2020 (6) TMI 800 - AAAR - GST

Appellate authority denies GST exemption for diagnostic imaging services under Notification No. 12/2017-CT(R)

The appellate authority upheld the ruling of the Advance Ruling Authority (AAR) that the diagnostic imaging services provided by the appellant do not ... Exemption from GST - provisioning of diagnostic imaging services under the agreement/contract executed by Siemens Healthcare Pvt. Ltd. (SHPL) with its customers - eligible for exemption under Serial Number 74 of the Notification 12/2017-CT(R) dated 28/06/2017 or not - HELD THAT:- The exemption is to Services and not to Technicians or Doctors/ Medical Practitioners or Para-Medics or Ambulance Operators - Clearly, the case of Appellant M/s. Siemens Healthcare Pvt. Ltd. (SHPL) is not covered under ambulance services. Whether the Appellant’s services meet the dual criteria of being health care services and clinical establishment? - HELD THAT:- Obviously the services under examination are not to be provided by the Appellant as Authorised Medical Practitioner’ or as ‘Para Medics’. The appellant’s contention is that since the circular 32/6/2018-GST dated 12.02.2018 allows exemption to the technicians hired by hospitals also, the exemption is admissible to SHPL also as its technicians are to operate MRI (Magnetic Resonance Imaging) & CT (Computerized Tomography), X-Ray and Mammography machines installed in the clinical establishments (Customers of SHPL) & are to provide diagnostic images to the clinical establishments - It is observed that there are kinds of Technicians. For the exemption to be admissible, the technician’s role/ activity has to amount to Healthcare Services. Not all the technicians provide healthcare Services. It is observed that services of technicians who are ‘Emergency Medical Technicians’ or the services of technicians who are akin to Para-medics, are healthcare services. Apparently the CBIC’s circular ibid refers to such technicians only. It is observed that SHPL is providing the input services of provision of installing/operating the MRI, CT scanners etc in the premises of its Customers (clinical establishments) and providing diagnostic images to them (clinical establishments) - providing diagnostic images is not equivalent to providing diagnosis, and the services by SHPL is not an independent establishments for providing diagnostic service. To avail the benefit of the exemption all the limbs of the notification must be satisfied i.e., the services have to be health care services as defined in clause (Zg) of para 2 of the notification & the services have to be provided by clinical establishment as defined in clause (s) of para 2 of the said notification. Since the appellant is to provide its diagnostic imaging services to the clinical establishment which in turn makes use of these images provided by the appellant & with the advice/opinion of medical practitioner/pathologist/radiologist makes diagnosis & provides it to the patient, the appellant can’t be said to provide diagnosis services to the patient, & hence not eligible to the exemption. It is therefore clear that the services exempt under the Notification are healthcare services and would include diagnosis where the services are in the line of aiding diagnosis. Also, from the Applicant’s ibid submission itself in the Statement of Facts, it is obvious that the ‘Diagnosis’ is not complete unless the Radiologist gives it on the basis of images prepared by the Applicant. Also the services have not been provided to the patient. Hon’ble Supreme Court’s judgment in TATA OIL MILLS CO. LTD. VERSUS COLLECTOR OF C. EX. [1989 (8) TMI 79 - SUPREME COURT] is not applicable. In the instant case the Appellant has not pleaded that intent of the legislature is to also exempt the inputs/ input services consumed for providing the Healthcare services; nor is there any notification or clarification providing such exemption viz. to input services. Appellant’s activity remains an Input Service for providing diagnosis. The AAR has correctly held that the nature of the Applicant’s services is of input services - Appeal dismissed. Issues Involved:1. Whether the provisioning of diagnostic imaging services qualifies for exemption from GST under Notification No. 12/2017-CT(R), S. No. 74.2. Whether the services provided by the appellant are considered 'healthcare services.'3. Whether the appellant qualifies as a 'clinical establishment.'4. Whether the services provided by the appellant are input services for hospitals.5. Compliance with the stipulated time period for passing the ruling.Issue-wise Analysis:1. Exemption from GST under Notification No. 12/2017-CT(R), S. No. 74:The appellant contested the ruling by the Advance Ruling Authority (AAR) which denied GST exemption for diagnostic imaging services under Notification No. 12/2017-CT(R). The AAR ruled that the services provided did not qualify for the exemption as they were not considered 'healthcare services' under the notification.2. Definition of 'Healthcare Services':The appellant argued that their diagnostic imaging services fall under 'healthcare services' as defined in clause (zg) of the Exemption Notification, which includes services by way of diagnosis. The appellant emphasized that their services are imperative for a comprehensive and accurate diagnosis of medical conditions, thus qualifying as healthcare services. They supported their argument with definitions from the National Cancer Institute and various dictionaries, and cited judicial precedents that support a broad interpretation of tax exemptions in line with trade parlance.3. Qualification as a 'Clinical Establishment':The appellant claimed to be a clinical establishment under the definition provided in the notification, which includes entities that offer diagnostic services. However, the appellate authority found that the appellant's services are not provided by a clinical establishment but are input services for hospitals that further provide diagnostic services to patients.4. Nature of Services as Input Services:The appellate authority held that the appellant's services are input services for the hospitals, which use the diagnostic images provided by the appellant for further diagnosis by authorized medical practitioners. The authority emphasized that the services provided by the appellant are not directly to the patients but to the hospitals, which then use these services to provide healthcare to patients. The authority distinguished between healthcare services provided directly to patients and input services provided to hospitals.5. Compliance with Stipulated Time Period:The appellant argued that the AAR failed to pass the ruling within the stipulated 90 days as required under Section 98(6) of the CGST Act. The ruling was served on the appellant after 15 months, which the appellant claimed invalidated the ruling. However, the appellate authority did not find this argument sufficient to overturn the ruling.Conclusion:The appellate authority dismissed the appeal, upholding the AAR's ruling that the services provided by the appellant are input services and do not qualify for GST exemption under Notification No. 12/2017-CT(R). The authority concluded that the appellant's services do not meet the criteria of 'healthcare services' provided by a 'clinical establishment' as defined in the notification.