In one of his first speeches as Minister for the National Disability Insurance Scheme, Bill Shorten flagged cracking down on fraud and rip-offs as one of the Government’s biggest priorities when it comes to the NDIS. An estimated $1 billion is stolen from the NDIS by fraudsters each year. That’s a huge amount of money that could be going towards supporting people with disability, which is why it’s taken so seriously.
So, what counts as fraud and how (as a service provider) can you avoid inadvertently ending up in the National Disability Insurance Agency’s sights?
What is fraud?
Fraud happens when someone breaks the law to gain something. When it comes to the NDIS, there are many kinds of fraud that providers can commit, but it generally relates to a person trying to 'rip off' or steal from NDIS participants and the NDIS.
What sort of actions count as fraud?
Fraud can range in scale from an organised criminal gang scamming hundreds of participants, through to a self-employed service provider overcharging for travel time.
Some of the actions that the NDIS categorise as fraud include:
- Unlawfully obtaining and using NDIA information or restricted data
- Providing false or misleading information
- Using fake documents and invoices
- Making claims for services or products that were not provided
- Misusing funds
- Theft
- Unlawful disclosure of official information
- Accounting fraud
- Fraudulently claiming leave, travel and other entitlements
- Misuse of assets, equipment or other facilities.
- Is fraud the same as non-compliance?
- Non-compliance is a broad term that refers to not following the rules of the NDIS. There are several types of non-compliance that range in severity from accidentally making a mistake all the way through to fraud and corruption.
- Invoicing over the price limit or charging a participant twice by mistake are not considered fraud, as fraud needs to have malicious intent behind it.
Who investigates NDIS fraud?
Cases of fraud that are particularly serious and organised are investigated by the NDIS Fraud Taskforce, a special partnership between the Australian Federal Police, the NDIA and Services Australia. Less severe cases of fraud are investigated by the NDIA directly, but the NDIA still take these accusations very seriously and the punishments reflect that.
What are the punishments for NDIS fraud?
Depending on the nature of the crime and the severity of the fraud, punishments can range from fines to jail time.
How can service providers avoid being non-compliant or accused of fraud?
Unless you’re intentionally committing fraud, it’s unlikely you’ll be accused or punished for it. Having said that, misunderstandings or accidents can occur, so it’s important you protect yourself as a service provider.
There are some simple steps you can take to ensure you stay on the right side of things and avoid being non-compliant:
Follow the rules: If you follow the rules and regulations of the NDIS, it's unlikely you will commit fraud. While this might sound obvious, it’s surprising how many service providers are not familiar with the many rules and regulations of the NDIS. These rules are complex and can change, so we suggest you take the time to familiarise yourself with them, and ask for help if there’s something you don’t understand.
Fill your invoices out correctly: Even if you’re following all the rules and charging your customers in line with the NDIS price limits, it’s important you can prove that to be the case. Taking the time to fill out every part of your invoices correctly – including the customer’s name, the date you provided the support, the line item and rate – can save you from running into issues in the future.
Make service agreements: Service agreements are one of the most effective and simple ways for both providers and participants to protect themselves. Effectively a contract between the two parties (you and your customer), the service agreement lists what service you’ll be delivering, how often you’ll provide that service, how much you’ll charge, and any other noteworthy details. Having a service agreement in place with each of your customers helps avoid misunderstandings – just be sure to keep them filed for when you need them.
Keep records of everything: All NDIS providers are required by law to keep accurate and complete records that detail the support you provided to participants. While this obviously includes invoices, you should also keep any other documentation that might help your case should the NDIA ask you to explain an expense or support you delivered. Taking photos of receipts and saving them to your computer can make record keeping much more efficient and help you to find specific documents fast.
Take warnings seriously: If the NDIA suspect you’ve made a mistake or are doing something that doesn't fall within the rules of the NDIS, they might issue you with a warning. If this happens, take it seriously and either fix the issue as soon as you can or confirm you’re in the right (and have the paperwork to back it up.) The worst thing to do is ignore a warning and hope it goes away.
We’re here to help
If you have any questions about invoicing your customers or your obligations as a service provider, our Knowledge Centre is filled with tips and guidance to bring clarity.
If Plan Partners are your customers’ plan manager or support coordinator, we can provide additional assistance with things like setting up service agreements or help with invoicing.