Providing medical education and health care services through a hospital amount to business; Maharashtra Appellate Authority for Advance Ruling upholds

The service of medical education falls under the category of “educational institution” as defined under the GST law, and accordingly, it was held that the medical education services provided by the appellant to the students will attract nil rate of GST. Further, as the appellant’s hospital is engaged in providing diagnosis and treatment of the patients, hence, their services can be termed as “health care services”, and accordingly held that the said services will be exempt from the payment of GST.

Appellate Authority for Advance Ruling (Maharashtra)

   

Appellate Authority for Advance Ruling (Maharashtra): In an appeal against the order of Maharashtra Authority for Advance Ruling that providing medical education to the students amounts to business, the two-member bench of Dr. D.K. Srinivas and Rajeev Kumar Mital concurred with the impugned advance ruling pronounced by MAAR. However, it modified its ruling saying that nominal charges received from patients towards an insurance scheme is eligible for exemption and renting immovable property will be considered as independent supplies and will be taxable. Further, it observed that the appellant is rendering exempted services as well as taxable services. Hence, it is liable to take registration in terms of section 22(1) of the CGST Act, 2017.

Issues, Decision and Analysis: (i) Whether the impugned activities by the appellant, wherein they are providing educational services by way of imparting medical education, and providing the health care services through a hospital, can be construed as “business” in terms of the provisions of Central Goods and Services Tax (‘CGST’) Act, 2017.

The Appellate Authority referred to the definition of “Business” under Section 2(17) of the CGST Act, 2017, and said that GST law has provided an inclusive definition to the term “business”, signifying that the scope of term “business” is not restrictive, and hence, the term “business” also includes any profession whether the same is carried out for pecuniary benefit or otherwise.

Further, after referring to the dictionary meaning of “profession”, it said that the appellant through its establishment is undertaking such job or work which requires the service of highly educated, trained, and skilled persons in the form of doctors hired by them for imparting the medical education to the students, hence the said work done by the appellant can be said to be in the nature of “profession”, and accordingly, will be construed as “business” in terms of the GST provisions.

Similarly, the provision of health care services by the appellant through its hospital can also be deemed as “profession” as envisaged under the definition of the term “business” provided under the GST law, and therefore, the said activity of the Health Care Services provided by the appellant will be construed as “business” under the CGST Act, 2017.

The Appellate Authority compared the definition of “business” provided under the former Bombay Sales Tax Act, 1959 (‘BSA’) and under the CGST Act, 2017, and said that the definition under the BSA ,1959, does not include the entries “profession and vocation”, which are present in the definition of the term “business” under the CGST Act, 2017, thereby, rendering much wider meaning and scope to the term “business” under CGST Act, 2017 and it is wide enough to include the activities of the appellant. Thus, the activities undertaken by the appellant are in the nature of business.

Thus, the Appellate Authority said that the services of medical education provided by the appellant in Maharashtra University of Health Sciences, an establishment of the appellant, falls under the category of “educational institution” as defined under the GST law, and accordingly, it was held that the medical education services provided by the appellant to the students will attract nil rate of GST.

It further said that, as the appellant, through its establishment Kasturba Hospital are engaged in providing services by way of diagnosis or treatment or care of the patients, hence, their services can be termed as “health care services”, and accordingly, it was held that the said services will be exempt from the payment of GST.

(ii) Whether the fees and other charges received from students and recoupment charges received from patients would constitute as “outward supply” as defined in section 2 (83) of CGST Act, 2017?

Further, the Appellate Authority referred to Section 7 of the CGST Act, 2017 and said that the activities of the appellant can also be construed as “supply” in term of section 7(1)(a) of the CGST Act, 2017. Thus, the said activities would also be considered as “outward supply” for the appellant in terms of the and provisions of section 2(83) of the CGST Act, 2017. Therefore, the fees other charges received from students, and recoupment charges received from patients would accordingly constitute consideration for outward supply.

(iii) Whether the cost of medicines and consumables recovered from OPD patients along with nominal charges collected for diagnosing by the pathological investigations and other investigations such as CT-Scan, MRI etc., during diagnosis and treatment of disease would fall within the meaning of “composite supply” qualifying for exemption under the category of “educational and/or health care services”?

The Appellate Authority said that the said activities would fall within the meaning of “composite supply” qualifying for exemption under the category of educational and/or health care services as the aforesaid services are indispensable for rendering the principal supply of health care services, and hence, the same may be considered as ancillary services to the main services of health care services being provided by the medical professionals of the appellant’s hospital.

(iv) Whether the nominal charges received from patients towards an “Unparallel Health Insurance Scheme” would fall within the meaning of “supply” and is eligible for exemption under the category of “Educational and/or Health Care Services”?

The Appellate Authority though concurred with MAAR that, the appellant has not obtained any license from the Insurane Regulatory & Development Authority of India, to run any insurance business, therefore, the said scheme cannot be considered as insurance services. However, it said that the nominal amount being charged by the appellant is in the nature of advances towards the provision of the health services, which would be provided by them to the subscribers of the said scheme, and hence is eligible for exemption.

(v) Whether the nominal amount received for making space available for essential facilities such as banking, parking, refreshment etc. which are support activities for attainment of main activities, and further amount received on account ot disposal of wastage would fall within the meaning of “composite supply” qualifying for exemption under the category of “educational and/or health care services”.

The Appellate Authority said that the main services of the appellant, i.e., educational services and health care services are provided to the students and patients, whereas the services of renting of immovable property are provided to some third-party consumers, who run their establishments on their own account on the land made available to them by the appellant against certain consideration. Thus, it is apparent that these services under consideration are not provided to a single recipient as mandated under the provisions of composite supply under section 2(30) of the CGST Act, 2017, and accordingly cannot be said to be part of the composite supply. Thus, the said service of renting immovable property will be considered as separate and independent supplies and will be taxable.

(vi) Whether the appellant is liable for registration under the provisions of Section 22 of the CGST Act, 2017.

The Appellate Authority observed that the appellant is rendering exempted services as well as taxable services. Hence, it is liable to take registration in terms of section 22(1) of the CGST Act, 2017 provided their aggregate turnover exceeds the threshold limit prescribed under the said Act.

[Kasturba Health Society, In re, 2022 SCC OnLine Mah AAAR-GST 3, decided on 05-12-2022]


Advocate who appeared in this case :

Present for the Appellant: Rajendra Bhutada.


*Apoorva Goel, Editorial Assistant has reported this brief.

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