YAKIMA, Wash. -- It was salt in the wound for Yakima Valley Memorial Hospital.

The state Department of Health announced Monday that nine new hospitals have been approved to add elective angioplasty to their cardiac services. Not on the list is Memorial, which is suing the state in federal court over the rules that let hospitals add the procedure.

The state's decision is the result of legislation passed in 2007. The law directed the Health Department to develop rules to determine where there was a need for the less invasive procedure. As written, the rules effectively determined that Yakima wasn't a big enough market to need two hospitals doing elective angioplasty.

So for now, Yakima Regional Medical and Cardiac Center -- because it has backup open heart surgical capability -- keeps its control over elective angioplasty, which is the opening of clogged arteries using a catheter with a balloon or stent on the end. (Memorial does lots of emergency angioplasty.)

Memorial's lawsuit alleges that the state is restraining trade and allowing Regional to keep a monopoly. The trial date isn't until November 2010.

Hospitals winning approval for elective angioplasty are St. John Medical Center, Longview; Stevens Hospital, Edmonds; Capital Medical Center, Olympia; Evergreen Hospital Medical Center, Kirkland; Skagit Valley Hospital, Mount Vernon; Good Samaritan Hospital, Puyallup; Valley Medical Center, Renton; and a joint program by St. Francis Hospital in Federal Way and Auburn Regional Medical Center in Auburn.