TaxTMI 
TaxTMI 
2026 (6) TMI 176
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....nbsp;04/2013 dated 29.04.2013 SCN No.16/2008/ST dt. 05.03.2008 SCN No. 36/2008/ST dt. 21.04.2008 SCN No. 87/2002/ST dt. 12.08.2008 01.10.2002 to 31.03.2007 April 2007 to September 2007 October 2007 to June 2008 38,04,382/- 6,85,218/- 12,12,718/- 2 ST/27661/2013 OIA 03- 04/2013 dated 29.04.2013 SCN No. 36/2008/ST dt. 21.04.2008 01.07.2008 to 31.03.2009 9,41,787/- 3 ST/20325/2024 OIO No. 42-49/2021- 22/ST/COMMR dated 30.03.2022 SCN No. 10/2010/ST dt. 09.02.2010 April 2009 to September 2009 6,74,688/- 4 ST/20329/2024 SCN No. 221/2010/ST dt. 02.12.2010 October 2009 to March 2010 9,20,176/- 5 ST/20331/2024 SCN No. 114/2011/ST dt. 24.08.2011 April....
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...., the present appeals are against the respective orders. 3. At the outset, the learned advocate for the appellant has submitted that appellant is engaged in the activity of providing healthcare services popularly known as Nagarjuna Ayurveda Hospital. They undertake specialized treatment for various ailments and treatments which are carried out by qualified Medical Professionals and Therapists under the Ayurvedic System of Medicine. The learned advocate has submitted that before the authorities below they have categorically argued that the services provided by them do not fall under the category of 'Health and Fitness Service' as defined under Section 65(51) of the Finance Act,1994, instead they are providing Healthcare Services following the Ayurvedic System of Medicine. They produced evidences to substantiate their claim of providing healthcare services which include the case-sheet of patients who had undergone treatments, invoices issued to the patients, registration certificates issued by the local authority accepting the appellant as a Ayurvedic Hospital, details of medical professional and qualified therapist and such other evidences which clearly prove that the appellant i....
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....er reasoning as to how the activity undertaken by the appellant could be classified as "Health and Fitness Services", despite the materials placed on record by the appellant. When the documents placed on record by the appellant, show that therapeutic and prophylactic care is provided by the appellant to its patients, the adjudicating authority should have adverted to the same, and to have given proper reasons to the conclusions in the impugned orders. • The appellant apart from placing on record documents relating to the treatment undergone by the patients in the Hospital, also produce materials showing the facilities and protocols followed by the appellant. The documents also included that pertaining to certifications, accreditations, awards, etc., which clearly prove that the appellant is a fullfledged Ayurvedic Hospital providing Healthcare Services following the Ayurvedic System of Medicine. • The lack of reasoning and non-consideration of the documents placed on record in the operative portion of the order of the Commissioner dated 30.03.2022, was addressed by the appellant through the rectification petitions. The summary....
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....uppression. When it is the case of the appellant right from the investigation stage that it provides only Healthcare Services and not "Health & Fitness Services", it could not be said that the conditions of Section 78 are satisfied in the facts and circumstances of the case. 4. He has further submitted that the evidences that has been considered by the Tribunal in the case of Commissioner of Central Excise, Cochin vs. Coconut Lagoon Kumarakom: 2019 (21) GSTL 548 (Tri.-Bang.) in holding that when therapeutic treatments are provided under ayurvedic system be considered as Ayurvedic Treatment Centre and not as Health and Fitness service as defined under Section 65(51) of the Finance Act, 1994 was not considered by the Learned Commissioner. Also, they referred to the judgment of the Hon'ble Andhra Pradesh in the case of Manthena Satyanarana Raju Charitable Trust vs. Union of India: 2017 (3) GSTL 213 (AP) wherein providing of naturopathy therapy has been considered as clinical establishment and exemption under Notification No.25/2012-ST dated 30.06.2012 has been extended. 5. Learned Authorised Representative (AR) for the Revenue reiterating the findings of the au....
