Fraud + Criminal Offences In the NDIS: How To Stay Safe

Fraud + Criminal Offences In the NDIS: How To Stay Safe

Written by: Cassandra Blecha l NDIS Plan Management Team

 

In November of 2022, a multi-agency partnership was established, to work together to reduce fraud against the Australian Government payments programs.  It was named the Fraud Fusion Taskforce (FFT).  Some of the agencies in this partnership are;

• NDIS Quality and Safeguards Commission (NDIS Commission);
• The National Disability Insurance Agency (NDIA);
• Services Australia;
• Australian Tax Office;
• Australian Federal Police; and
• Australian Criminal Intelligence Commission.

This task force’s members work together to share information and investigate and prevent fraud so that the NDIS and other government programs can keep providing necessary support to Australians.

What Is Fraud In The National Disability Insurance Scheme?

Well, according to the definition in the Oxford Dictionary:

Fraud is: ‘wrongful or criminal deception intended to result in financial or personal gain’.

Fraud is a crime that requires intent.  This is because as the definition of fraud above states, it is when there is wrongful or criminal deception which means people will attempt to get benefits for themselves or others by being dishonest on purpose.  This could be when someone is trying to be paid with NDIS funds for a support that they do not actually provide to an NDIS Participant.

Within the NDIS there are a few types of fraud that could be included:

• Making False Claims: this means that someone could be claiming for supports that were not provided to the NDIS Participant, charging for more time than what was provided to the NDIS Participant, trying to claim the same invoice more than once, or charged more than the agreed price for the supports provided;
• Overpricing: this is when a provider is charging an NDIS Participant more for a support than recommended in the price guide, or more than someone who does not have an NDIS Plan would be charged.  This is also known as price gouging;
• Access Fraud: using fake information and evidence when trying to become an NDIS Participant;
• Eligibility Fraud: using fake information and evidence to try and get more funding in an NDIS Plan;
• Identity Theft: using fake identification information or someone else’s identity, contact details or address to try to get access to an NDIS Participant’s funds; and
• Deliberate Non-Disability Spending: using NDIS Funds to pay for everyday expenses or items that are not NDIS supports.  (This could be things like rent, home loan repayments or even utility bills, child support fees or debt repayments, and standard recreational equipment and tools – including toys, balls and racquets.)

What Has The NDIS Done To Help NDIS Participants?

The immediate previous Minister for the National Disability Insurance Scheme (NDIS) and Government Services – The Hon. Bill Shorten, has said that the FFT in the two years since its inception has launched more than 500 investigations and referred 50 people to court, accused of ripping off millions of dollars from people with a disability and Australian Taxpayers.

The Minister is also quoted saying –

“The establishment of the Fraud Fusion Taskforce was a line-in the sand moment, whereby government agencies came together to ensure any low-life individual seeking to exploit not only anyone who relies on additional support but also Australian taxpayers has their crimes exposed.”

As of November 2024 – the most recent FFT NDIS data shows that the 21 FFT member agencies currently have 97 operations underway with 521 active investigations and over 50 people have been referred to go before the courts.

Within the National Disability Insurance Agency (NDIA) there are currently 75 active investigations underway, and they are expecting hundreds of prosecutions that are expected to result for them.

The value of the current NDIA FFT investigations is more than $1 billion.

The NDIS has identified over 15,000 NDIS Participants who may have been impacted by fraudulent providers.

The NDIS Commission has undertaken 165 FFT-related compliance actions against providers and individuals, including:

• 88 banning orders;
• 21 suspensions of registration; and
• 23 revocations of registration.

Of those 88 banned providers and individuals, they claimed nearly $28 million in the 12 months prior to banning.

In the second part of the new legislation – National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No.1) Act – Bill Shorten announced that the Government will significantly increase protections for NDIS Participants and workers and improving the quality and safety of supports for all participants.

Critically, the penalties for providers will increase from a maximum of $400,000 to increase in excess of $15 million when an NDIS Participant is hurt or injured under the care of a provider.

Investigations + Crackdowns From the National Disability Insurance Agency

In early November 2024, three people were jailed for their roles in a multimillion-dollar defrauding of the NDIS.

This sentencing is the result of the investigation into several suspected fraudulent providers in Western Sydney.

Of the three people jailed, they were sentenced to a total of nearly 12 years and eight months imprisonment, and a reparation order was made in the amount of $575,274.94 that is to be repaid back to the Commonwealth.

How To Keep An NDIS Participant You Know Safe?

If you want to know more about how to keep yourself or someone you know safe from fraud, we recommend making sure that you get confirmation of:

• Appropriate qualifications, skills and experience of the provider, practitioner or worker;
• NDIS Workers Screening Check;
• Working with Children Check;
• Police Check;
• First Aid Qualifications;
• Drivers License (if providing transport);
• Policies and Procedures; and
• Insurances; like public liability, professional indemnity, car, accident and/or Work Cover.

Want to know even more about what you should be looking for when it comes to choosing your NDIS Providers?  Check out this previous blog we put together: What Makes a Good NDIS Provider? 

We also recommend that, whilst it is not mandatory, another way to ensure that you can keep yourself or another NDIS Participant you know safe, is by having a Service Agreement drawn up.  Whilst verbal agreement or understanding generated through a ‘gentleman’s handshake’ could be considered an agreement – it is more reliable to have a written service agreement.

The things that we recommend you need to include as a minimum on the Service Agreement are:

• The parties to the agreement;
• The time frame for the agreement (this could be for the duration of the NDIS Plan date);
• Responsibilities of the parties;
• Type of support to be delivered;
• The specific support to be delivered;
• When the support will be delivered;
• Travel – including the rate per kilometre;
• Prices and costs of the support being delivered;
• Any report writing if necessary;
• Feedback and complaints process;
• Options to review the agreement; and
• Signatures or verification of acceptance and agreement.

Want to know more about Service Agreements, what they should include and when you need one?  Check out this previous blog we put together: NDIS Participants + Service Agreements.

If you have plan managed funds, it is advisable to provide your NDIS Plan Manager with a copy of your NDIS Plan and the Service Agreements you have in place with your providers.  This helps the NDIS Plan Management team to monitor the compliance of the claims of the providers against your NDIS Plan and NDIS Funding.

Canny Plan Management + Navigating The NDIS