by William Tauro

“Dr. Mouhab Rizkallah is my hero,” says Stephen Lopez, a current patient.

To get kids their rightful braces coverage from MassHealth, Dr. Rizkallah sued MassHealth three times in the last decade.

Dr. Rizkallah won against MassHealth all 3 times.

According to the National Health Law Program, “Dr. Rizkallah challenged the system” with a class action lawsuit on behalf of numerous children. During the litigation “Dr. Rizkallah treated those patients – at no charge” says the Law Program.

And what did he do with the financial winnings of the lawsuits?
He donated it to NHeLP (link below – donation press release), a kids health-advocacy program.

Litigation Brings Improved Access to Dental Health Care for Low Income Children in Massachusetts

Every time he sued MassHealth, the Attorney General defended MassHealth. Perhaps that is why the AG hates Rizkallah. He is a thorn in her side. But he is a hero to thousands of kids.

Just two months ago, Rizkallah was awarded an injunction against MassHealth, because MassHealth was apparently trying to force orthodontists to intentionally misdiagnose kids orthodontic problems. (link below – court order)

Click to access Order%20on%20Injunctive%20Relief%2012.14.20.pdf

These are the facts. Dr. Rizkallah saved he kids again (just 2 months ago).

So what about the recent AG allegations? I asked him about those today.

1. The AG said you use improper mouthguards?
Rizkallah says, “I use the only kind of mouthguard that exists for a child in braces. How can that be wrong? If they don’t wear it in Phys Ed and get bumped by a ball, their lip will get stuck in their braces and they are off to the ER. It happens all the time. I would be negligent to not provide it.”

2. The AG said you are “clipping off a price” from the packaging to hide the price?
To that Rizkallah says, “They don’t even come in a retail package, so that is theatrical nonsense. They come 12 in a professional case for doctors to fit right in the patient’s mouth. We pre-trim it, put it in the mouth, and check that it fits comfortably. It needs to be wide enough to let the teeth move, but narrow enough to not irritate the cheeks. We adjust as needed throughout the treatment.”

3. The kids are in Braces too long because you only put braces on one jaw to start?
Rizkallah says, “In order to get covered by MassHealth for braces, a child needs to have a severe problem. So by definition, they will be in treatment for a long time. My policy is to put braces on the jaw that has the most time-consuming problem to start (usually the upper jaw). This keeps the other jaw’s free of braces, plaque, pokey things, etc. I then put the second jaw’s braces on when the first jaw and second jaw have about the same time left in treatment. So the treatment time is actually the same if I put on both jaws or one jaw to start. But the teeth are cleaner and healthier the way I do it. We explain this to parents and they appreciate our advice. I did this for my own kids, for goodness sake.”

4. The AG is making it seem like putting only one jaw of braces to start is unusual?
Dr. Rizkallah says, “The AG is not an orthodontist, and all orthodontists are trained in the ‘2×4 appliance’ and ‘Driftodontics’ and ‘Arch Expansion.’ These ‘one jaw’ start of treatment approaches have advantages over full braces, and are very commonly used for orthodontists. Look them up and see for yourself. These are the facts.”

5. So what are your next steps with the AG allegations?
Dr. Rizkallah says, ” Look, I am not perfect, but the statements from the AG are simply incorrect assertions. We will present the appropriateness of our policies in court.”

6. So why does MassHealth try to reduce Federal Medicaid entitlement for kids?
Dr. Rizkallah says, “It is a story of corruption by the MassHealth dental program administrator Dentaquest (which is owned by Delta Dental). Basically, by Dentaquest advising reduced MassHealth approvals for braces, Delta Dental can follow MassHealth’s reduced approval policy for private patients. Delta Dental saves hundreds of millions of dollars by doing this. I was about to lobby for a bill at the statehouse to disallow any private insurance company from administrating the MassHealth program, due to the conflict of interest. Destroying my reputation disallows my ability to fight for the kids.”

To put Dr. Rizkallah’s advocacy into perspective, the thousands of kids around the state that received braces through MassHealth since 2014 owe it to him. According to NHeLP, Rizkallah changed the approval rating from 12 percent to 52 percent.

We will continue to monitor this matter and update our readership.