Submission 2999 — Name Withheld — NDIS Future Generations Bill

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Submission1 on the National Disability Insurance Scheme

Amendment (Securing the NDIS for Future Generations) Bill 2026

1 June 2026

Introduction

1 The National Disability Insurance Scheme Amendment (Securing the NDIS for Future

Generations) Bill 2026 (NDIS Bill) presents the most significant reform to the NDIS since its

commencement.

2 The NDIS Bill was introduced to Parliament with no prior consultation. Members of the community were given 11 business days to provide a response to the NDIS Bill and

explanatory memorandum, which together span hundreds of pages. Despite receiving

numerous submissions calling for an extension to the submission period (including from the

Justice and Equity Centre that suggested the submission window be extended to August) the

Committee provided an extension of just one business day.

3 The pressure on the Committee suggests that the Government intends to press forward with this significant legislative reform without including disabled people in the design and impact of

legislative reform.

4 The message to the disability community is that the Government does want feedback or submissions on content of the NDIS Bill. It is not concerned that people with a disability who

have, in many cases, difficulties advocating for themselves should not benefit from the

insights and analysis provided gratuitously by disability advocates, peak bodies for legal

representatives and others with insights into matters canvassed by the NDIS Bill.

5 By conflating the measures in the NDIS Bill with the federal budget, insisting on false urgency, and failing to consult on the NDIS Bill, the Government severs the few remaining

threads of confidence and trust connecting it to disabled Australians.

1 This submission is written by a disabled person. Generative AI tools have not been used in the creation of this submission. 1 of 16

6 This submission focuses on the most concerning aspects of the NDIS Bill. These flaws are grouped into the following:

 The NDIS Bill enables the NDIA to evade scrutiny of the ART (Maintain checks and balances).

 Limiting unscheduled plan reassessments is unjustified and will lead to significant harm (Unscheduled plan reassessments).

 Direct connection between an impairment and a need is misconceived and should be reconsidered (Link between impairment and need for support).

 Tightening the meaning of permanence in the way proposed under the NDIS Bill places disabled Australians in a position of either accepting an unreasonable level of risk (exceeding what would otherwise be acceptable for the non-disabled Australian public in comparable contexts), or being unsupported (Proposed permanence measures are unreasonable).

 The support determination mechanism is critically flawed and runs contrary to the intent of the NDIS

 Deferring pricing decisions to the Minister politicises the NDIS and negatively impacts its integrity (Pricing arrangements).

 The support determination mechanism is grossly inappropriate and should be abandoned (Support determinations are fatally flawed)

 The inclusion of the value for money considerations in s 34(1) are inherently flawed and will lead to incorrect decisions (Value for money considerations are inherently flawed and will lead to incorrect decisions).

 The NDIS Bill correctly underscores the importance of an integrated system along with other state and territory systems of support (the role of other service systems).

 The failure of the NDIS Bill to scaffold an appropriate system of registration for NDIS providers which reflects the nature of the work done by these providers (Registration of NDIS providers),

 The benefits of enhanced powers for investigating and responding to instances of fraud (Fraud measures).

 Improvements to the NDIS Bill to support the automation of administrative actions (Automation of administrative actions).

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Maintain checks and balances

7 The NDIS Bill allows the NDIA to evade scrutiny through the Administrative Review Tribunal (ART) and the judiciary for politically-motivated decisions on disability supports.

8 There is also a concerning pattern of deferring matters of high significance to subordinate legislation.

9 The NDIS Bill gives the current Minister and future Ministers complete authority over funded supports. The Government’s mandate to change laws is conditional on the scrutiny of the

Australian Parliament. And while it is appropriate for the Government to act on its mandate, it

should do so in accordance with established system of lawmaking.

10 The approach taken by the Government obfuscates the Government’s true intentions and evades scrutiny commensurate to the level of impact on people with disability. As there has

been no public consultation prior to the introduction of the NDIS Bill, it is reasonable to

assume that this evasion is intentional.

11 Any instance of an administrative decision should be subject to internal review and scrutiny by the ART. In the time provided, I have not been able to review the entirety of the NDIS Bill and

itemise all instances where a decision should be subject to internal and external merit review.

