FAA Issued New Medical Requirements for Small Aircraft Pilots but

FAA Issued New Medical Requirements

for Small Aircraft Pilots but Lacks

Procedures and Data To Oversee the

Program

Report No. AV2020044

September

2, 2020

FAA Issued New Medical Requirements for Small Aircraft Pilots

but Lacks Procedures and Data To Oversee the Program

Requested by the

Chairmen of the House Committee on Transportation and Infrastructure and its Aviation

Subcommittee

Federal

Aviation Administration | AV2020044 |September 2, 2020

What We Looked At

The United States has the largest and most diverse general aviation community in the world. In 2017,

the Federal Aviation Administration (FAA) issued a new rule, referred to as BasicMed, which

implemented an alternative way for many general aviation pilots to establish medical eligibility

without having to undergo the previous medical certification process. As of April 2020, more than

55,000 pilots had been registered for BasicMed. To aid in their oversight of the new BasicMed

process, then Chairmen Bill Shuster of the House Committee on Transportation and Infrastructure and

Frank A. LoBiondo of the Subcommittee on Aviation requested that we examine FAA's

implementation of the new BasicMed requirements. Our audit objectives were to assess FAA’s

(1) procedures for implementing new medical requirements for certain small aircraft pilots, including

identifying challenges to its implementation, and (2) plans for measuring the impact of the new

BasicMed process on aviation safety.

What We Found

FAA issued the BasicMed rule in compliance with the Act on January 11, 2017, and provided guidance

and conducted outreach to stakeholders to implement the program. Under BasicMed, pilots can fly an

aircraft the moment they complete the online medical course and submit other required information.

However, FAA lacks an effective process to confirm pilots meet all eligibility requirements, such as

whether they have a valid U.S. driver’s license. FAA also does not have a process to verify that pilots’

medical examinations are being performed by State-licensed physicians as required. In addition, FAA’s

plan to measure the safety impact of the program is limited by a lack of available data. According to

FAA, it may take several more years until there is sufficient data to identify trends and evaluate the

rule’s safety impacts, due in part to the lengthy process for accident investigations.

Our Recommendations

FAA concurred with our two recommendations to improve FAA’s process for verifying pilot’s eligibility

for the BasicMed program and measuring the program’s impact on aviation safety.

All OIG audit reports are available on our website at www.oig.dot.gov.

For inquiries about this report, please contact our Office of Government and Public Affairs at (202) 366-8751.

AV2020044

Contents

Memorandum 1

Results in Brief 3

Background 4

FAA Issued the BasicMed Rule but Lacks Procedures To Verify Program

Compliance 5

FAA’s Plan To Measure Safety Impacts of BasicMed Is Limited by Lack of

Available Data 9

Conclusion 11

Recommendations 12

Agency Comments and OIG Response 12

Actions Required 12

Exhibit A. Scope and Methodology 13

Exhibit B. Organizations Visited or Contacted 15

Exhibit C. List of Acronyms 16

Exhibit D. Major Contributors to This Report 17

Appendix. Agency Comments 18

AV2020044 1

Memorandum

Date: September 2, 2020

ubject: ACTION:

FAA Issued New Medical Requirements for Small Aircraft Pilots but

Lacks Procedures and Data To Oversee the Program

| Report No. AV2020044

From: Matthew E. Hampton

Assistant Inspector General for Aviation Audits

To: F

ederal Aviation Administrator

The United States has the largest and most diverse general aviation community in

the world, with more than 220,000 active aircraft, including amateur-built aircraft,

rotorcraft, balloons, and highly sophisticated turbojets. Prior to May 2017, the

Federal Aviation Administration (FAA) required private, recreational, and student

pilots, as well as flight instructors, to obtain a third-class medical certificate

validation that they met the Agency’s medical standards. On July 15, 2016,

Congress enacted the FAA Extension, Safety, and Security Act of 2016 (the Act),

which established an alternate pilot physical examination and education

requirement. On January 11, 2017, FAA issued a new rule,

referred to as

BasicMed, which implemented the alternative way to establish medical eligibility

to be a pilot in command of certain powered aircraft with specific operating

restrictions.

