Submission 254
National Disability Insurance Scheme
Amendment (Securing the NDIS for
Future Generations) Bill 2026
May 2025
Pedorthic Association of Australia
PO Box
Dee Why NSW 2099
Submission 254
Contents Introduction - Pedorthic Association of Australia ………………………………………………………… 2
Executive Summar\ ……………………………………………………………………………………………….. 3
Recommendation ………………………………………………………………………………………………….. 4
Schedule 1 – Amendments Relating to Participant Access and Supports ………………………. 4
Part 1 – Defining Functional Capacity ……………………………………………………………………. 4
Part 2 – Plan Reassessments ………………………………………………………………………………. 5
Part 3 – Strengthening the Link Between Impairment and Support Needs …………………… 6
Part 4 – Support Determinations …………………………………………………………………………… 6
Part 5 – Plan Renewals ………………………………………………………………………………………. 7
Part 6 – Reasonable and Necessary Supports ……………………………………………………….. 7
Part 8 – Meaning of Permanence …………………………………………………………………………. 8
Part 9 – Eligibility Based on Access to Other Services……………………………………………… 8
Schedule 2 – Integrity and Safeguarding Measures ……………………………………………………. 8
Part 1 – Registration of NDIS Providers …………………………………………………………………. 9
Part 2 – Civil Penalties and Regulatory Powers ………………………………………………………. 9
Part 4 – Retention of Records ………………………………………………………………………………. 9
Part 5 – Reducing Claim Timeframes ………………………………………………………………….. 10
Schedule 3 – Decision Making on Pricing ……………………………………………………………….. 10
Part 1 - Decision Making on Pricing …………………………………………………………………….. 10
Part 2 – Automation of Administrative Actions ………………………………………………………. 11
Schedule 4 – New Framework Planning ………………………………………………………………….. 11
Schedule 5 – Transitional Arrangements …………………………………………………………………. 12
Conclusion …………………………………………………………………………………………………………. 12
Introduction - Pedorthic Association of Australia
The Pedorthic Association of Australia (PAA) is the peak representative body of Pedorthists, who are client-centric health professionals trained in the analysis and treatment of gait and foot & ankle problems. Pedorthists are autonomous allied health practitioners who optimise National Disability Insurance Scheme (NDIS) participants function using highly specialised footwear manufacturing and modification techniques to prevent and treat foot pain and deformity, increase mobility, prevent falls, and reduce the risks of amputation in people with diabetes. Pedorthists are experts in the use of both prefabricated and custom-made orthopaedic footwear, foot orthotics, and ankle braces to provide practical and positive solutions to improve people’s daily life.
PAA Submission | NDIS Amendment (Securing the NDIS for future Generations) Bill 20262
Submission 254
Pedorthists play an important role in foot and lower limb healthcare in Australia, including areas relating to diabetes, disability, human movement science and more, and are a critical part of the NDIS. Pedorthists are helping NDIS participants by maintaining function or improving mobility to be able to fulfill daily tasks, archive their goals and to participate in society.
Pedorthists are predominantly small business owners who work from their own private pedorthic clinic, but they also deliver services in clients’ homes and some public and private hospitals. Pedorthic services are defined as assistive technology and assigned to the Custom Prostheses and Orthoses registration group.
PAA is a full member of Allied Health Professions Australia (AHPA), the recognised national peak association for Australia’s allied health professions and is part of AHPS’s Disability Working Group.
Pedorthists are self-regulated allied health professionals. PAA has full membership with the National Alliance of Self-Regulated Health Professions (NASRHP) and fulfills the conditions and standards set by NASRHP, which are equivalent to the regulations of the Australian Health Practitioner Regulation Agency (AHPRA).
Executive Summary
PAA thanks the Senate Community Affairs Legislation Committee for the opportunity to provide feedback on the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026.
