Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Management of Financial Sustainability Risks - Statement of Financial Sustainability
Question reference number: NDIA IQ26-000024
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Statement of financial sustainability: The NDIS Annual Financial Sustainability Report (AFSR) identifies NDIS cost projections, pressures and reforms affecting projected NDIS costs and refers to measures of participant outcomes, but it does not explicitly say whether the NDIS is sustainable¹.
(a) Does the NDIA have a view on whether the NDIS is sustainable? If so, please elaborate on this view.
(b) What are the key factors leading to any NDIS financial sustainability issues?
(c) How will new approaches, including the ‘New Framework Planning’ and the NDIS alternative measure Thriving Kids, improve the financial sustainability of the scheme?
¹ Auditor-General Report No. 41 2025–26, p. 57.
Answer:
- The Annual Financial Sustainability Report (AFSR) provides actuarial analysis relevant to the National Disability Insurance Scheme (NDIS) financial sustainability, including projections, cost pressures and the impact on reforms. Section 180B(1) of the National Disability Insurance Scheme Act 2013 outlines what must be included in the AFSR.
(a) The AFSR shows that projected NDIS growth remains above agreed targets under current policy settings and highlights that reforms are required to moderate growth over the long term, including meeting National Cabinet’s target of 8%, with further changes needed to achieve the 5-6% target.
The AFSR also notes that the NDIS is delivering positive outcomes for NDIS participants and their families and carers. Implementation of the reforms will help ensure that these outcomes can be maintained in a financially sustainable way.
(b) The key drivers of NDIS financial sustainability pressures are outlined in the 2024-25 AFSR. These include stronger than expected growth in participant numbers, particularly among those with a primary disability of autism, and growth in average plan costs at a rate above inflation.
(c) New Framework Planning is designed to improve consistency and transparency in the planning process, better align supports with participant needs, and moderate growth in plan costs over time. This is expected to improve predictability in Scheme expenditure while enhancing participant experience and choice and control.
Thriving Kids is intended to support children aged eight and under with developmental delay and/or autism with low to moderate support needs, through improved access to mainstream and community-based supports. This approach is designed to ensure children receive appropriate support earlier, while helping to ensure the NDIS remains focused on supporting people with permanent and significant disability, supporting the long-term sustainability of the NDIS.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Management of Financial Sustainability Risks - NDIS Growth
Question reference number: NDIA IQ26-000025
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Projected growth is greater than committed growth: An annual scheme growth target of 8 per cent by 1 July 2026 was set in April 2023, when it was announced by the Minister for the NDIS as part of the NDIS Financial Sustainability Framework¹. Budget Paper No. 1 for the 2024–25 Federal Budget stated, ‘NDIS Commonwealth funded participant payments growth is expected to average 9.2 per cent per year over the projections period’ (to 2034–35)².
(a) Will the target of 8 per cent growth of NDIS by 1 July 2026 be met?
(b) Why is the scheme growing faster than expected?
(c) What is the expected increase in NDIS costs over the next 10-year projection period?
(d) What are the projected agency costs for the NDIA over the next 10-year projection period?
¹ Auditor-General Report No. 41 2025–26, p. 58. ² Auditor-General Report No. 41 2025–26, p. 7-8.
Answer:
2 (a) National Cabinet agreed to moderate National Disability Insurance Scheme (NDIS) growth to 8% annually by 2026–27. As reported in the NDIS 2025–26 Q3 Quarterly Report to disability ministers, NDIS expense growth for the 12 months to 31 March 2026 was 11.3%. Current projections indicate NDIS growth remains above the 8% target under current legislative settings.
(b) Compared with the original 2017 Productivity Commission estimates, Scheme growth has been higher due to stronger than expected growth in participant numbers, particularly among participants with a primary disability of autism, as well as growth in package costs above inflation and pricing increases.
(c) The 2024–25 Annual Financial Sustainability Report projected Scheme expenses on an accrual basis to increase from $50.7 billion in 2025–26 to $95.8 billion in 2034–35.
(d) Please refer to the 2026–27 Health, Disability and Ageing Portfolio Budget Statements for information on the NDIA’s budget for the period 2025–26 to 2029–30.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Management of Financial Sustainability Risks - Projected Growth Vs Committed Growth
Question reference number: NDIA IQ26-000026
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Certainty over projected growth: There have been changes in the growth of the NDIS over the 10-year projections periods in the Budgets for October 2022, May 2023 Budget, and May 2024 – respectively 13.8 per cent¹, 10.4 per cent² and 9.2 per cent³.
(a) How much certainty does the NDIA have over the growth of the NDIS in the future?
¹ Auditor-General Report No. 41 2025–26, p. 7. ² Auditor-General Report No. 41 2025–26, p. 8. ³ Auditor-General Report No. 41 2024–25, p. 18.
