Aetna Health Inc., Fka Aetna U.S. Healthcare Inc. and Aetna U.S. Healthcare of North Texas Inc. v. Juan Davila (542 U.S. 200)
U.S. Supreme Court · decided June 21, 2004 · Supreme Court Database (Spaeth)
- Citation
- 542 U.S. 200 · 124 S. Ct. 2488
- Decided
- June 21, 2004
- Term
- October Term 2003
- Vote
- 9–0
- Majority author
- Justice Thomas
- Issue area
- Federalism
- Disposition
- Reversed and remanded
- Outcome
- Petitioning party won
- Ideological direction
- Liberal
Opinion excerpt
Justice Thomas delivered the opinion of the Court. In these consolidated cases, two individuals sued their respective health maintenance organizations (HMOs) for alleged failures to exercise ordinary care in the handling of coverage decisions, in violation of a duty imposed by the Texas Health Care Liability Act (THCLA), Tex. Civ. Prac. & Rem. Code Ann. §§88.001-88.003 (West 2004 Supp. Pamphlet). We granted certiorari to decide whether the individuals’ causes of action are completely pre-empted by the “interlocking, interrelated, and interdependent remedial scheme,” Massachusetts Mut. Life Ins. Co. v. Russell, 473 U. S. 134, 146 (1985), found at § 502(a) of the Employee Retirement Income Security Act of 1974 (ERISA), 88 Stat. 891, as amended, 29 U. S. C. § 1132(a) et seq. 540 U. S. 981 (2003). We hold that the causes of action are completely pre-empted and hence removable from state to federal court. The Court of Appeals, having reached a contrary conclusion, is reversed. I A Respondent Juan Davila is a participant, and respondent Ruby Calad is a beneficiary, in ERISA-regulated employee benefit plans. Their respective plan sponsors had entered into agreements with petitioners, Aetna Health Inc. and CIGNA Healthcare of Texas, Inc., to administer the plans. Under Davila’s plan, for instance, Aetna reviews requests for coverage and pays providers, such as doctors, hospitals, and…
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