GST applicability in Healthcare services

GST on Healthcare Services: An Overview

In the 25th council meeting dated 18.01.2018, following clarifications relating to healthcare services were given:

1) Services provided by senior doctors/consultants/technicians hired by the hospitals, whether employees or not, are healthcare services which is exempt.

2) Hospitals also provide healthcare services. The entire amount charged by them from the patients including the retention money and the fee/payments made to the doctors etc., is towards the healthcare services provided by the hospitals to the patients and is exempt.

3) Food supplied to the in-patients as advised by the doctor/nutritionists is a part of composite supply of healthcare and not separately taxable. Other supplies of food by a hospital to patients (not admitted) or their attendants or visitors are taxable.

♦Vide Notification No. 9/2017-Integrated Tax (Rate), dated: 28th June, 2017, the Central Government, on the recommendations of the GST Council, exempts the inter-state supply of health care services from the levitation of Integrated Tax under sub-section (1) of section 5 of the GST Act, specified in the corresponding entry without any conditions: 

• Entry No. 48(SAC – 9983): Services by a veterinary clinic in relation to health care of animals or birds.
• Entry No. 76 (SAC – 9993): Services provided by the cord blood banks by way of preservation of stem cells or any other service in relation to such preservation.
• Entry No. 77 (SAC – 9993): Services by way of-

health care services by a clinical establishment, an authorised medical practitioner or para-medics; services provided by way of transportation of a patient in an ambulance, other than those specified in (a) above.

• Entry No. 78 (SAC – 9994): Services provided by operators of the common bio-medical waste treatment facility to a clinical establishment by way of treatment or disposal of bio-medical waste or the processes incidental thereto.

♦ Definition: some important terms used in the notification were defined and clarified for the healthcare purposes:

♦ 2(k) “authorised medical practitioner” means a medical practitioner registered with any of the councils of the recognised system of medicines established or recognised by law in India and includes a medical professional having the requisite qualification to practice in any recognised system of medicines in India as per any law for the time being in force;

♦ 2(s) “clinical establishment” means a hospital, nursing home, clinic, sanatorium or any other institution by, whatever name called, that offers services or facilities requiring diagnosis or treatment or care for illness, injury, deformity, abnormality or pregnancy in any recognised system of medicines in India, or a place established as an independent entity or a part of an establishment to carry out diagnostic or investigative services of diseases;

♦ 2(zg) “health care services” means any service by way of diagnosis or treatment or care for illness, injury, deformity, abnormality or pregnancy in any recognised system of medicines in India and includes services by way of transportation of the patient to and from a clinical establishment, but does not include hair transplant or cosmetic or plastic surgery, except when undertaken to restore or to reconstruct anatomy or functions of body affected due to congenital defects, developmental abnormalities, injury or trauma;

♦ 0Para-medics mean a healthcare professional which includes Nursing Staff, physiotherapists, technicians, lab assistants etc. They responds to emergency care of a sick or injured person during transport to a hospital, including administration of injections and intravenous fluids, reading of electrocardiograms and performance of defibrillation and other advanced life-support measures if ordered by a physician.

♦ Vide Notification No. 11/2017-Central Tax (Rate), dated: 28th June, 2017, The Central Government, on the recommendations of the Council, hereby notifies that the central tax, on the intra-State supply of services of description as specified below shall be levied at the rate as specified in the corresponding entry without any conditions:

• Entry No. 31 (SAC – 9993): Human health and social care services (Rate – 9%)

Health care services provided by a clinical establishment, an authorised medical practitioner or para-medics are exempt. [Sl. No. 74 of notification No. 12/2017- CT (Rate) dated 28.06.2017 as amended refers].

With these above exemption notification, it is clear that health care services are exempt from GST except hair transplant, cosmetic or plastic surgery, otherwise when undertaken to restore or to reconstruct anatomy or functions of body affected due to congenital defects, developmental abnormalities, injury or trauma, which remains taxable.

