AHPA concerns regarding NDIS reforms (Provider advocacy) | External submission

Submission 280

NDIS Amendment (Securing the NDIS for

Future Generations) Bill 2026

May 2026

Submission 280

About Allied Health Professions Australia and the allied health sector Allied Health Professions Australia (AHPA) is the recognised national peak association for Australia’s allied health professions. AHPA’s membership consists of 29 full member organisations, each representing a particular allied health profession. AHPA collectively represents over 195,000 allied health professionals and AHPA works on behalf of the Australian allied health sector.

AHPA’s Disability Working Group (the Working Group) comprises policy and clinician representatives drawn from the range of AHPA’s members that provide services to people with disability including through the National Disability Insurance Scheme (NDIS). The Working Group is therefore informed by the views and experiences of both individual allied health professions and the broader allied health sector.

AHPA and its member associations are committed to ensuring that all Australians can access safe, evidence-based services to assist them to realise their potential for physical, social, emotional and intellectual development.

Executive Summary

AHPA thanks the Senate Community Affairs Legislation Committee for the opportunity to provide feedback on the National Disability Insurance Scheme (NDIS) Amendment (Securing the NDIS for Future Generations) Bill 2026 (‘the Bill’).

AHPA strongly supports the need for a sustainable and effective NDIS and recognises the essential role it plays in supporting and enriching the lives of people with disability. AHPA also recognises the importance of ensuring the NDIS is making appropriate use of public funds and that the government has a responsibility to deliver a safe, quality, and sustainable Scheme.

The changes proposed in this Bill are not minor amendments. They confer broad new powers to the Minister and government, reducing independence and oversight. They will fundamentally reshape key aspects of the NDIS, and move it away from its original intent. The proposed changes narrow eligibility, reduce access to supports and weaken a number of participant safeguards, including review rights.

The NDIS has been a world-leading Scheme. However, the reforms that will be enabled by this legislation shift the Scheme away from being inclusive, person-centred and enabling of participation, towards a model that is restrictive, focused on cost containment, and that will likely no longer (fully) fund what has been assessed as reasonable and necessary.

While AHPA acknowledges the importance of financial sustainability, embedding this concept in the objects of the Act, together with the associated changes proposed in the Bill, shifts the balance too far from the Scheme’s original purpose. In doing so, the Bill places at risk participants’ rights to choice and control, inclusion and participation in the community, and access to reasonable and necessary supports based on individual need. In AHPA’s view, both the rights of people with disability and Australia’s obligations as a signatory to the United Nations Convention on the Rights of Persons with Disabilities are placed at risk by these reforms.

Reforms of this magnitude are too important to get wrong and should not be rushed. Where cost containment is a key driver, additional caution is needed to ensure that reductions in the accessibility of supports don’t impact participant safety, dignity and participation in their

Submission 280

community. 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.

AHPA joins other stakeholders in arguing in the strongest possible way that additional time is essential to allow the Bill to be reviewed in detail, to enable people to understand its full implications, and for meaningful consultation on the proposed changes. This cannot reasonably be achieved within a two-week consultation window. In the absence of legislated review or oversight requirements, clearer communication is also needed about how the Commonwealth will use the powers conferred by this legislation in the long term. Reform of this scale must be underpinned by proper scrutiny and genuine consultation.

AHPA recognises that further detail will be become available as subsequent rules, legislative instruments and guidelines are developed. This will include critically important information such as who qualifies for supports and how functional capacity is assessed. Concerningly, many of these subsequent agreements will not be subject to parliamentary oversight or scrutiny.

It is difficult to support legislation that will confer significant Ministerial powers without a clearer understanding of how those powers will be used to shape short and longer-term participant access to allied health and other supports. Perhaps most critically, it’s difficult to see how this legislation protects people with disability from misuse by a future government with less commitment to the Scheme and the needs of the people it supports. Any government could find itself subject to fiscal or political pressure that make even more substantial limits to access expedient. The substantial increase in Ministerial powers in this Bill must be addressed through the addition of clear governance arrangements, robust safeguards governing the use of those powers, and independent oversight and reporting.

The ability for the Minister to reduce funding and supports below what is deemed to be reasonable and necessary must be struck out. The introduction of support determinations (s34A) and use of caps in the revisions for reasonable and necessary (s33 (2EA) and (2EB)) both enable these reductions. This departs from the fundamental principles of the Scheme and the importance of individualised, needs-based supports. The current Bill shows little evidence that meaningful protections have been considered, with no evidence that the potential of longer-term harms from underfunding supports will guide decision-making.

It is not clear why the legislative power to make cuts and put in place caps that reduce funding beneath the assessed level are needed. Other elements of the Bill such as the tightening of reasonable and necessary criteria, limits on eligible conditions, and the introduction of new framework planning already allow government to tighten criteria. If government has concerns about the effectiveness of new framework planning and other reforms, these should be addressed directly rather than also putting in place the power to enact broad sweeping cost-containment mechanisms, which risk leaving people without access to supports that have been determined to be reasonable and necessary.