PAA supports the long-term sustainability and integrity of the NDIS and recognises the need for government to ensure public resources are used responsibly and effectively. The NDIS has transformed the lives of many Australians living with disability and has enabled access to supports that promote independence, mobility, participation, safety and inclusion. It is therefore essential that any reforms preserve these fundamental objectives while ensuring the Scheme remains financially sustainable for future generations.
However, PAA is concerned that the proposed amendments extend well beyond administrative reform and introduce significant changes to the operation and philosophy of the NDIS. The Bill grants substantial new powers to the Minister and government while reducing opportunities for parliamentary scrutiny and independent oversight. Many of the most significant decisions affecting participant access, support eligibility, funding levels and evidence requirements will be determined through future rules and legislative instruments, yet the Bill provides limited clarity regarding how these powers will be exercised in practice or what safeguards will be available to participants.
The collective effect of the proposed reforms creates significant risks for participants who rely on specialised supports to maintain mobility, independence and participation.
PAA is concerned about the ability to apply broad reductions to support categories across plans.
A universal reduction may result in participants receiving less support than is clinicallyreasonable and necessary.
PAA Submission | NDIS Amendment (Securing the NDIS for future Generations) Bill 20263
Submission 254
The proposed reasonable and necessary criteria require careful consideration. PAA supports evidence-informed decision-making, but a narrow focus on peer-reviewed evidence may disadvantage specialised, individualised allied health interventions. Pedorthic care often relies
on a combination of published evidence, clinical reasoning, functional assessment, gaitanalysis, pressure mapping, clinical guidelines, responsiveness and real-world outcomes to provide the best solution for the participants.
Additionally, the Bill assumes mainstream and foundational supports will be available to meet needs outside the NDIS. In many areas, these supports are not yet established, funded or accessible. Without these safeguards, participants may be left without either NDIS-funded support or an alternative pathway.
PAA supports efforts to improve consistency and transparency in functional capacity
assessments. However, the proposed definition of functional capacity raises significantconcerns, and it may not accurately reflect how disability affects a person’s everyday life when excluding the impact of the person’s environmental and personal circumstances.
Finally, PAA shares AHPA’s concern regarding equity. Participants in regional areas, people with complex lower-limb disability, people with diabetes-related risk, and those requiring highly specialised footwear interventions may be disproportionately affected if reforms reduce access, increase evidence burdens, or narrow eligibility.
The changes proposed in this Bill are not minor amendments. They will fundamentally reshape key aspects of the NDIS and move it away from its original intent. Reforms of this magnitude are too important to get wrong and should not be rushed. Each of the key elements of the legislation has the capacity to profoundly impact outcomes for participants. Changing all of these at once, with almost no capacity for the community to fully assess the proposals creates significant and unnecessary risk.
PAA notes that AHPA has also made a submission to this inquiry and PAA supports the submission from AHPA.
Recommendation
PAA strongly recommends that the Bill not pass in its current form. Reasonings are included within the detailed feedback below.
Schedule 1 – Amendments Relating to Participant Access and Supports
Part 1 – Defining Functional Capacity
PAA supports efforts to improve consistency and transparency in functional capacity
PAA Submission | NDIS Amendment (Securing the NDIS for future Generations) Bill 20264
Submission 254
assessments. However, the proposed definition of functional capacity raises significantconcerns as it may not accurately reflect how disability affects a person’s everyday life.
Disability does not exist in isolation from the environment in which a person lives. A person’s ability to participate in education, employment and community life is influenced by factors
including mobility, access to assistive technology, environmental barriers, footwearrequirements, support networks and transport availability. Assessments that focus only on what a person can do in a controlled setting risk underestimating the true impact of disability.
For many participants, mobility is one of the primary determinants of functional capacity. Gait, balance, standing tolerance, falls risk, pain and footwear accommodation requirements directly influence independence and participation. A participant may demonstrate adequate mobility during a brief assessment while experiencing substantial restrictions in real-world environments.
PAA recommends that future functional capacity assessment frameworks reflect real world functioning like mobility, gait, balance, standing tolerance, footwear requirements, falls risk and participation outcomes and it should incorporate the person’s environmental and personal context. Standardised assessments are unlikely to adequately capture functional capacity for all people with disability.