♦ Though health care services are exempted from tax however various other supply like medicines, implants, room rent, food etc. creates complex situation for hospitals. However most of the issues have been clarified in the Circular No. 32/06/2018-GST, dated: 12th February 2018: 

Entry No. 5: Is GST leviable in following cases:

• Hospitals hire senior doctors/ consultants/technicians independently, without any contract of such persons with the patient; and pay them consultancy charges, without there being any employer- employee relationship. Will such consultancy charges be exempt from GST? Will revenue take a stand that they are providing services to hospitals and not to patients and hence must pay GST? 

Clarification: Services provided by senior doctors/ consultants/ technicians hired by the hospitals, whether employees or not, are healthcare services which are exempt.

• Retention money: Hospitals charge the patients, say, Rs.10000/- and pay to the consultants/ technicians only Rs. 7500/- and keep the balance for providing ancillary services which include nursing care, infrastructure facilities, paramedic care, emergency services,   checking  of temperature, weight, blood pressure etc. Will GST be applicable on such money retained by the hospitals?

Clarification: Healthcare services have been defined to mean any service by way of diagnosis or treatment or care for illness, injury, deformity, abnormality or pregnancy in any recognised system of medicines in India[para 2(zg) of notification No. 12/2017- CT(Rate)]. Therefore, hospitals also provide healthcare services. The entire amount charged by them from the patients including the retention money and the fee/payments made to the doctors etc., is towards the healthcare services provided by the hospitals to the patients and is exempt.

• Food supplied to the patients: Health care services provided by the clinical establishments will include food supplied to the patients; but such food may be prepared by the canteens run by the hospitals or may be outsourced by the Hospitals from outdoor caterers. When outsourced, there should be no ambiguity that the suppliers shall charge tax as applicable and hospital will get no ITC. If hospitals have their own canteens and prepare their own food; then no ITC will be available on inputs including capital goods and in turn if they supply food to the doctors and their staff; such supplies, even when not charged, may be subjected to GST.

Clarification: Food supplied to the in-patients as advised by the doctor/nutritionists is a part of composite supply of healthcare and not separately taxable. Other supplies of food by a hospital to patients (not admitted) or their attendants or visitors are taxable.

♦ For understanding the classification of the services, SAC codes for healthcare services are provided:

SAC CODE 

9993

Human health and social care services

99931

Human health services

This service code includes:

• Other paramedical human health services not elsewhere classified, such as acupuncture, aroma therapy, speech therapy, homeopathy, nutrition therapy etc.

999311

inpatient services

This service code includes:

• surgical services delivered under the direction of medical doctors to inpatients, aimed at curing, restoring and/or maintaining the health of a patient gynaecological and obstetrical services delivered under the direction of medical doctors to inpatients, aimed at curing, restoring and/or maintaining the health of a patient psychiatric services delivered under the direction of medical doctors to inpatients, aimed at curing, restoring and/or maintaining the health of a patient
• other hospital services delivered under the direction of medical doctors to inpatients, aimed at curing, restoring and/or maintaining the health of a patient. These services comprise medical, pharmaceutical and paramedical services, rehabilitation services, nursing services and laboratory and technical services, including radiological and anaesthesiological services, etc.

999312

Medical and dental services

This service code includes:

• general medical services consisting of the prevention, diagnosis and treatment by doctors of medicine of physical and/or mental diseases, such as:

a. consultations

b. physical check-ups,  etc.