As of April 2020, more than 55,000 pilots had been registered for

BasicMed.

To aid in their oversight of the new BasicMed process, the Chairmen of the House

Committee on Transportation and Infrastructure and its Aviation Subcommittee

requested that we examine FAA's implementation of the new BasicMed

In most cases, a first-class medical certificate is required for operations requiring an airline transport pilot certificate.

At minimum, a second-class medical certificate is required for operations requiring a commercial pilot certificate.

Airmen exercising sport pilot privileges in a light sport aircraft may operate with a medical certificate or driver’s

license. Persons operating gliders and balloons are not required to hold a medical certificate.

Pub. L. No. 114-190 (2016), Section 2307, Medical Certification of Certain Small Aircraft Pilots.

Alternative Pilot Physical Examination and Education Requirements, effective May 1, 2017.

The aircraft must be authorized by FAA to carry not more than six occupants and with a maximum certified takeoff

weight of no more than 6,000 pounds. The aircraft must operate at or below 18,000 feet and not exceed an air speed

of 250 knots (288 mph) for the entire flight.

U.S. DEPARTMENT OF TRANSPORTATION

OFFICE OF INSPECTOR GENERAL

AV2020044 2

requirements.

In addition, they requested that we identify any lessons learned

from FAA's implementation of this provision and the impact of the new BasicMed

process on general aviation safety. Accordingly, our objectives were to assess

(1) FAA’s procedures for implementing new medical requirements for certain

small aircraft pilots, including identifying challenges to its implementation, and

(2) FAA’s plans for measuring the impact of the new BasicMed process on

aviation safety.

We conducted this audit in accordance with generally accepted Government

auditing standards. Exhibit A details our scope and methodology, and exhibit B

lists the organizations we visited or contacted. For a list of the acronyms used in

the report, see exhibit C.

We appreciate the courtesies and cooperation of FAA representatives during this

audit. If you have any questions concerning this report, please call me at

(202) 366-0500 or Marshall Jackson, Program Director, at (202) 366-4274.

cc: The Secretary

DOT Audit Liaison, M-1

FAA Audit Liaison, AAE-100

Then Chairmen Bill Shuster of the U.S. House of Representatives Committee on Transportation and Infrastructure

and Frank A. LoBiondo of the Subcommittee on Aviation requested this audit on November 21, 2017.

AV2020044 3

Results in Brief

FAA issued the BasicMed rule but lacks procedures to

effectively verify program compliance.

FAA issued the BasicMed rule in compliance with the Act on January 11, 2017,

and provided guidance and conducted outreach to stakeholders to implement

the program. Under BasicMed, pilots can fly an aircraft the moment they

complete the online medical course and submit other required information.

However, FAA lacks a process to confirm pilots meet all eligibility requirements,

such as whether they have a valid U.S. driver’s license, at the time of registration.

When pilots register for BasicMed, they authorize FAA to conduct a driving

record check with the National Highway Traffic Safety Administration’s (NHTSA)

National Driver Register (NDR). However, FAA’s record check is limited.

Specifically, FAA only reviews pilots’ driving records for violations for driving

under the influence (DUI), driving while intoxicated (DWI), and substance abuse.

FAA does not check over 100 other possible violations that could result in a

suspended or revoked driver’s license, such as violations resulting in fatal

accidents and reckless driving. This is because FAA has not developed policies

and procedures specific to BasicMed but instead uses the existing process for

medical certification, which does not require a valid driver’s license. FAA also

does not have a process to verify that pilots’ medical examinations are being

performed by State-licensed physicians, a key requirement of BasicMed eligibility.

According to FAA officials, this is because verifying physicians’ credentials was

not included in the Act, and they have no plan to do so. Yet, a one-time study

requested in March 2019 by FAA’s Office of Aerospace Medicine revealed that

3 percent of pilots’ medical examinations were performed by medical providers

who did not appear to qualify as State-licensed physicians.

As a result of these

issues, FAA cannot have reasonable assurance that pilots meet BasicMed

eligibility requirements.

FAA’s plan to measure safety impacts is limited by the lack

of available data.

