A federal appeals court on Wednesday revived a lawsuit challenging a Virginia law that requires state approval for new or expanded medical facilities. A three-judge panel of the 4th U.S. Court of Appeals unanimously ruled that a judge who dismissed the lawsuit must consider whether Virginia's "certificate of need" program violates the Commerce Clause of the U.S. Constitution by putting out-of-state health care providers at a competitive disadvantage. The lawsuit was filed by Colon Health Centers of America and Progressive Radiology, two out-of-state companies that want to open clinics in Virginia. Under state law, applicants for new medical facilities must demonstrate a public need for the services.