> Note: These services are not limited to specified or particular conditions, diseases or anatomical regions. They can be provided in general practitioners’ practices and also delivered by outpatient clinics, at home, in firms, schools etc. or by phone, Internet or other means.

consultation services in paediatrics, gynaecology-obstetrics, neurology and psychiatry, and various medical services, surgical consultation services, treatment services in outpatients clinics, such as dialysis, chemotherapy, insulin therapy, respiratory treatment, radiation treatment and the like analysis and interpretation of medical images (x-ray, electrocardiograms, endoscopies and the like)

> Note: These services can be provided in specialized practitioners’ practices and also delivered by outpatient clinics, at home, in firms, schools etc. or by phone, Internet or other means.

orthodontic services, e.g., treatment of protruding teeth, crossbite, overbite, etc., including dental surgery even when given in hospitals to inpatients services in the field of oral surgery other specialized dental services, e.g., in the field of periodontics, paedodontics, endodontics and reconstruction diagnosis and treatment services of diseases affecting the patient or aberrations in the cavity of the mouth, and services aimed at the prevention of dental diseases

> Note: These dental services can be delivered in health clinics, such as those attached to schools, firms, homes for the aged, etc., as well as in own consulting rooms. They cover services in the field of general dentistry, such as routine dental examinations, preventive dental care, treatment of caries, etc.

This service code does not include:

• childbirth services by qualified practitioners other than medical doctors :- 999313
• services of medical laboratories :- 999316

999313

Childbirth and related services

This service code includes:

• services such as supervision during pregnancy and childbirth
• supervision of the mother after birth

> Note: These services are provided by qualified practitioners, other than medical doctors.

This service code does not include:

• gynaecological and obstetrical services provided by hospitals to in-house patients : 999311

999314

Nursing and Physiotherapeutic services 

This service code includes:

• services in the field of nursing care (without admission), advice and prevention for patients at home, the provision of maternity care, children’s hygiene, etc.
• services in the field of physiotherapy, ergotherapy, occupational therapy etc.

> Note: These services are provided by qualified practitioners, other than medical doctors.

999315

Ambulance services

This service code includes:

• services involving the transport of patients by ambulance, with or without resuscitation equipment or medical personnel

999316

Medical Laboratory and Diagnostic-imaging services

This service code includes:

• analysis and testing services provided by medical laboratories
• diagnostic imaging services without analysis or interpretation, e.g., x-ray, ultrasound, magnetic resonance imaging (MRI), etc.

999317

Blood, sperm and organ bank services

 This service code includes:

• services provided by blood, semen, embryo, stem cells, tissue and transplant organ banks, including storing and cataloguing of available specimen, matching of donated specimen and potential recipients etc.

999319

Other human health services including homeopathy, unani, ayurveda, naturopathy, acupuncture etc.

This service code includes:

• Other paramedical human health services not elsewhere classified, such as acupuncture, aroma therapy, speech therapy, homeopathy, nutrition therapy etc.

> Note: These services are provided by qualified practitioners, other than medical doctors.

998351	Veterinary services for pet animals (for health care)	Nil
998351	Veterinary services for pet animals (others)	0
998352	Veterinary services for livestock (for health care)	Nil
998352	Veterinary services for livestock (others)	0
998359	Other veterinary services n.e.c. – 18	%

♦ To get more clarity with regards to GST taxability on healthcare services, AAR rulings of various states are described below as reference:

Name of Applicant: ERNAKULAM MEDICAL CENTRE PVT. LTD

Industry: Health Care Services

Order No./date/State: AAR No. KER/16/2018, dated: 19.09.2018, Kerala

Query: Whether the supply of medicines and allied items through the pharmacy of the hospital run by the applicant attracts liability under GST?

Case Ruling: The supply of medicines and allied items provided by the hospital through the pharmacy to the in-patients is part of composite supply of health care treatment and hence not separately taxable. The supply of medicines and allied items provided by the hospital through the pharmacy to the outpatients is taxable.

