Aug

California work comp – Part One, the fee schedule debate

Posted by Joe Paduda on Tuesday, August 24th, 2010 | Comments

There’s a lot going on in California’s workers comp system – medical costs zooming up and driving premium increases along the way, narcotic usage skyrocketing, a dramatic increase in scripts for medical foods and compounds, judges upholding controversial decisions, and momentous decisions re changes to the fee schedule. Add the continued news about rising hospital costs, and you’ve got more than enough activity to keep anyone busy.
We can’t cover all the issues here, so a summary will have to suffice – promise to dig deeper into a few later this week and into next.
First, the controversy over changing the workers comp fee schedule.
California does not currently use Medicare’s RBRVS methodology as the basis for its non-facility fee schedule, making CA the only fee schedule state to not use RBRVS.(the other states that don’t use UCR, and I’d argue they really don’t have ‘fee schedules’ in the true sense of the term). The state has been considering moving from its current methodology the Official Medical Fee Schedule, or OMFS) to RBRVS for several years, with considerable progress over the last couple of months.
Most recently, public hearings were held in Sacramento with various stakeholders asked to respond to the latest revisions to the suggested fee schedule, revisions that added an additional $52 million in projected physician payments. I’ll spare the details on the methodological discussions, which have to do with changing teh conversion factor, one of the components of the RBRVS pricing methodology. (workcompcentral.com posted on this August 18). The basic argument advanced by providers is, well, pretty basic – if you reduce reimbursement, there may well be an access problem as providers opt out of workers comp.
According to workcompcentral.com;
“Destie Overpeck, the DWC’s chief counsel, said she was encouraged that most of the providers in the audience seemed to support the division’s multiple conversion factor plan, or at least understood it was needed to smooth the transition to a new system.
Primary care physicians, occupational therapists and providers who bill under the “all other” category would generally see an increase in payments, Overpeck said. “They seem to be saying, ‘Hey, we understand it’s not as high as we want or would get with a single conversion factor, but if you lower the rate on surgeons too much they won’t be there anymore,” she said.”
There is some evidence that lower work comp reimbursement does impact provider participation. When Florida increased reimbursement over a decade ago, anecdotal reports indicated more surgeons started accepting work comp patients. A pretty solid research effort (albeit one specific to neurologists) presented at the meeting showed a strong correlation between reimbursement rates (as a percentage of RBRVS) and provider participation rates; according to the study, “G{eneral] M[edical] fee levels provide the highest correlation (90.7%) with neurologist willingness to accept workers’ compensation patients.”
The study also noted “a modified RBRVS medical fee schedule set at 156% of Medicare for EM fees and 121% for all other fees (an often-discussed plan) would result in a neurologist WC participation rate of 12.0%, third lowest in the U.S.”
(A METHODOLOGY FOR PREDICTING PROVIDER PARTICIPATION IN WORKERS’ COMPENSATION MEDICAL FEE SCHEDULES
STEVEN E. LEVINE, M.D., PH.D. AND RONALD N. KENT, M.D.)
Perhaps the key point was best made by Kent Spafford, CEO of OneCall Medical, the leading work comp imaging company. Spafford noted: “The California Workers’ Compensation Fee Schedule is designed to provide adequate compensation to providers, so they are willing to provide care to injured workers. It is not the vehicle to control costs. Any action relative to the fee schedule should be designed to induce current and future providers into the system and not disenfranchise the existing providers.”
Recognizing OneCall’s is keenly interested in the fee schedule as it bears directly on the company’s ability to profitably operate in the state, Spafford’s comments are nonetheless well worth consideration. Without reasonable access to care, disability durations may well increase, the quality of care decline, and system costs continue their current upward trend. Notably, access under the current OMFS is pretty good, with 90% of patients reporting ‘good access to quality care’; the access problems that did occur weren’t related to cost but to administrative hassles, language issues and UR delays. As access is good under the current system, one has to consider the possible benefits of reduced prices – for some providers and some services in light of possible decreased access.
Moreover, as I’ve discussed here on numerous occasions, price per service is but one of, and certainly not the most important, contributor to total cost. As we’ve seen with California’s revised drug fee schedule, cutting price often doesn’t reduce cost – in fact, total drug costs in CA went up – way up – after the fee schedule was slashed.
I’ll draw a distinction between physicians and hospitals; as I’ll discuss tomorrow, California’s hospital costs are high and trending higher, with no likely end in sight.
California’s Division of Workers Comp is working diligently to balance the cost:access equation. I’d suggest that a careful and thorough assessment of hospital costs may well indicate there are lots of dollars to be saved, dollars that won’t compromise access.

