Yakima Valley Mem'l Hosp. v. Dep't of Health

Regulations allowing hospitals without on-site cardiac surgical facilities to perform elective percutaneous coronary interventions so long as they obtained a Certificate of Need “demonstrating sufficient need in the region” does not violate the dormant commerce clause because the “impact on interstate commerce, if any, was highly attenuated, and did not outweigh the safety benefits of the regulation[].”

Yakima Valley Memorial Hospital (“Memorial”), filed a constitutional challenge under the Commerce Clause against Washington State Department of Health (the "Department”) on the grounds that the Department’s Certificate of Need (“Certificate”) regulation targeting “scheduled or elective percutaneous coronary interventions (“PCIs”), . . . nonsurgical procedures used to treat coronary heart disease.” The regulation requires hospital “without on-site cardiac surgical facilities . . . [to] obtain a Certificate demonstrating sufficient need in the region to support an annual minimum volume” in order to perform PCIs. Yakima regional Medical and Cardiac Care Center (“Regional”) is the only hospital in the Yakima Valley area with an on-site surgical facility and is a for-profit hospital requiring 20-30% prepayment prior to performing elective PCIs. Memorial is a nonprofit hospital that serves uninsured and insured residents of the Yakima Valley. Memorial contended that the requirement of a “minimum annual volume of 300 procedures . . . violat[ed] the dormant Commerce Clause” because it “lack[ed] a reasonable basis[, ] its putative benefits, including safety, are outweighed by the burdens it place[d] on interstate commerce”. The Ninth Circuit held that under the Pike balancing test the regulation did not create a “substantial burden” and “the regulations do not impair the free flow of materials and products across state borders.” The panel also held that the benefits of the 300-PCI minimum were not illusory, therefore the regulation did not violate the dormant Commerce Clause. AFFIRMED.