Roxana Hegeman, AP

A Kansas doctor accused of illegally prescribing drugs linked to 68 deaths testified that he knew some patients had died from overdoses, but his clinic changed its practices to prevent future overdoses. Dr. Stephen Schneider and his wife, Linda, were charged in a 34-count indictment with illegally prescribing drugs and committing health care fraud and money laundering.

When Assistant U.S. Attorney Tanya Treadway asked Schneider whether he knew that people who received prescriptions from him had died, he said, “I know of some.” When Treadway questioned him about notices he received from emergency room doctors, the medical examiner, hospital faxes and law enforcement, he again said he was aware of some of them. He said he did not know whether he had attempted to determine the circumstances of the overdose deaths.

Schneider testified earlier that his practice evolved in an effort to prevent overdoses. The clinic changed its pain management agreement several times, started doing more urine screening tests and began referring more patients for psychological evaluations, among other things.

Treadway also tried to cast doubt on the doctor's claim that the reason his clinic was overwhelmed with 10,000 patients was because it was one of the few in the area that accepted lower-paying Medicaid patients. The defense has tried to portray Schneider as a caring physician who took in indigent patients who had nowhere else to go.

But Treadway pointed out that 320 other providers in the area took Medicaid patients. She also showed the doctor a letter sent to Medicaid in October 2005 in which his clinic informed the agency it would no longer accept new Medicaid patients. Schneider had testified that if he had just been interested in money, he would have stopped treating Medicaid patients and focused on those with better-paying insurance. He said he asked other area physicians to take on some of his Medicaid patients at a 2005 medical conference, but they declined.

Treadway noted Schneider's letter to Medicaid was sent two months after that meeting. Asked whether he believed he had any responsibility for patients who abused drugs, Schneider replied he had a responsibility to treat every patient individually. “If they are abusing drugs and we find out they are abusing drugs, we discontinue the drugs and get them appropriate treatment,” he said.

That prompted Treadway to show Schneider three letters, purportedly written by him, to the Kansas Board of Healing Arts in response to complaints about the care of patients. In the letters, Schneider acknowledged he knew those patients had forged a prescription or might be selling their medications.

Schneider has insisted that he would never have written prescriptions for patients who overdosed if he thought it would hurt them. He testified he told agents during a September 2005 raid on his clinic that he left pre-signed prescription pads for his physician assistants but said he didn't know then it was inappropriate.