NDIS Amendment (Securing the
NDIS for Future Generations) Bill – OTA Supplementary Submission – July 2026
Introduction
About Occupational Therapy Australia
OTA is the peak membership body representing occupational therapists nationally. We empower and elevate over 34,000 exceptional professionals who in turn work in partnership with individuals and communities to enable meaningful participation in the activit ies of life. We’re the single, unifying connection point for occupational therapists in the nation, leading the profession through education, support, and advocacy, so every occupational therapist is informed, inspired and fulfilled in their profession.
As one of Australia’s largest allied health workforces, occupational therapists provide essential supports across primary care, aged care, disability, mental health, veteran care and more.
About Occupational Therapy
Occupational therapy is a person -centred health profession concerned with promoting health and wellbeing through participation in occupations. Occupational therapists achieve this by working with participants to enhance their ability to engage in the occup ations they want, need, or are expected to do; or by modifying the occupation or the environment to better support their occupational engagement. Occupational therapists provide services across the lifespan and have a valuable role in supporting participan ts affected by developmental disorders; physical, intellectual, chronic and/or progressive disability; and mental health issues.
Occupational therapists are highly skilled in assessing the degree to which a person’s disability affects their level of function in daily tasks. Given their expertise and area of practice, many occupational therapists deliver services funded by the NDIS. Services focus on promoting independence in activities of daily living and enablement of social and economic participation. These services may include functional capacity assessment and intervention; disability -related chronic disease management; prescript ion and implementation of assistive technology and/or environmental modifications; mental health interventions; positive behaviour support; driving assessments (when specifically trained to do so); and targeted, goal -focussed rehabilitation.
Recommendations
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OTA recommends inserting an additional line requiring that NDIS rules specify that assessors hold relevant health qualifications.
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OTA recommends amending subsection 45C(17) to require the Minister seek and publish written advice from an independent body – such as IHACPA - or input from allied health peaks, before making a pricing determination.
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OTA recommends inserting “must have regard to any existing regulatory obligations of the provider under a Commonwealth or state law” into the Bill’s compliance enforcement provision.
Report
Occupational Therapy Australia (OTA) welcomes the opportunity to provide additional feedback on the (‘the Bill’) to the Senate Community Affairs Legislation Committee. We acknowledge the Committee Secretariat for its work supporting this inquiry, including reviewing a substantial volume of responses within a short consultation period.
OTA maintains our serious concerns with the Bill , which remains insufficiently safeguarded and overly centralised. It introduces changes that would restrict participant access and place considerable pressure on the occupational therapy workforce.
The 13 recommendations outlined in our original submission call for amendments that protect participant access and choice, ensure occupational therapists and allied health professionals play a central role in assessment and reform design, constrain broad ministerial powers over funding and pricing, and reduce regulatory burden on allied health practitioners. We continue to advocate for those 13 recommendations.
Interim Report
OTA has closely followed the Bill’s progression through Parliament and the Senate Community Affairs Legislation Committee. Since our original submission, OTA has analysed the Bill further, engaged with MPs, ministers and senators, read published submissions, observed hearings, and reviewed the Committee’s interim report. We welcome recent minor amendments to the Bill that strengthen safeguards and protections for participants .
Alongside over 4,000 submissions, including many from occupational therapists at the frontline of service delivery, we have advocated strongly for changes to the Bill. Even within the limited time available, the weight of that evidence was clear and consistent - the Bill poses serious risks to participant safety, independence, and human rights. OTA has yet to see the Inquiry meaningfully address this feedback. A Bill that fundamentally reshapes access, funding, and oversight across the NDIS deserved a stronger response , reflecting the scale and significance of concerns raised. OTA cannot support a Bill that
continues to prioritise budget savings and growth reduction targets at the expense of participant wellbeing and access to supports .
The interim report defers questions about the Bill’s most controversial provisions to future rules, the Technical Advisory Group, and Explanatory Memorandum clarifications. While the Committee acknowledged widespread community concern, it has not recommend ed any amendments to the Bill itself before it passes. This suggest s a preference for legislative momentum over legislative rigour .
The inquiry also operated under compressed timeframe s, with submissions open for just 11 days , and the reporting deadline extended twice. OTA welcomes this extension as an opportunity for the Committee to receive additional feedback and genuinely address these concerns in its final report. OTA also requests the opportunity to engage directly with the Committee during these additional hearings. This time must be used to hear further witnesses and evidence, and address feedback from people with disability, their families, advocates , service providers, and organisations.
Recommendations
The interim report acknowledged widespread concerns for participant safety, independence and human rights. These outcomes rely on a stable, well -supported occupational therapy workforce and viable provider base to deliver them. If the Bill proceeds , OTA recommends incorporating three amendments that mitigate the workforce and provider pressures most likely to compromise participant outcomes if left unaddressed. Without action, these negative impacts will compound, and will ultimately impact the participants the Scheme is intended to support.
The changes proposed in this Bill will further limit access to qualified OTs , who deliver supports at the heart of the frontline of the NDIS, every day, across every state and territory. They face mounting workforce pressures - our members tell us they can no longer sustain NDIS work under the current conditions. More than 7000 participants lost access to essential occupational therapy supports in 2025 because providers can’t afford to stay.
