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United States v. Mashali

United States District Court, D. Massachusetts

February 7, 2018

UNITED STATES OF AMERICA
v.
FATHALLA MASHALI

          ORDER

          RYA W. ZOBEL, SENIOR UNITED STATES DISTRICT JUDGE.

         This is the court’s second competency determination of defendant Fathalla Mashali. Formerly a licensed physician who operated several pain clinics in New England, defendant has pleaded guilty to charges of healthcare fraud, conspiracy to commit mail fraud, and money laundering. (Docket # 131 (Second Superseding Indictment), Docket # 329 (Plea Hearing).)

         In late 2015, defendant’s counsel moved for a competency hearing pursuant to 18 U.S.C. § 4241. The court allowed that motion, and on September 9, 2016, after several evaluations and an evidentiary hearing, found defendant competent to stand trial. Trial was scheduled to commence on March 20, 2017, but on March 1, 2017, defendant moved for a Rule 11 hearing. At the March 2 plea hearing, defendant denied knowledge of the fraud charged, although he acknowledged his responsibility for the clinic’s activities. As a result, the court did not accept his plea and continued the hearing. At a second plea hearing two weeks later, defendant explained in some detail his regimen of outpatient mental health and medical treatment, acknowledged his guilt, and stated that he fully understood the proceedings. Defendant explicitly admitted knowledge of the healthcare fraud scheme and of the scheme’s illegality. He acknowledged that he had instructed his employees to bill incorrectly and submit claims for work not performed. The court accepted his plea.

         A sentencing hearing was scheduled on July 26, 2017. On July 20, 2017, defendant’s counsel moved for a competency determination. At the hearing on that motion, the government joined the request for a competency ruling, but requested that defendant be committed to the Bureau of Prisons (“BOP”) for such mental evaluation. The court allowed both motions. The BOP issued its report on January 8, 2018 (Docket # 355), and an evidentiary hearing to determine competency for sentencing followed on January 23, 2018. At the hearing, defendant moved orally and without counsel’s support to withdraw his guilty plea, which was denied. Below are my findings of fact and conclusions of law with respect to defendant’s competency for sentencing.

         I. The Record

         The sole witness at the hearing was Dr. Shawn Channell, a forensic psychologist and the author of the January 2018 BOP report evaluating defendant’s competency. In addition to Dr. Channell’s testimony and report, the parties agree that the record before me consists of several earlier reports and findings as follows:

• Report of the government’s expert Dr. Martin J. Kelly, dated February 10, 2017 (Docket # 310);
• Reports of defendant’s expert Dr. Roger H. Gray, dated December 8, 2016, July 19 and 20, 2017 (Docket # 341-1);
• Reports of defendant’s expert Dr. Leslie Vogel, dated July 20 and 21, 2017 (Docket # 341-1);
• Findings of fact contained in this court’s previous determination of defendant’s competency (Docket # 276), and any materials relied upon therein, including the record of the June 30, 2016 competency hearing.

         II. Findings of Fact

         I analyze each expert’s findings separately.

         A. Dr. Martin J. Kelly

         As the government’s expert, Dr. Kelly found defendant competent to stand trial as of February 2017. Before reaching that conclusion, Dr. Kelly conducted four and a half hours of psychiatric interviews of defendant in January 2017 and reviewed defendant’s medical and legal records. Throughout the course of these interviews, defendant “repeatedly stressed his innocence and that he was unaware of any problem with his practice until authorities became involved and that it was never his intention to defraud the government nor did he engage in any fraudulent activity.” (Docket # 310, at 4.) I credit Kelly’s characterization of defendant as a person with ...


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