We propose Metropolis-Hastings sampling methods for estimating the exact conditional p-value for tests of goodness of fit of log-linear models for mortality rates and standardized mortality ratios. We focus on two-way tables, where the required conditional distribution is a multivariate noncentral hypergeometric distribution with known noncentrality parameter. Two examples are presented: a 2 x 3 table, where the exact results, obtained by enumeration, are available for comparison, and a 9 x 7 table, where Monte Carlo methods provide the only feasible approach for exact inference.