Aug

Defining work comp medical cost ‘savings’

Posted by Joe Paduda on Monday, August 23rd, 2010 | Comments

In the course of my consulting practice, I see a lot of work comp medical bill review ‘savings’ reports. Over the last fourteen years (since founding Health Strategy Associates in 1996) I’ve collected, reviewed, and analyzed scores of savings reports from pretty much every vendor in the business – as well as many of the larger TPAs and insurers.
There’s some consistency in the business, but not near enough. That alone makes it hard to compare one vendor to another, much less benchmark one company’s performance against the industry.
Leaving that aside, there are a number of issues with most reports, issues that clients/insureds/policyholders would do well to consider when evaluating performance or comparing potential vendors.
1. Does the savings report include reductions below state fee schedule (SFS) and/or Usual Customary and Reasonable (UCR)? Many vendors don’t split out savings below SFS/UCR, instead lumping all reductions into one ‘overall’ category. This is either a) an oversight as any vendor should be willing and able to demonstrate their ability to reprice bills to comply with regulations, or b) a way to inflate savings so the naive buyer sees a bit percentage reduction and thinks the vendor’s doing a crackerjack job.
2. Does the savings report clearly identify the source of UCR data? There are several vendors out there that provide these data, and knowing which is important in evaluating performance.
3. How are savings percentages calculated? Do they include savings for duplicate bills or duplicate line items (they shouldn’t). Do they include all types of care, such as pharmacy and imaging? In many instances these services are outsourced to specialists, requiring the customer to combine results to get an overall figure.
4. For pharmacy, savings should be reported using AWP as the benchmark – if the vendor wants to include SFS, that’s fine, but AWP (and make sure they define the source) is the universal standard.
5. How is network penetration calculated? Is the basis the number of bills or dollars? Dollars are preferred, but may skew the numbers higher than number of bills, as network penetration tends to be higher for facilities (which have higher average bill charges).
6. Over time, have you seen a decrease in fee schedule reductions and an increase in so-called ‘nurse review’ or ‘bill audit’ or ‘professional review’ savings? Hint – if these are billed separately, there’s often an inherent motivation on the part of the vendor to lowball SFS reductions in favor of these ‘other’ reductions.
7. Semantics and definitions. Make sure there’s a clear and complete understanding of each and every term, including such seemingly-obvious ones as ‘bill’ – can be a ‘staple’, a single page, a date of service, or ‘up to x lines’.
What does this mean to you?
There’s lots more to this, but the message should be clear – don’t assume you understand the report, ask lots of questions, consider how the vendor gets paid, and don’t hesitate to ask the vendor to revise the report to give you the information you need the way you want to see it.
After all, you’re the customer.

Aug

Work comp claims systems – the state of the industry

Posted by Joe Paduda on Friday, August 20th, 2010 | Comments

It’s hard to overstate the importance of the claims IT system in workers comp.
Systems directly, and materially, affect: productivity; compliance; claimant and policyholder satisfaction; medical costs; litigation rates, expenses, and outcomes; administrative expense (both unallocated and allocated); claims cost; employee retention and satisfaction; and ultimately growth, revenues, and profitability.
To date there hasn’t been a comprehensive survey of claims systems providing insights and data on features, trends, user satisfaction, key attributes, cost, flexibility, connectivity, issues and problems.
That’s about to change.
Next month Health Strategy Associates will conduct the First Annual Survey of Workers Comp Claims Systems, gathering input from all stakeholders including IT executives, claims executives, managers, and desk adjusters. The results of the survey will be available early in the fourth quarter, with an executive summary available at no cost to interested parties.
Management responses will be gathered in a structured telephonic interview format, while an online survey instrument will be used to gather responses from desk-level experts. Input from the two groups will be compared and contrasted, and we’re betting there are areas where the folks ‘on the front lines’ see things a bit differently than the people ‘in the management suite’.
Sandy Blunt, former COO of the Ohio state workers comp fund and former CEO of the North Dakota state fund, is running the project, and we couldn’t have a better leader. Sandy’s been intimately involved identifying requirements, selecting systems, comparing vendors, assessing performance, and designing workflows. His leadership will ensure the Survey is as practical as it is timely.
If you are interested in participating in the survey, send an email to Sandy at SBluntAThealthstrategyassocDOTcom.
Participants will receive a detailed version of the Survey Report.
We anticipate this will become an annual Survey, one of the series of Surveys conducted by Health Strategy Associates as we continue to help work comp payers, providers, and stakeholders make more informed decisions.

