Dutch Court Rules: No VAT Exemption for Dental Emergency Service Fees

• The court ruled that the honorarium received by a partnership of dental practices for being available for emergency service is not exempt from VAT.
• The service does not relate to the protection of health or healing through diagnosis and treatment of diseases or other health problems.
• The partnership provides dental emergency treatment outside regular opening hours for patients of dental practices in the region.
• The partnership uses dentists who are employed, dentists who work as freelancers, and dentists who work in the dental practices of the partners.
• The work performed by the dentists working at the practices of the partners is considered an input into the partnership.
• The dental practices in the region have concluded contracts for services with the partnership.
• The partners of the partnership have also concluded such contracts for services.
• The agreement states that the partnership will receive an honorarium during the period in which it will be available for emergency service for the benefit of the patients of the dental practice.
• Patients conclude a separate agreement with the partnership for their treatment and the partnership charges the emergency treatment to the patients.
• Patients pay directly after treatment.
• The court considered that the performance underlying the honorarium is an independent performance.
• The court considered that the performance is not a separable part of the medical treatment or is ancillary to it.
• The court considered that each performance must normally be regarded as distinct and independent for the purposes of VAT.
• The court considered that there is one performance to be taken into account for VAT if one or more elements must be considered to constitute the main service.
• The court considered that one or more other elements must be considered as one or more ancillary services.
• The court considered that in that situation, the ancillary elements share the tax fate of the main service.
• The court considered that the partnership concludes separate treatment agreements with patients under which the partnership performs emergency treatment on these patients.
• The court considered that the costs of the emergency treatment are charged by the partnership to the patient and the patient pays the partnership directly after treatment.
• The court considered that this emergency treatment qualifies as an exempt medical treatment.

Source: fiscaalvanmorgen.nl

Note that this post was (partially) written with the help of AI. It is always useful to review the original source material, and where needed to obtain (local) advice from a specialist.