Issn Print: 1076-2752

Publication Date: 2003/01/01


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Qualifications of Medical Review Officers (MROs) in Regulated and Nonregulated Drug Testing

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Excerpt

The medical review officer (MRO) concept was first introduced in 1988 with the announcement of the federal Department of Transportation drug testing regulations. The MRO’s primary role is to determine whether a medical explanation exists for a laboratory-verified positive controlled substance test. The MRO was defined as “a licensed physician (MD or DO) who has knowledge of substance abuse disorders and has appropriate medical training to interpret and evaluate an individual’s positive test result together with his or her medical history and any other relevant biomedical information.” Neither official training nor certification were required.
In the original 1990 American College of Occupational and Environmental Medicine (ACOEM) position paper on MRO qualification, it was recommended that an MRO be “certified as having received at least 14 hours of [continuing medical education] CME credit for instruction as medical review officers, including the pharmacology of substance abuse, laboratory testing methodology and quality control, forensic toxicology, federal regulations, legal and ethical requirements, chemical dependency illness, employee assistance programs and rehabilitation.…”
As testing for controlled substance expanded in the nonregulated arena, several states began to develop laws concerning protocols and procedures to be followed. Although testing performed under federal standards required the reviewing MRO to be a physician, some states passed legislation that would allow a nonphysician to provide MRO services in state regulated situations.
Extensive changes to the Procedures for Transportation Workplace Drug and Alcohol Testing programs were published in the December 19, 2000, Final Rule. Among the changes were training and certification requirements for MROs.
As a result of this change and upon recommendation of the Medical Review Office Section, ACOEM updated its position paper on the Qualifications of Medical Review Officers (MROs) to include both regulated and non-regulated drug testing. This updated position paper was passed by the ACOEM Board of Directors on July 28, 2001. It reflects the new MRO requirements and supports that MRO services in nonregulated drug testing should be provided by a licensed physician consistent with the requirement for federal testing.

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