HHS Publishes List of Approved MRO Certification Entities

The Department of Health and Human Services (HHS), through the Substance Abuse and Mental Health Services Administration (SAMHSA), published a notice in the Federal Register on October 23, 2026 listing the entities it has approved to certify Medical Review Officers (MROs) for federal workplace drug testing programs. The notice is Federal Register document 2026-21671 (91 FR 66864). The approval took effect on October 23, 2026, and the notice has no comment period. The notice is signed by Robert F. Kennedy, Jr., Secretary of HHS.

This is a notice of approval, not a rule. It lists the approved certifying entities and does not amend the Mandatory Guidelines.

The full notice is available on the Federal Register at HHS Approval of Entities That Certify Medical Review Officers.

The Approved Entities

The HHS Secretary approved two MRO certifying entities, both of which offer MRO certification through examination:

• American Association of Medical Review Officers (AAMRO), Durham, North Carolina.
• Medical Review Officer Certification Council (MROCC), Chicago, Illinois.

Why HHS Publishes the List

The notice is issued under Section 13.2 of the HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs. The current guidelines took effect October 10, 2023 for oral fluid and February 1, 2024 for urine, and they address the role and qualifications of MROs and HHS approval of the entities that certify them. HHS published proposed revisions to both sets of guidelines on October 29, 2026.

Under Section 13.2, nationally recognized entities or subspecialty boards seeking approval must submit their qualifications, a sample examination and other supporting examination materials. HHS bases approval on an objective review that includes the MRO applicant application form, documentation that continuing education courses are accredited by a professional organization, and the delivery method and content of the examination. Each approved entity must resubmit its qualifications every 2 years, and the Secretary must publish a list of approved entities in the Federal Register at least every 2 years.

HHS stated that it completed its review of the requests submitted by certifying entities before publishing this list.