96-112

Response July 18, 1996

 

 

Request

State of Utah

Utah State Tax Commission

210 North 1950 West

Salt Lake City, Utah 84134

 

RE: Sales taxability of XXXXX's products

 

Dear Sir/Madam:

 

XXXXX is currently registered, collecting, and remitting sales tax in your state. However, review of the statutes and regulations in your state indicates that, because your state's medical equipment exemption was broadened in 1995, some of XXXXX's products may be exempt from sales tax. The purpose of this letter is to request your written opinion of the taxability of the following list of products in your state.

 

XXXXX is a XXXXX manufacturer and distributor of medical devices and related accessories. XXXXX is registered as a foreign corporation in your state. Most of XXXXX's sales are patient sales, which must be prescribed by a health professional. Sales of some specific products are made to clinics, doctors or other health professionals and either used in their offices, or resold to patients on prescription. Please note that the medical devices can be rented, rented and converted to sale, or sold to the patients.

 

The medical devices sold by XXXXX include:

 

XXXXX A XXXXX device is used to treat chronic and acute pain with electrical stimulation. A XXXXX device consists of a small, portable, battery-powered pulse generator that is connected via wires to electrodes and placed on the skin at or near the site of the patient's pain. A XXXXX device generally reduces pain while the device is being used, as well as for a period of time following usage, but does not cure the cause of the pain. XXXXX devices are designed to be worn on the person of the user.

 

XXXXX An XXXXX device is used to activate muscles for rehabilitation purposes. The XXXXX device produces controlled, involuntary muscle contractions, aiding in maintaining the strength and mobility of a limb or preventing deterioration of muscle tissues in patients who are unable to perform voluntary muscle contractions. Like XXXXX, XXXXX devices are small, portable, battery powered pulse generators designed to be worn on the person of the user.

 

XXXXX The XXXXX system provides biofeedback through auditory and visual display to aid in muscle reeducation and rehabilitation. The clinical system would be utilized in the office of a doctor, physical therapist, or other health professional, while a portable device is available to the patients for use in their home.

 

XXXXX XXXXX is used by a patient for in-home treatment of XXXXX. XXXXX is composed of an externally worn, microprocessor-based electrical neuromuscular stimulator that activates a tampon-like vaginal electrode worn internally. XXXXX is an electro-therapeutic device that causes involuntary contractions of the pelvic musculature and urinary sphincter in order to treat or cure XXXXX.

 

XXXXX XXXXX is a process that uses electrical current to assist drug transfer through the skin. XXXXX applications include the delivery of local anesthesia and anti-inflammatory medication for tissue management. The XXXXX system includes a device transmitter and a buffered electrode. Currently, the XXXXX system is used exclusively in the office of a health care professional, but is designed to be worn on the person of the user.

 

XXXXX The dynamic splint is used to treat range of motion problems that can occur following injuries and certain surgeries. The splint is worn on the patient. The health professional prescribes the splint for the patient and makes certain modifications to the splint for specific use by the particular patient.

 

XXXXX This unit, worn on the person of the user, is designed to apply upward pressure to the patient's head by pumping the rubber bulb pump. This pressure lifts the head, applying a stretch to the neck, which aids in relieving chronic cervical pain and tension.

 

Accessories Related accessories include electrodes, batteries, conductive gels, and skin care products. None of the accessories may be used without the use of the device. Except for the Innova electrode, none of the electrodes are reusable. (i.e., skin care products are only used to help in the electrode application, removal, or related irritation)

 

Questions to be answered:

 

1. Is the sale of the various products listed above subject to sales tax in your state when sold to a patient under a written prescription?

 

2. Is the rental of the various products listed above subject to sales tax in your state when rented to patients under a written prescription?

 

3. Is the sale of the various products listed above subject to sales tax in your state when sold to a doctor or clinic, either to provide a service or to resell to patients under prescription?

 

4. Are the sale of accessories related to the various medical products listed above taxable in your state?

 

Brochures are enclosed to help you understand our products and their applications. Your earliest reply would be greatly appreciated. Thank you, in advance, for your assistance. Please call me at XXXXX if you have any questions.

 

Sincerely,

 

XXXXX

 

 

July 18, 1996

 

XXXXX

 

Advisory Opinion - Sales tax exemption on medical equipment

 

Dear XXXXX

 

We have received your request for an opinion as to the application of the medical equipment tax exemption on products marketed by XXXXX. Although you asked that we identify the taxable status of each item on your list, we cannot do so. The nature of the item does not, by itself, determine its eligibility for exemption. Instead, the item must be

 

1. prescribed by a medical doctor,

2. as necessary for the treatment of a medical illness or injury or as necessary to mitigate and impairment resulting from illness or injury, and

3. eligible for payment under Medicare or state Medicaid guidelines.

 

With regard to Medicare and Medicaid eligibility, we are in the position of relying on outside experts to help make that determination. In our short experience with Medicare and Medicaid guidelines, we have learned that eligibility often depends upon the individual circumstances of the person for whom the equipment is prescribed.

 

Medical equipment and supplies purchased by or on behalf of a health care facility, doctor, nurse or other health care provider for use in their professional practice are ineligible for the exemption.

 

I am sorry we cannot be more specific with regard to your products, but these decisions are very fact-specific. The best advice that we can offer is this: if you sell or rent your equipment directly to a Utah patient who seems to meet the qualifications listed above, contact us for assistance in determining whether the equipment qualifies under Medicare or Medicaid. Alternatively, we suggest that you collect and remit sales tax on the sale or rental and direct the patient to contact us for assistance in obtaining a refund if one is due.

 

For the Commission,

Alice Shearer,

Commissioner