Kassim Lawal v. State

368 S.W.3d 876, 2012 WL 1951101, 2012 Tex. App. LEXIS 4321
Court of Appeals of Texas·Decided May 31, 2012·No. 14-11-00705-CR·Published·Cited by 25 cases

Opinion

*879 OPINION

JEFFREY V. BROWN, Justice.

Appellant Kassim Lawal pleaded guilty to theft of property by a government contractor. After the trial court conducted a pre-sentence investigation, the court sentenced Lawal to ten years in prison. On appeal, Lawal contends that (1) the trial court abused its discretion when it did not allow him to withdraw his guilty plea and (2) the trial court’s denial of his motion for a Health Insurance Portability and Accountability Act of 1996 (HIPAA) protective order denied his right to due process during his appellate proceeding. We affirm.

I

Lawal owned Singapore Drug and Alcohol Rehabilitation, a licensed chemical dependency treatment facility that provided counseling to minors and others under the Medicaid program for chemical dependency. Lawal contracted with a charter school group, Community Education Partners (C.E.P.), to provide individual or group counseling to juveniles during school hours. Lawal billed Medicaid for the services provided. Under Medicaid’s billing requirements, Lawal was obligated to provide the services for which he billed Medicaid, and the person receiving the services had to need them.

Sergeant William Marlowe, an investigator with the Medicaid Fraud Control Unit of the Attorney General’s Office, received a referral regarding Singapore from the Texas Department of Health and Human Services. Marlowe looked through the claims data from March 2005 through April 2006 that Lawal submitted to see what Medicaid was billed for and what it paid. Marlowe immediately noticed that the records showed services being rendered to school-age children for eight to twelve hours of chemical dependency treatment during school hours.

Marlowe was able to locate thirty-four of the juveniles who were the subject of the billing. Interviews with the juveniles or their guardians revealed that sixteen of the thirty-four Medicaid recipients either received little or inadequate services from Singapore. Further, the services provided were of an educational nature rather than for chemical dependency treatment — services for which Medicaid did not provide reimbursement. In some cases, the services were provided by unqualified individuals such as a receptionist and interns. Singapore also billed and received payments for individual counseling when in fact it provided group counseling. Singapore submitted billing for these sixteen Medicaid recipients totaling $67,267.88 and received $41,161.22.

Eighteen of the thirty-four Medicaid recipients never received any services. Some had never heard of the facility at all. Singapore submitted billing for these 18 Medicaid recipients totaling $73,641 and received $50,566.82. Thus, the investigation showed that Medicaid had reimbursed Singapore a total of $91,728.04 based on fraudulent billing.

Marlowe also interviewed employees of Singapore, including Kelvin Devereaux, who had been one of the clinical directors at Singapore from November 2004 until October 2005. The interviews revealed a high turnover rate of both clinical directors and employees. Many employees left over ethical concerns or personality conflicts. The employees acknowledged that they were providing educational and life skills services rather than chemical dependency treatment. Despite the high turnover, the billing pattern and deficiencies in the file quality were consistent throughout the billing period alleged in the indictment.

*880 The employee interviews also indicated that that Lawal kept the patient files under lock and key and did the billing himself. Although Lawal initially used a billing company to submit billings to Medicaid, the majority of the time frame alleged in the indictment he personally did the billing.

Based on the records submitted for billing, Marlowe determined that Singapore had treated ninety-eight juveniles. Marlowe also obtained the patient files from Singapore, but discovered that the files only covered sixty-two of the patients, and many files were missing. The files that were recovered included no parent consent forms, even though Medicaid required parents of juveniles to be aware of and sign off on chemical dependency treatment. Moreover, the majority of the files indicated no chemical dependency. Few of the juveniles diagnostic exams reflected more than recreational drug use, and most appeared to be referred for anger management, parental issues, ór general life skills. Therapy notes in the files indicated that the therapy being performed was drug education or anger management, which did not qualify as chemical dependency treatment. Additionally, the group therapy session notes appeared to be mass copied between files and few were related to drug abuse; many were signed by unlicensed and untrained individuals.

Marlowe testified that he interviewed about a third of Singapore’s patients before he ran out of time. Although he acknowledged he did not know what the missing files reflected, he testified that he was able to prove $91,000.00 in fraud based on the records he was provided and the interviews he had conducted. Although Marlowe had not been able to prove more than $91,000.00 due to time, statutory constraints, and the ages of the patients involved, in his opinion all the billing was fraudulent.

In July 2010, the State indicted Lawal for aggregate theft by a government contractor of between twenty-thousand and one-hundred-thousand dollars. The case was set for jury trial commencing February 14, 201L

Before trial, Lawal wrote a letter to the trial court complaining about his attorney, but also indicating that he was willing to accept the consequences on behalf of his company even though he claimed he was innocent. In the letter, Lawal claimed that Devereaux had broken into his office and stolen all the patient files in retaliation for being fired. According to Lawal, Dev-ereaux still had the files and therefore Lawal was unable to respond to the theft charge.

After the trial was reset, Lawal’s counsel moved to withdraw due to a medical condition. The trial court granted the motion and appointed new counsel to represent Lawal on March 2. Lawal’s new attorney requested appointment of an investigator and the trial court granted the motion.

On May 11, Lawal pleaded guilty to the offense without a punishment recommendation. He waived his rights and entered a judicial confession stipulating to the facts alleged in the indictment. Lawal testified that he was pleading guilty for no other reason than because he was guilty. He also denied that anyone had threatened or coerced him to enter into the plea. Because Lawal was not a citizen of the United States, the trial court admonished him that it was possible he could be deported as a result of his plea. Nevertheless, La-wal indicated that he still wished to continue his plea. He agreed that his attorney had answered all his questions and he was satisfied with his representation. Lawal’s counsel also indicated that he had suffi *881 cient time to visit with Lawal and he believed Lawal was competent and understood what he was doing.

Lawal further testified that he understood he was pleading without an agreed recommendation. The trial court admonished him regarding the range of punishment, and Lawal indicated he understood that the punishment assessed would fall within that range.

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Kassim Lawal v. State, 368 S.W.3d 876, 2012 WL 1951101, 2012 Tex. App. LEXIS 4321 (Tex. Ct. App. 2012).

368 S.W.3d 876 (Kassim Lawal v. State) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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