In Yakima Valley Memorial Hospital v. Washington State Department of Health et al., the United States Court of Appeals for the Ninth Circuit affirmed the dismissal of the plaintiff hospital’s challenge to Washington state’s restrictions on the number of hospitals that can perform elective angioplasties. The complaint alleged that the practices were anticompetitive and discriminatory, but the Court held that they fell within the power of the state and did not impinge on inter-state commerce.
The challenged regulations prohibited hospitals without on-site cardiac surgical facilities from performing elective percutaneous coronary interventions — nonsurgical procedures treating coronary heart disease – unless they first obtained a certificate of need showing that the area had a minimum number of cases. The plaintiff argued that the regulations effectively favored “large New York Stock Exchange-traded health care systems” at the expense of smaller health care facilities, decreasing access and increasing prices. Although the regulations limited the provision of the service and thus affected competition, the Ninth Circuit held “the regulations did not violate the dormant Commerce Clause, which prohibits states from discriminating against interstate commerce, because the impact on interstate commerce, if any, was highly attenuated, and did not outweigh the safety benefits of the regulations.”