According to the VAT Directive, Member States grant a VAT exemption for medical care in the context of the exercise of medical and paramedical professions as defined by the Member State concerned. It follows from a judgment of the Court of Justice of the European Union of 27 April 2006 that the exemption applies to health care for humans by care providers with the required professional qualifications and for care providers with an equivalent quality level for the care recipient.
In the Decree of 29 March 2016, it has been determined for the equivalent quality level in the case of a foreign study program that a statement is required from a recognized Dutch institution or a comparable institution showing that the foreign study program is equivalent to a relevant Dutch HBO. – or university education.
It has been established that in the plaintiff’s case the statement as referred to above is missing. Nor has it been found that Plaintiff has basic medical knowledge (MBK) or psychosocial basic knowledge (PSBK). The recognition of the FVB or of individual scientists from the professional field is not an explanation within the meaning of the Decree. The foregoing leads to the interim conclusion that the plaintiff does not meet the requirements to qualify for the exemption, as laid down in the Decree.
Fiscal neutrality precludes treatment of human health care services which have an equivalent level of quality for the care recipient from being treated differently. In the opinion of the court, the neutrality principle has not been violated as there has been no clarity about the quality and supervision criteria used by the FVB. In addition, Plaintiff has not provided any insight into the size of the clients that she is referred from physiotherapists and psychomotor therapists. The observation of the pediatric physiotherapist and the report of the findings of the parents of a client of the plaintiff do describe the success of the treatment method, but they do not provide insight into the alternative treatment methods from which to choose. Also when asked, Plaintiff was unable to provide insight into the criteria that were present for the municipality to choose Plaintiff’s method of treatment, in deviation from the Youth Act, in an assignment awarded to her. Therefore, it has not become plausible that the services provided by the plaintiff are in a legal sense of at least an equivalent quality level as those of (child) physiotherapists or psychomotor therapists.
Source: rechtspraak.nl (Dutch)