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.
The ECJ has held that a German VAT exemption for nursing and similar services provided by medical or nursing organisations does not extend to the charges by an employment agency supplying the necessary staff.
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.
Art. 132 (1) (j) VAT Directive also covers teaching units that relate to training, advanced training, or job requalification measures as a VAT exempt service. The narrow standards and requirements set by the ECJ for the tax exemption of school and university teaching in Article 132(1) (i) do not apply here. Accordingly, the Supreme Tax Court held that services provided by a supervisor may be exempt from VAT under Article 132 (1) (j) VAT Directive.
Emergency medical services are also exempt from Value Added Tax if provided and charged by a physician on duty for another medical doctor (e.g., on weekends and outside the consultation hours of panel doctors). This was decided by the Supreme Tax Court in a recently published judgment.
The Supreme Tax Court held that expert reports (appraisals) on the care and support needs of patients in order to determine the extent of their entitlement to medical care on behalf of the Medical Service of the Health Insurance (“MDK”) are not exempt from VAT under national law. A tax exemption under EU law is also not possible according to an earlier ECJ judgement pertaining to the case in dispute.
In a request for a preliminary ruling, the Supreme Tax Court has referred several questions to the ECJ regarding the compatibility of non-profit tax status and the prohibition of state aid under EU law. The question to be answered is whether the extension of tax relief for special-purpose entities to companies that provide services for remuneration in cooperation with a corporation that is recognized as a non-profit organization (so-called service corporation) constitutes illicit state aid in accordance with Art. 107 of the Treaty on the Functioning of the European Union (TFEU).