Proposed changes in the definition of reasonable and necessary supports raise further serious concerns in the allied health sector about future access to many supports, including allied health capacity building supports. The proposal for the CEO to have the power to exclude any support that doesn’t have the highest level of peer-reviewed evidence, despite individual evidence of effectiveness, is a dangerous overreach and appears to wilfully ignore the paucity of evidence for disability related supports. This lack of research evidence is structural rather than being

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associated with a lack of efficacy as any researcher with experience in this area would attest to. In our view, a key failure of the National Disability Insurance Agency (NDIA) has been the inability to meaningfully build, and support research capacity created in the system.

The Commonwealth has noted at length its concern about financial and other barriers that prevent potential participants from accessing the NDIS and its supports. This concern has been a key foundation for the introduction of new framework planning. Yet the Bill, as proposed, creates new and potentially far more considerable barriers to entry that risk entrenching issues of inequity. The updated definition of permanence will enable the NDIA to deny a person access to the Scheme regardless of their level of functional need, if they have not exhausted all appropriate treatment options. In doing so, it fails to outline how the parameters for ‘all appropriate treatment’ options will be applied in practice, leaving this a potentially arbitrary requirement with limited checks or balances and no requirement for this to be clinically determined. Even more importantly, it explicitly rules out access to the NDIS on the basis that the person is unable to afford or access all appropriate treatment options. This will significantly increase risk for the most vulnerable members of our community.

The proposed changes to the NDIS cannot be considered in isolation. The current broader context matters, particularly when the proposed changes look to restrict access and reduce available supports through the NDIS. A person’s support needs do not simply disappear because they are no longer met by the NDIS. Instead, they get shifted to other areas of the care economy, where limited supports may exist but more often will result in poorer outcomes and potentially higher longer-term costs by increasing health system costs, reducing participation in education and employment, and further reducing the productivity of those with caregiving roles.

The NDIS Review argued that the NDIS became the only option for many people with disability.i The Commonwealth appears to have chosen to interpret this as the basis on which to shift responsibility for supports for many people with disability to the States and Territories. In doing so, it has not considered its own responsibilities outside of the NDIS and the extent to which systems such as Medicare are meeting the needs of people with disability. Until the ecosystem of supports outside of the NDIS is fully established, accessible, well-resourced and demonstrated to be effective, no substantial reductions in NDIS access or support should proceed.

AHPA notes that the impact analysis undertaken identifies that the proposed changes will impact providers, some substantially. It also notes that these impacts will disproportionately affect women working in the Scheme. The lack of focus on the gender-specific impacts of this Bill appear at odds with the overall philosophy of this government and must be addressed.

AHPA notes that many of our member organisations have also made submissions to this inquiry, and that those submissions provide further feedback including profession specific perspectives on the proposed reforms.

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Key Recommendations

AHPA strongly recommends that the Bill not pass in its current form. Further, AHPA strongly recommends that there be no provisions in the Bill that would enable plan funding to be lower than the cost of providing reasonable and necessary supports.

Below outlines AHPAs key recommendations to amend the Bill. Further recommendations are included within the detailed feedback section below.

Schedule 1 Part 1- Defining functional capacity

Amend section 9B, the definition of functional capacity, to reflect real world functioning and incorporate the person’s environmental and personal context. Part 4- Support determination
Delete section 34A. If s34A proceeds, add additional safeguards. This should include requiring consultation, increased parliamentary scrutiny and impact analyses for proposed determinations. Safety should be defined to not only include imminent risks of harm but also longer-term impacts of funding cuts. Determinations should be a reviewable decision, and determinations should be required to hold for a limited fixed period of time. Part 6- Reasonable and necessary supports
Delete item 66 and retain the principles to be considered for a participant’s plan outlined in section 31.
Delete proposed item 68- addition of s32 (2EA) and (2EB) which will permit caps on funding or intensity of supports. If this item is retained add additional participant safeguards such as a requirement for the Minister to consider immediate and longer-term safety implications of caps and the ability to review the decision.
Amend proposed item 73- addition of s34 (1E) and (1F) to remove the clause that enables the CEO to disregard other evidence, including a participant’s own evidence of effectiveness, in determining if a support is reasonable and necessary. Part 8- Meaning of permanence
Define all appropriate treatment to include treatments that are readily available, affordable, culturally safe, and accessible. Part 9- Eligibility based on access to other services
Amend to only permit exclusion to the NDIS in situations where alternative supports are available, accessible and offer equivalent levels of support.

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Schedule 3 Part 1- Decision making on pricing

Amend the Bill to require the Minister to make publicly available all advice received in relation to pricing as well as explanatory notes on pricing determinations.

