LAWRENCE — An orthodontist with ties to the Merrimack Valley is facing additional charges after state Attorney General Maura Healey filed an amended lawsuit claiming Dr. Mouhab Z. Rizkallah illegally charged MassHealth patients for missed or cancelled appointments.

The new claims were added to a suit already filed against the doctor, who owns six practices in Massachusetts, including The Braces Place of Lawrence LLC.

According to the previous suit filed in February, Rizkallah is also said to have fraudulently submitted millions of dollars in false claims to MassHealth, kept children in braces for longer than medically necessary and fraudulently billed for mouth guards.

The amended lawsuit was filed by the Attorney General's Office in Suffolk Superior Court Monday against Rizkallah and two companies — Dr. Mouhab Z. Rizkallah DDS MSD PC and The Braces Place of Lawrence LLC.

In addition to Lawrence, Rizkallah does business in Somerville, Boston, Lowell, Framingham and Lynn.

An investigation into Rizkallah's business practices was opened after a complaint from a patient's guardian was received, the attorney general's office said in a statement. Through its investigation, the attorney general's office found that the defendants required MassHealth patients to sign a "MassHealth Treatment Contract" and agree to a minimum $20 fee for missed or cancelled appointments not rescheduled with 24 hours' notice, according to the statement. The office allegedly charged and collected such fees, which is prohibited under MassHealth regulations.

MassHealth guidelines stipulate patients are not to be charged out-of-pocket fees for covered services, including costs for missed appointments.

Healey's office alleges that Rizkallah instituted illegal policies and practices dating as far back as November 2013 with the intention of defrauding MassHealth. He did so by increasing the amount of money collected from MassHealth regardless of whether services were medically necessary, the office said.

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