The Aroostook Medical Center will be allowed to offer cardiac catheterization and angiography services provided it meets a variety of conditions, according to a letter sent to the hospital’s chief executive by the Department of Human Services.

The Presque Isle hospital will be allowed to build one catheterization laboratory at a cost of up to $1.7 million. Because of the distance from TAMC to other cardiac catheterization services, the department decided it should offer the services even though it won’t achieve within three years the 300 annual procedures required by state statute, Department of Human Services Commissioner Kevin Concannon said in an interview late Friday.

“The way to compensate for that is we require them to submit the program to external review that we agree to,” he said. The review and other performance data will be made public to ensure that doctors are providing quality treatment even while getting less practice at the procedure than doctors at hospitals with more need for cardiac services, Concannon said.

“We’re very pleased,” said John Ginty Jr., senior vice president for patient services at TAMC. “It improves access dramatically. There’s a long road from here to Bangor and that’s been eliminated.”

Officials at TAMC and Eastern Maine Healthcare, with which it is affiliated, were guarded in their comments as they continued to analyze the implications of Concannon’s conditions late Friday.

“These are a bit more rigorous than you commonly see with [DHS] approval,” said P. Jerry Whalen vice president for business development for Eastern Maine Healthcare, Eastern Maine Medical Center’s parent corporation.

“The conditions need to be sorted through,” McGinty said. “On the surface they seem to be consistent with some of our discussions with the department.”

In addition to releasing quality-of-care information to the public, which isn’t released by hospitals already offering catheterization services, Concannon required disclosure of charges and arrangements with other providers who will access the new services. He also required TAMC to expand or create new cardiovascular disease prevention programs as a condition of approval.

“It shouldn’t just be the interventions after the fact,” Concannon said. Developing programs that help people reduce their risks for cardiovascular trouble would improve their quality of life and decrease the need for the expensive cardiac services.

A catheterization at EMMC costs about $3,000 without considering any discounts.

Cardiac catheterization is used to look for cardiovascular blockages. A flexible tube is inserted into a vein or artery in a leg or arm and slithered toward the heart.

Medical guidelines call for cardiac catheterization procedures at hospitals without open-heart surgery, like TAMC, to be done on low-risk patients who aren’t likely to need immediate surgery as a result of the procedure or its findings. An estimated 20 percent to 40 percent of procedures in Maine are done on high-risk patients.

TAMC’s approval is separate from the application by St. Joseph Hospital in Bangor for cardiac services and won’t affect any decision on that application, contrary to some hospital executives’ opinions, Concannon said.

St. Joseph first applied for cardiac catheterization services back in 1997. It has been a winding road for the 100-bed hospital. Just last year, the state suspended the application along with others after a flood of applications. Over the summer a consultant studied the statewide need for catheterization services.

The consultant, Public Health Resource Group of Portland, reported to the DHS that more services in Bangor were not needed. But the Certificate of Need Unit of DHS then recommended that Concannon approve the application. Concannon has the last word.

EMMC has fought St. Joseph’s request vigorously. EMMC argues that St. Joseph would duplicate services already available at EMMC and draw away patients from the larger hospital, resulting in underutilization of services.

EMMC recently asked for a public hearing to present arguments against the St. Joseph application. The hearing was convened last month but never got off the ground. Members of the state advisory committee who were charged with reviewing the arguments disclosed significant conflicts of interest at the outset. The disclosures resulted in a lack of a quorum.

The DHS has scheduled a new hearing for April 9, but both St. Joseph and EMH attorneys have asked that the hearing be postponed until a decision has been reached in court, said Joseph Kozak, an Augusta attorney representing St. Joseph. Should the request be denied, St. Joseph will ask the court to stay the hearing, he added.