Document ID: FAA-2016-9157-0008
Agency: faa
Document Type: Rule
Title: Alternative Pilot Physical Examination and Education Requirements
Posted Date: 2017-01-11T05:00Z

[Federal Register Volume 82, Number 7 (Wednesday, January 11, 2017)]
[Rules and Regulations]
[Pages 3149-3167]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-31602]

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DEPARTMENT OF TRANSPORTATION

Federal Aviation Administration

14 CFR Parts 61, 68, and 91

[Docket No.: FAA-2016-9157; Amdt. Nos. 61-140, 68-1, and 91-347]
RIN 2120-AK96

Alternative Pilot Physical Examination and Education Requirements

AGENCY: Federal Aviation Administration (FAA), Department of 
Transportation (DOT).

ACTION: Final rule.

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SUMMARY: This final rule will allow airmen to exercise pilot in command 
privileges in certain aircraft without holding a current medical 
certificate. This rule, which conforms FAA regulations with 
legislation, is intended to ensure that pilots who complete a medical 
education course, meet certain medical requirements, and comply with 
aircraft and operating restrictions are allowed to act as pilot in 
command for most part 91 operations.

[[Page 3150]]

DATES: This rule is effective on May 1, 2017.
    Docket: Background documents may be read at http://www.regulations.gov at any time. Follow the online instructions for 
accessing the docket or go to the Docket Operations in Room W12-140 of 
the West Building Ground Floor at 1200 New Jersey Avenue SE., 
Washington, DC, between 9 a.m. and 5 p.m., Monday through Friday, 
except Federal holidays.

FOR FURTHER INFORMATION CONTACT: John Linsenmeyer, General Aviation and 
Commercial Division, AFS-800, Flight Standards Service, Federal 
Aviation Administration, 55 M Street SE., 8th floor, Washington, DC 
20003; telephone: (202) 267-1100; email: 9-AWA-AFS-BasicMed@faa.gov.

SUPPLEMENTARY INFORMATION: 

I. Executive Summary

    The Federal Aviation Administration (FAA) Extension, Safety, and 
Security Act of 2016 (Pub. L. 114-190) (FESSA) was enacted on July 15, 
2016. Section 2307 of FESSA, Medical Certification of Certain Small 
Aircraft Pilots, directed the FAA to ``issue or revise regulations to 
ensure that an individual may operate as pilot in command of a covered 
aircraft'' without having to undergo the medical certification process 
under 14 CFR part 67 if the pilot and aircraft meet certain prescribed 
conditions as outlined in FESSA. The FAA is amending parts 61 and 91 
and creating a new part 68 to conform to this legislation.
    This final rule implements, without interpretation, the 
requirements of section 2307 of FESSA. This rule reiterates the 
provisions of section 2307 of FESSA and describes how the FAA is 
implementing those provisions.

II. Legal Authority and Administrative Procedure Act

A. Authority for This Rulemaking

    The FAA's authority to issue rules on aviation safety is found in 
Title 49 of the United States Code (49 U.S.C.). Subtitle I, Section 106 
describes the authority of the FAA Administrator. Subtitle VII, 
Aviation Programs, describes in more detail the scope of the agency's 
authority.
    This final rule is promulgated under the authority described in 
Subtitle VII, Part A, Subpart iii, section 44701, General Requirements; 
section 44702, Issuance of Certificates; and section 44703, Airman 
Certificates. Under these sections, the FAA is charged with prescribing 
regulations and minimum standards for practices, methods, and 
procedures the Administrator finds necessary for safety in air 
commerce. The FAA is also authorized to issue certificates, including 
airman certificates and medical certificates, to qualified individuals. 
This rule is within the scope of that authority.
    This rule is further promulgated under section 2307 of Public Law 
114-190, the FAA Extension, Safety and Security Act of 2016. Section 
2307, Medical Certification of Certain Small Aircraft Pilots, provides 
the requirements and terms of this rule.

B. Administrative Procedure Act

    The Administrative Procedure Act (5 U.S.C. 553(b)(3)(B)) requires 
an agency to conduct notice and comment rulemaking except when the 
agency for good cause finds (and incorporates the finding and a brief 
statement of reasons therefor in the rules issued) that notice and 
public procedure thereon are impracticable, unnecessary, or contrary to 
the public interest. The FAA finds that notice and the opportunity to 
comment are unnecessary and contrary to the public interest in this 
action because the FAA has simply adopted the statutory language 
without interpretation and is implementing that language directly into 
the regulations. The FAA further finds that delaying implementation of 
this rule to allow for notice and comment would be contrary to the 
public interest as to do so would delay the new privileges Congress 
sought to provide.

III. Background

A. Current Situation

    In general, a person may serve as a required pilot flightcrew 
member of an aircraft only if that person holds the appropriate medical 
certificate.\1\ 14 CFR 61.3(c)(1). There are a few exceptions to this 
requirement, such as for pilots flying gliders, balloons, and/or light-
sport aircraft. 14 CFR 61.3(c)(2).
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    \1\ When referring to a ``medical certificate'' in this final 
rule, the FAA is referring only to a current and valid first-, 
second-, or third-class FAA airman medical certificate issued under 
14 CFR part 67, which may have been issued under an authorization 
for special issuance (``special issuance medical certificate'').
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    A medical certificate provides validation that a person meets FAA 
medical certification requirements. Title 14, Code of Federal 
Regulations (14 CFR) part 67 provides for the issuance of three classes 
of medical certificates--first-, second-, and third-class medical 
certificates.\2\ At minimum, a third-class medical certificate is 
required for operations requiring a private pilot certificate, a 
recreational pilot certificate, a flight instructor certificate (when 
acting as pilot in command or serving as a required flight crewmember 
in operations other than glider or balloon), or a student pilot 
certificate. An applicant who is found to meet the appropriate medical 
standards,\3\ based on a medical examination and an evaluation of the 
applicant's history and condition, is entitled to a medical certificate 
without restriction or limitation.
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    \2\ In most cases, a first-class medical certificate is required 
for operations requiring an airline transport pilot (ATP) 
certificate. At minimum, a second-class medical certificate is 
required for operations requiring a commercial pilot certificate. 
The requirement to hold a first or second class medical certificate 
when exercising the privileges of a commercial or airline transport 
pilot certificate is not changed by this rulemaking.
    \3\ Part 67 contains the requirements for medical standards and 
certification.
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    A person obtains a medical certificate by completing an online 
application (FAA form 8500-8, Application for Medical Certificate) 
using the FAA's medical certificate application tool, MedXPress, on the 
FAA Web site and undergoing a physical examination with an FAA-
designated Aviation Medical Examiner (AME). The majority of applicants 
are issued an unrestricted medical certificate by an AME. An AME may 
defer an applicant to the FAA for further review (which may include 
further examination by a specialist physician) when there is 
information indicating the existence or potential of an adverse medical 
finding that may warrant further FAA medical evaluation and oversight. 
Title 14 CFR 61.23 specifies the duration of validity for unrestricted 
medical certificates based on the applicant's age on the date of 
examination. For third-class medical certificates, certificates for 
airmen under age 40 are valid for 5 years and for airmen age 40 and 
over are valid for 2 years.

B. Section 2307, Medical Certification of Certain Small Aircraft Pilots

    Section 2307, Medical Certification of Certain Small Aircraft 
Pilots, provides that, within 180 days of enactment of Public Law 114-
190, the FAA Extension, Safety and Security Act of 2016, the 
Administrator of the FAA shall issue or revise regulations to ensure 
that an individual may operate as pilot in command of a covered 
aircraft if certain provisions stipulated in section 2307 of FESSA are 
met. Those provisions, discussed further below, include requirements 
for the person to:
     Possess a valid driver's license;
     Have held a medical certificate at any time after July 15, 
2006;
     Have not had the most recently held medical certificate 
revoked, suspended, or withdrawn;

[[Page 3151]]

     Have not had the most recent application for airman 
medical certification completed and denied;
     Have taken a medical education course within the past 24 
calendar months;
     Have completed a comprehensive medical examination within 
the past 48 months;
     Be under the care of a physician for certain medical 
conditions;
     Have been found eligible for special issuance of a medical 
certificate for certain specified mental health, neurological, or 
cardiovascular conditions;
     Consent to a National Driver Register check;
     Fly only certain small aircraft, at a limited altitude and 
speed, and only within the United States;
     Not fly for compensation or hire.
    The FAA notes that the use of this rule by any eligible pilot is 
voluntary. Persons may elect to use this rule or may continue to 
operate using any valid FAA medical certificate.\4\ The FAA recognizes 
that a pilot who holds a medical certificate may choose to exercise 
this rule and not to exercise the privileges of his or her medical 
certificate. Even though a pilot chooses not to exercise the privileges 
of the medical certificate for a particular operation, the FAA retains 
the authority to pursue enforcement action to suspend or revoke that 
medical certificate where there is evidence that the pilot does not 
meet the FAA's medical certification standards. 49 U.S.C. 44709(a).
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    \4\ Section 2307(k) states the provisions and requirements of 
the section do not apply to anyone who elects to operate under Sec.  
61.23(b) and (c)--which govern operations not requiring a medical 
certificate and operations requiring either a medical certificate or 
U.S. driver's license, respectively. Because this final rule amends 
Sec.  61.23(c) to include the relief outlined in FESSA, the 
reference to Sec.  61.23(c) in section 2307(k) applies to that 
section as it was written at the time the legislation was enacted.
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IV. Pilot Requirements of Section 2307 of FESSA

    Section 2307(a)(1) through (7) contains several requirements the 
pilot must meet in order to act as pilot-in-command (PIC) of a covered 
aircraft. The FAA is implementing those requirements by revising Sec.  
61.23(c)(1) and by adding new Sec.  61.23(c)(3).\5\ The following 
sections discuss the pilot requirements of section 2307 and the FAA's 
implementation of those requirements in more detail.
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    \5\ Section 61.23(c) currently addresses operations that may be 
conducted using either a medical certificate or a U.S. driver's 
license.
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A. Applicability of Section 2307

    Section 2307(a) states that an ``individual'' may operate as PIC of 
a covered aircraft in accordance with the requirements of FESSA. Thus, 
the privileges of this rule are not limited to persons holding a 
private pilot certificate; it also applies to persons exercising 
student pilot, recreational pilot, and private pilot privileges and to 
persons exercising flight instructor privileges when acting as PIC.\6\ 
Accordingly, Sec. Sec.  61.3 and 61.23 indicate that persons exercising 
the privileges of these certificates may act as PIC of an operation 
conducted under the conditions and limitations set forth in Sec.  
61.113.\7\ However, persons exercising privileges of a student pilot or 
recreational pilot certificate must continue to operate consistent with 
the limitations on their certificate.\8\ The FAA is therefore adding 
new Sec. Sec.  61.89(d) and 61.101(k) to make clear that while 
individuals exercising the privileges of a student pilot or 
recreational pilot certificates may operate under Sec.  61.113(i), they 
must comply with the limitations in Sec. Sec.  61.89 and 61.101, as 
applicable, when those limitations conflict with Sec.  61.113(i). 
Individuals holding a private pilot certificate issued on the basis of 
a foreign pilot license under Sec.  61.75 may also operate under this 
rule, provided they meet the requirements of Sec. Sec.  61.23(c)(3) and 
61.113(i). However, an individual who is applying for a U.S. private 
pilot certificate under Sec.  61.75 is still required to hold a medical 
certificate issued under part 67 or a medical license issued by the 
country that issued the person's foreign pilot license.\9\ Section 2307 
does not apply to persons exercising privileges of a commercial pilot 
certificate or an airline transport pilot certificate because section 
2307 prohibits operations for compensation or hire.\10\ Persons 
exercising privileges of a commercial pilot or ATP certificate must 
continue to hold a first or second class medical certificate in 
accordance with Sec.  61.23(a)(1) and (2).
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    \6\ The FAA has found that, in conducting flight training, the 
PIC is not carrying passengers or property for compensation or hire, 
nor is acting as PIC of an aircraft for compensation or hire. Final 
Rule, ``Pilot, Flight Instructor, Ground Instructor, and Pilot 
School Certification Rules,'' 62 FR 16220, at 16242 (Apr. 4, 1997).
    \7\ Section 61.113(i) contains the operating requirements of 
section 2307. Section 61.23(a)(3) requires a person to hold a third 
class medical certificate when taking a practical test in an 
aircraft for a recreational pilot, private pilot, commercial pilot, 
or airline transport pilot certificate, or for a flight instructor 
certificate. Accordingly, this rule contains a conforming amendment 
to allow these pilots to operate under the conditions and 
limitations of Sec.  61.113(i) when taking a practical test.
    \8\ Section 61.89 contains the general limitations of a student 
pilot. Section 61.101 contains the privileges and limitations for 
recreational pilots.
    \9\ Under Sec.  61.75(b), a person who holds a foreign pilot 
license issued by a contracting State to the Convention on 
International Civil Aviation may be issued a U.S. private pilot 
certificate based on the foreign pilot license without any further 
showing of proficiency, provided the applicant meets the 
requirements of Sec.  61.75. One of these requirements is to hold a 
medical certificate issued under part 67 or a medical license issued 
by the country that issued the person's foreign pilot license. 14 
CFR 61.75(b)(4).
    \10\ The FAA notes that Sec.  61.113 provides that certain 
activities conducted by a private pilot acting as PIC are excepted 
from the general prohibition on operations conducted for 
compensation or hire. These activities are listed in Sec.  
61.113(b)-(h). Although the FAA considers these activities to be 
operations involving compensation or hire, the compensation or hire 
exceptions for these operations permit these operations to be 
conducted under this rule.
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B. Valid Driver's License (Sec.  61.23(c)(1) and (c)(3))

    Section 2307(a)(1) of FESSA requires that, to be eligible to act as 
PIC without a medical certificate, an individual possess a valid 
driver's license issued by a State, territory, or possession of the 
United States and comply with all medical requirements or restrictions 
associated with that license. As with other FAA regulations, the FAA 
interprets ``valid driver's license'' to mean a current and valid U.S. 
driver's license. Each State will determine what, if any, medical 
requirements or restrictions are necessary and associated with each 
driver's license issued.
    The FAA is implementing section 2307(a)(1) by revising Sec.  
61.23(c)(1) and by adding new Sec.  61.23(c)(3). The FAA is adding 
paragraphs (v) and (vi) to Sec.  61.23(c)(1) to require a person 
exercising a student pilot certificate, recreational pilot certificate, 
private pilot certificate, or flight instructor certificate (while 
acting as the pilot in command or as a required flight crewmember) to 
hold and possess either a medical certificate or a driver's license 
issued by a State, territory, or possession of the U.S. when operating 
under this rule. Additionally, the FAA is adding new Sec.  61.23(c)(3) 
to require a person using a U.S. driver's license to meet the 
requirements of Sec.  61.23(c)(1) while operating under section 2307 of 
FESSA to comply with all medical requirements or restrictions 
associated with his or her U.S. driver's license.
    The FAA notes that, while some pilots use an official passport as a 
valid form of photo identification under Sec.  61.3(a)(2), it does not 
meet the requirements of section 2307(a)(1) of FESSA. All pilots, 
including pilots who were issued U.S. private pilot certificates in 
accordance with Sec.  61.75,

[[Page 3152]]

must hold a U.S. driver's license to operate under this rule. An 
international driver's license or any driver's license issued by a 
country or territory other than the United States does not suffice to 
meet this requirement.
    Individuals who do not have a medical certificate and whose 
driver's license has been revoked or rescinded for any reason are not 
eligible to use this rule, unless and until the driver's license is 
reinstated. Any restrictions on a driver's license (e.g., corrective 
lenses, prosthetic aids required, daylight driving only) also apply 
under this rule.
    Since FESSA requires the individual to possess a driver's license, 
pilots are required to have the driver's license in their personal 
possession when operating using this rule.