General

Delay any substantial changes to NDIS access or supports until the ecosystem of supports outside of the NDIS is fully established, accessible, well-resourced and demonstrated to be effective.
Amend the Bill to ensure adequate parliamentary oversight is maintained, review rights are protected and sufficient participant safeguards are in place.
Establish an NDIS Therapy Supports Advisory Group to provide independent oversight of reform implementation.

Detailed feedback The content below provides more specific feedback on key elements of the Bill that create significant risk of harm and unintended consequences. AHPA notes that the short timeframe for feedback has significantly limited the opportunity to provide input. Given additional time, AHPA would welcome the opportunity to provide more extensive analysis and feedback.

Submission 280

Schedule 1

Part 1. Defining Functional Capacity

AHPA notes that the new definition for functional capacity (section 9B) looks to seek what activities participants can do without assistance and excludes, to the extent possible, the impact of one’s personal circumstances and environment. This is incongruent with the World Health Organisations International Classification of Functioning, Disability and Health (ICF) that recognises that the functioning and disability of a person is shaped by their context.ii Disability does not exist in isolation. This proposed definition means the assessment may not capture the entire picture, presenting a risk that participant function won’t be captured accurately, leading to significant consequences for access, planning and participant outcomes.

AHPA recommends the definition be revised to ensure that functional capacity is captured holistically, reflecting real-world functioning and participation.

AHPA understands that the proposed Bill will enable future rules to be created to determine tools and criteria to measure and assess functional capacity. The allied health sector argues in the strongest possible terms that standardised assessments are unlikely to adequately capture functional capacity for all people with disability. The role of the Technical Advisory Group (TAG) will be pivotal to establishing the functional capacity assessments and thresholds in the context of eligibility for the NDIS. This group will provide advice on appropriate thresholds and assessments for substantially reduced functional capacity. Getting this right is essential. Allied health professionals are the primary professionals who understand and undertake functional capacity assessments. AHPA argues strongly that appropriately experienced clinicians from the key allied health professions responsible for assessing functional capacity must comprise the majority of membership within the TAG alongside participant representatives. Furthermore, 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 a vital role in supporting adjustments to plans when there are significant changes to participants needs. They are a critical feature of the NDIS that ensures safety and enables choice and control. These reassessments should be completed in a time sensitive manner to ensure participants can assess the supports they need without delay. The extension of the time period from 21 to 90 days, presents a risk that supports may be delayed, impacting on participants safety. Adequate safeguards must be in place to mitigate risks from this expanded duration.

AHPA argues strongly against measure to reduce the ability for participants to request reassessments. This will further 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. With the introduction of any new process for determining eligibility and support needs, there will be a clear need to evaluate and, at times, recalibrate assessment processes and outcomes. Given changes to the right for legal review of administrative decisions, participants are facing a scenario in which there will be limited recourse when plans fail to meet their needs. This appears to hold true regardless of the level of risk of harm. AHPA recommends strongly that specific provisions are implemented until framework planning is fully rolled out that enable additional access to plan reassessments.

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Advocates, including providers, should be able to support participants where appropriate to make requests during this time. It would be appropriate to require providers or other advocates to need to declare any conflicts of interest when requesting reassessment.

AHPA highlights that the limited opportunities for plan reassessments pose further issues when considering the proposed changes for plan renewals (Schedule 1, Part 5). It is our understanding that many plans will be automatically renewed and that this process would largely replicate the existing plan with some adjustments. This renewal appears to be able to be made without participant or clinician input and is not subject to review. Compounded with the restrictions on plan reassessments, this leaves minimal safeguards for participants. Automatic renewal cannot be used in instances where existing plans no longer meet the needs of the participant and there must be easily accessible pathways to enable reassessments or review.

Part 3: Strengthen link between impairment and need for support The proposed Bill will more clearly define that supports can only be provided for needs that arise directly from an impairment or impairments that meet NDIS functional need thresholds under disability or early intervention requirements. This is an existing area of contention, and many participants already struggle to access supports for functional support needs arising from secondary areas of impairment. While it is easy to see how this is an effective means of cost containment, it has little connection to the real-world experience of participants and allied health professions who understand the fundamental interconnectedness of multiple impairments and that functional impairment can fluctuate over time. Fully excluding access to funding will result in poorer outcomes for many participants with secondary issues such as mental ill-health and chronic pain.

The decision to restrict access to supports based on a direct link to an impairment, should only be made where there are other mainstream and foundational supports in the disability ecosystem to help participants meet their support needs. This is not the case right now. There are limited non NDIS supports widely available and existing reviews show clearly that Medicare funding of allied health services is very significantly below the real cost of services.iii,iv This results in those non NDIS Medicare service being inaccessible to people with limited financial means. Medicare and other non-NDIS programs also most often fail to fund the cost of accessing services for a person with disability who are more likely to require support to travel to access supports.

