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TMI Blog2018 (11) TMI 278X X X X Extracts X X X X X X X X Extracts X X X X ..... uma. As far as an inpatient is concerned, hospital is expected to provide lodging, care, medicine and food as part of treatment under supervision till discharge from the hospital. The nature of the various services in a bundle of services will help in determining whether the services are bundled in the ordinary course of business - the medicine and allied goods supplied to inpatient are indispensable items of the treatment and it is a composite supply to facilitate health care services. Pharmacy is an outlet to dispense medicines or allied items based on prescription. The in-patient pharmacy and operation theater pharmacy supplied medicines and consumables only to in-patients. Whereas an outpatient is concerned, hospital gives only presc ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... medicines, consumables, implants, dietary food and other surgeries/ procedures required for the treatment. The Central store of the hospital procures stocks of medicines, implants, consumables etc from various suppliers and distribute to its outlets such as in-patient pharmacy, operation theater pharmacy and out-patient pharmacy based on the indent issued. The in-patient pharmacy and operation theater pharmacy supplied medicines, implants and consumables only to in-patients. Whereas the out-patient pharmacy attached to the hospital entertain the medical prescription of out-patients and outside customers with valid prescription. The medicines, consumables and implants used in the course of providing health care services to the patie ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... tion thereof, which are naturally bundled and supplied in conjunction with each other in the ordinary course of business, one of which is a principal supply. The applicant provides more than two taxable supplies such as room rent, medicines, dietary food, consumables etc along with health care treatment to in-patients. Supplies of these services are part and parcel of the treatment and they are essentially required to provide health care services. These are naturally bundled in the ordinary course of business. Bundled service means a bundle of provision of various services wherein an element of provision of one service is combined with an element or elements of provision of any other service or services. The medicines, consumables, imp ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... nt to carry out diagnostic or investigative services of diseases. The in-patient services are classified as exempted service under the sub-group 9993 11. Patients are only admitted to a hospital when they are extremely ill or have severe physical trauma. As far as an inpatient is concerned, hospital is expected to provide lodging, care, medicine and food as part of treatment under supervision till discharge from the hospital. The nature of the various services in a bundle of services will help in determining whether the services are bundled in the ordinary course of business. If the nature of services is such that one of the services is the main service and other services combined with such service are in the nature of incidental or anci ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... m to procure the medicines or allied items prescribed, either from the pharmacy run by the hospital or from any other medicine dispensing outlets. Hospital reserves no control over his continuous treatment. As far as an outpatient is concerned there is no difference for procuring medicine either from the dispensing outlet within the hospital or from outside the hospital. In both places medicines dispensed based on prescription. Hence there is no privilege for the hospitals 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 medici ..... X X X X Extracts X X X X X X X X Extracts X X X X
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