The reforms in this Bill also point to a broader pattern of regulatory complexity affecting small businesses across the disability sector. For a sector already operating on tight margins, the Bill threatens the viability of sole -practitioner and smaller providers , risking reduc ed service supply at a time when demand remains high. OTA’s NDIS Provider Survey, conducted last year, found 39% of OT s do not expect to remain profitable under current pricing rules, and 55% made no profit in 2024 -25.
Providers in rural, regional, and remote areas are already at breaking point, bearing a disproportionate burden compared to their metro counterparts. They are often the first to feel the impact of NDIS reforms, and the participants they work with are often the first to lose services. The same survey found 92% of OTs expected to reduce travel and outreach, and 63% would reduce service provision in regional and remote areas , due to continued price freezes.
A qualified allied health workforce is crucial to better outcomes and cost savings in the NDIS , including through the assessment process . Occupational therapists are best placed to identify participant needs and appropriate supports, preventing long -term and downstream reliance on the broader health system.
However, pricing, registration, and uncertainty around assessments and reforms are driving instability and attrition among occupational therapists. The government must address the factors destabilising the workforce the Scheme depends on - you cannot build a sustainable NDIS on an unsustainable workforce .
We have presented three recommendations below, which respond to these pressures and would stabilise the Scheme - qualified assessors protect the clinical basis of the scheme; pricing transparency addresses the affordability pressures driving provider exit; and streamlined registration eases the regulatory burden weighing hardest on small and rural providers.
A. Qualified assessors
Occupational therapists have long conducted functional capacity assessments as an established, evidence-based clinical practice. The Bill gives the NDIA power to set the rules, criteria and classifications used to assess functional capacity, without requiring that assessors hold relevant clinical qualifications. Removing this role from qualified allied health professionals risks turning assessment into an administrative exercise rather than a clinical one, reducing the quality, consistency and fairness of outcomes for participants , as well as reducing the cost effectiveness of the Scheme .
NDIS participants rely on robust, effective, and clinically-informed functional capacity assessments, and occupational therapists are indispensable to delivering them. Yet when their clinical expertise and skills are not recognised or fully utilised, this creates a disincentive to working in the NDIS. Undermining that expertise not only weakens the Scheme’s most consequential functions, it also puts participants who depend on it at risk.
This change would align with Recommendation 9 (6.63) of the recent Integrity report by the Joint Standing Committee on the NDIS, which recommended that the NDIS Act 2013 be amended to specify that assessments “ can only be completed by clinicians who are registered with relevant professional bodies “.
Recommendation 1: OTA recommends inserting an additional line requiring that NDIS rules specify that assessors hold relevant health qualifications.
B. Pricing transparency
The NDIA’s pricing methodology has systematically undervalued occupational therapy pricing for eight consecutive years. The Bill transfers pricing authority from the NDIA to the Minister without requiring independent advice , removing a key opportunity to correct this. Robust ministerial decision making must be supported by a range of evidence that is diverse and independently sourced . Accordingly, OTA calls for additional safeguards and stronger transparency in this decision-making process.
OTA acknowledges the recent amendment requiring the NDIA to provide a summary of advice to the Minister to support a pricing determination, and the tabling of that advice in Parliament. This is welcome, but insufficient on its own. Pricing decisions must draw on an independent body beyond the NDIA - such as the Independent Health and Aged Care Pricing Authority (IHACPA) - or structured input from allied health peak bodies, such as OTA . Without this independent check, small and sole-practitioner providers in particular bear the cost of pricing decisions they had no opportunity to influence.
Small and sole practitioner providers
Small and sole -practitioner providers already operate on thin margins and have limited capacity to absorb unexplained pricing changes or freezes , as other business costs go up . Opaque decision-making makes it difficult for these providers to plan, invest or forecast . The government should ensure that reforms intended to strengthen the scheme do not come at the expense of a sustainable, viable small business sector.
Recommendation 2: OTA recommends amending subsection 45C(17) to require the Minister seek and publish written advice from an independent body – such as IHACPA - or input from allied health peaks, before making a pricing determination.
C. Registration alignment
Occupational therapists already meet rigorous registration obligations through Ahpra and the National Registration and Accreditation Scheme. The Bill’s expanded compliance and enforcement powers take no account o f this obligation , creating a risk of duplicative regulatory burden. Any new NDIS registration approach must recognise this existing oversight and avoid unnecessary duplication .
Many rural and regional providers operate as sole practitioners with limited administrative support. Duplicative regulatory burden is felt most acutely by these providers, who are often the primary source of support in those communities . In thin rural markets, this added burden increases the risk of providers scaling back or exiting service delivery altogether .
Recommendation 3: OTA recommends inserting “must have regard to any existing regulatory obligations of the provider under a Commonwealth or state law” into the Bill’s compliance enforcement provision.
Conclusion
OTA thanks the Committee for the opportunity to provide this additional feedback and for extending the inquiry timeframe to allow further consideration.
The three amendments outlined above offer a practical path to strengthen the Bill’s safeguards, protect the occupational therapy workforce and support the viability of small and rural providers, without delaying the Bill’s passage.
OTA requests the opportunity to engage directly with the Committee during additional hearings and remains available to provide further evidence or clarification as the inquiry progresses.
We can be reached at policy@otaus.com.au .
Section
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NDIS Amendment Bill 2026 - OTA Supplementary Submission - July 2026