26 January 2018 Ministerial Correspondence 2017-0728281M4 - Medical expenses - cost of doulas & birth centres

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: Whether amounts paid for doulas and birth centres in Alberta are eligible expenses for the purpose of the medical expense tax credit.

Position: Amounts paid for doulas are not eligible medical expenses; however, amounts paid for a birth centre would be considered eligible medical expenses if the service is provided by a medical practitioner (e.g., a registered midwife).

Reasons: 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, the reference is to a person authorized to practice as such pursuant to the laws of the jurisdiction in which the service is rendered.

January 26, 2018

XXXXXXXXXX

Dear XXXXXXXXXX:

Thank you for your correspondence about the eligibility of fees paid to doulas and birth centres in Alberta for the medical expense tax credit. The office of the Right Honourable Justin Trudeau, Prime Minister of Canada, also sent me a copy. I appreciate your understanding regarding the delay of this response.

The Income Tax Act sets out the rules for determining if a medical expense qualifies for the medical expense tax credit. Amounts paid for medical services provided by medical practitioners who meet specific requirements under the Act are generally eligible for this credit. The Act requires the medical practitioner to be authorized to practice in accordance with the laws of their particular jurisdiction.

Generally, these laws provide for the licensing or certification of the medical practitioner and the establishment of a governing body, such as a college or board, with the authority to determine competency, enforce discipline, and set basic standards of conduct.

In Alberta, for purposes of the Income Tax Act, a medical practitioner is a health care professional who is regulated by Alberta’s Health Professions Act and Health Disciplines Act. Doulas are not listed as a regulated health care profession in either of these acts. As a result, amounts paid for services provided by doulas are not eligible for the medical expense tax credit. However, you may be interested to know that registered midwives are regulated under the Health Disciplines Act. Therefore, generally, amounts paid for medical services provided by a registered midwife are eligible for the medical expense tax credit.

Payments made to corporations, partnerships, societies, and associations for medical services provided by their employees or partners are eligible for the medical expense tax credit only if the person who provided the service is a medical practitioner, as described above. Therefore, birth centre costs may be eligible for the medical expense tax credit under these conditions.

As the regulation of health care professions is a provincial matter, you may wish to seek information about this process from the responsible provincial authority for Alberta.

I appreciate the opportunity to respond to your concerns and trust the information I have provided is helpful.

Sincerely,

The Honourable Diane Lebouthillier
Minister of National Revenue

Randa El-Kadi
613-670-9054
2017-072828