Other references similar to the case:

M/s. CMC Vellore Association (Tamil Nadu AAR), TN/50/AAR/2019 DATED 25.11.2019

M/s. Shifa Hospitals (Tamil Nadu AAR)– TN/42/AAR/2019 dated 23.09.2019

KIMS Health Care Management Ltd (AAR-KERALA)

Terna Public Charitable Trust (Maharashtra AAR) GST-ARA- 135/2018-19/B- 55 Mumbai dated 21.05.2019

M/s. Rajagiri Healthcare & Education Trust, KER/ 24 /2018 Dt.06.10.2018 

Comments: Other taxable income of hospitals: Though it is clear from above discussion that the health services are exempted vide exemption notification, there are multiple heads of income for a hospital which are liable to tax under GST. These may include income from renting of premises from canteen or pharmacy, sale of scrap, sale or disposal of asset/machinery, parking fees or lodging-boarding of attendants with OPD patients etc.

Name of Applicant: Alcon Resort Holdings Pvt. Ltd.

Industry: Health Care Service

Order No./date/State: GOA/GAAR/6/201 8-19, Dated 22.01.19

Facts: The applicant provides health care treatment service to Indian as well as International Patients through Ayurveda, Naturopathy & Yoga.

The questions were raised-

Query: Whether the service provided by the applicant including all incidental services amounts to a composite service under the classification of health care service exempt under Entry No. 74 of Notification 12/2017-Central Tax?

Case Ruling: The applicant qualifies to be a clinical establishment and the services offered provided by the applicant qualify to be Health Care Services. The Intra state supplies of the said services attract NIL rate of Tax as per 74 of Notification 12/2017-Central Tax dated 28th June 2017. 

Name of Applicant: J C Genetic India Private Limited

Industry: Healthcare Company (M.P AAR)

Order No./date/State: NO. 01/19-20 Dated 21.01.2019

Facts: The applicant is a healthcare company. The applicant has collaboration with diagnostic companies, accredited by NABL, and DSIR certified to provide advance genetic tests that help in prevention and management of Cancer & various health & metabolic disorders.

The question was raised:

Query 1: Whether exemption provided under Sl. No. 74 of Notification No. 12/2017-Central Tax (Rate) dated 28.06.2017 is applicable to the applicant?

Query 2: Whether applicant qualifies to be a “Clinical Establishment” under clause 2(s) of the said notification?

Case Ruling: The applicant has failed to prove their legal status as Clinical Establishment and they are merely working as subcontractors to other accredited companies, and accordingly the applicant are not entitled to avail exemption 12/2017-Central Tax (Rate) & corresponding notification issued under MPGST Act.

Name of Applicant: Bilcare Limited

Industry: Healthcare Services (Maharashtra AAR)

Order No./date/State: GST-ARA- 117/2018-19/B- 45 Mumbai dated 26.04.2019

Facts: M/s. Bilcare Ltd. is engaged in Healthcare Services, Discover of New Drugs for effective solution of various diseases, Pharmaceutical Packaging Solutions comprising of a wide range of specialty Polymer Films and Aluminum Foils mainly used for packaging of solid dosage pharmaceutical products, etc.

The following questions were raised

Query 1: Determining whether the various services provided to foreign clients i.e. situated outside India and for which the place of supply is in the taxable territory shall be liable to Integrated Tax (herein referred to as “IGST”) or Central Goods and Service Tax (herein referred to as “CGST”) and State Goods and Service Tax (herein referred to as “SGST”) for the purpose of levy of Goods and Services Tax (GST) under the GST Law.

Case Ruling: The above mentioned services are liable to CGST and SGST as the location of ‘supplier of service’ and the ‘place of supply’ is in the same State, in terms of Section 13(3)(a) of IGST Act, 2017. 

Query 2: In case it is ruled that IGST is payable, the procedure to be followed for payment of IGST as the GST portal does not permit the payment of IGST where the place of supply is indicated as state of Maharashtra.

Case Ruling: Not answered since IGST is not applicable.

