The National Disability Insurance

Scheme Amendment (Integrity and Safeguarding) Bill 2025

Joint submission to the Senate Community

Affairs Legislation Committee Inquiry

Abbreviations

Table of Contentsand acronyms used in this submission …………………………………………………… 3

Introduction …………………………………………………………………………………………………………… 4

Background ……………………………………………………………………………………………………….. 4

Outline of the Bill …………………………………………………………………………………………………. 5

Commencement …………………………………………………………………………………………………. 7

Strengthening the regulatory framework to safeguard NDIS participants …………………………. 8

The role of the NDIS Commissioner and NDIS Commission ………………………………………. 8

Current limitations of the NDIS Commissioner’s powers ……………………………………………. 8

Stronger penalty framework ………………………………………………………………………………….. 9

Introducing tiered civil penalties ………………………………………………………………………….. 9

New civil penalties and criminal offences …………………………………………………………….11

Expanding banning order powers ………………………………………………………………………….11

Regulating promotional conduct related to NDIS supports and services through anti-

promotion orders …………………………………………………………………………………………………12

Information gathering …………………………………………………………………………………………..13

Requiring documents from registered providers ……………………………………………………13

Shorter timeframes for production of information and/or documents …………………………13

Delegation of existing rule-making powers ………………………………………………………………14

Evidentiary Certificates ………………………………………………………………………………………..15

Strengthening the integrity of the NDIS ……………………………………………………………………..16

The role of the NDIA ……………………………………………………………………………………………16

Introducing a cooling-off period and accessible options to withdraw from the NDIS ……….16

Requiring providers to lodge claims electronically …………………………………………………….17

Clarifying plan variations ………………………………………………………………………………………19

Attachment A – legislative instrument making powers proposed ……………………………………20

Abbreviations and acronyms used in this submission

• ACCC means the Australian Competition and Consumer Commission
• ACL means the Australian Consumer Law under schedule 2 of Competition and Consumer Act 2010
• Aged Care Act means the Aged Care Act 2024
• Agency means the National Disability Insurance Agency
• Bill means the National Disability Insurance Scheme Amendment (Integrity and Safeguarding) Bill 2025
• CEO means the Chief Executive Officer of the National Disability Insurance Agency
• Criminal Code means the Criminal Code Act 1995
• CRPD means the United Nations Convention on the Rights of Persons with Disabilities
• Disability Royal Commission means the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability
• Department means the Department of Health, Disability and Ageing
• Legislation Act means the Legislation Act 2003
• LEOMR means the Legislation (Exemptions and Other Measures) Regulation 2015
• NDIS Act means the National Disability Insurance Scheme Act 2013
• NDIS Commission means the National Disability Insurance Scheme Quality and Safeguards Commission
• NDIS Commissioner means the National Disability Insurance Scheme Quality and Safeguards Commissioner
• NDIA means the National Disability Insurance Agency
• NDIS means the National Disability Insurance Scheme
• NDIS Review means the 2023 Independent Review into the NDIS
• NDIS rules means rules made under section 209 of the National Disability Insurance Scheme Act 2013
• Protected Commission Information means information about a person (including a deceased person) that is or was held in the records of the Commission (as described in section 9 of the NDIS Act)
• Scheme means the National Disability Insurance Scheme
• SES means the Senior Executive Service established under section 35 of the Public Service Act 1999
• WHS Act means the Work Health and Safety Act 2011

Introduction

This submission is jointly made by the Department of Health, Disability and Ageing (Department), the National Disability Insurance Agency (NDIA) and the NDS Quality and Safeguards Commission (NDSI Commission). It is intended to provide a background and summary of the Bill as well as expand on some of the more critical and complex aspects to assist the Senate Community Affairs Legislation Committee in its consideration. This submission is made based on the Bill as introduced into the Senate on 26 November 2025. The voices of people with lived experience of disability will be at the centre of the way reforms will be designed and implemented. The policy intent of these measures has undergone consultation with the disability community. The NDIS Commission undertook public consultation on the quality and safeguarding measures between 28 October and 20 December 2024. This included a town hall with the former Minister for the NDIS, the Hon Bill Shorten, in November 2024, targeted engagements with people with disability and peak bodies, and a call for public submissions and survey responses. Targeted consultations were also undertaken throughout September 2025. These consultations were led by the Department and NDIA and included peak disability representatives and participant representative forums.

