GST Impact on Healthcare Industry in India

Goods and service tax is a major factor which has a potential to cover the economic base of the country along with its sidelines also India is not just one of the biggest performing nations for generics, however additionally encountering a blast in remedial tourism which creates extra returns for the Healthcare Industry. India’s Pharmaceutical Industry as of now is 3rd largest as far as volume and 14th largest regarding esteem all inclusive. As populace is persistently developing, so is the requirement for good Healthcare Services, which brings the need of growing more qualified personnel to fill the present crevice in the part and giving state-of-the-workmanship offices and innovations to patients.

Latest Update in Healthcare Industry Under GST

• 54th GST Council Meeting – A GST rate from 12% to 5% reduced on cancer drugs like Trastuzumab Deruxtecan, Osimertinib, and Durvalumab.
• A decision has been made to GST-exempt Dinutuximab (Quarziba) medicine from IGST when imported for personal use according to the 50th GST Council.
• The Kerala GST AAR has published the order for the M/s. Uralungal Labour Contract Co-operative Society Ltd (ULCCS). The order said, that 18% GST is applicable on works contract services for construction supplied to Malabar Cancer Centre. Read Order
• The Authority for Advance Ruling of Andhra Pradesh has ruled that the 5 per cent GST rate applicable on vaccination of COVID-19 administered via hospitals. Read more
• “47th GST Council Meeting: Room rent (excluding ICU) exceeding Rs 5000 per day per patient charged by a hospital shall be taxed to the extent of amount charged for the room at 5% without ITC.”
• “Like CETPs, common bio-medical waste treatment facilities for treatment or disposal of biomedical waste shall be taxed at 12% so as to allow them ITC”
• Maharashtra GST AAR has notified a new judgment ruled for the Jyoti Ceramic Industries that there is no GST applicable on the Artificial Teeth, Crown, Bridges. Read Order
• Gujarat Authority for Advance Rulings (AAR) has ordered that the services of health care provided through hospitals on a lump-sum payment for many years are exempt from the GST regime. read order
• AAR (Authority of Advance Ruling) of Karnataka has been ordered to pay a 12 per cent GST levy on laboratory & diagnostic reagents. “The Applicant, Bio-Rad Laboratories India is a limited company, registered under the GST Acts (CGST/KGST) 2017” read order

Center Reconsiders GST on COVID-19 Vaccine

Vaccine maker Bharat Biotech has set out the rate of his vaccine named COVAXIN at Rs 600 per dose to the state government and Rs 1200 per dose to the private hospitals. In between the high covid-19 vaccine rates the center is thinking goods and services tax GST waiver to lesser the rates towards state government and private hospitals.

Health Care Services May Get Relief in Tax Rate Under GST

Government of India is leaving no stone unturned to ease the Healthcare services and bring down its cost to the affordability. Undoubtedly, the Healthcare Federation of India (NATHEALTH) which is an apex body for health-maintenance services is also not lacking behind in backing government’s intentions with proposals which will result in the availability of ITC for health care service providers and quality health services to the people residing in underdeveloped areas.

NATHEALTH’s approach and proposals for Budget 2020 will not only ensure consistent quality of service but also bring down the cost of wellness services & programmes for the consumers as the costs are ultimately be borne by costumers because of the unavailability of ITC for health care providers under the current practices. Further, this will boost the savings for health professionals and increase their investment capacities.

Revised Hospital Room Rent with GST Tax Slabs

Hospital Room Rent	Applicable GST Rates
Below Rs.1000	0%
Rs.1000 to Rs.2499	12%
Rs.2500 to Rs.7499	18%
Above Rs.7500	28%

The final GST rates have been disclosed and have included numerous categories from the wide range of healthcare amenities.

Tax Rate	Healthcare Commodities
0%	Contraceptives, Human Blood
5%	Medicines, Animal or Human Blood Vaccines
12%	Ayurvedic Medicines, Medicinal Grade Hydrogen Peroxide, Anaesthetics, Potassium Iodate, Iodine, Steam, Glands And Other Organs For Organo-Therapeutic Uses, Ayurvedic, Unani, Homoeopathic Siddha Or Biochemical Systems Medicaments, Sterile Suture
18%	Tampons, Disinfectants

The health-care industry has been hit by the GST tax rates and various other rules and regulations. But the goods and services tax has created a hazardous situation for the normal person who is drifted under the fate. As the tax charges are geared up to a hefty number it seems that the GST has cursed in the health-care industry more than it has blessed. It is said that if there is an ailment, there is a medicine but this has changed after the 15th August took away the independence of health-care to many of those underprivileged.