Answer:
3 (a) The Annual Financial Sustainability Report produced each year by the Scheme Actuary, includes a dedicated section on risk and uncertainties, which outlines the key sources of uncertainty in the projections and the extent to which outcomes are sensitive to changes in underlying assumptions. This is consistent with the requirements under the National Disability Insurance Scheme (Scheme Actuary) Rules 2013, which require the Scheme Actuary to explicitly consider and report on uncertainty and risks in projecting future Scheme costs.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Management of Financial Sustainability Risks - Income Expenditure Gap
Question reference number: NDIA IQ26-000027
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Income-expenditure gap: As at May 2025, NDIA’s expenses were greater than its own-source income.¹
(a) How will NDIA address the gap between income and expenditure to achieve as a minimum a neutral underlying position and to meet the growing community needs?
(b) What is the NDIA’s approach to managing the financial sustainability of the NDIS?
¹ Auditor-General Report No. 39 2024–25, p. 95.
Answer:
4 (a). The National Disability Insurance Agency’s (NDIA) role is to administer the National Disability Insurance Scheme (NDIS) efficiently and sustainably, including through ongoing efforts to improve cost effectiveness, strengthen financial stewardship, and ensure supports are delivered in line with legislative requirements.
(b) The NDIA’s approach to managing the financial sustainability of the NDIS includes ongoing monitoring of Scheme costs and participant outcomes, actuarial analysis and forecasting, and implementation of operational and policy reforms designed to moderate growth over time.
The National Disability Insurance Scheme Act 2013 establishes the role of the Scheme Actuary, who is responsible for assessing the financial sustainability of the NDIS and reporting on key risks and pressures through the Annual Financial Sustainability Report (AFSR). The AFSR includes analysis on emerging trends, sustainability risks and the impact of reforms and operational measures on future Scheme costs.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Management of Financial Sustainability Risks - NDIS Expenditure by Jurisdiction
Question reference number: NDIA IQ26-000028
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- NDIS expenditure by jurisdiction: From 2019–20 to 2024–25, the proportion of state and territory funding has reduced from 56 per cent to 27 per cent.1
(a) Can the NDIS be sustained whilst the proportion of state and territory funding is reducing over time?
1 Auditor-General Report No. 48 2024–25, p. 14. The ANAO referenced data from the Productivity Commission: Productivity Commission, Report on Government Services 2025, Part F, Section 15, 30 January 2025, Table 15A.1, available from https://www.pc.gov.au/ongoing/report-on-government services/community-services/services-for-people-with-disability/ [accessed 31 January 2025]. Between 2019–20 and 2023–24, state and territory NDIS contribution increased from approximately $10 billion to $12 billion. Over the same period, the Australian Government’s NDIS contribution has increased from approximately $8 billion to $30 billion.
Answer:
5 (a) Under the National Disability Insurance Scheme Financial Sustainability Framework and Heads of Agreement, all governments are committed to ensuring the Scheme is financially sustainable over the long term, including through maintaining cost growth at agreed levels and delivering system reforms.
Under the Heads of Agreement, states and territories have agreed to maintain funding contributions in line with Scheme growth of up to a cap of 8 per cent from 2027–28 to 2030–31.
The key determinant of sustainability is not the funding split, but whether governments collectively deliver the agreed reforms and maintain discipline over Scheme growth in line with the Financial Sustainability Framework.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Management of Financial Sustainability Risks - Policy Committee
Question reference number: NDIA IQ26-000029
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Strategic Leadership Team (SLT) Policy Committee: Established in March 2025, the terms of reference for the SLT Policy Committee state that it is responsible for responsible for ‘Managing overall Scheme coherence, integrity and sustainability’. As of April 2025, the SLT Policy Committee had not held a meeting1.
(a) How many meetings have been held since April 2025?
(b) Are there performance requirements for the SLT? If so, what are they and is the committee performing as intended?
Answer:
6 (a) The Policy Committee met 21 times between 1 April 2025 and 31 December 2025.
(b) The Terms of Reference outline the operating principles and objectives of the Policy Committee, there are no specific performance related criteria.
1 Auditor-General Report No. 48 2024–25, p. 52 and 53.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Management of Financial Sustainability Risks - Risk Reporting
Question reference number: NDIA IQ26-000030
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Risk reporting: Since September 2024, the quarterly Chief Risk Officer Report (presented to the NDIA Audit and Risk Committee and the NDIA Board) included information on progress implementing NDIS reforms as part of reporting on NDIA’s strategic risk 4 — scheme sustainability. As at March 2025, the measures did not have a defined target, results were reported as delayed, and not available for December 2024. In December 2024, the NDIA advised the Board it had started work on a ‘Scheme Reform Program’ risk profile.1
(a) Why was a target not defined for the progress of the reforms?
(b) What is the current progress of reform implementation and completion?
(c) Why was reporting delayed and not made available in December 2024?
(d) What steps have been taken to improve strategic risk reporting on scheme sustainability and progress on implementing reforms?
(e) What is the current risk assessment on scheme sustainability?
