The Federal Labor Government has recently established the Fraud Fusion Taskforce to deliver on its election commitment to reduce fraud in the NDIS. Over the weekend (21-22 January), the NDIA announced that the NDIS Commission has issued banning orders on two companies and five individuals associated with those companies because of evidence of their submitting falsified and inappropriate claims for payment to the NDIS.  Since its inception, the NDIA has undertaken random audits of provider payment requests. Recently, we have been made aware of prepayment reviews undertaken by the NDIA Claims and Payments Integrity team. Such audits assess claims against NDIA pricing controls as described in the NDIA Pricing Arrangements documents. Reviews might delay up to five days payment claims for selected items.  It is a good reminder for providers that payment requests must align with the service or support provided to a NDIA participant.  Payments can only be issued if the participant has funds on that support category in their NDIA support plan. The NDIA expects providers to make accurate claims reflecting the support provided. The claim should specify the NDIS participant, the correct rate of payment, and the date and time of the support. In addition to information submitted with a claim, providers should keep records of all supports, such as invoices and service agreements.  

Other records that can help validate the claim include digital or printed logs of the services’ start and finish times that is signed or verified by participant or nominee, a sign-in register for centre-based group supports, or a therapist’s clinical notes.  Please see information on the NDIS website on provider compliance and the Agency’s Fraud Strategy.