Legal analysis: The medical services provided by qualified clinics are exempt from VAT, including medicines, medicines, medical materials and instruments, ambulances, ward accommodation and catering services related to medical services. According to the Notice of the Ministry of Finance on Pushing Forward the Pilot Project of Changing Business Tax to Value-added Tax in State Taxation Administration of The People's Republic of China, People's Republic of China (PRC), medical institutions were entrusted by other medical institutions from February 1 2065 to February 3 1 2020. The guiding price of medical services (including the government-guided price and the price negotiated by the supply and demand sides according to the regulations) formulated by the price administrative department at or above the base (city) level in conjunction with the health administrative department at the same level and other relevant departments can provide the value-added tax exemption policy stipulated in Item 7 of Article 1 of the Provisions on the Pilot Transition Policy of Changing Business Tax to Value-added Tax (Cai Shui [2016] No.36) for the services listed in the national medical service price project specification.
Second, the tax policy of private hospitals.
The government encourages private capital to enter the medical and health field in order to gradually break the monopoly situation and realize the pattern of "taking public ownership as the main body and implementing various forms of medical treatment". This is a direction of medical and health system reform. However, Zhao Chun, Secretary General of Private Hospital Management Branch of China Hospital Management Society, pointed out that although the state encourages the development of private hospitals, the relevant supporting measures are insufficient. The mismatch of medical market policies in private hospitals is first manifested in tax policies. The inadaptability and disunity of tax policies have greatly affected the survival and development of private hospitals. The health department defines private hospitals as for-profit hospitals, and the tax department gradually begins to levy taxes on for-profit hospitals. Because private hospitals are basically new things, the policies of health departments and tax departments on the nature of taxation are not uniform. If the enterprise collects taxes, the hospital will have to pay 5.5% of the gross income in addition to the tax of 16, which the hospital can hardly afford. Regarding the tax exemption of for-profit hospitals, local policies are also varied. At the beginning of 2000, in order to encourage the development of private hospitals, the state issued relevant preferential tax policies. Private hospitals will give the following benefits within 3 years from the date of obtaining the practice registration certificate: the medical services obtained are exempt from business tax; Self-produced and self-used preparations are exempt from value-added tax; Property tax, urban land use tax and vehicle and vessel use tax shall be exempted for the real estate, land and vehicle and vessel used by for-profit medical institutions. After the three-year tax exemption expires, taxation will be resumed. However, some local tax authorities believe that taxes should be paid from the date of classified registration; Some places have to pay taxes since the establishment of hospitals. According to this policy, hospitals that have been in operation for 10 years are exempt from taxes for three years and pay taxes for seven years. Millions or even tens of millions of taxes make hospitals unable to collect taxes. Zhao Chun also admitted that many private hospitals do not operate immediately after obtaining the practice registration, and it often takes two years to operate. Therefore, private hospitals have not benefited much from the three-year preferential tax policy. In fact, the for-profit and non-profit medical reform in 2000 was a failure. Public hospitals have many patients, high drug costs and high fees, forming a monopoly; But medical clinics are low-priced drugs with low profits. One is an aircraft carrier and the other is a ship; Private medical institutions are completely uncompetitive. Fortunately, in 2009, State Taxation Administration of The People's Republic of China, the Ministry of Finance of People's Republic of China (PRC), issued the following documents, which promptly terminated the content of levying business tax on private medical institutions, and attached 3360 Notice of People's Republic of China (PRC) and State Taxation Administration of The People's Republic of China, the Ministry of Finance, on the publication of normative documents on the partial abolition or invalidation of business tax, Caishui [2009] No.665438 +0 Document on the partial abolition or invalidation, and the Notice of State Taxation Administration of The People's Republic of China, the Ministry of Finance, on the tax policy of medical and health institutions (Caishui [2009]).
3. What kind of medical services are exempt from VAT?
Medical services provided by medical institutions are exempt from VAT. 1. Medical institutions refer to institutions registered in accordance with the Regulations on the Administration of Medical Institutions (OrderNo. 149 of the State Council) and the Ministry of Health (Order No.35 of the Ministry of Health), as well as various medical institutions at all levels in the military and armed police forces. Specifically, it includes hospitals, outpatient departments (clinics), community health service centers (stations), emergency centers (stations), urban and rural health centers, sanatoriums (stations), sanatoriums, clinical laboratories, health and epidemic prevention stations (CDC), various professional disease prevention stations (stations), and maternal and child health centers (stations) organized by governments at all levels. 2. The term "medical services" as mentioned in this item refers to the medical institutions that provide services listed in the Detailed Rules for the Implementation of the Regulations on the Administration of Medical Institutions for medical patients in conjunction with the health authorities at the same level and other relevant departments, as well as medical institutions that provide health, epidemic prevention and quarantine services to the society according to the medical service guidance prices set by the price authorities at or above the prefecture level (including government guidance prices and prices determined by the supply and demand sides through consultation according to regulations).
4. Is the medical service provided by the hospital exempt from business tax?
Yes, the medical services provided by hospitals are exempt from business tax.
5. Is the medical service income of for-profit medical institutions exempt from VAT?
It's free. Article 1 of Annex III to the Practice License of Medical Institutions (Caishui [2016] No.36) stipulates: "The following items are exempt from value-added tax: (7) Medical services provided by medical institutions." Medical institutions refer to the State Council (the State Council) 149 and No.35 (Order No.35 of the Ministry of Health) of the Ministry of Finance of People's Republic of China (PRC), the Notice of State Taxation Administration of The People's Republic of China on the Pilot Project of Changing Business Tax to Value-added Tax, and various medical institutions of the military and armed police forces. Specifically, it includes various hospitals, outpatient departments (institutes), community health service centers (stations), emergency centers (stations), urban and rural hospitals, sanatoriums (institutes), sanatoriums and other medical institutions. Medical service institutions refer to medical institutions that are not higher than the prefecture (city) level.
The above-mentioned price authorities shall, jointly with the health authorities at the same level and other relevant departments, formulate the guidance price of medical services (including government guidance price and the price determined by the supply and demand sides through consultation according to regulations, etc.). ) to provide various services listed in the national medical service price standard, and medical institutions shall provide health and epidemic prevention and health and quarantine services to the society. The medical services listed in the national medical service price standard are divided into comprehensive medical services, laboratory diagnosis, pathological diagnosis, imaging diagnosis, clinical diagnosis, clinical physical therapy, clinical non-surgical treatment, clinical surgical treatment, clinical auxiliary surgery, traditional Chinese medicine and ethnic medical services.
6. How should doctors pay taxes for their own small clinics and what taxes should they pay? Is there a difference between the city and the countryside? National tax or local tax?
The medical services provided by qualified clinics are exempt from value-added tax (and additional tax), including medicines, medicines, medical materials and equipment, ambulances, ward accommodation and catering services related to medical services. Conditions mainly refer to obtaining the practice license of medical institutions. It shall be levied by State Taxation Administration of The People's Republic of China, declared tax-free and declared on schedule (tax exemption must also be declared). Individual income tax should be paid according to the income from production and operation of individual industrial and commercial households, and the taxable income should be the tax basis, with a progressive tax rate of 5%~35%. The rules in cities and rural areas are the same. The local tax bureau is responsible for collecting and reporting taxes on schedule.