Unscheduled plan reassessments

12 There is inadequate safeguarding in the NDIS Bill to prevent the NDIA from abusing the power to decline a request for a plan reassessment. The NDIA will interpret the term ‘genuine’ in a

way which will likely be materially different from the way that it is interpreted by a participant,

who has no budget remaining for essential supports. Introducing a legislative control for

unscheduled plan reassessments should only occur when the NDIA has reached a point of

maturity where there is a high degree of confidence that a funding allocation is accurate. This

is not yet the case.

13 Participants should be able to request service providers to initiate a plan reassessment on their behalf. Introducing a requirement that a participant make this request creates an

unnecessary additional administrative step which has not been justified by the Government.

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Link between impairment and need for support

14 While the purpose of these amendments appear to be related to clarifying that, where multiple impairments or comorbidities exist, only the support needs arising from the impairment for

which the participant meets the disability or early intervention requirements, are eligible for

NDIS funding.

15 Despite the intent stated in the explanatory memorandum for this to provide clarity and certainty, in practice it will lead to poor administrative decisions made by the NDIA.

16 The approach proposed in the NDIS Bill is misconceived and is ignorant to the complex nature of many disabilities. It is a shift to a medical model and away from a social model and is a

significant point of regression in the evolution of the NDIS. These aspects of the NDIS Bill

should only be passed into law following consultation with the disability community, and for the

time being removed from the proposed NDIS Bill in their entirety.

Continued over

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Proposed permanence measures are unreasonable

17 The National Disability Insurance Scheme Act 2013 and the National Disability Insurance

Scheme (Becoming a Participant) Rules 2016 currently guide the CEO in determining whether

or not an impairment is permanent or likely to be permanent. Paragraph 5.4 to 5.7 state, with

added emphasis:

When is an impairment permanent or likely to be permanent for the disability requirements?

5.4 An impairment is, or is likely to be, permanent (see paragraph 5.1(b)) only if there are no

known, available and appropriate evidence-based clinical, medical or other treatments that

would be likely to remedy the impairment.

5.5 An impairment may be permanent notwithstanding that the severity of its impact on the

functional capacity of the person may fluctuate or there are prospects that the severity of the

impact of the impairment on the person’s functional capacity, including their psychosocial

functioning, may improve.

5.6 An impairment may require medical treatment and review before a determination can be made

about whether the impairment is permanent or likely to be permanent. The impairment is, or is

likely to be, permanent only if the impairment does not require further medical treatment or

review in order for its permanency or likely permanency to be demonstrated (even though the

impairment may continue to be treated and reviewed after this has been demonstrated).

5.7 If an impairment is of a degenerative nature, the impairment is, or is likely to be, permanent if

medical or other treatment would not, or would be unlikely to, improve the condition.

18 Item 92 inserts a new definition for ‘appropriate treatment’ in proposed section 25A. This definition adds a high degree of additional prescription and appears intended to supplant the

term ‘appropriate’ which is currently in the National Disability Insurance Scheme (Becoming a

Participant) Rules 2016. It adds three criteria which must be met for treatment to be

considered ‘appropriate treatment’. In summary, these criteria are: (1) that the treatment is

evidence-based, (2) can reliably be expected to materially improve, reverse or alleviate the

impact of the impairment or impairments, and (3) is regularly undertaken or performed in

Australia.

19 Proposed subsection 25A(2) allows the CEO to disregard whether a person’s individual circumstances impact their ability to access the treatment. Proposed subsection 25A(3)

provides a limited safeguard through the expression, “except appropriate medical treatment

the person cannot undertake for medical reasons.“

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20 The explanatory memorandum provides some insight into the threshold for deciding whether something is an appropriate treatment (emphasis added):

Item 91 – After subsection 25(1A)

The purpose of this item is to define how permanence is assessed for the purposes of determining

whether a person meets the early intervention requirements. It inserts a new subsection 25(1B),

which provides that an impairment or impairments are not permanent or likely to be permanent

unless a person has undertaken all appropriate treatment for an impairment or impairments. Further,

an impairment cannot be found to be permanent if there are any other treatments that are likely to

materially improve, reverse, or alleviate the impact of the impairment or impairments. In this context,

materially means noticeably or significantly.