Aug

Medical foods and workers comp

Posted by Joe Paduda on Wednesday, August 18th, 2010 | Comments

The good folks at CWCI just published a research report (The Cost and Utilization of Compound Drugs, Convenience Packs and Medical Foods in California WC) documenting the rise in spend on medical foods, repackaged drugs, and compound drugs from 2006 – 2009; the highlight is these categories accounted for almost 12% of drug spend in California in Q1 2009.
A couple of the findings that jumped out at me…
– the average amount paid per compound drug as $728 in Q1 2009.
– medical food reimbursement hit $233 per script that quarter
– a new category, ‘co-packs’ has emerged as a significant therapy; these are combinations of drugs with medical foods dispensed as a single unit.
The story of drug costs and attempts to address same in California is fascinating, with lessons aplenty for regulators and payers.
– A drastic reduction in the fee schedule was followed by explosive growth in repackaged drugs.
– Regulatory changes finally addressed that issue, but meanwhile the use of narcotic opioids increased six-fold, likely negatively impacting disability duration as well as increasing cost.
– New entrants into the therapeutic armamentarium, entrants that are foreign to many adjusters, case managers, and work comp execs alike, are growing in importance, requiring regulators and payers alike to understand their impact and develop policies for coverage and reimbursement.
The list of medical foods includes Theramine, Gabadone, Sentra, Apptrim, Trepadone, and others, with Theramine (pain) and Sentra (sleep aid) accounting for over half of the volume in California. Medical foods are pretty new to me; according to the Orphan Drug Act (1988 Amendment), a medical food is “a food which is formulated to be consumed or administered enterally (orally) under the supervision of a physician, and which is intended for specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.”
I’m no pharmacist or clinician, and am certainly not able to comment on the efficacy of medical foods or specific medications. For a primer on medical foods, click here.
There does appear to be evidence supporting the use of medical foods for treatment of pain, osteoarthritis, and other conditions, with one medical food, Limbrel, the subject of large, double-blind, placebo-controlled clinical studies in the United States and Japan. According to one source, “Limbrel administration has resulted in statistically significant improvement in all primary clinical endpoints (functional mobility, functional stiffness and functional joint discomfort).”
What does this mean for you?
If your P&T Committee hasn’t looked at medical foods yet, you may want to add it to the agenda for the next meeting. It is highly likely we’re going to see more of these scripts, and far better to be ready than to have your adjusters making decisions completely unprepared.

Aug

The cost of forgoing care

Posted by Joe Paduda on Tuesday, August 17th, 2010 | Comments

A new report documents the impact of the recession on the health care system, and for many Americans, the news is proof of what they know all too well – higher deductibles and copays are reducing their ability to access care.
The report [fee req] does not document whether the forgone care would have been necessary/appropriate/supported by evidence-based guidelines, and it is likely some of the forgone care was unnecessary. That said, it’s only ‘some’, and it is highly likely Americans with slimmer benefits, or no benefits at all, are skipping visits, medications, therapies, and operations that will over the long term will have very serious implications.
According to a piece in the NYTimes, the researchers reported “We find strong evidence that the economic crisis — manifested in job and wealth losses — has led to reductions in the use of routine medical care.” 26.5 percent of respondents reported reducing their use of routine medical care since the start of the global economic crisis in 2007.
The report adds more weight to the increasing evidence that the recession, coupled with the unique American health insurance system, has had a significant impact on Americans’ ability to access care.
The importance of primary care in prevention is well documented; [opens pdf] timely use of primary care tends to reduce the need for interventional procedures such as CABG, thereby reducing cost and improving long term quality of life. Delaying or forgoing primary care will likely have the opposite effect, increasing future health care costs.
Impact on workers comp
Over the short term, this ‘side effect’ of the recession will likely increase work comp costs and extend disability duration, as more injured workers will have poor health status due to forgone care. If diabetics aren’t controlling their blood sugar, asthma sufferers have more acute episodes, and hypertensives are taking their meds every other day, it is going to be more difficult, costly, and time-consuming to help these claimants recover functionality.
Over the long term, health reform will reduce work comp costs as many more individuals will have coverage. But until 2015 (or so), we won’t see this positive influence.