In June 2018, FAA formed the BasicMed Reporting and Analysis Working Group

and established plans to report on the changes in general aviation aircraft activity

and safety issues, such as whether the risk varies between pilots operating under

BasicMed compared to pilots with active medical certificates. FAA provided us

with the working group’s first report in October 2019, which did not draw any

conclusions on the safety impact, and plans to report to Congress in 2021 as

According to the BasicMed rule, FAA relies on the determination of each State as 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.

AV2020044 4

required. However, FAA told us that it may take several more years until there is

sufficient data to identify trends and evaluate the rule’s safety impacts, due in

part to the lengthy process for accident investigations. Moreover, FAA cannot

make a meaningful comparison between the BasicMed rate of accidents and

fatalities to those occurring among pilots holding a medical certificate because

the Agency does not collect data on BasicMed pilots’ flight hours. Without these

data, FAA’s ability to accurately and fully assess whether BasicMed has impacted

safety may be limited.

We made recommendations to improve FAA’s process for verifying pilot’s

eligibility for the BasicMed program and measuring the program’s impact on

aviation safety.

Background

As part of an effort to offer greater flexibility to pilots flying for recreation and

personal transportation, Congress directed 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 FAA’s 2017

rule, to be eligible to fly under BasicMed, pilots must have a valid U.S. driver’s

license, undergo a medical examination by a State-licensed physician within the

preceding 48 months, and complete an online medical self-assessment education

course

in the preceding 24 calendar months. Additionally, pilots must have had a

valid FAA medical certificate after July 14, 2006, that had not been revoked,

suspended, or withdrawn, or must not have had the most recent application for a

medical certificate denied.

In contrast, pilots flying under a third-class medical certificate must complete an

online application and be examined by an FAA-designated Aviation Medical

Examiner. A third-class medical certificate is valid for 5 years for pilots under age

40 and 2 years for pilots age 40 and over. It is ultimately the pilot’s responsibility

to ensure they are fit to fly, whether they fly under BasicMed or a medical

certificate.

The following table shows further differences between BasicMed and

third-class medical certification requirements.

A covered aircraft means an aircraft that is authorized to carry not more than six occupants and has a maximum

certificated takeoff weight of not more than 6,000 pounds.

The Aircraft Owners and Pilots Association and the Mayo Clinic provide the BasicMed online medical self-assessment

courses.

14 CFR Section 61.53 states that no person who holds a medical certificate may act as pilot in command while that

person knows of any medical condition that would make the person unable to meet the requirements for the medical

certificate. It also states a person operating without a medical certificate shall not act as pilot in command while that

person knows of any medical condition that would make the person unable to operate the aircraft in a safe manner.

AV2020044 5

Table. Differences in BasicMed and Third-Class Medical Requirements

BasicMed Third-Class Medical

Possess a current and 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.

No equivalent requirement.

Hold or have held any medical certificate (1st,

2nd, or 3rd class) at any point after July 14, 2006.

Persons without a medical certificate or with a

revoked or suspended certificate must obtain a

new one prior to operating under BasicMed.

Pilots must hold a valid third-class medical

certificate.

Receive a comprehensive medical examination

from any State-licensed physician within the past

48 months.

Persons who were under age 40 at the time of the

medical examination are not required to have

another medical examination for 60 calendar

months; persons who were age 40 and over at the

time of the medical examination for 24 calendar

months. Only an FAA-designated Aviation Medical

Examiner can perform the medical examination.

Complete an online medical education course in

the past 24 calendar months.

No equivalent requirement.

Fly an aircraft that is authorized to carry no more

than six occupants (including the pilot) and not

fly for compensation or hire, with a maximum

certificated takeoff weight of no more than 6,000

lbs., and with an indicated airspeed of 250 knots

or less and an altitude at or below 18,000 feet

mean sea level.

Flight limits depend on the type of airmen

certificate (private, recreational, or student pilot)

when operating an aircraft with third-class

medical.

Source: OIG analysis of FAA regulations

FAA Issued the BasicMed Rule but Lacks

Procedures To Verify Program Compliance

FAA issued the BasicMed rule to comply with the Act, provided guidance to

pilots, and conducted outreach to internal and external stakeholders. However,

the Agency has not developed procedures to confirm pilots meet eligibility

requirements.