21 In relation to item 92 (emphasis added):

Item 92 – After section 25

Treatment may be appropriate treatment for a person’s impairment or impairments regardless of

whether the person’s individual circumstances restrict the person from accessing the

treatment. A person’s personal and environmental circumstances, including financial and

geographical circumstances, are not relevant in considering whether a person has undertaken all

appropriate treatment. This is because ensuring people with disability have access to

mainstream services, regardless of their circumstances, is the responsibility of all

mainstream support systems.

22 The explanatory memorandum makes it clear that circumstances may be declared as category D NDIS Rules and could include consideration of cultural or personal belief systems

(emphasis added):

Item 92 – After section 25

Proposed new paragraph 25A(3)(b) together with proposed new subsection 25A(4) will provide that

a person is also taken to have undertaken all appropriate medical treatment in circumstances

determined in category D NDIS rules. Such circumstances could include consideration of

cultural or personal belief systems.

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23 There is an example provided in the explanatory memorandum explaining how proposed section 25A may work in practice, in circumstances where an adverse decision is made in

relation to access. The example is as follows:

Item 92 – After section 25

Example – Soo

Soo is a 5 year old with a history of long term middle ear infections who lives with her mother

in regional Australia. Soo’s mother has applied for her to access the NDIS providing an

audiogram indicating a bilateral moderate hearing loss with no indication of sensorineural

(permanent) components. Soo is on a waiting list to see an ENT specialist who visits children

in her local area every second month.

Soo is found to not be eligible for the NDIS as there is not enough evidence that her

impairment will be permanent and will likely persist for her lifetime. She has not yet undergone

all investigations for potential treatment options that may improve, reverse or alleviate the

impact of her impairment, including evidence-based, low-risk interventions such as grommets.

The fact that she is living in a regional area where waitlists to see specialists are longer

than in metropolitan areas is not able to be taken into consideration in determining

whether Soo is eligible for the NDIS.

Her mother is informed that she can re-apply for the NDIS on behalf of her daughter, after

further investigations and recommended treatment options are completed and if it is confirmed

that her hearing loss is likely permanent and results in substantially reduced functional

capacity.

24 Items 88 to 94 elevate the threshold required for an impairment to be considered permanent and embeds it in the National Disability Insurance Scheme Act 2013. No explanation is given

in the explanatory memorandum as to why this consideration is uplifted from subordinate

legislation into the primary legislation.

25 The explanatory memorandum properly captures the irreconcilable tension and ultimately critical flaw. with the new permanence test. It states that in the context of an impairment being

found to be permanent, and consideration of other treatments that are likely to ‘materially

improve, reverse or alleviate’ the impact of the impairment or impairments. The term materially

means ‘noticeably’ or ‘significantly’.

26 What is ‘noticeable’ and what is ‘significant’ are very different, yet the explanatory memorandum appears to use them as synonyms for one another. A skilled clinician may

observe small improvements in a person’s level of function, and this would be objectively

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‘noticeable’. Those improvements may however be insignificant when considering how useful

those improvements are in everyday life. The high threshold of ‘significant’ should be accepted

as the correct threshold, and the NDIS Bill should reflect this.

27 The explanatory memorandum contains useful information about the limitations of this new approach to determining permanence, While it is arguable that the current guidance provided

for in paragraph 5.4 to 5.7 of the National Disability Insurance Scheme (Becoming a

Participant) Rules 2016 should be sufficient to support administrative decision making, the

proposed amendments could be supported with some additional safeguards elevated into

primary legislation. The purpose of these recommendations is to ensure that the NDIA

receives appropriate scaffolding when it comes to matters of material risk to participants or

where there are personal or cultural reasons as indicated in the explanatory memorandum.

Additionally, there should be notification regime for persons who apply but are determined not

to be eligible on the basis of failing the new permanence test. This would streamline a

subsequent application in circumstances where a person is found not to be eligible for the

NDIS on the basis that there is not enough evidence that an impairment will be permanent

and will likely persist for a lifetime.