C. Medical Certificate Issued by the FAA (Sec.  61.23(c)(3)(i)(B))

    Section 2307(a)(2) of FESSA requires that the individual (1) hold a 
medical certificate issued by the FAA on the date of enactment of 
Public Law 114-190, (2) have held a medical certificate at any point 
during the 10-year period preceding the date of enactment, or (3) 
obtain a medical certificate after the date of enactment. Because 
Public Law 114-190 was signed into law on July 15, 2016,\11\ the FAA 
calculates the 10-year period preceding the date of enactment as 
beginning on July 15, 2006. Thus, at any point after July 14, 2006, a 
person must have held a medical certificate issued under part 67. The 
FAA is implementing this requirement in Sec.  61.23(c)(3)(i)(B).
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    \11\ Public Law 114-190.
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    Consistent with section 2307(a)(3) of FESSA, the medical 
certificate required under Sec.  61.23(c)(3)(i)(B) may have been a 
first-, second-, or third-class medical certificate, including a 
medical certificate issued under an authorization for special issuance 
(``special issuance medical certificate'').
    A person who has not held a medical certificate at any point after 
July 14, 2006, must obtain a medical certificate issued under part 67. 
After that medical certificate expires, that person may use, or 
continue to use, the alternative pilot physical examination and 
education requirements, provided that person meets the other conditions 
and limitations.
    For individuals relying on an already expired certificate, a person 
should use the date that his or her most recent medical certificate 
expired to determine whether it meets the 10-year period look-back 
described in FESSA. Special-issuance medical certificates are always 
time-limited and will explicitly state the date when the certificate 
expires or is no longer valid. Therefore, any special-issuance medical 
certificate with an expiration date on or after July 15, 2006, would 
meet the 10-year look-back requirement.
    Unrestricted (``regular issuance'') medical certificates do not 
list a specific expiration date. Therefore, persons with an 
unrestricted FAA medical certificate should refer to the ``Date of 
Examination'' displayed on the certificate, and then use Sec.  61.23(d) 
to determine when it expired for operations requiring a third-class 
medical certificate.\12\ The expiration date is based on a person's age 
on the date of the examination as calculated from his or her date of 
birth (i.e., ``under age 40'' vs. ``age 40 and over''). For example, a 
person born on January 2, 1963 would be ``under age 40'' if the date of 
examination was January 1, 2003, but would be ``age 40 and over'' if 
the examination occurred one day later on January 2, 2003. The FAA 
advises individuals to carefully review Sec.  61.23(d), which specifies 
the duration of medical certificates.\13\
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    \12\ The FAA notes that a first or second class medical 
certificate lapses into a third class medical certificate when it 
exceeds the duration period for first or second class medical 
certificates under Sec.  61.23(d). For example, for a pilot under 
the age of 40, a first class medical certificate expires on the 12th 
month after the month of the date of examination shown on the 
medical certificate. Upon the date of expiration for a first class 
medical certificate, the certificate would lapse into a third class 
medical certificate.
    \13\ On July 24, 2008, the FAA published a final rule, 
``Modification of Certain Medical Standards and Procedures and 
Duration of Certain Medical Certificates,'' that extended the 
duration of certain medical certificates (73 FR 43059). Before the 
2008 final rule, first-class medical certificates had a maximum 
duration of 6 months, regardless of the person's age, while third-
class medical certificates had a maximum duration of 3 years for 
individuals under age 40. With publication of the final rule, the 
duration of first- and third-class medical certificates for 
individuals under age 40 was extended to 1 year for first-class 
medical certificates and 5 years for third-class medical 
certificates. For persons over age 40, the duration of first- and 
third-class medical certificates remained 6 months and 2 years, 
respectively.
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    Persons age 40 or over on the date of their examination would meet 
the 10-year period described in FESSA if their examination was on or 
after July 15, 2004. This date is based on the two-year validity period 
for third class medical certificates issued to persons age 40 or over. 
Persons under age 40 on the date of their examination would meet the 
10-year period described in FESSA if their examination was on or after 
July 15, 2003. This date is based on the three-year validity period for 
third class medical certificates issued to persons under 40 years of 
age that was in effect prior to 2008.\14\
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    \14\ Under the 2008 final rule that extended the duration of 
third class medical certificates for persons under the age of 40 
from three years to five years, the FAA construed the extended 
validity period as ``reviving'' expired medical certificates if 
those certificates would have been valid under the extended period. 
For example, a third-class medical certificate issued in 2004 (four 
years before the effective date of the 2008 rule) expired in 2007. 
When the 2008 final rule became effective, the FAA applied the new 
five-year duration to the expired certificate. Thus, the medical 
certificate was revived and remained valid until 2009.
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    Individuals operating under this rule are not required to carry or 
possess the expired medical certificate when operating under this rule.

D. Requirements of a Medical Certificate (Sec.  61.23(c)(3)(ii) and 
(iii))

    Section 2307(a)(3) of FESSA requires that the most recent medical 
certificate issued by the FAA to the individual: (1) Indicates whether 
the certificate is first-, second-, or third-class; (2) may include 
authorization for special issuance; (3) may be expired; (4) cannot have 
been revoked or suspended; and (5) cannot have been withdrawn.
    The requirement that the medical certificate indicate whether the 
certificate is first-, second-, or third-class is captured in Sec.  
61.23(c)(3)(i)(B), which requires the medical certificate to have been 
issued under part 67.\15\ The FAA is implementing the remaining 
requirements of section 2307(a)(3) in Sec.  61.23(c)(3)(ii) and (iii). 
Accordingly, Sec.  61.23(c)(3)(ii) now states that the most recently 
issued medical certificate: (1) May include an authorization for 
special issuance; (2) may be expired; and (3) cannot have been 
suspended, revoked, or withdrawn.
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    \15\ Under part 67, a person may be issued a first-, second-, or 
third-class medical certificate.
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    Thus, the most recently issued medical certificate, which the 
person must have held at any point after July 14, 2006, may have been a 
special issuance medical certificate and may be expired. However, it 
may not have been suspended or revoked, or in the case of an 
authorization for a special issuance (i.e., a restricted medical 
certificate), it may not have been withdrawn. Unrestricted medical 
certificates can be suspended or revoked if the certificate holder does 
not meet the medical standards of part 67 or as the result of 
noncompliance with other regulatory requirements. The FAA may also 
suspend or revoke a medical certificate on the basis of a reexamination 
of that certificate under section 44709 of Title 49 of the United 
States Code.
    Section 2307 of FESSA states that the medical certificate ``cannot 
have been revoked or suspended.'' Accordingly, if

[[Page 3153]]

a person's most recently issued medical certificate has been suspended 
or revoked, the person must apply for and be issued a new medical 
certificate prior to using the privileges afforded under this rule. 
This holds true even if the medical certificate was suspended and 
reinstated because FESSA expressly states that the certificate ``cannot 
have been . . . suspended.'' \16\ Therefore, if a person's last medical 
certificate was under suspension at any point in time that medical 
certificate cannot be used for relief under this rule.
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    \16\ If a person's medical certificate is suspended, modified, 
or revoked under Sec.  67.413(b), that suspension or modification 
remains in effect until the person provides the requested 
information, history, or authorization to the FAA and until the FAA 
determines that the person meets the medical standards set forth in 
part 67. 14 CFR 67.413(c).
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    Further, if the person's medical certificate expired while under 
suspension, the person must apply for and be issued a new medical 
certificate to use the privileges of this rule. This requirement is 
based on the language in FESSA stating that the certificate ``cannot 
have been suspended.'' The fact that the certificate expired while 
under suspension does not change the fact that it was suspended (for 
purposes of exercising relief under this rule).
    Finally, Sec.  2307 requires that the most recently issued medical 
certificate ``cannot have been withdrawn.'' The FAA notes that 
unrestricted medical certificates may be denied, suspended, or revoked 
and authorizations for special issuances (i.e., restricted medical 
certificates) may be denied or withdrawn. Accordingly, the requirement 
that the most recently issued authorization for special issuance cannot 
have been withdrawn is implemented in Sec.  61.23(c)(3)(iii).

E. Application for an Airman Medical Certificate (Sec.  
61.23(c)(3)(iv))

    Section 2307(a)(4) of FESSA requires that the most recent 
application for airman medical certification submitted to the FAA by 
the individual cannot have been completed and denied. The FAA is 
implementing this requirement in Sec.  61.23(c)(3)(iv).
    Consistent with the Guide for Aviation Medical Examiners and online 
information on the Aerospace Medical Certification Subsystem (AMCS), 
the FAA considers an application to be completed once the AME imports 
the individual's MedXPress application data into AMCS.\17\ If an 
individual submits a MedXpress application but the information is never 
imported into AMCS by an AME (e.g., the individual never makes an 
appointment or does not show up for the appointment), then the un-
imported application would not be completed and, as such, the FAA would 
have no basis to make a denial or other certification action.\18\ 
Therefore, any un-imported application would not be subject to the 
portion of section 2307 relating to ``completed and denied'' 
applications, and the individual would look to the most recent 
application where the FAA either issued or denied a medical certificate 
in order to determine eligibility under this rule.
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    \17\ ``Information for Aviation Medical Examiners Processing 
MedXPress Applications'' instructs AMEs that ``MedX applications 
must be imported before the applicant leaves your [the AME's] 
office'' and ``As soon as you [the AME] import an application into 
AMCS, it is a signed FAA form and should be treated accordingly.'' 
(https://www.faa.gov/other_visit/aviation_industry/designees_delegations/designee_types/ame/amcs/media/MedXPress%20AME%20Procedures_Jan%202012.pdf.)
    \18\ When an individual does not follow up a MedXPress 
application by presenting to an AME for an examination, the data 
entered through MedXPress system remains valid for 60 days, after 
which the application expires and is deleted from the MedXPress 
system. (https://www.faa.gov/other_visit/aviation_industry/designees_delegations/designee_types/ame/amcs/media/MedXPress%20AME%20Procedures_Jan%202012.pdf.)
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    After importing a MedXPress application into AMCS, the AME may take 
one of three actions on the completed application. The AME may: (1) 
Issue a medical certificate; (2) defer issuance to the FAA; or (3) deny 
the issuance of a medical certificate. Guidance to AMEs makes clear 
that once the AME has imported the individual's application in 
MedXpress, the AME is required to transmit the application to the 
FAA,\19\ regardless of whether (a) the applicant leaves the AME office 
in the middle of the examination, (b) all elements of the AME's 
examination have been accomplished, or (c) the applicant does/does not 
provide all additional information required by the AME or the FAA.\20\ 
Whenever an AME defers an examination, the FAA makes a determination on 
that application (denial or issuance).
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    \19\ The AME Guide states that all completed applications and 
medical examinations, unless otherwise directed by the FAA, must be 
transmitted electronically via AMCS within 14 days after completion 
to the AMCD (https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/app_process/general/disposition/.
    \20\ The AME Guide states that, when an applicant is advised by 
an Examiner that further examination and/or medical records are 
needed, the applicant may elect not to proceed. The Examiner is 
directed to note this in Block 60 [of the FAA form 8500-8, 
Application for medical certificate]. No certificate should be 
issued, and the Examiner should forward the application form to the 
AMCD, even if the application is incomplete. (https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/app_process/app_review/item62/.)
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    An individual's application is considered completed and denied and 
that individual is unable to use the privileges of this rule when:
    (1) An AME denies an application immediately after completing the 
examination and the FAA does not reverse that decision.
    (2) The FAA denies the application after the applicant has been 
deferred by the AME.
    (3) A denied application remains under judicial appeal (e.g., to 
the National Transportation Safety Board), since no valid medical 
certificate has been issued.
    Additionally, if a person held a medical certificate within the 10-
year period preceding July 15, 2016, but subsequently submitted a new 
application that was completed and denied, that person could not revert 
to the previous medical certificate meeting the 10-year look back 
requirement. That person would need to re-apply and be issued a new 
medical certificate to use the privileges of this rule.

F. Completion of Medical Education Course (Sec.  61.23(c)(3)(i)(C))

    Section 2307(a)(5) of FESSA requires the individual to have 
completed a medical education course during the 24 calendar months 
before acting as pilot in command of a covered aircraft and demonstrate 
proof of completion of the course. The FAA notes that section 2307(c) 
prescribes the medical education course requirements, which are 
implemented in new part 68 and discussed in section VI of this 
preamble.
    Section 61.23(c)(3)(i)(C) implements the requirement to have 
completed the medical education course during the 24 calendar months 
before acting as PIC of an operation under Sec.  61.113(i).\21\ The 
term ``24 calendar months'' as used throughout 14 CFR means ``24 unit 
months,'' and ``unit months'' is defined as beginning on the first of 
the month and ending on the last day of the month.\22\ Thus, a pilot 
has from the beginning of the 24th calendar month before the month in 
which he or she wants to act as PIC of an operation under Sec.  
61.113(i) to complete the medical education course. For example, if a 
pilot wants to act as PIC of an operation under Sec.  61.113(i) on 
August 19, 2019, that pilot must have, since August 1, 2017, completed 
the medical education course.
---------------------------------------------------------------------------

    \21\ Section 61.113(i) implements the operating requirements of 
section 2307 of the Act.
    \22\ Legal Interpretation to Mr. Sean Conlin (Feb. 24, 2000).

