Beth L. Roberts
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.
Beth gains great satisfaction from her pro bono work and giving back to the community.
On behalf of associations and individual clients, drafted amendments to most of the major Medicare and Medicaid legislation over the past two decades.
Obtained drug and device pass-through payments, new technology APCs, and NTAPs for several new drugs, devices, and procedures.
Secured continued Medicare coverage for osseointegrated implants after CMS proposed to reclassify them as non-covered hearing aids.
Successfully lobbied for a provider association and a major trade association for statutory language for more favorable Medicare reimbursement.
Enabled an implantable device manufacturer to commercialize its core product by obtaining appropriate Medicare reimbursement for its category B device.
Helped secure a statutory mandate for Medicare coverage and adequate payment rates for a breakthrough new technology by a small medical device company.
Gained a retroactive reimbursement increase for a lifesaving therapy by working with a biotechnology company to articulate legal basis for its action.
Facilitated coverage and reimbursement for a client's new medical procedure by successfully obtaining a Category I CPT code.
Healthcare – District of Columbia
Life Sciences Regulatory Star
LMG Life Sciences
Top Rated Health Care Attorney
Washington, D.C. Super Lawyers
The LaSalle D. Leffall Hidden Hero Award
Outstanding Young Healthcare Lawyers of 2004
Nightingale's Healthcare News
Top Lawyer, Food and Drugs
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28 September 2016