Continued over

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28 What this aspect of the NDIS Bill fails in achieving is creating the necessary level of clarity concerning the differences between ‘individual circumstances which restrict a person from

accessing treatment’ (which the NDIS Bill precludes as a relevant consideration in deciding

permanence favourably to a prospective participant) and personal belief systems (which are

ostensibly included, or are reasonably expected to be included as a relevant consideration in

deciding permanence favourably, through the creation of category D NDIS Rules). Personal

belief systems, and restrictions on access to services due to geography overlap for certain

racial and cultural groups. For those affected, they will find themselves in an impossible

position of having to decide to relocate to an area (for which they have a lesser cultural

connection) for the sole purpose of accessing medical support which may ultimately fail to

provide them with the necessary level of improvement to overcome the new permanence test.

Recommendation In relation to Item 89: omit the words ‘materially improve, reverse or

alleviate’ and replace with ‘significantly reduce’.

In relation to Item 92:

 include a new paragraph under subsection 25A(1) which

requires that appropriate treatment is ‘not likely to cause harm to

the person’.

 remove subsection 25A(2).

Continued over

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Pricing arrangements

29 Shifting decisions on pricing to the Minister is a critical flaw and undermines the independence of pricing in the disability ecosystem. It explicitly transforms pricing into a political decision.

30 Although the approach taken under the Annual Pricing Review had issues which were legitimately identified in the NDIS Review, the answer is to establish greater transparency and

greater independence in pricing of supports in the disability market through a mechanism

independent of both the NDIA and the Minister. Failure to achieve this will result in an

increasing discrepancy between the market rate for disability supports and the amount offered

by the Minister based on the other government fiscal concerns at any given point in time.

31 The unprecedented consolidation of power in the Minister is a recurring theme in the NDIS Bill, and is a legitimate cause for concern. This should worry all Australians, not just those with

disability.

32 Analogies can be made between the current systemic failings in the Medicare system and a long legacy of Government inaction in addressing the void between the cost of health services

and what is subsidised under both Medicare and the pharmaceutical benefits scheme.

Reforming the NDIS and supporting public health services delivered in Australia should not be

conceived as a race to the bottom, or presented as a financial zero-sum game.

33 As reported in the media, past Governments have demonstrated a ready willingness to make comments which are derogatory toward people with disabilities, and threaten the use of

ministerial powers to reverse decisions of the external review system.2 The Government must

ensure that the NDIS is as protected from external threats as much as it is protected from

internal threats, and anticipate political ideologies which are hostile to systems of social

support.

Recommendation Pricing determinations should not be made by the Minister, they should be

made by an independent body with requirements concerning the

transparency of pricing decisions.

Support determinations are fatally flawed

34 The NDIA, through the existing reasonable and necessary decision-making processes should

2 Tom Stayner, ‘Disability advocates condemn Stuart Robert’s ‘crass’ comments about NDIS access to ‘prostitutes’’, SBS News (online, 4 February 2021) 10 of 16

ensure that individual support plans represent a person’s entitlements under the National

Disability Insurance Scheme Act 2013.

35 The concept of support determinations find no support in the NDIS Review, and are at its core a blunt cost-cutting tool which is explicitly excluded from merits review based on a

misapplication 26-year-old guidance from the ARC. Support determinations are not sunsetted,

meaning, once they are made, they have enduring impact unless revoked. Once a

determination is in place, the Scheme Actuary will no doubt recalculate future liabilities with

the determination as a consideration, which means that realistically, once a determination is

made, it will never be revoked.

36 The practical effect is that when the NDIA assesses a person to require 100 units of support, when there is a support determination in place which reduces that by 20%, a participant will

have to pay a gap fee equivalent to 20 units of support or not receive support which they have

been assessed as requiring.

37 To make matters worse, there is evidence to suggest that certain services have inflated in cost significantly since the introduction of the NDIS, and because of the NDIS. This is because the

Government chose a market-led model for support. The market has failed, and the

Government through this aspect of the NDIS Bill has decided that people with disabilities will

bear the burden of its failures.

