Principal Issues: Is the CRA of the view that a pharmacist is a medical practitioner?
Position: Yes
Reasons: The term "medical practitioner" can include individuals such as a pharmacist provided that he or she is authorized to practice in the profession according to the laws of the jurisdiction in which the service is rendered.
XXXXXXXXXX 2011-040709 S. D'Angelo June 6, 2011
Dear XXXXXXXXXX :
Re: Medical Practitioner
This is in response to your correspondence of May 19, 2011, inquiring whether the Canada Revenue Agency is of the view that a pharmacist is a medical practitioner.
You are referring to the following statement made in Income Tax Rulings document 2011-039553:
"Thus, a drug that may only be acquired through the intervention of a medical practitioner (a pharmacist, for example) may qualify under section 5701 of the Income Tax Regulations even if it does not lawfully require a prescription. However, pursuant to this provision, the patient must still obtain a prescription for the particular use of the drug."
You are asking whether a pharmacist is a medical practitioner. You have also asked about the Federal Court of Appeal v. Couture (2009 DTC 5040) court case.
Our comments
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 Couture, The Federal Court of Appeal had to address the issue of whether amounts paid for acupuncture services in Ontario qualified under paragraph 118.2(2)(a) of the Act. We agree with the Federal Court of Appeals' findings in this case that "authorized to practise" in subsection 118.4(2) of the Act was not "synonymous with permitted to practise or not prohibited from practicing," but rather "required some formality or formal recognition of the particular service as a discipline that is legally countenanced under Ontario law."
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.
The term "medical practitioner" can include individuals such as a medical doctor, dentist, pharmacist, nurse or optometrist provided that he or she is authorized to practice in the stated profession according to the laws of the jurisdiction in which the service is rendered.
The CRA Web site provides a summary chart identifying those health care professionals authorized to practice as medical practitioners by province or territory for the purposes of claiming medical expenses. A pharmacist is authorized to practice as a medical practitioner in every province and territory in Canada.
We trust that our comments will be of assistance.
Yours truly,
G. Moore
For Director
Business and Partnerships Division
Income Tax Rulings Directorate
Legislative Policy and Regulatory Affairs Branch