FOI 25/26-0018 DOCUMENT 7

Within Budget Threshold Manual Payment Requirements CRM plans

Determine Resolution Process CRM Plans

Before considering if a payment can be made using the within budget threshold process. The payments officers must first ensure that the payment does not meet the requirements for resolution under any of the following processes:

• The support was provided on or after 3 October 2024 and is not an NDIS support under section 10.
• The Payment enquiry can be resolved by providing education
• The Payment enquiry can be resolved via the Plan Adjustment Failure process
• The Payment enquiry can be resolved via a Self Managed CRM payment
• The Payment enquiry can be resolved using Agency or Plan Managed - Alternative Service Booking Resolution
• The Payment enquiry can be resolved via the Specialist Disability Accommodation (SDA) Process
• This process is not applicable if the matter has been referred to the Administrative Review Tribunal.
• This process should not be used if the Provider or Self-Managed Participant is on the Compliance Watchlist. Refer to the Compliance Watchlist SOP for details. In those instances payment may be appropriate if it meets the requirements of the Over Budget - Tier 3 Payment Requirements CRM Plan
• Before a plan managed payment can be made, the Plan Manager must provide:
  • the Service Provider’s ABN; or
  • a completed ATO Statement by a supplier form stating why they are exempt from providing an ABN.
• The Provider, Plan Manager or Self-Managed Participant must have submitted a payment enquiry.
• The Provider or Plan Manager must provide invoices for supports provided, containing relevant details.
• A Self-Managed Participant must provide an MSC form AND invoices or receipts where payment will be over budget.
• The funded support must be included in the affected plan.
• The payment request must be for an old/expired plan.
• The invoice/MSC must not have already been paid or have a Payment Request awaiting approval.

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