Aug

California’s compound med bill – half a loaf is worse than no loaf at all –

Posted by Joe Paduda on Tuesday, August 10th, 2010 | Comments

California’s Senate will be considering AB 2779 today, a bill that would (among other things) require Prior Authorization of compound medications for work comp claimants. While there’s no question compound meds are a big issue, the bill would do nothing to solve the Golden State’s larger problem – out of control drug utilization.
(thanks to WorkCompCentral for the heads up)
Here’s the issue.
The work comp drug fee schedule in California is pegged to Medi-Cal, resulting in the lowest reimbursement for drugs in the nation (with the possible exception of WA).
Pharmacy Benefit Managers (PBMs) operate on the difference between what they pay the pharmacy and what their customers pay them. In California, that delta is tiny, if not negative. If PBMs don’t have any operating margin, they can’t afford to allocate clinical resources to deal with prior auth requirements; they’ll lose even more money in an effort to help their clients. That’s neither appropriate nor good for the long term health of the comp business in California.
To those who claim the low fee schedule hasn’t caused any problems, I’d suggest a thorough read of CWCI’s excellent discussion of the explosive growth of narcotic opioids among comp claimants. Here’s the brief takeaway – California slashed the work comp pharmacy fee schedule just about in half six years ago. Since that time, the number of scripts per claimant has increased 25% and costs per claimant are up 31% (CWCI stats). And that’s not the worst of it. Schedule II narcotics have gone from less than one percent of scripts to almost six percent, a six-fold increase.
But what does that have to do with a bill designed to attack one of the emerging cost drivers – compound meds? Isn’t the proverbial half a loaf better than no loaf at all?
No. While the bill enables payers to deny compound meds for medical necessity (a relatively easy call, as I don’t know of any evidence-based guidelines that recommend compounded medications, PBMs simply can’t afford to develop the workflows, do the research, hire the clinical staff, and manage and monitor the intake/referral to the adjuster/approval-denial/appeal processes. This is a lot of work, requires careful planning and implementation, and must include clinical staffing – nurses, pharmacists, and in some cases perhaps physicians.
We’ve seen the impact of the low fee schedule on total costs – they’ve gone up. What we haven’t seen is the impact on injured workers – many more are now on narcotic opioids, with some undoubtedly suffering from all the complications linked to these potentially debilitating and addictive drugs.
AB 2779 piles more work on top of an already overburdened industry, while doing nothing to address the underlying problem.
A major step in the right direction would be for California to de-link the comp fee schedule from Medicaid. That would give PBMs the pricing stability they need to help their clients regain control over drug costs.
For a detailed discussion of Medicaid’s suitability for work comp drug pricing, click here.

Aug

Updates from the wonderful world of medicare set asides…

Posted by Joe Paduda on Thursday, August 5th, 2010 | Comments

There’s been a lot of ‘under the radar’ activity in the work comp space of late, with much of it coming from the Medicare Set Aside sector. As ‘unique’ as the workers comp services sector may be, there’s no niche as…fascinating as the MSA business.
It is brutally competitive; rife with personal, public attacks; and abounding in claims, counter-claims, and counter-counter-claims. Here’s a quick tour of some of the news.
Coventry sales chief Ken Loffredo will be leaving CVTY after over a decade to take an equity role at Med-Allocators. The departure isn’t imminent, as he and Work Comp Division boss David Young are working together to find a successor, looking at both internal and external candidates.
Coventry isn’t doing much in the MSA business these days, and reports indicate management probably wished it didn’t do anything with MSAs in the past.
Gould and Lamb and (former CEO) John Williams have parted ways, reportedly because Mr Williams ‘wants to spend more time with his family’; evidently G&L’s owners are fully supportive of that desire. No announcement yet on a replacement.
The book on G&L has been out for some time; no word on whether the company is still looking for a sale or additional investment. The costs associated with preparing for CMS reporting, and challenges thereof, may be a factor
Despite some competitors’ statements (public(!)) to the contrary, PMSI is not contemplating, thinking about, planning to, or even preliminarily exploring a sale of the company’s MSA division. Don’t know how that got started, but there’s nothing to it
Those are just the highlights.
The rough-and-tumble MSA industry reminds me of the oil and gas business of a hundred years ago. So far no John D Rockefeller has made an appearance, but the industry is ripe for consolidation. Lots of folks are trying, but no one’s looking like a clear leader.

