A Medical Review Officer (MRO) is an independent physician who reviews laboratory drug test results. This role ensures the accuracy and fairness of drug tests by providing an objective evaluation of findings before they are reported to employers. An MRO interprets complex scientific data and considers medical explanations, contributing to a reliable and equitable drug testing program.
Understanding the Medical Review Officer
A Medical Review Officer is a licensed physician, holding either a Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.) degree. This professional evaluates drug test results to determine if a legitimate medical explanation exists for any non-negative findings.
MROs maintain independence from both the employer and the testing laboratory, ensuring impartiality and objectivity. To qualify, MROs must possess knowledge of substance abuse disorders, pharmacology, and toxicology. They also undergo specific training and certification from recognized organizations, such as the American Association of Medical Review Officers (AAMRO) or the Medical Review Officer Certification Council (MROCC), with recertification typically required every five years.
The MRO’s Core Responsibilities
The MRO’s duties begin upon receiving laboratory results, which can range from negative to positive, adulterated, substituted, or invalid. The MRO reviews all reported specimens to ensure proper procedures were followed. For non-negative or invalid results, the MRO confidentially contacts the individual to discuss the finding.
During this conversation, the MRO evaluates medical documentation, such as prescriptions or medical records, that could explain the presence of a substance. Based on this review and interview, the MRO makes a final determination, verifying the result as positive, negative (due to a legitimate medical reason), or cancelled. The MRO then confidentially reports the verified result to the employer. MROs also ensure compliance with federal regulations, particularly those from the Department of Transportation (DOT), such as 49 CFR Part 40, which outlines specific procedures for drug and alcohol testing in safety-sensitive industries.
The MRO Review Process
The MRO’s involvement begins after a drug testing laboratory has analyzed a specimen and reported a non-negative or invalid result. The laboratory sends these results directly to the MRO, initiating the review. The MRO or their supervised staff then attempts to contact the donor confidentially. Federal regulations, such as those for DOT testing, often require multiple attempts to reach the donor, usually at least three times within 24 hours.
If contact is made, the MRO conducts a private interview with the donor to discuss the test results. The donor can provide any medical explanation, such as a valid prescription for a detected substance. The MRO verifies this information, often by contacting the prescribing physician or pharmacy. After evaluating all available information, the MRO renders a verified result and reports it to the employer, without disclosing specific medical details unless legally required or authorized.
Why the MRO Role is Critical
The MRO ensures the integrity and accuracy of workplace drug testing programs. Their involvement protects both the employer and the employee. For employees, the MRO provides an opportunity to present legitimate medical explanations for test results, safeguarding against false positives from prescribed medications or other valid reasons.
This physician’s review also helps employers avoid legal challenges by ensuring drug testing policies are implemented fairly and in compliance with regulations. The MRO’s expertise adds a layer of objective verification, which is important for safety-sensitive positions where drug testing outcomes have significant implications. By reviewing results and confirming their validity, MROs contribute to maintaining a safe working environment while upholding individual rights and confidentiality.