(f) Detail the ‘Scheme Reform Program’ risk profile
1 Auditor-General Report No. 41 2024–25, p. 59.
Answer:
7(a) The governance arrangements for the reform program were designed to track delivery. Given the early stage and complexity of these reforms, as at March 2025, progress was monitored against agreed delivery timetables and milestones rather than quantitative targets.
(b) Reform implementation is progressing across multiple workstreams, including New Framework Planning (NFP), fraud and integrity measures, participant pathway reforms and supporting technology and operational changes.
The Australian Government has set a revised commencement date of 1 April 2027 for NFP. To support this timeframe, the program is progressing through scheduled design and build phases.
The Crackdown on Fraud program was completed on 5 February 2026. This was within the funded build and completion timeframes for this program of work.
(c) There was no reform policy forum meeting held in December 2024 due to the National Disability Insurance Agency’s (NDIA) reduced activity period during the Christmas and New Year holiday season. As a result, reporting for the December 2024 period was incorporated into reporting at the next meeting on 17 January 2025.
(d) Strategic risk reporting on these matters has been strengthened to integrate program risks and the outcomes of independent assurance assessments into strategic risk reporting.
Performance and risk are now assessed at project and program levels, which is then consolidated to inform an overall strategic risk profile, providing a more integrated view of reform progress and associated risks.
(e) Scheme sustainability remains a key strategic risk for the Agency, reflecting ongoing participant and cost growth pressures and the scale and complexity of the Scheme.
The Annual Financial Sustainability Report (AFSR) identifies a range of risks and uncertainties relevant to Scheme sustainability, including participant growth, utilisation, market behaviour, inflation and the implementation and effectiveness of reforms.
The NDIA monitors these risks through regular actuarial reporting, strategic risk reporting, reform monitoring and oversight by the Board and its Sustainability Committee.
The 2026–27 Budget includes a range of measures intended to moderate Scheme growth over the medium term. Implementation of these measures, will be subject to legislative passage and ongoing monitoring.
(f) The risk profile for this financial year identifies a range of delivery, policy and implementation risks typical of a large‑scale program, including legislative, technology, workforce, and change risks and benefits realisation. The program is supported by structured governance and independent assurance assessments.
The strategic risks and risk profile are reviewed and updated annually and published in the Agency’s Corporate Plan.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Management of Financial Sustainability Risks and the NDIA Board - Scheme Financial Sustainability
Question reference number: NDIA IQ26-000031
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Scheme financial sustainability: The ANAO found that while the NDIA Board considered NDIS sustainability, it did not provide direction on the NDIA’s response to the growth in NDIS expenses1.
(a) Why did the Board not provide direction?
(b) What direction has the NDIA board provided in response to the growth in NDIS expenses since the ANAO finding?
1 Auditor-General Report No. 41 2024–25, p. 57.
Answer:
8 (a) The National Disability Insurance Agency (NDIA) Board has been actively engaged in oversight of Scheme sustainability and has provided strategic direction to the NDIA on reform initiatives and operational measures designed to moderate Scheme growth and support long-term sustainability.
(b) Financial sustainability and Scheme projections remain a standing focus of the NDIA Board. The NDIA Board receives regular reporting from the NDIA, including on Scheme costs, projections, reform implementation and emerging financial sustainability risks. Prior to the ANAO findings, the Sustainability Committee directed management to prepare reports and deep dives on implementation progress to help ensure the Board could monitor the effectiveness of the reform initiatives on curbing growth. This reporting is now provided on a quarterly basis to the Sustainability Committee and is part of the Committee’s workplan.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Management of Financial Sustainability Risks and the NDIA Board - Board Skills Matrix
Question reference number: NDIA IQ26-000032
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Board skills matrix: The ANAO found that Board discussions of its performance did not refer to an assessment of skills or competencies1.
(a) Has the NDIA Board conducted an assessment of its skills and competencies?
(b) Is the NDIA Board appropriately resourced with the right people to deal with issues of sustainability and operating beyond the budget?
1 Auditor-General Report No. 41 2024–25, p. 37.
Answer:
9 (a) Yes, the National Disability Insurance Agency (NDIA) Board considers the skills, experience and attributes of its members annually as part of its governance process.
(b) As outlined in the National Disability Insurance Scheme Act 2013 (NDIS Act), NDIA Board members are appointed by the Minister following consultation with states and territories, with the majority of jurisdictions required to support appointments. The NDIS Act also sets out the skills, experience and expertise to be represented on the NDIA Board, including being a person with disability, a person with lived experience of disability or experience in areas relevant to financial management, governance and insurance.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Management of Financial Sustainability Risks and the NDIA Board - Scheme Financial Sustainability
Question reference number: NDIA IQ26-000033
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- The role of the NDIA Board in maintaining financial sustainability: The ANAO found that it was not clear whether the NDIA Board provided NDIA management with direction on financial sustainability reform initiatives before these were included in advice to government. It was also not clear to the ANAO whether the NDIA Board had been active in providing direction for reporting on the progress of reform initiatives to assure itself that the NDIA will fulfil the Australian Government’s NDIS Financial Sustainability Framework commitments of reducing NDIS growth to 8 per cent by 1 July 2026.1
(a) Why has the NDIA Board not provided clear direction on reform initiatives and direction for reporting on the progress of financial sustainability initiatives?
