14 July 2006 Ministerial Correspondence 2006-0180991M4 - Christian Science; Medical Expense Tax Credit

Please note that the following document, although believed to be correct at the time of issue, may not represent the current position of the CRA.
Prenez note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle de l'ARC.

Principal Issues: Request for information concerning CRA practice with respect to payments for Christian Science practitioners.

Position: Payments to a Christian Science practitioner do not qualify for the METC unless the practitioner is otherwise a medical doctor, a nurse or a "medical practitioner" in accordance with the definition in s.118.4 of the Act acting within the scope of his or her profession. Other information was also provided as requested where possible.

Reasons: Christian Scientists are not "medical practitioners" authorized to practice as such under any provincial legislation currently in force.

Sent on July 14, 2006

XXXXXXXXXX

The Honourable Carol Skelton, Minister of National Revenue, has asked me to reply to your correspondence addressed to officials of the Department of Finance Canada concerning medical expenses and Christian Science practitioners. Minister Skelton received a copy of your correspondence from that department on March 30, 2006.

The Canada Revenue Agency's (CRA's) Interpretation Bulletin IT-519R2, Medical Expense and Disability Tax Credits and Attendant Care Expense Deduction, is updated to reflect changes in the law and, occasionally, changes in our interpretation of the law on a particular issue. The CRA adds new information to the interpretation bulletin when it becomes aware of issues of general interest to taxpayers.

The bulletin does not discuss what is medically necessary, for purposes of the medical expense tax credit, since medical necessity is not a requirement for the cost of a service to be an eligible medical expense. Under paragraph 118.2(2)(a) of the Act, an eligible medical expense includes any reasonable expense paid to a medical practitioner for medical services. Generally, a medical service is a service performed by a medical practitioner acting within the scope of his or her professional training. This is why fees for services such as cosmetic surgery qualify for the medical expense tax credit.

I can confirm that the Canada Revenue Agency (CRA) does not keep track of notices of objections, disallowed or otherwise, related to fees paid to Christian Science practitioners. The CRA's treatment of fees paid to Christian Science practitioners has not changed other than in response to federal and provincial legislative changes - such fees are evaluated in the same way as other amounts claimed as medical expenses. As you are aware, the CRA does not allow fees paid to Christian Science practitioners as eligible medical expenses for purposes of the medical expense tax credit. This is based on the wording of the Act, which specifies that, for general medical and dental services, only fees paid to "a medical practitioner, dentist or nurse or a public or licensed private hospital in respect of medical or dental services" are eligible medical expenses. For the purposes of the medical expense tax credit, a medical practitioner must be a person authorized by a province or territory to practise as such. I am not aware of any provincial or territorial legislation that currently authorizes Christian Science practitioners as medical practitioners.

The term "holistic treatment" is not defined in the Act or in common law. The CRA therefore follows its dictionary definition. For example, the Concise Oxford Dictionary defines "holism" as "the treating of the whole person including mental and social factors rather than just the symptoms of a disease."

The CRA does not have a list of medical practitioners whose fees for holistic treatment are generally allowed as eligible medical expenses. An eligible medical expense can include any reasonable expense paid to a medical practitioner in respect of medical services. If a medical practitioner uses holistic treatments and the treatments appear to be within the scope of the practitioner's professional training, the cost of the treatments will be allowed as eligible medical expenses.

To obtain a copy of the notes from any meetings that CRA officials may have had with Senator Arthur Roebuck, you must file an Access to Information request in writing. I invite you to contact Ms. Danielle Jean-Venne, Director of the Access to Information and Privacy Directorate, by calling 0-613-688-9065 collect, or by faxing 613-941-9395. You can also visit the Government of Canada's Info Source Web site at www.infosource.gc.ca, which discusses the Government's information holdings and provides a complete list of the Government's Access to Information and Privacy coordinators.

In your letter, you ask for the results of an internal review concerning alternative medicine practices for purposes of the medical expense tax credit mentioned by Mr. Sam Papadopoulos, a CRA spokesman, in the Hamilton Spectator. I regret that I am not aware of any general internal review of alternative medicine practices; however, the CRA regularly reviews the provincial and territorial status of alternative medicine practitioners to determine whether their fees qualify for the medical expense tax credit. New types of alternative medicines are reviewed as the CRA becomes aware of them. The review may include asking the relevant province or territory for information about the scope of its legislation for a particular practice.

I trust that my comments are helpful.

Sincerely,

Brian McCauley
Assistant Commissioner
Legislative Policy and
Regulatory Affairs Branch
Canada Revenue Agency

c.c.: Minister's Office
Political Assistant

Eliza Erskine
613-957-2046
2006-018099