CLINIC'S TROUBLES PREDATE RAID

Records Show The Schneider Medical Clinic Drew State Scrutiny Over
Prescriptions In 2003

The Schneider Medical Clinic in Haysville was facing state allegations of
improperly prescribing dangerous narcotic drugs long before police raided
the facility last week, records show.

Concerns were raised as early as October 2003 about overuse of narcotics,
prescriptions of multiple painkiller drugs for the same patients, and
inadequate monitoring and record keeping to make sure the medicines were
properly used, according to records obtained by The Eagle.

The Schneider clinic and its owner, Stephen Schneider, also face the
potential loss of eligibility to treat Medicaid patients, the records show.

Schneider did not reply to messages seeking comment for this report.

The clinic vaulted into the public eye on Tuesday, when a team of federal
and state agents strung police-line tape around it and spent the day
searching the premises.

The clinic reopened Wednesday.

Details of the raid are sketchy, with officials declining to comment on
what they were looking for.

But it is known that the raid involved agents from the federal Drug
Enforcement Agency, the Kansas Bureau of Investigation, the U.S. Postal
Inspector's Office and the Medicaid Fraud Control Unit.

A lawyer who has represented Schneider's clinic on Medicaid issues said she
had not discussed the raid with the doctor.

Martha Aaron Ross, of the Wichita-based Foulston Siefkin law firm, said she
did not know if Schneider had a lawyer working on the search warrants.

Gavin Young of the state Office of Administration said the DEA/KBI search
"is a totally separate thing" from the state efforts to yank the clinic's
Medicaid eligibility.

According to court documents, the clinic serves about 4,000 patients, 1,200
of whom are on Medicaid.

Doctor Debated

So what kind of doctor is Stephen Schneider?

The record shows he's an osteopathic physician in family practice with a
concentration on pain management.

He was born in 1953 and licensed to practice in Kansas in 1988.

Beyond that, it depends on whom you talk to.

Some of his patients have rallied to support him, while others familiar
with his practice were harshly critical.

Darrell Hicks said he believes Schneider is a major contributor in the
death of his 24-year-old son, Darrell Hicks III, who died of a drug
overdose last year while under Schneider's care for complaints of back pain.

Hicks said his son had two MRI exams, neither of which showed a discernible
problem with his back.

But he said his son's medical records show that Schneider was prescribing
him 180 pills a month of Lortab -- a powerful and addictive narcotic pain
reliever -- along with 120 pills of Soma, a muscle relaxant.

An overdose involving those two drugs killed actress Dana Plato, the former
co-star of the NBC sitcom "Diff'rent Strokes," in 1999.

After the show's cancellation in 1984, Plato became addicted to
prescription painkillers and twice was convicted of drug-related crimes.
Her death was ruled a suicide.

But while it involved the same drugs, Hicks III's death was deemed
accidental by the Sedgwick County coroner's office.

He died July 17, 2004, from a combination of drugs including the
medications he got from Schneider, plus doses of the anti-anxiety drugs
Valium and meprobamate and marijuana, which he obtained from an unknown source.

"I'm not saying the doctor is 100 percent at fault for my son's death,"
Hicks said.

"There are three people that I blame. I blame my son for not thinking about
what he took, I blame the doctor for prescribing the drugs over and over,
and I blame the third person who gave him the Valium and the tranquilizer."

Hicks filed a complaint against Schneider with the Kansas Board of Healing
Arts, which regulates physicians. He said he received an acknowledgment
that the board got the complaint, and has heard nothing since.

Kelly Cavender-Arnold said she left the Schneider clinic because of its
inattention to her needs.

Patients who consistently use narcotic painkillers must sign a contract
saying in part that they won't give or sell their pills to others, that
they won't seek more drugs from other doctors and that they will submit to
random drug testing.

Cavender-Arnold said she was receiving a low-strength dose of Lortab for
chronic back pain from the Schneider clinic. The clinic referred her to a
surgeon, and she underwent a six-hour operation that put her in a body cast
that she's still in.

The surgeon prescribed a stronger dose of Lortab, but Cavender-Arnold said
when she tried to have the prescription filled, the pharmacist called the
Schneider clinic and someone there said to tear the prescription up because
it was a violation of her contract.

She said that the clinic receptionist refused to get her in contact with a
doctor there who could take care of the problem and she spent two weeks in
unrelieved agony.

"That was the most miserable experience I've ever gone through," she said.
"It was unbelievable.

"To be treated like a drug addict... it was a miserable experience and I'm
never going back there."

But Schneider and his clinic have their staunch defenders as well.

More than 50 patients and their families have signed a petition and a
plastic banner supporting Schneider outside his clinic door.

Among them are John Koop, 61, who has lost both his legs and parts of two
fingers to Burger's disease, an excruciatingly painful circulatory ailment.

"I've never had a doctor who took care of me like he (Schneider) does,
without me having to force him to do tests," Koop said. "Now all of a
sudden, this comes up."

