In Re: M\/s. Rajagiri Health Care & Education Trust
GST
2018 (11) TMI 278 – AUTHORITY FOR ADVANCE RULINGS, KERALA – TMI
AUTHORITY FOR ADVANCE RULINGS, KERALA – AAR
Dated:- 6-10-2018
AAR No. KER\/24\/2018
GST
SHRI. B.G. KRISHNAN IRS AND SHRI B.S. THYAGARAJABABU B.Sc., LLM, MEMBER
\nAuthorized Representative: Mr. K. Sivarajan, Mr. Srihari, Mr. Shubham Mishra
\nThe applicant is a multi-specialty teniary care hospital providing health care services. They have categorized the patients as Out-Patients and In-Patients for the administrative convenience. The out-patients are those who visit the hospital for routine check-ups or clinical visits. The in-patients are those who are admitted in to the hospital for the required treatment. The in- patients are provided with stay facilities, medicines, consumables, implants, dietary food and other surgeries\/ procedures required for the treatment.
\nThe Central store of the hospital procures stocks of medicines, implants, consumables et<\/p>\n
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Plain text (Extract) only<\/strong> = = = = = = = =<\/p>\n ly the health care service but also the life will also be at stake. Being a composite supply the principal supply is predominant and the room rent and dietary food provided to in-patients are ancillary supply. The applicant sought for an advance ruling on the following: = = = = = = = =<\/p>\n Plain text (Extract) only<\/strong> = = = = = = = =<\/p>\n ursing services, supply of medicines, consumables and implants are integral services of health care. = = = = = = = =<\/p>\n Plain text (Extract) only<\/strong> = = = = = = = =<\/p>\n in the nature of incidental or ancillary services which help in better utility of main service. Hence the medicines, implants, room provided on rent, dietary food advised by nutritionists etc used in the course of providing health care services to the patients admitted for diagnosis or treatment in the hospital or clinical establishment is undoubtedly naturally bundled in the ordinary course of business. The patients expect to receive health care services by way of an appropriate diagnosis, appropriate medicines as well as relevant consumables or implants required to make sure that they get the best possible treatment. Hence the medicine and allied goods supplied to inpatient are indispensable items and it is a composite supply to facilitate health care services. This authority has already given a Ruling in this regard vide order No. KER16\/2018 Dt.26.09.2018 = 2018 (10) TMI 511 – AUTHORITY FOR ADVANCE RULINGS, KERALA to the effect that the supply of medicines and allied items provided <\/p>\n = = = = = = = =<\/p>\n Plain text (Extract) only<\/strong> = = = = = = = =<\/p>\n tals that are dispensing medicine to outpatients. Therefore pharmacy run by hospital dispensing medicine to outpatient or bye standers or others can be treated as individual supply of medicine and not covered under the ambit of health care services. Hence such supply of medicine and allied goods are taxable. = = = = = = = =<\/p>\n Plain text (Extract) only<\/strong> = = = = = = = =<\/p>\n","protected":false},"excerpt":{"rendered":" In Re: M\/s. Rajagiri Health Care & Education TrustGST2018 (11) TMI 278 – AUTHORITY FOR ADVANCE RULINGS, KERALA – TMIAUTHORITY FOR ADVANCE RULINGS, KERALA – AARDated:- 6-10-2018AAR No. KER\/24\/2018 GSTSHRI. B.G. KRISHNAN IRS AND SHRI B.S. THYAGARAJABABU B.Sc., LLM, MEMBER Authorized Representative: Mr. K. Sivarajan, Mr. Srihari, Mr. Shubham Mishra The applicant is a multi-specialty … Continue reading “In Re: M\/s. Rajagiri Health Care & Education Trust”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-14831","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/goodsandservicetax.in\/GST\/index.php?rest_route=\/wp\/v2\/posts\/14831","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/goodsandservicetax.in\/GST\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/goodsandservicetax.in\/GST\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/goodsandservicetax.in\/GST\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/goodsandservicetax.in\/GST\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=14831"}],"version-history":[{"count":0,"href":"https:\/\/goodsandservicetax.in\/GST\/index.php?rest_route=\/wp\/v2\/posts\/14831\/revisions"}],"wp:attachment":[{"href":"https:\/\/goodsandservicetax.in\/GST\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=14831"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/goodsandservicetax.in\/GST\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=14831"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/goodsandservicetax.in\/GST\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=14831"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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\nWhether the medicines, consumables and implants used in the course of providing health care services to patients admitted to the hospital for diagnosis or treatment would be considered as “Composite Supply” of health care services under GST and consequently exemption under Notification No.12\/2017 read with Section 8(a) of GST?
\nThe authorized representative of the applicant was heard. It is stated that, the medicines, consumables and implants used in the course of providing diagnosis or treatment to the in-patients would be part of 'composite supply' of health care services vide classification 9993. Composite supply would mean a supply made by a taxable person to a recipient consisting of two or more taxable supplies <\/p>\n
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\nNotification No.12\/2017-Central Tax exempt health care services provided by an authorized clinical establishment, The applicant is providing health care services to its patients. The medicines and surgical items supplied to the patients under medical prescription of doctors is incidental to the health services rendered in the hospital entitled to exemption being health care services. There are several decisions pertaining to the point that the supply of medicines, surgical items, etc to the patients in the course of treatment by hospital cannot be said to be sale.
\nThe issue is examined in detail. Health care services provided by a clinical establishment an authorized medical practitioner or para medics are exempted vide Sl.No.74 of Notification No.12\/2017-CT (Rate) Dt.28.06.2017. The word 'clinical establishment' means a hospital, nursing home, clinic, sanatorium or any other institut<\/p>\n
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\nGovernment of India vice Circular No.27\/01\/2018-GST Dt.04-01-2018 has clarified that room rent in hospital is exempted. As for as inpatients are concerned, room facility in a hospital is one limb of bundled service of health care. The clarifications issued based on the approval of 25th GST Council Meeting held on 18-01-2018 [F.No.354\/17\/201B-TRU Dt.12-02-2018, it was clarified that food supplied to the inpatients as advised by the doctor\/nutritionist is a pan of composite supply of health care and not separately taxable. Other supplies of food by hospital to patients not admitted are taxable. The same principle is applicable in the case of dispensing of medicine also.
\nIn view of <\/p>\n
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