AV2020044 6

FAA Issued the BasicMed Rule in Time To

Comply With the Statute

In the FAA Extension, Safety, and Security Act of 2016, Congress required that

FAA issue a rule no later than 180 days after the President signed it into law on

July 15, 2016. FAA issued the BasicMed rule on January 11, 2017, exactly 180 days

after the law was enacted.

FAA formed a rulemaking team consisting of several Agency offices to develop

the new rule and implement the Act’s requirements. When issuing the rule, FAA

bypassed the public notice and comment period using the “good cause”

exception,

which can be deployed when this period is deemed unnecessary and

contrary to the public interest. As required, the Agency provided the reason for

using the exception in the Federal Register, stating that notice and the

opportunity to comment were not necessary because the Agency implemented

the statutory language directly into the regulations without interpretation.

Furthermore, delaying implementation of the rule would be contrary to the public

interest on the basis that it would have delayed the new privileges Congress

sought to provide.

In January 2017, FAA issued an advisory circular providing guidance to pilots and

other stakeholders prior to the rule becoming effective in May 2017. FAA

coordinated with the Aircraft Owners and Pilots Association to provide pilots with

access to the online medical education course. FAA also conducted outreach with

internal and external stakeholders, such as FAA safety inspectors, through articles

in the FAA Safety Briefing magazine and presentations at general aviation events.

Pilots Can Begin Flying Immediately

After Registering for BasicMed, but FAA

Lacks Procedures To Verify Their

Eligibility

FAA’s Flight Standards Service, the office that has oversight responsibility for the

BasicMed program, has not developed policies and procedures specific to the

BasicMed program, including procedures to verify pilots’ compliance with the

program’s requirements. According to FAA officials, pilots are registered and can

fly an aircraft under BasicMed the moment they successfully complete the online

The Administrative Procedure Act requires an agency to conduct notice and comment rulemaking except when the

agency for good cause finds that notice and public procedure are impracticable, unnecessary, or contrary to the

public interest.

AV2020044 7

medical course and submit required information. FAA begins to verify pilots’

eligibility only after they are registered under BasicMed. However, FAA’s

verification efforts are limited to program requirements related to having a

medical certificate, rather than requirements that were developed specifically for

the BasicMed program. For instance, FAA verifies that the pilot had a valid

medical certificate after July 14, 2006, but does not verify that the pilot has a valid

driver’s license or that medical examinations are performed by medical providers

that meet FAA requirements. The Agency has no plans to begin verifying these

requirements.

FAA Does Not Verify That Registered Pilots Have a Valid

Driver’s License

The BasicMed rule requires pilots to have a valid driver’s license and comply with

all medical requirements or restrictions associated with that license to operate an

aircraft. The rule also states that individuals whose driver’s license has been

revoked for any reason are not eligible to use the BasicMed rule unless the

driver’s license is reinstated. However, FAA lacks a process to verify that pilots

meet these requirements. FAA does not require pilots to provide information

confirming that they hold a valid driver’s license when registering for BasicMed,

and FAA’s current process does not verify that they do. An FAA official told us

that there is no plan to add a process to verify that BasicMed pilots actually hold

valid driver’s licenses.

Furthermore, FAA is missing opportunities to identify ineligible pilots during its

check of NHTSA’s NDR. The NDR contains information reported by States on

individuals whose privilege to operate a motor vehicle has been revoked,

suspended, canceled, or denied. After a pilot is registered for BasicMed, FAA

receives authorization to access the NDR. While the NDR will not verify that all

pilots have a valid driver’s license, it can be used as one tool to determine if some

pilots have suspended or revoked driver’s licenses. Yet according to FAA officials,

the Agency uses the NDR check only to determine whether pilots who have DUI,

DWI, and substance abuse violations have reported them to FAA as required.

FAA does not check more than 100 other violations in the NDR to determine

whether pilots may have a suspended or revoked driver’s license, such as

violations resulting in fatal accidents and reckless driving. This is because FAA has

not developed policies and procedures specific to BasicMed but instead uses the

identical NDR check process that it uses for medical certification, which does not

require a valid driver’s license.

