TMI Blog2023 (3) TMI 1318X X X X Extracts X X X X X X X X Extracts X X X X ..... with contract of taking a space with all amenities related to the Gastroenterological department or in other words M/s Asian will enter into a contract with M/s ARPK to outsource the supply of doctors (specialists)/ nurses and other staff. Further, it is also observed that the applicant who is a company will render its specialized services at the premises of M/s Asian hospital Faridabad, who are the recipient of the services, and the applicant will supply the services to consumers/ patients who don't make payment to the applicant. The applicant is paid only by the recipient of the services (M/s Asian). Here it can be said that the services are rendered by one company to another company/ hospital and one of them is supplier and another is recipient of the services. It needs to be seen, what is the legislative intention behind any exemption of tax given under the GST Act i.e. the purpose for not taxing the healthcare services is to give benefit to the common man/patients as it (Healthcare services) is one of the basic necessities of life. Similarly in the field of education i.e. School/College/University tuition fees is exempted whereas the tuition fees charged by the coac ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... he provisions of the Act. The applicant has generated CPIN with reference to the applicable fee of Rs. 10,000/- under both the Acts. As the applicant is not registered under the HGST Act, 2017 so he could not raise DRC-03. The matter is being examined on merits by the authority. Statement of facts as per ARA-01:- M/s ARPK Healthcare Private Limited is providing Health Care Services as defined in clause (zg) of the notification number 12/2017 dt. 28.06.2017. Similarly, M/s Asian Institute of Medical Science (a unit of Blue Sapphire Healthcare Private Limited) is providing Healthcare Services as defined in clause (zg) of notification no. 12/2017 dated 28.06.2017. M/s ARPK has approached to M/s Asian Institute of Medical Science, Faridabad that authorised medical practitioner employed in M/s ARPK Healthcare Provide Ltd. will provide Gastroenterologist services (Healthcare Services) to the patients of M/s Asian. Fee/Charges of Gastroenterologist services will be paid by patient to M/s Asian Hospital. Thereafter M/s Asian will pay to M/s ARPK for the services rendered by them to the patients of M/s Asian Hospital. Both M/s Asian hospital and M/s ARPK healthcare will share the ch ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... ecognized by law in India and includes a medical professional having the requisite qualification to practice in any recognized system of medicines in India as per any law for the time being in force, The circular No. 32/06/2018-GST New Delhi, 12th February 2018 was issued for clarifications regarding GST in respect of certain services including levy of GST on Healthcare Services. The relevant portion of above circular is as: Sr. No. Issue Clarification 5 Is GST leviable in following cases: (1) Hospitals hire senior doctors/ consultants/technicians independently, without any contract of such persons with the patient, and pay them consultancy dated 28.06.2017 as amended refers], charges, without there being any employer relationship. Will 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? (2) Retention money: Hospitals charge the patients, say, Rs. 10000/-and pay to the consultants/ technicians only Rs. 7500/- and keep the balance for providing ancillar ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... unced by the authority of Karnataka state on 30th September, 2019 in the case of Matrix Imaging Solutions India Private Limited [Advance Ruling No. KAR ADRG 105/2019, dated September 30, 2019. Facts of the case to some extents are same as in our case. In this ruling it was held that such fee/charges for healthcare services are exempt under GST. Queries on which Advance Ruling has been sought:- 1. Whether Fee/ charges received by M/s ARPK Healthcare from M/s Asian Hospital is exempted under the provisions of the GST Act, 2017? 2. Whether Fee/charges for Health Care Services received by M/s Asian is exempted under the provisions of the GST Act, 2017? PERSONAL HEARING: On 11.10.2022 Sh. Rajesh Kumar, Chartered Account presented the matter before the authority on behalf of the applicant and enumerated the detail facts of the case. The applicant has also submitted as following on 20.12.2022:- 1. Both of directors of the M/s ARPK Healthcare Private Limited Company are Authorized medical practitioner. The name of both of directors are (1) Dr. Ruchika Miglani (2) Dr. Amit Miglani. Both of them are MBBS doctor and registered with medical Council. Both are providing ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... viding medical services under the Clinical Establishment (Registration/Regulation) Act, 2010 and the applicant company is planning to execute a contract with M/s Asian Hospital Pvt. Ltd., Faridabad (recipient of the services) to supply the services related to the human resources in the form of' Doctors/nurses/other staff. The applicant will be overall incharge of the gastroenterology department of the recipient of services i.e. M/s Asian Hospital. Primarily, the applicant has raised the query that whether the said supply of services through an agreement/contract to M/s Asian Hospital falls under the