Background

The Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (Disability Royal Commission) published its final report on 29 September 2023. This followed over four years of investigating community concern about widespread reports of violence against, and the neglect, abuse and exploitation of, people with disability. The Disability Royal Commission gathered information through research, public hearings, personal experiences and submissions, private sessions, and other forums. On 18 October 2022, the former Minister for the NDSI, the Hon Bill Shorten, announced there would be an Independent Review into the NDI (NDIS Review) to improve the wellbeing of Australians with disability and the Scheme’s sustainability. The NDIS Review published its final report on 7 December 2023. The Bill considers the findings from the NDIS Review and the Disability Royal Commission, both of which identified systemic issues of abuse, neglect, and exploitation in the NDIS. Both the Disability Royal Commission and NDIS Review have called for the NDIS Commission to adopt a more active approach to monitoring, and a stronger approach to compliance and enforcement. Enhanced regulatory oversight would allow the NDIs Commission to monitor and enforce compliance more effectively, ensuring that providers meet the necessary standards of care and support.   As highlighted by both reports, strengthening safeguards is crucial to protect the rights and wellbeing of participants, and ensuring issues are addressed swiftly and appropriately. Additional powers would enable the NDIS Commission to adopt a more proactive regulatory approach to preventing abuse and neglect of participants. The independent review of the adequacy of the regulation of the supports and services provided to Ms Ann-Marie Smith, an NDIS participant, who died on 6 April 2020 (the Robertson Review) also emphasised the need for an integrated and responsive regulatory framework, further highlighting the need for the NDSI Commission to be empowered adequately to act to ensure the safety of participants.   The Bill includes amendments to strengthen the NDIIS Commission’s regulatory powers to detect, prevent and respond to breaches of obligations under the NDIS Act. In addition, the Bill introduces enabling measures required by the NDIA and the NDIS Commission to protect the NDIS and participants from non-compliance. The Bil will also implement critical integrity measures required to safeguard the NDIS and to deliver on the government’s commitment to support the financial sustainability of the NDIS through cracking down on non-compliance in the Scheme.

Outline of the Bill

Stronger Penalty Framework

The Bill introduces a stronger penalty framework to reflect the seriousness of the offending conduct and ensure there is a credible deterrence against contraventions of the NDIS Act.

Tiered penalties will allow for more targeted and proportionate action against unlawful behaviour and considers the impact on participants, ensuring penalties are not viewed as a cost of doing business. A stronger penalty framework will strengthen the NDIS Commission’s ability to respond to, and prevent, contraventions of the NDIS Act.

This measure introduces new civil penalties including:

• introducing a serious contravention of a provision of the NDIS Act element, that involves a significant failure or a systemic pattern of conduct, and a higher civil penalty for these breaches;
• for providing false or misleading information or documents;
• for failing to comply with the requirement to provide information or documents; and
• for contraventions of requirements relating to the use or disclosure of Protected Commission information.

It also introduces two new criminal offences:

• for providing NDIS supports that require registration without being registered to do so; and
• for breaching a banning order.

Expanding Existing Banning Orders

The Bill expands the categories of persons against whom a banning order can be imposed.

This will expand the NDIS Commissioner’s current power to make a banning order to include additional categories of persons who operate in the NDIS. This change addresses a regulatory gap, ensuring that individuals’ working across different roles in the NDIS, such as auditors and consultants, can also be banned from operating in the NDIS. This measure seeks to improve participant safety and prevent future harm.

Anti-promotion Orders

The Bill introduces a new power allowing the NDIS Commissioner to issue an anti-promotion order. An anti-promotion order will restrict a person from engaging in regulated promotional conduct where that conduct undermines the objects of the NDIS Act or the principles in section 4. Prohibited conduct will be outlined in new NDIS rules. This will promote transparency and market growth while maintaining participant safety and NDIS integrity.

Failure to comply with an anti-promotion order would incur a civil penalty.

Information Gathering - Registered Providers

The Bill will expand the registration requirement on NDIS providers to provide documents, in addition to existing requirements to provide information, when requested by the NDIS Commissioner.

Information Gathering - Shorter Timeframes

The Bill will allow shorter timeframes for production of information or documents to the NDIS Commissioner when requested. This shortened timeframe would only be used if the NDIS Commissioner reasonably believes that to not do so would significantly increase the risk of serious harm to a participant. The request for the shorter period must also be reasonable in the circumstances.

This request, as per section 55A of the NDIS Act, applies to anyone other than current participants or prospective participants. This recognises that there are some situations where the NDIS Commissioner needs to obtain information in less than 14 days (current period) to enable a reasonable and proportionate response in the circumstances.

This is intended to reduce the risk of harm to NDIS participants.

Delegation of Rule-Making Powers

The Bill will delegate to the NDIS Commissioner, as one of its NDIS Rule making powers, the existing power to make and amend NDIS rules prescribing the persons or bodies to which protected NDIS Commission information may be disclosed. This change is consistent with the other rule-making powers that can be delegated to the NDIS Commissioner, that is, those that relate to the Commission’s functions.

Evidence Certificates

The Bill will provide for an evidentiary certificate signed by the NDIS Commissioner to be prima facie evidence of the matters specified in the certificate. This will provide the NDIS Commissioner legislative authority to issue a certificate which can be relied on in criminal or civil penalty proceedings.

This change increases efficiency in providing uncontroversial evidence and aligns with the legislative authority of other regulators.

Withdrawing from the Scheme

The Bill introduces a 90-day cooling off period for all participants when they request to withdraw from the Scheme, providing a new safeguard for participants against unintended withdrawal. It also allows participants (including nominees or child representatives) to notify the NDIA Chief Executive Officer (CEO) that they no longer wish to be a participant in a manner other than writing (for example, over-the-phone or in-person). The manner must be approved by the CEO.

Electronic Claims Forms

The Bill provides that claims for payment of amounts under the NDIS (including claims made by providers) must be made in a manner approved by the CEO. This includes lodgement through certain electronic channels. The Bill further provides that a claim is not payable if the CEO has provided a written notice requesting further information about the claim that the CEO reasonably requires and that information has not been provided.

This will improve the administration of claims and payments under the NDIS. This also allows for enhanced oversight over the payment of claims in certain circumstances, supporting the integrity and sustainability of the NDIS.