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[[Page 3154]]

G. Care and Treatment by a Physician (Sec.  61.23(c)(3)(i)(E))

    Section 2307(a)(6) of FESSA requires that the individual, when 
serving as PIC, is under the care and treatment of a physician if the 
individual has been diagnosed with any medical condition that may 
impact the ability of the individual to fly. This requirement is 
implemented in Sec.  61.23(c)(3)(i)(E).

H. Receipt of Medical Exam During the Previous 48 Months (Sec.  
61.23(c)(3)(i)(D))

    Section 2307(a)(7) of FESSA requires the individual to have 
received a comprehensive medical examination from a State-licensed 
physician during the previous 48 months. This requirement is 
implemented in Sec.  61.23(c)(3)(i)(D). The FAA notes that section 
2307(a)(7) contains additional requirements regarding the comprehensive 
medical examination. Those additional requirements are implemented in 
new part 68 and discussed in section VII of this preamble.
    In implementing section 2307(a)(7), the FAA notes that section 
2307(a)(5) uses the term ``calendar months'' and section 2307(a)(7) 
uses the term ``months.'' As evident from a legal interpretation issued 
on February 24, 2000,\23\ the FAA interprets the terms ``calendar 
months'' and ``months'' differently. The term ``calendar months'' means 
``unit months,'' as previously discussed, which is defined as beginning 
on the first day of the month and ending on the last day of the month. 
The term ``months,'' however, means months from the exact date at 
issue. For example, under Sec.  61.23(c)(3)(i)(D), if an individual 
wants to act as PIC of an operation under Sec.  61.113(i) on July 19, 
2021, that individual must have received a comprehensive medical 
examination on or after July 19, 2017.
---------------------------------------------------------------------------

    \23\ Id.
---------------------------------------------------------------------------

V. Covered Aircraft Requirements and Operating Requirements

    Section 2307(j) of FESSA contains the covered aircraft requirements 
and section 2307(a)(8) contains the operating requirements. The FAA is 
implementing these requirements in new Sec.  61.113(i).\24\ The 
following sections discuss the FAA's implementation of the covered 
aircraft and operating requirements in more detail.
---------------------------------------------------------------------------

    \24\ Section 61.113 currently addresses private pilot privileges 
and limitations.
---------------------------------------------------------------------------

A. Covered Aircraft Requirements of Section 2307 of FESSA

    Throughout section 2307, FESSA refers to a ``covered aircraft.'' 
Section 2307(j) of FESSA defines a covered aircraft as an aircraft that 
(1) is authorized under Federal law to carry not more than 6 occupants; 
and (2) has a maximum certificated takeoff weight of not more than 
6,000 pounds.
    The FAA is implementing these requirements for type certificated 
aircraft in Sec.  61.113(i)(1). For type certificated aircraft, the 
aircraft's design approval would authorize the number of occupants the 
aircraft may carry and would contain the maximum certificated takeoff 
weight. The aircraft's design approval may be a type certificate (TC), 
a supplemental type certificate (STC), or an amended type certificate 
(ATC). The FAA recognizes that changes could be made to an aircraft's 
type design. For example, an aircraft type certificated to carry more 
than 6 occupants may be altered to carry 6 or less occupants. In order 
to make such a change, that aircraft would have to obtain a new design 
approval, such as an STC or an ATC. So long as an aircraft's design 
approval (i.e., TC, STC, or ATC) authorizes the aircraft to carry no 
more than 6 occupants, that aircraft would meet the requirement of 
section 2307(j)(1). Additionally, if an aircraft with a maximum 
certificated takeoff weight of more than 6,000 pounds is altered to 
have a maximum certificated takeoff weight of less than 6,000 pounds, 
that aircraft would meet the requirement of section 2307(j)(2).
    The FAA is implementing the requirements of section 2307(j) for 
experimental aircraft by adding paragraph (j) to Sec.  91.319. 
Experimental aircraft, which are not type certificated, are issued 
special airworthiness certificates. The FAA prescribes operating 
limitations to accompany the special airworthiness certificates. 
Additionally, Sec.  91.319 prescribes operating limitations for 
aircraft having experimental certificates. Consistent with section 
2307(j) of FESSA, Sec.  91.319(j) states that no person may operate an 
aircraft that has an experimental certificate under Sec.  61.113(i) 
unless the aircraft is carrying not more than 6 occupants. The FAA is 
adding this paragraph to make clear that experimental aircraft meet the 
requirements for covered aircraft under this rule.
    The FAA notes that the maximum takeoff weight of an experimental 
aircraft is determined as part of the special airworthiness 
certification process. Prior to issuing a special airworthiness 
certificate, the FAA checks the current weight and balance information 
for an aircraft, which includes the maximum gross weight established by 
the operator.
    While a person may operate an aircraft that meets the requirements 
of section 2307(j) under this rule, the FAA notes that section 2307 
does not relieve an aircraft from the requirement to be operated in 
accordance with its operating limitations.\25\ Accordingly, if an 
aircraft being operated under this rule has any operating limitations 
that conflict with Sec.  61.113(i),\26\ that aircraft must comply with 
its operating limitations.
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    \25\ 14 CFR 91.9(a).
    \26\ As noted previously, Sec.  61.113(i) implements the covered 
aircraft requirements and operating requirements of the Act.
---------------------------------------------------------------------------

B. Operating Requirements of Section 2307 of FESSA

    Section 2307(a)(8) of FESSA requires that the individual operate in 
accordance with the following operating requirements:
     The covered aircraft is carrying not more than 5 
passengers.
     The individual is operating the covered aircraft under 
visual flight rules or instrument flight rules.
     The flight, including each portion of that flight, is not 
carried out--
     for compensation or hire, including that no passenger or 
property on the flight is being carried for compensation or hire;
     at an altitude that is more than 18,000 feet above mean 
sea level;
     outside the United States, unless authorized by the 
country in which the flight is conducted; or
     at an indicated airspeed exceeding 250 knots.
    The following sections discuss the FAA's implementation of these 
requirements in more detail.
1. The Covered Aircraft Is Carrying Not More Than 5 Passengers
    Section 2307(a)(8)(A) of FESSA requires that the covered aircraft 
carry no more than five passengers. This requirement is implemented in 
Sec.  61.113(i)(1).
    As previously discussed, section 2307(j) of FESSA requires the 
covered aircraft to be authorized to carry no more than six occupants. 
While section 2307(j) and section 2307(a)(8)(A) may appear to conflict, 
the FAA notes that it interprets the terms ``occupants'' and 
``passengers'' differently. The term ``occupants'' includes all persons 
onboard an aircraft including any required flightcrew members.\27\ A 
flightcrew member is required if he or she is required by type 
certification of the aircraft or by regulation. The term

[[Page 3155]]

``passengers'' does not include required flight crewmembers. Therefore, 
under this rule, a covered aircraft may be authorized to carry up to 6 
occupants (including any required flight crewmembers) and may be 
operated with up to five passengers on board. For example, a person may 
operate an aircraft type certificated for one pilot flightcrew member 
under this rule with up to five additional occupants on board. An 
aircraft type certificated for two pilot flightcrew members may be 
operated under this rule with up to four additional occupants on 
board.\28\ An occupant in the aircraft (other than the pilot operating 
under this rule) may be a passenger, a required pilot flightcrew member 
(if the aircraft is type certificated for more than one pilot or if the 
regulations require more than one pilot), or a flight instructor (if 
the flight is a training operation). If a pilot operating an aircraft 
under this rule carries another pilot on board who is not a required 
pilot flightcrew member, that additional pilot would be a passenger 
under the FAA's regulations.
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    \27\ A flightcrew member means a pilot, flight engineer, or 
flight navigator assigned to duty in an aircraft during flight time. 
14 CFR 1.1
    \28\ An operation requiring two pilots could not carry five 
passengers under Sec.  2307(a)(8)(A) because it would exceed the 
number of occupants allowed under Sec.  2307(j). The FAA considers 
that, due to the limitations for maximum certificated takeoff 
weight, all, or nearly all, covered aircraft will require only a 
single pilot.
---------------------------------------------------------------------------

    The operations under this rule include training operations. As 
such, a person may receive flight training from an FAA-authorized 
flight instructor while the person receiving flight training is acting 
as PIC and operating under this rule. Alternatively, an individual may 
receive flight instruction from a flight instructor while the flight 
instructor is acting as PIC and operating under this rule.
    This rule is applicable only to the person acting as the PIC. Thus, 
for any flight operated under this rule, the status of the medical 
certificate of any other pilot aboard who is not acting as the PIC is 
irrelevant. For example, flight instructors meeting the requirements of 
this rule may act as PIC while giving flight training without holding a 
medical certificate, regardless of whether the person receiving flight 
training holds a medical certificate. While flight training for 
compensation is considered ``other commercial flying'' for flight and 
duty requirements under parts 121 and 135,\29\ ``a certificated flight 
instructor who is acting as PIC and is receiving compensation for his 
or her flight instruction is exercising flight instructor privileges 
for the flight training being provided and is exercising private pilot 
privileges while acting as PIC of the flight.'' \30\
---------------------------------------------------------------------------

    \29\ Legal Interpretation to Richard Martindell (March 11, 
2009); Legal Interpretation to Arturo Rodriguez (July 2, 2012).
    \30\ Pilot, Flight Instructor, Ground Instructor, and Pilot 
School Certification Rules, 62 FR 16220 (Apr. 4, 1997).
---------------------------------------------------------------------------

2. Operate the Aircraft Under Visual Flight Rules or Instrument Flight 
Rules
    Section 2307(a)(8)(B) of FESSA permits an operation under that 
section to be conducted under visual flight rules or instrument flight 
rules. An individual operating under this rule may, therefore, conduct 
the flight in visual meteorological conditions or instrument 
meteorological conditions. The FAA notes, however, that FESSA does not 
relieve an individual from the requirement to hold an instrument rating 
and be instrument current to act as PIC under instrument flight rules. 
Nor does FESSA relieve an aircraft from the requirement to be approved 
for IFR operations in order to be operated under instrument flight 
rules.
3. The Flight, Including Each Portion of the Flight
    Section 2307(a)(8)(C) requires that the flight, including each 
portion of the flight, is not carried out: (i) For compensation or 
hire, including that no passenger or property on the flight is being 
carried for compensation or hire; (ii) at an altitude that is more than 
18,000 feet above mean sea level; (iii) outside the United States, 
unless authorized by the country in which the flight is conducted; or 
(iv) at an indicated air speed exceeding 250 knots.
    Because the statute includes the phrase ``. . . flight, including 
each portion of the flight,'' all of the limitations for the operation 
set forth in section 2307(a)(8)(C)(i)-(iv) (i.e. compensation/hire 
prohibition, altitude, geographic, and airspeed limitations) apply to 
the entire flight. Accordingly, if this rule is being exercised in any 
flight, it must be applied for the entire flight (takeoff to full-stop 
landing) and all the operational restrictions apply for the entire 
flight. The FAA is implementing the requirements of section 
2307(a)(8)(C)(i)-(iv) in Sec.  61.113(i)(2)(i)-(iv). These requirements 
are discussed in more detail below.
i. Flight Is Not Conducted for Compensation or Hire
    Section 2307(a)(8)(C)(i) of FESSA requires that the flight, 
including each portion of that flight, is not carried out for 
compensation or hire, including that no passenger or property on the 
flight is being carried for compensation or hire. Section 61.113(a) 
already prohibits private pilots from acting as PIC of an aircraft that 
is carrying passengers or property for compensation or hire and from 
acting as PIC for compensation or hire. Accordingly, this FESSA 
requirement is already addressed by the existing regulation.
ii. Altitude Restriction
    Section 2307(a)(8)(C)(ii) of FESSA requires that the flight, 
including each portion of that flight, is not carried out at an 
altitude that is more than 18,000 feet above mean sea level (MSL). This 
requirement is implemented in Sec.  61.113(i)(2)(ii).
    For pilots operating aircraft capable of flight above 18,000 feet 
MSL, the pilot's preflight planning must accommodate the altitude 
limitation. For instance, if weather phenomena like icing or 
thunderstorms are forecast (or is within reasonable possibility) within 
the pilot's route of flight that would necessitate climbing above 
18,000 feet MSL, the FAA considers initiating such a flight to be 
contrary to this rule. The aircraft must operate at or below 18,000 
feet MSL during the entire flight.
iii. Geographic Restriction
    Section 2307(a)(8)(C)(iii) of FESSA requires that the flight, 
including each portion of that flight is conducted within the United 
States, unless authorized by the country in which the flight is 
conducted. This requirement is implemented in Sec.  61.113(i)(2)(iii).
    Title 14 CFR 1.1 defines the United States as the States, the 
District of Columbia, Puerto Rico, and the possessions, including the 
territorial waters, and the airspace of those areas. Thus, a pilot 
operating in the United States, as defined in Sec.  1.1, may elect to 
use this rule.
    Airmen certificated by the FAA are represented to the International 
Civil Aviation Organization (ICAO) as compliant with ICAO standards for 
private pilots, among other requirements. As FESSA and this final rule 
describe standards that divert from ICAO requirements,\31\ flights must 
be geographically limited to operations within the United States.
---------------------------------------------------------------------------

    \31\ Annex 1 to the Convention on International Civil Aviation, 
``Personnel Licensing,'' Chapter 6 ``Medical Provisions for 
Licensing,'' 11th Edition (July 2011).
---------------------------------------------------------------------------

iv. Airspeed Restriction
    Section 2307(a)(8)(C)(iv) of FESSA requires that the flight, 
including each portion of that flight, is conducted at an indicated 
airspeed not exceeding 250 knots. The FAA is implementing this 
requirement in Sec.  61.113(i)(2)(iv).

[[Page 3156]]

    Recognizing that many aircraft have airspeed indicators that read 
in miles per hour (mph), 250 knots is equivalent to 288 mph. No 
aircraft may be operated in any phase of flight at an airspeed greater 
than 250 KIAS (knots indicated airspeed).

VI. Medical Education Course Requirements of Section 2307 of FESSA

    The following sections describe the medical education course 
requirements of section 2307 of FESSA and the FAA's implementation of 
those requirements.