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....ital engaged in the treatment of serious, acute or life-threatening medical conditions and instead reflects a clientele seeking relief from lifestyle related discomforts. Further, he has submitted that across the discharge summaries, the complaints are overwhelmingly functional and lifestyle oriented, such as neck pain, shoulder pain, low back pain, joint stiffness, body ache, acidity, sleep disturbance and stress. There is no evidence of emergency admission, acute infection, trauma or serious systemic disease warranting hospitalization as a matter of medical necessity. 7. He has submitted that diagnoses recorded such as Greevagraha, Katigraha, Sandhigata Vata, Apabahukam and Agnimandhya are indicative of musculoskeletal, degenerative or lifestyle related conditions causing discomfort and stiffness, rather than acute or serious illnesses. The nature of treatment administered further confirms the true character of the services rendered. The treatments predominantly consists of massage centric Panchakarma therapies such as Abhyangam, Elakizhi or Podikizhi, Pizhichil, Njavara, Dhanyamladhara and Sirodhara. Further, he has submitted that a review of Samanya Pareeksha (General ....
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....rs conferred by sub-section (1) of section 93 of the Finance Act, 1994 (32 of 1994) (hereinafter referred to as the said Act) and in supersession of notification number 12/2012-Service Tax, dated the 17th March, 2012, published in the Gazette of India, Extraordinary, Part II, Section 3, Sub-section (i) vide number G.S.R. 210(E), dated the 17th March, 2012, the Central Government, being satisfied that it is necessary in the public interest so to do, hereby exempts the following taxable services from the whole of the service tax leviable thereon under section 66B of the said Act, namely :- 1. ............. 2. Health care services by a clinical establishment, an authorised medical practitioner or para-medics; ......" 2. Definitions. - For the purpose of this notification, unless the context otherwise requires, - ..... (j) "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....
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....hearing, they have furnished records indicating the method of diagnosis and methods of treatment, booklet containing standard pattern of procedure for various treatments. A sample copy of treatment of patient is reproduced below: 12. In their affidavit dated 25.03.2022 before the adjudicating authority, the Senior Chief Physician attached to the appellant's hospital who is a holder of Bachelor's Degree in Ayurvedic Medicine and Surgery and worked in various hospitals narrated in detail the procedure adopted by the appellant. Relevant portion of the affidavit are reproduced below: "7. The hospital is run by a set of doctors led by myself and the therapies are carried out by qualified therapists based on the instruction given by the doctors. The Hospital has a full-fledged pharmacy, fresh medicine making unit, yoga centre, canteen where prescribed diet is served. 8. It would be worth mentioning that patients upon having a serious ailment and where they did not get relief from modern medicine, the patient looks at alternative methods and tends to reach Ayurveda. They contact the hospital through references or search on the website. Upon finding us they make an enq....
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....x Bupa Insurance Company, Star Health Insurance Company, Reliance Life Insurance Company, SBI Life Insurance Company etc, provide reimbursement of treatment expenses for the treatment done in NACL. The approval by the Insurance Companies is on account of the strict compliance to norms and systems associated with the NABH certification etc., and other standard operating procedures." Thus from the evidences produced, it is clear that the appellant has been following a proper procedure of diagnoses and Ayurvedic treatment to the patients. They produced evidences indicating adoption of standard operating procedure for running the hospital, list of doctors and therapist with qualification, registration of patients, etc., which spread over 600 pages filed during the course of hearing. It reveals that the appellant is providing medical facilities to the patients from their Hospital. No contrary evidence has been placed by the Revenue. It is argued by the Revenue that the sample case history of patients produced do not cover the entire period, is devoid of merit. As the paper-book contains sample of case history, treatment procedure, etc., for the entire period 2006-20....
