National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 835
Submission on the National Disability Insurance Scheme Amendment Bill
SUBMISSION TO THE JOINT STANDING COMMITTEE ON THE NATIONAL DISABILITY INSURANCE SCHEME National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024 June 2026
- Introduction This submission is made by a Children’s Physiotherapy and Occupational therapy provider. We provide therapy services to children with developmental delay and complex diagnosed genetic and neurological conditions.
Whilst we support the overarching intent of the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track) Bill to improve consistency and sustainability within the Scheme, we have significant concerns about specific provisions that, if enacted as drafted, risk undermining the quality of supports available to participants, particularly those with the most complex presentations or those who are currently awaiting diagnosis to better inform their needs
This submission addresses three areas of concern: eligibility and access criteria, price caps on NDIS supports, and the conditions for plan reassessment. We urge the Committee to consider these concerns carefully and to engage in further co-design with people with disability, disability service providers and allied health professionals before this legislation is finalised.
- Summary of Recommendations
- Retain diagnostic criteria as a pathway to NDIS access, particularly for children with progressive, neurological, or genetic conditions where early intervention is clinically indicated.
- Preserve early intervention and developmental delay diagnoses (including Developmental Delay and Global Developmental Delay) as eligible access pathways for children.
- Overhaul the price determination methodology to reflect true market rates, incorporate a tiered pricing structure that recognises clinical experience and specialisation, and apply complexity loadings for high-needs participants.
- Ensure price determinations are based on current, independently verified market data - not retrospective benchmarks.
- Broaden the conditions for plan reassessment to include demonstrated inadequacy of the current plan, even in the absence of a change in functional capacity.
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 835
Submission on the National Disability Insurance Scheme Amendment Bill
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Establish a specific reassessment pathway for children whose initial allocation was determined by a domain-count methodology.
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Recognise clinical evidence from treating therapists as sufficient grounds to trigger a plan reassessment.
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Extend the public consultation period and facilitate genuine co-design with disability service providers and allied health professionals before this legislation is finalised.
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Access and Planning Measures (Action 3.1) We support the intention to introduce greater consistency and transparency in eligibility determinations. However, we have significant concerns regarding the proposed removal of diagnosis as a criterion in favour of sole reliance on standardised functional capacity assessments.
3.1 The Limitations of Functional Capacity Assessments in Isolation For many participant, particularly children with neurological, genetic, progressive, or degenerative conditions, a functional capacity assessment captures only a snapshot in time. It fails to account for the trajectory of a condition and the critical role of early intervention in altering that trajectory.
A standardised functional capacity tool, applied in isolation, is inherently retrospective: it measures impairment that has already manifested. For conditions where diagnosis itself predicts future functional need, removing diagnostic criteria undermines the early intervention principles that are foundational to the NDIS and risks creating a system that only responds to functional decline rather than preventing it.
3.2 The Cost of Early Intervention vs. the Cost of Decline Insurance schemes are built on a foundational principle: expenditure today prevents greater expenditure in the future. Children receiving NDIS-funded therapy should be understood as an investment, one that prevents future healthcare costs through improved functional capacity and reduced need for surgery or long-term support.
A framework that deems a child eligible for support only once their functional capacity has already declined fails to account for this long-term cost saving. Two clinical examples illustrate this clearly: • Duchenne muscular dystrophy (DMD): Children with DMD require targeted therapy to guide movement patterns and slow the rate of functional decline. At early stages, a functional capacity assessment may not reflect the severity of future impairment; however, the underlying diagnosis makes the need for intervention medically certain. Denying access on the basis of current functional capacity alone would delay therapy during the window in which it is most effective, accelerating long-term decline and significantly reducing quality of life. • Cerebral palsy: Children with cerebral palsy require early therapeutic intervention to prevent contracture development and support weight-bearing. If provided early, these interventions can prevent the need for surgical procedures later in life. Surgery carries both significant cost to the healthcare
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 835
Submission on the National Disability Insurance Scheme Amendment Bill
system and the risk of further reduced functional capacity. Removing diagnostic criteria could deny access to precisely the preventative therapy that reduces long-term NDIS costs and improves participant outcomes.
3.3 Children Without a Confirmed Diagnosis A further and significant complication arises for children who do not yet have a confirmed diagnosis. It is common for children to carry a working diagnosis of Developmental Delay or Global Developmental Delay while undergoing neurological or genetic investigation. Diagnostic processes for infants and young children involve long waitlists and, in some cases, clinical judgements that a particular diagnostic procedure is not in the child’s best interests at the time.
For example, obtaining an MRI for an infant requires general anaesthesia, which carries risk, a risk that is frequently considered unacceptable for medically unstable children. Under a framework that requires a confirmed diagnosis to access NDIS support, these children could be denied the therapeutic intervention they urgently need while they wait for a diagnostic process that cannot safely be expedited.
We therefore recommend: • Early intervention pathways, including diagnoses of Developmental Delay and Global Developmental Delay, should be retained as eligible access pathways for children under any revised eligibility framework. • Any revised eligibility framework should retain diagnostic criteria as a pathway to access, particularly where evidence-based clinical guidelines support early intervention as a means of reducing long-term functional impact and Scheme costs.
- Price Caps on NDIS Supports (Section 45C(7)) We understand that price regulation serves to protect participants from exploitation and to support the Scheme’s long-term sustainability. However, we have serious concerns about price caps that are set below true market value and the unintended consequences this creates for both providers and participants.