Name of Applicant: The Leprosy Mission Trust Of India

Industry: Health Education Service Provider (Maharashtra AAR)

Order No./date/State: GST-ARA- 116/2018-19/B- 44 Mumbai dated 26.04.2019

The following questions were raised: 

Query1: Whether services provided under vocational training courses recognized by National Council for Vocational Training (NCVT) or Jan Shikshan Sansthan (JSS) is exempt either under Entry No 64 of exemption list of Goods and Service Tax Act 2017 or under Educational Institution defined under Notification 22/Central Tax (Rate)?

Case Ruling: The mentioned service is not exempted. 

Query 2: Whether services provided under vocational training courses provided by the applicant are exempt under Entry No 66 of the Notification 22/2017- Central Tax (Rate)?

Case Ruling: Only the vocational training courses pertaining to Diesel Mechanic , Computer Operator & programming assistance , welder , Motor Mechanic are exempted under the S. No. 66(a) of Notification No. 12/2017-CT(Rate) dated 28.06.2017 as amended

Name of Applicant: Kasturba Health Society

Industry: Medical Education Provider (Maharashtra AAR)

Order No./date/State: GST-ARA- 120/2018-19/B- 51 Mumbai dated 04.05.2019

The following questions were raised:

Query 1: Whether the applicant, a Charitable Society (registered under Societies Act 1860 & also Bombay Public Trust Act , 1950) having the main object and factually engaged in imparting Medical Education, satisfying all the criteria of “Educational Institution”, can be said to be engaged in the business so as to cast an obligation upon it to comply with the provisions of Central Goods and Service Tax Act, 2017 and Maharashtra Goods and Service Tax Act, 2017 in totality.

Case Ruling: In view of the discussion made above it is MGIMS which appears to be engaged in imparting medical education & not the applicant. The applicant has entered into a joint project with the state & central govt. to form MGIMS which is an entity different from that of the applicant. Hence the applicant cannot be said to be satisfying all the criteria of an “Educational Institution”

Query 2: Whether the applicant, a Charitable Society having the main object and factually engaged in imparting medical education, satisfying all the criteria of “Educational Institution” is liable for registration under the provisions of section 22 of the Central Goods and Service Tax Act, 2017 and Maharashtra Goods and Service Tax Act, 2017 or it can remain outside the purview of registration in view of the provisions of section 23 of the said act as there is no Taxable supply. 

Case Ruling: As applicant has been found to be not an educational institution , the applicant falls within the scope of Sections 22 or 24 of GST Act ,2017, they are liable to obtain registration if they provide taxable services and their turnover exceeds the threshold limit prescribed for registration.

Query3: In a situation if above questions are answered against the contention of the applicant institution then following further questions are being raised for the kind consideration by the Honorable Bench:

a) Whether the fees and other charges received from students and recoupment charges received from patients (who is an essential clinical material for education laboratory) would constitute as “outward supply” as defined in section 2 (83) of The Central Goods and Service Tax Act, 2017 and Maharashtra Goods and Service Tax Act, 2017 and if yes then whether it will fall in classification entry at Sr. No 66 or the portion of nominal amount received from patients (who is an essential clinical material for education laboratory) at Sr. 74 in terms of Notification 12/2017 Central Tax-dt. 28/6/2017.

b) Whether the cost of Medicines and Consumables recovered from OPD patients along with nominal charges collected for Diagnosing by the pathological investigations, other investigation such as CT-Scan, MRI, Colour Doppler, Angiography, Gastroscopy, Sonography during the course of diagnosis and treatment of disease would fall within the meaning of “composite supply” qualifying for exemption under the category of “educational and/or health care services.”

c) Whether the nominal charges received from patients (who is an essential clinical materials for education laboratory) towards an “Unparallel Health Insurance Scheme” to retain their flow at one end for the purpose of imparting medical education as a result to provide them the benefit of concessional rates for investigations and treatment at other end would fall within the meaning of “supply” eligible for exemption under the category of “educational and/or health care services.”

d) Whether the nominal amount received for making space available for essential facilities needed by the students and staffs such as Banking, Parking, and Refreshment which are support activities for attainment of main activities and further amount received on account of disposal of wastage would fall within the meaning of “supply” qualifying for exemption under the category of “educational and/or health care services.”