Plan Variation

The NDIA CEO can only vary existing plans in specified circumstances under the NDIS Act. This provision allows changes to be made without the need for a plan reassessment.

The amendment clarifies the term “vary” can mean both increase or decrease under the existing power of the CEO to vary a participant’s total funding amount, as long as it is a permitted variation. This amendment does not change circumstances where variations are permitted or review rights.

Commencement

If passed, Schedule 1 of the Bill will commence on the day after the Bill receives Royal Assent. Schedule 1 of the NDIS Act contains the NDIS Commission measures. Schedule 2 contains NDIA measures and will commence on the 28th day after the Bill receives Royal Assent. Anti-promotion orders will be operationalised by new NDIS rules, which will specify the type of regulated promotional conduct in connection with the NDIS that is prohibited and therefore able to be the subject of an anti-promotion order. The Department, the NDIA and the NDIS Commission are committed to working with the disability community and continuing to put people with disability at the heart of NDIS reforms.

Strengthening the regulatory framework to safeguard

NDIS participants

The role of the NDIS Commissioner and NDIS Commission

The NDIS Commission is the independent national regulator responsible for regulating the NDIS market and ensuring people with disability receive safe and quality NDIS supports and services.

The NDIS Commission was established in 2018 following amendments to the NDIS Act. The NDIS Commission is led by the NDIS Quality and Safeguards Commissioner (NDIS Commissioner), the statutory office holder appointed under the NDIS Act. The NDIS Commission commenced operations in New South Wales and South Australia on 1 July 2018, in Victoria, Queensland, Tasmania, the Australian Capital Territory and the Northern Territory on 1 July 2019, and in Western Australia from 1 December 2020.

The core functions of the NDIS Commissioner (as set out in section 181E of the NDIS Act) include upholding the rights of people with disability, developing a nationally consistent approach to managing quality and safeguards of NDIS supports and services, and securing compliance with the NDIS Act. In addition to these core functions, the NDIS Commissioner has functions related to the registration of providers and reportable incidents, complaints and behaviour support. The NDIS Commissioner also operates and maintains the NDIS worker screening database.

The NDIS Commission uses a range of compliance and enforcement tools to prevent and address breaches of the NDIS Act. The NDIS Act provides the NDIS Commissioner with compliance and enforcement powers including banning orders, compliance notices and court- based outcomes. The NDIS Commission works with NDIS providers through engagement and education activities to promote and assist them in their compliance with their legislative requirements.

Current limitations of the NDIS Commissioner’s powers

The NDIS Commission has a critical role in safeguarding the rights, safety and wellbeing of people with disability who receive supports and services under the NDIS through regulation and oversight of NDIS providers and individuals operating within the NDIS. However, the NDIS Commission’s ability to fulfil this role has been constrained by limitations in the NDIS Commissioner’s powers to address current concerns of safety and non-compliance within the NDIS.

The Disability Royal Commission and the NDIS Review identified significant regulatory gaps that limit the NDIS Commission’s ability to detect and respond to concerning behaviours and poor practices promptly. Both inquiries revealed significant failures by NDIS providers to prevent abuse, neglect and exploitation, or to respond effectively to complaints and incidents.

The Disability Royal Commission recommended the NDIS Commission strengthen its monitoring, compliance and enforcement powers in relation to NDIS providers that have a history of non- compliance or repeatedly fail to meet their obligations to provide safe and quality supports and services, have demonstrated a disregard for the safety of people with disability, and have caused serious harm to a person with disability. The NDIS Review similarly recommended the NDIS Commission should have the resources, powers and approach to proactively and effectively regulate the disability supports market.

There are regulatory gaps in enforcement and coverage across the NDIS market. The NDIS Commission has experienced challenges and limitations in applying consistent and proportionate compliance action, particularly in relation to individuals and areas of the NDIS market that are not subject to the same oversight requirements. For example, consultants and NDIS auditors may continue to operate in the NDIS market even where there may be known safeguarding risks.

Stronger Penalty Framework

The Current State of Penalties Under the NDIS Act

There is also growing evidence of exploitative business practices involving the promulgation of inaccurate and spurious advertising for the purpose of maximising financial gain. These practices can fetter the positive sustainable development of the NDIS market and negatively impact participant choice and control.

The NDIS Commission has a market oversight function to help ensure participants receive safe and quality supports across the NDIS market; however, the NDIS Commission currently has limited or no ability to regulate this conduct under the NDIS Act or NDIS Code of Conduct.

Recent high profile media cases, including the Cocoon SDA Care matter which revealed serious and systemic misconduct, have also highlighted the legislative limitations such as timeframes for requesting information and documents as well as issuing banning orders to consultants. These limitations hindered the NDIS Commission’s ability to obtain regulatory intelligence and information and to take earlier and stronger regulatory action.

The amendments contained in the Bill respond to the limitations in the NDIS Commission’s powers by addressing these regulatory gaps. The amendments will enable earlier regulatory intervention, introduce stronger and more proportionate compliance tools, and enhance the NDIS Commission’s capacity to gather and analyse regulatory intelligence to inform appropriate regulatory action and more effectively prevent harm to participants.

