AG Healey sues orthodontist for keeping kids in braces longer than needed | Boston.com

A Massachusetts orthodontist kept kids in braces longer than necessary and submitted millions of dollars in false claims to MassHealth, according to a lawsuit filed by Attorney General Maura Healey Monday.

The defendant, Dr. Mouhab Rizkallah, runs six practices under the name “The Braces Place,” which has locations in Boston, Somerville, Lawrence, Lowell, Framingham, and Lynn. The attorney general’s complaint alleges that Rizkallah has intended to defraud the state’s Medicaid program since November 2013.

“For years, this orthodontist used his young patients as pawns to steal millions of dollars from the state,” Healey said in a statement. “This illegal behavior harmed families from low-income communities and communities of color who rely on MassHealth for health care coverage. We are suing to hold Dr. Rizkallah accountable for these exploitative practices that victimized vulnerable residents in Massachusetts.”

The headline example in Dr. Rizkallah’s alleged fraudulent activity involved arbitrarily delaying putting braces on children’s bottom teeth to increase their treatment time — and, by proxy, money from MassHealth. The investigation began after a patient complaint.

The suit also states that the doctor billed MassHealth for custom sports mouth guards that did not exist. The complaint says that he told his staff to cut the $9.99 price tag off of prefabricated retail mouth guards, gave them to patients, and billed MassHealth up to $95 for each one. The AG’s office says that MassHealth paid Dr. Rizkallah over $1 million for the mouth guards.

The office alleges that the conduct violates the state False Claims Act and the state Medicaid False Claims act, constitutes a breach of contract by Dr. Rizkallah’s companies, and resulted in the unjust enrichment of the doctor. The suit seeks treble damages and civil penalties.

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