Last updated: March 27, 2023
In short, the Medical Review Officer (MRO) serves as the drug testing liaison between the donor, the collector, the test facility (lab), and the employer.
MROs are currently licensed physicians holding either a Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.) degree who meets the requirements laid out by the United States Department of Health and Human Services (HHS).
The qualifications of a Medical Review Officer are:
- Knowledge regarding the pharmacology and toxicology of illicit drugs;
- Completes all required training to serve as an MRO;
- Satisfactorily passed required examinations; and
- Attends requalification training at least every 5 years.
HHS outlines the responsibilities of a Medical Review Officer as follows:
- Review all positive, adulterated, rejected for testing, invalid, and (for urine) substituted test results;
- Ensure that specimens reported as negative and (for urine) negative/dilute are properly reviewed and reported to the agency’s designated representative. The MRO must review at least 5% of the negative results reported by staff to ensure the MRO staff are properly performing the review process. This review should include all specimens that required corrective action;
- Discuss potential invalid results with the HHS-certified laboratory to determine whether further testing at another HHS-certified laboratory is warranted;
- Complete action on a report from an HHS-certified laboratory or (for urine) HHScertified IITF by—
– Reviewing the information on the MRO copy of the Federal Custody and Control Form (CCF) that was received from the collector and the report received from the HHS-certified laboratory or IITF;
– Interviewing the donor when required (e.g., to verify the existence of prescribed medication that could explain the result and/or to collect evidence of the prescription and subsequent dispensing of that prescription);
– Making a determination regarding the result; and
– Reporting the verified result to the federal agency.
- Maintain all records for a minimum of 2 years while maintaining the confidentiality of the information. The MRO may discard hardcopy records 6 months after conversion to electronic records (with appropriate security);
- Conduct a medical evaluation of the donor or a review of the examining physician’s findings and make a determination of “refusal to test” or “cancelled test” when a collector reports that the donor was unable to provide a urine specimen;
- Monitor the frequency of errors and notify responsible parties to take corrective action to prevent recurrence; and
- Review the results of federal agency blind samples and perform the initial investigation into discrepant results.
- Request additional testing (as allowed) to help in the determination of a final result
for a donor specimen.
The MRO reviews and verification prevent an employee from being labeled as a drug user when they receive a positive drug test result due to taking legally prescribed medication. If an employee tests positive, they’re contacted by the MRO and asked if they have a medical explanation for the positive result.
The process is in place to eliminate false positive drug test results.
Introducing our Chief Medical Review Officer
David R. Nahin, M.D. leads the USAMDT Medical Review Officer team as Chief Medical Review Officer.
Dr. Nahin has been practicing medicine for nearly four decades and possesses over 25 years of Medical Review Officer experience.
In addition to being board-certified in emergency medicine, Dr. Nahin is certified by the American Association of Medical Review Officers (AAMRO) and the Medical Review Officer Certification Council (MROCC).
In November 2010, Dr. Nahin was appointed to the Medical Review Officer Certification Council Examination Development Committee. His responsibilities include writing the MROCC certification exam questions.
The Committee, appointed by the Board of Directors, was made up of recognized leaders in the workplace drug and alcohol testing industry and was selected from the fields of substance abuse, occupational medicine, toxicology, and the legal profession.
In addition, Dr. Nahin was appointed to a committee formed by Research Triangle Institute, Inc. (RTI) who were tasked with developing medical review standards and procedures for Health and Human Services (HHS) oral fluid drug testing.
Prior to serving as a Medical Review Officer, Dr. Nahin practiced emergency medicine at several of Wisconsin’s finest hospitals, including St. Luke’s Hospital, Memorial Hospital, Trinity Memorial Hospital, Waukesha Memorial Hospital, and Columbia Hospital.
Raised in Milwaukee, Wisconsin, Dr. Nahin received his Bachelor’s Degree in Chemistry from St. Norbert College and his Medical Degree from the Medical College of Wisconsin. He completed his internship and residency training in internal medicine at Mount Sinai Medical Center in Milwaukee.
A partnership of quality and confidence
USA Mobile Drug Testing (USAMDT) assists companies nationwide with complete Medical Review Officer (MRO) services as the first line of defense in drug testing.
When you partner with us, you have access to a far-reaching and highly qualified team of medical doctors.
Of course, each member of our team is certified by the American Association of Medical Review Officers (AAMRO) and the Medical Review Officer Certification Council (MROCC). They have extensive experience in the review of DOT and Non-DOT drug tests.
In addition to our stellar medical team, we provide online management tools that are designed to be used by MRO agents, support staff, and officers themselves.
USAMDT MRO Services include:
- Electronic data management
- Final disposition of records
- Chain of Custody management tools
- Real-time status updates
- Qualified third party Translator Service for interviews with non-English speaking donors
- MRO Expert testimony and telephone litigation support
- MRO consultation regarding testing program implementation, interpretation, prescription abuse and prescription monitoring
Partner with us!
You can trust USA Mobile Drug Testing to provide you with exceptional service from our initial contact. We’re located nationwide so reach out!
You’ll be glad you did.