TaxTMI 
TaxTMI 
2025 (9) TMI 730
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....Ruling obtained by the applicant by fraud or suppression of material facts or misrepresentation of facts, shall render such ruling to be void ab initio in accordance with Section 104 of the Act. 5. The provisions of both the Central Goods and Services Tax Act and the Tamil Nadu Goods and Services Tax Act (herein referred to as the Act) are the same except for certain provisions. Therefore, unless a mention is specifically made to such dissimilar provisions, a reference to the Central Goods and Services Tax Act would also mean a reference to the same provisions under the Tamil Nadu Goods and Services Tax Act. M/s. Theni Nattathi Kshatriya Kula Hindu Nadargal Uravinmurai Dharma Fund, No. 37, No. 12, White House Street, Theni, Tamil Nadu - 625 531 (hereinafter called as the "Applicant") are registered under the GST Act with GSTIN 33AAAAT3384M1Z8. The applicant has sought advance ruling on the following questions :- 1. Whether Consultation service and medicines supplied to out-patients attracts GST? 2. Can we treat consultation and supply of medicine to outpatient as composite supply? 3. If the above is a Composite Supply, is a single invoice required, ....
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....Mr. Lokesh. T, Accounts Executive, and Mr. Santosh Kumar S.V, Accounts Executive, appeared for the personal hearing as the authorized representatives (AR) of M/s. Theni Nattathi Kshatriya Kula Hindu Nadargal Uravinmurai Dharma Fund. They reiterated the submissions made under the Application for Advance Ruling filed by them. During the hearing, they furnished additional submissions containing copies of the relevant notifications, Doctor's prescriptions, OPD Case Sheet, Bills for consultation, Bills for medicine, etc. They stated that their trust is a charitable organisation dedicated to serving society through their hospital which provides essential healthcare services to both inpatients and outpatients. They further stated that they operate pharmacies within the hospital premises for the convenience of patients and medicines are supplied to patients only on a prescription issued by their own hospital doctors. Under these circumstances, they stated that they are of the opinion that medicines supplied to outpatients based solely on their hospital doctor's prescription is exempt from payment of GST, as the same is liable to be treated as a 'composite supply' alongwith the main supply ....
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....ith, we note that 'Health care' services provided by a clinical establishment or an authorized medical practitioner or paramedics are exempted vide Sl.No.74 of Notification No. 12/2017-C.T(Rate) dated 28.06.2017 as amended and Sl.No.74 of Notification No. II(2)/CTR/532(d-15)/2017 vide G.O.(Ms.) No. 73, dated 29.06.2017. For ease of reference, the relevant entry is given below: SI.No. Chapter, Section, Heading, Group or Service Code (Tariff) Description of Services Rate (percent) Condition 74 Heading 9993 Services by way of - a) health care services by a clinical establishment, an authorised medical practitioner or para medics; b) services provided by way of transportation of a patient in an ambulance, other than those specified in (a) above. Nil Nil "Clinical Establishment" is defined in the said notification under 2(s), as, "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 recognized system of medicines in In....
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....g and/ or maintaining the health of a patient. iii) Psychiatric services delivered under the direction of medical doctors to inpatients, aimed at curing, restoring and/or maintaining the health of a patient. iv) Other hospital services delivered under the direction of medical doctors to inpatients, aimed at curing, restoring and/or maintaining the health of a patient. These services comprise medical, pharmaceutical and para medical services, rehabilitation services, nursing services and laboratory and technical services, including radiological and anaesthesiologic services, etc. Thus, inpatient services mean services provided by hospitals to inpatients under the direction of medical doctors aimed at curing, restoring and/or maintaining the health of a patient and the service comprises of medical, pharmaceutical and paramedical services, rehabilitation services, nursing services and laboratory and technical services till the patient gets discharged. A complete gamut of activities required for well-being of a patient from admission till discharge, provided by a hospital under the direction of medical doctors is a composite supply of service and is covered under '....
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....omposite supply. Therefore, supply of medicines and consumables to in-patients in the course of the treatment till the patient is discharged is indeed a composite supply of health care services. 6.11 In this regard, it is to be noted that while providing health care related services to out-patients, medicines and consumables which is only of advisory nature, are prescribed to them by the Doctor who attends to the patient. It is also to be noted here that the pharmacy attached to the hospital/clinical establishment is an outlet to dispense medicines and consumables based on prescriptions, but in the case of out-patients, the said patients are not mandated to procure them only from the pharmacy attached to the hospital, and they are at liberty to procure the same from the hospital or other pharmacies of their choice. Whereas, in the case of in-patients, medicines and consumables are necessitated to be issued by the hospital's pharmacy to ensure timely and proper treatment, and becomes an integral part of the healthcare service provided together to the in-patients. Further, as already discussed, the clarification provided as in para 5(3) of the Circular No.32/06/2018-GST, dated 12.....