category of health care services (SAC 9993) or not? And whether the consideration to be received by the applicant from the Asian Hospital as to be agreed upon by both parties(the contract is yet to be executed) is eligible for exemption under Sr. No 74 of Notification No 12/2017/CT(R) dated 28 June, 201 7 as amended? Before proceeding further to decipher the issue at hand, it is worthwhile to go through the legal provisions as applicable in the present case. (A) Relevant provisions of the CGST Act, 2017 are reproduced as under: Section 7 (Scope of supply) - (1) For the ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... supply; Section 2(93) recipient of supply of goods or services or both, means- (a) where a consideration is payable for the supply of goods or services or both, the person who is liable to pay that consideration; (b) where no consideration is payable for the supply of goods, the person to whom the goods are delivered or made available, or to whom possession or use of the goods is given or made available; and (c) where no consideration is payable for the supply of a service, the person to whom the service is rendered, and any reference to a person to whom a supply is made shall be construed as a reference to the recipient of the supply and shall include an agent acting as such on behalf of the recipient in relation to the goods or services or both supplied; Section 2 (102) services means anything other than goods, money and securities but includes activities relating to the use of money or its conversion by cash or by any other mode, from one form, currency or denomination, to another form, currency or denomination for which a separate consideration is charged; Section 2 (105) supplier in relation to any goods or services or both, shall mean the person ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... ith the diagnosis or treatment of diseases where pathological, bacteriological, genetic, radiological, chemical, biological investigations or other diagnostic or investigative services with the aid of laboratory or other medical equipment, are usually carried on, established and administered or maintained by any person or body of persons, whether incorporated or not, And shall include a clinical establishment owned, controlled or managed by,- (a) The Government or a department of the Government; (b) A trust, whether public or private; (c) A corporation(including a society) registered under a Central, Provincial or State Act, whether or not owned by the Government; (d) A local authority; and (e) A single doctor, But does not include the clinical establishments owned, controlled or managed by the Armed Forces. D. Further, Entry No 74 of Notification 12/2017-CT (R) dated 28 June, 2017 is as under:- 74 Heading Services by way of- Rate Condition 9993 (a) Health care services by a clinical establ ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... tial and M/s ARPK). The above procedure can be divided in two parts- In the first part M/s Asian Hospital Private Ltd. will provide healthcare services to the patients through the doctors hired/outsourced by it form M/s ARPK. In second pail, it can be said that the infrastructure including apparatus and instruments etc. established by M/s Asian Hospital is outsourced to M/s ARPK Healthcare Private Ltd. Therefore the services provided by M/s Asian Hospital Private Ltd. are covered under the definition of Healthcare Service as defined under clauses 'zg', 's' and 'k' of the notification no. 12/2017. But the outsourcing of infrastructure by M/s Asian Hospital to M/s ARPK Healthcare Private Ltd. is not covered under these definitions, Therefore, the charges/fee paid to M/s Asian Hospital for the said outsourcings of infrastructure are not exempted under the notification no. 12/2017-CT (R) dated 28.06.2017. In the case at hand, the Applicant has stated that authorised medical practitioner employed in M/s ARPK Healthcare Provide Ltd. will provide Gastroenterologist services (Healthcare Services) to the patients of M/s Asian. So, M/s Asian will pay to M/s AR ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... inical establishment only if it is involved in treating the patients as defined under the definition (of the healthcare services) of the notification issued under the Act ibid but it becomes a supplier of specialized man power if it act differentially as it's in the present case. 2. M/s Asian Hospital outsourced its requirements of specialized doctors particularly for the gastroenterological services from the applicant company and not treating the patient by itself as a clinical establishment. The exemption claimed by the applicant is available as per the entry of the said notification only when the clinical establishment itself provides this service (treatment related to gastroenterological problems) as a part of health care services to the in-patients as well as out-patients and the same is not available when such supply of services provided by a third party as a contractual arrangement. In this regard, we need to see what is the legislative intention behind any exemption of tax given under the GST Act i.e. the purpose for not taxing the healthcare services is to give benefit to the common man/patients as it (Healthcare services) is one of the basic necessities of li ..... X X X X Extracts X X X X X X X X Extracts X X X X
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