(b) How does the NDIA Board assure itself that the NDIA will fulfil the Australian Government’s NDIS Financial Sustainability Framework commitments to moderate growth?
1 Auditor-General Report No. 41 2024–25, p.10 and 58
(c) What direction has the NDIA board provided NDIA management on the reform initiatives and financial sustainability since the ANAO findings?
Answer:
10 (a) The National Disability Insurance Agency (NDIA) Board has been actively engaged in oversight of Scheme sustainability and has provided direction to the NDIA on reform initiatives and operational measures designed to moderate Scheme growth and support long-term sustainability.
b) The NDIA Board recognises the importance of its role in monitoring Scheme sustainability through the NDIA Board’s Sustainability Committee. The Committee’s workplan includes quarterly reform monitoring reports which provide visibility reform progress and impacts on Scheme growth.
c) The NDIA Board regularly monitors Scheme sustainability, including consideration of the Annual Financial Sustainability Report (AFSR), and quarterly Scheme monitoring reports provided by the Scheme Actuary, consistent with its responsibilities under the National Disability Insurance Scheme Act 2013.
Prior to the ANAO findings, the NDIA Board and its Sustainability Committee had strengthened their focus on reform implementation and monitoring, including by directing the NDIA to prepare more regular reporting and detailed analysis on the implementation and progress on reform initiatives designed to moderate Scheme growth and support long-term sustainability.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Compliance with NDIS Claim Requirements - Sustainability and Compliance
Question reference number: NDIA IQ26-000034
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Sustainability and compliance: How are the fraud and compliance issues impacting the financial sustainability of the NDIS?
Answer:
- Fraud and non-compliance impact the financial sustainability of the National Disability Insurance Scheme (NDIS) by diverting funding away from supports intended for NDIS participants and reducing the capacity of the NDIS to deliver supports in a financially sustainable way over the long term.
The National Disability Insurance Agency has implemented a range of integrity and compliance measures to detect, prevent and respond to these risks.
The current estimate of financial integrity loss in the NDIS is between 8.2% and 8.3% of Scheme payments. This estimate reflects a combination of deliberate fraud and broader non-compliant claiming behaviour identified through data analysis and operational insights. Some forms of integrity loss are not currently measurable and are therefore not included in this estimate.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Compliance with NDIS Claim Requirements - Self Managed Participants
Question reference number: NDIA IQ26-000035
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- 1Self-managed participation plans can exceed NDIS price limits: The NDIA publishes the NDIS Pricing Arrangements and Price Limits which lists a catalogue of supports for which providers can lodge claims and maximum prices registered providers can charge for specific supports. 1Price limits are imposed on plan-managed and NDIA-managed participant plans.
(a) Why is it that self-managed participant plans can exceed NDIS price limits and does this impact financial sustainability of the NDIS?
1 Auditor-General Report No. 48 2024-25, p. 16
Answer:
12 (a) Section 43 of the National Disability Insurance Scheme Act 2013 (NDIS Act) enables participants to request self-management and provides that their statement of participant supports must give effect to this request unless certain specified circumstances exist. Self-management supports key objectives of the NDIS Act by enabling choice and control and promoting the independence and social and economic participation of people with a disability.
The prices paid for services by self-managed participants for supports do not materially impact the financial sustainability of the National Disability Insurance Scheme (NDIS), which is primarily managed through overall participant plan budgets and other legislative controls. As is the case with other plan management types, self-managed participants must ensure that spending of NDIS funding is in accordance with their plan. This includes only spending NDIS funding on NDIS supports described in their plan and within any specified total funding amount or funding period.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Compliance with NDIS Claim Requirements - Frameworks for Compliance
Question reference number: NDIA IQ26-000036
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Frameworks for compliance: The ANAO found that the NDIA has not established a fit-for-purpose framework for managing NDIS claim compliance. The submission from NDIA states that it has refreshed its Compliance and Enforcement Framework.1
(a) What actions have been commenced and completed to address the deficiencies in NDIA’s compliance framework, and how does the refreshed Compliance and Enforcement Framework address the deficiencies identified by ANAO?
(b) How are compliance activities targeted to address key non-compliance risks?
1 NDIA, Submission 42, p.13
Answer:
13 (a-b) The National Disability Insurance Agency (NDIA) aims to make it easier to do the right thing and harder to do the wrong thing. In all actions we are committed to ensuring National Disability Insurance Scheme (NDIS) participant safety and the continuity of genuine disability-related NDIS supports. The NDIA focuses on financial risks caused by people doing the wrong thing and responds to those risks in a range of ways according to the extent and nature of the harm they cause. The NDIA also focuses on prevention and deterrence first.