A. Development and Availability of the Medical Education Course

    Section 2307(c)(1) requires the medical education course to be 
available on the internet free of charge. Section 2307(c)(2) requires 
the course to be developed and periodically updated in coordination 
with representatives of relevant nonprofit and not-for-profit general 
aviation stakeholder groups.
    To implement these requirements, the FAA will work with nonprofit 
and not-for-profit general aviation stakeholder groups to coordinate 
and develop a medical education course that meets the requirements of 
FESSA, which are discussed in more detail below. A nonprofit or not-
for-profit general aviation stakeholder group may submit a medical 
education course to the FAA for consideration. Upon receipt of the 
submission, the FAA will verify the course meets the requirements of 
Sec.  68.3. If the FAA accepts the course, the FAA will provide a link 
to the course on the FAA public Web site. Thus, for public awareness, 
the FAA's Web site will contain a list of each medical education course 
that the FAA has accepted.
    The FAA has determined that it is appropriate to enter into 
agreements with nonprofit or not-for-profit general aviation 
stakeholder groups who elect to provide the course.

B. Course Requirements

    Pursuant to the requirements of section 2307(c)(3) through (9) of 
FESSA, the course must:
     Educate pilots on conducting medical self-assessments;
     Advise pilots on identifying warning signs of potential 
serious medical conditions;
     Identify risk mitigation strategies for medical 
conditions;
     Increase awareness of the impacts of potentially impairing 
over-the-counter and prescription drug medications;
     Encourage regular medical examinations and consultations 
with primary care physicians;
     Inform pilots of the regulations pertaining to the 
prohibition on operations during medical deficiency and medically 
disqualifying conditions; and
     Provide the checklist developed by the Federal Aviation 
Administration in accordance with section 2307(b).
    The FAA is implementing these requirements in Sec.  68.3(a)(1)-(7). 
The FAA notes that the requirements for the checklist, which the course 
must provide, are implemented in Sec.  68.5.

C. Documents the Course Must Provide to the Individual and Transmit to 
the FAA

    Pursuant to the requirements of section 2307(c)(10) of FESSA, upon 
successful completion of the course, the medical education course must 
electronically provide to the individual and transmit to the FAA--
     A certification of completion of the medical education 
course;
     A release authorizing the National Driver Register through 
a designated State Department of Motor Vehicles to furnish to the FAA 
information pertaining to the individual's driving record;
     A certification by the individual that the individual is 
under the care and treatment of a physician if the individual has been 
diagnosed with any medical condition that may impact the ability of the 
individual to fly;
     A form that includes information regarding the individual, 
the physician, the comprehensive medical exam, and a certification by 
the individual that the checklist was followed and signed by the 
physician; and
     A statement signed by the individual certifying that the 
individual understands the existing prohibition on operations during 
medical deficiency. A copy of this signed statement must be provided to 
the pilot and retained by the pilot.
    These requirements are implemented in Sec.  68.3(b)(1)-(5) and are 
discussed in more detail below.
1. Certification of Completion
    Section 2307(c)(10)(A) requires the certification of completion of 
the medical education course to be printed and retained in the 
individual's logbook and made available upon request. This 
certification of completion must contain only the individual's name, 
address, and airman certificate number.\32\ The FAA is implementing 
this requirement in Sec.  68.3(b)(1).
---------------------------------------------------------------------------

    \32\ The term ``certification'' was used in the legislation. The 
FAA notes that this term may cause confusion with the general use of 
that term within FAA regulations. This document need only contain 
the information required by FESSA as set forth in Sec.  68.3(b)(1).
---------------------------------------------------------------------------

    The PIC must maintain the certification of completion along with 
his or her pilot logbook. The certification must be available along 
with the logbook at any time the pilot is presenting the logbook to 
comply with any regulatory requirement (such as applying for a 
certificate or rating), or upon request by a representative of the FAA 
Administrator. Under the terms of FESSA, there is no requirement for 
pilots to carry compliance documentation that shows their compliance 
with the relief described in this rule.
    The FAA recognizes that many pilots maintain logbooks 
electronically. Pilots may carry an electronic facsimile or 
representation of the certification along with their pilot logbook 
entries, as long as that representation of the certification is 
available and clearly legible when the logbook is being used to comply 
with a regulatory requirement or upon request by a representative of 
the FAA Administrator.
2. Authorization for Access to National Driver Register
    Section 2307(c)(10)(B) requires a release authorizing the National 
Driver Register through a designated State Department of Motor Vehicles 
to furnish to the FAA information pertaining to the individual's 
driving record. Section 2307(d) states that the authorization under 
section 2307(c)(10)(B) shall be an authorization for a single access to 
the information contained in the National Driver Register. The FAA is 
implementing these requirements in Sec.  68.3(b)(2).
    The National Driver Register (NDR) is a division in the National 
Center for Statistics and Analysis under the National Highway Traffic 
Safety Administration (NHTSA). The NDR maintains the computerized 
database known as the Problem Driver Pointer System (PDPS), which 
contains information on individuals whose privilege to operate a motor 
vehicle has been revoked, suspended, canceled or denied or who have 
been convicted of serious traffic-related offenses.
    Each time an individual indicates his or her consent for the NDR 
release, the FAA will conduct a single NDR check in an identical manner 
to the NDR check currently conducted when a person applies for a 
medical certificate. Similarly, the information the FAA receives from 
the NDR check will be used in the same way as for an applicant for a 
medical certificate.

[[Page 3157]]

3. Certification That the Individual Is Under the Care and Treatment of 
a Physician
    Section 2307(c)(10)(C) requires a certification by the individual 
that the individual is under the care and treatment of a physician if 
the individual has been diagnosed with any medical condition that may 
impact the ability of the individual to fly, as required by section 
2307(a)(6).\33\ This requirement is implemented in Sec.  68.3(b)(3).
---------------------------------------------------------------------------

    \33\ Section 2307(a)(6) requires the individual, when serving as 
PIC, to be under the care and treatment of a physician if the 
individual has been diagnosed with any medical condition that may 
impact the ability of the individual to fly. This requirement is 
implemented in Sec.  61.23(3)(i)(E).
---------------------------------------------------------------------------

    The FAA recognizes that there are many thousands of diagnosable 
medical conditions, as well as innumerable medical treatments and 
medications. Many conditions, treatments, or medications are unlikely 
to impact a person's ability to safely operate an aircraft. However, 
there are numerous conditions, treatments, and medications that are 
aviation safety risks. Potential adverse effects may result from sudden 
incapacitation (e.g., epilepsy, coronary artery disease, implantable 
cardioverter-defibrillators, etc.) or reduced cognitive, mental or 
physical abilities (e.g., visual impairments, neurological diseases, 
psychiatric diseases, diabetes or other metabolic diseases, sedative-
hypnotic medications, etc.). Each of these, independently or in 
combination, can adversely affect the pilot's ability to safely perform 
pilot duties and are a hazard to the national air space. Additionally, 
the adverse effects of many medical conditions and medications are 
exaggerated under typical flight conditions, including reduced air 
pressure, available oxygen, or acceleration forces. Pilots should 
consult with their physician or other medical care provider for care 
and treatment of their conditions, but also for guidance on the impact 
their conditions may have on flight safety. Pilots, in discussion with 
their physician/medical care provider, should also consult available 
aeromedical resources on the flight hazards associated with medical 
conditions/medications. The Do not Issue/Do not Fly list (www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/dni_dnf/) is readily available in the AME Guide on the FAA Web site. 
Chapter 8 of the FAA's Aeronautical Information Manual (AIM 8-1-1) also 
addresses medical factors for pilots. Additional resources include the 
FAA's AME Guide, other FAA flight safety Web sites, and the Web sites 
of non-profit and not-for-profit general aviation stakeholders.
    While the pilot is required to attest that he or she is under the 
care and treatment of a physician for any condition that affects safe 
flight, the FAA emphasizes that all pilots are expected to exercise 
good judgment (whether operating under this rule or not) and conduct a 
personal self-assessment of their condition before every flight.\34\ 
The FAA's recommended self-assessment guidance is found in the 
``IMSAFE'' checklist found in Chapter 8 of the FAA Aeronautical 
Information Manual at https://www.faa.gov/air_traffic/publications/media/aim.pdf.
---------------------------------------------------------------------------

    \34\ Section 61.53(c) requires that for operations provided for 
in Sec.  61.23(c), a person must meet the provisions of Sec.  
61.53(b). That paragraph states that a person shall not act as pilot 
in command, or in any other capacity as a required pilot flight 
crewmember, while that person knows or has reason to know of any 
medical condition that would make the person unable to operate the 
aircraft in a safe manner.
---------------------------------------------------------------------------

    The FAA notes that under section 2307(e) of FESSA, which prescribes 
requirements for the special issuance process, an individual clinically 
diagnosed with a mental health condition or a neurological condition 
shall certify every 2 years,\35\ in conjunction with the certification 
requirement of section 2307(c)(10)(C), that the individual is under the 
care of a State-licensed medical specialist for that mental health or 
neurological condition.\36\ The requirements for the special issuance 
process are discussed in section VIII of this preamble.
---------------------------------------------------------------------------

    \35\ The FAA notes that section 2307(e) uses the phrase ``two 
years'' when discussing the certifications made as part of the 
medical education course, whereas section 2307(c) uses the phrase 
``24 calendar months.'' For purposes of these certifications, the 
FAA anticipates that the certification will occur in conjunction 
with completion of the medical education course.
    \36\ Section 2307(e)(3) contains the special rules for mental 
health conditions. Section 2307(e)(4) contains the special rules for 
neurological conditions.
---------------------------------------------------------------------------

4. Form
    Section 2307(c)(10)(D) of FESSA requires the form, which must be 
electronically provided to the individual and transmitted to the FAA 
upon successful completion of the course, to include the following 
information:
     The name, address, telephone number, and airman 
certificate number of the individual;
     The name, address, telephone number, and State medical 
license number of the physician performing the comprehensive medical 
examination \37\ required in section 2307(a)(7);
---------------------------------------------------------------------------

    \37\ The FAA notes that the comprehensive medical examination 
occurs every 48 months while the medical education course must be 
completed every 24 calendar months. As such, a pilot may be 
reporting a medical exam that occurred 24 calendar months prior.
---------------------------------------------------------------------------

     The date of the comprehensive medical examination required 
in section 2307(a)(7); and
     A certification by the individual that the checklist 
described in subsection (b) was followed and signed by the physician in 
the comprehensive medical examination required in section 2307(a)(7).
    These requirements are implemented in Sec.  68.3(b)(4)(i)-(iv).
5. Certification Regarding the Prohibition on Operations During Medical 
Deficiency
    Section 2307(c)(10)(E) of FESSA requires the individual to sign 
\38\ a statement certifying that the individual understands the 
existing prohibition on operations during medical deficiency by 
stating: ``I understand that I cannot act as pilot in command, or any 
other capacity as a required flight crew member, if I know or have 
reason to know of any medical condition that would make me unable to 
operate the aircraft in a safe manner.'' This statement shall be 
electronically provided to the individual and transmitted to the FAA 
upon successful completion of the course. The FAA is implementing this 
requirement in Sec.  68.3(b)(5).
---------------------------------------------------------------------------

    \38\ Section 2307 indicates that the statement should be 
``printed and signed'' prior to being transmitted to the FAA. The 
FAA is construing this requirement to allow for electronic signature 
and electronic retention of this statement. See Government Paperwork 
Elimination Act (GPEA), Public Law 105-277 Title XVII.
---------------------------------------------------------------------------

    The Advisory Circular (AC) 68-1, Alternative Medical 
Qualifications, contains additional information about the medical 
education course requirements.

VII. Comprehensive Medical Examination

    In order to act as PIC under this rule, an individual must receive 
a comprehensive medical examination from a State-licensed physician 
during the previous 48 months in accordance with section 2307(a)(7). 
This requirement is reflected in Sec.  61.23(c)(3)(i)(D).
    Section 2307(a)(7)(A) requires that prior to the examination, the 
individual do the following: (1) Complete the individual's section of 
the medical examination checklist described in section 2307(b); and (2) 
provide the

[[Page 3158]]

completed checklist to the physician performing the examination. The 
FAA is implementing these requirements in Sec.  68.5(a)(1)-(2).
    Section 2307(a)(7)(B) of FESSA requires the physician to: (1) 
Conduct the comprehensive medical examination in accordance with the 
checklist; (2) check each item specified during the examination; and 
(3) address, as medically appropriate, every medical condition listed 
and any medications the individual is taking. The FAA is implementing 
these requirements in Sec.  68.5(b)(1)-(3).