Given the evidence before government from previous reviews and about the purchasing power of people with disability,v this provision appears to suggest a dangerous willingness to increase inequity. The Commonwealth has a responsibility to address these issues, by strengthening supports outside of the NDIS, particularly through federally funded programs like Medicare. The NDIS must also continue to address the barriers to accessing other services and supports offered outside of the NDIS, such as through funding of transport and support workers.

Submission 280

Part 4: Support determination Part 4 of Schedule 1, provides a mechanism to directly manage the financial sustainability of the Scheme by granting the Minister powers to reduce funding for specified groups of support across the Scheme, with very limited safeguards. AHPA strongly recommends the deletion of Section 34A.

In our view, this proposed change fundamentally undermines the philosophy of the NDIS. The NDIS was built upon the principle that reasonable and necessary supports, that help participants live as ordinary a life as possible, are funded. Blanket funding restrictions will mean that regardless of how carefully and consistently a participant’s needs are assessed, government can choose to fund less than what is deemed reasonable and necessary. This risks completely undermining the intent of this Scheme and its premise to deliver individualised support. It also means participants may not have enough funding to address their support needs with little or no controls to consider the safety impact of these changes.

In the explanatory memorandum it highlights that support determinations will allow for adjustments to the funding of certain classes of supports that may be overfunded or no longer justified. Furthermore, the document explains that targeted reductions can reduce pressure whilst ensuring critical supports are maintained at necessary levels. AHPA disagrees with these assertions. These determinations can reduce a person’s funding below what is deemed reasonable and necessary, essentially preventing a participant from accessing all the critical supports they are assessed as needing. It gives no consideration to the impact of cutting off a program of supports part way through, of providing too little funding for meaningful participatory activities to occur, or of how cuts will impact the ability to achieve participant goals. With other measures being introduced such as new framework planning and stronger definitions, there should not be the need for this Bill to introduce ‘controls’ to target and tighten the funding of plans by universally bluntly applying reductions to support categories.

Supports deemed reasonable and necessary should be funded in full. In the absence of the full funding of reasonable and necessary supports, which AHPA does not support, meaningful safeguards are essential. Whilst the Bill requires the Minister to have regard to the ‘safety of participants’, this is an insufficient level of safeguarding as safety does not appear to be defined. In the absence of a formal definition, safety could be taken to only mean risk of imminent harm rather than the longer-term impact of being isolated at home, unable to complete a program of supports, or at risk of failing to achieve developmental and capacity-building outcomes due to inadequately funded functional supports. Furthermore, these decisions will not be subject to review. This must change. Consideration must be given to how participants and advocates can identify and address the impact of cuts on participant plans, how safety is defined to encompass the breadth of harms, and how these powers can be constrained by independent oversight.

Where Section 34(A) is retained, the Bill must be amended to include greater consultation and parliamentary scrutiny over support determination decisions. Further, participants must be able to access reviews or reassessments to address individual concerns.

AHPA understands that should this proposed change proceed, capacity building daily activities budgets, which include allied health therapy supports, will be reduced by 10% from 1 October

These capacity building supports enable participants to improve and maintain their functional capacity. These are not optional extras. AHPA strongly opposes these restrictions.

Submission 280

The Impact Analysis supporting the Bill models this cut, as well as a 50% cut to social community and civic participation. The impact analysis however fails to account for any future cuts and the impact these will have on participants and providers. There must be assurances that all future decisions are supported by thorough analysis of the impacts. AHPA calls for an amendment that requires the Minister to undertake and publish the impact analysis for any future decisions.

The impact analysis notes that the capacity building daily activity cuts won’t necessarily have profound impacts on the allied health workforce, citing that there is unmet demand across other areas of the care and support economy.vi The Minister on a number of occasions, has stated a similar view. AHPA argues strongly that this is an overly simplistic view of how the allied health workforce operates that fails to recognise the extensive skills and experience of allied health professionals who operate in disability and the expertise needed to work in other areas of practice. It also fails to address significant funding barriers in those other Schemes. AHPA has recently written a statement to express our concerns about these assumptions.vii

The impact analysis also states, “for most participants, the reform will not impact their CBDA spending and would likely result in increased utilisation rather than needing to reduce services.” AHPA disagrees with this assumption. Utilisation rates are impacted by many factors such as workforce shortages and thin markets. AHPA is not aware of modelling that demonstrates that the workforce who is impacted by the cuts will be the appropriate workforce to address underutilisation.

Part 6- Reasonable and necessary Reasonable and necessary supports are a foundational component of the NDIS. AHPA recognises that historically there have been differences in interpretation of reasonable and necessary that have contributed to inconsistencies in planning. Providing further clarity around what is reasonable and necessary is helpful and needed. However, AHPA views that the changes outlined in this Bill are extremely restrictive and mean participants may not be able to access services and supports that would be reasonable for them to attain their rights as a person with disability.