Allied health professionals and the evidence they provide must play roles in both the assessment of functional capacity and support needs in any future version of the NDIS. Clinical judgement cannot be overridden by administrative processes.
Part 2 – Plan Reassessments
Plan reassessments play an essential role in supporting adjustments to plans when there are significant ongoing changes to participants needs. These reassessments should be completed in a time sensitive manner to ensure participants can access the supports they need without delay.
PAA is concerned that extending reassessment timeframes from 21 to 90 days and limiting opportunities for participants to seek reassessment may reduce the responsiveness of the Scheme. Participants with progressive conditions, neurological disorders, musculoskeletal deterioration or changing mobility needs may require timely adjustments to their plans to maintain safety and independence.
PAA strongly argues against any measure to reduce the ability for participants to request reassessments. This will reduce safety mechanisms at a time when major other changes are being introduced including broad cuts to plan funding and the introduction of new framework planning. PAA recommends strongly that specific provisions are implemented until framework planning is fully rolled out that enable additional access to plan reassessments.
Many pedorthic interventions are provided in response to changes in function, deformity, balance, skin integrity or mobility. Delays in reassessment may result in participants continuing with inadequate supports, increasing the risk of falls, pressure injuries and loss of participation. Automatic renewals cannot be used in instances where existing plans no longer meet the needs of the participant and there must be accessible pathways to enable reassessments or reviews.
PAA Submission | NDIS Amendment (Securing the NDIS for future Generations) Bill 20265
Submission 254
Part 3 – Strengthening the Link Between Impairment and Support
Needs
PAA acknowledges the need to ensure supports are appropriately linked to disability-related needs. However, the proposed amendments risk creating an overly narrow interpretation of how disability affects function.
Participants frequently experience mobility limitations that arise from the interaction of multiple
impairments, secondary conditions and environmental barriers. Chronic pain, balance
impairment, fatigue, musculoskeletal deterioration and secondary complications oftencontribute significantly to disability-related support needs even where they are not the primary impairment.
Restricting supports only to needs arising directly from a qualifying impairment risk overlooking the complexity of disability and may result in poorer participant outcomes. While it is easy to see
how this is an effective means of cost cutting from a bureaucratic perspective, it has littleconnection to the real-world experience of participants. This is particularly concerning given the limited availability of mainstream and foundational supports outside the NDIS.
Part 4 – Support Determinations
PAA is concerned by the substantial expansion of Ministerial powers proposed within the Bill. The ability to apply broad reductions to categories of supports, regardless of individual participant circumstances, represents a significant departure from the principle of individualised support that underpins the NDIS. Under the proposed arrangements, participants may receive less funding than what has been assessed as reasonable and necessary.
While flexibility is important in administering a scheme of the scale and complexity of the NDIS, the proposed amendments allow many significant decisions affecting participant access, support eligibility, funding levels and operational arrangements to be determined through future rules and legislative instruments that may not be subject to the same level of parliamentary scrutiny as primary legislation.
The Bill provides limited detail regarding how these powers will be exercised in practice and contains insufficient safeguards to ensure decisions remain transparent, evidence-based and consistent with the objectives of the NDIS Act. PAA shares concerns raised across the disability sector regarding the absence of robust oversight mechanisms and the limited opportunities for participants and stakeholders to challenge decisions that may significantly affect access to supports.
Given the significance of these powers, PAA believes that stronger governance arrangements are required, including meaningful consultation requirements, transparent publication of impact assessments, independent review mechanisms and appropriate parliamentary oversight.
For participants requiring pedorthic interventions, reductions in support funding may limit access to custom-made footwear, footwear modifications, orthoses, gait assessments and ongoing
PAA Submission | NDIS Amendment (Securing the NDIS for future Generations) Bill 20266
Submission 254
review services. These interventions are frequently preventative and are designed to avoid more significant complications such as falls, ulceration, hospitalisation and loss of mobility that result in a higher financial burden on the health care system.
