NH implements NRII, only 2 states remain

August 20, 2026

As of August 17, 2026, New Hampshire is in full compliance with the new NRII requirements. As a result, only two states (Louisianna and Alaska) remain on the list of states yet to comply with the new regulations.

Paper submissions coming to an end

NH is now meeting the requirements of the Federal Motor Carrier Safety Administration (FMCSA) and will no longer accept paper copies of the Medical Examiner Certificates (med cards), including drop box, email, and in-person submissions. The last paper copy was accepted on August 14, 2026.

All med cards issued to commercial driver’s license (CDL) holders by FMCSA-certified examiners will now be electronically submitted to the state’s Department of Motor Vehicle (DMV) and automatically added to the driver’s record. CDL drivers who don’t maintain a valid med card will risk losing their driving privileges. Drivers may check their med card status by calling 603-227-4000.

Two states left

LA and AK are the final two states to comply with the FMCSA’s requirement for receiving med cards electronically and directly from a certified examiner. CDL drivers in these states must continue to submit their med card information directly to the state.

The FMCSA has a current exemption in place until October 11, 2026, which allows CDL holders and carriers to use a copy of a CDL driver’s DOT med card for up to 60 days to show proof of medical certification. This exemption was issued to allow the remaining states time to transition to the NRII process, as well as address issues with transfer delays in states that have already implemented the NRII process.

NRII background

Since June 23, 2025, the “National Registry II” dictated that if a certified medical examiner finds that a CDL driver is physically qualified to drive a CMV, the examiner will complete a CMV Driver Medical Examination Results Form (MCSA-5850) in the National Registry of Certified Medical Examiners (NRCME). That information will be electronically transferred to the driver's licensing authority. Upon receiving this information, the state will post a medical qualification status of “certified” on the driver’s motor vehicle record (MVR), along with other required exam information. The driver’s state driving record (i.e., MVR) is official proof of medical certification for CDL drivers and their carrier.

None of these changes apply to non-CDL drivers, who must follow all existing regulations concerning physical qualification status.

Publish Date

August 20, 2026

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Industry News

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