Aug

Group health medical costs moderated; how’d you do?

Posted by Joe Paduda on Monday, August 2nd, 2010 | Comments

Data from several sources, including Farrah and Associates (got to love a company that is located in Maine) indicates group insurers were able to reduce medical trend to 4.9% last year. That’s the best result, in, well, further back than I can remember.
Coventry’s recent Q2 2010 earnings call indicated their results were comparable, and med loss trends were pretty close.
Aetna’s numbers are comparable, as are the reasons for the improvement. According to a WSJ piece, “Aetna and its peers are reporting lower utilization of medical services this year. [President Mark] Bertolini attributed the trend to the weak economy, a less severe flu season, harsh weather in the first quarter and some wearing off of Cobra coverage for people who were laid off their jobs.”
How’d they do it? Can you do what they did?
First, let’s deconstruct the reasons for the happy news.
The flu season wasn’t a) as bad as predicted and b) insurers, burned by the previous flu season, probably over-reserved.
Members covered by Cobra are notoriously expensive; people don’t sign up for Cobra unless they think they’ll need it, and in most cases they are right. Loss ratios for Cobra tend to be well above 125%; thus the expiration of Cobra helps dump unprofitable business. Expect this to continue to aid MLRs for several quarters to come.
Many health plans now have higher deductibles and copays, cost-sharing arrangements that may well be causing members to avoid seeking care. (research suggests the care avoided may be necessary or unnecessary). Coventry Allen Wise mentioned this in his earnings call as a possible contributor.
From a purely speculative perspective, it is possible that employers who were faced with high premiums due to poor experience rating, older populations, or other factors, have dropped their coverage at a higher rate than in the past. This might contribute to lower utilization. I’d also note that rate increases may have the opposite effect; employers that really need coverage will hold their noses and pay up, while employers who don’t think it’s worth it (read – don’t expect to need insurance) drop out.
We’re left with results driven by benefit design, demographic changes, and one-time events.
Don’t get me wrong, the numbers are good, but the drivers aren’t what we need to really gain control over costs over the long term.
Fortunately, some health plans are already taking steps to do just that with smaller, tighter networks and limited access out of network.
If you are a workers comp payer in California, chances are your results were a whole lot worse, as medical costs are once again back up to pre-reform levels. According to this piece in Risk and Insurance;
“…looking at first-year payments on lost time claims, researchers found that since hitting their post-reform lows, average amounts paid per claim for treatment have increased 41 percent; average amounts paid for pharmaceuticals and durable medical equipment are up 69 percent; [emphasis added] average amounts paid for med-legal reports are up 79 percent; and average amounts paid for medical cost containment are up 86 percent.”
Of course, this simply means reform cut costs dramatically over the last few years, and only now, several years after reform’s implementation, have costs returned to the levels seen in 2004.
That said, comp payers can’t fiddle with benefit design, out of network contribution differentials, cost sharing, and the like.
What does this mean for you?
a) a temporary hiatus from structural trends, or a pause to show us what the future may hold if we get serious about containing cost.
b) for comp payers, the recent moves to smaller networks should be a big wakeup call.