PAA is particularly concerned that the legislation provides limited safeguards regarding how participant safety, long-term outcomes and unintended consequences will be considered when support determinations are made.
PAA believes that supports assessed as reasonable and necessary should continue to be funded in full. Any mechanism that permits reductions below assessed need should be subject to strong safeguards, independent review and clear evidence demonstrating that participant outcomes will not be adversely affected.
PAA strongly recommends the deletion of Section 34A.
Part 5 – Plan Renewals
PAA supports efforts to streamline administrative processes where appropriate. However, automatic renewal processes should not occur at the expense of participant safety or support adequacy.
Participants with changing mobility needs, progressive conditions or deteriorating lower-limb function may require adjustments to their supports that would not be identified through an automated renewal process. Clinical input and participant feedback should remain important components of plan renewal decisions.
Part 6 – Reasonable and Necessary Supports
PAA is concerned about the weighting of ‘sustainability’ in the legislation. While scheme sustainability is highly relevant, individualised approaches in relation to support needs cannot be ignored if the intentions of the scheme are to be retained.
PAA supports evidence-informed decision-making and acknowledges the need for greater consistency in the interpretation of reasonable and necessary supports. However, the proposed changes create concerns regarding the hierarchy of evidence that may be used when determining whether a support is effective and beneficial.
Many disability-related interventions, including pedorthic interventions, are highly individualised. Clinical decisions are often informed by a combination of published evidence, clinical expertise, objective assessment findings and participant-specific outcomes. While peer-reviewed research is important, it should not be regarded as the sole determinant of effectiveness.
The disability sector has historically received significantly less research funding than many areas of healthcare. As a result, the absence of high-level published evidence may reflect
structural limitations in research investment rather than a lack of effectiveness. PAA isconcerned that an overly narrow interpretation of evidence may exclude supports that have demonstrated benefit for individual participants and are supported by established clinical practice.
PAA Submission | NDIS Amendment (Securing the NDIS for future Generations) Bill 20267
Submission 254
Reasonable and necessary determinations should continue to recognise participant-specific outcomes, clinical expertise, objective functional assessments, clinical guidelines and real-world evidence.
Part 8 – Meaning of Permanence
PAA has concerns regarding the proposed changes to permanence requirements and the expectation that participants must exhaust all appropriate treatment options before becoming eligible for the Scheme.
While it is reasonable to consider whether treatment options exist, the proposed approach risks creating substantial inequities for individuals who cannot access or afford treatment. Many interventions have lengthy waiting periods, are unavailable in regional areas, or are financially inaccessible. Participants should not be denied access to disability supports because of circumstances beyond their control.
PAA believes that any requirement to pursue treatment should only apply where treatment
options are readily available, affordable, accessible, culturally appropriate and clinicallyindicated. The legislation should also recognise that individuals may reasonably choose not to undertake particular treatments without jeopardising their eligibility for disability supports.
Part 9 – Eligibility Based on Access to Other Services
PAA supports the development of stronger mainstream and foundational support systems. However, the proposed reforms appear to assume that alternative systems are already available and capable of meeting needs that may no longer be funded through the NDIS.
In practice, many participants currently rely on the NDIS because equivalent supports are unavailable, inaccessible or inadequately funded through other systems. Health, disability and community services outside the NDIS remain inconsistent across jurisdictions and often fail to meet the needs of people with complex disability.
PAA believes that no substantial reduction in access to NDIS-funded supports should occur until alternative systems are established, adequately resourced and demonstrated to provide equivalent outcomes.
Schedule 2 – Integrity and Safeguarding Measures
PAA supports measures to ensure integrity of the scheme and address fraud. These must be appropriately balanced to ensure that a viable provider market exists to provide supports and services to participants.
