Medical Review Officer (MRO) and the Clearinghouse

Update: 12/13/2019 –
Getting close to the effective date of the Clearinghouse – January 6, 2020. Our company can help the Medical Review Officer (MRO) with their responsibilities in the FMCSA Clearinghouse. Consultation and guidance is available for one low cost annual membership. As an MRO will you be ready on January 6, 2020 to start reporting positive drug tests to the Clearinghouse? As an MRO are you aware of what drug test refusals you are required to report?

Are you an MRO for the DOT drug testing program?  Effective January 6, 2020 your duties and responsibilities will change.  The new Commercial Driver’s License (CDL) Drug and Alcohol Clearinghouse (Clearinghouse) will add to the workload of the Medical Review Officer (MRO).

The role of the MRO is to review and verify drug test results received from the laboratory.  For non-negative or positive drug test results, the MRO contacts the donor (individual submitting specimen for testing) to discuss any medical explanation like a prescription. A legal medical explanation can reverse a laboratory positive result to a negative result before the employer receives the final test results from the MRO.  This is a required process under the DOT drug and alcohol testing regulations.

Other MRO duties include:

  • Determining refusals to test due to adulteration or substitution (cheating)
  • Investigating invalid drug screen results
  • Coordinating shy bladder medical evaluations
  • Coordinating split specimen test requests

Medical review officers are licensed physicians that have received additional training and taken an exam to be certified as an MRO.  Training and certification exams are provided by organizations such as the American Association of Medical Review Officers (AAMRO) or Medical Review Officer Certification Council (MROCC).  Continuing education and five- year refresher training and re-certification is required.

New MRO Duties in the FMCSA Clearinghouse

The new MRO duties in the Clearinghouse effective January 6, 2020 are as follows:

  1. The MRO must report positive drug test results to the Clearinghouse database (within two business days of making a determination)
  2. Refusals to drug test as determined by the MRO must be reported to the Clearinghouse including adulterated and substituted specimens (within two business days of making a determination)
  3. Report changes to Clearinghouse within one business day after making a change to a previously reported result

Note: a driver need not be registered in the Clearinghouse for the MRO to report a violation.

The information the MRO must report to the Clearinghouse includes the following:

  • Driver’s name, date of birth, and CDL number and State of issuance
  • Employer’s name, address, and USDOT number, if applicable
  • Reason for test (pre-employment, random etc.)
  • Date of the test and date of the verified result
  • Federal Drug Testing Custody and Control Form specimen ID number
  • Verified test result, one of the following:
    • Positive including the drug tested positive
    • Refusal to test adulterated or substituted
    • Refusal based on no medical explanation for a shy bladder or a refusal of the driver to seek the medical evaluation
    • Any other MRO determined refusal 

Adulterated or substituted results indicate an attempt by the driver to cheat on the test. 

MRO Registration in the Clearinghouse

The MRO will be required to register in the Clearinghouse and assign any team members to access the Clearinghouse on behalf of the MRO.  MRO staff member registrations will be managed by the MRO company individual who will serve as the company administrator the company’s Clearinghouse account. has stated that registration will begin in October.

Information required for Clearinghouse registration for MRO’s 

  • Name, address, telephone number
  • Documentation of the MRO’s certification  
  • Certification that the MRO access to the Clearinghouse is conditioned on his or her compliance with the applicable qualification and/or training requirements in 49 CFR part 40 

Assistance from Clearinghouse Services, Inc

Clearinghouse Services, Inc helps Medical Review Officers (MRO) in navigating the Clearinghouse.  Our MRO membership will offer guidance and consultation, so the MRO has assistance available from registration to reporting violations.  From now till December 31, 2019, get 50% off any of our memberships with coupon code 2019DISCOUNT at checkout!