FAA has laid out some specific rules and regulations in relation to Medical review Officers (MRO).

• The employer shall designate or appoint a Medical Review Officer (MRO) who shall be qualified in accordance with 49 CFR part 40 and shall perform the functions set forth in 49 CFR part 40 and this subpart. If the employer does not have a qualified individual on staff to serve as MRO, the employer may contract for the provision of MRO services as part of its drug testing program.
• The MRO must perform the functions set forth in subpart G of 49 CFR part 40, and subpart E of this part. The MRO shall not delay verification of the primary test result following a request for a split specimen test unless such delay is based on reasons other than the fact that the split specimen test result is pending. If the primary test result is verified as positive, actions required under this rule (e.g., notification to the Federal Air Surgeon, removal from safety-sensitive position) are not stayed during the 72-hour request period or pending receipt of the split specimen test result.
• As part of verifying a confirmed positive test result or refusal to submit to a test, the MRO must ask and the individual must answer whether he or she holds an airman medical certificate issued under 14 CFR part 67 or would be required to hold an airman medical certificate to perform a safety-sensitive function for the employer. If the individual answers in the affirmative to either question, in addition to notifying the employer in accordance with 49 CFR part 40, the MRO must forward to the Federal Air Surgeon, at the address listed, the name of the individual, along with identifying information and supporting documentation, within 2 working days after verifying a positive drug test result or refusal to submit to a test.
• Records concerning drug tests confirmed positive by the laboratory shall be maintained by the MRO for 5 years. Such records include the MRO copies of the custody and control form, medical interviews, documentation of the basis for verifying as negative test results confirmed as positive by the laboratory, any other documentation concerning the MRO's verification process.
• Should the employer change MRO's for any reason, the employer shall ensure that the former MRO forwards all records maintained pursuant to this rule to the new MRO within ten working days of receiving notice from the employer of the new MRO's name and address.
• Any employer obtaining MRO services by contract, including a contract through a C/TPA, shall ensure that the contract includes a recordkeeping provision that is consistent with this paragraph, including requirements for transferring records to a new MRO.
• The employer and the MRO shall permit the Administrator or the Administrator's representative to examine records required to be kept under this subpart and 49 CFR part 40.

Click here to find out more about the FAA rules & regulations for drug testing & alcohol testing. 1.1.2

Who is an MRO?

According to the DOT, a Medical Review Officer (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 is required to have basic knowledge and have clinical experience in controlled substances abuse disorders, including detailed knowledge of alternative medical explanations for laboratory confirmed drug test results.
• The MRO must be knowledgeable about issues relating to adulterated and substituted specimens as well as the possible medical causes of specimens having an invalid result.
• The MRO must be knowledgeable about the DOT MRO Guidelines and the DOT agency regulations applicable to the employers for whom they evaluate drug test results. The MRO must keep current on any changes to these materials.
• The MRO must have qualification training on collection procedures for urine specimens, chain of custody, reporting, and recordkeeping, interpretation of drug and validity tests results, role and responsibilities of the MRO in the DOT drug testing program, interaction with other participants in the program (e.g., DERs, SAPs) and DOT agency rules applying to employers for whom the MRO review test results.
• The MRO must act as an independent and impartial "gatekeeper" and advocate for the accuracy and integrity of the drug testing process.
• The MRO must provide feedback to employers, collection sites and laboratories regarding performance issues where necessary.
• The MRO must determine whether there is a legitimate medical explanation for confirmed positive, adulterated, substituted, and invalid drug tests results from the laboratory.
• The MRO while providing medical review of employees' test results must not deem to have established a doctor-patient relationship with the employees whose tests they review.
• The MRO must act to investigate and correct problems where possible and notify appropriate parties (e.g., HHS, DOT, employers, service agents) where assistance is needed, (e.g., cancelled or problematic tests, incorrect results, problems with blind specimens).
• The MRO must not enter into any relationship with an employer's laboratory that creates a conflict of interest or the appearance of a conflict of interest with your responsibilities to that employer.
• The MRO must review negative test results and non negative test results, prior to releasing it to the DER. Norton Medical has a full time Medical Review Officer on staff trained in the Federal Drug and Alcohol Abatement program. Each test result is reviewed. Our commitment is to protect both the employee and the employer.

Learn More

Click here to view the complete regulation about DOT Medical Review Officer in Sub part G in 49 CFR Part 40.