Rome - The Italian tax administration (Agenzia delle Entrate) will be given far-reaching powers to monitor healthcare expenditure from next year. A new decree issued by the Ministry of Economy and Finance on October 29, 2025 will allow officials to directly access data transmitted via the „Sistema Tessera sanitaria“ (health card system) for expenditure from January 1, 2025.
The aim is to check the medical and veterinary invoices deducted in the 730 and „Redditi“ tax return models. This new regulation is intended to make formal checks (in accordance with Article 36-ter) considerably more efficient. Until now, taxpayers often had to submit cumbersome supporting documents such as invoices or receipts (scontrini) during audits. In future, the competent tax offices will be able to compare the declared sums directly with the digital data stored in the healthcare system for centrally selected declarations. The tax authorities will be able to see the amounts, dates, type of service and the respective provider (doctor, pharmacy).
What will change for citizens and service providers
The decree also changes the reporting obligations for the service providers themselves. From 2025, doctors, pharmacies and clinics will only have to submit data annually (instead of every six months as before) by January 31 of the following year. For taxpayers, the important right of objection (opposizione) remains in place. Citizens can block the transmission of individual or all health data to the tax authorities via the Tessera Sanitaria portal (using the SPID, CIE or CNS digital identity).
Data protection and the obligation to retain data
If an objection is lodged, this data will neither appear in the pre-filled tax return (dichiarazione precompilata) nor can it be viewed directly by the auditors. In this case, however, the taxpayer must keep the paper receipts in order to be able to prove the expenditure in the event of an audit. The change also strengthens the position of tax advisors and CAFs (tax assistance centers), who can rely more heavily on digital data when preparing the declaration as long as the client has not lodged an objection.