To illustrate the extent to which FAA’s current NDR process may be missing

opportunities to identify ineligible pilots, we requested an NDR check of the

FAA regulation requires pilots to provide a written report to the Agency of each motor vehicle action involving

DUI/DWI violations of Federal or State statute within 60 days of the action.

AV2020044 8

more than 50,000 pilots registered for BasicMed since the start of the program.

There were 850 possible matches

of pilots who may have violations that could

have resulted in a suspended or revoked driver’s license. This indicates that some

registered pilots may not be eligible for BasicMed.

FAA Does Not Verify That Medical Examinations Are Performed by State-

Licensed Physicians

BasicMed also requires pilots to be examined by a State-licensed physician and

have the physician sign their comprehensive medical examination checklist.

During the registration process, pilots must submit the name and State medical

license number of the physician who performed their latest medical examination.

However, FAA does not have a process to verify that pilots’ medical examinations

are being performed by State-licensed physicians.

Officials with FAA’s Office of Aerospace Medicine identified this issue and in

March 2019 requested a one-time study to determine whether the medical

providers were State-licensed physicians and eligible to perform the

examinations. The study of a random sample of 600 pilots from the Registry

found that 3 percent of pilots’ medical examinations appeared to have been

performed by ineligible providers such as nurse practitioners and physician’s

assistants, which would render those pilots ineligible for BasicMed. However, FAA

officials stated that the Agency has no future plans to verify physicians’

information. According to these officials, this is because a process to verify

physicians’ credentials was not included in the Act, and they believe this action

would require additional rulemaking that would be difficult to issue with the

current policy of reducing regulations. However, it is unclear why verifying this

information would require rulemaking as opposed to a revision of FAA’s internal

policy. Without verification, FAA cannot ensure that BasicMed pilots will be

examined by eligible medical providers.

The NDR matches on last name, first name, and date of birth and only indicates that a driving violation was

reported by a State, but it does not indicate the action taken by the State and the status of pilot’s driver’s license. Due

to similar names, birthdates, and errors, it is necessary for FAA to investigate each match to ensure it is actually the

BasicMed pilot and to determine the action taken by the State.

AV2020044 9

FAA’s Plan To Measure Safety Impacts of BasicMed

Is Limited by Lack of Available Data

FAA established a working group in June 2018 to measure and analyze the safety

impacts of BasicMed. However, FAA anticipates that additional time is needed to

gather sufficient and relevant data to fully assess the program.

FAA Established a Working Group To

Assess the Safety Impacts of BasicMed

The FAA Extension, Safety, and Security Act of 2016 requires FAA, in coordination

with the National Transportation Safety Board (NTSB), to submit a report to

Congress no later than July 15, 2021, that describes the effect of BasicMed and

includes statistics with respect to the changes in small aircraft activity and safety

incidents.

FAA formed the BasicMed Reporting and Analysis Working Group in June 2018

with members from Flight Standards Service, the Office of Aerospace Medicine,

and the Office of Accident Investigation and Prevention (AVP). The working group

developed a charter detailing the Agency’s strategy and identifying data

requirements needed to report the impact of BasicMed from the standpoint of

aircraft activity and safety.

According to the charter, the working group’s data analysis will address the

changes in aircraft general aviation activity, such as the number of general

aviation pilots registered as BasicMed, including those with a medical certificate;

the number of third-class special issuance

and unrestricted medical certificates

issued; and under what circumstances people who could not or would not

otherwise fly are now operating under BasicMed.

Some of the potential safety issues the working group plans to explore are

whether the risk is different with airmen operating under BasicMed compared to

medically certificated airmen, and if changes should be made to the BasicMed list

of conditions requiring a special issuance of a medical certificate. The group will

also analyze the number of fatal and non-fatal accidents and incidents involving

BasicMed pilots and accident/incident rates by categories, such as age, type of

operation, and former special issuance holder. Additionally, the working group

Pilots who do not meet FAA standards that entitle them to a medical certificate may be granted a special issuance

of a medical certificate if they satisfy FAA that they can perform the duties of the class of medical certificate applied

for without endangering public safety.

AV2020044 10

will identify any aspects of BasicMed revealed by its data analysis that adversely

affect safety.

