Can an MRO Have a Financial Relationship with a Drug Testing Laboratory?

Not one that creates a conflict of interest. Under 49 CFR 40.125, an MRO "may 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 the MRO's responsibilities to that employer. The MRO also may not derive any financial benefit by having an employer use a specific laboratory.

Section 40.125 points to 49 CFR 40.101(b) for examples of relationships that DOT regards as creating a conflict of interest or its appearance. The rule states that the list is not intended to be exclusive or exhaustive. The examples are a laboratory that employs an MRO who reviews its test results, a laboratory with a contract or retainer with the MRO for review of its results, and a laboratory that designates the MRO an employer is to use, gives the employer a slate of MROs or recommends certain MROs. They also include a laboratory that gives an employer a discount or other incentive to use a particular MRO, a laboratory whose place of business is co-located with an MRO or MRO staff who review its results, and a laboratory that lets an MRO or an MRO's organization have a financial interest in it.

Under 49 CFR 40.123(a), one of the MRO's basic responsibilities is acting as an "independent and impartial" gatekeeper and advocate for the accuracy and integrity of the drug testing process. Under 40.123(b)(3), employers and service agents are prohibited from limiting an MRO's access to DOT for help with program issues and from retaliating against an MRO for discussing drug testing issues with DOT.

MRO qualifications are covered in Who Can Be a Medical Review Officer for DOT Drug Tests?, and laboratory specimen retention in How Long Does a Laboratory Keep a DOT Drug Test Specimen?.

MROs, collection sites and Labs appear as separate provider categories in the MyDrugTesting.com directory.