Inquiry Submission

I am an adult with Cerebral Palsy and have just begun my second NDIS plan.

It seems to me there is a lack of accountability in NDIS billing that leaves the opportunity wide open for “fee for no service” in the NDIS. My last plan was agency managed. Yes, providers were required to set up a service agreement. The start date was at the start of my plan and the end date was at the end. Once I had provided my NDIS number, there was no paperwork that they needed me to sign per appointment (for example, for physio appointments) to authorise them to be paid. They simply claimed against my number each time.

I have not had a problem with “fee for no service” but I am very concerned that the opportunity for it seems to be there. On an agency managed plan, the NDIS portal does not provide the participant with a dated and itemised record of what money has been taken from the account and when (as a bank statement does). It is difficult to check that the money that has gone out is the money that should have gone out. Instead, once a provider has my number, they appear to be free to withdraw funds from the account as long as the period of the service agreement has not expired. There seems to be nothing in place to prevent them from withdrawing funds for more appointments than I actually attend, as long as there are funds available. Hopefully, if someone was doing the wrong thing, I would notice before it was too late - but since I don’t have an itemised list, that could be difficult. This seems ridiculously trusting and risky. I would like to see a bank statement style record of funds withdrawn on the portal so that NDIS participants can see exactly what they have paid for and when. I also think providers should need to collect a signature for each payment. Without these measures, I believe the service is open to abuse. It could lead to the misuse of public funds and leave people without the services they need.

I am also concerned about a lack of transparency and information about the kind of information that is likely to support the desired funding decision. For my first plan, I was not asked for detailed reports to support my funding requests. I answered the planners’ questions and the plan was approved on the basis of what came out of that conversation, plus a letter from my doctor about how my disability impacts my everyday life. The budget initially allocated for repairs to my electric wheelchair was very small. After I pulled together some quotes for the kind of work that may need to be done, a higher amount was approved.

Entering into my second plan, it wasn’t very clear to me what information (if any) was required from the providers I had worked with during the first plan in order to inform the funding decisions of the second plan. My Local Area Coordinator (LAC) suggested I get a written report from my physiotherapist and the rehab employment agency I had been working with. The physiotherapist wrote a thorough report detailing the progress I had made throughout the year and laying out plans and anticipated needs for the following year. I already had a progress report from the rehab employment company, written in May, which said that the next stage of their work with me would be to do 8 hours reverse marketing on my behalf to employers.

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to the LAC for submission. At his request, I asked them for a further report to support funding for the new plan. When it didn’t arrive, the LAC followed up and was sent a service agreement for 2019.

I had written a statement outlining how I had worked with the rehab employment company during the last plan and what my anticipated needs were. This was submitted, along with the progress report that I had received in May. As my LAC was about to go on leave, the plan request was submitted without a specific report from the rehab employment company to argue for my 2019 funding.

My understanding was that NDIS needed to know that I had made some progress towards achieving my goals during the last plan and that they needed some indication of what I was looking for and why for the next plan. Since this seemed to be covered, the plan request was submitted.

It was not clear to me that the report I had not yet received from the rehab employment company was crucial to support my funding request. However, when the plan came back, I had been approved for 8 hours funding from the rehab employment service. The amount approved matched exactly the amount they suggested in their progress report.

It was a progress report, demonstrating what had been achieved and what the next steps work in the 2018 plan. It did not attempt to argue for my 2019 funding. The case I had put forward for 2019 funding seemed to have been completely ignored.

NDIS is supposed to provide people with disabilities with more choice and control – and yet my funding was clearly based on a report from the provider while my own input seemed to have no bearing on the decision. The funding requested for physiotherapy (for which the therapist had provided what was obviously the desired type of report) was provided in full.

I am in the process of following up to get the type of report I requested from the rehab employment provider so that I can ask for the funding to be reviewed. In the process, I have looked at the information provided on the NDIS website for providers about the documentation that they need to provide. I have not found anything explaining to them that they need to comprehensively argue the case for a participants’ funding for the coming year; so I am not altogether surprised that they didn’t seem to know what I was asking for. Participants and providers need much clearer information about what kind of input NDIS planners are seeking and will take into account in approving a new plan. A report template would be a good start. I also think it would be helpful if, when the approved funding is less than the requested funding, the participant is given some indication of the basis for that decision.

Jane Scott