38 Not only should support determinations be not accepted by the committee, the Government, the Minister, the Department of Health, Disability and Ageing and the NDIA should be

ashamed for bringing this aspect of the NDIS Bill before Parliament. It is negligent policy and

lawmaking at its most extreme and represents a deep betrayal of not only Australians with

disability, but Australians without a disability who may one day need the support under the

NDIS.

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Value for money considerations are inherently flawed and will lead to incorrect decisions

39 Item 73 adds a number of mandatory considerations in deciding whether a support is reasonable and necessary. It has an intentional focus on cost elements of disability supports.

Value for money

40 Section 34(1) the NDIS Act currently requires the NDIA to consider whether a support represents ‘value for money’ in that the costs of the support are reasonable relative to both the

benefits achieved and the cost of an alternative support.

41 Item 73, if adopted, will require the NDIA to engage in hypothetical cost comparisons in order to determine whether a particular support represents ‘value for money’. These hypothetical

theorisations extend to considering whether a person’s needs are likely to change in the short

term, in a way that would affect a participant’s need for equipment or modifications. There is

insufficient focus on the quality of supports and the ways to measure the benefits of supports.

42 This NDIA should not be unilaterally engaging in speculation concerning a person’s change in functional capacity. Given the extreme external and internal pressure to reduce costs, NDIA

staff will have an (understandable) bias to refusing support in reliance on the vague qualitative

assessments which fall under Item 73.

43 The impact of this will be felt most by those with degenerative disabilities - in effect allowing the NDIA to refuse to fund a support which would have a significant and profound impact on a

person, because the NDIA speculates that they will be in a lower level of functioning at some

point in the future. This is demonstrated by the example provided in the explanatory

memorandum. It is unfair to burden participants with the onus to demonstrate that purchasing

a support represents value for money compared to leasing a support.

Recommendation In relation to Item 73, omit proposed subsection 34(1C), or in the

alternative, ensure that decisions around prospective future levels of

impairment are made only after consultation with a participant and their

treating allied health and medical practitioners.

Effective and beneficial considerations.

44 The proposed effective and beneficial considerations provide a hierarchy of considerations for the CEO in deciding whether a support is reasonable and necessary. The proposed change

directly conflicts with the stated object of the Act to promote the provision of high quality and

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innovative supports (emphasis added):

3 Objects of Act

(1) The objects of this Act are to:

(g) promote the provision of high quality and innovative supports that

enable people with disability to maximise independent lifestyles and full

inclusion in the community; and

45 The focus on research and evidence in relation to the support that is published, peer-reviewed and generalizable is provided in an order which deliberately minimises the participants

individual circumstances and experiences. The benefits of a support to an individual

participant should be given equal weighting – as one factor among many.

46 The new section 34(1K) explicitly supports the CEO to obtain a windfall from informal supports for adult participants in the form of unpaid care. The NDIA already obtained a financial benefit

for the informal care provided by parents, family and friends and this is reflected in unused

NDIS funds.

Recommendation In relation to Item 73:

 Omit “, if considering 2 or more of the 9 following matters,

consider them in the following order of 10 importance:” and

substitute with: “Consider the following matters.”

 Omit proposed s 34(1F) in its entirety.

 Omit proposed s 34(1K) in its entirety.

The role of other service systems

47 Other service systems incredibly important to the financial sustainability of the NDIS. The inclusion of provisions about eligibility and access to other systems indicate that there is being

borne by the NDIS which should be funded by other service systems.

48 The NDIS from its inception was designed to work within a network of other systems including state-based motor vehicle accident schemes and workers compensation schemes. The NDIS

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Act contained subordinate legislation which supported the NDIA to reduce NDIS plans in

recognition of the services provided by these other systems. Paragraphs 3.17 and 3.18 of the

National Disability Insurance Scheme (Support for Participants - Accounting for

Compensation) Rules 2013 provide:

Compensation reduction amount—participant in a Commonwealth, State or Territory

statutory insurance scheme

3.17 In the case of compensation mentioned in paragraph 3.1(c), the CEO is to identify the

compensation reduction amount by identifying the total value of the care and support

expected to be provided to the participant under that scheme until the plan is required

to be reviewed in accordance with paragraph 33(2)(c) of the Act.