These amendments will enhance the NDIS Commission’s ability to meet its mandate and take effective and formidable regulatory action to protect and uphold the rights, safety and wellbeing of people with disability receiving NDIS supports and services.

Stronger Penalty Framework

The NDIS market has evolved significantly since the current penalty framework was first designed and introduced in 2018. The current penalties framework under the NDIS Act is no longer fit-for-purpose and has limited effectiveness as a credible deterrent against non-compliance with requirements under the NDIS Act.

The Bill includes amendments to strengthen the penalty framework in the NDIS Act by introducing new civil penalty provisions and criminal offences, and the availability of higher civil penalties for aggravated contraventions of certain civil penalty provisions.

These amendments intend to enable more effective and targeted penalties that are proportionate to the seriousness of the offending conduct and deter non-compliance. The amendments will also help foster a culture of regulatory awareness and compliance.

A stronger penalties framework will strengthen the NDIS Commission’s ability to respond to and prevent contraventions of the NDIS Act which in turn will prevent harm to people with disability and improve the quality and safety of NDIS supports and services.

Introducing Tiered Civil Penalties

The current maximum civil penalties available for contraventions of the NDIS Act are not adequate where a breach results in serious harm and are inconsistent with penalties available in comparable legislation, such as the Work Health and Safety Act 2011 (WHS Act) and the Aged Care Act 2024 (Aged Care Act).

There is currently no mechanism under the NDIS Act to differentiate between penalties based on gravity of harm or seriousness of the conduct. This “one size fits all” approach can limit the effectiveness of penalties as a credible deterrent against future offending behaviour, particularly for NDIS providers claiming significant NDIS payments. These providers may see these limited penalties as the cost of doing business rather than improving the standard of care to ensure they don’t contravene the NDIS Act. Significant claim volume could also indicate a large number of participants under their care potentially increasing the risk to a larger cohort of participants.

The Bill proposes introducing tiered civil penalties where there is a serious contravention of a provision of the NDIS Act. A serious contravention either ‘involves a significant failure’ or ‘is part of a systematic pattern of conduct’. These terms are defined in the Bill.

The concepts of ‘significant failure’ and ‘systematic pattern of conduct’

The concepts of ‘significant failure’ and ‘systematic pattern of conduct’ are consistent with the same concepts used in aged care (see subsections 19(1) and (2) of the Aged Care Act 2024). This alignment is intended to support consistency in interpretation and application of the concepts across the NDIS and aged care. The availability of a higher penalty for a serious contravention, where a breach involves a significant failure or a systemic pattern of conduct, aims to enable a more proportionate and effective response to these types of aggravated contraventions of provisions of the NDIS Act. The availability of higher penalties in these circumstances is also consistent with the Disability Royal Commission findings that the NDIS Commission take stronger compliance action in response to serious or repeat non-compliance, demonstrated disregard for the safety of people with disability, or where non-compliance has caused serious harm to a participant. Higher penalties will also help ensure penalties are not viewed as a cost of doing business by NDIS providers. There is a risk that the current penalties under the NDIS regulatory framework might be considered by unscrupulous providers as merely being part of their business model. This will inevitably impact quality and safety of supports and services they provide.

The Bill introduces a maximum of 10,000 penalty units, where there has been a serious contravention by an NDIS provider of certain provisions under the NDIS Act. This is currently the equivalent of $16.5 million for a body corporate, as of 7 November 2024. Where there has not been a serious contravention, there is still a lower maximum civil penalty available. Currently, the potential maximum penalty available for a breach of the Code of Conduct or condition of registration is $412,500 for an NDIS provider. For example, the amendments will enable two tiers of civil penalties available for contravention of the NDIS Code of Conduct under section 73V of the NDIS Act. For serious contraventions by an NDIS provider (both registered and unregistered), the maximum civil penalty available is 10,000 penalty units. In any other case the maximum civil penalty is 250 penalty units. The availability of a higher civil penalty for a serious contravention of the NDIS Code of Conduct is intended to deter people from non-compliance with this requirement. The NDIS Code of Conduct sets out expected standards of behaviour of NDIS providers and workers and is critical to protecting and promoting the rights and safety of participants.

Recent legislative reviews into Work Health and Safety legislation, therapeutic goods, the corporate and financial sector and aged care have resulted in legislative changes to increase maximum penalty units. The key reason underlying these changes has been public interest considerations to ensure penalties are able to act as a sufficient deterrent against non-compliance. There is disparity in available penalties under the NDIS Act compared with legislation with similar objects and purpose. For example, despite both the NDIS Act and WHS Act seeking to achieve the same purpose, namely that people are kept safe from injury or harm, there is a considerable disparity between the penalties available under the WHS Act and the NDIS Act. In the scenario that a disability support worker dies or is seriously injured, the work health and safety regulator would likely apply significantly higher penalties against the disability provider than the NDIS Commission currently could if it is a person with a disability that dies. If a disability support worker is seriously injured while performing work at their workplace, under the WHS Act, as of 13 January 2026, their employer could potentially receive a penalty of $2,090,000 per contravention for failing to comply with a health and safety duty to keep that person safe. If this conduct was considered negligent or reckless, the penalty could be up to $15 million for a corporation. Whereas, if a person with disability is injured while in the care of a provider, potentially suffering worse injuries, that NDIS provider could only be penalised a maximum of $412,500 per contravention under the NDIS Act. These amendments are aimed at ensuring there is consistency across legislation, so that if a worker or participant is injured or killed, the penalties are aligned.

