The procedure, known as a percutaneous coronary intervention (PCI), costs thousands and could take business away from Stringfellow's competitors.
Stringfellow and RMC have entered one of the hottest debates in medicine, according to the American Heart Association.
Kidada Hawkins, an associate administrator at Stringfellow in Anniston, said the hospital can only perform a PCI when a patient is having a heart attack. The procedure removes plaque from arteries and helps clear blockages.
Stringfellow wants the ability to do elective PCIs which do not require a medical emergency.
The State Health Plan currently requires all urban hospitals that perform elective PCIs to have an on-site open-heart surgery program. Hawkins said the current rules are based on the risks associated with balloon angioplasty. Today the main method of the PCI procedure is a coronary stent, according to a Stringfellow press release.
"The risk with stents is low," Hawkins said.
Regional Medical Center in Anniston, which does have a heart surgery center, performs the elective procedure. Jacksonville Medical Center does not.
Rules for rural hospitals are less restrictive, according to the Stringfellow press release. It says rural hospitals can use elective PCI regardless of whether they can perform open-heart surgery.
Other Alabama hospitals on board with the idea are Crestwood Medical Center in Huntsville, Decatur General Hospital and Helen Keller Hospital in Sheffield, the press release says.
The first step for Stringfellow will be getting approval through the Statewide Health Coordinating Council, said Jim Sanders, deputy director of the state Health Planning and Development Agency. The agency serves as the administrative arm of both the Health Coordinating Council and the state Certificate of Need Board.
Sanders said that the Health Coordinating Council determines if there is a need for a certain procedure. The Certificate of Need Board determines which providers can meet that need. He said the Health Coordinating Council met May 28 and Neal Canup, RMC's medical director, spoke against the rules changes proposed by Stringfellow and the other hospitals. Susan Williamson, RMC spokeswoman, said Canup was joined by physicians from Thomas Hospital in Fairhope and Eliza Coffey Memorial Hospital in Florence.
In response to RMC, Hawkins said research supports Stringfellow's stance and said changing the rule would help all small hospitals that don't have open heart surgery backup.
Sanders said if the Health Coordinating Council decided to move forward with the changes it would set a public hearing. The process would take months, he said.
Johnny Lee, a cardiologist in New York and spokesman for the American Heart Association, said there is an ongoing study to determine whether the risk outweighs the benefit of elective PCIs at hospitals such as Stringfellow.
"This is the biggest (medical) controversy in the United States right now," Lee said.
Sanders said physicians arguing against changing the rules want the council to wait until the study is finished.
Lee said there are questions about the procedure. One is about medical safety.
An initial study of 453 emergency heart cases found there were no surgeries required when PCIs were done at hospitals without surgery centers, Lee said.
The current study will focus on the elective procedure.
"That's looking at this question that most cardiologists are hypothesizing," Lee said. "If we took care of the sickest and it's OK, shouldn't it be OK if people are not as sick?"
But there are variables. Not every PCI is a straightforward case; some are complex. They include such complications as calcified arteries or other ailments.
Lee expects the study will show that elective PCIs done at hospitals without surgery centers are OK if the case is not complex.
Another concern is economic.
He said any hospital would want to do the procedure which costs between $10,000 and $15,000 per case.
"The (local) hospitals will pick off all the easy cases and leave the highly complex cases to the university hospitals which are higher risk," Lee said. "So they may lose money."