30 September 2013 External T.I. 2013-0490121E5 - Medical Practitioner - Doulas in Alberta

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: Are the services provided by a doula in Alberta considered as services provided by a medical practitioner for the purposes of the medical expense tax credit?

Position: No.

Reasons: Paragraph 118.4(2)(a) states that where the reference to a medical practitioner is used in respect of a service rendered to an individual, that reference is to a person authorized to practice as such pursuant to the laws of the jurisdiction in which the service is rendered.

XXXXXXXXXX
A. Mahendran
2013-049012

September 30, 2013

Dear XXXXXXXXXX:

Re: Prenatal and Postpartum Services Provided by a Certified Doula

This is in response to your correspondence dated May 23, 2013, wherein you asked for our interpretation as to whether amounts paid for doula services in Alberta qualify as eligible medical expenses for purposes of the medical expense tax credit ("METC").

Written confirmations of the tax implications inherent in particular transactions are provided by this Directorate where the transactions are proposed and are the subject matter of an advance income tax ruling submitted in the manner set out in Information Circular 70-6R5, "Advance Income Tax Ruling", dated May 17, 2002. This Information Circular and other CRA publications can be accessed on the internet at http://www.cra-arc.gc.ca/formspubs/menu-e.html. Notwithstanding the foregoing, we are prepared to provide the following comments that may be of assistance.

Medical expenses which are eligible for the METC are limited to those described in subsection 118.2(2) of the Income Tax Act ("Act"). If a particular expenditure is not described as an eligible medical expense in subsection 118.2(2) of the Act, or if the conditions under which the expenditure would qualify are not met, the expenditure does not qualify for purposes of the METC, even though the expenditure may have been incurred for medical reasons.

Under paragraph 118.2(2)(a) of the Act, qualifying medical expenses include payments made to a medical practitioner, dentist or nurse or a public or licensed private hospital when the payments are made in respect of medical or dental services provided to the individual, the individual's spouse or a dependant of the individual. Paragraph 118.4(2)(a) of the Act provides that where the reference to a medical practitioner is used in respect of a service rendered to an individual, that reference is to a person authorized to practice as such pursuant to the laws of the jurisdiction in which the service is rendered. Therefore, in order to determine whether a particular medical practitioner qualifies as such under the Act, one must look to the relevant provincial legislation to determine whether the particular practitioner is authorized under the laws of that province.

In our view, a person is authorized by the laws of the jurisdiction to act as a medical practitioner if there is specific legislation that enables, permits or empowers a person to perform medical services. Generally, such specific legislation would provide for the licensing or certification of the practitioner as well as for the establishment of a governing body (e.g., a college or board) with the authority to determine competency, enforce discipline and set basic standards of conduct.

In Alberta, a medical practitioner includes those practitioners of health professions regulated by the Health Professions Act and the Health Disciplines Act. Based on our review, it appears that doulas are not currently authorized to practise as medical practitioners in the province of Alberta and therefore, the amounts paid for services provided by such doulas in Alberta do not qualify as eligible medical expenses for the purposes of the medical expense tax credit.

Further information on medical expenses can be found in the Income Tax Folio S1-F1-C: Medical Expense Tax Credit, which is available at http://www.cra-arc.gc.ca/tx/tchncl/ncmtx/fls/s1/f1/s1-f1-c1-eng.html.

We trust that our comments will be of assistance to you.
Yours truly,

Sharmini Ratnasingham
for Director
Business and Employment Division
Income Tax Rulings Directorate
Legislative Policy and Regulatory Affairs Branch