New civil penalties and criminal offences

The Bill proposes several new civil penalty provisions and criminal offences to provide the NDIS Commissioner with more flexible compliance and enforcement tools to respond to non-compliance.

Several new civil penalty provisions have been proposed in addition to provisions which already have a criminal offence attached for non-compliance. This includes: a civil penalty for failing to comply with a requirement to give information (currently a criminal offence under section 57 of the NDIS Act); and a civil penalty for contraventions of requirements relating to the use or disclosure of protected Commission information (currently criminal offences under sections 67B, 67C and 67D). The Bill also includes a new civil penalty for providing false or misleading information or documents for the purposes of the NDIS Act, which has an associated criminal offence available under Part 7.4 of the Criminal Code.

The availability of a civil penalty provision in addition to the existing criminal offence provisions is intended to promote deterrence against non-compliance and will enable the NDIS Commissioner to take proportionate compliance action in circumstances where a criminal prosecution may not be appropriate. The Bill also introduces new criminal offences including: a criminal offence for providing supports that require registration under section 73B and a criminal offence for failing to comply with a banning order under section 73ZN. For both these provisions, there is currently a civil penalty available for non-compliance with these requirements.

Deterrence against non-compliance with the requirement to be registered is important as certain high risk supports, such as developing or implementing behaviour support plans which may include the use of a restrictive practice, require a provider must meet the quality and standards to deliver those supports. Similarly, deterrence against conduct which is in breach of a banning order is critical to safeguarding participants as banning orders are used for the most serious unlawful conduct.

The availability of a criminal offence is intended to help safeguard participants by creating a stronger deterrence against non-compliance with the requirements to be registered or to comply with a banning order. Where a provider contravenes these requirements, participants may receive poor quality, unsafe or inadequate supports and put them at greater risk of harm.

Expanding banning order powers

The Bill expands the categories of persons against whom a banning order can be imposed to ensure unsuitable persons in a broader range of roles, including NDIS auditing and consultant-related roles, can be restricted or prohibited from undertaking specified activities in the NDIS.

Currently, in circumstances where a person is not engaged by an NDIS provider, such as in the case of approved quality auditors and consultants, the NDIS Commissioner is unable to issue a banning order against these categories of person from continuing to operate in the NDIS.

The Bill proposes to provide the NDIS Commissioner with the power to make a banning order prohibiting or restricting specified activities by certain persons, outlined in new subsection 73ZN(2C), where certain circumstances exist. For example, where the NDIS Commission has revoked a person’s registration or approval as an approved quality auditor, a banning order may be issued.

Specified activities that may be prohibited or restricted in a banning order could include engaging in NDIS audits and misleading or predatory provider consultancy practices. A banning order may also specify activities in relation to misleading promotional conduct. An example of this is where consultants make misleading claims in relation to training. This also aims to prohibit consultants

Regulating promotional conduct related to NDIS supports and

services through anti-promotion orders

The NDIS Commission frequently responds to conduct which fundamentally undermines the objects of the NDIS Act or the principles in section 4, which are designed to protect participants of the Scheme and promote transparency and market growth.

Unlike other standard consumer industries, the NDIS market is a social market. In a well- f functioning market, participants would access safe, and quality supports that drive continuous improvement in service provision, and this would in turn enhance outcomes for people with disability.

However, as highlighted by the NDIS Review and in complaints to the NDIS Commission, many participants have reported feeling that the market is being driven by business models that focus on profit at the expense of quality and innovation, and that this no longer enables consumer choice and control.

As the NDIS market grows, it has become clear that there is a need to regulate advertising and sales practices that undermine and are contrary to the intent and operation of the Scheme and to provide information and guidance for appropriate advertising practices aimed at promoting transparency and market growth while upholding the human rights of participants.

Work undertaken by the Fraud Fusion Taskforce and the NDIS Commission has revealed several exploitative business practices involving the promulgation of inaccurate and spurious advertising for the purpose of maximising financial gain. These are included in page 21 of the Explanatory Memorandum, and listed below, for ease of reference. Anti-promotion orders are intended to prevent:

• businesses from using advertisement and promotional materials to mislead participants about how they can use their allocated funds, particularly in relation to short term respite. These advertisements falsely claim that participants can use their NDIS funds to pay for items such as holidays where they can bring their families along for free (a misrepresentation of how NDIS funds are intended to be used);
• people advertising the sale of NDIS registered businesses in an unethical way that raises concerns about the continuity and quality of care for participants, the potential for exploitation or misuse of NDIS funds by those seeking to profit from the Scheme, and the commodification of participants for profit. Often the parties conducting business in this way are not registered providers nor are they “providing supports or services to people with disability”. Accordingly, the NDIS Commission currently has no authority to regulate the conduct under the NDIS Act or Code of Conduct. The proposed new power will enable the NDIS Commissioner to issue anti-promotion orders to any person to prohibit or restrict a person from engaging in regulated promotional conduct (namely, promotional conduct related to supports or services for people with disability, or NDIS providers. This conduct may also include the misrepresentation of the use of NDIS funds, which undermines the objects of the NDIS Act or the principles in section 4 of the NDIS Act. This will help ensure appropriate oversight and compliance tools are available to protect market and Scheme integrity with respect to all entities or individuals involved in advertising or promotion practices that undermine the principles and integrity of the Scheme. This is critical to restricting

