlog of driver examination reports that weren’t entered into the system limited the agency’s oversight abilities.

“In addition, weaknesses associated with the accuracy and completeness of data in the National Registry limit the effectiveness of FMCSA’s oversight,” a summary of the report findings states.

The OIG report also stated that FMCSA has not fully implemented requirements for random periodic monitoring of medical examiners’ eligibility and performance.

“While FMCSA has conducted initial certification reviews of medical examiners’ eligibility qualifications, the agency is not yet conducting annual eligibility audits after initial certification,” the report states. “Without these oversight reviews, FMCSA may be missing fraud indicators or other risks that may require mitigation and has less assurance that drivers are physically qualified to safely operate a commercial vehicle.”

Findings

In May 2014, FMCSA initiated the National Registry of Certified Medical Examiners to assist in verifying that medical examiners can effectively determine if interstate commercial drivers meet physical qualification standards.

In December 2017, the registry experienced an outage that lasted seven months. During that time, FMCSA suspended medical examiners’ uploading of driver examinations until that functionality was restored. Because of the outage and technical issues in relaunching the registry, OIG auditors estimate approximately 780,000 driver examinations could be missing from the database. The OIG audit was announced in February 2019.

OIG’s analysis of National Registry data indicated that 46% of its 70,208 records of certified medical examiners as of May 2019 had outdated medical license information, according to the report. Additionally, two separate samples totaling 452 driver examinations from three state driver’s licensing agencies found that 21% were not recorded in the National Registry. Auditors say the data quality issues occurred in part because of data availability and monitoring limitations that occurred after the National Registry was taken offline.

“Without quality data, FMCSA cannot effectively ensure that drivers meet physical qualification standards to operate a commercial vehicle safely,” the audit states.

Audit recommendations

The report notes that FMCSA is building a new national registry, “but it is unclear when it will be complete.”

OIG auditors made four recommendations, which the agency concurred with. The recommendations are:

  • Implement agency plans for eliminating the backlog of driver examination results held by medical examiners.
  • Develop a plan to allocate resources to the Medical Programs Division to fully implement requirements for medical examiner eligibility audits and random selection performance monitoring.
  • Update agency processes for conducting periodic medical examiner eligibility audits and random selection performance monitoring as needed to incorporate upgraded National Registry tools.
  • Reinstate the conduct of eligibility audits and random selection performance monitoring of medical examiners.

In the agency’s response to the audit, FMCSA acting Administrator Wiley Deck wrote that a “fully functional National Registry is a priority” under the agency’s IT Modernization Plan. FMCSA plans to award a contract to rebuild the National Registry in the second quarter of Fiscal Year 2021.

The Owner-Operator Independent Drivers Association says the OIG audit highlights just a few of the problems that drivers have experienced with the National Registry of Certified Medical Examiners since its 2014 implementation.

“Drivers can often be charged excessive costs for unnecessary screenings recommended by CMEs, encounter difficulties when requesting a second opinion from an initial evaluation, or have their personal medical data compromised by inadequate IT infrastructure,” said Jay Grimes, OOIDA’s director of federal affairs. “FMCSA must improve these shortcomings so the NRCME becomes a more fair and reliable system for ensuring that drivers meet physical qualification standards.” LL