After 15th August, as the new stock will arrive, it will lash out the tax rates on the general public as many important heart and kidney operations are under the slab rates 12 to 28 percent GST which will increase its costing per individual. While it is learned that around 80 percent of life-saving medicines will be expensive after the August timeline.

While many hospitals and specialists are going according to the old rates but it is done that once new stocks come in, the revised rates will be applicable. The experts are very much shocked concerning the tax rates over the life-saving medicines and machines and predicted that if the government did not take any actions then a certain protest is awaiting.

Let’s examine the fields where the impact will be severe along with the expert comment over it:

Department	Summary	Pre-GST	Post-GST	Items Getting Expensive	Impact	Expert Comments
Nephrology	Dialysis Under Heavy Tax	5%	12%	Homo Dialysis Machine, Tubings, Dialysis Needles, Catheter, Plasma filter, Dialysis fluid	Currently, dialysis is charged at a rate of INR 1800 to 2200 which will be further burdened with INR 300. According to this, those individuals who are getting dialysis treatment 10 to 12 times per month will be getting additional INR 40,000 annual burden.	Nephrologist  Doc. Alok Jain from Fortis Hospital mentioned that the must be tax-free and the rates must be revised very soon.
Heart Treatment	Pacemaker under 18 percent GST	5.5%	12% to 18%	Lead valve of Pacemaker, Device (Heart failure machine CRT – ICD)	Pacemaker worth 1.5 lakh will be costing 15-20 thousand extra after the August timeline. ICD also will be costing at an extra 40 thousand which comes at currently 3 lakh per machine. Currently, there are 200 pacemakers installed across the state.	Doctore Jitendra Makkad of EHCC hospital mentions it as an error by the government and seeks for a correction as soon as possible.
Eyes Treatment	Lens surged upto INR 500 while operations became 15 percent costlier	9%	12% to 18%	Checkup machines, Indian lens INR 1200 to 3000 has surged INR 1500 to 3500. Foreign machines which used to cost at INR 5000 to 9000 currently they are hiked at INR 6000 to 10000.	Lenses prices have hiked up to 12% from 9%, while many of the machines are attracting 28%. Along with the lenses, the operations cost has also increased up to 15 to 20%.	Senior professor Kishor Kumar of SMS hospital assured that government hospitals would be away from the impact however, private hospitals would be costlier upto 15 to 20%.
Orthopedics	Support devices getting costlier, Implants neutral	5%	12% to 18%	Disposable items, Bone cement, Operation equipment like drill machines and its batteries.	Implant taxes are 5% but the supported items in operation are now under 7% to 28% tax rate. Finger coat, Kneecap, Brep belt also attract 12% now.	Rajendra Bhargav, a dealer in ortho implants mentioned that there will be an overall 15 to 20% higher tax rates while multiple meetings are being conducted to understand the future procedures.
Cancer treatments	Except for blood cancer treatments, every other treatment of cancer costs 12% extra	5%	7% to 12%	–	All the imported medicines became getting expensive. Advanced stage cancer patient will be incurring INR 10,000 extra on the treatment.	Mahaveer cancer hospital director PS Lodha stated that Anticancer medicines will be getting costlier by 6.5% as there will be 12% GST applicable on them. However, it has to be seen how much exercise will be reduced.

These Health-care Products also in the List of Expensive Category:

Items	Pre-GST	Post-GST
Surgical Item	5.5%	12%
Wing Scale	5%	28%
Hot Water Bag	5.5%	28%
Wheel Chair	5%	18%

In the present scenario, there is about 17 item in the negativity list in which there is no service tax is levied on the items. Including approximately 60 services similar to pilgrimage, health-care, education, skill development, journalistic activities which are exempted from the service tax duty and are not bounded by the abrupt taxation.

In India, 5% of the GDP is spent on Health-care – 4% by the private division and now the Indian Health-care Industry has been exponentially developing in the current year, and the Ministry of Health focuses on the advancement of 50 new innovations before the current year’s over to treat ailments, for example, cancer and tuberculosis. To draw in more foreign direct investment (FDI), the Government raised the FDI top for brown-field Pharmaceutical investments to 74% in June. Inevitably, 100% FDI is allowed in greenfield Pharmaceutical investments and past 74% under government endorsement in brown-field Pharmaceutical investments.

Recommended: Easy Guide of Reverse Charge Mechanism Under GST with All Aspects

As of late, the release of the most anticipated Goods and Services Tax (GST) Bill got the consideration all through all businesses in India. It ought to profit most segments and make taxation less demanding as it replaces a few distinct duties and taxes. The Health-care Industry in India has turned out to be one of the largest sectors in the nation with respect to business and income. As Health-care propagates, so do the tax incomes for India as of late, India’s Government chosen to execute GST, which subsumes various taxes of the vast State and Central Tax framework in India into one formally dressed tax framework.

