[Code of Federal Regulations]
[Title 49, Volume 1]
[Revised as of October 1, 2007]
From the U.S. Government Printing Office via GPO Access
[CITE: 49CFR40.121]

[Page 569-570]
 
                        TITLE 49--TRANSPORTATION
 
          Subtitle A--Office of the Secretary of Transportation
 
PART 40_PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING 
 
     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.

[[Page 570]]

    (ii) If you became an MRO before August 1, 2001, but have not yet 
met the qualification training requirement, 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]