Memorial still blocked from offering angioplasties

YAKIMA, Wash. -- A federal court has ruled against Yakima Valley Memorial Hospital in its bid to offer doctor-advised angioplasties in competition with Yakima Regional Medical and Cardiac Center.

Memorial will appeal the decision to the 9th Circuit Court of Appeals, a process that could take a year.

"We respectfully disagree with the court's decision and have instructed our legal counsel to appeal," CEO Rick Linneweh said Friday.

U.S. District Court Judge Edward Shea of Richland agreed with the state Department of Health and Secretary Mary Selecky that their process for issuing a certificate of need for angioplasties did not restrain trade and violate the Sherman Antitrust Act as Memorial argued. The Sherman Act was a law passed by Congress in 1890 and was designed to promote more competition at a time when Americans were concerned about the monolopistic power of railroads and oil companies.

In his ruling, Shea agreed with Washington officials that states are immune from antitrust liability.

In a final rule adopted in 2008, the state Health Department effectively extended Regional's monopoly on doctor-advised, or elective, angioplasties. Memorial challenged the ruling last year, resulting in Shea's May 25 order.

Regional has argued all along that allowing Memorial to do the procedure would create an unnecessary and expensive duplication of medical services in Yakima County.

Memorial has offered cardiology services for years but is limited by state law to emergency procedures, diagnostic testing and rehabilitation. If something goes wrong during an emergency angioplasty at Memorial and open-heart surgery is required, the patient is taken to Regional.

Hospitals are reimbursed up to $18,000 for each elective angioplasty, formally called adult elective percutaneous coronary intervention.

During the procedure, a thin tube called a catheter with a balloon on the end is inserted into an artery and threaded to the blockage. The cardiologist inflates the balloon, pushing the blockage against the artery walls and allowing blood to flow to the heart. A tiny metal scaffold called a stent may also be inserted to keep the wall open.