Information gathering

Requiring documents from registered providers

Subsection 73F(2) of the NDIS Act provides that the registration of a person as a registered provider is subject to certain conditions. The Bill is seeking to strengthen requirements on NDIS providers in respect of their obligations to respond to requests for information and documents. It is a condition of registration that the person give to the NDIS Commissioner, on request, information specified in the request within the period specified in the request (which must not be less than 14 days) (s73F(2)(i)). However, the NDIS Commission is currently unable to use this provision to request documents as a condition of registration. The Bill proposes a technical amendment that seeks to clarify that it is a condition of registration that a person must comply with a request by the NDIS Commissioner to provide documents specified in a request, in addition to the existing power to request information. By amending s 73F(2)(i) to also include documents, failure to comply with a request to produce documents would be a breach of registration conditions and as such, the NDIS Commissioner could then take a range of compliance actions in relation to that breach including civil penalties. Registered NDIS providers should co-operate with requests for information and/or documents from the NDIS Commissioner as the regulator of their activities in the NDIS sector.

Shorter timeframes for production of information and/or documents

The NDIS Act provides for sanctions where persons fail to provide information or documents requested by the NDIS Commissioner:

• section 55A – where the recipient is any person (other than a participant or prospective participant) that the NDIS Commissioner reasonably believes has information or

• documents that may be relevant to certain matters, including to the NDIS Commissioner’s
• paragraph 73F(2)(i) – where the recipient is a registered NDIS provider (a civil penalty). The timeframe for responding to such requests cannot currently be less than 14 days. It is, however, sometimes necessary to obtain information urgently so that the NDIS Commissioner can act swiftly to reduce the risk of serious harm to a participant. NDIS Commission officers involved in overseeing the use of restrictive practices frequently avoid using section 55A and paragraph 73F(2)(i) to obtain information where there is a high level of concern for a participant’s health and safety, due to the requirement in those provisions to give recipients at least 14 days to provide the information. This is particularly the case in situations where providers may be using unauthorised restrictive practices with respect to children and/or restrictive practices that are prohibited in a state or territory. In these situations, NDIS Commission officers will instead conduct unannounced site visits to the provider in order to respond more immediately to the issue and the risk to a participant’s health and safety. Requesting information more quickly than 14 days would be an additional useful intermediate tool for monitoring safeguarding. For example, where a site visit to a provider highlights a number of serious immediate safeguarding concerns, the NDIS Commission may conduct regular site visits while a banning order is put in place. The NDIS Commission could then reduce the frequency of site visits on the expectation that the banned person/s is no longer involved. Allowing the NDIS Commissioner to request information such as copies of records and logs from the provider in less than 14 days would test compliance with the banning order and provide a means of monitoring and oversight. Requesting information more quickly than 14 days would also be a useful tool for responding to an immediate safeguarding risk. For example, the NDIS Commission may receive information, such as through a complaint, that a participant who lives in supported accommodation has been admitted to the emergency department of a hospital. Allowing the NDIS Commissioner to request information about the participant’s injuries from the hospital more quickly than 14 days would ensure appropriate compliance and enforcement action could be taken swiftly. Enabling requests for information to be provided more quickly than 14 days may raise concerns among the recipients of such requests. However, before the NDIS Commissioner can require this quicker turnaround, they would need to reasonably believe that specifying the shorter period or earlier time would significantly decrease the risk of serious harm to a participant and that the shorter period or earlier time is reasonable in the circumstances. The ‘reasonableness’ requirement means that there would need to be evidence available that would objectively support such a belief in the particular circumstances of each case. The proposed amendment would not, for example, authorise a shorter timeframe simply because the NDIS Commissioner considered it desirable. Delegation of existing rule-making powers The ability to make NDIS rules related to recording, disclosing and using Protected Commission Information, is an existing rule-making power under paragraph 67A(1)(db) of the NDIS Act. Section 201A of the NDIS Act, allows for the Minister to delegate their authority to the NDIS Commissioner to make NDIS rules under the NDIS Act. The NDIS Commissioner is best placed to prescribe bodies to which Protected Commission Information may be disclosed pursuant to s 67A(1)(db). The Bill seeks to change the delegation of this existing rule-making power from the Minister to the NDIS Commissioner. Delegation of this rule-making power to the NDIS Commissioner is consistent with the other rule- making powers that can be delegated to the NDIS Commissioner, that is, those that relate to the NDIS Commission’s functions.

Evidentiary Certificates

Information pertaining to a provider’s registration and registration status is often relevant evidence in civil penalty contraventions and criminal proceedings involving the NDIA and NDIS Commission. This information is already held by the NDIS Commission as part of its responsibility as the regulator of the NDIS.

Currently, NDIS Commission officers are required to take considerable time preparing affidavits and attending court proceedings to give evidence relating to the registration status and history of a provider. This evidence is non-controversial, easily accessible and generally not challenged in legal proceedings.

For example, NDIS Commission officers regularly provide statements regarding the registration status of NDIS providers to support NDIA-led fraud prosecutions pursuant to section 7.3 of the Criminal Code Act 1995 (Criminal Code). NDIS Commission officers are required to attend court (and be on stand-by) each time a prosecution proceeds.

