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Aetna Health, Inc. v. Davila

Docket No.: 02-1845
Argued: March 23, 2004
Decided: June 21, 2004
Consolidated with: CIGNA Healthcare of Texas, Inc., dba CIGNA v. Ruby R. Calad, No. 03-83

Topics:

Employee Retirement Income Security, Federalism, Federal Preemption of State Regulation, ADA, Civil Procedure, ERISA, Employee Retirement Income Security Act, First Amendment, Labor Management Relations Act, equitable relief, judicial review, preemption, preliminary injunction, separation of powers

PartyNames: Aetna Health Inc., fka Aetna U.S. Healthcare Inc. and Aetna U.S. Healthcare of North Texas Inc. v. Juan Davila
Petitioner: Aetna Health Inc., fka Aetna U.S. Healthcare Inc. and Aetna U.S. Healthcare of North Texas Inc.
Respondent: Juan Davila

Court Below: United States Court of Appeals for the Fifth Circuit
Citation: CA 5, 307 F.3d 298. QUESTION PRESENTED: Whether § 502(a) of the Employee Retirement Income Security Act of 1974 ("ERISA"), 29U.S.C. § 1132(a), completely preempts a state-law tort claim seeking damages for an allegedly erroneous determination of entitlement toa benefit under an ERISA-governed health benefit plan when the
Supreme Court Docket

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 (2004)
Question Presented:

Whether the Employee Retirement Income Security Act of 1974, 29 U.S.C.§§ 1001 et seq. ("ERISA"), as construed by this Court in Pilot Life Insurance Co. v. Dedeaux , 481 U.S. 41 (1987), and its progeny, completely preemptsstate-law claims by ERISA plan participants or beneficiaries who assert that a managed care company tortiously "failed to cover" (i.e., pay for) medical care. 03-83 CIGNA HEALTHCARE OF TEXAS v. CALAD . CA 5, 307 F.3d 298. QUESTION PRESENTED: Whether § 502(a) of the Employee Retirement Income Security Act of 1974 ("ERISA"), 29U.S.C. § 1132(a), completely preempts a state-law tort claim seeking damages for an allegedly erroneous determination of entitlement toa benefit under an ERISA-governed health benefit plan when the determination is based in part on the exercise of medical judgment. CERT. GRANTED: 11/3/03 Consolidated for one hour oral argument.

Question:

Does the Employee Retirement Income Security Act of 1974 prohibit individuals from suing their HMOs in state court when the HMOs refuse to provide a recommended treatment?

Note:

. CA 5, 307 F.3d 298.

Aetna Health, Inc. v. Davila
ORAL ARGUMENT

March 23, 2004

Holding: reversed and remanded
Decision: Decision: 9 votes for Aetna Health, Inc., 0 vote(s) against
Vote: 9-0
Opinion By: Justice Clarence Thomas
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