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GST ON HEALTH CARE – NOT TRULY EXEMPT

Date 17 Jul 2017
Replies2 Replies
GST treatment of healthcare goods and services shapes exemption scope and input tax credit consequences for suppliers.
GST distinguishes exempt health care services from taxable medical goods: services by clinical establishments and authorised practitioners are exempt, while medicines, implants and aids are treated as taxable goods under different tariff classifications. This produces a divergence in tax incidence for patients and suppliers, and raises policy issues about the treatment of essential medical devices, the effect on non-profit suppliers, and the interaction between exemption scope and availability of input tax credit for manufacturers and traders. (AI Summary)

Health care services have been specifically kept out ride the scope of GST net. This  is a fact and a perception too. These include services provided by medical establishments, clinics, medical practitioners, diagnostic centers etc.

The exemption has been provided vide the following entry No. 77 in Notification No. 9/2017-intergrated tax (Rate) dated 28.06.2017 .

"77 Services by way of health care services by a clinical establishment, an authorised medical practitioner or para-medics."

However, medicines sold by pharmacy are subject to GST at varied rates and so are items like stents, implants etc taxed.

The general rate of medicines etc, inter alia is covered under the following classification:

Chapter No.

Items

Rate

30

Drugs or medicines including their salts and esters and diagnostic test kits, specified in List 3 or List 4 appended to the Notification No.12/2012- Customs, dated the 17th March, 2012

5%

98

9804 Specified drugs and medicines [i.e. List, 1 of Notification No. 12 / 2012-Central Excise, dated 17.03.2012 and List 3, 4 of notification No.12/2012- Customs, dated 17.03.2012] intended for personal use.

5%

98

9804 Other drugs and medicines intended for personal use.

12%

The Government has however, also taxed implants such as artificial limbs which is a necessary and integral part of health care services in relation to loss of limbs. Such artificial limb is recommended as a post health care to restore life  or to at least provide a workable living means so that one is not left to miseries. The GST shall be levied @ 5 percent (2.5% CGST + 2.5% SGST) or 5 percent IGST alongwith other items such as tricycle, wheel chair, walking aid etc. It is an irony that artificial limb has been equated to such equipments, though others are just aids. On the contrary, artificial limb is fitted to a body part.

The rates of GST on implants is @ 5% as per following classification:

  1. Coronary stents and coronary stent systems for use with cardiac catheters.
  2. Artificial kidney
  3. Disposable sterilized dialyzer or micro-barrier of artificial kidney
  4. Parts of the following goods, namely:-
  1. Crutches;
  2. Wheel chairs;
  3. Walking frames;
  4. Tricycles;
  5. Braillers; and
  6. Artificial limbs

Shockingly, all there items have been taxed but deserve to have been exempt fully. These are not luxury or cosmetic items meant for human consumption. Moreover, a large number of non-profit organizations are engaged in free or concessional supply of such goods.

There could be an argument that many big or corporate hospitals are also engaged in such supplies and charge a huge amount for this. But then, if we can tax hotels and restaurants at different tax rates based on categories on the basis of 'ability to pay', who stops the Government from adopting the same formula here. Tax big hospitals but spare such supplies generally. Tax officers, also human beings, must understand this and act upon. They are too answerable, atleast to God.  

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