Joint APG-AHIP Letter to USDT Requesting Additional Guidance on Telehealth Services

March 20, 2020


Ms. Carol Weiser
Benefits Tax Counsel
U.S. Department of the Treasury
1500 Pennsylvania Avenue, N.W.
Washington, D.C. 20220


Dear Ms. Weiser:

We are writing on behalf of America’s Health Insurance Plans (AHIP) and America’s Physician Groups (APG) to request additional guidance that will enable access to more telehealth services as stakeholders across our health care system, government, and private sector work together to combat the COVID-19 pandemic. We need to be able to direct as many Americans seeking health care during this crisis as possible to virtual sites of care through telehealth services. Doing so is a key part of freeing up space in physical care treatment settings for the treatment of COVID-19 patients, and also helps to protect our nation’s medical professionals from exposure to the highly communicable virus. At this time, we believe that additional guidance from Treasury and the IRS would go a long way in helping to manage the pandemic.

We greatly appreciate the Department of the Treasury and IRS for issuing Notice 2020-15 on March 11, 2020 to allow substantial flexibility for Health Savings Account (HSA) eligible High Deductible Health Plans (HDHPs) to serve enrollees during this crisis. As health insurance providers, we are committed to making sure that Americans have access to the care they need without financial barriers during this crisis and are seeking solutions that alleviate unnecessary burdens on our health care infrastructure. For more than 32 million Americans enrolled in HDHPs subject to IRS regulations, that requires guidance that clarifies HDHPs may cover telehealth services pre-deductible without risking their HSA eligibility.

On March 13, 2020, President Trump issued Proclamation 9994, declaring a national emergency under sections 201 and 301 of the National Emergencies Act.1 President Trump has already taken action to expand telehealth services as a way to relieve crowding at hospitals, granting relief under Medicare and Medicaid, as well as waiving penalties under HIPAA, with the express aim of encouraging utilization of telehealth services. Authority exercised by the Department of Health and Human Services has made it easier for health care providers to offer telehealth services2; we seek a similar exercise of authority from the Department of the Treasury to enable more health plans to cover telehealth services.

We request that IRS issue sub-regulatory guidance explicitly extending the relief granted by Notice 2020-153 to coverage of all telehealth services paid for by an HDHP for any plan year in effect during the duration of the national emergency declared in Proclamation 9994. Throughout the duration of the COVID-19 national emergency, millions of HDHP enrollees will require medical care, much of which can be accessed through telehealth services. Enabling access to telehealth is a key component of slowing the spread of COVID-19, including to our first responders and medical professionals, and freeing up space in hospitals and emergency departments for COVID-19 treatment.

We thank Treasury and IRS for your work on this and sharing our commitment to sweeping efforts to address this national emergency.



Matthew Eyles
President and CEO
America’s Health Insurance Plans

Don Crane
President and CEO
America’s Physician Groups

cc: Internal Revenue Service,
Office of the Chief Counsel


1 Proclamation of the President of the United States, 85 Federal Register 15337 (March 13, 2020).


3 “all medical care services received and items purchased associated with testing for and treatment of COVID-19 that are provided by a health plan without a deductible, or with a deductible below the minimum annual deductible otherwise required under section 223(c)(2)(A) for an HDHP, will be disregarded for purposes of determining the status of the plan as an HDHP”


Please click here to download a copy of the letter.