By PEDRO SIMÕES
GENERALLY ALL health activities are IVA (VAT) exempt. However, there are a few forms of treatment that are not recognised in Portugal, such as chiropractic, homeopathy, aromatherapy, naturopathy, osteopathy and acupuncture, among others. But, in 2003, a law was approved with the purpose of recognising some non-conventional therapies as regular health activities, which are accepted in other countries such as the UK and Canada.
In Portugal, we have a large number of international therapists who are not considered to be ‘real doctors’, because of the non-acceptance of their therapies as regular health activities.
Currently, a technical commission is working towards governing the practise of some of the non-conventional therapies mentioned above. However, until now, nothing has been decided. Initially, the intention was to have a structure in place by the end of 2005, but the political changes over the past two years have affected this objective, causing a delay in the matter being solved. The commission members need to study and analyse the general parameters for the work carried out by non-conventional therapists.
Those were the aims, but we now need to wait for the process to be concluded, which involves many different entities. The main problem is, who is going to be in charge of supervising these activities? The Ordem dos Médicos (Order of Doctors)? A new entity for all these alternative activities, or should each type of therapy be given its own supervisory body? There are already several associations and federations that want to govern some of these activities.
This introduction was important for you to understand the background to the process, and why these non-conventional therapies are not yet considered official health activities. Please note, only an officially accepted health activity is exempt of IVA.
Currently, none of the non-conventional therapies already mentioned are IVA exempt. Therefore, bills paid by patients cannot be claimed as health expenses on their personal IRS return. The main reason for non-acceptance for individual IRS is because these therapists are not exempt from paying IVA.
But, what health expenses are IVA exempt? Invoices from doctors, nurses, midwives, and paramedic professionals. Other medical areas which are recognised are physiotherapy, clinical analysis, pathology, cytology, audiometric, dietetics, pharmacy, oral hygiene, radiology, radiotherapy, dental proteases, occupational therapy, environment health and hygiene.
To summarise, the therapists are required to wait for the regulation process to be concluded, however, the fact that they are currently not recognised does pose a problem for them – they need to promote the benefits of their therapy, while explaining to patients that their treatment costs are not tax deductible.