Certain care facilities are exempt from trade tax if, in at least 40 percent of cases, the costs of care are covered in full or for the most part by statutory social insurance or social welfare providers. According to a decision of the Supreme Tax Court, this also applies if the services are billed through a third party.
In a Dutch case, the General Court of the European Union decided that exemption for services provided by a member of a VAT group in the field of health care and social care can only be granted if the relevant group member itself meets the legal requirements for VAT exemption.
In a most recent judgment, the European Court of Justice addressed the issue whether VAT on mandatory healthcare equipment for tax-exempt services can be proportionally deducted if those items are also used for additional taxable services. The decision suggests that a statutory obligation to purchase goods and services doesn't automatically grant deduction, but that proportional deduction is possible if a direct link to taxable activities exists.
The Muenster Tax Court has ruled that services provided by a self-employed hygiene specialist to geriatric facilities and nursing homes are exempt from VAT under Article 132 (1) (g) of the VAT Directive.
The ECJ has held that a condition for the VAT exemption of health care services that a minimum proportion must be supplied to members of the state system cannot be accepted if its effect is to deny equal treatment with public bodies offering the same services.
