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TMI Blog2022 (6) TMI 34X X X X Extracts X X X X X X X X Extracts X X X X ..... on hospital's payroll, working in different corporate for providing health check-up service, ambulance facility, and allied medical services to their employees and also the camps conducted for health check-up outside the hospitals, to be treated as Health Care service and hence not taxable under CGST / SGST? 3. The GAAR, vide Advance Ruling No. GUJ/GAAR/R/106/2020 dated 30.12.2020 has ruled as follows - (i) The supply of medicines, surgical items, implants, consumables and other allied items provided by the hospital through their hospital inhouse pharmacy used in the course of providing health care services as well as supply of food and room on rent to in-patients admitted to the hospital for diagnosis or medical treatment or procedures is a composite supply of In-Patient Healthcare Service. Supply of inpatient health care services by the applicant hospital as defined in Para 2(zg) of the Notification No. 12/2017-Central Tax (Rate) dated 28.06.2017, as amended, is exempted from CGST as per Sl. No. 74 of the above Notification. (ii) The applicant will be liable to pay GST @ 18% (CGST @9% + SGST 9%) on the payment received directly from the business entity for health services p ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... p and prevention is being provided by the appellant to the business entities. 5.4 The appellant has submitted that the impugned advance ruling provides for classification of occupational health check up under 'Human Health and Social Care Services' in terms of Sr. No. 31 of the table of Notification No. 11/2017Central Tax (Rate) dated 28.06.2017. The appellant has referred to the explanatory notes to the scheme of classification of services related to "Human health services" (Group 99931) and has submitted that services provided by the appellant merit classification under Service Code 999312 as far as occupational health - check ups are concerned as the said Service Code is wide enough to consist general medical services consisting of the prevention, diagnosis and treatment by doctors of medicine of physical and / or mental diseases, such as : (a) consultations; (b) physical check-ups, etc. It has been submitted that the Board has given specific note for this SAC (Services Accounting Code), specifically mentioning that these services are not limited to specified or particular conditions, diseases or anatomical regions; that they can be provided in general practitioners' practices ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... pellant has referred to the definition of "health care services" given at clause (zg) of Para 2 of Notification No. 12/2017-Central Tax (Rate) dated 28.06.2017. The appellant has also referred to various rules of Draft Occupational Safety, Health and Working Condition (Central) Rules, 2020, and has submitted that the entire scheme and objective of Occupational Health Check up is medical examination of a patient. It is further submitted that when it is a case of medical examination of a patient, the word 'diagnosis' defined in various dictionaries is broad enough to include occupational health check up. 6.3 The appellant has further submitted that the word 'care' includes preventive care as well, wherein the measures are taken to prevent disease from occurring rather than curing them and occupational health checkup is also focused on the same along with diagnosing the disease. 6.4 The appellant has also submitted that in order to be eligible to claim benefit of exemption, what is important is that the above said Health Care Services must be supplied by a clinical establishment, an authorized medical practitioner or paramedics and not to whom, as it can also be provided to firms, s ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... shall agree to provide round the clock Doctors, Nurses, medical assistants, Paramedical staff / personnel, etc. for offering treatment , diagnosis , allied healthcare services to the recipient of supply on their site; that the number of such personnel deployed may be varied based on the needs of the recipient of supply. It has been submitted that accordingly, the consideration will be based on the requirements of the recipient of supply. It has further been submitted that these personnel's may be deployed throughout in all shifts including holidays and shall look after emergencies, medical treatment, medical Check-ups, etc. of the employees of the recipient unit. These contracts may include providing of Doctors, Nurses other para medical staff / personnel, etc. of the Appellant. 9. The appellant has requested to grant exemption as per Entry No. 74 of Notification No. 12/2017-Central Tax (Rate) dated 28.06.2017. 10. There has been change in one of the two Members of this authority consequent upon the transfer and posting of the Chief Commissioner, Gujarat Goods and Services Tax, after Personal Hearing has been held in this case. The appellant was therefore given fresh hearing on ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... s per any law for the time being in force;" "(s) "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 recognised 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;" "(zg) "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 restore or to reconstruct anatomy or functions of body affected due to congenital defects, developmental abnormalities, injury or trauma;" 14.1 The appellant under their proposed agreement of Occupational Health Checkups will provide round the clock Doctors, Nurses, medical assistants, Paramedical staff etc ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... practices and also delivered by outpatient clinics, at home, in firms , schools etc. or by phone, internet or other means" The services to be provided by the appellant very well covers under the referred code. And that the above entry specifically merits classification at Entry No. 74 of Notification No. 12/2017-Central Tax (Rate) dated 28.06.2017 as the said Service Code is wide enough to cover general medical services consisting of the prevention, diagnosis and care and they can be provided in general practitioner's practices and also delivered by outpatient clinics at home, in firms, schools etc or by phone, internet or other means. 14.4 It is clear that objective of medical examination is diagnosis. The definition of diagnosis, as per Cambridge dictionary means a judgement about what particular illness or problem is, made after examining and as per freedictionary.com is the act of process of identifying or determining the nature and cause of a disease or injury through evaluation of patient's history, examination and review of laboratory data, are broad enough to include occupational health check -ups within the meaning of word diagnosis. Further, occupational health check ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... 999331 Residential care services for children suffering from mental retardation, mental health illnesses or substance abuse 618 999332 Other social services with accommodation for children 619 999333 Residential care services for adults suffering from mental retardation, mental health illnesses or substance abuse 620 999334 Other social services with accommodation for adults 621 Group 99934 Social services without accommodation for the elderly and disabled 622 999341 Vocational rehabilitation services 623 999349 Other social services without accommodation for the elderly and disabled nowhere else classified 624 Group 99935 Other social services without accommodation 625 999351 Child day-care services 626 999352 Guidance and counseling services nowhere else classified related to children 627 999353 Welfare services without accommodation 628 999359 Other social services without accommodation nowhere else classified We find that GAAR has classified the service under major heading 9993 as mentioned at Sr.31 the Notification No. 11/2017-CT (Rate) dated 28.0 ..... 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