There have been so many announcements from the NDIA lately that it’s hard to keep up. We have pulled these together to try and help you to get across them – let us know if we have left anything out.
2025 Federal Election
The election is approaching quickly. The inevitable mention of the NDIS has been posed by both the ALP and the Coalition who have both pledged not to tighten eligibility criteria. This is really not a surprise as updated legislation around this was only passed in October and besides, the new rules and operational guidelines contain plenty of ways for Participants who are completely eligible for the NDIS to have their support reduced or declined.
One party has suggested a reduction of the public service may have an effect on efficiency.
Plan Management Integrity Audits and Service Agreements
More conversations have been taking place about the reasons why providers are being asked for additional documentation, such as ID, qualifications and evidence that a service actually happened. This is due to payment integrity audits which are being regularly applied by the NDIA to claims uploaded by Plan Managers. The documentation is requested from the Plan Manager, who then passes the request along to you, the Allied Health Business.
This is the Agency trying to reel in incorrect and fraudulent claims which we know are being lodged sometimes accidently, but sometimes by nefarious people who are trying to take advantage of the previously lax claiming process.
While it can be frustrating, it will protect good providers in the long run and once registration becomes mandatory for everyone some of these loopholes will be closed.
Adding the relevant qualification and professional registration information to your invoices of the implementing clinician might help to curb some of the requests. Ensuring that your service agreement is nice and tight, has considered that the support being delivered is on the approved NDIS Supports list AND is applicable directly to the impairment for which the Participant has been made eligible for – should reduce the chances of having an NDIS debt raised against the business (yes they can do this now).
Impairment Notices
As we understand it, Impairment Notices will be sent out to Participants in the very near future. This notice will tell the Participant exactly what disability they have that has been made eligible for the NDIS. Whether it will be a separate notice or just added to a Plan is not yet known.
It is important that you know what this document says as supports that are not directly related to that Impairment can be declined and a provider can even have a debt raised against them if they are found to be delivering a support that is not directly related to the listed Impairment.
Start flagging with your Participants and their families that you will, ideally, need to see that document or at least know what is listed so that you can ensure that you are complying with these rules.
Total Budget Management
The NDIA have announced that in May, they will begin to write Plans with a total budget amount and define the funding period in which that budget must last. This is in opposition to the stating of supports that we are seeing more and more within the Capacity Building budgets and we anticipate that we may see a combination of these approaches in future plans.
We are flagging the potential for Providers to have to support Participants in managing total budgets, for their benefit and to ensure that you don’t end up with unpaid invoices.
2025 Price Guide
The NDIA have gotten out on something resembling the front foot this year and announcing that we won’t see the 2025 Pricing Arrangements and Price Limits (PAPL) document until after Fair Work announce any change to minimum wages and conditions. This tends not to happen until June so we are expecting the usual mid to late June drop of what is probably the most influential document in this sector.
We have no read on whether we will see any changes to the Allied Health rate – but to be honest it’s the policy changes that arrive in the PAPL that seems to make people more nervous. But for now, just continue with business as usual.
Stated supports
More and more often we are seeing specific disciplines within plans, often Speech Pathology and Occupational Therapy. While we are purely speculating, we think that this is something of an attempt to prevent both fraudulent use of the Therapeutic Supports category, as well as attempting to provide only the supports that meet the Reasonable and Necessary criteria. Unfortunately, there are reported incidents of the stated disciplines in the plan being those that have not been requested within the supplied reports, or even not having been accessed by the Participant at all before.
This underlines the importance of coaching your clients to be forthright and clear about the support that they know work to progress them towards their goals; ensuring that your reports meet the Operational Guidelines and Reasonable and Necessary criteria and please, if your discipline is experiencing this process of being stated out of Plans, engage with your Peak organisations to work at a systemic level.
Edit: over the past Anzac Day weekend, the NDIA have published a FAQ which first of all suggested that in many cases, individual supports within Capacity Building are not stated, rather the Support Category (Improved Daily Living) is what is stated, with flexibility within that category. This would mean that any discipline that is allowed to claim via the IDL category could provide supports flexibly (and in line with other Rules of course). Within days this FAQ was changed to seem to be far more restrictive. So we suggest that everyone continue to watch this topic carefully and keep an eye on the socials for any updates.
Foundational Supports
We know that these are on the boil and the ALP’s proposed budget contained a dollar figure for what the Commonwealth would contribute to them.
As far as we are aware the States and Territories, and the Commonwealth, are yet to find a place of agreement given there is still no clarity about how many people, or which services, would need to be offered.
We do know that the States and Territory governments are working to complete some potential design work within their own departments and we expect to hear about consultation from them once an agreement has been reached.
Watch this space.
Support Needs Assessments
There is still talk that Support Needs Assessments will be getting off the ground in September. We are not sure whether these logistics line up given the tender for the build of the tool(s), the training and the IT component has only just closed. We are keeping our ears and eyes open and will let you know as soon as we have anything to update.
Context for those who are not across these – Support Needs Assessments is the proposed tool that will be used to determine what a person needs to be included within their NDIS Plan. We believe that the scores within the tool will dictate the funding that will be allocated within the Plan. They will be conducted by NDIA employees and may or may not be Allied Health Professionals.
For more information on this, Cathy recently recorded a great podcast with Muriel Cummins which you can listen to here.
Co-Design Promises
This month, the NDIA committed to a better approach to co-design with the disability community for a range of initiatives, including Support Needs Assessments.
More to come on this one.
Music and Art Therapy
The formal review of Music and Art Therapy has been completed by Dr Stephen Duckett AM and his report has been submitted to government. Music and Art Therapy will continue to be funded as before under the NDIS with more detail to come when the Agency have assessed the findings. Its a pertinent reminder that with the stating of supports (as above) happening more and more within Therapeutic Supports, your client may need to advocate for themselves quite strongly to ensure that they are included.
Once more, watch this space
If you feeling like you are watching this space for too many things, please join us on the viewing deck.
Stay as up to date as you can by following our public Facebook page at Allied Health Business Brilliance and if you would like to chat for an intensive couple of hours with us, you can access our NDIS Power Pack here.
Feeling overwhelmed by all these changes? You’re not alone. If you’d like some calm, qualified help cutting through the chaos and figuring out what this all means for your business, we’re here.
Book a free Power Call with our Nacre Consulting team—we’ll meet you where you’re at and talk practical steps forward. No fluff, just clarity.
