The National Disability Insurance Scheme (NDIS) is a cornerstone of support for Australians living with disabilities, providing essential services and resources that improve quality of life. However, there are growing concerns that the integrity of the Scheme has been under threat from a minority of providers exploiting the system for financial gain. In response, the government has launched a comprehensive crackdown aimed at rooting out fraud and non-compliance, ensuring that the NDIS is protected from waste, fraud, and abuse.
To that end, in June 2024, the government passed amendments to the NDIS Act which sought to strengthen the NDIS Quality and Safeguards Commission's ability to detect and respond to fraud and non-compliance, deregister non-compliant providers, and define what support NDIS participants can access.
In addition, there have been a number of police raids in recent weeks targeting providers suspected of fraudulent activity. Dozens of those providers are already being progressed towards criminal prosecutions.
What is the NDIS Commission?
The NDIS Quality and Safeguards Commission is an independent body established to enhance the quality and safety of services funded by the National Disability Insurance Scheme (NDIS).
The Commission is imbued with powers under the National Disability Insurance Scheme Act 2013 to investigate providers suspected of non-compliance with the with NDIS Practice Standards, the NDIS Code of Conduct, or other legislative requirements. Where a compliance issue is identified, the Commission has powers to take various actions based on the severity of the non-compliance or harm identified during an investigation.
NDIS Commission Powers
Under sections 73N and 73P of the National Disability Insurance Scheme Act, the Commissioner can suspend or revoke a provider's registration if they are deemed unsuitable to offer services to people with disabilities. This can happen if the Commissioner identifies that the provider's actions jeopardise public trust in the NDIS, or if the provider's operations threaten the health, safety, or wellbeing of participants.
Additionally, the Commissioner can issue banning orders under section 73ZN, which prevent a provider, or individuals associated with a provider, from engaging in specified activities if they are found unfit to deliver NDIS services. Such orders can be permanent or temporary and can apply broadly or to specific activities. Before making these decisions, the Commissioner is required to notify the provider and invite them to make submissions.
The Commissioner is also empowered to issue Infringement notices, typically issued for straightforward, lower-impact breaches of the NDIS Act, such as failing to submit required reports or documents on time.
What are My Rights If I am Impacted By an NDIS Commission Decision?
If an individual or provider is affected by a decision made by the NDIS Commission, they can ask for an internal review within 3 months of receiving the decision.
Additionally, some decision of the Commission are reviewable by the Administrative Appeals Tribunal (AAT). You have 28 days from the time you received the decision to lodge your application for review with the AAT.
It is crucial to act quickly to ensure that all options are explored within these strict timeframes.
Early legal intervention can often mitigate the risk of higher-level compliance actions and may lead to more favourable outcomes. Our lawyers can help providers show their willingness to take corrective action, potentially leading to less severe disciplinary measures.
Criminal Prosecutions for NDIS Fraud
In cases of serious misconduct, providers can be prosecuted for serious criminal offences and potentially face significant terms of imprisonment. Several Commonwealth offences can apply to fraudulent activities involving the NDIS, each carrying significant penalties. Here are some relevant offences and their maximum penalties:
- Obtaining Financial Advantage by
Deception (Section 134.2 of the Criminal Code Act
1995 (Cth)):
- Maximum Penalty: 10 years imprisonment.
- Maximum Penalty: 10 years imprisonment.
- General Dishonesty—Causing a
Loss (Section 135.1(5) of the Criminal Code Act
1995 (Cth)):
- This applies when a person dishonestly causes a loss, or risks causing a loss, to the Commonwealth or another person.
- Maximum Penalty: 10 years imprisonment.
- General Dishonesty—Obtaining a Gain (Section
135.1(1) of the Criminal Code Act
1995 (Cth)):
- This applies when a person dishonestly obtains a gain from the Commonwealth or another person.
- Maximum Penalty: 10 years imprisonment.
- Conspiracy to Defraud (Section 135.4 of
the Criminal Code Act 1995 (Cth)):
- This covers cases where two or more people conspire to defraud the Commonwealth or obtain a financial advantage from it.
- Maximum Penalty: 10 years imprisonment.
- False or Misleading
Statements (Section 137.1 of the Criminal Code
Act 1995 (Cth)):
- This applies to providing false or misleading information in circumstances where it is required by law.
- Maximum Penalty: 12 months imprisonment or 10 years
imprisonment if the false statement results in a financial
benefit.
- False or Misleading Documents (Section 137.2 of
the Criminal Code Act 1995 (Cth)):
- This offence applies to providing a document that is false or misleading in a material particular to the Commonwealth.
- Maximum Penalty: 12 months imprisonment or 10 years imprisonment if the document is given with the intent to gain a financial advantage.
These offences underscore the serious consequences of engaging in fraudulent activities against the NDIS.
Navigating the Risks in the NDIS Crackdown
The recent government crackdown on NDIS providers underscores the serious implications of non-compliance and fraud within the scheme. As the NDIS Quality and Safeguards Commission intensifies its enforcement efforts, providers should be aware of the regulatory landscape and the severe consequences of failing to adhere to the rules.
For those facing investigation or enforcement action, it is crucial to seek legal advice early. Our team is here to help providers navigate these challenges, mitigate risks, and work towards the most favourable outcomes.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.