TMI Blog2019 (3) TMI 757X X X X Extracts X X X X X X X X Extracts X X X X ..... ee, etc. Thus, it is clear that in case of an inpatients the hospital has provided a bundle of supplies which is classifiable under h care services. Supply of medicines and allied items provided by the hospital through the pharmacy to the out-patients - Held that:- On analysis of the case sheet and the invoices raised in respect of an outpatient, it can be seen that even though the invoice is named as OP SERVICES-CASH , the invoice is raised only for supply of medicines and no consultation charges are seen raised in the invoice. Thus, in case of outpatient. the doctor's consultation and supply of medicines are not bundled together - In case of outpatients, it is the choice of the patient whether to follow the medical advice given by the doctor or not. Neither the hospital nor the consulting doctors can coerce the patient to follow the medical advice given by the doctor. Thus, in certainty, it can be established that the medical care other than the doctor's consultation is outside the control of the hospital. Neither the consulting doctor nor the hospital has any control on the patienes medical care. In case of outpatients, the health care service provided by the hosp ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... etc., to the patients in the course of treatment by hospital cannot be said to be sale. 3. The Authority for Advance Ruling had deliberated on the issue raised and after hearing the authorized representative of the applicant elaborated as follows; 3.1. Health care services provided by a clinical establishment or an authorized medical practitioner or para medics are exempted vide Sl.No.74 of Notification No. 12/2017-CT-(Rate) dated 28.06.2017. The word clinical establishment means a hospital, nursing home, clinic, sanatorium or any other institution by. whatever name called, that offers services or facilities requiring diagnosis or treatment or care for illness, injury, deformity, abnormality or pregnancy in any recognized system of medicines in India or a place established as an independent entity or a part of an establishment to carry out diagnostic or investigative services of diseases. 3.2. Pharmacy is an outlet to dispense medicines or allied items based on prescription. 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 ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... ellant preferred appeal vide paper read 2nd above, before the Appellate Authority for Advance Ruling. The appellant has stated that the ruling by the Advance ruling Authority is opposed to law, facts, circumstances and the legislative intent behind the exemption granted vide Notification No. 12/2017-CT(Rate) dated (Sl. No. 74). GROUNDS OF APPEAL 7. The authorized representative of the appellant has stated that the Authority for Advance Ruling has erred in ruling that the supply of medicines and allied items by the Hospital through the pharmacy to the outpatients is taxable. He further contented that Advance Ruling Authority ought not to have relied on the clarification issued based on the decisions of the 25th GST Council meeting held on 18.01.2018 to the effect that supplies of food by hospital to patients not admitted or their attendants or visitor are taxable . The authority missed to note that the supplies of medicines to outpatients under the prescription of the medical officers of the hospital cannot be equated with supplies of food by hospital to patients or their attendants. Outpatients may purchase food from the canteens or other food outlets at their will and ple ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... SSIONS AND FINDINGS 8. The Appellate Authority heard the authorized representative of the appellant. During the personal hearing, the authorized representative reiterated the contentions raised in the grounds of appeal. Further, he produced the case sheets and invoices raised on inpatients and outpatients, who underwent treatment in the hospital. He further deposed that the pharmacy has been maintained for providing medicines to patients (inpatient and outpatient) who consult the medical officers on appointment. No medicine can be supplied to any customer from outside without consulting the doctors in the hospital after taking admission as per hospital card issued. Often in the case of inpatients, after discharge from the hospital also, periodical consultation of doctors and supply of medicines under their prescription is made. The findings of the authority for advance ruling placing reliance on the clarification dated 18.01.2018 issued by the 25th GST Council is absolutely illegal. The above clarification has specifically exempted the entire amount of hospital charges realized for health care services without segregating inpatients or outpatients. However, Para 5(3) of the abo ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... heir prescription is made. In such instances, whether the inpatient after discharge from the hospital comes back for periodical follow up consultation is at his own discretion, which is outside the control of the hospital. The hospital in no way can insist that the medicines should be purchased from the pharmacy run by the hospital. Further, on scrutiny of the invoice submitted along with the case sheet of an inpatient, who has undergone further periodical consultation, it can be seen that even though the invoice is named as OP SERVICES-CASH , the invoice is raised only for supply of medicines and no consultation charges are seen raised in the invoice. From this it is evident that there is no bundling of supplies but clearly differentiable supplies one of which is supply of medicines, which is a taxable supply under GST. 12. Further, on analysis of the case sheet and the invoices raised in respect of an outpatient, it can be seen that even though the invoice is named as OP SERVICES-CASH , the invoice is raised only for supply of medicines and no consultation charges are seen raised in the invoice. Thus, in case of outpatient. the doctor's consultation and supply of medicin ..... X X X X Extracts X X X X X X X X Extracts X X X X
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