GST is relied upon to positively affect the Pharmaceutical part. It will help the business by streamlining the tax structure since eight different taxes are exacted in the Pharmaceutical Industry right now. A solidification of all these into one tax would ease working together, too as mitigate the falling effects of numerous taxes connected to one item. Aside from this, GST will likewise bring about yielding proficiency by streamlining the store network which can alone add 2% to India’s Pharmaceutical market measure. Since GST will help Pharmaceutical companies rationalise their production network, they should audit their circulation systems and technique.

Moreover, GST usage will likewise conceive a seamless stream of the tax credit, represent a change in general consistency and is additionally anticipated that would make a level-playing field for  Pharmaceutical organisations in India. A major favourable position for organisations will be diminished in exchange costs with the discontinuance of Central Sales Tax (CST). GST is required to cut down the assembling cost and even a 2% decrease underway or appropriation cost is acceptable to include over 20% to benefits.

Read Also: Meaning of SGST, IGST, CGST with Input Tax Credit Adjustment

Then again, Pharmaceutical organisations will encounter enhanced operational effectiveness, diminished manufacturing & exchange costs and also enhanced compliance. Also, it will profit Pharmaceutical companies’ warehousing methodology. Starting at now, organisations kept distribution centres in various States to maintain a strategic distance from CST of various States. Presently, with CST subsumed under GST, they can merge stockrooms at vital areas as they will just need to pay Integrated GST (IGST) on inter-state supplies of Goods and Services.

Generally speaking, the impacts of GST usage on the Healthcare and Pharmaceutical segment is somewhere very hard for the general public. The Healthcare Industry, on the off chance that the tax rate is set at an effective level, will profit as GST absolutely diminishes complexities and evacuates many obstacles to the business’ growth.  The business is on a way of promising development and expanded profitability.

Cost Of Treatment Is Up Due To Higher Tax Rates

GST has increased the cost of various medical equipment which is necessary for everyday life. For an example, the dialysis cost has increased for kidney patients as hospitals are paying 12% tax on a dialysis machine, tubings, dialysis needles, Catheter, plasma filter, dialysis fluid which was earlier in the tax slab of 5% tax rate.

The fact is that around 2,10,000 patients suffer from kidney related problems in a year and require a transplant of a kidney. From them, only 6,000-7,000 are capable of getting the kidney from donors and the life of rest only depends on regular dialysis. The calculation shows the cost for each patient for dialysis is costing 40,000 extra in a year.

The dialysis process costing more is just an example of how harshly the patients are affected by higher tax rates. There are so many other daily using medical equipment went high like the lead valve of a pacemaker are imposed by 18% tax and CRT-ICD are taxed at 12% which is costing 15,000-20,00 extra on pacemaker and 40,000 extra on CRT-ICD.

Cost of Blood-Related Supplies Increases under GST

After the introduction of new tax system, the blood related supplies bring under the ambit of Goods and Services Tax (GST) System. GST rates being levied up to 12 percent on blood related supplies. Post GST, the blood rates has increased from Rs 1050 to Rs 1250. After the announcement of the rise in the prices of blood related supplies, Rajasthan State Blood Transfusion Council has issued notification that they are going to increase the prices from 1st January 2018. Additionally, some of the blood banks in the state have started charging higher prices.

Earlier No GST rates were charged on the blood collecting bag, which has now been brought under the ambit of GST and is being levied with 12.5 percent GST. After the implementation of GST, blood-related supplies are brought under the new indirect tax system. Due to the imposition of GST, it has increased the prices of blood by Rs 200.

Blood Rates and Blood Red Cells increased from Rs 1050 to Rs 1250 respectively. 12 percent GST is being charged on blood carry bags, it was exempted under previous tax regime.

The government is charging 12 percent GST rates on Platelet Carry Bag. HB Kit being charged 18 percent GST rates, earlier it was 5.5 percent. 18 percent GST Rates being levied on Glass slide, earlier it was 14 percent. Test Tab being charged 18 percent GST rates, earlier it was 14.5 percent.12 percent GST being levying on tracer tape, earlier it was 5.5 percent. Banded being charged 12 percent tax rates under GST, earlier it was 5.5 percent.

Fact Figures About Blood Banks

A total of 89 blood banks are available in the state. 44 government blood banks are available in the state. 45- non-government blood banks are available in the state. Every year 56 lakhs check-ups done in SMS Hospitals. 13 thousand checkups take place per day in the SMS Hospital. 3000 blood donation camps are organized every year in the state. Every year 6 lakh units of blood are collected from the blood donation camps.