VIII. Comprehensive Medical Examination Checklist

A. Checklist Requirements of Section 2307 of FESSA

    Section 2307(b)(1) of FESSA requires that the FAA develop a 
checklist for an individual to complete and provide to the physician 
performing the required comprehensive medical examination.
    Section 2307(b)(2) of FESSA requires the checklist to contain three 
sections: (1) A section for the individual to complete; (2) a section 
with instructions for the individual to provide the completed checklist 
to the physician performing the examination; and (3) a section for the 
physician to complete, which contains instructions for the physician 
performing the examination. Section 2307(b) prescribes requirements for 
each of these sections, which are discussed below. The FAA is 
implementing the comprehensive medical examination checklist 
requirements in Sec.  68.7 and has developed the checklist in 
accordance with these requirements.
1. Section for the Individual To Complete
    Section 2307(b)(2)(A)(i) of FESSA requires the checklist to contain 
a section for the individual to complete, which contains boxes 3 
through 13 and boxes 16 through 19 of the FAA form 8500-8, Application 
for Airman Medical Certificate (3-99).\39\ This requirement is 
implemented in Sec.  68.7(a)(1). The AC contains the specific 
information required by boxes 3 through 13 and boxes 16 through 19.
---------------------------------------------------------------------------

    \39\ Section 2307 of FESSA specifically references the FAA form 
8500-8 revision dated 3-99. The FAA notes that since that revision 
the FAA has revised the form several times, most recently with 
publication of the final rule Student Pilot Application 
Requirements, 81 FR 1292 (Jan. 12, 2016). In accordance with the 
requirements of FESSA, the FAA has developed the comprehensive 
medical examination checklist using boxes 3-13 and 16-19 as they 
appeared on the FAA form 8500-8 revision 3-99.
---------------------------------------------------------------------------

    Section 2307(b)(2)(A)(ii) of FESSA requires the checklist to 
contain (in the section for the individual) a signature line for the 
individual to affirm that:
     The answers provided by the individual on that checklist, 
including the individual's answers regarding medical history, are true 
and complete;
     The individual understands that he or she is prohibited 
under Federal Aviation Administration regulations from acting as pilot 
in command, or any other capacity as a required flight crew member, if 
he or she knows or has reason to know of any medical deficiency or 
medically disqualifying condition that would make the individual unable 
to operate the aircraft in a safe manner; and
     The individual is aware of the regulations pertaining to 
the prohibition on operations during medical deficiency and has no 
medically disqualifying conditions in accordance with applicable law.
    The FAA is implementing these requirements in Sec.  68.7(a)(2)(i)-
(iii).
2. Section Containing Instructions for the Individual
    Section 2307(b)(2)(B) requires the checklist to contain a section 
with instructions for the individual to provide the completed checklist 
to the physician performing the comprehensive medical examination. The 
FAA is implementing this requirement in Sec.  68.7(b).
3. Section for the Physician To Complete With Instructions for the 
Physician
    Section 2307(b)(2)(C)(i) of FESSA requires the checklist to include 
a section for the physician to complete, that instructs the physician 
to perform a clinical examination of the following:
     Head, face, neck, and scalp;
     Nose, sinuses, mouth, and throat;
     Ears, general (internal and external canals), and eardrums 
(perforation);
     Eyes (general), ophthalmoscopic, pupils (equality and 
reaction), and ocular motility (associated parallel movement, 
nystagmus);
     Lungs and chest (not including breast examination);
     Heart (precordial activity, rhythm, sounds, and murmurs);
     Vascular system (pulse, amplitude, and character, and 
arms, legs, and others);
     Abdomen and viscera (including hernia);
     Anus (not including digital examination);
     Skin;
     G-U system (not including pelvic examination);
     Upper and lower extremities (strength and range of 
motion);
     Spine and other musculoskeletal;
     Identifying body marks, scars, and tattoos (size and 
location);
     Lymphatics;
     Neurologic (tendon reflexes, equilibrium, senses, cranial 
nerves, and coordination, etc.);
     Psychiatric (appearance, behavior, mood, communication, 
and memory);
     General systemic;
     Hearing;
     Vision (distant, near, and intermediate vision, field of 
vision, color vision, and ocular alignment);
     Blood pressure and pulse; and
     Anything else the physician, in his or her medical 
judgment, considers necessary.
    The FAA is implementing these requirements in Sec.  68.7(c)(1)(i)-
(xxii).
    Section 2307(b)(2)(C)(ii) requires the physician to exercise 
medical discretion to address, as medically appropriate, any medical 
conditions identified, and to exercise medical discretion in 
determining whether any medical tests are warranted as part of the 
comprehensive medical examination. The FAA is implementing this 
requirement in Sec.  68.7(c)(2).
    Section 2307(b)(2)(C)(iii) of FESSA requires the checklist to 
instruct the physician to discuss all drugs the individual reports 
taking (prescription and nonprescription) and their potential to 
interfere with the safe operation of an aircraft or motor vehicle. The 
FAA is implementing this requirement in Sec.  68.7(c)(3).
    Furthermore, section 2307(b)(2)(C)(iv) of FESSA requires the 
checklist to instruct the physician to sign the checklist, stating: ``I 
certify that I discussed all items on this checklist with the 
individual during my examination, discussed any medications the 
individual is taking that could interfere with his or her ability to 
safely operate an aircraft or motor vehicle, and performed an 
examination that included all of the items on this checklist. I certify 
that I am not aware of any medical condition that, as presently 
treated, could interfere with the individual's ability to safely 
operate an aircraft.'' The FAA is implementing this requirement in 
Sec.  68.7(c)(4).
    Lastly, section 2307(b)(2)(C)(v) of FESSA requires the checklist to 
instruct the physician to provide the date the comprehensive medical 
examination was completed, and the physician's full name, address, 
telephone number, and State medical license number. This requirement is 
implemented in Sec.  68.7(c)(5).
    The FAA relies on the determination of each State (as well as each 
territory and possession of the United States) as

[[Page 3159]]

to which persons it will license as physicians. If the person holds a 
license as a physician issued by any State, territory, or possession, 
then he or she meets the requirement as a State-licensed physician. The 
FAA notes that all States license medical doctors (M.D.s) and doctors 
of osteopathic medicine (D.O.s) as physicians, although Federal and 
some State laws may permit the licensure of other persons, such as 
doctors of dental surgery (D.D.S.) as physicians. While the FAA expects 
that a specialist physician, (e.g., D.D.S., dentist, podiatrist) who 
does not also hold an M.D. or D.O. would not have the breadth of 
training to conduct a medical exam as required in this rule, the FAA 
will rely on each State-licensed physician to determine whether he or 
she is qualified to conduct the medical exam required by FESSA.
    Existing FAA prohibitions against self-endorsements would apply, 
prohibiting a State-licensed physician from conducting the physical 
examination on himself or herself.

B. Inclusion of the Completed Checklist in the Pilot's Logbook

    Section 2307(b)(3) of FESSA requires that the completed checklist 
be retained in the pilot's logbook and be made available upon request. 
The FAA is implementing this requirement in Sec.  61.113(i)(3).
    The FAA recognizes that many pilots now maintain logbook 
information electronically. Similar to the requirements described 
previously for the course completion certification described in section 
2307(c)(10)(A), the FAA notes that pilots may retain an electronic 
version of the completed checklist using whatever method they choose so 
long as an accurate electronic or physical representation of the 
document can be made available upon request.

C. FAA Implementation of the Comprehensive Medical Examination 
Checklist Requirements of Section 2307 of FESSA

    Section 2307(c)(9) of FESSA requires the medical education course 
to provide the medical examination checklist developed by the FAA. For 
purposes of implementation, the FAA will require that any nonprofit or 
not-for-profit general aviation stakeholder group that provides a 
medical course for this rule make the checklist available at that 
group's Web site.
    To implement the medical checklist provisions of FESSA, the FAA has 
developed the Comprehensive Medical Examination Checklist. The 
checklist is a fillable PDF form available on the FAA Web site, in 
addition to the location discussed immediately above. Pilots may 
complete the form either electronically or may print it out and 
complete it. Regardless of how the pilot chooses to complete the form, 
the pilot must print the form, sign it, and take it to the State-
licensed physician performing the medical examination. The FAA will 
provide the blank Comprehensive Medical Examination Checklist but will 
not be collecting and maintaining the checklist in any FAA system of 
records. As noted, the pilot will be required to retain the checklist 
as one of the items necessary for verification that he or she is 
eligible to operate under this rule.

IX. Special Issuance Process

A. Requirements of Section 2307 of FESSA

    Section 2307(e)(1) of FESSA states that an individual who has 
qualified for the third-class medical certificate exemption under 
subsection (a) of section 2307 and is seeking to serve as a PIC of a 
covered aircraft shall be required to have completed the process for 
obtaining an Authorization for Special Issuance of a Medical 
Certificate if that person has any of the following: (1) A mental 
health disorder; (2) a neurological disorder; or a (3) cardiovascular 
condition.
    Section 2307(e)(1)(A) states that a mental health disorder is 
limited to an established medical history or clinical diagnosis of:
     Personality disorder that is severe enough to have 
repeatedly manifested itself by overt acts;
     Psychosis, defined as a case in which an individual: (i) 
Has manifested delusions, hallucinations, grossly bizarre or 
disorganized behavior, or other commonly accepted symptoms of 
psychosis; or (ii) may reasonably be expected to manifest delusions, 
hallucinations, grossly bizarre or disorganized behavior, or other 
commonly accepted symptoms of psychosis;
     Bipolar disorder; or
     Substance dependence within the previous 2 years, as 
defined in Sec.  67.307(a)(4) of title 14, Code of Federal Regulations.
    Section 2307(e)(1)(B) states that a neurological disorder is 
limited to an established medical history or clinical diagnosis of any 
of the following:
     Epilepsy.
     Disturbance of consciousness without satisfactory medical 
explanation of the cause.
     A transient loss of control of nervous system functions 
without satisfactory medical explanation of the cause.
    Section 2307(e)(1)(C) states that a cardiovascular condition is 
limited to a one-time special issuance for each diagnosis of the 
following:
     Myocardial infarction.
     Coronary heart disease that has required treatment.
     Cardiac valve replacement.
     Heart replacement.
    The FAA is implementing the requirements of section 2307(e)(1)(A)-
(C) in Sec.  68.9(a)(1)-(3).
1. Special Rule for Cardiovascular Conditions
    Section 2307(e)(2) of FESSA states that in the case of an 
individual with a cardiovascular condition, the process for obtaining 
an Authorization for Special Issuance of a Medical Certificate shall be 
satisfied with the successful completion of an appropriate clinical 
evaluation without a mandatory wait period.\40\
---------------------------------------------------------------------------

    \40\ Current guidance establishes mandatory wait periods for 
certain cardiovascular conditions. For example, there is a 3-month 
recovery time after a myocardial infarction from non-coronary heart 
disease before an applicant may be considered for a medical 
certificate. 2016 Guide for Aviation Medical Examiners.
---------------------------------------------------------------------------

    The FAA is implementing this requirement in Sec.  68.9(b).
2. Special Rule for Mental Health Conditions
    Section 2307(e)(3)(A)(i) of FESSA states that in the case of an 
individual with a clinically diagnosed mental health condition, the 
ability to operate without a third-class medical certificate under 
subsection (a) of section 2307 shall not apply if in the judgment of 
the individual's State-licensed medical specialist, the condition: (1) 
Renders the individual unable to safely perform the duties or exercise 
the airman privileges described in the operating requirements of 
subsection (a)(8); or (2) may reasonably be expected to make the 
individual unable to perform the duties or exercise the privileges 
described in the operating requirements of subsection (a)(8).
    Additionally, section 2307(e)(3)(A)(ii) states that in the case of 
an individual with a clinically diagnosed mental health condition, the 
ability to operate without a third-class medical certificate under 
section 2307(a) shall not apply if the individual's driver's license is 
revoked by the issuing agency as a result of a clinically diagnosed 
mental health condition.
    The FAA is implementing section 2307(e)(3)(A)(i)-(ii) in Sec.  
68.9(c)(1)(i)-(ii).
    Section 2307(e)(3)(B) of FESSA requires that an individual 
clinically

[[Page 3160]]

diagnosed with a mental health condition shall certify every 2 years, 
in conjunction with the certifications under subsection (c)(10)(C), 
that the individual is under the care of a State-licensed medical 
specialist for that mental health condition. The FAA is implementing 
this requirement in Sec.  68.9(c)(2). This certification will be 
incorporated into the medical education course process. The FAA notes 
that the certifications required under subsection (c)(10)(C) of FESSA 
are implemented in Sec.  68.3(b)(3).
3. Special Rule for Neurological Conditions
    Section 2307(e)(4)(A)(i) states that in the case of an individual 
with a clinically diagnosed neurological condition, the ability to 
operate without a third-class medical certificate under subsection (a) 
of section 2307 shall not apply if in the judgment of the individual's 
State-licensed medical specialist, the condition: (1) Renders the 
individual unable to safely perform the duties or exercise the airman 
privileges described in the operating requirements of subsection 
(a)(8); or (2) may reasonably be expected to make the individual unable 
to perform the duties or exercise the privileges described in the 
operating requirements of subsection (a)(8).
    Section 2307(e)(4)(A)(ii) states that in the case of an individual 
with a clinically diagnosed neurological condition, the ability to 
operate without a third-class medical certificate under subsection (a) 
of section 2307 shall not apply if the individual's driver's license is 
revoked by the issuing agency as a result of a clinically diagnosed 
neurological condition.
    The FAA is implementing the requirements of section 2307(4)(A) in 
Sec.  68.9(d)(1)(i)-(ii).
    Section 2307(4)(B) of FESSA requires that an individual clinically 
diagnosed with a neurological condition shall certify every 2 years, in 
conjunction with the certification under subsection (c)(10)(C), that 
the individual is under the care of a State-licensed medical specialist 
for that neurological condition. As with the requirements for certain 
mental health disorders, this certification will be incorporated into 
the medical education course process.
    Regarding the certification related to mental health disorders and 
neurological disorders, the FAA recognizes that the inclusion of such a 
certification could create confusion. So to clarify, the FAA has 
written the certifications for the individual to attest (1) that the 
individual does not have a mental health disorder or neurological 
disorder or, (2) if the individual has a mental health disorder or 
neurological disorder, that the individual is under the care of a 
State-licensed medical specialist for that mental health condition or 
neurological condition. The FAA's intent is to ensure that no medical 
information is collected. Rather, the FAA views these certifications as 
a place for the individuals to attest that if they have a mental health 
or neurological disorder listed in section 2307, then they meet the 
section 2307 requirement that they are under the care of a State-
licensed medical specialist for that condition.

B. Special Issuance Medical Certificates

    All persons who currently hold an FAA-issued special issuance 
medical certificate, or who have held an FAA-issued special issuance 
medical certificate within the 10-year period preceding the enactment 
of FESSA, for conditions other than the specified cardiovascular, 
mental health, and neurological conditions listed in FESSA, may elect 
to use this rule. These persons are no longer required to maintain 
their special issuance medical certificate if they choose to comply 
with the requirements of section 2307 of FESSA. The FAA emphasizes that 
it expects all pilots, including persons who hold or have held a 
special issuance medical certificate, to comply with care and treatment 
protocols recommended by their State-licensed physician.
    If a pilot, while using this rule, is diagnosed with a condition 
that would have, in the past, required the pilot to be considered for a 
special issuance medical certificate, but is not one of the specified 
conditions described in FESSA, then that pilot may continue to exercise 
the privileges of this rule so long as all other requirements of 
section 2307 of FESSA are met.
    FESSA prescribes specific responsibilities and prohibitions that 
must be met for pilots who have certain cardiovascular, neurological, 
or mental health conditions. Persons who have, or are newly diagnosed 
with, a cardiovascular, neurological, or mental health condition 
described in FESSA, may not use this rule until they have been found 
eligible for special issuance of a medical certificate. Once issued a 
medical certificate, the person may then use this rule if he or she 
meets all other requirements of FESSA.

