). The THCLA requires that health plans exercise ordinary care when marking health care treatment decisions. Davila claimed that administrators at Aetna were controlling health care decisions (as opposed to physicians), and that this action violated the requirement to exercise ordinary care as required by the THCLA (Juan Davila V. Aetna U.S. Healthcare, Inc., 2002).
Aetna was successful in moving the case to federal court from the state court. The United States District Court of Northern Texas found in favor of Aetna's contention that the federal Employee Retirement Income Security Act (ERISA) preempted the THCLA claim. Davila appealed to the United States Court of Appeals for the Fifth Circuit. The Court of Appeals for the Fifth Circuit reversed the District Court decision, and remanded the case to the District Court for further proceedings (Juan Davila V. Aetna U.S. Healthcare, Inc., 2002). Aetna then appealed to the United States Supreme Court.
The United States Supreme Court agreed to hear the case. Arguments were made before the Court in March 2004, and the decision of the Court was rendered in June 2004. The United States Supreme Court reversed the decision of the Court of
Appeals for the Fifth Circuit (Aetna Healthcare Inc., FKA Aetna U. S. Healthcare Inc. et al. V. Juan Davila, 2004).
The Court of Appeals for the Fifth Circuit found that Aetna Healthcare Inc. was making mixed eligibility and treatment decisions when the HMO denied the medical treatment - Vioxx - prescribed by Davila's physician, and that Aetna in this situation was not acting only as the employers health plan fiduciary. Thus, t
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