In the opinion of the Court, it follows from the facts in this case that the management services are not independent, but must be regarded as additional services to the specialist medical services. The Court points out in that regard that the management services as described in 2.6 necessarily arise from and are closely related to the specialist medical services. In essence, in a case such as the present, the management services are only broken down in order to gain insight into the structure of the total compensation that the interested party receives from the hospital. In the opinion of the Court, the provision of medical services and the provision of additional management is regarded as the same performance provided to the hospital, whereby the management services follow the tax fate of the main performance, ie the provision of medical services. It is not in dispute that the medical specialist services in the present period are fully exempt from VAT on the basis of Article 11, first paragraph, part g, sub 1, under a, of the OB Act. The management services are therefore also exempt from VAT under the same article.
Source: rechtspraak.nl
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