If the requirements, according to the wording of a national VAT exemption regulation, of sec. 4 of the German VAT Act are not met, VAT exemptions will usually be denied by the German tax authorities. The European law is not taken into consideration. The Federal Court of Finance repeatedly directly applied a VAT Directive tax exemption regulation, in this case to supplies carried out by private hospitals. Supplies carried out by private hospitals are not subject to VAT, independent of their certification with respect to social security law.
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