A health care institution (a foundation) has entered into agreements with a health insurer for multidisciplinary care, integrated primary care, frail elderly, and practice accreditation. Under these agreements, the foundation receives various reimbursements from the health insurer. The foundation primarily uses general practitioners and other health care providers employed by it for medical care. The question is whether VAT is due on the reimbursements received from the health insurer. Given the specific set of legal agreements under national law, the court finds that there is a legal relationship under which the foundation provides (exempt) medical care and of which the health insurer is the recipient, even though the patient is the direct beneficiary. The fees paid by the health insurer serve to finance that medical care. The agreements do not give rise to a legal relationship between the foundation and the health insurer pursuant to which other types of services are provided to the health insurer.
Source: rechtspraak.nl