Sustainability considerations.

AHPA 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. AHPA does not support the removal of principles to be considered for a participant’s plan outlined in section 31 (Division 1 of Part 2 of Chapter 3), as proposed in item 66. These principles are critical in enabling reasonable and necessary individualised, person-centred supports. Financial sustainability must not come at the expense of plans that are individualised, participant-directed, goal-oriented, offer choice and control and that maximise participation.

Effective and beneficial considerations.

AHPA notes the inclusion of an order of importance that the CEO must have regard to in determining whether supports will be effective and beneficial. This evidence hierarchy (S34(1E)) should be refined to operate as a guide only, outlining a range of evidence sources available to determine whether a support is effective and beneficial. These should not be ranked as peer reviewed evidence (for example) may be less relevant to an individual participant’s needs than individual evidence.

Submission 280

AHPA notes that allied health providers must, to meet their ethical and clinical requirements as health professionals, draw on evidence of efficacy including research and individual evidence to guide their practice and ensure they are responding to the participant’s individual circumstances.

The reliance on peer-reviewed published and generalisable evidence is inappropriate in light of the systemic structural barriers that limit disability specific allied health research. Allied health research in general is funded at a much lower level than medical research, is impacted by limitations in research infrastructure, and further impacted by the high volume of supports provided in community settings where data collection and other elements that support research are not in place. The limitations of allied health research are exacerbated in relation to research for some specific groups, including people with disability. A reliance on high quality, peer reviewed and generalisable evidence, despite known limitations around the existing evidence based is inappropriate and biased given the known nature of these constraints. The NDIA has had over a decade now to address issues with limited disability specific research by commissioning and collating NDIS specific research. The NDIA has failed to do so. Punishing participants for this shortfall is unacceptable. The new Evidence Advisory Committee (EAC) process recognises that there are gaps in empirical research and is including a range of evidence sources within its work, including grey literature and evidence of lived experience.viii More general evidence or evidence from a participant must be considered when determining whether a support has sufficient evidence to be considered effective and beneficial. AHPA supports that a broader lens is necessary in relation to applicable evidence; research supporting different types of intervention should be considered even if it has not been undertaken for a specific type of disability.

AHPA strongly recommends the removal of clause (34(1F)), which would enable the CEO to decide that a support is not effective or beneficial where there is limited peer reviewed evidence, despite evidence of effectiveness either generally or for the participant.

Furthermore, AHPA notes that several of our members and their professions such as art and music therapy have been subject to internal evidence reviews undertaken by the NDIA. Our members have raised concerns about how these processes were undertaken and the inaccurate conclusions that were drawn. Interpretation of evidence is a highly specialised skill. In this context, given the proposed changes enable the CEO to make decisions about whether there is evidence to consider a support reasonable and necessary, AHPA highlights that the CEO must have appropriate qualifications and experience in research, evidence interpretation and synthesis.

AHPA calls for assurances that there are protections in place to ensure these decisions are made with rigour and by those with the expertise to do so.

Family support considerations.

The impact analysis notes that proposed changes may result in increased expectations of informal supports. AHPA argues that any changes related to reasonable and necessary supports must not place additional undue requirements on families, carers and informal networks to support participants. These informal supports are often under significant stress, and many have to reduce hours or cease work to take up roles as carers. The act must not further enshrine this. We note that a key intention of the NDIS was to enable greater productivity among people with disability and their caregivers. Any considerations in relation to reasonable and necessary should also require consideration of how they impact productivity and participation.

Submission 280

Maximum funding, intensity or ratios for support classes.

AHPA understand that this change (s32 (2EA) and (2EB)) provides for a legislative instrument that allows the Minister to set maximum funding amounts, intensity or ratios for individual supports or classes of supports that may be lower than what has been assessed as reasonable and necessary for an individual participant. Consistent with the concerns raised earlier under support determination, AHPA considers giving the Minister the ability to no longer fully fund supports, with limited safeguards in place for participants, inappropriate and too likely to result in harms to participants. We fear that these changes move away from individualised support decisions and funding within the NDIS. There is insufficient information available on how these maximums will be determined, where the evidence for change will come from, and how transparent the reasoning behind changes will be. It is unclear for example, if these decisions will come as a result of the work of the EAC and if the Minister must follow the outcomes of formal reviews or can choose to make other determinations that may contradict the advice from such processes. In the absence of any completed reviews to date, we are unable to judge the quality and effectiveness of the EAC process and have yet to see how findings translate into policy.

Given the paucity of disability specific research outlined above, AHPA remains uncertain how a Minister would make such determinations for reasonable and necessary supports.