3.18 For paragraph 3.17, the identification must be:

(a) in accordance with any applicable actuarial model published by the Agency on

its website at the time the calculation is undertaken; and

(b) done in consultation with the person or entity that administers the scheme.

49 Based on the current rules, it is clear that there is an expectation that the NDIA is accounting for benefits received from other state and territory systems and ensuring that those costs are

not borne incorrectly by the NDIS, which inflates the overall NDIS spend while territories and

states obtain an unintended windfall. Benefits received from states and territories should

mirror the reasonable and necessary supports funded by the NDIS except for medical and like

benefits. It is deeply concerning if the existing rules have not been applied by the NDIA or if

they are not operating as intended. Depending on the extent of the issue, it could be a

material contributing factor to the cost pressures on the NDIS.

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50 Addressing this at the eligibility stage reduces the likelihood that a person may draw benefits from both state-based systems and the NDIS, however, the NDIA will need to be careful to

ensure that it can address the evidentiary issues associated with determining whether a

disability which predates a workplace injury or a motor vehicle accident injury qualify that

person for NDIS support. Though, there is a likelihood that for many types of injuries they will

be the predominant factor which gives rise to a need for NDIS support.

Registration of NDIS providers

51 The NDIS Bill fails to provide a pathway for regulation of providers that deliver low-risk supports. In the appropriate context, registration should be light touch, and have minimal

industry impact. The provisions in the NDIS Bill are highly paternal, and do not acknowledge

the fact that many NDIS participants are capable of engaging and disengaging from service

providers when there are quality or safety concerns.

52 The approach proposed to be adopted by the NDIS Bill will limit the ability to achieve cost efficiencies through the identification of low cost alternatives to higher cost assistive

technology and home services in circumstances where there is a high degree of natural

safeguarding.

53 By creating red tape through unnecessary regulatory requirements on low-risk providers, the Government is itself contributing to the costs of the NDIS despite the proposal of oppressive

measures such as support determinations.

Fraud measures

54 The fraud measures are a good addition to the current regulatory framework. Although the enhanced powers for investigation should be reserved for circumstances where there is clear

evidence of a potential fraud. The new powers are highly invasive and should not be enabled

without significant consideration toward those on whom these powers will be used.

55 In order to ensure that these powers are used appropriately, there should be ongoing parliamentary oversight or oversight from an independent body. Alternatively, the Government

should consider another way to ensure that there are checks and balances on the use of

these high impact powers.

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Automation of administrative actions

56 Automation will increasingly become a part of the way that public services operate. The Government must be accountable for decisions which have been made using AI. Participants

in the NDIS should have full access to information about any instance in which their

information has been used as a part of an automated decision-making process. Where

generative AI products have created personal information about a participant, they should be

informed and have an opportunity to correct that information if it is incorrect, consistent with

Commonwealth privacy laws. This will require the NDIA to tag information and keep records

which support identifying how and where generative AI products are used.

Recommendation The use of automation and generative AI products by the NDIA should be

subject to ongoing parliamentary oversight. Its approach to the use of

these products should be continually re-evaluated in light of emerging

evidence which may indicates harm caused by generative AI products.

Conclusion

57 Changes to the objects of the NDIS Act are disproportionate and place financial sustainability above human need.

58 As described above, there are some aspects of the NDIS Bill which are beneficial and should be passed. However, the majority of the NDIS Bill should not be passed into law. Similar laws

at a state and territory level would fail when tested against state-based human rights

legislation.

59 I would suggest that a key failure which is likely responsible for increases in the cost of supports is deficient, ineffective and inefficient administrative decision making. I would

speculate that the cause of this is an inability to support and evolve a workforce of effective

decision makers, likely as a result of a combination of internal cultural factors, a large

workforce and an inability to instigate significant internal reform due to fear of system shocks

and service delivery failures.

60 At its worst the NDIS Bill is a crude cost-cutting measure sold as necessary reform. If the NDIS Bill is passed into law, it will hurt people.

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