Ben Carson stands by shady business associate and 'best friend' who pleaded guilty to healthcare fraud

Ben Carson is continuing to stand by his business associate and “best friend” Alfonso Costa following revelations that Costa pleaded guilty in federal court in 2007 to healthcare fraud.

Costa, a former dentist from Pittsburgh, is a self-employed real estate speculator with properties in Pennsylvania, New York City, Florida and elsewhere.

“Al Costa is my best friend,” Carson said on Thursday in a statement obtained by the Guardian. “Al Costa is my very best friend. I know his heart. I am proud to call him my friend. I have always and will continue to stand by him. That is what real friends do!”

Carson and Costa are also business associates, with Costa’s firm managing a suburban Pittsburgh office building owned by Carson that last year earned the former neurosurgeon between $200,000 and $2m, according to financial disclosure forms cited by Mother Jones . (Disclosure documents require candidates to report income in ranges not precise figures.)

In a break from the campaign trail earlier this fall, Carson spent a week at one of Costa’s properties, a villa on Italy’s Amalfi coast . Years earlier, Costa had given a Travel Channel series called Jaw-Dropping Rentals a guided tour of the property.

“The jacuzzi terrace is very unique to the villa, because as you may know, the Amalfi coast is on a cliffside,” Costa said then. “So therefore we had to actually utilize a helicopter to drop the jacuzzi down upon the terrace.”

Carson has for years been a frequent visitor to the villa, which rents for between $30,000 and $50,000 per week depending on the season, according to the Baltimore Sun, which has published a photo of Carson vacationing there and an interview in which Carson was asked to “share a magical memory”.

“Flying through the water at high speed on a private boat and arriving for the first time on the island of Capri and then on to Sorrento,” Carson was quoted as saying. “Roaming through the streets with multiple stops with friends and family is an unbeatable experience.”

Carson has known Costa since the mid-1990s, when Costa helped set up the Pittsburgh chapter of the Carson Scholars Fund, the charity started by the neurosurgeon that awards $1,000 college scholarships to upstanding and outstanding high school students. Costa has given $2,700 to Carson’s presidential campaign, the maximum allowable for an individual, according to elections records .

Three years after Costa acquired the Italian property in 2004, US federal prosecutors hit him with charges relating to criminal activity from his previous life as a dentist.

Costa participated in a “healthcare fraud scheme of several years’ duration beginning in approximately 1995, involving false insurance billing for dental care,” according to court documents . “In the government’s investigation, over 50 patients confirmed that certain procedures billed by Dr Costa or associates of his dental practice had not been performed as billed.”

The scheme defrauded insurers of $44,579.47, the US district court for the western district of Pennsylvania found. Costa, 46 at the time, faced a maximum prison sentence of 18 months. He was sentenced to one year of house arrest with an electronic ankle bracelet, three years’ probation, 100 hours of community service and a $250,000 fine.

“He regrets profoundly what he has done and takes full responsibility for his acts,” lawyers for Costa wrote in a request for leniency.

“Words cannot express the pain and sorrow I’ve felt for what I’ve caused my family,” Costa said after he was sentenced, according to local media . “They honestly deserve better. I have worked all my life to respect others and gain the respect of others.”

Costa admitted his culpability, but Carson, apparently, has not. The Carson campaign did not reply to a request for comment on Thursday on Costa’s guilt. Costa’s company, Costa Land Company, did not return a call for comment.

In a 2012 book, America the Beautiful, Carson tells the story of a close friend trained as an oral surgeon – whom he does not name – who was hit by a Medicare fraud case. Carson suggests that the Justice Department pursued the surgeon not because he was a criminal but because prosecutors were either jealous of this friend or “incorrectly concluded that he had organized crime connections”.

A former dental partner of Costa, Roberto Michienzi, also pleaded guilty in the federal case to one count of healthcare fraud. Michienzi bought the joint practice in 1999, according to court documents, but Costa continued performing surgery there until 2001. Michienzi received a lesser sentence than Costa: three years’ probation and a $44,000 fine. A message left for Michienzi was not returned.

In his book, Carson suggests the fraud was all the fault of his unnamed friend’s dental partner (although he does not name this man), “but he did not have deep pockets – so the investigating agents came after my friend, even though he no longer owned the practice. They meticulously examined 15 years of his practice records for evidence of fraud and were only able to uncover two questionable bills, amounting to a total of $180.

“My friend owns a spectacular home, a Manhattan penthouse, two Ferraris, and a European villa. However, given the fortune he amassed, he lives modestly compared to the lifestyle he could have had if he so desired. I believe the lead agent was either jealous of his success or incorrectly concluded that he had organized crime connections that produced his wealth.”

Elsewhere in the book, Carson argues for strict penalties for healthcare fraud, punishments he calls “the Saudi Arabian solution”.

“I would not advocate chopping off people’s limbs, but there would be some very stiff penalties for this kind of fraud, such as loss of one’s medical license for life, no less than 10 years in prison, and loss of all of one’s personal possessions.”

Costa allowed his dental license to lapse in 2006. Carson expressed a different view of justice in a 2007 letter he wrote to ask Judge Gary Lancaster for leniency in Costa’s sentencing.

“Thank you for entertaining letters of support for one of my closest, if not my very closest friend, Dr Alfonso Costa,” Carson wrote. “We became friends about a decade ago because we discovered that we were so much alike and shared the same values and principles that govern our lives ...

“I could literally trust him with all of my earthly possessions and rest assured that I would get them all back with interest. To sum it up, next to my wife of 32 years, there is no one on this planet that I trust more than Al Costa.”

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