PAA Submission | NDIS Amendment (Securing the NDIS for future Generations) Bill 20268
Submission 254
Part 1 – Registration of NDIS Providers
PAA provided feedback to the Getting It Right: A New Definition for NDIS Providers in February
- In our submission, we argued in support of allied health professionals and their services being captured in the definition of a NDIS provider and to recognise existing professional regulation and credentialing pathways across allied health, to avoid unnecessary duplication of regulatory burden, and ensuring that compliance requirements remain proportionate and risk based.
PAA supports measures that strengthen the integrity, quality and safety of services delivered under the NDIS. Participants should have confidence that providers delivering supports within the Scheme are appropriately qualified, accountable and operating within robust professional and clinical governance frameworks.
PAA supports a risk-proportionate registration model that recognises existing regulatory requirements applicable to allied health professionals and certified practitioners. Any future
registration framework should avoid unnecessary duplication of regulation and shouldacknowledge existing professional standards, certification schemes and quality assurance processes already operating within the health sector.
The introduction of registration requirements should not create barriers that reduce participant access to specialised providers, particularly in rural and regional areas where workforce availability is already limited. Any future registration model should be designed to support participant safety while maintaining a viable and sustainable provider market.
Part 2 – Civil Penalties and Regulatory Powers
PAA supports appropriate measures to address fraud, misuse of funds and deliberate non compliance within the Scheme. Participants and taxpayers should have confidence that NDIS funding is being used appropriately and that providers are held accountable for serious misconduct.
However, expanded regulatory powers and penalties should be proportionate, transparent and accompanied by appropriate safeguards. Distinction should be made between deliberate fraud and genuine administrative errors. The legislation should ensure that enforcement actions are fair, consistent and proportionate to the nature of any breach.
Given the complexity of NDIS administration, providers should have access to clear guidance, education and support to understand their obligations. Regulatory approaches that rely solely on punitive measures may create unintended consequences for smaller providers and ultimately reduce participant access to specialised services.
Part 4 – Retention of Records
PAA supports appropriate record-keeping requirements as an important component of participant safety, clinical governance and accountability.
PAA Submission | NDIS Amendment (Securing the NDIS for future Generations) Bill 20269
Submission 254
Certified Pedorthists, already maintain detailed clinical records to support assessment,treatment planning, prescription decisions and ongoing review. Appropriate documentation
assists in demonstrating clinical reasoning, treatment outcomes and compliance withprofessional standards.
Future record-keeping requirements should align with existing health sector standards and requirements (eg AHPRA or NASRHP) and avoid creating duplicate or conflicting obligations.
Part 5 – Reducing Claim Timeframes
PAA understands the rationale for improving administrative efficiency and reducing delays in claiming processes. However, any significant reduction in claim timeframes must be supported by reliable systems and appropriate safeguards.
Specialised providers often work with participants and multiple stakeholders, includingparticipants, nominees, support coordinators, plan managers and government agencies. Delays may occur for reasons beyond a provider’s control.
PAA recommends that mechanisms be established to address circumstances where claim submission delays arise due to administrative issues, participant circumstances or system failures. The objective of improving efficiency should not inadvertently create financial risks for providers or reduce participant access to specialised services.
Schedule 3 – Decision Making on Pricing
Part 1 - Decision Making on Pricing
PAA supports greater transparency, consistency and independence in NDIS pricingarrangements. Sustainable pricing is critical to ensuring participants have access to high-quality supports delivered by appropriately qualified providers.
Specialised services such as pedorthic assessment, custom footwear provision, footwear
modification and orthotic management require highly skilled practitioners, specialisedequipment, manufacturing capability and significant clinical expertise. Pricing arrangements must recognise the actual cost of delivering these services.
PAA is concerned that the proposed reforms provide significant influence over pricing decisions without sufficient transparency regarding how decisions will be made. Pricing decisions have a direct impact on provider viability and participant access to services.
PAA supports the publication of independent pricing advice, transparent decision-making processes and clear explanations regarding how pricing determinations are reached. This is
particularly important for specialised services where workforce capacity is limited, andparticipant choice may already be constrained.
