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TMI Blog2019 (11) TMI 154X X X X Extracts X X X X X X X X Extracts X X X X ..... dietary services etc. As a provider of health care service, the applicant undertakes inpatient and outpatient treatments. In this sector there is a conflict that, whether all services provided by a hospital are to be bundled as a composite service or each service and supply of goods is to be treated as individual transactions. Hence the applicant requested advance ruling on the following: * Whether the applicant, a Multi Speciality Hospital is liable to pay GST on supply of medicines, drugs and other surgical goods from its pharmacy to inpatients? * Whether the applicant, a Multi Speciality Hospital is liable to pay GST on supply of medicines, drugs and other surgical goods from its pharmacy to outpatients? * Whether the applicant is ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... ctitioner or para medics are exempted vide SI.No.74 of Notification No.12/20l7-CT (Rate) Dt.28.06.2017. The medicines, consumables and implants used in the course of providing diagnosis or treatment to the patients would be part of 'composite supply' of health care services vide classification 9993, Composite supply would mean a supply made by a taxable person to a recipient consisting of two or more taxable supplies of goods or services or both or 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. The applicant provides more than two taxable supplies such as medicines, implants, consumables etc. as part of the healt ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... mables as required, conduct of pathological tests, if necessary, conduct of X-ray/Scanning if necessary, supply of diet food etc 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, ff 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 ancillary services which help in better utility of main service. Hence the medicines, implants, room provided on rent, dietary food advised by nutritionists etc used in the course of providing health care services to the patients admitted for diagnosis or ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... and (b) a mixed supply comprising two or more supplies shall be treated as a supply of that particular supply which attracts the highest rate of tax." This authority has already given a Ruling in the case of M/s. KIMS Healthcare Management Ltd = 2018 (11) TMI 281 - AUTHORITY FOR ADVANCE RULINGS, KERALA, M/s. Rajagiri Healthcare and Education Trust = 2018 (11) TMI 278 - AUTHORITY FOR ADVANCE RULINGS, KERALA, M/s. Ernakulam Medical Centre Pvt Ltd = 2018 (10) TMI 511 - AUTHORITY FOR ADVANCE RULINGS, KERALA, M/s. Kinder Women Hospital and Fertility Centre Pvt Ltd = 2019 (5) TMI 905 - AUTHORITY FOR ADVANCE RULINGS, KERALA, M/s. Kindorama Healthcare Private Ltd = 2019 (5) TMI 960 - AUTHORITY FOR ADVANCE RULINGS, KERALA, Starcare Hospital Koz ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... e may or may not be required; the nature / taxability of supply has to be determined on a case to case basis considering the facts and circumstances of each case. Hence a genera! ruling regarding the nature or taxability of such supplies cannot be issued. In,view of the observations stated above, the following rulings are issued: * Whether the applicant, a Multi Speciality Hospital is liable to pay GST on supply of medicines, drugs and other surgical goods from its pharmacy to inpatients? The supply of medicines, drugs and other surgical goods from its pharmacy to in-patients are in the course of providing health care services which are naturally bundled and are provided in conjunction with each other, would be considered as '"Compo ..... X X X X Extracts X X X X X X X X Extracts X X X X
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