The NDIA Board provides an annual risk appetite statement for integrity risks which includes fraud and corruption risk. The NDIA Board has conservative (low) appetite for fraud and corruption and takes deliberate measures to prevent, detect and respond to fraud and corruption risks. The NDIA Board has instructed the NDIA and its officials to make all reasonable efforts to protect the NDIA, the NDIS and its participants from fraud and corruption.
The Fraud and Corruption Control Plan (FCCP) and the Compliance and Enforcement Framework (CEF) outline how compliance activities are targeted to address key non-compliance risks. Together, these documents provide a fit-for-purpose framework for managing NDIS claim compliance. Both documents were updated in January 2026 and are publicly available on the NDIS website at NDIS Fraud and non-compliance (external).
The FCCP outlines the NDIA’s approach to managing fraud and corruption risks for the NDIA and the NDIS. The FCCP contains information on, and governance arrangements for, the fraud and corruption framework, control systems, risk assessment, accountabilities, and reporting structures that support the NDIA to achieve its purposes and objectives as outlined in the NDIA Corporate Plan 2025-26.
The CEF provides the public with information about how the NDIA approaches compliance and enforcement activities and functions.
Updating the CEF was a key recommendation of the Australian National Audit Office review of claims and payments in June 2025. The CEF now:
- Outlines how compliance activities are targeted to addressing key non-compliance risks.
- Provides an up-to-date outline of our compliance approach.
- Provides clear definitions of scheme requirements.
- Incorporates the Crack Down on Fraud Program and the intent of the ‘strategic prevention concepts’ for the Fraud Fusion Taskforce that outline appropriate control frameworks.
- Includes a table of compliance actions matched to compliance behaviours.
- Provides clear demarcation between the NDIA, the NDIS Quality and Safeguards Commission and the Fraud Fusion Taskforce for actions taken to address non-compliance activity.
- Includes clear information about how the NDIA monitors and reports on fraud prevention and detection efforts.
- Provides a succinct overview of the compliance and enforcement approach taken by the NDIA in conjunction with our partners and stakeholders.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Compliance with NDIS Claim Requirements
Question reference number: NDIA IQ26-000037
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Prevention controls: The ANAO found that NDIS lacked basic prevention controls for fraud and non-compliance.1 After identifying in 2023 that the NDIA was implemented with ‘catastrophically weak’ prevention controls, the NDIA has not yet established effective processes for preventing non-compliant claims.1
(a) What specific steps have been taken to address the prevention control deficiencies?
1 Auditor-General Report No. 48 2024–25, p.8
Answer:
14 (a) The Australian National Audit Office (ANAO) audit examining the National Disability Insurance Agency’s (NDIA) management of claimant compliance with National Disability Insurance Scheme (NDIS) claim requirements commenced in July 2024. The Crack Down on Fraud (CDOF) program commenced in February 2024. The ANAO audit commenced while the team was designing new processes, establishing multiple risk profiles, building detection analytics reporting capability, and implementing CDOF system uplifts. As such, findings reflect a function in early maturity and rapid development.
Over the last 2 years the CDoF program has progressively delivered system and capability uplifts to enhance the NDIA’s ability to better detect and prevent the exploitation of participants and the NDIS.
Through the CDOF program the NDIA has undertaken actions including:
- System uplifts and redesign, including improved verification of identity, enhanced claims verification, and better use of real time data and analytics to detect anomalous behaviour.
- Implementation of pre and post payment controls, including universal risk scoring of claims and Manual Payment Reviews (MPR) for high-risk entities.
- Embedding FFT building blocks into NDIA operations, such as “verify by default,” layered controls, and improved data sharing across agencies. Use of behavioural nudges to reduce inadvertent non-compliance by participants and providers.
This work has seen the rejection and prevention of significant volumes of non-compliant claims, and informed debt recovery, regulatory action and criminal investigations.
As part of the CDoF program, specific actions have been implemented to improve payment integrity in the NDIA. This includes:
- Universal Claim Risk Assessment:
- The NDIA now risk assesses every NDIS claim prior to payment, using data and analytics to identify high-risk claims for further scrutiny, a major shift from historically reactive, post payment review models.
- Manual Payment Reviews:
- High-risk entities (providers, nominees or participants) are subject to MPR, requiring claims to be substantiated before payment.
-
MPR involve third party verification (participants, service records, bank accounts) and are used alongside criminal investigations where required.
-
Rejection and Prevention of non-compliant claims:
- The NDIA has rejected tens of thousands of high-risk claims, halting payments worth tens of millions of dollars before release.
- The NDIA now reviews more claims per day prepayment than were reviewed annually prior to 2023, indicating a step change in scale and capability.
-
Dedicated Payment Integrity Workforce:
- The NDIA has stood up, and expanded a specialist payment integrity workforce, complementing system uplifts delivered through the CDoF program.
-
Changes to operational responses where vulnerabilities affect participants, including safeguarding actions, plan changes and payment suspensions where required.