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....on for curing diseases such as arthritis, chronic low back pain and sciatica etc. Ayurvedic massages, acupressure therapy, etc. given by qualified professionals under medical supervision for curing diseases/disorders will come under the category of therapeutic massages. If the massage is performed without any medical supervision or advice but for the general physical well being of a person, such massages do not come under the purview of therapeutic massages and they would be liable to service tax". 5.2 On going through the records of the case, it is found that the different ayurvedic centres have the following common credentials: (i) They are run under the supervision of a qualified ayurvedic doctors. (ii) Having a license from Municipal Council or Gram Panchayat to run such ayurvedic hospitals (iii) They have certificates given by the Department of Tourism also. 5.3 The department has attempted to contradict the claims of the respondents by saying that these resorts are only for pleasure and holidaying and massages are optional and invariably are of general wellbeing than treatment of a particular disease. However, ongoing through....
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.... be concluded that the massages or treatments offered by these centres are only for general well-being and not for any therapeutic value. The Order-in-Original also refers to the ambience and the fees charged in the packages and finds that these cannot be equated to treatment. We fail to understand as to how the cost of treatment and the ambience of the treatment would render such treatments to be non-therapeutic and only for well-being. For that matter, the duration of treatment is also no criteria. In case of consultations by psychiatrists, the sessions may last even one day, for that reason one cannot conclude that the psychiatrists ceases to be a doctor. The duration and the type of treatment depends on the diseases, the conditions of the patient, and the expertise of the doctor. It is not always necessary that the treatment should be only in the dull / dreary atmosphere of hospitals alone. If some well to do patients prefer to have treatment in a better circumstances and are willing to pay for the same, such treatments cannot be 'for that sole reason', held to be no treatment. It is common knowledge that a good number of foreign tourists visit Kerala during a particular season....
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....rnment of Tamilnadu, (W.P. Nos. 3589 and 4452 of 2012 of the Madras High Court). Paragraph Nos. 53 to 60 of the said decision is extracted as follows : 53. The history of Ayurveda and Siddha dates back to several centuries. Literally meaning the "science of life", Ayurveda is often used in a narrow sense as a "system of medicine", which considerably dilutes and distorts its real scope and objective. Health, according to Ayurveda is not only freedom from disease. According to Susruta, one of the great early practitioners, it is a state of the individual where, in addition to harmony among the functional units (dosas), digestive and metabolic mechanisms (agnis), structural elements (dhatus), and waste products (malas), a person should also be in an excellent state (prasanna) of the spirit (atman), senses (indriyas), and mind (manas). The Encyclopaedia Britannica states that Ayurvedic practitioners work in rural areas, providing healthcare to at least 5 million people in India. Pointing out that the golden age of Indian medicine from 800 B.C., till 1000 A.D., was marked by the production of the medical treatises known as "caraka-samhita" and "susrutasamhita", the Britannica r....
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....nd immediately behind the new part an incision is made through the skin which passes around both alae, and goes along the upper lip. The skin now brought down from the forehead and being twisted half around, is inserted into this incision, so that a nose is formed with a double hold above and with its alae and septum below fixed in the incision. A little Terra Japanica (pale catechu) is softened with water and being spread on slips of cloth, five or six of these are placed over each other to secure the joining. No other dressing but this cement is used for four days. It is then removed and clothes dipped in ghee (clarified butter) are applied. The connecting slip of skin is divided about the twentieth day, when a little more dissection is necessary to improve the appearance of the new nose. Four, five or six days after the operation, the patient is made to lie on his back and on the tenth day bits of soft cloth are put into the nostrils to keep them sufficiently open." 55. The learned author of the Book Mr. Udwadia, goes on to say that the above occurrence caught the attention of J.C. Carpue, a 30 year old Surgeon in London. He successfully used the same skin graf....
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....S and Siddha System of Healthcare - an experience of 13 years". He reported in the said paper that after the Government Hospital of Thoracic Medicine at Tambaram adopted an open door policy for HIV/AIDS in 1992, there was an exponential increase in the number of HIV sufferers seeking care and treatment. While the number of patients were only 2 in 1993, it rose upto 365 in 1996 and 6,791 in the year 2000. Since ARV Drugs could not be provided by the Government to all the patients, the Hospital invited 90 Siddha Physicians to a Seminar to identify suitable Siddha formulations to combat the killer disease. All of them agreed on formulations containing processed Sulphur and processed Mercury to fight the disease. As a consequence, a formulation known as RAN was born as the child of Tambaram. The acronym RAN stands for Rasagandhi Mezhugu, Amukkira Chooranam and Nellikkai Ilagam. It has become an immunogenic and adaptogenic drug. The said Medical Practitionaer demonstrated through laboratory evidence that there was clinical improvement in more than 60% of the patients who received either RAN alone or in combination with OL controlling drugs (reported in the publication "Evaluation of Sid....
