Deducting medical conference attendance.

For the first time, the IRS has ruled that certain costs of attending a medical conference, when recommended by a physician, can be a deductible medical expense.

In Rev. Rul. 2000-24, a taxpayer lived in City A: his child was chronically ill. The child's physician recommended that the, taxpayer attend a conference in City B sponsored by an association that supports research and education about the child's disease. The conference was attended by medical practitioners and individuals with the disease and their families.

The taxpayer spent the majority of his time in City B at the conference. His expenses included transportation to and from City B, local transportation to and from the conference site, conference registration fee and meals and lodging while attending the conference.

Sec. 213(a) and (d)(1) allow a deduction for unreimbursed expenses incurred for "medical care"--the diagnosis, cure, mitigation, treatment or prevention of disease, or for the purpose of affecting any body structure or function--if the 7.5% adjusted gross income threshold is met. Under Regs. Sec. 1.213-1(e)(1)(ii), the deduction is confined strictly to expenses incurred primarily for the prevention or alleviation of a physical or mental defect or illness. Whether an expense is "primarily" for medical care is a question of fact.

Under Sec. 213(d)(1)(B), medical care includes transportation "primarily for and essential to" medical care. Sec. 213(d)(2) provides that the cost of lodging up to $50 per night while away from home that is primarily for and essential to medical care is paid for medical care if the care is provided by a physician in a licensed hospital or equivalent facility and there is no significant element of personal pleasure, recreation or travel in the away-from-home travel.

On the other hand, Regs. Sec. 1.213-1(e)(1)(iv) and (v) provide that meals are not deductible medical expenses unless provided at a hospital or other facility at which the taxpayer, his spouse or dependent is receiving medical care.

The IRS ruled that the conference registration fee and costs of travel to and from the conference were deductible medical expenses. The meals and lodging were nondeductible.

Rev. Rul. 2000-24 distinguished Rev. Rul. 76-79, 1976-1 CB 70, in which the costs of a physician-recommended cruise were deductible only to the extent attributable to the physician cruise staff reviewing the taxpayer's medical records, performing medical tests and reporting the results to the taxpayer's physician.

It is unclear how broadly the IRS will apply the holding of Rev. Rul. 2000-24 to other taxpayers who attend what purport to be medical conferences. The burden is on the taxpayer to prove legitimate expenses and actual conference attendance. The taxpayer should strive to obtain in writing his, his spouse's or dependent's physician's recommendation to attend the conference.

Rev. Rul. 2000-24 may be a bright spot for clients who are chronically ill or have chronically ill spouses or dependents. Even if the 7.5% Federal threshold cannot be met, the expenses may nevertheless be deductible on a state return.