Combating evasion

Health expenditure control, how the IRS accesses health card data

The IRS will be able to consult taxpayers' health expenditure directly via the Health Card to improve tax controls

by Marcello Tarabusi

12 November 2025

2' min read

Translated by AI

Versione italiana

Key points

Expenditure documents
News and Controls 2025

2' min read

Translated by AI

Versione italiana

The Revenue Agency will be able to consult the health and veterinary expenses of citizens as part of the formal checks on their tax returns (the 730 or the Income Form for individuals), by directly accessing the information on the Health Card (Ts) system. This also enhances the evidentiary effectiveness of the data downloaded from the Health Card website.

The novelty is envisaged by the Mef decree of 29 October 2025, which set the deadline for sending healthcare expenses to the pre-filed (see "Il Sole 24 Ore" of 11 November).

In particular, a new paragraph 4-bis is introduced to the article 4 of the decree of 19 October 2020, which regulates the submission by healthcare providers: it provides for direct access by the IRS to the data on healthcare expenses. This transposes by decree a provision that had been anticipated in the provision 281068/2025 of the Inland Revenue.

Expenditure documents

The changes will apply as of the year 2025: the Agency will have to select, on a centralised basis, a number of declarations to be subjected to formal control (based on the article 36-ter of Presidential Decree 600/73); only for the declarations thus selected, the employees assigned to the office territorially competent for the control will be made available to consult the detailed data of the veterinary and health expenses relating to the taxpayer and his family members with tax dependents (identified on the basis of the declaration submitted).

Access will allow the official to read the details of each expenditure document, namely:

tax code of the taxpayer or of the dependent family member to whom the expense or reimbursement refers;
tax code or VAT no. and surname and first name or name of the person providing the service or reimbursement;
date of the tax document of expense;
type of expense (according to the classifications provided for sending to the TS system: co-payment, drugs, medical devices, healthcare services and so on);
amount of the expense or reimbursement;
date of payment or reimbursement;
presence of traced payment (when required for deductibility).

Data for which the taxpayer has expressed an opposition shall be excluded from consultation.

News and Controls 2025

The new access for control purposes, applicable from the 2025 data, will make the option - contained in the response to the Faq of 17 July by the Revenue Agency - to base the proof of the incurrence of healthcare expenses, for the purposes of deduction or deduction, on the statement of expenses downloaded from the Ts System, self-certified as compliant, without producing receipts and invoices. This simplified mode was, in fact, a facilitation especially for Cafes and professionals, who can thus affix the conformity certificate on the expenses resulting from the Ts system without checking the expense documents one by one. However, when checking, the pure and simple results of the Ts system may not be enough: there are data, in fact, that the precompiled software discards even if regularly sent (see "Il Sole 24 Ore" of 29 September). With the new procedure, during verification the official will be able to examine the details of each invoice directly online and confirm the deduction or deduction, without the need to produce any paper documents.

There remains the need to keep invoices and receipts for which an objection has been made (and which, therefore, depending on the case, are not present in the system, or cannot be consulted by the Agency), and those of expenses not forwarded to the pre-filled form (e.g. treatment abroad, purchases online or at supermarkets: see again 'Il Sole 24 Ore' of 29 September).