In March 2026, the NDIA CDOF program was assessed in an End Stage Gateway Review, conducted by an independent review team, coordinated under the Department of Finance’s Assurance Review Framework. The review found that the program delivered enhanced integrity management capabilities supporting the efficient operation of the NDIS. It also found that all milestones were completed on time and within budget, while embedding durable integrity controls across core systems and processes.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Compliance with NDIS Claim Requirements - Detection and Response
Question reference number: NDIA IQ26-000038
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Detection and response to non-compliant claims: The ANAO found that the NDIA had established processes to detect and respond to non-compliant claims1. The NDIA targets its manual pre-payment reviews based on ‘risk profiles’2, which included reviewing a small proportion of NDIS claims paid in quarters 1 and 2 of 2024–25 (0.4 per cent by dollar value) and detected high levels of non-compliance (by dollar value, over 50 per cent of claims were cancelled in 2024)3.
(a) Why was only a small portion of claims reviewed?
(b) Since the ANAO report, has NDIA expanded the proportion of claims it reviews for non-compliance, given the high levels of non-compliance detected? If so, what proportion of NDIS claims (by dollar value) paid have been reviewed?
(c) In any subsequent reviews of non-compliant claims, how much by dollar value has been cancelled?
1 Auditor-General Report No. 48 2024–25, p. 8, 45. 2 Auditor-General Report No. 48 2024–25, p. 9. 3 Auditor-General Report No. 48 2024–25, p. 8, 45.
(d) What detection and response controls has the NDIA put in place since the ANAO report?
(e) Have all risk profiles been endorsed at a senior level?
Answer:
15 (a-e) As part of the Crack Down on Fraud (CDoF) program, which commenced in February 2024, specific actions have been implemented to improve payment integrity in the National Disability Insurance Agency (NDIA). This includes:
-
Universal Claim Risk Assessment:
- The NDIA now risk assesses every NDIS claim prior to payment, using data and analytics to identify high-risk claims for further scrutiny, a major shift from historically reactive, post payment review models.
-
Manual Payment Reviews (MPR):
- High-risk entities (providers, nominees or participants) are subject to MPR, requiring claims to be substantiated before payment.
- MPR involve third party verification (participants, service records, bank accounts) and are used alongside criminal investigations where required.
-
Rejection and Prevention of non-compliant claims (pre-payment reviews):
- The NDIA has rejected tens of thousands of high-risk claims, halting payments worth tens of millions of dollars before release.
- The NDIA now reviews more claims per day pre-payment than were reviewed annually prior to 2023, indicating a step change in scale and capability.
During the 12 months of 2024–25, the NDIA conducted pre-payment reviews on 33,588 claims totalling $108.7 million. Of these, 16,894 claims worth $65.9 million were rejected or cancelled (61% of all the claims reviewed), noting that these claims were identified through high-risk detection profiles.
In the first 6 months of 2025–26, the NDIA had already conducted pre-payment reviews on 34,055 high-risk claims valued at $113 million (0.4% of total payments for 2025–26 to date). Of these, 22,207 claims worth $74.4 million were rejected (66% rejection rate and 0.29% of total payments for 2025–26 to date).
In addition, the NDIA has now implemented MPR on over 2,500 providers who have submitted incorrect or non-compliant claims to the NDIS or had other significant risk indicators. In the 12 months prior to the disruption, these providers had collectively claimed $1 billion from the NDIS. Since the start of the NDIS, these
providers had collectively claimed over $4.8 billion. While it is not possible to determine the exact proportion of problematic claims, all these funds should have been directed to genuine supports or higher quality providers.
As well as implementing a process to measure integrity loss, since the finalisation of the ANAO report, the NDIA continues to mature its detection and response controls and implement a vast range of risk interventions to detect fraud and non-compliance in a variety of ways.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Compliance with NDIS Claim Requirements - Payment Assurance Testing
Question reference number: NDIA IQ26-000039
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Payment assurance testing: The ANAO recommended that the NDIA expand the scope of its assurance testing of claims to estimate the financial impacts of more complex fraud and non-compliance1.
(a) How has the NDIA expanded its scope for payment assurance testing?
1 Auditor-General Report No. 48 2024–25, p. 62.
Answer:
16 (a) The National Disability Insurance Agency (NDIA) is progressively implementing more sophisticated methodologies to estimate the measurement of all types of non-compliance (including fraud and sharp practice).
Whilst the NDIA has already implemented and reported on integrity losses being measured through a more expansive assurance testing model, further revisions to the methodology are expected to be implemented by the end of 2026.
However, consistent with international best practise, the NDIA recognises that integrity loss estimation is complex, and that estimating the full financial impact of complex fraud and non-compliance requires a combination of payment assurance testing, targeted investigations and broader integrity loss modelling. The development of these measures will require ongoing uplifts to system maturity in coming years.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Compliance with NDIS Claim Requirements - Crack down on Fraud
Question reference number: NDIA IQ26-000040
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Crack Down on Fraud: The ANAO found that the NDIA is working to improve the effectiveness of NDIS preventative and detective controls through the Crack Down on Fraud program, including introducing identity verification and claim validation processes and enhanced data analytics capabilities1. Tranche two of its Crack Down on Fraud program expected to be implemented by December 20251.
