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📄 Law Review · Seton Hall University
Biomedical Treatment for PDD-NOS: A Valid Medical Expenditure
About This Article
What This Research Argues
Rose Harper's published law review article makes a compelling case that biomedical treatment for children diagnosed with Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS), a form of Autism Spectrum Disorder, constitutes a valid and necessary medical expenditure that private health insurance providers should be legally required to cover. Written during her time at Seton Hall University School of Law, this piece demonstrates Rose's deep commitment to advocating for vulnerable communities — long before she stepped into a courtroom as a personal injury attorney.
Why It Still Matters
The article tackles one of the most persistent failures of the U.S. health insurance system: denying coverage for treatments that are clinically beneficial but not yet mainstream. Rose argues that insurance companies use broad "Complementary and Alternative Medicine" exclusions to avoid covering effective therapies like biomedical interventions — and that courts and legislatures must step in to protect children with ASD and their families from catastrophic out-of-pocket costs that can exceed $72,000 per year.
Key Argument
Biomedical treatment reduces ASD symptoms at the cellular level — it is not "alternative" medicine.
Policy Proposal
Mandatory insurance coverage with $10,000 annual limit and physician referral requirement.
Financial Impact
Early intervention can reduce the average $3–5M lifetime cost of ASD care by two thirds.
Legal Framework
Analyzes ERISA, NJ and federal statutes, and key case law on "medical necessity" standards.