Fall River Pediatrician Settles for $175,000 with Attorney General’s Office

In a significant enforcement action targeting healthcare fraud, the Massachusetts Attorney General’s Office has secured a $175,000 settlement with Dr. Ali Tural and his Fall River-based Tural Pediatrics practice for improper billing practices that spanned over five years.

The settlement resolves allegations that Dr. Tural and his practice systematically billed MassHealth, the state’s Medicaid program, for medical services performed by physician assistants and nurse practitioners while falsely claiming that Dr. Tural himself had provided the care. According to state officials, this improper billing practice occurred from January 2019 through January 2025.

Beyond the financial penalty, the agreement imposes stringent compliance requirements on Dr. Tural and his practice for the next three years. The monitoring program mandates the implementation of new billing policies, annual staff training sessions focused on healthcare regulations, and regular audits to ensure adherence to proper billing procedures. Results from these compliance measures must be regularly reported to the Attorney General’s Office for review.

This case highlights the state’s ongoing efforts to combat Medicaid fraud, which costs taxpayers millions of dollars annually and undermines the integrity of public healthcare programs. MassHealth serves approximately 2.2 million Massachusetts residents, including low-income families, seniors, and people with disabilities, making proper oversight of its funds critical.

The investigation was led by Assistant Attorney General Mary-Ellen Kennedy and her team within the Medicaid Fraud Division, with crucial support from MassHealth’s own compliance staff. The division operates with substantial resources, including $6,458,176 in federal funding for fiscal year 2026, supplemented by $2,152,724 from state coffers.

Healthcare billing fraud has become an increasing concern nationwide, with the Department of Health and Human Services estimating that improper payments across all Medicaid programs total billions of dollars annually. “Incident to” billing – charging for services provided by non-physician staff under a physician’s supervision as if the physician performed them – represents one of the more common forms of healthcare fraud.

The settlement with Tural Pediatrics reflects Massachusetts’ aggressive stance on healthcare fraud enforcement. The state has recovered millions in improper payments in recent years through similar actions against healthcare providers.

Fall River, where Tural Pediatrics operates, is a city of approximately 94,000 residents in Bristol County, Massachusetts. The community, like many across the nation, faces challenges in healthcare access, making the integrity of providers who serve vulnerable populations particularly important.

For healthcare providers across Massachusetts, this case serves as a reminder of the importance of accurate billing practices and proper documentation. Industry experts note that pediatric practices face particular billing challenges due to the high percentage of patients covered by Medicaid and the complex billing requirements associated with the program.

The Attorney General’s Office continues to encourage residents to report suspected healthcare fraud or abuse. Massachusetts maintains a dedicated reporting system through the Attorney General’s website where individuals can file complaints about fraudulent Medicaid claims or suspected abuse of patients in healthcare facilities and long-term care settings.

As healthcare costs continue to rise and public programs face increasing financial pressure, enforcement actions like this settlement represent an important tool for maintaining the fiscal health and integrity of vital safety net programs like MassHealth.