X. Authority To Require Additional Information

    Section 2307(l)(1) of FESSA states that if the Administrator 
receives credible or urgent information, including from the National 
Driver Register or the FAA Hotline Program, that reflects on an 
individual's ability to safely operate a covered aircraft under the 
third-class medical certificate exemption in subsection (a) of section 
2307, the Administrator may require the individual to provide 
additional information or history so that the Administrator may 
determine whether the individual is safe to continue operating a 
covered aircraft. Section 2307(l)(2) states that the Administrator may 
use credible or urgent information received to request an individual to 
provide additional information or to take actions under section 
44709(b) of title 49, United States Code.
    The FAA has implemented the provisions of section 2307(l) in new 
Sec.  68.11.

XI. Advisory Circular

    To further implement this final rule, the FAA has developed 
Advisory Circular 68-1, Alternative Pilot Physical Examination and 
Education Requirements. The advisory circular describes the relief and 
provides guidance on how to comply with the rule's provisions. It also 
includes frequently asked questions and guidance on how a nonprofit or 
not-for-profit general aviation stakeholder group can offer an approved 
course under this rule.

XII. Section-by-Section Discussion of the Final Rule

    In part 61, Certification: Pilots, flight instructors, and ground 
instructors, Sec.  61.3, requirement for certificates, ratings, and 
authorizations, is revised to add operations conducted under this rule 
to the list of exceptions to the requirement to hold a medical 
certificate.\41\ Section 61.3 is also amended to add the documents 
establishing alternative medical qualification under part 68 to the 
list of documents available for inspection under paragraph (l).
---------------------------------------------------------------------------

    \41\ The FAA notes that Sec.  61.113(i) contains the operating 
requirements for this rule. The FAA also notes that persons 
operating under this rule without a medical certificate must hold a 
valid U.S. driver's license.
---------------------------------------------------------------------------

    Section 61.23, medical certificates: requirement and duration, is 
revised to provide an exception for operations conducted under this 
rule for persons otherwise required to hold a third-class medical 
certificate.
    For operations requiring either a medical certificate or U.S. 
driver's license, Sec.  61.23(c)(1) is amended to state that a person 
must hold and possess either a medical certificate or a U.S. driver's 
license when exercising the

[[Page 3161]]

privileges of a student, recreational or private pilot certificate and 
operating under this rule, or when exercising the privileges of a 
flight instructor certificate and acting as the PIC or as a required 
flight crewmember if the flight is conducted under this rule.
    The FAA is also adding Sec.  61.23(c)(3), which contains the 
requirements for persons using a U.S. driver's license to operate under 
this rule.
    In Sec.  61.89, the FAA is adding paragraph (d) to allow the holder 
of a student pilot certificate to operate under this rule without 
holding a medical certificate.
    In Sec.  61.101, the FAA is adding paragraph (k) to allow a 
recreational pilot to operate under this rule without holding a medical 
certificate.
    Section 61.113 is revised to add paragraph (i), which contains the 
operational requirements of section 2307.
    The FAA is adding part 68, Requirements for operating certain small 
aircraft without a medical certificate, to title 14 of the Code of 
Federal Regulations. Section 68.1 provides the applicability of the 
part.
    Section 68.3 provides the Medical Education Course Requirements.
    Section 68.5 implements the requirements for the Comprehensive 
Medical Examination, including the requirements for the physician and 
the individual.
    Section 68.7 provides the requirements for the Comprehensive 
Medical Examination Checklist.
    Section 68.9 implements the requirements for the Special Issuance 
Process.
    Section 68.11 provides the FAA with authority to require additional 
information as described in FESSA.
    In Sec.  91.319, the FAA is adding paragraph (j) to make clear that 
experimental aircraft may operate under the conditions and limitations 
of Sec.  61.113(i).

XIII. Regulatory Notices and Analyses

A. Regulatory Evaluation

    Changes to Federal regulations must undergo several economic 
analyses. First, Executive Order 12866 and Executive Order 13563 direct 
that each Federal agency shall propose or adopt a regulation only upon 
a reasoned determination that the benefits of the intended regulation 
justify its costs. Second, the Regulatory Flexibility Act of 1980 (Pub. 
L. 96-354) requires agencies to analyze the economic impact of 
regulatory changes on small entities. Third, the Trade Agreements Act 
(Pub. L. 96-39 as amended) prohibits agencies from setting standards 
that create unnecessary obstacles to the foreign commerce of the United 
States. In developing U.S. standards, the Trade Agreements Act requires 
agencies to consider international standards and, where appropriate, 
that they be the basis of U.S. standards. Fourth, the Unfunded Mandates 
Reform Act of 1995 (Pub. L. 104-4) requires agencies to prepare a 
written assessment of the costs, benefits, and other effects of 
proposed or final rules that include a Federal mandate likely to result 
in the expenditure by State, local, or tribal governments, in the 
aggregate, or by the private sector, of $100 million or more annually 
(adjusted for inflation with base year of 1995). This portion of the 
preamble summarizes the FAA's analysis of the economic impacts of this 
final rule. We suggest readers seeking greater detail read the full 
regulatory evaluation, a copy of which we have placed in the docket for 
this rulemaking.
    In conducting these analyses, FAA has determined that this final 
rule: (1) Has benefits that justify its costs, (2) is not an 
economically ``significant regulatory action'' as defined in section 
3(f) of Executive Order 12866, (3) is not ``significant'' as defined in 
DOT's Regulatory Policies and Procedures; (4) will not have a 
significant economic impact on a substantial number of small entities; 
(5) will not create unnecessary obstacles to the foreign commerce of 
the United States; and (6) will not impose an unfunded mandate on 
State, local, or tribal governments, or on the private sector by 
exceeding the threshold identified above. These analyses are summarized 
below.
Total Benefits and Costs of This Rule

                                       Total Savings and Costs of the Rule
                                                 [2017 to 2026]
----------------------------------------------------------------------------------------------------------------
 
----------------------------------------------------------------------------------------------------------------
                            SAVINGS                                         COSTS
----------------------------------------------------------------------------------------------------------------
Medical Examination: 3rd Class Medical            $290,421,038  Physical Examinations by            $262,656,213
 Certificates for Pilots Age 40-and-Over.                        State-Licensed Physician:
                                                                 Pilots Age 40-and-Over.
                                                                Physical Examinations by              $3,055,973
                                                                 State-Licensed Physician:
                                                                 Special Issuance.
Medical Examination: 3rd Class Medical              90,679,136  Online Training Course.......         42,004,478
 Certificates with a Special Issuances.
FAA Savings................................          1,782,230  NDR Checks...................          7,422,763
    Total Savings..........................        382,882,405  Total Costs..................        315,139,427
        Present Value (7% discount rate)...        272,835,610  Present Value (7% discount           227,799,517
                                                                 rate).
----------------------------------------------------------------------------------------------------------------
Totals may not add due to rounding.

Who is potentially affected by this Rule?
    All pilots with eligible pilot certificates are affected by this 
rule. Eligible pilots will need to have held a valid FAA medical 
certificate within the 10 years preceding the date of enactment of 
FESSA, July 15, 2016, and will need a valid U.S. driver's license.
    Assumptions:
     Costs and benefits are estimated over 10 years from 2017 
through 2026.
     Costs and benefits are presented in 2016 dollars.
     The present value discount rate of seven percent is used 
as required by the Office of Management and Budget.
     An FAA medical examination with an AME is approximately 
$117.
     An FAA follow-up evaluation with an AME is approximately 
$58.50.
     A pilot's medical examination with a state-licensed 
physician is approximately $225.\42\
---------------------------------------------------------------------------

    \42\ Four Coding and Payment Opportunities You Might Be Missing, 
American Academy of Family Physicians. 2016 May-June;23(3):30-35. 
http://www.aafp.org/fpm/2016/0500/p30.html.
---------------------------------------------------------------------------

     An annual growth rate of 1.0 percent per year is applied 
to hourly

[[Page 3162]]

wages per Department of Transportation Guidance.\43\
---------------------------------------------------------------------------

    \43\ 2015 Department of Transportation Value of Travel Time 
Guidance; https://www.transportation.gov/administrations/office-policy/2015-value-travel-time-guidance.
---------------------------------------------------------------------------

     Vehicle operating cost per mile (VOC) as determined by the 
Internal Revenue Service (IRS) is $0.19.\44\
---------------------------------------------------------------------------

    \44\ Internal Revenue Service (IRS) Standard Mileage Rate for 
2016, 0.19 cents per mile driven for medical or moving purposes; 
https://www.irs.gov/uac/newsroom/2016-standard-mileage-rates-for-business-medical-and-moving-announced Dec. 17, 2015.
---------------------------------------------------------------------------

     The hourly rate of a pilot's travel time (VTTS) as 
determined by the Department of Transportation (DOT) is $12.50 in 2013. 
This value is augmented by 1.0 percent per year to project future 
benefits of travel time saved from 2013 to 2026.\45\
---------------------------------------------------------------------------

    \45\ 2015 Departmental Guidance on Valuation of Travel Time in 
Economic Analyses; Table 4: Recommended Hourly Values of Travel Time 
Savings (Personal category for local surface modes of 
transportation). https://www.transportation.gov/administrations/office-policy/2015-value-travel-time-guidance.
---------------------------------------------------------------------------

     The hourly rate of a pilot's time (VPT) as determined by 
DOT is $25.00 in 2013. This value is augmented by 1.0 percent per year 
to project the annual growth rate of real median household income from 
2013 to 2026.\46\
---------------------------------------------------------------------------

    \46\ 2015 Departmental Guidance on Valuation of Travel Time in 
Economic Analyses; Table 3: Recommended Hourly Earning Rates for 
Determining Values of Travel Time Savings, https://www.transportation.gov/administrations/office-policy/2015-value-travel-time-guidance.
---------------------------------------------------------------------------

     The FAA assumes 0.5 hours to complete the MedXpress form.
     The FAA assumes that the time required to fill out the 
MedXpress form will be the same time required to fill out section 1 of 
the medical checklist that must be partially completed by the pilot and 
taken to the physician.
     The FAA assumes 1 hour to complete a medical examination.
     The FAA assumes 0.5 hours to complete a follow-up 
evaluation.
     The value of FAA time to review medical applications per 
hour is shown in table 1 and includes fringe benefits for federal 
employees.\47\
---------------------------------------------------------------------------

    \47\ http://www.whitehouse.gov/sites/default/files/omb/memoranda/fy2008/m08-13.pdf.

 Table 1--2016 Weighted Average of Hourly Wage for FAA Employees Reviewing Applications for Medical Certificates
----------------------------------------------------------------------------------------------------------------
                                                                    Wages with       Number of
                                                                     benefits         people
                                                                               A               b           a x b
----------------------------------------------------------------------------------------------------------------
Legal instrument examiners \48\.................................          $50.46              42          $2,119
Regional Flight Surgeons \49\...................................          139.59               9           1,256
Senior Executives \50\..........................................          139.59               3             419
Civil Aerospace Medicine Institute (CAMI) Medical Officers \51\.          139.59               6             838
Civil Aerospace Medicine Institute (CAMI) Physicians \52\.......          139.59               3             419
    Total.......................................................  ..............              63           5,051
        Weighted Average Wage Rate = $5,051/63..................  ..............  ..............           80.17
----------------------------------------------------------------------------------------------------------------
Totals may not add due to rounding.

Benefits of this Rule
---------------------------------------------------------------------------

    \48\ 2016 General Schedule (GS) Locality Pay Tables; GS-11 Step 
5 locality pay The REST OF UNITED STATES; https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2016/RUS_h.pdf ; plus fringe benefits; http://www.whitehouse.gov/sites/default/files/omb/memoranda/fy2008/m08-13.pdf.
    \49\ SALARY TABLE NO. 2016-ES plus fringe benefits; https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2016/ES.pdf, Agencies with a Certified SES Performance 
Appraisal System Maximum; http://www.whitehouse.gov/sites/default/files/omb/memoranda/fy2008/m08-13.pdf.
    \50\ SALARY TABLE NO. 2016-ES plus fringe benefits; https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2016/ES.pdf, Agencies with a Certified SES Performance 
Appraisal System Maximum; http://www.whitehouse.gov/sites/default/files/omb/memoranda/fy2008/m08-13.pdf.
    \51\ 2016 General Schedule (GS) Locality Pay Tables; GS-11 Step 
5 locality pay The REST OF UNITED STATES; https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2016/RUS_h.pdf; plus fringe benefits; http://www.whitehouse.gov/sites/default/files/omb/memoranda/fy2008/m08-13.pdf.
    \52\ 2016 General Schedule (GS) Locality Pay Tables; GS-11 Step 
5 locality pay The REST OF UNITED STATES; https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2016/RUS_h.pdf ; plus fringe benefits; http://www.whitehouse.gov/sites/default/files/omb/memoranda/fy2008/m08-13.pdf.
---------------------------------------------------------------------------

    The FAA estimates potential savings to pilots, based on age and a 
pilot's medical condition, from eliminating medical examinations with 
an AME. The elimination of these examinations will save pilots the time 
to complete the online medical application (MedXpress), travel time to 
the medical examination, the time required to complete the medical 
examination, vehicle operating costs based on miles traveled to the 
examination, and the cost of the medical examination. For pilots with 
special-issuances, the FAA anticipates added savings by eliminating 
follow-up medical evaluations, determined by their medical condition, 
with an AME. Additionally, the FAA will save time by reducing the 
number of applications reviewed for special-issuance medical 
certificates. Total savings are estimated at $382.9 million ($272.8 
million at a 7 percent present value) over 10 years.
Costs of this Rule
    Costs for this rule are attributed to the physical examination 
completed by a State-licensed physician every 48 months, the medical 
education course that pilots will complete every 24 calendar months, 
and an increase in NDR checks for pilots under age 40 with a special 
issuance medical certificate. Unlike pilots 40 years of age and older, 
who the FAA expects will benefit from the elimination of the AME 
examinations, the FAA expects the savings to pilots under 40 years of 
age will only occur for those pilots requiring Authorization for a 
special issuance medical certificate. Total costs are estimated at 
$315.1 million ($227.8 million at a 7 percent present value) over 10 
years.
    Overall, the rule results in a net benefit of $67.7 million over 10 
years.

