The CRA has just published an interpretation letter that deals with manual osteopathic services, among other things.

Here are some passages:

For purposes of section 7, to be a practitioner in respect of osteopathic services, a person must be licensed or otherwise certified to practise the profession of osteopathy in the province in which the service is supplied (paragraph (b) of the definition of practitioner), or, where the person is not required to be licensed or otherwise certified to practise the profession in that province, the person must have the qualifications equivalent to those necessary to be so licensed or otherwise certified in another province (paragraph (c) of that definition).

In order to be licensed or otherwise certified to practise a particular health profession in a province, a person must be a member of a provincial regulatory body responsible for the regulation of the health profession in that province. The role of these provincial regulatory bodies and the authority to monitor and regulate their respective health professions is set out in provincial legislation.

In Ontario, the practice of osteopathy is regulated in conjunction with the practice of medicine under the Medicine Act, 1991 and falls under the jurisdiction of the College of Physicians and Surgeons of Ontario (College). Subsection 9(1) of the Medicine Act, 1991 provides, in part, that no person other than a member of the College shall use the title “osteopath” or any variation or equivalent. Further, pursuant to subsection 9(3) of the Medicine Act, 1991, no person other than a member of the College shall hold himself or herself out as a person who is qualified to practise as an osteopath in Ontario.

Therefore, with respect to supplies of services made in Ontario, an osteopathic manual practitioner, such as a person who possesses a Diploma in Osteopathy Manual Practice, is not a practitioner for purposes of section 1 of Part II of Schedule V and, consequently, a supply of manual osteopathic services rendered by such an osteopathic manual practitioner is not exempt under section 7 of Part II of Schedule V.

With respect to supplies of manual osteopathic services made in provinces other than Ontario, the relevant provincial legislation for each province or territory was reviewed in order to identify any provincial licensing or certification requirements. Based on this review, it is our understanding that there are no provincial licensing or certification requirements in any province or territory in Canada for the profession of manual osteopathy and, accordingly, there are no provincial regulatory bodies responsible for the regulation of the profession of manual osteopathy. Therefore, a manual osteopathic practitioner is not a “practitioner”, as defined in section 1 of Part II of Schedule V, and supplies made by a manual osteopathic practitioner are not exempt under section 7.

The practice of osteopathy in Ontario can only take place if the person rendering the service is a member of the College governed by the College of Physicians.

In Quebec, section 14 of the Règlement sur les conditions et modalités de délivrance du permis et des certificats de spécialiste du Collège des médecins du Québec recognizes as equivalent to a medical degree the diploma of doctor of osteopathy awarded by a school of osteopathic medicine located in the United States.

Since there does not appear to be a professional order that supervises the practice of osteopathy in provinces other than those for physicians, the supply of an osteopathic service is taxable when made by a person other than a physician. 

It is therefore important to take the necessary steps to register suppliers of such services under the GST/HST and QST regimes. It seems that Revenu Québec is aiming to bring these persons into compliance for the future. However, this is a situation that will be analyzed on a case-by-case basis.

If you wish to consult the interpretation letter, follow this link.