Jul

Coventry – getting with the post-reform program

Posted by Joe Paduda on Friday, July 30th, 2010 | Comments

Coventry earnings call this morning was notable in at least two ways – more discussion about underlying cost drivers, utilization trends and management thereof, and the growing importance of low cost delivery systems from management.
And more evidence that (most) financial analysts don’t understand this business.
Here’s my view on the takeaways from the call.
The per-share earnings charge of $1.18 (from work comp PPO litigation in Louisiana) was the subject of a good deal of discussion during Coventry’s Q2 2010 earnings call this morning, but has to be considered in the context of the overall solid performance of the company.
Coventry actually increased guidance for the full year, marking another improvement in financials for the company that has been on a steady upward trend since CEO/Chair Allen Wise resumed his post a year and a half ago.
Commercial group membership grew nicely, while MLR (medical loss ratio) guidance decreased for the entire year. Coventry expects medical costs to increase in the second half of 2010, consistent with past experience.
In the prepared remarks part of the call, management diiscussed the implications of health reform, asserting the company’s recent results show it is well prepared for reform as it is able to control MLR while maintaining membership and expanding the company’s footprint in selected markets (the Mercy deal is an example)
The company’s statement noted Wise’s enthusiasm for results and performance of the company’s clinical management programs.
Clarity around MLR regulations was the first question – unsurprisingly, given the new regulations regarding limits on insurers’ administrative and other fees. Wise noted that the cost structure in one market in particular was going to improve by shrinking the company’s network, selecting more cost effective delivery systems/health systems. This marked a significant change from calls as recently as last year at this time. Coventry is clearly seeking to partner with more cost efficient health systems; as Wise put it, ‘we need to stop fighting over nickels and focus on overall costs’. [paraphrasing]
This was followed by a question about health plan utilization trends – overall utilization appears to have tapered off industry-wide, the question is why? Wise admitted Coventry doesn’t know, although they’ve spent a lot of time looking at this and their preliminary conclusion is the high deductibles and copays are leading to lower utilization, coupled with expiring COBRA benefits for some employees laid off quite a while ago.
Going forward, Wise sees the market as getting more competitive, making customer service and managing the little things critical to survival and success.
Wise thinks the group health product pendulum has swung back to mid-eighties model where networks are smaller, there’s less choice, and better control over cost and utilization. Coventry’s going to offer products with smaller networks based on provider systems with documented better outcomes and lower costs. They will preferentially look to buy provider-owned plans as they tend to have better cost structures than non-provider-owned plans. The analyst who asked the question wasn’t particularly interested in what Coventry was doing, but rather focused on pricing implications given the MLF regs coming out shortly.
That’s another example of how most of the analysts following this business are out of their depth. The real issue, the key to success, for Coventry and every other health plan, is how they are going to compete in a post-reform world. Price is a result of cost structure, and the failure of the analysts to focus on cost and cost drivers shows how disconnected the analysts are.
Another analyst asked if other health plans are pursuing similar acquisition strategies. Wise noted that there just aren’t that many potential acquisition targets that have good cost structures, fit geographically, and are provider-owned.
The company will be revamping its individual health product offering – in response to a question, Wise noted that the company’s distribution, IT, and benefit design are all works in progress, and there’s still a ways to go.
More to come after I review the transcript

Jul

Feland or Blunt: Who’s the criminal?

Posted by Joe Paduda on Monday, July 26th, 2010 | Comments

As I reported Saturday, the prosecutor who charged former North Dakota state fund CEO Sandy Blunt with felony ‘theft of services’ is herself under investigation for allegedly withholding exculpatory evidence from Blunt’s defense attorney.
Cynthia Feland’s case has been heard by the ND Supreme Court’s Inquiry Board, who found enough evidence to convene a Disciplinary Board. From the ND Supreme Court website – “Formal proceedings are begun when there is probable cause to believe that misconduct has occurred that deserves a public reprimand, suspension, or disbarment.” [emphasis added]
This isn’t a routine, ‘happens all the time’ thing. Far from it. although to hear Feland tell it, this is no big deal – according to the Bismarck Tribute, Feland “said it is not uncommon for people to file complaints against prosecutors.”
Well, Cynthia, let’s look at the numbers, shall we?
Last year there were 349 cases that went thru the Disciplinary Board program.
192 were dismissed or the attorney was referred to an assistance program and 123 are still pending. That leaves 34 cases where there was some kind of final ruling. 17 went to a Panel Hearing. That’s where Feland is headed. And the odds aren’t good.
Only 2 cases were dismissed. Of the remaining cases, the Panel reprimanded the attorney in 6, the Supreme Court suspended the attorney in seven, and disbarred the offender in 2.
So Feland has a much better chance of being disciplined, or having her license to practice suspended, than she does of acquittal.
If she’s not reprimanded or suspended, it’s even odds if she’s acquitted or disbarred.
And she has the temerity, the unmitigated gall, to pooh pooh this? A sitting prosecutor, looking at a hearing where she has just over a one-in-ten chance of escaping unscathed? And a 60% chance of losing her license, at least temporarily?
I find it hard to believe that the Inquiry Panel would find probable cause where none exists, particularly in a case where a sitting prosecutor is accused of withholding evidence from a defendant.
As a prosecutor, I’m sure Feland would love those kind of odds.
Interestingly, none of the other media outlets in the state picked this up; neither did the local AP writer (who happens to be a facebook friend of Feland’s).
I’m vastly unimpressed with the media in NoDak; here’s a case of potential wide-ranging import, one where a prosector is charged not only with withholding evidence, but also suborning perjury, yet it’s not worthy of coverage.
Nope, not when the state fair parade’s in town, by golly!

Category: Workers Comp