Integrated services are permissible for several years and are gaining in popularity. These are, for example, a contract with an insurance company, which includes first, a medical service and the other a supply of drugs. By the health insurance is obtained in return for flat-rate compensation.
The question is whether sales tax accrues.
benefits from working as a doctor or other professional medical activities referred to in § 4, No. 14 Sales Tax Law are generally exempt from VAT. For the exemption of this provision, it does not matter, in what legal form of the contractor supply (see, BFH ruling of 4 3rd 1998 XI R 53/96, Federal Gazette 2000 II p. 13). The exemption depends on the We-essentially from the fact that there are medical or paramedical services and that those provided by persons who possess the necessary professional qualifications (see ECJ Judgement of 10 9th, 2002, C-141 / 00, ECR I p. 6833). The services can be provided with the help of workers who have the requisite professional qualifications (see BFH ruling of first 4th 2004, PR 54/98, Federal Tax Gazette II, p. 681, for a foundation). Accordingly, the MCC also provide a sales-tax-free performance.
The question is whether the medical service also includes the supply of drugs. In our On-making is it is the delivery of drugs to a so-called ancillary service. The sales tax guidelines result from this:
fringe benefits tax law, the revenue share of the principal service. This applies even if required for the ancillary service and pay a special fee (see BFH ruling of 28 4th, 1966, V 58/63, Federal Tax III p. 476) is. A performance work is basically to see to as ancillary to a principal service, if it is marginal compared to the main service, with her closely - for economically justified complement and supplement - related and usually in their wake occurs (see BFH Rating 9th of 10 in 1992, cited above). Of which is likely in particular, when the power is for the recipient is not an end in itself but a means to address the principal service providers under the best conditions to complete (see BFH ruling of 31 5th, 2001, cited above). Subject of an ancillary service ... can be a dependent supply of goods ....
Whether this scheme is also applicable to the supply of drugs in the context of integrated care is, so far neither the law nor the tax authorities clarified. A final assessment is quite safe, therefore we have not at this point in time.
We therefore recommend the following procedure: First, should
Contract with the insurance company a so-called net arrangements. That is, the contract should contain a clause that says: if it should be determined by the tax authorities that the supply of drugs is subject to VAT, the consideration of the health insurance increased by this amount of sales tax.
advise the other, we make the case for any final conclusions, a binding information at the tax office to obtain financial. To this end, the planned approach to the tax office will be changed geschil. The facts may, however, do not be achieved. Obtaining a liability for information has now become a charge.
The amended from 2009 version of § 4, No. 14 Sales Tax Law has for our previous findings, no effect on the classification of the above facts.
