Given its key role in financing U.S. health care reform to the tune of $10 billion over 10 years, it seems safe to assume that unless the government can scrounge up $10 billion from alternative sources, the controversial 2.3 percent federal medical device excise tax is here to stay. Foreign manufacturers selling taxable medical devices in the United States should therefore take necessary steps to not only ensure they are complying with the tax if liable but also to ensure they are not paying more than required by law.