Unlike other regulators, the NDIS Commissioner does not have legislative authority to issue a certificate which can be relied on as prima facie evidence of certain registration matters in criminal and civil penalty proceedings. The need for sworn evidence diverts resources away from The NDIS Commission’s core functions, placing a significant drain on NDIS Commission resources.

The Bill proposes to provide the NDIS Commissioner the power to issue a certificate that establishes basic facts regarding certain registration matters, that can be used as prima facie evidence. The certificate may specify any one or more of the following:

• the date on which the NDIS Commissioner received a person’s application under section 73C to be a registered NDIS provider;
• the date on which the NDIS Commissioner registered a person under section 73E as a registered NDIS provider;
• the date on which a person or entity transitioned from a registered provider of supports to a registered NDIS provider under rules made for the purposes of paragraph 81(2)(b) of Schedule 1 to the National Disability Insurance Scheme Amendment (Quality and Safeguards Commission and Other Measures) Act 2017;
• the date on which a person’s registration as a registered NDIS provider will (subject to section 73K) cease to be in force;
• the date on which a person’s registration as a registered NDIS provider ceased to be in force or was revoked (if applicable);
• the classes of supports or services that a registered NDIS provider is registered to provide;
• the date on which a variation of a person’s registration as a registered NDIS provider takes effect;
• the date on which the NDIS Commissioner decided to vary or revoke a person’s registration as a registered NDIS provider;
• any other matter prescribed in the NDIS rules for the purposes of this paragraph.

Alleviating the need for the NDIS Commissioner and NDIS Commission staff to prepare affidavits and attend court proceedings to give uncontroversial evidence would allow officers to increase focus on their core functions, optimising resource allocation and operational efficiency. As the certificate would be prima facie evidence only, the right to contest or challenge the evidence presented in the certificate would remain available to a defendant/respondent.

Strengthening the integrity of the NDIS

The role of the NDIA

The NDIA is a Corporate Commonwealth entity under the Public Governance, Performance and Accountability Act 2013 and was established under the National Disability Insurance Scheme Act 2013 (NDIS Act).

The NDIA’s role is to administer the NDIS by providing eligible Australians with a significant and permanent disability with access to reasonable and necessary supports. In administering the NDIS, the NDIA is responsible for determining access, developing and approving individual participant plans, and ensuring that funded supports are aligned with participants’ asessed needs, goals and circumstances, while having regard to the effective and sustainable operation of the NDIS.

In performing its functions, the NDIA is required to support participant choice and control and to engage with participants in a manner that promotes autonomy, dignity and inclusion. This includes engaging with people with disability, their families and carers, and the broader disability community in the design, implementation and continuous improvement of policies, processes and service delivery. The NDIA is also responsible for ensuring that its engagement and decision-making processes are accessible and respond to individual circumstances, including cultural and communication needs, to support participants to make informed decisions and pursue their goals.

The NDIA also has broader stewardship responsibilities for the effective operation of the NDIS. This includes contributing to the development of a diverse, sustainable and high- quality disability support market, working with governments, providers and other stakeholders to promote quality and safeguards, and using data and evidence to support continuous improvement in the design and delivery of the NDIS.

As the administrator of the NDIS, the NDIA plays a central role in maintaining the integrity of the Scheme. Effective integrity, compliance and safeguarding arrangements are essential to protecting participants, maintaining public confidence in the NDIS, and ensuring that the NDIS continues to deliver positive outcomes for participants, their families and carers, both now and into the future. These responsibilities are directly relevant to the matters under consideration in the amendment of this Bill.

Introducing a cooling-off period and accessible options to withdraw from the NDIS

A small number of participants choose to withdraw from the NDIS each year. In the 2024-25 financial year, this was approximately 1,900 individuals. Of these, around 58% of withdrawals were made on behalf of children aged 0-18, and 10% were made by people aged over 65. Participants may choose to leave the Scheme due to a variety of reasons including having met their goals and no longer requiring NDIS support and or experiencing a change in circumstances that means that they will no longer meet the residence requirements. When a participant withdraws from the Scheme, they are no longer eligible for NDIS funding for supports and need to reapply if their situation changes in the future and they want to once again become a participant. Currently, participants wishing to withdraw from the Scheme must notify the CEO in writing that they no longer wish to be a participant, and this takes effect immediately. The Bill will introduce a ’cooling-off period’ for all participants who notify the NDIA they would like to withdraw from the Scheme. The cooling-off period is a new safeguard. It will ensure that the

The National Disability Insurance Scheme Amendment (Integrity and Safeguarding) Bill 2025

Requiring Providers to Lodge Claims Electronically

The NDIA processes over 600,000 claims per day. The majority of these are received through the NDIA’s online systems, with 99.9% of provider claims currently submitted electronically. Online submissions ensure that the people making the claim are properly identified and pass through secure risk detection systems.

Unlike other Commonwealth legislative frameworks, the NDIS Act does not currently prescribe the manner in which claims forms are to be submitted. This means that the NDIA must accept claims lodged through any means, such as post, email, or fax.

There is a proportion of claims which are received through off-system channels. These generate manual payment processes. While there are some valid reasons for a claim to require manual processing, there are some providers who utilise this facility out of convenience, or because they wish to bypass NDIA online system controls.

