• Medical review officers confirm test results, check the lab’s performance, and check the chain-of-custody for employers.
• Companies should only use licensed and trained physicians as MROs.

The medical review officer’s (MRO) responsibility is a significant function within the testing process. The MRO’s job is to provide a “clinical confirmation” of a presumptive positive as reported by the laboratory.

Essentially, a positive test is initially a scientific conclusion which then must be legitimized by medical considerations made by the MRO. The MRO then determines whether a true positive exists. The laboratory reports the result directly to the MRO for a professional review of the results which will only be reported to the company after a “clinical confirmation” has been achieved by the MRO.

This is likely to be the most critical decision employers make within a testing program. The MRO will have more contact with the company than anyone else within the program. The person will become the company’s “agent” providing final analysis of the total process and representing the company in any challenge litigation that may evolve.

MRO chief duties include:

• Verify results, both negative and positive;
• Check the lab’s performance; and
• Check the chain-of-custody.

Seek out only licensed physicians (Doctor of Medicine or osteopaths). MROs must meet the knowledge, training, and education requirements described in 40.121. There are professional bodies which provide certification such as AAMRO (American Association of Medical Review Officers) and MROCC (Medical Review Officer Certification Council). This certification guarantees a knowledgeable and competent MD; it is the assurance a company should demand from a qualified professional. The websites of these organizations include searchable databases of certified MROs to help employers find an acceptable one:

• American Association of Medical Review Officers
• Medical Review Officer Certification Council