What is a Medical Review Officer (MRO)

We get the question very often – what is a Medical Review Officer or MRO for drug testing. This article will answer the question and talk more about the medical review officer in drug testing. We call the MRO the gatekeeper in the employment drug testing process.

What Is A Medical Review Officer - MRO?

Medical Review Officer (MRO) – A Medical Review Officer or 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. The MRO receives the laboratory drug test results from the lab and reports the results to the employer.  Many TPA’s have in house MRO’s working for them.  For Federal Programs, DOT programs and under many State laws and State law programs the MRO must be trained, qualified and certified by a nationally-recognized MRO certification board or subspecialty board for medical practitioners in the field of medical review of DOT-mandated drug tests. 

The MRO is required for testing for Federal Agency employees, DOT testing programs and under many State laws and State law programs.  It is a best practice to use an MRO for all workplace laboratory drug testing.

The Medical Review Officer (MRO) – An Overview

Drug testing by employers is fairly commonplace, but it is not without potential difficulties.  The drug testing process must be conducted with strict adherence to established protocols and best practices. An essential part of this process is how positive drug test results are handled as they present issues of medical confidentiality that require expertise to appropriately manage.  A Medical Review has that expertise.

The Medical Review Officer (MRO) – An Overview

How The Medical Review Officer - MRO Benefits The Employee

The medical review officer or MRO is a licensed physician that reviews drug test results that are reported by the laboratory. The MRO is a gatekeeper for the drug testing process.  The employee or applicant is protected with a proper drug test result review by an MRO.  When the employee or applicant is taking legally prescribed medications, there is possibility of the laboratory reporting the drug test result as positive.

The MRO will call every employee or applicant with a laboratory reported positive and verify legally prescribed medications. If everything checks out, the MRO will report the result to the employer as negative. This process eliminates the possibility of a false positive. The medical review officer should be reviewing all employment-based drug tests to make sure everything is done right before the employer gets the final result.  

Medical Review Officer - MRO Qualifications

An MRO must have in-depth knowledge of the toxicology and pharmacology of illicit drugs and controlled substance abuse disorders, as well as alternative medical explanations for positive drug test results.

Comprehensive training and examination are required for certification as an MRO.  Qualified training programs provide instruction in

At the completion of training, the MRO candidate must past an examination administered by a nationally recognized MRO certification board.  The resulting certification is valid for a period of five years, at which time the MRO must undergo requalification training and subsequent successful re-examination in order to maintain certification.

Medical Review Officer - MRO Restrictions

There are some restrictions regarding MRO’s.  An MRO cannot be an agent or employee of anyone with a financial interest in any lab or instrumental initial test facility (IITF) where the MRO is reviewing the results of drug tests.  Additionally, the MRO cannot receive any financial benefit as a result of recommending the use of a particular facility or be in an agreement with any lab or IITF that could be perceived as a conflict of interest.

Employer Protection With The MRO

Ultimately, an MRO serves to protect the employer by assuming responsibility for the assessment of drug testing results and for handling the procedural response to positive drug tests, including the review and release of confidential employee medical information.  This includes conducting a verification interview with the employee following a confirmed positive drug test result.  The MRO informs the employee of the positive result and the specific drug or drugs which caused it.  Additionally, the MRO interviews the employee to determine if there is a legitimate medical explanation for the positive result, and makes a final evaluation of that result.  The MRO then notifies the appropriate parties of that final determination while adhering to confidentiality regulations.

An MRO review is not required in every state or for all employers.  However, the utilization of an MRO’s expertise is highly recommended for all drug testing programs.  By utilizing an MRO, an employer can feel confident knowing a highly trained, certified physician is ensuring the integrity of the drug testing process and handling the issues of confidentiality in a manner that will help to protect the employer from possible litigation.

Learn more about Medical Review Officer Services (MRO) from National Drug Screening.

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