The Agency provided us with the working group’s first of two planned reports on

BasicMed findings on October 16, 2019. The report focused on the program’s first

2 years—May 1, 2017, through April 30, 2019—and contained a comparative

analysis of BasicMed and medically certificated pilot demographics and accident

information. However, the report drew no conclusions regarding the safety

impacts of the program. FAA plans to issue its next report to Congress in July

2021 to meet the statutory requirement.

It Is Too Early in the Program To Collect

Sufficient Data on the Impact of

BasicMed

As noted above, FAA’s working group plans to collect and analyze safety data

related to BasicMed starting from the rule’s implementation in 2017 up until

2021, as required by law. However, FAA officials from both AVP and the Civil

Aerospace Medical Institute (CAMI) stated that 5 years of data may not be

sufficient to draw conclusions on the BasicMed program’s operational safety

impacts.

According to an AVP official, at least 10 years of data is preferable for identifying

trends. The CAMI official indicated that a report similar to FAA’s Continued

Operational Safety Report on Light Sport Aircraft would eventually be issued. This

report contains data analysis of fatal accidents from July 2004 through

September 2018 and graphical representations of a 10-year trend (fiscal years

2009–2018) of fatal accidents by aircraft fleet.

FAA stated in its first report on

BasicMed findings that the Agency anticipates several more years of operational

data will be necessary to assess causation in a meaningful analysis due to the

lengthy accident investigative process.

Furthermore, FAA is missing a critical piece of information for a thorough analysis

of BasicMed’s safety impacts. Specifically, FAA lacks a reliable source for the

number of flight hours for pilots exempt from medical certification requirements.

FAA officials from both Flight Standards and CAMI identified this information as

key to accurately determining the rate of accidents and fatalities among the

BasicMed pilots per 100,000 hours and comparing it to those holding the third-

class medical certificate. NTSB also identified these missing data in a September

FAA, Continued Operational Safety (COS) Report: Special Category Light-Sport Aircraft, July 2014–September 2018

(issued January 2019).

AV2020044 11

2014 safety study on pilot impairment.

The study found that it was not possible

to compare the safety of medically certificated pilots with those flying under the

sport pilot and light sport aircraft rule—which does not have the same medical

requirements

for pilots—because there is limited information about the number

and flight activity of pilots without medical certificates. This situation is now

amplified by the more than 55,000 pilots who have chosen to fly under the

BasicMed rule and are added to the sport pilots flying without an FAA medical

certificate.

NTSB recommended that FAA require pilots who are exempt from medical

certification requirements to periodically report their status as an active pilot and

provide a summary of recent flight hours. After almost 4 years, NTSB closed the

recommendation noting that FAA took unacceptable action. According to FAA

officials, the Agency believes that the voluntary reporting of flight hours is

sufficient, and any further mandate will not provide an added safety benefit.

However, NTSB maintains that voluntary submission of flight hours does not

meet the intent of its recommendation and would not allow FAA to accurately

determine the accident risk of pilots flying without a medical certificate.

As a result of these issues, it may be several more years before FAA can collect

and analyze sufficient data to accurately assess the safety impacts of BasicMed, if

any.

Conclusion

BasicMed has generated interest in the general aviation community with more

than 55,000 pilots now registered to fly under the new rule. FAA took steps to

implement BasicMed in compliance with legislative requirements. However, the

lack of procedures to identify pilots who should not be flying under BasicMed

and prevent them from operating aircraft raises questions about the impact of

the new rule. While it is too soon to determine whether the new medical

requirements have had any impact on flight safety, implementing effective

procedures to prevent ineligible pilots from flying and developing methodologies

to collect key safety data will be critical to successfully implementing BasicMed in

the long run.

NTSB, Drug Use Trends in Aviation: Assessing the Risk of Pilot Impairment, September 2014.

Sport pilots can fly light-sport aircraft other than a glider or a balloon with a valid U.S. driver’s license or a medical

certificate.

AV2020044 12

Recommendations

To effectively implement and assess the safety impact of BasicMed, we

recommend that the Federal Aviation Administrator:

1. Conduct a risk assessment of the issues related to valid driver’s

licenses and use of State-licensed physicians noted in this report, and

implement processes to mitigate any identified risks. Include the

results of this risk-assessment in the required report on the safety

impact of BasicMed to Congress.