AHPA notes our strong concern that these caps will have the greatest impact on those with the highest support needs. Unlike the determinations under s34A these do not appear to apply a proportionate response, meaning that those with the highest assessed support needs would have the greatest unmet need, in instances where maximum funding or intensities are applied.

Community supports and consistency across government systems.

AHPA notes the commentary and intent to have consistency across other government systems. AHPA argues that this is inappropriate as there are substantive differences across the Schemes, including the paradigms in which they operate. The NDIS must continue to be underpinned by the social model of disability, irrespective of how other Schemes operate in order to uphold Australia’s obligations under the Convention on the Rights of Persons with Disabilities.

AHPA notes the view that some supports may be better provided as community or mainstream supports rather than considered reasonable and necessary NDIS supports. AHPA argues that these supports largely do not exist or where they do are often inaccessible. Until these exist, changes cannot be rushed through within the Scheme.

Part 8- Tightening meaning of permanence to reduce access where an impairment can be treated. Participants have always needed to demonstrate permanence in order to be eligible for funding. That process has also required evidence that treatment options have been exhausted.ix In AHPA‘s view, these requirements are likely a key driver for the underrepresentation of some cohorts such as people with psychosocial disability whose access rates are dramatically lower than that of people with other areas of disability. The lack of access for people with psychosocial disability has been flagged as an urgent issue for the Scheme.

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The decision to strengthen requirements in the legislation in relation to permanence appear at odds with these known issues. In Part 1 of Schedule 1, part of the rationale for moving away from diagnosis lists to standardised functional capacity assessments aimed to reduce some of the inequities experienced when people were unable to obtain a diagnosis, for example due to financial constraints. The proposed legislative changes for ‘permanence’ can only be seen as a risk for reintroducing equity issues given that the legislation notes that the new requirement to have undertaken all appropriate treatment options before being able to access the NDIS holds irrespective of whether a person’s individual circumstance enables them to access the treatment. This means people who are unable to afford or access these treatments may inadvertently be blocked from the Scheme.

The proposed change will mean that applicants will have to show they have pursued potentially expensive and lengthy processes to prove there are no effective treatments available for them. Treatment options may have significant wait times, be prohibitively expensive or not be geographically viable. For some, these challenges will delay access to the NDIS and supports they need, many of which may be time-sensitive to have the best outcomes. For others, pursuing expensive and lengthy process won’t be an option, and they will be unable to meet this permanence threshold to access the Scheme, despite experiencing significantly reduced functional capacity.

For the early intervention pathway in particular, AHPA notes that extensive delays to accessing the Scheme as a result of a requirement to pursue all appropriate treatments, is at odds with the purpose of early intervention.

AHPA strongly recommends that ‘all appropriate treatments’ be defined to include only those that are available, affordable, culturally safe and accessible. Future rules must also include that it is reasonable for a participant to exercise their right to choose not to undergo a treatment and this must not prevent access.

This proposed change also raises questions about how it will be implemented, who and what defines the appropriate treatment options and who will assess whether someone has exhausted all treatment options for them. This requires clinical assessment and judgement; it cannot be left to NDIA delegates. Our members report incidences where non-clinical delegates have recommended very inappropriate treatment options to participants. This is an unacceptable safety risk.

AHPA recommends that an independent clinical advisory group be established to support the introduction of this change. Existing compensatory Schemes have independent clinical panels available to review decisions and provide advice.

AHPA notes that although some treatments, including allied health services, may not materially improve, reverse or alleviate the impact of an impairment, these treatments are still critical for participants once on the Scheme to maintain or improve functional capacity. There must be assurances that participants can continue to access these therapies once in the Scheme.

Submission 280

Part 9- Eligibility based on access to other services AHPA understands that this change would limit access to the NDIS for people who are eligible for other service systems, such as workplace compensation or motor vehicle accident compensation. Whilst AHPA recognises the importance of reducing ‘double dipping’ across Schemes, we cannot support the proposed change if it results in a blanket exclusion. Access to, and eligibility for, other services does not equate to access to equivalent services that meet equivalent needs. Other services and Schemes potentially provide significantly different levels of support that may not sufficiently meet the person’s reasonable and necessary needs.

Furthermore, some offer time-limited services and supports, meaning people would potentially be ineligible for much-needed supports once that elapses. There is also little clarity about how or what would make another service a ‘declared alternative support’ or how potential inequity in relation to the level of available support is addressed. AHPA agrees that any future rules around this must be agreed by all states and territories and argues strongly that consideration should be given to how funding could potentially be provided by more than one program in order to avoid double-dipping while still providing a consistent level of support.

AHPA recommends that this section of the Act be amended to confirm that other alternative supports only include those that are available, accessible and offer equivalent level of supports.

Schedule 2 AHPA supports measures to ensure the 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.

