A 41-year-old man who cheated public and private health insurance plans and the Internal Revenue Service out of $2.5 million over seven years at his father's eye clinic should spend at least 2 1/2 years in federal prison, a prosecutor argued Tuesday.

But a defense lawyer countered that Anthony Curtis Neal suffers from autism spectrum disorder and was acting as a "servant'' for his "manipulative,'' "monstrous'' and "distorted'' father.

Dr. Dean Elton Neal, 80, died from a stroke in May 2015 before federal prosecutors could charge the ophthalmologist.

"Tony wouldn't be here but for his father,'' Assistant Federal Public Defender Thomas Price told U.S. District Judge Robert E. Jones. "He was the minion for his dad's legacy.''

Assistant U.S. Attorney Seth Uram didn't dispute that Dr. Neal was the mastermind behind the lengthy scam, but the prosecutor didn't accept that the younger Neal was his father's "puppet.''

The son was well aware of the fraud, Uram said, and became a partner in perpetuating it. The prosecutor cited emails between the son and another ophthalmologist who worked at the small practice and had complained about unethical billing practices before he was fired.

"Tony Neal was a knowing front man in this scheme and his father worked behind the scenes in this scheme to make it a success,'' Uram said.

Neal pleaded guilty last summer to committing health care fraud by submitting false bills to public and private health benefit programs and conspiring to defraud the United States through a family scheme to evade paying federal income taxes. He's agreed to pay $2.5 million in restitution.

He and his late father ran 20/20 Eye Care in Gresham. They required patients to undergo unnecessary testing, double-billed patients for certain tests and then put the revenue in a bank account of a shell company called Oculus Inc., prosecutors said.

"Tony Neal and his father subjected hundreds of patients to unnecessary medical testing just to make more money,'' Uram and Assistant U.S. Attorney Donna Maddux wrote in a sentencing memo.

The father and son used about $3 million in Oculus funds to start building a multimillion-dollar 35,000-square-foot-house, complete with a helipad and tennis pavilion, for Anthony Neal and his wife in Damascus. It was to be linked through a heated tunnel to Dr. Neal's house 75 yards away, where the younger Neal and his wife lived in the basement. The house was never finished.

The father and son concealed from the IRS more than $1.3 million in company revenue each year from 2009 to 2013.

"There's no dispute the entire Neal family lived off of about $3 million in unreported income,'' Uram said.

Anthony Neal's defense lawyer painted a disturbing portrait of the father that was strikingly different from his glowing obituary, which described a "devoted, caring, and compassionate eye doctor who was still seeing his patients through 52 years of service.''

As the defendant's mother, wife, brothers and other relatives looked on, Price told the judge that Dr. Neal wreaked havoc on his family, abused his wife and his disabled son, was "obsessed by his image'' and driven by enormous ego and greed.

When Anthony Neal reported that he was raped as a child by an acquaintance, the father refused to report the sexual assault to police because he was concerned it would be "bad for his image,'' Price said.

Instead, the elder Neal told his son to toughen up. The child turned to chewing the back of his hands, his way of dealing with the abuse. Price showed the court slides of teeth marks on Neal's hands as a child.

When Neal was 13, his father would stumble drunk into his son's bedroom and demand that the boy go to the master bedroom to tell his mother to have sex with her husband.

Dr. Neal also abused his wife, Price said. He would tie her up and rape her, prompting her to file a restraining order against him in 1997, the lawyer said. In the petition, she wrote that Dr. Neal would force her to have sex, was unstable and abused alcohol. She filed for divorce that year, but they remained married.

The doctor's wife, Sharon Neal, sat in the front row of the courtroom gallery, surrounded by family, closing her eyes at times as Price revealed the sordid personal details.

Anthony Neal dropped out of school after 10th grade, his lawyer said. He tried to escape his father's control by faking his name on a passport and traveling to Russia, Price said.

But he couldn't fully get away. After returning to the United States, he began working at his dad's practice.

"Tony Neal complied with his father because of all that history of abuse,'' Price said.

Though the son managed the practice and handled the billing paperwork, he never put himself on the payroll and didn't file personal income tax returns during those years.

Their scheme unraveled after the practice's primary ophthalmologist and only surgeon, Dr. Jay Futterman, was fired on Jan. 9, 2012, after having worked there for about four years. Less than six months before, Futterman refused to allow the practice to fraudulently bill health insurance programs for unnecessary tests on patients. Tony Neal claimed in emails that the firing was due to Futterman's reduced revenue.

Futterman became the federal government's initial source about the fraud.

He told authorities, for example, that Dr. Neal was billing patients for an exam to diagnose Best's disease. He said the tests served no purpose and that Dr. Neal didn't even know how to interpret the test results.

Patrick Guiton, director of the special investigations unit for Regence Blue Cross Blue Shield, told the judge that the health insurer suffered a loss of about $466,000 because of the Neals' fraud.

Tony Neal, dressed in a dark suit, stood and addressed the judge briefly. He thanked his defense team for helping him understand "what I was doing.''

"It took me some time to get a clear picture,'' he said. "I want to apologize to all parties involved in this.''

He asked that he be granted help going forward to steer clear of such negative influences and pursue a career, perhaps in computer science or electric circuitry.

The judge took a 10-minute break and then issued his sentence.

"This is about as tough as it gets,'' Jones said.

The main culprit responsible for the massive fraud is dead. Dr. Neal was an abusive alcoholic -- "about as evil a person you can imagine, especially involving his disabled son,'' the judge said.

Yet Jones told the younger Neal: "You are not dumb. You were certainly under the thumb of your father, but you knew right from wrong. So you have culpability.''

Dr. Neal left his son with no assets, no job. The judge found the man before him wasn't driven by greed.

"You're vulnerable without any doubt in my mind,'' Jones said, "but something has got to be done. My solution is not perfect.''

Jones sentenced Neal to one year and one day in federal prison, meaning he will receive credit for time served and likely serve 15 percent of that followed by three years of supervised release. He was ordered to pay $1.7 million in restitution to Medicare, Care Oregon and several private health insurance companies and $817,378 to the IRS.

Neal's lawyer asked if Neal's prison surrender date could be delayed until after his two children finish school for the year. The judge consented and ordered him to start his sentence on July 5.

-- Maxine Bernstein

mbernstein@oregonian.com

503-221-8212

@maxoregonian