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TRI during Probable or Confirmed Outbreaks

Temporary Rate Increases (TRI) are available to providers during CONFIRMED outbreaks. By CDC definition, probable outbreaks are a minimum of 5 cases at a facility, within 14 days, and ALL are antigen POC tests run via a certified CLIA lab/staff and then entered in REDCap accordingly. A confirmed outbreak is a minimum of 5 cases within 14 days and at least 1 has to be a PCR test run by a lab such as HETL. We can NOT use at home tests for outbreaks for any reason. Good as a reference but the CDC recommends lab confirmation with a PCR to fully confirm their positive status and document their case for the 90-day window after being positive. Maine CDC bases the dates on the test collection date and NOT the report date since there can be delays in the reporting date. The Maine CDC can close the outbreak when the facility has gone 14+ days without a new case. Once they close the first time, the facility must go another 14 days without any new cases. If a new case pops up anytime in those 14 days, we re-open the outbreak back to its initial status of confirmed and testing etc must continue.
 
Increased reimbursement rates (TRI) are only applicable during CONFIRMED outbreaks and for the times the outbreak is open. These funds are designed for assisting with the extra cost of handling COVID in your facility and there are rules on how you use them of course. 

As a note, if the facility does not want the increased rates, then they are not obligated to get them. It's an option. The outbreak and response stays the same but no extra billing changes are necessary. If there are any discrepancies about dates etc – please contact Joel Vail, Maine CDC Epi (Joel.Vail@maine.gov) directly with a line list and he is willing to audit or validate any data to ensure CDC systems are up to date. 

Staff Contact: dwatford@mehca.org

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