Part 1- Registration of NDIS Providers

AHPA provided feedback to the Getting It Right: A New Definition for NDIS Providersx in February

In our submission, AHPA argued in support of allied health professionals and their services being captured in the definition of an NDIS provider. We also strongly recommended that future provider registration must be truly risk proportionate and take into account the existing health professional regulation requirements that apply to allied health professionals practising in the Scheme. AHPA supports a light touch registration (or enrolment) model for allied health, alongside a requirement for practitioners to be registered or certified by their health regulator.

Any proposal for future registration models must consider and address the failures of our current registration system, in particular the duplication of regulatory processes and the administrative costs associated with that duplication, as well as the high financial cost of third-party audits.

Part 2- Civil penalties and regulatory powers. AHPA understands that the proposed changes will introduce new regulatory powers and a broader range of penalties. AHPA recommends that any future use of the expanded regulatory powers and penalties must be used appropriately, and actions must be proportionate to the issue. There must be reasonable provisions for when genuine mistakes occur.

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Furthermore, there must be safeguards to protect participants, nominees and providers from unfair penalties and unintended consequences of these changes. AHPA notes there is limited detail on how these changes will be implemented and clarity is needed about how the powers of both the Agency and Commission will work alongside each in practice to avoid unnecessary duplication.

Part 4- Retention of records. Allied health professionals must keep appropriate records for their services under the requirements imposed by Ahpra or their self-regulating health profession, and by other funders. AHPA recognises the importance of record-keeping requirements for NDIS-funded services. Introducing rules for NDIA record keeping is in line with statutory record keeping requirements in other areas of the care economy where allied health professionals routinely work.

However, we argue that the allied health sector must be engaged in the design of the rules around provider record keeping to ensure these align with other standards and requirements. There also must be room for exceptions, where there are genuine reasons where there are issues with records and any compliance approaches must be proportionate. Once the new rules determine the types, formats and minimum standards of records, there will be a need to communicate these new obligations to all providers. AHPA and our member organisations will need to be involved in work to communicate changes, co-develop guidance and resources for the sector, and co-deliver education and information for the allied health sector.

Part 5- Reducing claim times. AHPA is concerned about the change for claims to be made within 90 days, as opposed to the existing 2-year provision. AHPA would like to see modelling of the effect this change will have for therapy supports to truly understand the potential impact.

Delays to claims being made are often outside of a providers control and we have heard of examples of delays that currently extend well beyond the 90-day period proposed. Providers often report issues with the existing claim systems and challenges with lodging claims. 90-days is too short to address issues. If this is to proceed, AHPA calls for assurances that the NDIA has the systems in place to process claims in a timely manner. Further, we call for clear and easy to use pathways to rectify issues where timeframes are exceeded for reasons outside of a providers control. Without this, this substantial reduction in timeframes may risk that claims are not paid, impacting on provider viability and ultimately on participants access to supports.

This drastic change will need to be supported by extensive communications to ensure providers and participants understand the new requirements.

Submission 280

Schedule 3 Part 1- Decision making on pricing. AHPA supports a move to independent price setting for the NDIS. While we recognise the work undertaken by the NDIA to engage with the sector through the annual price review (APR) process, our view is that there is too little transparency about how prices are benchmarked, how data gaps are addressed, and how the cost of service delivery is quantified.

We also argue that there is too little transparency about how the NDIA Board, as the current decision maker about pricing, weights the advice provided through the APR process.

AHPA also recognises the active role that the government should play in overseeing Scheme sustainability, and that pricing and payments are a key element of Scheme sustainability.

However, it is our understanding that the current legislation provides no mechanism for increased independence or transparency. In the absence of those factors, we have strong concerns about the ability of the Minister of the day to unilaterally direct pricing and argue strongly that those safeguards must be introduced.

AHPA call for stronger safeguards and independent oversight to ensure that the Minister of the day who holds responsibility for pricing does not make decisions that result in unsustainable service delivery rates for providers and the associated risk for participants of being unable to access safe and high quality services. To ensure transparency, we argue for amendments that will require an independent pricing review to be undertaken and published, and for the Minister to make publicly available any and all advice they receive in relation to pricing as well as an explanation of how they have made pricing determinations.

AHPA has provided feedback on pricing differentiation based on types of support and service delivery and provider and participant characteristics as part of this year’s annual pricing review.xi AHPA welcomes the opportunity to continue to engage in upcoming consultations about differentiated pricing.

Part 2- Automation of administrative action AHPA recognises the ever-increasing role of technology and automation and appreciates that establishing efficiencies is beneficial to any Scheme. However, like many other stakeholders, AHPA holds reservations about the use of automation of administrative actions in the NDIS. The historical issues with Robodebt, the more recent challenges with algorithms not being able to be overridden in aged care, and general questions about the safety of AI, all underpin our concern.

AHPA cautions against the use of automation and calls for the inclusion of appropriate safeguards.