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....tional drug and healthcare companies. Apart from the questionable economics of this prescription, it completely overlooks the existence of alternative systems of medicine and the possibility of using them to ensure healthcare coverage for the rural and urban populations of the nation." 60. Therefore, it is clear that there has been some resistance worldwide, to the Government patronage of indigenous systems of medicine. But Latin American countries and even China, spend millions of dollars for developing indigenous systems of medicine. The National Health Service of the United Kingdom is said to be funding billions of pounds every year on Homeopathy, despite opposition. In February, 2010, the Science and Technology Committee of the British Parliament submitted a report alleging that there is no evidence to show that Homeopathic treatments work better than a placebo. Therefore, the Committee recommended that the National Health Service should cease to provide funds for Homeopathic Hospitals and that Doctors in the N.H.S. System should not refer patients to Homeopaths. The Committee even recommended that the Medicines and Healthcare Products Regulatory Agency (MHPRA) should ....
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.... speedkolalaom), jurinym estarias-ası 2001-02. " modusole cd-torinom.(100 (aoruegajesocialaomooni. Benão.p.o இரவேதி auconim, msomjan aggiodlo Pasaje casiallequal. : Var egaBang megfontolaños, mintegy reggio esa Bominha, Aneist. THE CHENL GRAMA PO ocuja solo; os ang- Guld). Hmen alocal 25.06.01 SECRETARY Okleel Grataa Panchayat Form 3 [See Sub-rule (7) of Rule 3] Registration Certificate of Private Hospitals and Private Para Medical Institutions M/s. Nagarjuna Ayurvedic Centre, a Private Hospital/Private Para Medical Institution, in Okkal Grama Panchayat, has renewed registration under the Kerala Panchayat Raj (Registration of Private Hospitals and Para Medical Institutions) Rules, 1997 on 25th day of June, 2001, as No.01/2001-02. The said registration is valid upto the end of the Financial Year 2001-02. Address of the Institution: Nagarjuna Ayurvedic Centre, Okkal P.O., Kalady Name & Address of the person V.G. Devdas Namboodirippad, running the institution : Nagarjuna Ayurvedic Centre, Kalady Place: Okkal Date:25.06.01 (Round seal) (Seal of Grama Panchayat) Name and Signature of S....
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.... Issuing Authority) 1. Lease Agreement/ Letter of Consent 2. Sanction from Pollution Control Board RISERR- CTO-R-747491 ... 28.03.2019 Rt. No. 120010103527 Dt. 05.03.2021 1250+1250 Rt. No. 120010103527 Dt. 05.03.2021 Details and NOC submitted for grant of license (Number, Date, Period, Issuing Authority) 1. Lease Agreement/ Letter of Consent 2. Sanction from Pollution Control Board RISERR- CTO-R-747491 ... 28.03.2019 (Office Seal) (Signature and Seal) Secretary Okkal Grama Panchayath Translated by Asmin Nayara Advocate Document 3 NAGARJUNA AYURVEDIC CENTRE LTD. Thannipuzha, Kalady - 683 550, Korala, India Phone :+91 484 2463350, 2460854 E-mail : [email protected] Website : www.nagarjunaayurveda.com CIN : U85199KL 1996PLCO10126 NAGARJUNA DISCHARGE SUMMARY Depart .... Vawarhikitsa Name: IP No: NAG-1607-IP-72 UID No:5960 Address: Consultant: Dr.C.Manoj Kumar Admitted on : 20/07/16,04.40pm Discharged on: 04/07/16,7.00pm Sex: Female Age:36 Presenting Complaints Patient presented complaints of pain on left upper arm, deltoid and triceps region. Pain aggravates after sitting without support, pain on left upper t....