The health secretary could be asked to decide if controversial changes to hospital services in Calderdale and Huddersfield can go ahead.
Jeremy Hunt could make the final decision on plans to centralise A&E care at an expanded hospital in Halifax and downsize Huddersfield Royal Infirmary.
A council watchdog could refer the planned shake-up to Mr Hunt if it is not convinced it will be safe.
The proposals, designed to tackle a £280m funding gap, have led to protests from NHS campaigners who fear that increased journey times to A&E would put patients in danger.
A referral to Mr Hunt could be made by the Calderdale and Kirklees joint health scrutiny committee.
At its last meeting the committee was told final plans for the hospital shake-up would be drawn up by Calderdale and Greater Huddersfield Clinical Commissioning Groups (CCGs) by the end of June.
The committee said in a statement: “The joint committee has the power to refer the CCGs’ decision to the Secretary of State for Health if it considers that the proposals would not be in the interests of the health service in its area.
“Any referral would require very clear evidence based reasons. The joint Committee concluded that this would remain a key consideration and agreed to decide on whether to make a referral by the end of July 2017.”
Under the proposals, up to 300 beds could be added to Calderdale Royal Infirmary, which would be the main A&E for the two districts.
Huddersfield’s existing 400-bed infirmary would be replaced with a 120-bed site designed for planned NHS care.
If a referral is made to Mr Hunt he could have the plans scrutinised by an independent panel.