"The difference is sales reps have a commission structure of 40%," Tully says. "It's very large and a [POD] doesn't need a sales rep. It's a functional difference in the delivery of the devices."
In the wake of the Senate Finance Committee report, nearly all parties involved await the release of an Office of Inspector General Report on the issue, expected sometime in August.
"The IG has spoken on this several times," says Bulleit, with a bit of frustration in his voice. "They wrote a letter in 2006, and there was congressional testimony. In each case, they said in essence the same thing: They had serious concerns for potential abuse of patients and programs and were worried when doctors had a financial interest in PODs."
Bulleit describes the expansion of PODs as the result of "the absence of government action." He says that the strongly worded Senate report "shows it is already giving this a serious look. They are not just dabbling; this isn't just fishing. A lot of investigating has been going on."
The major problem is that the POD model "changes the game" in the medical device field, says Steinmann.
Whether the game changes or not may depend on the next move, by the Inspector General's Office, in August, when it gets really hot and muggy in Washington.