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2020 (7) TMI 380

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..... g) of para 2 of Notification no. 12/2017 - Central Tax (Rate) Date: 28.06.2017, defines service by way of diagnosis, or treatment or care for illness, injury, deformity, abnormality or pregnancy in any recognised system of medicines in India. In common parlance, when one looks into the definition, 'the treatment or care' extended by hospital can be thought of devoid of medicines, relevant consumable, or implants, by no stretch of imagination. The supply of medicines and the consumables are integral part of the treatment extended to the in-patients by the hospital - the services rendered by the applicant is a composite supply as defined under section 2(30) of CGST Act, 2017 in which the principal supply is health care, being predomin .....

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..... oods and Services Tax Act, 2017) 1. The present application has been filed u/s 97 of the Central Goods Services Tax Act, 2017 and AP Goods Services Tax Act, 2017 (hereinafter referred to CGST Act and APGST Act respectively) by M/s CMC Vellore Association, (hereinafter referred to as applicant), registered under the Goods Services Tax. 2. The provisions of the CGST Act and APGST Act are identical, except for certain provisions. Therefore, unless a specific mention of the dissimilar provision is made, a reference to the CGST Act would also mean a reference to the same provision under the APGST Act. Further, henceforth, for the purposes of this Advance Ruling, a reference to such a similar provision under the CGST or AP GST Ac .....

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..... pharmacy, operation theatre pharmacy and out-patient pharmacy based on the indent issued. The in-patient pharmacy and operation theatre pharmacy supply medicines, implants and consumables only to in-patients. Whereas the out-patient pharmacy attached to the hospital entertain the medical prescription of out-patients. The medicines, consumables and implants used in the course of providing health care services to the patients admitted for diagnosis or treatment in the hospital or clinical establishment is naturally bundled in ordinary course of business. The patients are expected to receive health care services which include receiving the appropriate medicine, relevant consumables, or implants required to make sure that appropriate diagnos .....

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..... ght by the applicant. 5. Applicant's Interpretation of Law and Facts: i) Health care Services: 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 resolve of to reconstruct anatomy or functions of body affected due to congenital defects, developmental abnormalities, injury or trauma. ii) Clinical establishment: The word 'clinical establishment' means a hospital, nursing home, clinic, sa .....

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..... 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. ii) The supply of medicines and allied items provided by the hospital through the pharmacy to the out-patients is taxable. In GST scenario health care services by a clinical establishment, an authorized medical practitioner or para medics have been exempted vide classification 9993. 6. Record of Personal Hearing: The authorized representatives of the applicant, CA Theresa D, FCA and CA P. Venkataraju, FCA appeared for Personal Hearing on 23.10.2019 and they reiterated the submission already made in the application. 7. Discussion and Findings: We hav .....

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..... mposite supply as defined under section 2(30) of CGST Act, 2017 in which the principal supply is health care, being predominant and the supply of medicines, drugs, implants, stents, and other consumables, come under ancillary supplies and accordingly tax liability has to be determined under section 8 of CGST Act, 2017. Since the entry of Services by way of - a) health care services by a clinical establishment, and authorised medical practitioner or para-medics; at Sl.No. 74 Heading 9993 vide Notification No 12/2017 - Central Tax (Rate) Date: 28.06.2017 is nil rated, the supply of medicines, drugs, implants, stents, and other consumables are exempted from liability under GST. Even the Circular No.32/06/2018-GST (F.No.354/17/2018-TR .....

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