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Medical Review Officer (MRO)- Frequently Asked Questions

An essential component of any drug testing program is a comprehensive final review of laboratory results, which includes a review of appropriate documentation, as well as an interview with the donor of the specimen to discover whether or not an acceptable medical explanation exists for the laboratory result. A confirmed positive test result reported from a laboratory does not automatically identify an employee or job applicant as having misused drugs, nor does a laboratory result of invalid, substituted, or adulterated automatically identify a person as having tampered with a specimen.

The Medical Review Officer or MRO is a licensed physician who is involved with employment drug testing. The MRO receives results from a laboratory and verifies these results. The MRO performs the comprehensive final review of laboratory results.

False Positives

It is always very important to be using a laboratory certified by the Federal government and the lab performing both initial screening and confirmation testing. These laboratories then send the lab results to the MRO. The MRO reviews and verifies the laboratory result. Part of the review and verification process is having an interview with the applicant or the employee to rule out any positives caused by legally prescribed medications.

If this process is followed correctly in accordance with guidelines established by the Department of Health and Human Services (DHHS); we will not see false positive drug test results. A great resource is the Medical Review Officer Guidance Manual for Federal Workplace Drug Testing Programs. https://www.samhsa.gov/sites/default/...

Why Use an MRO?

The MRO protects both the donor and the employer. The donor is the applicant or employee taking the drug test. Using the MRO provides for a legally defensively drug test result. The MRO helps you to stay out of issues regarding EEOC, ADA, and HIPAA. Medical information gathered in the drug testing process is confidential and protected information.

MRO Process

The MRO will review the test results and any related information and contact the employee to conduct an interview (by phone).
The purpose of the interview is to:
1) allow the employee to present medical information to the MRO;
2) for the MRO to ask questions that he/she may have; and
3) for Federal tests, the MRO will inform the employee of his/her opportunity for a retest of the split specimen.

The MRO will ask the employee if he/she has taken any medications and/or other substances and ask the employee to provide substantiation for any prescribed medication. Based on the information provided by the employee, the MRO will determine if the positive result was caused by a legitimate medication or substance. If the employee cannot be reached for an interview, the MRO will proceed without it. Employers will be asked for assistance as to contacting a donor for the MRO interview.

MRO and the FMCSA Clearinghouse

Starting in January of 2020, MRO’s will be required to report for CDL drivers DOT verified positive and MRO verified refusals to test to the new FMCSA Clearinghouse. This will require extra work for the medical review officers. It is possible that many MRO’s throughout the country may elect to not perform this service and get out of the MRO business. National Drug Screening will have MRO’s available that will report to the Clearinghouse. For assistance with the new FMCSA Clearinghouse visit FMCSA Clearinghouse Services. https://clearinghouseservices.com/

For more info on the drug testing industry, drug and alcohol testing regulations and upcoming changes, and a whole lot more visit the NDS Blog regularly: http://www.NationalDrugScreening.com

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