GST on Healthcare Industry by Sankar Majumdar – September Edition 2026

GST on Healthcare Industry is the most exhaustive and practice-oriented treatise on the taxation of India’s healthcare sector under the Goods and Services Tax (GST) regime. This Edition, updated up to notifications issued on 17th September 2025, incorporates the paradigm changes introduced through GST 2.0, including reforms on the taxability of hospital room rent, healthcare insurance premiums, and the rationalisation of GST rates on pharmaceutical products, medical devices, and consumables. The book goes far beyond statutory reproduction—it dissects the legal, procedural, and economic interplay of GST within India’s multi-layered healthcare system, spanning hospitals, diagnostics, pharmaceuticals, wellness, IT, and insurance. It provides a 360° analysis of every element—from exemptions and composite supplies to ITC eligibility, registration, accounting, and judicial precedents—backed by examples, Advance Rulings, and High Court decisions. The author also presents an economic and policy lens, connecting the taxation framework to affordability, public health expenditure, and government initiatives such as Ayushman Bharat, Fit India, PM-JAY, and the Digital Health Mission, thereby creating a unique blend of law, finance, and healthcare policy.

This book serves as an indispensable reference for:

• Hospital Administrators & Finance Controllers seeking compliance clarity in billing, canteen, pharmacy, and diagnostic operations
• Tax Professionals & Consultants handling GST assessments, AAR rulings, and advisory services for healthcare clients
• CAs, CMAs, and CSs advising multi-speciality hospitals, diagnostic chains, pharmaceutical manufacturers, and insurers
• Lawyers & Policymakers analysing the intersection of healthcare delivery, exemptions, and fiscal policy
• Healthcare Start-ups & IT Platforms involved in telemedicine, health-tech, and digital health services under the GST network
• Academicians, Researchers & Students studying public policy, tax law, or healthcare economics

The Present Publication is the 2026 Edition, authored by CMA Sankar Majumdar, with the following noteworthy features:

• [Comprehensive Analysis of Healthcare Taxation] Explains GST’s impact on hospitals, diagnostics, pharmaceutical industries, health insurance, and allied services
• [Fully Updated with GST 2.0 Changes] Discusses major exemptions and rate cuts, including GST exemption on health insurance premiums, 33 life-saving drugs, and reduced rates on medical equipment
• [Comparative Legal Framework] Contrasts pre-GST regimes—Service Tax, VAT, Excise, and Entry Tax—with the unified GST framework for seamless understanding
• [Exemptions Simplified] Dissects the myth of healthcare exemption, demonstrating how embedded input taxes inflate costs despite zero-rating
• [Chapter-wise Practical Commentary] Every concept—such as composite supplies, ITC, room rent, ambulance services, and bundled transactions—is elaborated through examples, case laws, and departmental clarifications
• [Integration with Public Policy] Evaluates how government schemes—Ayushman Bharat, PMUY, Swachh Bharat, Fit India, and Jal Jeevan Mission—influence public health, affordability, and tax design
• [Rich Judicial Reference] Over 150 AAR/AAAR and High Court rulings summarised with precise tax positions
• [Case Studies] ‘Typical Situations’ chapter analyses practical GST dilemmas in healthcare operations—telemedicine, pharmacy billing, outsourced services, room rent, and donations

The book unfolds systematically across 14 chapters covering every facet of healthcare taxation:

• Introduction & Socio-Economic Context
  • Explores healthcare as a social security measure and the rationale for GST exemptions, juxtaposing public health imperatives with fiscal policy
• Economics of the Healthcare Industry
  • Assesses affordability, out-of-pocket spending, insurance penetration, and comparative global healthcare economics with data-backed tables and government statistics
• Broad Healthcare Industry
  • Defines healthcare, healthcare services, and the healthcare industry—covering hospitals, pharmaceuticals, medical devices, R&D, IT, and insurance
• Pre-GST Tax Regimes
  • Explains chargeability under Service Tax, VAT, CST, and Excise, including exemptions for hospitals, paramedics, ambulance services, and cord blood banks
• Chargeability under the GST Regime
  • Lays out the constitutional foundation (Articles 246A, 366(12A)), key notifications (12/2017, 2/2017), and GST applicability to healthcare and allied services
• Exemptions and Taxability
  • Provides clause-wise commentary on Notification No. 12/2017-Central Tax (Rate) with detailed coverage of para-medics, yoga professionals, nutritionists, diagnostics, rehabilitation, ambulance services, and bundled supply structures
• Pharmacy Supplies
  • Evaluates the taxability of medicines for in-patients versus out-patients and the implications of ITC reversals
• Hospital Canteens
  • Clarifies tax positions for hospital-run vs outsourced canteens and food supply under composite supply rules
• Room Rent in Hospitals
  • Dissects the levy of GST on non-ICU room rent above ₹5,000, with analysis of council debates, progressive taxation principles, and compliance implications
• Input Tax Credit (ITC)
  • Covers entitlement, proportionate reversal under Rule 42, and cost implications of blocked credits in healthcare
• Registration & Accounting
  • Lists comprehensive documentation and record-keeping formats—from billing registers to patient records—for hospital compliance
• Pharma & Allied Sectors
  • Discusses GST’s role in pharmaceutical manufacturing, job work, research, IT services, and insurance under GST 2.0 reforms
• Typical Situations
  • Contains over 40 illustrative scenarios clarifying GST treatment for diagnostics, donations, online aggregators, cosmetic procedures, leasing, and yoga services
• Is GST Exemption in Healthcare a Myth?
  • Concludes with an economic critique—showing how non-creditable input taxes inflate healthcare costs, and proposes an ideal ‘tax-neutral’ model for healthcare sustainability

Each chapter follows a layered analytical structure:

• Conceptual Foundation – Statutory provisions and constitutional references
• Interpretative Commentary – Simplified explanations of ambiguous terms
• Judicial & Administrative Insight – Case law summaries with GST Council references
• Illustrations & Flowcharts – Graphical presentation of GST mechanics in hospitals and pharma
• Practical Guidance – Accounting formats, ITC calculations, and compliance workflows
• The book’s progressive logic—from pre-GST to GST 2.0—helps readers trace the continuity and reform trajectory of healthcare taxation