The National Registry is necessary because information from the NTSB crash investigations indicates that improper medical certification of CMV drivers with serious disqualifying medical conditions has directly contributed to fatal and injury crashes. The FMCSA developed the National Registry of Certified Medical Examiners final rule as part of the agency’s commitment to enhancing the medical oversight of interstate drivers, and preventing commercial vehicle-related crashes, injuries and fatalities. The final rule addresses four NTSB recommendations on a comprehensive medical oversight program for interstate drivers.