A federal prosecutor said a Haysville couple got greedy in their medical practice and broke the law, giving lethal drugs to their patients and stealing from insurance programs.
A defense lawyer for Stephen Schneider said the government made up charges against the doctor because he and his wife, Linda, were taking in poor patients and costing Medicare and Medicaid too much money.
A jury of nine men and three women settled in for a trial that is expected to last weeks. It began Tuesday with contentious arguments and meticulously detailed evidence from six years of the Schneiders' medical practice.
"You and you alone are the judges of the facts," U.S. District Judge Monti Belot told the jury as the trial began.
What are the facts?
The prosecution's version of the facts finds the Schneiders seduced by millions of dollars from thousands of patients coming to their clinic seeking prescription painkillers.
"This is a case about money, not medicine," Assistant U.S. Attorney Tanya Treadway told jurors in her opening address.
Treadway compared the architectural style of the Schneider Medical Clinic to a Mexican restaurant.
"And like a Mexican restaurant, people lined up at the door, waiting to get in," Treadway said.
They wanted drugs, Treadway said, and they received them from Schneider clinic workers with little medical training or supervision.
Prescriptions were dispensed when the doctor was not in, was out of town or was even out of the country, the prosecutor said.
"This caused abuse, overdoses and deaths," Treadway said.
Lawrence Williamson, Stephen Schneider's attorney, compared the government's case to a novel written by Dan Brown, author of the "Da Vinci Code" and "Angels & Demons."
"He takes a few truths, adds to it, and calls it fiction," Williamson said. "This is historical fiction."
The defense's version of the facts finds the Schneiders willing to take in Medicaid patients when no one else would, billing government health care rolls more than any other doctor in the state.
"He was costing them too much money," Williamson said of Stephen Schneider.
So the government decided to stop him, Williamson contended.
Treadway pointed to 68 patient deaths from overdosing on drugs obtained by prescriptions from the Schneider clinic. The Schneiders are charged with directly contributing to 21 of them.
Williamson pointed to 10,000 or more patients the Schneiders cared for, claiming the Schneiders didn't know the extent of the overdoses until the charges were filed.
The Schneiders are also charged with conspiracy in the writing of illegal prescriptions, health care fraud and money laundering.
"The only thing they conspired in was a marriage," said Kevin Byers, a lawyer for Linda Schneider, who managed the clinic. "They ran a business together. That's the only conspiracy."
Treadway played a video for the jury of Linda Schneider telling an agent from the Drug Enforcement Administration that she knew about one patient overdosing.
Linda Schneider also told DEA Special Agent Martin Redd that the people most likely to be upset at not receiving a prescription were those "really in pain, or selling."
Prosecutors accuse the Schneiders of being too lax in their refilling prescriptions and should have known that patients were abusing narcotics.
"Linda Schneider didn't tell you that Dr. Schneider knew about 68 deaths, did she?" Williamson asked on cross examination.
"That wasn't there," Redd said.
Redd said DEA agents searched more than 90 Wichita-area pharmacies to obtain the prescription records of Schneider patients.
There were 10 physician assistants working at the clinic during its six years of operation. Schneider was listed as the only supervising physician for most of them. Many of them worked at the clinic only a few months.
They sometimes were left without supervision, Treadway pointed out.
Schneider was gone 51 days over four years, according to information the FBI compiled from credit card records, passport stamps and attendance logs at medical conferences.
Redd said physician assistants could be approved by the DEA to write prescriptions. DEA regulations hold physician assistants individually liable for the prescriptions they wrote, he added.
"How many providers from the Schneider clinic are here on trial today?" Williamson asked.
"One," Redd said.
After taking a day off, the trial resumes Thursday.