2015-0585011I7 Osteopaths & naturopaths in Quebec

Principal Issues: 1) Whether osteopaths and naturopaths are authorized medical practitioners in the province of Quebec for purposes of the federal medical expense tax credit (METC). 2) Whether Revenue Quebec’s brochure entitled “Medical Expenses” can be relied on in determining whether a practitioner is an authorized medical practitioner for the purposes of the federal METC.

Position: 1) No. 2) No.

Reasons: 1) There is currently no specific legislation in Quebec which authorizes osteopaths and naturopaths to provide medical services. 2) The Office des professions du Quebec seems to be the provincial authority for the purpose of determining which regulated professions are recognized in the province of Quebec.

Author: El-Kadi, Randa
Section: 118.4(2)

                                                                                          August 7, 2015

                                                                                          HEADQUARTERS
Ms. Nadia Zinck                                                                Income Tax Rulings
GST/HST/QST and Benefits Information Section             Directorate
Information Programs Division                                          Randa El-Kadi
Taxpayer Services Directorate                                          (613) 670-9054
Assessment and Benefit Services Branch                                                   

                                                                                           2015-058501

      Osteopaths and naturopaths in Quebec – Federal criteria for the medical expense tax credit

Dear Ms. Zinck:

We are writing in response to your email of May 4, 2015, in which you ask us to confirm whether osteopaths and naturopaths in the province of Quebec can be added to the list of Authorized medical practitioners by province or territory for the purposes of claiming medical expenses (the List) which is currently posted on the Canada Revenue Agency (“CRA”) website.

You indicate that it was pointed out to you that naturopaths and osteopaths are eligible “practitioners” for the purposes of the Quebec medical expense tax credit. This is evidenced by the list of practitioners on page 28 of Revenue Quebec’s brochure entitled Medical Expenses. As such, it is believed that naturopaths and osteopaths should also be recognized as authorized medical practitioners for the purposes of the federal medical expense tax credit.

Our comments

For the purpose of claiming an amount for the medical expense tax credit under section 118.2 of the Income Tax Act, paragraph 118.4(2)(a) of the Act specifies that:

“118.4 (2) For the purposes of sections 63, 64, 118.2, 118.3 and 118.6, a reference to an audiologist, dentist, medical doctor, medical practitioner, nurse, occupational therapist, optometrist, pharmacist, physiotherapist, psychologist, or speech-language pathologist is a reference to a person authorized to practise as such,

(a) where the reference is used in respect of a service rendered to a taxpayer, pursuant to the laws of the jurisdiction in which the service is rendered;”

As we explain in paragraph 1.22 of Income Tax Folio S1-F-C1: Medical Expense Tax Credit:

“1.22 In accordance with the decision of the Federal Court of Appeal in Canada v Couture, 2008 FCA 412, 2009 DTC 5040, it is the CRA’s view that an individual is authorized by the laws of the jurisdiction to act as a medical practitioner if there is specific legislation that enables, permits or empowers that individual 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 (for example, a college or board) with the authority to determine competency, enforce discipline and set basic standards of conduct.”

Osteopathy and naturopathy in Quebec

We understand that the Office des professions du Quebec (the “Office des professions”), which is established under section 3 of the Professional Code of Quebec, is the independent government body that oversees all professional orders (that is, regulatory bodies) in Quebec. Section 26 of the Professional Code provides that “The members of an order shall not be granted the exclusive right to practise a profession except by an Act…” In our view, a regulated health professional recognized under the Professional Code, who is acting within the scope of their professional training, would be considered a medical practitioner for the purposes of subsection 118.4(2) of the Income Tax Act.

According to the list of professional orders on the Office des professions website, there is currently no regulatory body for osteopaths or naturopaths in Quebec. Additionally, we recently contacted the Office des professions and received confirmation that osteopaths and naturopaths are not governed by the Professional Code. As such, there does not appear to be specific legislation in Quebec which authorizes the practice of osteopathy or naturopathy and which provides for a regulatory body for osteopaths or naturopaths. Therefore, it is our view that osteopaths and naturopaths in the province of Quebec are not medical practitioners within the meaning of subsection 118.4(2) of the Income Tax Act.

However, where a regulated health professional (for example, a medical doctor) under the Professional Code provides osteopathic or naturopathic services, we are of the view that these services may be eligible for the federal medical expense tax credit as long as they are provided within the scope of the medical practitioner’s professional training.

Distinguishing between federal and provincial income tax provisions

The Quebec Taxation Act has a specific provision which allows the services rendered by homeopaths, naturopaths, osteopaths, and phytotherapists to be eligible for the purposes of the provincial medical expense tax credit. In particular, paragraph 752.0.18.(b) of the Quebec  Taxation Act defines the term “practitioner” as follows:

“752.0.18. For the purposes of sections 358.0.1 and 752.0.11 to 752.0.14, “practitioner” means

 (a) a person practising a profession within the scope of which health-related care and treatments are provided to individuals, unless the person is practising a profession described in the second paragraph, in which case, a person practising such a profession in respect of the services mentioned in that paragraph, and who is authorized to practise such a profession in accordance with [the laws of the jurisdiction…];

 (b) a person practising the profession of homeopath, naturopath, osteopath or phytotherapist, in respect of the services the person provides in that capacity;” (emphasis added)

The Income Tax Act does not have a provision that is similar to paragraph 752.0.18.(b) of the Quebec Taxation Act. Accordingly, the latter paragraph may not be relied upon when determining whether a practitioner is an authorized medical practitioner for the purposes of administering the federal medical expense tax credit. The same is true regarding Revenue Quebec’s brochure entitled Medical Expenses, given that this brochure reflects the provisions of the Quebec Taxation Act as opposed to the federal Income Tax Act.

We trust that these comments will be of assistance.

Yours truly,

Pamela Burnley, CPA, CA
Manager - Tax Credits and Ministerial Issues
Business and Employment Division
Income Tax Rulings Directorate

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