For the past two decades, Beth Roberts has helped life science companies optimize the value of their innovations. She helps clients navigate the complex coding, coverage, and reimbursement challenges faced by their new technologies.
Beth counsels on Medicare and other healthcare issues and lobbies the U.S. Congress and regulatory agencies on her clients' behalf. Her clients include healthcare providers; pharmaceutical, biotechnology, and medical device manufacturers; investors; and professional and trade associations.
Beth is a creative problem solver who is passionate about improving patient access to care. She works collaboratively to solve bet-the-company issues in innovative ways. She helps turn reimbursement challenges and changes into business opportunities. She also explains complicated laws and regulations in a simple and straightforward way.
Beth guides clients from reimbursement strategy through implementation. She applies for new International Classification of Disease (ICD-10), Healthcare Common Procedure Coding System (HCPCS), and Current Procedural Terminology (CPT) codes. She helps clients obtain favorable coverage for their products through the Local Coverage Determination (LCD) and National Coverage Determination (NCD) processes and advises on the opportunities and pitfalls of coverage with evidence development (CED) and parallel review. She also helps clients obtain appropriate payment, often through new technology add-on payments (NTAPs), drug and device pass-through payments, and new technology ambulatory payment classifications (APCs). Over and above, Beth advises on seizing opportunities through the Centers for Medicare and Medicaid Innovation (CMMI), including Accountable Care Organizations (ACOs) and the Oncology Care Model (OCM). When existing mechanisms do not work, Beth creates new solutions through policy initiatives or by amending the law.