PAA Submission | NDIS Amendment (Securing the NDIS for future Generations) Bill 202610
Submission 254
Part 2 – Automation of Administrative Actions
PAA recognises the potential benefits of automation in improving efficiency and reducing administrative burden. However, automation should only be used for low-risk administrative processes where outcomes can be objectively determined.
Disability support decisions frequently involve complex clinical, functional and socialconsiderations that require professional judgement. Decisions affecting eligibility, functional capacity, reasonable and necessary supports, participant safety or clinical needs should not be determined solely through automated processes.
PAA recommends that participants retain access to human review and that all automated
processes be subject to transparency, monitoring and independent oversight. Clinicaljudgement should remain central to decision-making where participant wellbeing and safety may be affected and cannot be overridden by administrative processes.
Schedule 4 – New Framework Planning
PAA has provided substantial feedback to the Commonwealth, outlining our concerns regarding new framework planning and the supports needs assessment process.
We understand that further work will be undertaken in preparation of the rules for new framework planning. PAA will continue to engage with the Commonwealth to support the development of these rules. The success of any future planning model will depend on the quality of the assessment processes used to determine support needs and funding levels.
Participants with disability often have highly individual circumstances that cannot be fully captured through standardised assessment tools alone. Functional capacity, support needs and participation goals vary significantly between individuals and require consideration of clinical evidence, lived experience and professional judgement.
PAA strongly supports the inclusion of allied health evidence within future framework planning processes. Reports prepared by appropriately qualified clinicians provide critical information regarding functional capacity, mobility limitations, support needs, risk factors and anticipated outcomes.
For participants requiring pedorthic interventions, assessments of gait, balance, falls risk, standing tolerance, footwear requirements, pressure management and mobility limitations are important components of understanding disability-related support needs. Future planning arrangements should ensure that such evidence is appropriately considered when determining support budgets.
PAA is also concerned about the interaction between framework planning and the proposed powers to impose support determinations and funding caps. If framework planning is intended to produce a more accurate assessment of support needs, participants should receive funding that reflects those assessed needs. Mechanisms that subsequently reduce funding below assessed requirements risk undermining the integrity of the planning process and may result in participants receiving insufficient supports.
PAA Submission | NDIS Amendment (Securing the NDIS for future Generations) Bill 202611
Submission 254
PAA recommends that framework planning processes maintain a strong focus on individual circumstances, functional outcomes, participant goals and evidence provided by qualified allied health professionals.
Schedule 5 – Transitional Arrangements
PAA is concerned that multiple significant reforms are being introduced simultaneously. The interaction between these reforms is difficult to predict and may create unintended impacts for participants.
As noted, PAA holds substantive concerns about the Ministerial power that is granted under this Bill, including this ability to set transitional rules. Additional safeguards, including parliamentary scrutiny, must be in place for the extraordinary powers that are granted to the Minister under this Bill.
Conclusion
PAA urges the Committee to carefully consider the significant implications of this Bill for people
with disability who rely on mobility-related supports. While sustainability is an importantobjective, it must be balanced against the fundamental principles of individualised support, participant choice and control, community participation and equal access.
PAA recommends that the Amendments to the Bill be amended to strengthen participant safeguards, preserve independent oversight, maintain access to reasonable and necessary supports, adopt a balanced approach to evidence and ensure that participants are not disadvantaged by the absence of accessible mainstream and foundational supports. The NDIS has been internationally recognised as a person-centred disability support system, and any reforms should preserve the principles that have contributed to its success.
The NDIS should ensure that participants continue to receive the supports necessary to live independently, safely and with dignity. The success of the NDIS should ultimately be measured not only by financial sustainability, but by its ability to improve the lives of Australians living with disability and support their full participation in society.
PAA thanks the Committee for the opportunity to comment on the Amendments to the Bill 2026 and welcome further engagement.
PAA Submission | NDIS Amendment (Securing the NDIS for future Generations) Bill 202612