Blanket authorisation of automation should not be granted. There must be transparency and control over what is automated and how, with adequate protections in place to reduce risks to participants. AHPA supports that there must be publication of the NDIS administrative actions that are automated. Only low risk tasks that are objectively verifiable should be allowed to be automated.

AHPA understands that the CEO must ensure that systems are in place to ensure programs produce valid decisions. In the explanatory memorandum this refers to possibly establishing an oversight committee within the agency.

Submission 280

AHPA strongly recommends that an independent monitoring function be established to oversee the adoption of automation of administrative actions.

AHPA holds concerns that the proposed changes mean that automation can include evaluative judgement or the ability to form a ‘state of mind’. AHPA strongly recommends that automation is not used for decisions that require clinical judgement and oversight. Furthermore, there must be avenues for human decisions to override administrative actions and the right to challenge automated decisions.

Schedule 4 AHPA has provided substantial feedback to the Commonwealth, outlining our concerns regarding new framework planning, including the supports needs assessment process.xii

We understand that further work will be undertaken in preparation of the rules for new framework planning. AHPA will continue to engage with the Commonwealth to support the development of these rules. These rules must outline specific information on the support needs assessment and budget setting processes. AHPA holds concerns that these rules, which will have significant implications for future plans, will have limited parliamentary scrutiny and calls for this to be rectified.

In the context of the changes proposed in this Bill, AHPA argues strongly for the need to ensure that allied health input and reports are included within the assessment information that an assessor and the NDIA must have regard to when making decisions about plan funding. Further assessors will need to have appropriate clinical expertise to fulfil their roles. Allied health professionals are the key workforce who have the skills, expertise and clinical governance to undertake needs assessments.

AHPA argues in the strongest possible terms that broad cuts to funding beneath that assessed as reasonable and necessary through the new framework planning process is dangerous and inappropriate. A participant’s future plan budget that has been based on a consistent planning and assessment process must fully cover the cost of reasonable and necessary supports.

Schedule 5 As noted in our summary AHPA holds substantive concerns about the increased Ministerial power that is granted under this Bill. This extends to the ability to set transitional rules. Additional safeguards, including parliamentary scrutiny, must be in place for the increased powers that are granted to the Minister under this Bill.

Submission 280

i Commonwealth of Australia, Department of the Prime Minister and Cabinet. Working together to deliver the

NDIS - Independent Review into the National Disability Insurance Scheme: Final Report. 2023. Available

from: https://www.ndisreview.gov.au/resources/reports/working-together-deliver-ndis/ ii World Health Organization. International Classification of Functioning, Disability and Health (ICF). Available from: https://www.who.int/standards/classifications/international-classification-of-functioning-disability and-health iii University of Melbourne. Evaluation of the Better Access initiative report. 2022. Available from: https://www.health.gov.au/resources/collections/evaluation-of-the-better-access-initiative-final report?language=en

iv Medicare Benefits Schedule Review Taskforce. Post Consultation Report from the Allied Health Reference

Group. 2019. Available from: https://www.health.gov.au/sites/default/files/documents/2021/06/final report-from-the-allied-health-reference-group.pdf. v Australian Institute of Health and Welfare. People with Disability in Australia. 2024. Available from: https://www.aihw.gov.au/reports/disability/people-with-disability-in-australia/contents/income-and finance.

vi Australian Government. Department of Health, Disability and Ageing. National Disability Insurance Scheme

Reforms. Impact Analysis. 2026. vii Allied Health Professions Australia. AHPA responds: You cannot fix allied health in aged care by cutting disability funding. 2026. Available from: https://www.ahpa.com.au/news-updates/you-cannot-fix-allied health-in-aged-care-by-cutting-disability-funding

viii Australian Government Department of Health, Disability and Ageing. NDIS Evidence Advisory Committee

frequently asked questions. 2025. Available from: https://www.health.gov.au/resources/publications/ndis evidence-advisory-committee-frequently-asked-questions?language=en ix National Disability Insurance Agency. What are the NDIS disability requirements? Available from: https://www.ndis.gov.au/applying/eligibility-requirements/what-are-ndis-disability-requirements x Allied Health Professions Australia. Submission: Getting it right: A new definition for NDIS providers. 2026. Available from: https://www.ahpa.com.au/news-updates/submission-getting-it-right-a-new-definition-for ndis-providers xi Allied Health Professions Australia. Submission: AHPA Responses to 2025-26 NDIS Annual Pricing Review.

Available from: https://www.ahpa.com.au/news-updates/submission-ahpa-response-to-2025-26-ndis- annual-pricing-review?rq=annual%20pricing%20review

xii Allied Health Professions Australia. Submission: NDIS Rules- Public Consultation on New Framework

Planning. 2026. Available from: https://www.ahpa.com.au/news-updates/ndis-rules-public-consultation on-new-framework-planning