2 July 1996 External T.I. 9615955 - NATUROPATHIC & HOMEOPATHIC MEDICINES

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.

Please note that the following document, although believed to be correct at the time of issue, may not represent the current position of the Department.

Prenez note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle du ministère.

Principal Issues:

deductibility of naturopathic and homeopathic medicines, requests a clear definition of "medical practitioner", "pharmacist" and "therapeutist".

Position:

deductibility of medicines is discussed in 118.2(2)(e), (k) and, to a lesser extent, 118.2(2)(a). Cannot give definitive list of professionals who qualify as a "medical practitioner" as, depending on the laws of the provinces or other jursisdictions, different health professionals qualify. Discuss definition of "pharmacist" for Ontario (a member of the Ontario College of Pharmacists). The reference to "therapist" in IT-519R (paragraph 5) is a general reference to a number of possible different therapists. In Ontario, for example, this may include speech therapists, phsiotherapists, occupational therapists, respiratory therapists, denture therapists and so on.

Reasons:see 951134

									961595
XXXXXXXXXX							Sandra Short

Attention: XXXXXXXXXX

July 2, 1996

Dear Sirs:

Re: Subsection 118.2(2) of the Income Tax Act (the Act)

This is in reply to your letter of April 25, 1996, which asks for the Department's position on the deductibility of naturopathic and homeopathic medicines, as prescribed by naturopaths, acupuncturists or other medical practitioners.

You understand that "drugs" must be prescribed by a medical practitioner and recorded by a pharmacist in a prescription record. In this regard, you request a clear definition of the terms "medical practitioner" and "pharmacist." You have also asked for a definition of "therapeutist." Specifically, you have asked what types of therapy, as offered by the therapeutist, or therapist, qualify for purposes of the medical expense tax credit.

General Comments

In order for drugs, medicaments and other preparations to qualify as a medical expense under paragraph 118.2(2)(n) of the Act, they must be:

-prescribed by a medical practitioner (discussed below) and recorded as such by a pharmacist (term also discussed below); and

-manufactured, sold or represented for use in:

a)restoring, correcting or modifying an organic function;

b)diagnosing, treating or preventing a disease, disorder or abnormal physical state; or

c)treating the symptoms of a disease, disorder or abnormal physical state.

Only substances mentioned in paragraph 118.2(2)(k) of the Act, which must be prescribed by a medical practitioner, may be obtained without a written prescription and purchased from a dispenser other than a pharmacist. Such substances are insulin, oxygen, liver extract injectable for pernicious anaemia or vitamin B12 for pernicious anaemia.

Some preparations and substances incidental to the treatment of a condition or illness may be included in the account of a medical practitioner or hospital as part of the fee charged for medical services. This fee qualifies as a medical expense under paragraph 118.2(2)(a) of the Act to the extent that the fee is for diagnostic, therapeutic or rehabilitative services. It will, therefore, be a question of fact in a particular case (type of service provided and amount and relevance of drug preparations to the medical service provided) if payments to a medical practitioner for these preparations and related services will qualify as a medical expense.

Medicines prescribed by a naturopath, acupuncturist or other medical practitioners qualify only to the extent they meet the conditions set out in paragraphs 118.2(2)(a), (k) and (n), as discussed above. If you wish to suggest changes to the Act, we refer you to the Department of Finance, whose responsibility it is to consider such suggestions.

References to Medical Practitioners

Subsection 118.4(2) of the Act provides that, for the purposes of sections 63 (child-care expense), 118.2 (medical expense tax credit) and 118.3 (disability tax credit), a reference to a medical doctor, medical practitioner, dentist, pharmacist, nurse or optometrist is a reference to a person authorized to practice as such. If the reference is used in relation to a service rendered to a taxpayer, the person must be so qualified pursuant to the laws of the jurisdiction in which the service is rendered.

We refer you to paragraph 5 of the enclosed Interpretation Bulletin IT-519R. As noted by you, a "medical practitioner" may include, depending upon the laws of the jurisdiction in which the service is rendered, a naturopath, an acupuncturist and a therapeutist (also referred to as a therapist). We cannot provide an exhaustive list of which health professionals qualify as a "medical practitioner," as the list differs between provinces and jurisdictions.

References to a Pharmacist

For purposes of the medical expense tax credit, a reference to a "pharmacist" means a person who is authorized to practice as such, according to the laws of the jurisdiction in which the pharmacist's services are offered. For example, in the province of Ontario, subsection 117(1) of the Drug and Pharmacies Regulation Act defines a "pharmacist" as a "member" (which is a reference to a member of the Ontario College of Pharmacists). Subsection 10(1) of the Pharmacy Act, 1991, provides that no person, other than a member of the Ontario College of Pharmacists, shall use the title "apothecary," "druggist," "pharmacist" or "pharmaceutical chemist," or any variation or abbreviation or an equivalent in another language. Subsection 10(2) provides that no person other than a member shall hold himself or herself out as a person who is qualified to practise in Ontario as a pharmacist or in a specialty of pharmacy.

References to Therapeutists or Therapists

The reference in paragraph 5 of Interpretation Bulletin IT-519R to a therapeutist, or therapist, is a general reference to a number of different health professionals, to whom payments may be considered amounts paid to a medical practitioner for medical services. For example, in the province of Ontario, a "therapist" includes those therapists governed by the Regulated Health Professions Act, 1991. These therapists include speech-language pathologists (a protected title under the Audiology and Speech-Language Pathology Act, 1991, as is the title "speech therapist"), denture therapists (a restricted title under the Denturism Act, 1991), a massage therapist (a restricted title under the Massage Therapy Act, 1991), an occupational therapist (protected title under the Occupational Therapy Act, 1991), a respiratory therapist (protected title under the Respiratory Therapy Act, 1991) and a physiotherapist (protected title under the Physiotherapy Act, 1991). Each of these health professionals is authorized to practise in the province of Ontario in accordance with the provisions of the Regulated Health Professions Act, 1991, and each health profession Act.

We trust our comments will be of assistance to you.

Yours truly,

John F. Oulton
for Director
Business and Publications Division
Income Tax Rulings and
Interpretations Directorate
Policy and Legislation Branch