The West Virginia Workers’ Compensation Commission in Charleston has terminated a Beckley physician from the program, “for providing health care that is excessive, medically unreasonable and unethical.”
Michael Kostenko, DO, of Beckley abused the workers’ compensation system by allowing massage therapists to administer IVs and certain types of injections to injured workers and engaged in “upcoding” in billing for services rendered, the Commission noted among its grounds for termination.
“We are sincerely concerned about the care of these injured workers,” said Dr. James Becker, the Commission’s medical director. “Dr. Kostenko has engaged in unauthorized, unproven and potentially unsafe treatment of these workers.”
In a “Notice of Termination” to Kostenko dated Feb. 18, the Commission informed Kostenko that his right “to obtain payment for services rendered to injured employees from the West Virginia Workers’ Compensation Commission shall be terminated permanently and irrevocably.”
The Commission also informed more than 350 of Kostenko’s patients of the termination in a separate letter. The Commission offered to help those patients transfer their care, providing them a list of other health professionals in the Beckley area.
Reform legislation passed in 2003 gave the Commission authority to permanently terminate health care providers from the workers’ compensation program. Last week’s action was taken following consultation with the Commission’s Health Care Advisory Panel.
Among the grounds cited for termination:
1. Kostenko “routinely performed exams/labs which were unrelated to the work-related injury and assessed diagnoses which are unaccepted by the general medical community;”
2. Kostenko either administered tendon sheath injections in excess of the treatment guidelines where the documentation did not support the medical necessity of a tendon sheath injection, or he billed for tendon sheath injections which were not administered, or both;
3. Kostenko allowed massage therapists to compound and administer IVs and administer tendon sheath and trigger point injections in violation of the massage therapists’ licensing; and,
4. Kostenko engaged in upcoding, or billing for services that imply a higher level of complexity than is documented in the medical records.
Kostenko must appear before an administrative law judge in Charleston on April 5 to show cause why his right to receive payment from the Commission should not have been terminated.
Injured workers who choose to continue receiving services from Kostenko will be solely responsible for payment for those services.
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