4.1 NDIS Clients Require Greater Clinical Complexity Therapy services delivered to NDIS participants are not equivalent to private-paying therapy. NDIS clients routinely present with greater clinical complexity, requiring: • Higher levels of clinical reasoning and risk management • Therapists with training and extended experience in complex disability • Longer preparation, reporting, and inter-professional coordination time per client • Greater emotional and professional demands on the treating clinician
Despite this increased complexity, price caps have historically failed to reflect the true cost of delivering high-quality, safe therapy to this cohort. This creates a structural problem that directly undermines the quality of care that participants receive.
4.2 The Inability to Implement Tiered Pricing
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 835
Submission on the National Disability Insurance Scheme Amendment Bill
In a market-based model, experienced clinicians with advanced skills and specialisations appropriately command higher fees. This incentivises professional development and ensures that clients with the most complex needs are matched with the most capable practitioners.
Under the current price cap framework, a therapist with 15 years of experience in complex disability cannot charge more than a new graduate, regardless of the clinical complexity of the participant’s needs. This: • Disincentivises experienced therapists from taking on NDIS clients, pushing them toward private-paying caseloads where their expertise is appropriately remunerated • Limits participant choice, as the most experienced and specialised clinicians increasingly cannot afford to serve NDIS participants at capped rates • Creates a workforce pipeline problem, where there is no financial pathway within NDIS practice that rewards professional growth and specialisation
4.3 Recommendations on Price Determination If Section 45C(7) is to be retained, we strongly urge that the price determination methodology under subsection (1) be overhauled to reflect:
- True market rates for therapy services, informed by regular, independent market analysis. Critically, this should not be based on retrospective data - pricing benchmarks that reflect what therapists should have been paid in a prior year entrench ongoing undervaluation of the workforce.
- Complexity loadings that account for the additional time and expertise required when delivering therapy to participants with high support needs.
Retaining artificially suppressed price caps does not protect participants - it erodes the quality and availability of the specialist workforce they depend on.
- Conditions for Plan Reassessment (Section 48A) We appreciate that the intent of Section 48A is likely to prevent unnecessary or vexatious reassessment requests and to provide greater plan stability for participants. However, as currently drafted, the provision creates an unduly restrictive threshold that does not reflect the real-world experience of participants - particularly children with complex and evolving needs - and risks entrenching inadequate funding allocations.
5.1 Plans Can Be Inadequate From the Outset As currently drafted, reassessment is contingent on demonstrating a significant change in functional capacity or personal or environmental circumstances. Our clinical experience highlights a critical gap: plans can be inadequate from the outset, and inadequacy alone - in the absence of any measurable change - would not appear to satisfy the conditions for reassessment under this provision.
When children first gain access to the NDIS, initial funding allocations are frequently determined by a formulaic approach based on the number of developmental domains in which a child presents with delay. While this may provide a workable
Confidential Submission
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 835
Submission on the National Disability Insurance Scheme Amendment Bill
starting point for children with discrete, well-defined needs, it routinely fails children with complex presentations, including those with:
• Global developmental delay • Neurological diagnoses • Genetic conditions with multi-system impacts
These children do not simply need more of the same therapy. They require highly coordinated, multidisciplinary team care where therapists actively collaborate, share clinical reasoning, and align goals across disciplines. This level of service is substantially more resource-intensive than siloed individual therapy sessions, yet initial funding allocations - based on domain counts - rarely account for this complexity.
The problem is not that the child’s needs have changed - the problem is that their needs were never adequately captured in the first place.
Under Section 48A as drafted, families in this situation may find themselves unable to request a reassessment because they cannot demonstrate a change in functional capacity. This places families in the position of waiting for their child’s condition to measurably worsen before accessing a review - an outcome directly contrary to the early intervention principles underpinning the Scheme.
5.2 Recommendations on Reassessment Conditions We recommend that the conditions for reassessment be broadened to include:
- Demonstrated inadequacy of the current plan relative to the participant’s assessed needs, even in the absence of a change in functional capacity.
- A specific pathway for children entering the Scheme whose initial allocation was based on a domain-count methodology (the number of developmental areas of delay identified at access), recognising that this approach systematically underfunds complex presentations.
- Clinical evidence from treating therapists as sufficient grounds to trigger reassessment, where that evidence demonstrates that current funding is insufficient to support goal achievement or functional maintenance.
Restricting reassessment to circumstances of change rather than adequacy risks entrenching underfunding and denying participants access to the level of support they were always entitled to receive.
- Closing Remarks We wish to draw attention to the significant constraints under which this submission has been prepared. The timeframe provided for public consultation on this Bill has been extremely limited, and given the breadth and complexity of the proposed changes, this has necessarily restricted the depth and scope of analysis that stakeholders have been able to undertake.
The points raised in this submission, while substantive, should not be taken as an exhaustive account of our concerns. It is likely that further review would surface additional provisions that warrant scrutiny, amendment, or clarification. The issues
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 835
Submission on the National Disability Insurance Scheme Amendment Bill
we have identified represent only those we have been able to examine within the time available.
Given the profound significance of this legislation - and its direct impact on the lives of some of Australia’s most vulnerable people - we strongly urge the Government to extend the consultation period and facilitate a more thorough and inclusive review process. We further call for genuine co-design with disability service providers and allied health professionals in any further development of this legislation. Rushed legislative reform in this space carries real risk of unintended consequences that may take years to identify and rectify, at considerable cost to both participants and the Scheme.
The NDIS represents a landmark commitment to Australians with disability. That commitment deserves the time and rigour necessary to get this legislation right.
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