2018 (9) TMI 2102 - AAR - GST

Levy of GST - Healthcare services or not - Doctor's Consultancy to the various categories of people - Tests and Scans to the various categories of people for IPD and /or OPD cases - Admission charges, Bed Charges, Operation Charges, Sundry Charges, etc - Medicine Dispensation to In-Patients - whether GST needs to be paid on supplies to Non-Employees for consideration only (with ITC on inward supplies) or GST needs to be paid on supplies made to employees without consideration as well? - Medicine Despensation to other patients - supplies to Non-Employees for consideration only (with ITC on inward supplies) or GST - Preventive Health Check-up. HELD THAT - The services provided by the applicant falls under the category of the service Health Care Services . Pertaining to the services provided by the Applicant to their Employees and their dependents ,it is observed that the Applicant run hospital is as per terms of employment contract and part of CTC.As this is a part of facility for employee in terms of contract of employment, it cannot be treated as service provided by employer to employee and hence may not subject to GST. This view is also supported by Press release issued by CBEC on 10.07.2017. Supply of Drugs and Medicines is a Taxable Supply under the GST Act and the rates are accordingly prescribed under Chapter 30 and Heading 9804 of the GST Tariff - Human Health Care and Social service is also a Taxable Supply under the GST Act and the rates are accordingly prescribed under the Heading 9993 of the GST Tariff - But vide SI No. 74 of Notification NO. 12/2017-Central Tax (Rates), dated 28.06.2017 Health Care Services are exempted from levy of GST. Services provided to non-employees - HELD THAT - Doctor's Consultancy services provided in the hospital is an activity for diagnosis or treatment or care for illness, injury, etc. Hence, it is covered by the definition of Health Care Services and accordingly not chargeable to GST - Test and Scan services provided in the hospital is an integral part for diagnosis or treatment or care for illness, injury, etc. Hence, it is covered by the definition of Health Care Services and accordingly not chargeable to GST - Admission Charges, Bed Charges, Operation Charges, Sundry Charges, etc. recovered from patients is towards miscellaneous facility provided in the hospital which is directly linked to treatment of illness, injury, etc. Hence, it is covered by the definition of Health Care Services and accordingly not chargeable to GST - Medicine Dispensation to In-Patients is in the course of treatment or care for illness, injury, etc. Hence it is covered by the definition of Health Care Services and accordingly not chargeable to GST - Medicine Dispensation to Other Patients after the consultancy from Doctor's is also in the course of treatment or care for illness, injury, etc. Hence it is covered by the definition of Health Care Services and accordingly not chargeable to GST - Preventive Health Check-up is a preliminary investigation process for diagnosis of illness. Hence it is covered by the definition of Health Care Services and accordingly not chargeable to GST. The activities undertaken by the applicant fall under Health Care Services as defined clause 2(zg) of the Notification issued under Union Territory Goods Service Tax Act, 2017. Health Care Services are exempted from levy of GST vide Circular No. 354/ 17/2018-TRU dated 12.02.2018.

Issues Involved:
1. Taxability of Doctor's Consultancy under GST.
2. Taxability of Tests and Scans under GST.
3. Taxability of Admission Charges, Bed Charges, Operation Charges, Sundry Charges, etc., under GST.
4. Taxability of Medicine Dispensation to In-Patients under GST.
5. Taxability of Medicine Dispensation to Other Patients under GST.
6. Taxability of Preventive Health Check-up under GST.

Detailed Analysis:

1. Taxability of Doctor's Consultancy:
The applicant sought to determine whether Doctor's Consultancy provided to various categories of people is taxable under GST. The ruling concluded that Doctor's Consultancy services provided in the hospital for diagnosis, treatment, or care for illness or injury fall under the definition of "Health Care Services" and are accordingly not chargeable to GST.

2. Taxability of Tests and Scans:
The applicant inquired about the taxability of Tests and Scans for IPD and OPD cases. The ruling clarified that these services are integral to the diagnosis, treatment, or care for illness or injury. Consequently, they fall under "Health Care Services" and are not subject to GST.

3. Taxability of Admission Charges, Bed Charges, Operation Charges, Sundry Charges, etc.:
The applicant sought clarification on whether these charges are taxable under GST. The ruling stated that these charges are directly linked to the treatment of illness or injury and, as such, fall under "Health Care Services." Therefore, they are exempt from GST.

4. Taxability of Medicine Dispensation to In-Patients:
The applicant questioned the GST applicability on medicine dispensation to in-patients. The ruling affirmed that this service is part of the treatment or care for illness or injury, thus falling under "Health Care Services" and exempt from GST. The ruling further clarified that if considered separately, medicine dispensation could be seen as a composite supply where the principal supply is health care services, which are exempt from GST.

5. Taxability of Medicine Dispensation to Other Patients:
The applicant sought clarity on the taxability of medicine dispensation to other patients. The ruling concluded that this service, following a doctor's consultation, is part of the treatment or care for illness or injury. It falls under "Health Care Services" and is not chargeable to GST.

6. Taxability of Preventive Health Check-up:
The applicant inquired about the taxability of preventive health check-ups. The ruling stated that preventive health check-ups are preliminary investigations for diagnosing illness, thus falling under "Health Care Services" and exempt from GST.

Conclusion:
The Advance Ruling Authority concluded that all the services provided by the applicant, including Doctor's Consultancy, Tests and Scans, Admission Charges, Bed Charges, Operation Charges, Sundry Charges, Medicine Dispensation to In-Patients and Other Patients, and Preventive Health Check-ups, fall under the category of "Health Care Services" and are exempt from GST as per Notification No. 12/2017-Central Tax (Rates) and Circular No. 32/06/2018-GST.

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