(a) Was the fraud program been completed within the December 2025 target timeframe?
Answer:
- The CDoF program was formally completed on 5 February 2026. This was within the funded build and completion timeframes for this program of work
1 Auditor-General Report No. 48 2024–25, p. 8.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Compliance with NDIS Claim Requirements - Savings and Benefits
Question reference number: NDIA IQ26-000041
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Savings and benefits from compliance activities: The ANAO recommended that in any reporting on savings and benefits from compliance initiatives, the NDIA should separately report estimated actual financial impacts and projected financial impacts and include explanatory notes on the assumptions underpinning projected figures.1
(a) To date, what actual savings and benefits have been realised since November 2022 from compliance activities?
(b) What are the projected savings and benefits?
(c) What assumptions underpin these savings and benefits?
1 Auditor-General Report No. 48 2024–25, p. 11.
Answer:
- The National Disability Insurance Agency (NDIA) publicly reports on integrity and compliance activities, including integrity intervention, fraud investigations and Scheme financial impacts, through its Quarterly Reports to Disability Ministers.
(a) As at 31 December 2025, from November 2022, the NDIA had realised approximately $480.0 million in savings from measured integrity interventions. In addition, approximately $938.0 million in payments had been redirected from problematic providers to higher quality providers and services.
(b) As at 31 December 2025, integrity interventions implemented up to September and December 2025 are estimated by the NDIA to deliver $3.4 billion in benefits between 1 November 2022 and 30 June 2029. Over $960 million in savings are estimated to the Scheme due to prevented non-compliant payments. A further $2.5 billion in payments are estimated to be diverted from problematic providers into higher quality spending.
(c) These estimates are based on a range of measured integrity interventions, including manual payment reviews, provider bans, targeted payment profiling, and integrity activities relating to Short Term Accommodation claims.
Estimated financial impacts are calculated by comparing observed payment patterns following an intervention against estimated payment levels had the intervention not occurred. Projected impacts are estimated based on observed reductions in payments following interventions continuing over time.
The model also assumes a proportion of reduced payments are redirected towards legitimate participant supports and services following integrity interventions. Estimates do not currently include reparation orders, asset confiscation, repaid debts and broader fraud deterrent effects.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Monitoring, Measurement and Reporting of NDIA Performance - Performance Measures
Question reference number: NDIA IQ26-000042
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Performance measures: The ANAO found that there were no performance measures in the 2023–24 performance statements relating to the NDIA’s management of fraud and non-compliance1 and NDIS financial sustainability2. There are new measures in the 2024–25 corporate plan that relate to the managing NDIS financial sustainability.
(a) Why were there no performance measures for management of fraud and non-compliance, and NDIS financial sustainability?
(b) Have performance measures for fraud and non-compliance been established and reported against since the ANAO finding? If so, what are the performance measures, and will these be published in the next performance statement?
1 Auditor-General Report No. 25 2024-25, p. 104 2 Auditor-General Report No. 25 2024-25, p. 10
Answer:
19 (a) The performance measure Annualised Scheme growth rate was added in the Corporate Plan 2024–25 following announcements by the National Cabinet in April 2023 regarding the National Disability Insurance Scheme (NDIS) Annual Financial Sustainability Framework, which included a commitment to an annual growth target of 8% by July 2026. A fraud and non-compliance measure was added to the Corporate Plan 2025–26 following the introduction of new laws for the NDIS, including amendments to National Disability Insurance Scheme Act 2013 adding a new fraud-related legislative function: to prevent, detect, investigate and respond to misuse or abuse of, or criminal activity involving, the NDIS. These laws came into effect in October 2023, after the publication of the Coporate Plan 2023–27.
(b) Yes, the National Disability Insurance Agency introduced a fraud and non-compliance performance measure, ‘claim integrity checks’ in the Corporate Plan 2025–26. This performance measure will be published in the 2025–26 Annual Performance Statement.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Monitoring, Measurement and Reporting of NDIA Performance - Risk Reporting
Question reference number: NDIA IQ26-000043
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Risk reporting: The ANAO recommended that the NDIA update its risk assessments at the fraud and operational levels to reflect known fraud and non-compliance risks and control weaknesses1.
(a) What specific steps has the NDIA taken to address the ANAO recommendation?
(b) What updates to the integrity strategic risk has the NDIA provided the NDIA Board?
1 Auditor-General Report No. 41 2024-25, p. 10
Answer:
20 (a) To address both this recommendation and ensure effective implementation of the Commonwealth Fraud and Corruption Control Framework (the Framework), the National Disability Insurance Agency (NDIA) developed and is continuing to implement a program of work to improve its fraud and corruption controls. The majority of this work is complete, including the external publication of the NDIA’s Fraud and Corruption Control Plan and Compliance and Enforcement Framework.
Work is underway to redesign the NDIA’s fraud and corruption risk profile, including enterprise and operational level fraud and corruption risk assessments. This work is expected to be completed by July 2026.