2. Develop and implement a process to collect pilot flight hours or an

alternative process that allows a meaningful assessment of the safety

impact of pilots operating under BasicMed compared with pilots

operating with a medical certificate.

Agency Comments and OIG Response

We provided FAA with our draft report on July 8, 2020, and received its response

on August 5, 2020, which is included as an appendix to this report. FAA also

provided technical comments, which we incorporated into this report where

appropriate. In its response, FAA concurred with both of our recommendations as

written and provided a completion date for implementing the recommended

actions.

Actions Required

We consider both recommendations to be resolved but open pending

completion of FAA’s planned actions.

Exhibit A. Scope and Methodology 13

Exhibit A. Scope and Methodology

We conducted this performance audit from December 2018 through July 2020 in

accordance with generally accepted Government auditing standards as

prescribed by the Comptroller General of the United States. Those standards

require that we plan and perform the audit to obtain sufficient, appropriate

evidence to provide a reasonable basis for our findings and conclusions based on

our audit objectives. We believe that the evidence obtained provides a

reasonable basis for our findings and conclusions based on our audit objectives.

To assess FAA’s procedures for implementing BasicMed, we reviewed applicable

laws, regulations, policies, and guidance. We met with Flight Standards Service

and the Office of Aerospace Medicine in Washington, DC. At the Mike Monroney

Aeronautical Center (MMAC) in Oklahoma City, OK, we met with FAA’s Civil

Aviation Registry (Registry), Airmen Certification Branch, the Deputy Director,

various divisions of FAA’s Civil Aerospace Medical Institute (CAMI), including

Medical Certification, Medical Education, and Medical Research, and the Office of

Security and Hazardous Material Safety.

We met with officials from the Registry to determine FAA’s processes for verifying

pilots’ program eligibility. We interviewed officials with DUI/DWI Investigations

Branch to determine their process for investigating BasicMed pilots with driving

violations in NHTSA’s NDR Problem Drivers Pointer System (PDPS) and discussed

with their Security Solutions Development Branch their process for sending and

retrieving pilots’ records through the NDR. We also interviewed personnel with

NHTSA’s NDR to determine their process of matching FAA’s BasicMed pilot files

to the PDPS. We also met with Aircraft Owners and Pilots Association officials in

Washington, DC to understand their involvement in developing the medical

education course.

We coordinated with FAA and NHTSA NDR to query the PDPS with a file

obtained from Registry containing 51,749 BasicMed pilots registered from May 1,

2017, through September 30, 2019. The query searched for matches to all

120 highway safety related codes for drivers’ convictions and/or withdrawals

defined in the American Association of Motor Vehicle Administrators Code

Dictionary Manual that require a pointer record in the PDPS.

To assess the reliability of FAA’s BasicMed Airmen data from May 1, 2017,

through September 30, 2019, we (1) talked to Agency officials about data quality

control procedures, (2) reviewed relevant documentation, and (3) electronically

tested the data to identify obvious problems with completeness or accuracy. We

determined the data were sufficiently reliable for the purpose of this report.

Exhibit A. Scope and Methodology 14

We reviewed the sampling methodology used by FAA’s Office of Aerospace

Medicine for its study of State-licensed physicians and obtained the file of

600 BasicMed pilots used in the study. We statistically tested the accuracy of the

analysis by independently researching 88 randomly selected pilots to determine if

the medical provider conducting the comprehensive medical exam held a state

issued medical license. The sample size was based on an expected error rate of

3 percent, a margin of error of 3 percent, and a confidence level of 90 percent.

The expected error rate was based on the error rate of the 600 BasicMed pilots.

The margin of error was set to 3 percent to include zero. Based on the results of

this sample, we believe the Office of Aerospace Medicine’s results are sufficiently

reliable for this report.