Case Ruling: Question 3 has been rejected.

Name of Applicant: M/s. Royal Care Speciality Hospitals Ltd

Industry: Health Care Services (Tamil Nadu AAR)

Order No./date/State: TN/46/AAR/2019 dated 26.09.2019

The following questions have been raised

Query1: Whether the medicines, consumables and implants used in the course of providing health care services to in-patients for diagnosis or treatment would be considered as “Composite Supply” and accordingly eligible for exemption under the category “Health Care Services?”

Case Ruling: Medicines, consumables and implants used in the course of providing health care services to in-patients by the applicant is a composite supply of Inpatient Services classifiable under SAC 999311.

Supply of health care services or inpatient services by the applicant as defined in Para 2(zg) of Notification no 12/2017-C.T. (rate) dated 28.06.2017 as amended and Notification No.II (2)/CTR/532(d-15)/2017 vide G.O. (Ms) No. 73 dated 29.06.2017 as amended is exempted from CGST and SGST as per SI No 74 of the above notifications respectively.

Query2: Whether ITC is eligible for obligatory services provided to In-patients through outsourcing?

Case Ruling:  The applicant is not eligible for the credit of tax paid on the Input services used exclusively for providing exempt services of health services to in patients such as laundry services used for in patients. For Input services such as housekeeping, leasing of equipment used for both exempt supply of health services to in patients and taxable supply of medicines etc. to outpatients , the appropriate ITC eligible is determined by Rule 42 of the CGST Rules 2017 and TNSGST Rules as amended read with Section 17(2) of CGST/TNGST Act 2017.

Name of Applicant: Matrix Imaging Solutions India Private Limited

Industry: Healthcare Service Provider (Karnataka AAR)

Order No./date/State: KAR/AAR/105/2019-20 dated 30.09.2019 

Facts: The applicant is in the business of providing health care services to the Government Hospitals only on PPP Model for a limited contract period. All expenditure related to the services provided by the applicant is borne by the applicant themselves, and the applicant receives the bills for the same by vendors of different GST slabs. The following questions have been raised –

Query1: Whether they, being a health care service provider, are exempted from tax or not?

Case Ruling:  The diagnostic services provided by the applicant to Hospitals and other establishments are covered under entry no. 74 of the Notification No.12/2017- Central Tax (Rate) dated 28.06.2017 and hence are exempted from CGST. Similarly, the services are also exempted under the Karnataka Goods and Services Tax Act, as it is covered under entry no.74 of Notification (12/2017) No. FD 48 CSL 2017 dated 29.06.2017.

Name of Applicant: M/s TATHAGAT HEALTH CARE CENTRE LLP

Industry: Health Care Services

Order No./date/State: KAR ADRG 04 /2018 Dated: 21st March, 2018

Facts: The impugned service of Rental or leasing services involving own or leased non-residential property is classified under the heading (SAC) 997212 and is taxable under GST. Further no specific exemption is available under any notification for the time being in force for the said service. Also there is no provision available in the Act which allows exemption on an input service if the output service provided by the taxable person is exempt.

The applicant sought advance ruling on the question / issue:

Query: “Whether GST is leviable on the rent payable by a Hospital, catering lifesaving services?”

Case Ruling: GST is leviable on the rent paid / payable for premises, taken on lease by the applicant.

Name of Applicant: M/s SAYRE THERAPUETICS PRIVATE LIMITED

Industry: Healthcare services

Order No./date/State: KAR ADRG 05 / 2018 Dated: 21st March, 2018

The applicant sought advance ruling on the question / issue:

Query 1: Whether the Applicant qualifies as clinical establishment?

Query 2: Whether the service provided by the applicant qualifies to be health care services?

