Source: minbuza.nl (Dutch)
- X operated a so-called health telephone on which medical advice was given to insured persons, and carried out patient guidance programs for chronically or long-term sick patients.
- The telephone advisory services were provided by nurses and medical staff who were also largely trained as health coaches. In more than a third of the cases, a doctor was also called in.
- Insofar as medical advice was requested, the medical conclusion was determined with the help of software, then the caller was advised about his specified therapeutic care situation.
- Diagnoses and possible therapies were explained and tips given on behavioral and treatment adjustments.
- The aim of the counseling programs was to better manage the costs of insured persons with chronic or psychological complaints and, in particular, to clearly reduce the number of new stationary admissions of the participants.
- X classified its activities as VAT exempt human health care. The German tax authorities disagreed.
- According to the German court, the applicant does not make remote diagnoses, but merely provides further information about a disease or provides information about diagnoses, without a required therapeutic purpose. The services are neither prescribed by a doctor nor performed as part of an individual prevention or rehabilitation measure.
Questions:
- Does the VAT exemption apply to advice that is given by telephone, on behalf of health insurance funds, on various topics in the field of health and illness?
- Is it sufficient for the required proof of professional qualification that the telephone consultations are conducted by ‘health coaches (medical staff, nurses) involving a doctor in about one third of the cases?
(Recent) case law cited :, C-212/01 ;, C-307/01; L.u.P., C-106/05
