CNN  — 

Larry Nassar, the former team doctor for USA Gymnastics and Michigan State University, is back in court Friday for his third sentencing hearing in as many months on charges of criminal sexual misconduct.

At least 65 accusers are expected to testify against him over days of testimony, which began Wednesday in Michigan’s Eaton County Circuit Court. Accusers say his abuse spanned more than two decades.

Here’s how we got here and what’s coming next:

Nassar already faces hundreds of years in prison

In January, Nassar was sentenced to between 40 and 175 years in prison. Nassar had pleaded guilty in Ingham County, Michigan, to seven counts of criminal sexual conduct — three of which involved victims under age 13 — and admitted to using his stature as a medical professional to assault and molest girls under the guise of medical treatment.

Former Michigan State University and USA Gymnastics doctor Larry Nassar listens during the sentencing phase in Eaton, County Circuit Court on January 31, 2018 in Charlotte, Michigan. Last week Nassar was sentenced in Ingham County to 40 years to 175 years in prison.
The number of identified sexual abuse victims of former USA Gymnastics doctor Larry Nassar has grown to 265, a Michigan judge announced Wednesday as a final sentencing hearing commenced. Prosecutors said at least 65 victims were to confront Nassar in court, in the last of three sentencing hearings for the disgraced doctor who molested young girls and women for two decades in the guise of medical treatment.
 / AFP PHOTO / JEFF KOWALSKY        (Photo credit should read JEFF KOWALSKY/AFP/Getty Images)
Nassar survivor: 'Have fun in prison'
01:58 - Source: CNN

In December, Nassar was sentenced to 60 years in prison He had pleaded guilty in federal court to three charges of child pornography. As part of the plea deal, officials agreed they wouldn’t prosecute Nassar for sexual exploitation and attempted sexual exploitation of children.

His accusers refuse to be silenced

More than 200 of Nassar’s victims will have addressed the courts. In addition to the 65 expected to testify in Eaton County, more than 156 women gave heartrending testimonies last month in Ingham County. His accusers included high-profile Olympians Aly Raisman, Gabby Douglas and McKayla Maroney.

Simone Biles competes in the floor exercise during Day 2 of the 2016 U.S. Women's Gymnastics Olympic Trials at SAP Center on July 10, 2016 in San Jose, California.
Biles: Testifying would have been a step back
02:00 - Source: CNN

Olympian Simone Biles also said she was sexually abused by Nassar. Biles’ statement came on the eve of Nassar’s sentencing in Ingham County last month, though she didn’t testify. She told CNN on Wednesday she wasn’t emotionally ready to face her abuser and that she’s “trying to move forward.”

A victim and newspaper exposed his crimes

The Indianapolis Star published an exposé bringing Nassar’s abuse to light. The September 2016 storyexposed Nassar’s misconduct and included an allegation that USA Gymnastics knew of his abuse and failed to notify Michigan State University or the gymnastics gym Twistars, where he worked.

Mark Alesia 1.25
Journalist talks about breaking Nassar story
01:23 - Source: CNN

The Star had received a crucial tip from one of Nassar’s victims, Rachael Denhollander. Denhollander said she’d been waiting for an opportunity to be believed. The Star gave her that chance.

The fallout is just beginning

USA Gymnastics’ board has stepped down The last of the board members resigned on Wednesday, as the organization moves to implement sweeping institutional changes recommended by a federal prosecutor in late 2016.

Amanda Thomashow
Thomashow: MSU covered up abuse (February 2018)
05:01 - Source: CNN

Two top officials at Michigan State University also called it quits. Last week, President Lou Anna Simon announced her resignation and Athletic Director Mark Hollis announced his retirement.

The allegations of a cover-up, which Michigan State denies, has prompted comparisons to the scandal that unfolded at Penn State in 2011 when Jerry Sandusky was arrested for sexually abusing young boys on campus and elsewhere.

Attendees at an emotional town hall meeting on Michigan State’s campus Thursday night called for the university’s Board of Trustees to resign.

The fallout could continue for years. Other individuals and organizations will continue to be scrutinized for their alleged part in the scandal.

Here’s what’s next

A special prosecutor has been tasked with investigating “every corner” of Michigan State University. William Forsyth, a retired prosecutor in Kent County, Michigan, will investigate how Nassar was able to abuse patients for so long without being stopped, who was aware of allegations against him and what university officials did when they were notified of his actions.

William Forsyth, a former Kent County prosecutor, speaks after Attorney General Bill Schuette, right, announced an open and ongoing investigation into the systemic issues with sexual misconduct at Michigan State University that began in 2017 on Saturday, Jan. 27, 2018 at the G. Mennen Williams Building in Lansing, Mich.  Schuette said  that the independent probe will shine a bright light on every corner of the university.    (Jake May/The Flint Journal-MLive.com via AP)
Special prosecutor: You will get my best effort
00:45 - Source: WDIV

The NCAA has also opened an investigation into the university. Several victims, including Amanda Thomashow, say they told university officials about Nassar’s abuse, but were either silenced or no action was taken.

More than 100 accusers are suing Michigan State and USA Gymnastics. The civil lawsuits accuse the university and sport’s governing body of negligent failure to warn or protect victims, intentional infliction of emotional distress and sex discrimination in education under Title IX.