Facts: In the instant case the applicant offers services / facilities requiring diagnosis such as patient counselling, suggesting the relevant test for the patient, collecting samples, obtaining the result of the test, sharing the test results and post counselling. The medical team of the applicant discusses with the oncologist / pathologist, takes samples of required tissues and sends it for the tests to US/Germany, with regard to the oncology / auto immune deceases. They play the role of referral / physician and also advice doctors for line of treatment to the establishment. They provide the said services in “Allopathy” system of medicines, recognised in India. Therefore they qualify to be a clinical establishment.

In the instant case the Applicant is involved in providing the services of diagnosis, pre & post counseling, therapy and prevention of diseases by providing tests that are sophisticated and relevant. The medical team of the applicant is involved in the complete cycle and hence they facilitate the diagnosis process and therefore the services provided by the applicant qualify to be health care services.

Case Ruling: The applicant qualifies to be a clinical establishment and the services offered / provided by the Applicant qualify to be Health Care Services. The intra-state supply of said services attracts NIL rate of central tax as per SL.No.74 of the Notification No. 12/2017- Central Tax (Rate) dated 28th June, 2017.

Name of Applicant: M/s DKM S BMST Foundation India (NPO)

Industry:

Order No./date/State: KAR ADRG 24/2O2O Dated : 23-04-2020

Facts: The applicant is a company registered under the provisions of the Goods and Services Act, 2017. The applicant states that they are a not for profit organisation facilitating the treatment of blood cancer and other blood disorders by promoting awareness and encouraging people to register as a potential blood stem cell donors as well as facilitating the process of blood stem cell donations.

The applicant has sought advance ruling in respect of the following questions:

Query: Whether  in  the  facts   and   circumstances   of  the  case,   DKMS   BMST Foundation India is liable to pay integrated Goods and Services Tax on the Human Leukocyte Antigen (’HLA’) testing services performed by the  overseas  laboratory outside India on the Human Buccal Swabs sent by DKM S-BMST from India?

Later at the time of personal hearing, he has modified the question and sought the advance ruling on the following questions:

Query1: From the overseas  laboratory  falls  under the definition of health care services by a clinical establishment, thereby exempt from the tax leviable thereon and accordingly not taxable in the hands of DKMS-BMST.

Query2: Notwithstanding the outcome of Question 7, whether in the facts and circumstances of the case, DKMS BMST Foundation India (’DKMS BMST’) is liable to pay Integrated Goods and Services Tax on the  testing  services performed by the overseas  laboratory  outside  India  on  the  Human  Buccal Swabs sent by DKMS BMST from India?

Case Ruling: The services of HLA Typing received by DKMS BMST Foundation India from the overseas laboratory is covered under the definition of health care services by a clinical establishment thereby is exempted from IGST leviable thereon and accordingly not taxable in the hands of the applicant under Reverse Charge  Mechanism.

The applicant is not liable to pay IGST on the testing services performed by the overseas laboratory outside India on the Human Buccal Swabs sent by DKMS BMST from India and is already answered in para 1 above

Name of Applicant: M/s SRI DMS HOSPITALITY PRIVATE LIMITED

Industry:

Order No./date/State: KAR ADRG 86/2019 Dated : 25th September, 2019

The applicant has sought advance ruling in respect of the following question:

Query1: Classification of services provided by Sri DMS Hospitality Private Limited to Sodexo Food Solutions India Private limited? 

Query2: Classification of services provided by the Builder owner to Sri DMS Hospitality Private Limited? 

Query3: Applicability of GST Notification No. 12/2017 – Central Tax (Rate) dated 28.06.2017, services by way of renting of residential dwelling for use as residence is exempt from GST? Applicability of GST on EMI per month charged from Sodexo Food Solutions India Private limited and security services provide by Sodexo Food Solutions India Private limited?