Koop said that Schneider has closely monitored his drug usage and that he
has to come in once a month for an examination to get his painkiller
prescriptions refilled. He said he has undergone several urine tests for
other drugs and that he has seen Schneider cut off other patients for such
things as using marijuana in addition to their prescription drugs.

Mark Nordstrand, also 61, called Schneider "totally ethical and very honest."

He receives pain medication for problems with the discs in his spine that
have left him unable to work for the past nine years. As he walks, he leans
heavily on a cane.

His theory, with which Koop agrees, is that the government launched last
week's raid in retaliation for Schneider vigorously defending himself in
the Medicaid investigation.

A National Problem

The Schneider controversy is just a microcosmic example of an issue playing
out on the national stage.

Prescription abuse drew widespread national attention in 2003, when it was
revealed that conservative radio icon Rush Limbaugh was addicted to
painkillers he had started taking after back surgery.

Today, about a third of all drug abuse in the United States is related to
prescription drugs, according to the federal Department of Health and Human
Services.

From 2000 to 2002, the number of Americans abusing prescription drugs
quadrupled,from 1.5 million to 6 million, the department said.

Lisa Robin, a vice president of the Federation of State Medical Boards of
the United States, said it's a national challenge to come up with a way to
assure that people don't divert or abuse prescriptions while making sure
that the drugs remain available to pain sufferers who really need them.

Her group issues a model policy for doctors to follow in prescribing
narcotic drugs to patients.

"Just simply the number of doses is not indicative of good or bad medical
practices," she said.

The key, in her agency's view, is careful record keeping and monitoring of
patients to make sure the drugs are used as they are intended.

Narcotics At Issue

Narcotic drugs are clearly at the heart of the Medicaid issue.

In a notice telling Schneider he was about to have his Medicaid eligibility
terminated, the state alleged a variety of serious violations, including:

* "Continued poly-pharmacy (multiple drug) practices and overuse of
narcotic medications without appropriate documentation."

* "Prescribing practices (that) appear to be determined by the requests and
desires of patients."

* Patients receiving "pain shots" of drugs that were potentially
antagonistic with the opium-based painkillers they were already taking,
placing the patients at high risk of withdrawal or other side effects.

* Failure to address alternative therapies that did not rely on drugs.

* Incomplete and missing documentation, including medication lists, patient
charts and test results.

By May of this year, Kansas Medicaid officials were moving to revoke the
Schneider clinic's eligibility for government funding, for failure to
comply with a corrective action plan imposed by the agency in February,
records show.

However, in the same month, FirstGuard, a private contractor administering
Medicaid programs for the state, was congratulating Schneider -- in capital
letters -- for his compliance with a corrective action plan that FirstGuard
had imposed in January.

In court records, Schneider cited his compliance with FirstGuard's action
plan as evidence that he had his narcotics prescription process under
control before Medicaid moved to rescind his eligibility.

Schneider maintains that he didn't even know that Medicaid had ordered him
to take corrective action, the court documents show.

He says he never got the Feb. 5, 2004, letter to inform him of Medicaid's
corrective action plan for his clinic and that state officials didn't
mention it, even though they demanded records from his clinic 11 months later.

Medicaid is still moving forward against the doctor, said Young.

He said there is no inconsistency in the state pursuing action against the
doctor while its contractor is lauding his compliance.

While Schneider may have satisfied FirstGuard, he still had to satisfy the
state, which he didn't do, Young said.

"You have two separate agencies, two separate administrators and two
separate action plans," he said.

Cutoff On Hold

In June, officials ordered the Schneider clinic cut off as of July 1 from
Medicaid funding. On July 1, Schneider filed a suit in Sedgwick County
District Court to block that order pending a hearing.

FirstGuard, which administers state-supported care programs known as
HealthConnect and HealthWave, informed Schneider that he was being dropped
from its programs on July 8.

FirstGuard is required by its contract with the state to cut off any doctor
whose Medicaid eligibility is revoked, according to court records.

But implementation of Medicaid's and FirstGuard's actions has been stayed
indefinitely.

Any doctor who is terminated from the state-supported programs is entitled
to a "fair hearing" from the state Office of Administrative Hearings.

In a July 8 order, District Court Judge Karl Friedel ruled that the
Schneider clinic will continue to receive state funds until the completion
of the fair hearing process.

"Plaintiff (Schneider) and those Medicaid recipients for whom providers
have provided medical care and treatment would suffer irreparable injury if
the requested relief is not granted," Friedel wrote in his order.

The order also said Schneider is "likely to succeed on the merits" of his
assertion that the state "acted in error" when it cut him from the Medicaid
programs.

No one knows how long the judge's stay will remain in effect because
"there's no way to tell when the hearing will be," Young said.

The first meeting between the two sides is set for Oct. 10.

The hearing itself "won't be sometime soon," Young said.