To determine FAA’s plans for measuring the impact of the new BasicMed process

on aviation safety, we reviewed FAA’s BasicMed Reporting and Analysis Working

Group Charter to determine what processes and procedures they are developing

to address the safety impact of BasicMed to be reported to Congress by July 15,

2021. We also met with FAA’s Office of Accident Investigation and Prevention in

Washington, DC, and CAMI’s Deputy Director and personnel from the Medical

Research division, to discuss their research on small aircraft activity and safety

incidents and accidents related to BasicMed pilots. In addition, we met with NTSB

officials at their Washington, DC, headquarters to determine how they are

coordinating with FAA to gather data for the report to Congress.

Exhibit B. Organizations Visited or Contacted 15

Exhibit B. Organizations Visited or Contacted

Federal Aviation Administration

Flight Standards Service, Washington, DC

Office of Accident Investigation and Prevention, Washington, DC

Office of Aerospace Medicine, Washington, DC

Office of Security and Hazardous Material, Security Solutions Development

Branch, Huntsville, AL

Civil Aerospace Medical Institute, Oklahoma City, OK

Office of Security and Hazardous Material, DUI/DWI Investigation Branch,

Oklahoma City, OK

Civil Aviation Registry, Airmen Certification Branch, Oklahoma City, OK

Other Organizations

Aircraft Owners and Pilots Association, Washington, DC

National Highway Transportation Safety Administration National Driver Register,

Washington, DC

National Transportation Safety Board, Washington, DC

Exhibit C. List of Acronyms 16

Exhibit C. List of Acronyms

AVP Office of Accident Investigation and Prevention

FAA Federal Aviation Administration

CAMI Civil Aerospace Medical Institute

CFR Code of Federal Regulations

DOT Department of Transportation

DUI/DWI Driving Under the Influence/Driving While Intoxicated

OIG Office of Inspector General

NDR National Driver Register

NHTSA National Highway Traffic Safety Administration

PDPS Problem Driver Pointer System

Exhibit D. Major Contributors to This Report 17

Exhibit D. Major Contributors to This Report

MARSHALL JACKSON PROGRAM DIRECTOR

TERRI AHURUONYE PROJECT MANAGER

ALFREDO ATREGENIO SENIOR AUDITOR

LYNN DOWDS SENIOR AUDITOR

AUDRE AZUOLAS SENIOR TECHNICAL WRITER

SETH KAUFMAN DEPUTY CHIEF COUNSEL

FREDERICK SWARTZBAUGH ASSOCIATE COUNSEL

GEORGE ZIPF SUPERVISORY MATHEMATICAL

STATISTICIAN

Appendix. Agency Comments 18

Appendix. Agency Comments

Federal Aviation

Administration

Memorandum

Date: August 5, 2020

To: Matthew E. Hampton, Assistant Inspector General for Aviation Audits

From: H. Clayton Foushee, Director, Office of Audit and Evaluation, AAE-1

Subject: Federal Aviation Administration’s (FAA) Response to Office of Inspector

General (OIG) Draft Report: FAA’s Implementation of Small Aircraft

Pilot Medical Reform

The FAA utilizes a risk-based approach to aviation system oversight so that Agency resources are

focused upon the areas of greatest risk to the general public. BasicMed implementation was based

upon the fact that small, non-commercial aircraft operations represent very low risk to the general

public. BasicMed also provided benefits by removing unnecessary aviation regulatory burdens.

The type of small aircraft operations allowed under BasicMed exhibit a low risk profile similar to

that of other non-commercial general aviation operations such as balloons, gliders, and light sport

aircraft, which do not require pilot medical certificates.

The FAA established the BasicMed Reporting and Analysis Workgroup with the mission to

quantitatively assess the BasicMed program. As additional operational data are compiled, the FAA

is committed to re-assessing the need for enhanced oversight in a manner consistent with the

FAA’s risk-based approach to safety oversight.

Based upon our review of the draft report, FAA concurs with both recommendations as written.

FAA plans to complete actions to implement the two recommendations by July 31, 2021.

FAA appreciates this opportunity to respond to the OIG draft report. Please contact H. Clayton

Foushee at (202) 267-9000 if you have any questions or require additional information about these

comments.

Our Mission

OIG conducts audits and investigations on

behalf of the American public to improve the

performance and integrity of DOT’s programs

to ensure a safe, efficient, and effective

national transportation system.