2019 (5) TMI 960 - AAR - GST

Court Rules Tax Exemption for Health Care Supplies in 'Composite Supply'

In Re: M/s. Kindorama Healthcare Private Limited

In Re: M/s. Kindorama Healthcare Private Limited - 2019 (24) G.S.T.L. 804 (A. A. R. - GST) Issues Involved:Whether the supply of medicines, consumables, surgical items, etc., used in providing health care services to in-patients and patients undergoing procedures like IVF constitutes a 'Composite Supply' eligible for exemption under the category of health care services.Analysis:The case involved a healthcare company categorizing patients as in-patients and out-patients for administrative purposes. In-patients receive a range of services including accommodation, medicines, consumables, implants, dietary foods, and surgical procedures. The company sought a ruling on whether the supply of various items to in-patients and patients undergoing procedures like IVF could be considered a 'Composite Supply' eligible for tax exemption under specific provisions.The hospital's central pharmacy supplies medicines, consumables, etc., to in-patient outlets and out-patient pharmacy. In-patients receive comprehensive care, including medicines and consumables, under strict supervision until discharge. The treatment protocol for in-patients is well-documented, and all supplies are considered incidental to the health care service provided. The critical question was whether these supplies could be deemed naturally bundled in the ordinary course of business.Upon examination, it was established that in-patients are admitted for treatment under continuous monitoring by medical staff. The billing for in-patients encompasses all services utilized during the treatment, including room rent, nursing care, consumables, medicines, and doctor's fees. The provision of these services to in-patients was deemed a bundle of supplies falling under health care services.The concept of 'Composite Supply' was crucial in this case, defined as a supply comprising two or more taxable supplies naturally bundled in the ordinary course of business. The ruling clarified that the provision of medicines, consumables, surgical items, etc., to in-patients and patients undergoing procedures like IVF constituted a composite supply eligible for tax exemption under the category of health care services. The principal supply of health care services rendered to in-patients made the other supplies ancillary to the main service, emphasizing the exemption eligibility under the relevant notification.In conclusion, the judgment affirmed that the supply of medicines, consumables, surgical items, and related services to in-patients and patients undergoing specific procedures formed a composite supply eligible for exemption under the health care services category, as per the provisions and definitions outlined in the CGST Act, 2017.