The immediate impact on companies operating digital healthcare platforms is the possibility of applying the VAT exemption to medical services invoiced to users, even if the platform operator does not hold the status of an authorized healthcare provider. This position has been confirmed by the Ministry of Finance following an analysis initiated by the Chamber of Tax Consultants, providing important clarification for the health-tech sector.
Thank you for reading this post, don't forget to subscribe!The analyzed business model concerns digital platforms that facilitate the relationship between patients and private clinics or hospitals. The patient selects and pays for the service through the application, while the consultation or treatment is performed exclusively by authorized medical personnel within the partner healthcare institutions. The platform operator collects the payment and subsequently settles the contractually agreed amount with the clinic.
From a tax perspective, the mechanism operates as a buy-sell transaction in which the platform invoices the service in its own name. Nevertheless, the actual medical service continues to be entirely provided by the authorized healthcare institution.
The legal basis for this interpretation is found in Article 292 (1) (a) of [Law No. 227/2015 regarding the Fiscal Code], which provides the VAT exemption for medical, hospital, and healthcare services supplied for therapeutic purposes.
The Ministry of Finance considers that the VAT exemption must be assessed based on the economic substance of the transaction and the purpose of the medical service. Both the substantive conditions and the social objective of the tax provision are fulfilled when the services aim at diagnosing, treating, or preventing illnesses and are effectively performed by authorized medical personnel.
Restricting the exemption exclusively to clinics would increase the costs borne by patients and create different tax treatments for similar medical services. Such an approach would conflict with the principle of fiscal neutrality established by the case law of the Court of Justice of the European Union.
For health-tech operators, this interpretation reduces the tax risk associated with digital intermediation models and allows the development of business structures based on medical marketplaces while maintaining the VAT exemption regime. However, the application of the exemption remains conditional upon the fact that the underlying medical services are performed by authorized healthcare providers and meet the requirements established by tax legislation.