---
kind: "section"
citation: "49 C.F.R. § 199.109"
title: "49"
number: "199.109"
heading: "Review of drug testing results."
url: "https://uscodex.org/cfr/49/199.109"
---

# §199.109. Review of drug testing results.

- (a) **MRO appointment.** Each operator shall designate or appoint a medical review officer (MRO). If an operator does not have a qualified individual on staff to serve as MRO, the operator may contract for the provision of MRO services as part of its anti-drug program.
- (b) **MRO qualifications.** Each MRO must be a licensed physician who has the qualifications required by DOT Procedures.
- (c) **MRO duties.** The MRO must perform functions for the operator as required by DOT Procedures.
- (d) **MRO reports.** The MRO must report all drug test results to the operator in accordance with DOT Procedures.
- (e) Evaluation and rehabilitation may be provided by the operator, by a substance abuse professional under contract with the operator, or by a substance abuse professional not affiliated with the operator. The choice of substance abuse professional and assignment of costs shall be made in accordance with the operator/employee agreements and operator/employee policies.
- (f) The operator shall ensure that a substance abuse professional, who determines that a covered employee requires assistance in resolving problems with drug abuse, does not refer the covered employee to the substance abuse professional's private practice or to a person or organization from which the substance abuse professional receives remuneration or in which the substance abuse professional has a financial interest. This paragraph does not prohibit a substance abuse professional from referring a covered employee for assistance provided through:
  - (1) A public agency, such as a State, county, or municipality;
  - (2) The operator or a person under contract to provide treatment for drug problems on behalf of the operator;
  - (3) The sole source of therapeutically appropriate treatment under the employee's health insurance program; or
  - (4) **The sole source of therapeutically appropriate treatment reasonably accessible to the employee.**

## Notes

### Amendments

[53 FR 47096, Nov. 21, 1988, as amended by Amdt. 199-2, 54 FR 51850, Dec. 18, 1989; Amdt. 199-15, 63 FR 13000, Mar. 17, 1998; Amdt. 199-15, 63 FR 36863, July 8, 1998. Redesignated and amended by Amdt. 199-19, 66 FR 47118, Sept. 11, 2001]

### Authority

Authority: 49 U.S.C. 5103, 60102, 60104, 60108, 60117, and 60118; 49 CFR 1.53.

### Source

Source: 53 FR 47096, Nov. 21, 1988, unless otherwise noted.

### Amendments

[53 FR 47096, Nov. 21, 1988, as amended by Amdt. 199-2, 54 FR 51850, Dec. 18, 1989; Amdt. 199-15, 63 FR 13000, Mar. 17, 1998; Amdt. 199-15, 63 FR 36863, July 8, 1998. Redesignated and amended by Amdt. 199-19, 66 FR 47118, Sept. 11, 2001]