B. Regulatory Flexibility Determination

    The Regulatory Flexibility Act of 1980 (Pub. L. 96-354) (RFA) 
establishes ``as a principle of regulatory issuance that agencies shall 
endeavor, consistent with the objectives of the rule and of applicable 
statutes, to fit regulatory and informational requirements to the scale 
of the businesses, organizations, and governmental jurisdictions 
subject to regulation. To achieve this principle, agencies are required 
to solicit and consider flexible regulatory proposals

[[Page 3163]]

and to explain the rationale for their actions to assure that such 
proposals are given serious consideration.'' The RFA covers a wide-
range of small entities, including small businesses, not-for-profit 
organizations, and small governmental jurisdictions.
    Agencies must perform a review to determine whether a rule will 
have a significant economic impact on a substantial number of small 
entities. If the agency determines that it will, the agency must 
prepare a regulatory flexibility analysis as described in the RFA.
    The FAA believes that this final rule would not have a significant 
impact on a substantial number of entities for the following reason: 
Pilots that choose to use this alternative requirement will receive a 
savings, however this final rule is voluntary hence there are no costs 
imposed on small entities.
    If an agency determines that a rulemaking will not result in a 
significant economic impact on a substantial number of small entities, 
the head of the agency may so certify under section 605(b) of the RFA. 
Therefore, as provided in section 605(b), the head of the FAA certifies 
that this rulemaking will not result in a significant economic impact 
on a substantial number of small entities.

C. International Trade Impact Assessment

    The Trade Agreements Act of 1979 (Pub. L. 96-39), as amended by the 
Uruguay Round Agreements Act (Pub. L. 103-465), prohibits Federal 
agencies from establishing standards or engaging in related activities 
that create unnecessary obstacles to the foreign commerce of the United 
States. Pursuant to these Acts, the establishment of standards is not 
considered an unnecessary obstacle to the foreign commerce of the 
United States, so long as the standard has a legitimate domestic 
objective, such as the protection of safety, and does not operate in a 
manner that excludes imports that meet this objective. The statute also 
requires consideration of international standards and, where 
appropriate, that they be the basis for U.S. standards. The FAA has 
assessed the potential effect of this final rule and determined that it 
will only have a domestic impact and therefore will not create 
unnecessary obstacles to the foreign commerce of the United States.

D. Unfunded Mandates Assessment

    Title II of the Unfunded Mandates Reform Act of 1995 (Pub. L. 104-
4) requires each Federal agency to prepare a written statement 
assessing the effects of any Federal mandate in a proposed or final 
agency rule that may result in an expenditure of $100 million or more 
(in 1995 dollars) in any one year by State, local, and tribal 
governments, in the aggregate, or by the private sector; such a mandate 
is deemed to be a ``significant regulatory action.'' The FAA currently 
uses an inflation-adjusted value of $155.0 million in lieu of $100 
million.
    This final rule does not contain such a mandate; therefore, the 
requirements of Title II of the Act do not apply.

E. Paperwork Reduction Act

    The Paperwork Reduction Act of 1995 (44 U.S.C. 3507(d)) requires 
that the FAA consider the impact of paperwork and other information 
collection burdens imposed on the public. According to the 1995 
amendments to the Paperwork Reduction Act, (5 CFR 1320.8(b)(2)(vi)), an 
agency may not collect or sponsor the collection of information, nor 
may it impose an information collection requirement unless it displays 
a currently valid Office of Management and Budget (OMB) control number. 
As required by the Paperwork Reduction Act of 1995 (44 U.S.C. 3507(d)), 
the FAA will submit these information collection amendments to OMB for 
its review.
    To implement the Act, the FAA is establishing one new information 
collection. This information collection includes the medical education 
course as well as the Individual Checklist for Medical Examination. 
Pursuant to the requirements of the Paperwork Reduction Act, the FAA 
published a 60-day notice seeking comment regarding this new 
information collection.
    For those individuals who elect to use this rule the FAA considers 
that they no longer possess any airman medical certificate. Thus, the 
FAA is making a corresponding change to information collection 2120-
0034, Application for Airman Medical Certificate, to reduce the burden 
associated with that information collection. The FAA published a 60-day 
notice seeking comment regarding the revision of this existing 
information collection.

F. International Compatibility and Cooperation

    In keeping with U.S. obligations under the Convention on 
International Civil Aviation, it is FAA policy to conform to 
International Civil Aviation Organization Standards and Recommended 
Practices to the maximum extent practicable. The FAA has reviewed ICAO 
Standards and Recommended Practices (SARPs) applicable to private 
pilots.
    The FAA has filed new differences and modified certain existing 
differences to reflect that certain U.S. private pilots no longer are 
required to hold a current FAA airman medical certificate. A filing is 
required for certain ICAO Annex 1 SARPs found in Chapters 1, 2, and 6.

G. Environmental Analysis

    FAA Order 1050.1F identifies FAA actions that are categorically 
excluded from preparation of an environmental assessment or 
environmental impact statement under the National Environmental Policy 
Act in the absence of extraordinary circumstances. The FAA has 
determined this rulemaking action qualifies for the categorical 
exclusion identified in paragraph 5-6.6f and involves no extraordinary 
circumstances.

XIV. Executive Order Determinations

A. Executive Order 13132, Federalism

    The FAA has analyzed this rule under the principles and criteria of 
Executive Order 13132, Federalism. The agency has determined that this 
action will not have a substantial direct effect on the States, or the 
relationship between the Federal Government and the States, or on the 
distribution of power and responsibilities among the various levels of 
government, and, therefore, will not have Federalism implications.

B. Executive Order 13211, Regulations That Significantly Affect Energy 
Supply, Distribution, or Use

    The FAA analyzed this rule under Executive Order 13211, Actions 
Concerning Regulations that Significantly Affect Energy Supply, 
Distribution, or Use (May 18, 2001). The agency has determined that it 
is not a ``significant energy action'' under the executive order and is 
not likely to have a significant adverse effect on the supply, 
distribution, or use of energy.

C. Executive Order 13609, Promoting International Regulatory 
Cooperation

    Executive Order 13609, Promoting International Regulatory 
Cooperation, (77 FR 26413, May 4, 2012) promotes international 
regulatory cooperation to meet shared challenges involving health, 
safety, labor, security, environmental, and other issues and to reduce, 
eliminate, or prevent unnecessary differences in regulatory 
requirements. The FAA has analyzed this action under the policies and 
agency responsibilities of Executive Order 13609, and has determined 
that this action would have no effect on international regulatory 
cooperation.

[[Page 3164]]

XVI. Additional Information

A. Availability of Rulemaking Documents

    An electronic copy of rulemaking documents may be obtained from the 
Internet by--
     Searching the Federal eRulemaking Portal (http://www.regulations.gov);
     Visiting the FAA's Regulations and Policies Web site at 
http://www.faa.gov/regulations_policies or
     Accessing the Government Publishing Office's Web site at 
http://www.fdsys.gov.
    Copies may also be obtained by sending a request to the Federal 
Aviation Administration, Office of Rulemaking, ARM-1, 800 Independence 
Avenue SW., Washington, DC 20591, or by calling (202) 267-9677. 
Requestors must identify the docket or amendment number of this 
rulemaking.
    All documents the FAA considered in developing this final rule, 
including economic analyses and technical reports, may be accessed from 
the Internet through the Federal eRulemaking Portal referenced above.

B. Small Business Regulatory Enforcement Fairness Act

    The Small Business Regulatory Enforcement Fairness Act of 1996 
(SBREFA) requires FAA to comply with small entity requests for 
information or advice about compliance with statutes and regulations 
within its jurisdiction. A small entity with questions regarding this 
document may contact its local FAA official, or the person listed under 
the FOR FURTHER INFORMATION CONTACT heading at the beginning of the 
preamble. To find out more about SBREFA on the Internet, visit http://www.faa.gov/regulations_policies/rulemaking/sbre_act/.

List of Subjects

14 CFR part 61

    Aircraft, Airmen, Aviation safety, Reporting and recordkeeping 
requirements.

14 CFR part 68

    Aircraft, Airmen, Health, Reporting and recordkeeping requirements.

14 CFR part 91

    Aircraft, Airmen, Aviation safety.

The Amendment

    In consideration of the foregoing, the Federal Aviation 
Administration amends chapter I of title 14, Code of Federal 
Regulations as follows:

PART 61--CERTIFICATION: PILOTS, FLIGHT INSTRUCTORS, AND GROUND 
INSTRUCTORS

0
1. The authority citation for part 61 is revised to read as follows:

    Authority: 49 U.S.C. 106(f), 106(g), 40113, 44701-44703, 44707, 
44709-44711, 44729, 44903, 45102-45103, 45301-45302; Sec. 2307 Pub. 
L. 114-190, 130 Stat. 615 (49 U.S.C. 44703 note).

0
2. In Sec.  61.3, revise paragraphs (c)(2)(viii) and (x) through (xii), 
add paragraphs (c)(2)(xiii) and (xiv), and revise paragraph (l) 
introductory text to read as follows:

Sec.  61.3  Requirement for certificates, ratings, and authorizations.

* * * * *
    (c) * * *
    (2) * * *
    (viii) Is exercising the privileges of a flight instructor 
certificate, provided the person is not acting as pilot in command or 
as a required pilot flight crewmember;
     * * *
    (x) Is operating an aircraft within a foreign country using a pilot 
license issued by that country and possesses evidence of current 
medical qualification for that license;
    (xi) Is operating an aircraft with a U.S. pilot certificate, issued 
on the basis of a foreign pilot license, issued under Sec.  61.75, and 
holds a medical certificate issued by the foreign country that issued 
the foreign pilot license, which is in that person's physical 
possession or readily accessible in the aircraft when exercising the 
privileges of that airman certificate;
    (xii) Is a pilot of the U.S. Armed Forces, has an up-to-date U.S. 
military medical examination, and holds military pilot flight status;
    (xiii) Is exercising the privileges of a student, recreational or 
private pilot certificate for operations conducted under the conditions 
and limitations set forth in Sec.  61.113(i) and holds a U.S. driver's 
license; or
    (xiv) Is exercising the privileges of a flight instructor 
certificate and acting as pilot in command for operations conducted 
under the conditions and limitations set forth in Sec.  61.113(i) and 
holds a U.S. driver's license.
* * * * *
    (l) Inspection of certificate. Each person who holds an airman 
certificate, medical certificate, documents establishing alternative 
medical qualification under part 68 of this chapter, authorization, or 
license required by this part must present it and their photo 
identification as described in paragraph (a)(2) of this section for 
inspection upon a request from:
* * * * *

0
3. In Sec.  61.23, revise paragraphs (a)(3), (c)(1)(iii) and (iv), add 
paragraphs (c)(1)(v) and (vi), revise paragraph (c)(2) introductory 
text, and add paragraph (c)(3) to read as follows:

Sec.  61.23  Medical certificates: Requirement and duration.

    (a) * * *
    (3) Must hold at least a third-class medical certificate--
    (i) When exercising the privileges of a private pilot certificate, 
recreational pilot certificate, or student pilot certificate, except 
when operating under the conditions and limitations set forth in Sec.  
61.113(i);
    (ii) When exercising the privileges of a flight instructor 
certificate and acting as the pilot in command or as a required 
flightcrew member, except when operating under the conditions and 
limitations set forth in Sec.  61.113(i);
    (iii) When taking a practical test in an aircraft for a 
recreational pilot, private pilot, commercial pilot, or airline 
transport pilot certificate, or for a flight instructor certificate, 
except when operating under the conditions and limitations set forth in 
Sec.  61.113(i); or
    (iv) When performing the duties as an Examiner in an aircraft when 
administering a practical test or proficiency check for an airman 
certificate, rating, or authorization.
* * * * *
    (c) * * *
    (1) * * *
    (iii) Exercising the privileges of a flight instructor certificate 
with a sport pilot rating while acting as pilot in command or serving 
as a required flight crewmember of a light-sport aircraft other than a 
glider or balloon;
    (iv) Serving as an Examiner and administering a practical test for 
the issuance of a sport pilot certificate in a light-sport aircraft 
other than a glider or balloon;
    (v) Exercising the privileges of a student, recreational or private 
pilot certificate if the flight is conducted under the conditions and 
limitations set forth in Sec.  61.113(i); or
    (vi) Exercising the privileges of a flight instructor certificate 
and acting as the pilot in command or as a required flight crewmember 
if the flight is conducted under the conditions and limitations set 
forth in Sec.  61.113(i).
    (2) A person using a U.S. driver's license to meet the requirements 
of paragraph (c) while exercising sport pilot privileges must--
    * * *

[[Page 3165]]

    (3) A person using a U.S. driver's license to meet the requirements 
of paragraph (c) while operating under the conditions and limitations 
of Sec.  61.113(i) must meet the following requirements--
    (i) The person must--
    (A) Comply with all medical requirements or restrictions associated 
with his or her U.S. driver's license;
    (B) At any point after July 14, 2006, have held a medical 
certificate issued under part 67 of this chapter;
    (C) Complete the medical education course set forth in Sec.  68.3 
of this chapter during the 24-calendar months before acting as pilot in 
command in an operation conducted under Sec.  61.113(i) and retain a 
certification of course completion in accordance with Sec.  68.3(b)(1) 
of this chapter;
    (D) Receive a comprehensive medical examination from a State-
licensed physician during the 48 months before acting as pilot in 
command of an operation conducted under Sec.  61.113(i) and that 
medical examination is conducted in accordance with the requirements in 
part 68 of this chapter; and
    (E) If the individual has been diagnosed with any medical condition 
that may impact the ability of the individual to fly, be under the care 
and treatment of a State-licensed physician when acting as pilot in 
command of an operation conducted under Sec.  61.113(i).
    (ii) The most recently issued medical certificate--
    (A) May include an authorization for special issuance;
    (B) May be expired; and
    (C) Cannot have been suspended or revoked.
    (iii) The most recently issued Authorization for a Special Issuance 
of a Medical Certificate cannot have been withdrawn; and
    (iv) The most recent application for an airman medical certificate 
submitted to the FAA cannot have been completed and denied.
* * * * *

0
4. In Sec.  61.89, add paragraph (d) to read as follows:

Sec.  61.89  General Limitations.

* * * * *
    (d) The holder of a student pilot certificate may act as pilot in 
command of an aircraft without holding a medical certificate issued 
under part 67 of this chapter provided the student pilot holds a valid 
U.S. driver's license, meets the requirements of Sec.  61.23(c)(3), and 
the operation is conducted consistent with the requirements of 
paragraphs (a) and (b) of this section and the conditions of Sec.  
61.113(i). Where the requirements of paragraphs (a) and (b) of this 
section conflict with Sec.  61.113(i), a student pilot must comply with 
paragraphs (a) and (b) of this section.