The Bill will make amendments to enable the CEO to require NDIS providers to lodge claims through an online system, such as the ‘my NDIS Provider Portal’.

This amendment will:

• reduce identity and account takeover risks associated with less secure means of communication, such as email1;
• allow the NDIA to apply risk analytics to more effectively identify claiming integrity concerns;
• safeguard participants through early fraud detection and intervention;
• reduce opportunities for human error and privacy breaches;
• ensure claims are received in a timely manner, processable format, and meet the evidence requirements. The amendments will support flexibility by enabling the CEO to determine how a claim must be made and what kinds of claims are required to be made in that way. For example, the amendments will enable the CEO to limit and control how providers submit claims, while providing flexibility for participants to make claims in a variety of ways. The second component of this amendment relates to the NDIA’s review of claims before they are paid. In Quarter 1, 2025-26, the NDIA’s Pre-Payment Team reviewed over 13,000 claims, with a total value of more than $48 million, representing approximately 0.38% of total amounts paid in the same quarter ($12.6 billion). Of those claims reviewed, 75% were rejected or cancelled. This high rate reflects the nature of the review sample, which includes duplicated claims, administrative errors, inconsistent or unusual claims, or other indicators of potential risk. While the pre-payment review process is an important integrity control, it does not impact the overwhelming majority of claimants. As part of a pre-payment review process, the CEO may seek additional information to understand the basis of the claim. If this information is not provided, the NDIA may be unable to establish the validity of a claim. Currently, the NDIS Act provides limited options for obtaining information in relation to claims at the point of claim (i.e. pre-payment). The amendments will allow the NDIA to obtain additional information to ensure claims are genuine before they are paid (i.e. post-claim, pre-payment) which will support the NDIA to be more proactive in identifying issues with claims and reduce the need to engage with compliance activity. This amendment clarifies that if information or documents requested by the CEO by written notice and in relation to the claim, are not provided within a specified period of at least 14 days, then the claim is not payable. Importantly:
• The CEO may extend the period within which the information or documents must be provided, and the period may be extended more than once.
• The CEO may treat information or documents as having been given within the specified period if satisfied that it is appropriate to do so.
• A note to new subsection 45(3A) makes clear that a person may resubmit a claim. This would apply in circumstances where a person is later able to provide the necessary information. The CEO can only request information reasonably required in relation to the claim. This will generally be limited to information which establishes that the:
• claim relates to a support which is an NDIS support for the participant;
• participant’s plan has been complied with in connection with the acquisition or provision of the support;
• support has been delivered (or it is reasonable to expect it will be delivered);
• claim is accurate (e.g. if there is a discrepancy between the totals in an invoice).

Clarifying Plan Variations

The NDIA publishes guidance that reflects best practice, outlining the types of documents and records that providers should keep.

Clarifying plan variations

The NDIS Act provides the circumstances in which the CEO may vary a participant’s NDIS plan, without the need for a plan reassessment. The permitted variations for old and new framework plans are specified in the Act. This amendment makes clear that “variation” of a total funding amount under this section can mean an increase or decrease in the total funding amount. Some variations specified in the Act can clearly only result in an increase in funding, for example crisis or emergency funding or fraud or financial exploitation. This amendment confirms that the CEO’s existing power to vary NDIS plans may result in either an increase or a decrease to a participant’s funding or budget. This is not a change to the current operation of the law.

Most plan variations result in an increase in the plan funding amounts, for example:

• Increasing a plan’s duration (e.g. increasing a two-year plan to a four-year plan).
• Providing funding for assistive technology or home modifications after receiving a quote.
• Adding crisis or emergency funding as a result of a significant change to the participant’s disability support needs.
• Adding funding that is necessary to prevent or lessen a threat to life, health or safety.
• Where a participant has experienced fraud or financial exploitation.

Plan variations may result in a reduced plan funding amount in limited circumstances such as:

• Where the duration of a plan is reduced (e.g. reducing a five-year plan to a three-year plan).
• Where a participant has received compensation for their disability supports under other state or territory statutory schemes for example, following a motor vehicle accident or workers compensation scheme.

For example, a participant may be entitled to compensation or supports under other statutory schemes. These entitlements may be finalised after the participant’s plan is approved, for example, as a result of a court judgment after the participant’s plan was approved. Currently, the CEO takes into account compensation and supports provided by other statutory schemes when approving the funding of reasonable and necessary supports in a participant’s old framework plan, to avoid duplication of funding for disability support needs. This measure clarifies these adjustments can be made to a participant’s budget in a new framework plan without the participant needing to undertake a new support needs assessment, since the outcome of the support needs assessment will not change.

This measure does not change the operation of variation decisions and does not give delegates the power to change a plan outside the existing provisions in the Act. The Bill does not allow funding amounts to be increased or decreased if it would be contrary to the Act or the NDIS rules. Any variations to a budget must be made in accordance with the reasonable and necessary criteria for old framework plans, or under the method set out in rules created under section 32K for new framework plans.

Plan variations will remain reviewable decisions. Where a participant is dissatisfied with a decision to vary or not vary their plan, they will retain their existing right to seek internal review and review by the Administrative Review Tribunal.

Attachment A – legislative instrument making powers proposed

Table of new NDIS rule and legislative instrument making powers proposed in this Bill