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What is the role of an MRO?

The MRO is a key person in the drug testing process. He or she ensures that the drug tests are administered properly, that the correct drug panel was used, and that all the correct procedures were followed. Additionally, a positive drug test calls for an MRO intervention to work with the donor to establish if the positive was caused by a valid prescription or medical treatment. If the donor cannot be contacted, the MRO will report a non-contact positive.

Nothing is assumed in the drug testing process.

Definition of an MRO

Per the Department of Transportation (DOT), the MRO’s role is as follows:

A Medical Review Officer (MRO) is a person who is a licensed physician and who is responsible for receiving and reviewing laboratory results generated by an employer's drug testing program and evaluating medical explanations for certain drug test results.

As an MRO, you act as an independent and impartial "gatekeeper" and advocate for the accuracy and integrity of the drug testing process. You provide quality assurance review of the drug testing process for the specimens under your purview, determine if there is a legitimate medical explanation for laboratory confirmed positive, adulterated, substituted and invalid drug test results, ensure the timely flow of test result and other information to employers and protect the confidentiality of the drug testing information.

MROs must complete training courses and fulfill obligations for continuing education courses; they are DOT-certified and registered on the DOT website. Our MRO is onsite to perform examinations including health history review through physical examination and urinalysis.

Responsibilities of an MRO

  • Any specimens that have been reported as substituted, adulterated, positive, or rejected for testing must be reviewed by the MRO.
  • If a donor must be contacted, due to an adverse result, it is the MRO’s responsibility to contact the donor and check for a medical history and prescription use or use of legal substance.
  • Any drug test reported as negative or negative/dilute will also be reviewed by the MRO before it is reported to the employer or state agency.
  • The MRO also must keep all drug test results confidential.

The DOT requires all drug tests and drug test procedures be reviewed by an MRO. Quality drug testing companies will have MROs on site who are certified and able to work with employers throughout the drug testing process when necessary.

Related Links

What is a non-contact positive?

The SAMHSA MRO manual

The Cat and Mouse Game of Beating a Drug Test

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