0
5. In Sec.  61.101, add paragraph (k) to read as follows:

Sec.  61.101  Recreational pilot privileges and limitations.

* * * * *
    (k) A recreational pilot may act as pilot in command of an aircraft 
without holding a medical certificate issued under part 67 of this 
chapter provided the pilot holds a valid U.S. driver's license, meets 
the requirements of Sec.  61.23(c)(3), and the operation is conducted 
consistent with this section and the conditions of Sec.  61.113(i). 
Where the requirements of this section conflict with Sec.  61.113(i), a 
recreational pilot must comply with this section.

0
6. In Sec.  61.113, add paragraph (i) to read as follows:

Sec.  61.113  Private pilot privileges and limitations: Pilot in 
command.

* * * * *
    (i) A private pilot may act as pilot in command of an aircraft 
without holding a medical certificate issued under part 67 of this 
chapter provided the pilot holds a valid U.S. driver's license, meets 
the requirements of Sec.  61.23(c)(3), and complies with this section 
and all of the following conditions and limitations:
    (1) The aircraft is authorized to carry not more than 6 occupants, 
has a maximum takeoff weight of not more than 6,000 pounds, and is 
operated with no more than five passengers on board; and
    (2) The flight, including each portion of the flight, is not 
carried out--
    (i) At an altitude that is more than 18,000 feet above mean sea 
level;
    (ii) Outside the United States unless authorized by the country in 
which the flight is conducted; or
    (iii) At an indicated airspeed exceeding 250 knots; and
    (3) The pilot has available in his or her logbook--
    (i) The completed medical examination checklist required under 
Sec.  68.7 of this chapter; and
    (ii) The certificate of course completion required under Sec.  
61.23(c)(3).

0
7. Add part 68 to subchapter D to read as follows:

PART 68--REQUIREMENTS FOR OPERATING CERTAIN SMALL AIRCRAFT WITHOUT 
A MEDICAL CERTIFICATE

Sec.
68.1 Applicability.
68.3 Medical education course requirements.
68.5 Comprehensive medical examination.
68.7 Comprehensive medical examination checklist.
68.9 Special Issuance process.
68.11 Authority to require additional information.

    Authority: 49 U.S.C. 106(f), 44701-44703, sec. 2307 of Pub. L. 
114-190, 130 Stat. 615 (49 U.S.C. 44703 note).

Sec.  68.1  Applicability.

    This part prescribes the medical education and examination 
requirements for operating an aircraft under Sec.  61.113(i) of this 
chapter without holding a medical certificate issued under part 67 of 
this chapter.

Sec.  68.3  Medical education course requirements.

    (a) The medical education course required to act as pilot in 
command in an operation under Sec.  61.113(i) of this chapter must--
    (1) Educate pilots on conducting medical self-assessments;
    (2) Advise pilots on identifying warning signs of potential serious 
medical conditions;
    (3) Identify risk mitigation strategies for medical conditions;
    (4) Increase awareness of the impacts of potentially impairing 
over-the-counter and prescription drug medications;
    (5) Encourage regular medical examinations and consultations with 
primary care physicians;
    (6) Inform pilots of the regulations pertaining to the prohibition 
on operations during medical deficiency and medically disqualifying 
conditions; and
    (7) Provide the checklist developed by the FAA in accordance with 
Sec.  68.7.
    (b) Upon successful completion of the medical education course, the 
following items must be electronically provided to the individual 
seeking to act as pilot in command under the conditions and limitations 
of Sec.  61.113(i) of this chapter and transmitted to the FAA--
    (1) A certification of completion of the medical education course, 
which shall be retained in the individual's logbook and made available 
upon request, and shall contain the individual's name, address, and 
airman certificate number;
    (2) A release authorizing single access to the National Driver 
Register through a designated State Department of Motor Vehicles to 
furnish to the FAA information pertaining to the individual's driving 
record;
    (3) A certification by the individual that the individual is under 
the care and treatment of a physician if the individual has been 
diagnosed with any medical condition that may impact the ability of the 
individual to fly, as

[[Page 3166]]

required under Sec.  61.23(c)(3) of this chapter;
    (4) A form that includes--
    (i) The name, address, telephone number, and airman certificate 
number of the individual;
    (ii) The name, address, telephone number, and State medical license 
number of the physician performing the comprehensive medical 
examination;
    (iii) The date of the comprehensive medical examination; and
    (iv) A certification by the individual that the checklist described 
in Sec.  68.7 was followed and signed by the physician during the 
medical examination required by this section; and
    (5) A statement, which shall be signed by the individual certifying 
that the individual understands the existing prohibition on operations 
during medical deficiency by stating: ``I understand that I cannot act 
as pilot in command, or any other capacity as a required flight crew 
member, if I know or have reason to know of any medical condition that 
would make me unable to operate the aircraft in a safe manner.''.

Sec.  68.5  Comprehensive medical examination.

    (a) Prior to the medical examination required by Sec.  61.23(c)(3) 
of this chapter, an individual must--
    (1) Complete the individual's section of the checklist described in 
Sec.  68.7; and
    (2) Provide the completed checklist to the State-licensed physician 
performing the medical examination.
    (b) The physician must--
    (1) Conduct the medical examination in accordance with the 
checklist set forth in Sec.  68.7,
    (2) Check each item specified during the examination; and
    (3) Address, as medically appropriate, every medical condition 
listed and any medications the individual is taking.

Sec.  68.7  Comprehensive medical examination checklist.

    The comprehensive medical examination required to conduct 
operations under Sec.  61.113(i) must include a checklist containing 
the following:
    (a) A section, for the individual to complete that contains--
    (1) Boxes 3 through 13 and boxes 16 through 19 of the FAA Form 
8500-8 (3-99); and
    (2) A signature line for the individual to affirm that--
    (i) The answers provided by the individual on that checklist, 
including the individual's answers regarding medical history, are true 
and complete;
    (ii) The individual understands that he or she is prohibited under 
FAA regulations from acting as pilot in command, or any other capacity 
as a required flight crew member, if he or she knows or has reason to 
know of any medical deficiency or medically disqualifying condition 
that would make the individual unable to operate the aircraft in a safe 
manner; and
    (iii) The individual is aware of the regulations pertaining to the 
prohibition on operations during medical deficiency and has no 
medically disqualifying conditions in accordance with applicable law;
    (b) A section with instructions for the individual to provide the 
completed checklist to the State-licensed physician performing the 
comprehensive medical examination required under Sec.  68.5; and
    (c) A section, for the physician to complete, that instructs the 
physician--
    (1) To perform a clinical examination of--
    (i) Head, face, neck, and scalp;
    (ii) Nose, sinuses, mouth, and throat;
    (iii) Ears, general (internal and external canals), and eardrums 
(perforation);
    (iv) Eyes (general), ophthalmoscopic, pupils (equality and 
reaction), and ocular motility (associated parallel movement, 
nystagmus);
    (v) Lungs and chest (not including breast examination);
    (vi) Heart (precordial activity, rhythm, sounds, and murmurs);
    (vii) Vascular system (pulse, amplitude, and character, and arms, 
legs, and others);
    (viii) Abdomen and viscera (including hernia);
    (ix) Anus (not including digital examination);
    (x) Skin;
    (xi) G-U system (not including pelvic examination);
    (xii) Upper and lower extremities (strength and range of motion);
    (xiii) Spine and other musculoskeletal;
    (xiv) Identifying body marks, scars, and tattoos (size and 
location);
    (xv) Lymphatics;
    (xvi) Neurologic (tendon reflexes, equilibrium, senses, cranial 
nerves, and coordination, etc.);
    (xvii) Psychiatric (appearance, behavior, mood, communication, and 
memory);
    (xviii) General systemic;
    (xix) Hearing;
    (xx) Vision (distant, near, and intermediate vision, field of 
vision, color vision, and ocular alignment);
    (xxi) Blood pressure and pulse; and
    (xxii) Anything else the physician, in his or her medical judgment, 
considers necessary;
    (2) To exercise medical discretion to address, as medically 
appropriate, any medical conditions identified, and to exercise medical 
discretion in determining whether any medical tests are warranted as 
part of the comprehensive medical examination;
    (3) To discuss all drugs the individual reports taking 
(prescription and nonprescription) and their potential to interfere 
with the safe operation of an aircraft or motor vehicle;
    (4) To sign the checklist, stating: ``I certify that I discussed 
all items on this checklist with the individual during my examination, 
discussed any medications the individual is taking that could interfere 
with his or her ability to safely operate an aircraft or motor vehicle, 
and performed an examination that included all of the items on this 
checklist. I certify that I am not aware of any medical condition that, 
as presently treated, could interfere with the individual's ability to 
safely operate an aircraft.''; and
    (5) To provide the date the comprehensive medical examination was 
completed, and the physician's full name, address, telephone number, 
and State medical license number.

Sec.  68.9  Special Issuance process.

    (a) General. An individual who has met the qualifications to 
operate an aircraft under Sec.  61.113(i) of this chapter and is 
seeking to serve as a pilot in command under that section must have 
completed the process for obtaining an Authorization for Special 
Issuance of a Medical Certificate for each of the following:
    (1) A mental health disorder, limited to an established medical 
history or clinical diagnosis of--
    (i) A personality disorder that is severe enough to have repeatedly 
manifested itself by overt acts;
    (ii) A psychosis, defined as a case in which an individual--
    (A) Has manifested delusions, hallucinations, grossly bizarre or 
disorganized behavior, or other commonly accepted symptoms of 
psychosis; or
    (B) May reasonably be expected to manifest delusions, 
hallucinations, grossly bizarre or disorganized behavior, or other 
commonly accepted symptoms of psychosis;
    (iii) A bipolar disorder; or
    (iv) A substance dependence within the previous 2 years, as defined 
in Sec.  67.307(a)(4) of this chapter.
    (2) A neurological disorder, limited to an established medical 
history or clinical diagnosis of any of the following:
    (i) Epilepsy;
    (ii) Disturbance of consciousness without satisfactory medical 
explanation of the cause; or

[[Page 3167]]

    (iii) A transient loss of control of nervous system functions 
without satisfactory medical explanation of the cause.
    (3) A cardiovascular condition, limited to a one-time special 
issuance for each diagnosis of the following:
    (i) Myocardial infarction;
    (ii) Coronary heart disease that has required treatment;
    (iii) Cardiac valve replacement; or
    (iv) Heart replacement.
    (b) Special rule for cardiovascular conditions. In the case of an 
individual with a cardiovascular condition, the process for obtaining 
an Authorization for Special Issuance of a Medical Certificate shall be 
satisfied with the successful completion of an appropriate clinical 
evaluation without a mandatory wait period.
    (c) Special rule for mental health conditions. (1) In the case of 
an individual with a clinically diagnosed mental health condition, the 
ability to operate an aircraft under Sec.  61.113(i) of this chapter 
shall not apply if--
    (i) In the judgment of the individual's State-licensed medical 
specialist, the condition--
    (A) Renders the individual unable to safely perform the duties or 
exercise the airman privileges required to operate an aircraft under 
Sec.  61.113(i) of this chapter; or
    (B) May reasonably be expected to make the individual unable to 
perform the duties or exercise the privileges required to operate an 
aircraft under Sec.  61.113(i) of this chapter; or
    (ii) The individual's driver's license is revoked by the issuing 
agency as a result of a clinically diagnosed mental health condition.
    (2) Subject to paragraph (c)(1) of this section, an individual 
clinically diagnosed with a mental health condition shall certify every 
2 years, in conjunction with the certification under Sec.  68.3(b)(3), 
that the individual is under the care of a State-licensed medical 
specialist for that mental health condition.
    (d) Special rule for neurological conditions. (1) In the case of an 
individual with a clinically diagnosed neurological condition, the 
ability to operate an aircraft under Sec.  61.113(i) of this chapter 
shall not apply if--
    (i) In the judgment of the individual's State-licensed medical 
specialist, the condition--
    (A) Renders the individual unable to safely perform the duties or 
exercise the airman privileges required to operate an aircraft under 
Sec.  61.113(i) of this chapter; or
    (B) May reasonably be expected to make the individual unable to 
perform the duties or exercise the privileges required to operate an 
aircraft under Sec.  61.113(i) of this chapter; or
    (ii) The individual's driver's license is revoked by the issuing 
agency as a result of a clinically diagnosed neurological condition.
    (2) Subject to paragraph (d)(1) of this section, an individual 
clinically diagnosed with a neurological condition shall certify every 
2 years, in conjunction with the certification under Sec.  68.3(b)(3), 
that the individual is under the care of a State-licensed medical 
specialist for that neurological condition.

Sec.  68.11  Authority to require additional information.

    (a) If the Administrator receives credible or urgent information, 
including from the National Driver Register or the Administrator's 
Safety Hotline, that reflects on an individual's ability to safely 
operate an aircraft under Sec.  61.113(i) of this chapter, the 
Administrator may require the individual to provide additional 
information or history so that the Administrator may determine whether 
the individual is safe to continue operating under that section.
    (b) The Administrator may use credible or urgent information 
received under paragraph (a) to request an individual to provide 
additional information or to take actions under 49 U.S.C. 44709(b).

PART 91--GENERAL OPERATING AND FLIGHT RULES

0
8. The authority citation for part 91 is revised to read as follows:

    Authority: 49 U.S.C. 106(f), 106(g), 1155, 40101, 40103, 40105, 
40113, 40120, 44101, 44111, 44701, 44704, 44709, 44711, 44712, 
44715, 44716, 44717, 44722, 46306, 46315, 46316, 46504, 46506-46507, 
47122, 47508, 47528-47531, 47534, Pub. L. 114-190, 130 Stat. 615 (49 
U.S.C. 44703 note); articles 12 and 29 of the Convention on 
International Civil Aviation (61 Stat. 1180), (126 Stat. 11).

0
9. In Sec.  91.319, add paragraph (j) to read as follows:

Sec.  91.319  Aircraft having experimental certificates: Operating 
limitations.

* * * * *
    (j) No person may operate an aircraft that has an experimental 
certificate under Sec.  61.113(i) of this chapter unless the aircraft 
is carrying not more than 6 occupants.

    Issued in Washington, DC, under the authority of 49 U.S.C. 
106(f) and Sec. 2307 of Public Law 114-190 on December 22, 2016.
Michael P. Huerta,
Administrator.
[FR Doc. 2016-31602 Filed 1-10-17; 11:15 am]
 BILLING CODE 4910-13-P