Opponents of the medical device tax can no longer rely on "the regular order" to score a win, according to Republicans on the House of Representatives’ powerful Ways & Means committee.

Member of the House are working on a "prearranged" agreement with the U.S. Senate in order to work out the details of a repeal bill before it comes to a vote in the House, a handful of Reps said during radio interviews this month.

House GOPers are looking for ways to ensure that the Senate and Majority Leader Harry Reid don’t "hijack" a medical device tax repeal bill as it passes between houses. That means generating behind-the-scenes support for the measure before any voting takes place, according to the Reps.

"If we were to simply pass a medical device tax repeal, send to the Senate, then Harry Reid loads it up with all sorts of nonsense, sends it back to the House, and jams us at a certain time," Rep. Tom Price (R-Ga.) told conservative radio talk show host Hugh Hewitt during an interview this week. "So you’ve got to get the agreement beforehand, before you pass it over to the Senate. Otherwise, they hijack the doggone thing."

Some repeal advocates had hoped the House would jump on the Senate’s recent 79-20 vote in favor of a non-binding amendment to repeal the medical device tax, using the momentum generated by the occasion to make progress on a more decisive measure.

Senate Minority leader Mitch McConnell (R-Ky.) and former Senator Scott Brown last month separately called for a “real” vote in the upper house, in part to leverage the momentum of the recent decision, but also to put pressure on the 33 Democrats who cast their votes for repeal when the stakes were low. Rumors later surfaced that the House "is not ready to send any tax vehicle to the Senate right now," tempering some of the enthusiasm produced by the Senate action.

More medical device tax coverage from MassDevice.com.

Rep Erik Paulsen (R-Minn.), a long-time friend of the medtech industry and opponent of the medical device tax, agreed with fellow House Ways & Means member Rep. Price that committee leadership was wise in putting off a vote while tracks were laid in the Senate.

"I think leadership, and [Ways & Means] Chairman [Dave] Camp (R-Mich.), are rightfully saying well, we don’t want to send a revenue bill, even though it’s the right political thing to do – the right policy thing to do, it makes sense – over to the Senate and have some mischief – change the bill and you know, alter revenue in some other way and do something that’s hostile to our intentions," Rep. Paulsen said during an interview last week. "So I think we’re going to try and see if we can work out some agreements with some of those 79 senators. That’s what we need to do."

The Senate bill passed by the 79-vote majority was largely symbolic in that it was a non-binding amendment, a move that former Senator Brown rejected when he was in office, he told MassDevice.com in an exclusive interview. A vote on a non-binding measure is little more than a token gesture meant to provide cover for lawmakers when they re turn home in their device-heavy districts, Brown said.

Rep. Paulsen likened GOP efforts to push the medical device tax repeal bill to the recent budget negotiations, saying that they’re using similar strategies to gain headway despite "a president who is very hostile, and the Senate leader is very hostile."

Of the Senate’s somewhat surprising support of the non-binding medtech tax repeal amendment, Paulsen said, "We’ve shamed the Senate into that vote."

It’s unclear whether a true repeal bill would make much headway given that Congress would have to find some means to make up for the $30 billion in revenue the medical device tax would generate. Previous pay-for proposals have rubbed Democrats the wrong way, and President Barack Obama has on more than 1 occasion promised to veto a device tax repeal bill should one land on his desk.

Repeal efforts face some serious headwinds, but the slow and steady route isn’t sitting well with some observers.

"That is not the regular order of the House that we were promised. We were promised that a GOP majority would pass good laws and send them to the Senate," interviewer Hewitt said during the conversation with Rep. Paulsen. "We were not promised back room negotiations with obstructionist Democratic senators."

Rep. Peter Roskam (R-Ill.) defended the slow-and-steady approach, calling it a necessary measure to make sure any tax bill the House sends over to the Senate "comes back and it’s clean, and that they don’t load it up with some other class envy tax hikes and a bunch of nonsense."

"It’s got to be prearranged with the U.S. Senate so that they agree to do the repeal and the repeal alone," Rep. Roskam told Hewitt in an interview earlier this month. "You’ve got this test vote in the U.S. Senate, that’s a very good thing. But test votes are different than commitments. And the commitment has to be that they don’t load it up with a bunch of other tax stuff, and jam the American taxpayers."

"I think we’ve got to be very sophisticated in how we’re approaching this," he added. "We’re dealing with the most partisan president in our lifetimes. There’s not anything that these guys do that isn’t partisan. And they play zero sum game politics. And in light of that, I think we’ve got to be pretty sophisticated in our thinking."