TMI Blog2019 (5) TMI 960X X X X Extracts X X X X X X X X Extracts X X X X ..... r any combination 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. As per Section 2(90) of the CGST Act, 2017, principal supply means the supply of goods or services which constitutes the predominant element of a composite supply and to which any other supply forming part of that composite supply is ancillary. The provision of services of supply of medicines, consumables, surgical items, items such as needles, reagents etc used in laboratory, room rent used in the course of providing health care services to in-patients and patients admitted for a day procedure such as IVF for diagnosis or treatments is a composite supply as defined i ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... mables, implants, dietary foods including surgical procedures required for the treatment As per Service Classification Code 9993, healthcare services by a clinical establishment, an authorized medical practitioner or paramedics have been exempted from tax. Accordingly, the applicant has requested advance ruling on the following: Applicant requested advance ruling on the following: Whether the supply of medicines, consumables, surgical items, items such as needles, reagents etc. used in laboratory, room rent used in the course of providing health care services to in-patients and patients admitted for a day procedure such as IVF for diagnosis or treatments which are naturally bundled and are provided in conjunction with ea ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... rally bundled in ordinary course of business. Without administering the medicines and use of the consumables or surgical items, appropriate health care service cannot be bundled, thereby exposing the in-patients to fatality. Being a composite supply, treatment is the principal supply which is predominant and the room-rent / medicines / consumables / surgical items / items such as needles, reagents etc. used in laboratory, provided to in-patients are ancillary to the main supply of health care service. The matter was examined detail. The patients visit the hospital with the basic intention of getting treatment for their ailment. Based on the severity of ailment and need for immediate or constant medical monitoring and care, the pati ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... viding health care services to in-patients and patients admitted for a day procedure such as IVF for diagnosis or treatments is a composite supply as defined in Section 2 (30) of the CGST Act, 2017 and accordingly tax liability has to be determined in accordance with Section 8 of the CGST Act, 2017. In this case the provision of health care services being the principal supply and the other supplies being dependent on the provision of health care services can only be considered as services ancillary to the provision of health care services. In view of the observations stated above, the following rulings are issued: Whether the supply of medicines, consumables, surgical items, items such as needles, reagents etc. ..... X X X X Extracts X X X X X X X X Extracts X X X X
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