To provide further assurance, the NDIA is actively assessing the design and effectiveness of existing fraud and corruption controls across the Agency.
(b) In addition to changes to the integrity strategic risk published in the 2025-26 Corporate Plan, the NDIA is conducting its annual review of strategic risks. The outcomes, including any changes to the integrity strategic risk, will be provided to the NDIA Board and published in the NDIA’s 2026-27 Corporate Plan later in 2026.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Monitoring, Measurement and Reporting of NDIA Performance, and the NDIA Board - Compliance Oversight
Question reference number: NDIA IQ26-000044
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Oversight of compliance and performance: The Board did not respond to senior executive advice that they could not give full assurance over their regulatory compliance obligations.1 The ANAO found the Board did not always seek further detail or assurance where internal reporting indicated poor results, non-compliance or potential issues with the reporting.2
(a) Why did the NDIA Board not provide a respond to senior executive advice that they could not give full assurance over regulatory compliance obligations?
(b) How does the NDIA Board gain assurance over regulatory compliance obligations?
(c) Why has the NDIA Board not questioned the poor results and reporting?
(d) What is the NDIA Board doing now to interrogate NDIA’s regulatory compliance, poor results and issues with reporting?
1 Auditor-General Report No.41 2024–25, p.10 2 Auditor-General Report No.41 2024–25, p.10 and 11
Answer:
21 (a) The National Disability Insurance Agency (NDIA) Board has oversight of the NDIA’s regulatory compliance obligations and the performance. While the Australian National Audit Office (ANAO) found the NDIA Board largely effective, it also identified opportunities for the NDIA Board to strengthen how it seeks additional information and assurance from the NDIA where reporting identifies poor result, non-compliance or emerging risks.
The NDIA Board acknowledged these findings and has since strengthened reporting requirements, including changes to briefing templates who ensure poor results, non-compliance, and assurance limitations are more clearly identified and escalated.
(b) The NDIA Board gains assurance over regulatory compliance through reporting from the NDIA to the Board Audit and Risk Committee (BARC), internal audit activities and targeted external reviews, with significant matters escalated to the full Board as necessary.
In March 2025, the NDIA Board directed the NDIA to strengthen the regulatory obligations attestation framework. Work is underway to improve how regulatory exposure, control effectiveness and assurance processes are identified, assessed and reported to the NDIA Board, to support clearer and more reliable reporting to the NDIA Board.
(c) The NDIA Board regularly monitors NDIA performance, risk and compliance reporting through the NDIA Board and its Committees. In response to the ANAO report, the NDIA Board acknowledged opportunities to strengthen how it interrogates poor results, non-compliance and reporting issues, including through more targeted requests for additional information and assurance from the NDIA.
(d) The NDIA Board has strengthened its expectations of the NDIA’s reporting, including requiring poor results, instances of non-compliance, emerging risks, and assurance limitations to be clearly identified.
Through the BARC, the NDIA Board has also increased its focus on trends, recurring issues and remediation activity, supported by enhancements to the NDIA’s regulatory obligations framework, including improved regulatory exposure reporting, stronger tracking of qualified attestations and remediations, and expanded controls assurance activity to provide more reliable evidence over time.
Joint Committee of Public Accounts and Audit
Inquiry into the Administration of the National Disability Insurance Scheme – 23 April 2026
Answer to Question on Notice
National Disability Insurance Agency
Topic: Monitoring, Measurement and Reporting of NDIA Performance, and the NDIA Board - Evaluation Requirements
Question reference number: NDIA IQ26-000045
Question asked by: Josh Burns
Type of Question: Written
Date set by the Committee for the return of answer: 18 May 2026
Question:
- Board and committee performance evaluation requirements: A Sustainability Committee provides support to the NDIA Board for the oversight of actuarial reporting and NDIS financial sustainability1. The ANAO found that the 2023–24 Board and committee charters did not include performance evaluation requirements2. None of the Board committees provide it with written advice3.
(a) How does the NDIA board know that the Sustainability Committee is performing as intended?
(b) Have performance evaluation requirements been established for the Sustainability Committee?
(c) Why did the Sustainability Committee not provide written advice to the Board? Since the ANAO report, has the Sustainability Committee commenced providing written advice?
1 Auditor-General Report No. 41 2024–25, p. 8. 2 Auditor-General Report No. 41 2024–25, p. 37. 3 Auditor-General Report No. 41 2024–25, p. 9 and 39.
Answer:
22 (a) In January 2025, the National Disability Insurance Agency (NDIA) Board undertook an external review of NDIA Board performance, which found that the Sustainability Committee is effective.
(b) Yes
(c) It has been the NDIA Board’s practice that the Chair of the Sustainability Committee provides a verbal update to the NDIA Board after every Committee meeting. The Board also receives Committee Chair approved minutes for review after each Committee meeting. Since July 2025, a written summary of advice has also been provided in addition to the verbal update from the Committee Chair at each NDIA Board meeting.