Case Ruling 1: The classification of service provided by sri DMS Hospitality Private Limited to Sodexo Food Solutions India Private Limited is covered under SAC 997212 and hence under entry no. 16 of Notification No. 11/2017 – Central Tax (Rate) dated 28.06.2017 and the security services provided is covered UNDER SAC 998529 and hence under entry 23(ii) and are hence liable to tax at respective rates.

Case Ruling 2: The Classification of service provided by the building owner to M/s. Sri DMS Hospitality Private Limited is covered under SAC 997212 and hence liable to tax under entry no. 16 of Notification No. 11/2017 – Central Tax (Rate) dated 28.06.2017

Case Ruling 3: The entry no. 12 of Notification No. 12/2017 – Central Tax (Rate) dated 28.06.2017, services by way of renting of residential dwelling for use as residence is not applicable to the present case on hand. The EMI charged on the goods supplied is an installment for the goods transferred and is a supply of goods under clause 1(c) of Schedule II to the CGST Act and hence is liable to tax at the rate applicable to each of the goods supplied at the time of delivery of such goods.

Name of Applicant: Abbott Healthcare Private Limited

Industry: Pharmaceuticals products, diagnostic kits, etc

Order No./date/State: AAR Order no. KER/15/2018 dated 26-09-2018/ Appeal order no. AAR/04/2018 dated 14.12.2018

The Company has sought an advance ruling on two questions:

Query1: Whether the placement of specified medical instrument to unrelated customers like hospital, labs etc. for their use without any consideration, for a specific period constitute supply?

Query2: Whether such movement of goods constitutes otherwise than byway of supply under GST?

Facts: The Company is engaged in the sale of Pharmaceuticals products, diagnostic kits etc. The Appellant has adopted the business model of placing their own medical instruments at the premises of unrelated hospitals or laboratories and supplied the products, reagents, diagnostic kits etc. to be used in such equipment’s by executing an agreement.

Case Ruling: We hereby uphold the original order as legally correct and proper and rule that the placement of specified medical instruments to unrelated customers like hospital, labs etc. for their use without any consideration, against an agreement containing minimum purchase obligation of products like reagents, calibrators, disposals, etc. for a specific period constitute composite supply , the principal supply being the transfer of right to use any goods for any purpose is liable to GST Under Sl. No. 17 (iii) – Heading 9973 of Notification No. 11/2017-Central Tax (Rate) dated 28.06.2017.

Name of Applicant: Baby Memorial Hospital Limited

Industry: Health Care services

Order No./date/State:  KER/57/2019, dated: 05-09-2019, (AAR-KERALA)

The Company has sought an advance ruling on following questions:

Query1: Whether the applicant is liable to pay GST on supply of incidental services as X-ray, Clinical laboratory etc. rendered as part of health care service? 

Case Ruling: As per SRO.No.371/2017 vide sl.no.74 (Notification No. 12/2017-CT (Rate) dated: 28-06-2017), services by way of diagnosis come under the category of health care services covered under SAC 9993 and thereby exempted.

Query2: Whether the applicant is liable to pay GST on supply of Implants and artificial limbs made during course of treatment to patients? 

Case Ruling: The supply of goods like wheel chairs, tricycles etc to the patients cannot be considered as a composite supply where the principal supply is health care services and accordingly will be liable to GST as individual supply of goods.

Name of Applicant: M/s. Medivision Scan and Diagnostic Research Center (P) Ltd.

Industry: Health Care services

Order No./date/State:  KER/41/2019, dated: 12-04-2019, (AAR-KERALA)

The Company has sought an advance ruling on question:

Query1: Whether diagnostic service provider has to take registration under GST?

Case Ruling: By Virtue of Section 23 of SGST Act, any persons engaged exclusively in the business of supplying goods or services or both, that are not liable to tax or wholly exempt from tax under GST Act, are not liable to take registration. However, such persons are liable to obtain registration if they are receiving any goods or services liable to tax under Reverse Charge as per notifications issued under section 9(3) of the SGST Act.

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