[Code of Federal Regulations]

[Title 49, Volume 1]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 49CFR40.121]



[Page 657-658]

 

                        TITLE 49--TRANSPORTATION

 

          Subtitle A--Office of the Secretary of Transportation

 

PART 40_PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING 

PROGRAMS--Table of Contents

 

     Subpart G_Medical Review Officers and the Verification Process

 

Sec. 40.121  Who is qualified to act as an MRO?





    To be qualified to act as an MRO in the DOT drug testing program, 

you must meet each of the requirements of this section:

    (a) Credentials. You must be a licensed physician (Doctor of 

Medicine or Osteopathy). If you are a licensed physician in any U.S., 

Canadian, or Mexican jurisdiction and meet the other requirements of 

this section, you are authorized to perform MRO services with respect to 

all covered employees, wherever they are located. For example, if you 

are licensed as an M.D. in one state or province in the U.S., Canada, or 

Mexico, you are not limited to performing MRO functions in that state or 

province, and you may perform MRO functions for employees in other 

states or provinces without becoming licensed to practice medicine in 

the other jurisdictions.

    (b) Basic knowledge. You must be knowledgeable in the following 

areas:

    (1) You must be knowledgeable about and have clinical experience in 

controlled substances abuse disorders, including detailed knowledge of 

alternative medical explanations for laboratory confirmed drug test 

results.

    (2) You must be knowledgeable about issues relating to adulterated 

and substituted specimens as well as the possible medical causes of 

specimens having an invalid result.

    (3) You must be knowledgeable about this part, the DOT MRO 

Guidelines, and the DOT agency regulations applicable to the employers 

for whom you evaluate drug test results, and you must keep current on 

any changes to these materials. The DOT MRO Guidelines document is 

available from ODAPC (Department of Transportation, 400 7th Street, SW., 

Room 10403, Washington, DC 20590, 202-366-3784, or on the ODAPC web site 

(http://www.dot.gov/ost/dapc)).

    (c) Qualification training. You must receive qualification training 

meeting the requirements of this paragraph (c).

    (1) Qualification training must provide instruction on the following 

subjects:

    (i) Collection procedures for urine specimens;

    (ii) Chain of custody, reporting, and recordkeeping;

    (iii) Interpretation of drug and validity tests results;

    (iv) The role and responsibilities of the MRO in the DOT drug 

testing program;

    (v) The interaction with other participants in the program (e.g., 

DERs, SAPs); and

    (vi) Provisions of this part and DOT agency rules applying to 

employers for whom you review test results, including changes and 

updates to this part and DOT agency rules, guidance, interpretations, 

and policies affecting the performance of MRO functions, as well as 

issues that MROs confront in carrying out their duties under this part 

and DOT agency rules.

    (2) Following your completion of qualification training under 

paragraph (c)(1) of this section, you must satisfactorily complete an 

examination administered by a nationally-recognized MRO certification 

board or subspecialty board for medical practitioners in the field of 

medical review of DOT-mandated drug tests. The examination must 

comprehensively cover all the elements of qualification training listed 

in paragraph (c)(1) of this section.

    (3) The following is the schedule for qualification training you 

must meet:

    (i) If you became an MRO before August 1, 2001, and have already met 

the qualification training requirement, you do not have to meet it 

again.

    (ii) If you became an MRO before August 1, 2001, but have not yet 

met the qualification training requirement,



[[Page 658]]



you must do so no later than January 31, 2003.

    (iii) If you become an MRO on or after August 1, 2001, you must meet 

the qualification training requirement before you begin to perform MRO 

functions.

    (d) Continuing Education. During each three-year period from the 

date on which you satisfactorily complete the examination under 

paragraph (c)(2) of this section, you must complete continuing education 

consisting of at least 12 professional development hours (e.g., 

Continuing Education Medical Units) relevant to performing MRO 

functions.

    (1) This continuing education must include material concerning new 

technologies, interpretations, recent guidance, rule changes, and other 

information about developments in MRO practice, pertaining to the DOT 

program, since the time you met the qualification training requirements 

of this section.

    (2) Your continuing education activities must include assessment 

tools to assist you in determining whether you have adequately learned 

the material.

    (3) If you are an MRO who completed the qualification training and 

examination requirements prior to August 1, 2001, you must complete your 

first increment of 12 CEU hours before August 1, 2004.

    (e) Documentation. You must maintain documentation showing that you 

currently meet all requirements of this section. You must provide this 

documentation on request to DOT agency representatives and to employers 

and C/TPAs who are using or negotiating to use your services.



[65 FR 79526, Dec. 19, 2000, as amended at 66 FR 41951, Aug. 9, 2001]