Dr. Kermit Gosnell, 72, pleaded guilty to federal drug charges after twice walking away from scheduled plea hearings.
"I've agreed to plead guilty, of my own free will," Gosnell told a judge.
Prosecutors say he sold prescriptions for $10 or $20, flooding Philadelphia streets with OxyContin, codeine-laced cough syrup and the antidepressant Xanax.
Investigators found more than $240,000 in cash in a 2010 raid of his West Philadelphia home. Informants later told them that Gosnell would sell prescriptions in dozens of names to the same customer, Assistant U.S. Attorney Joan Burnes said in court Tuesday. Gosnell also sold monthly refills.
"A license to practice medicine is not a license to deal drugs," Burnes said after the hearing, which stalled as Gosnell weighed the $200,000 asset forfeiture contained in the plea agreement.
Gosnell is already serving life without parole in the deaths of three babies born alive at his Women's Medical Society in West Philadelphia in a case that became a flashpoint in the nation's abortion debate. He was also convicted of involuntary manslaughter in the drug overdose death of an abortion patient.
It was during an investigation more than two years ago into prescription drug trafficking at the clinic that investigators discovered the fetid conditions there: bags and bottles of fetuses, including jars of severed feet, along with bloodstained furniture, dirty medical instruments, and cats roaming the premises.
Gosnell's federal drug plea calls for a guideline sentence of 24 to 30 years.
Sentencing was set for Oct. 4.