NDIA Expands Reviews of Older NDIS Claims
The National Disability Insurance Agency (NDIA) has updated its review process for older NDIS claims. While these changes are unlikely to affect most participants' day-to-day services, they may impact how long it takes for some older invoices and reimbursement requests to be processed.
What's changing in October?
From 15 October 2026, the NDIA will introduce additional integrity checks for claims submitted 90 days or more after a support has been delivered.
The additional checks may apply to claims submitted by:
- Self-managed participants
- Plan managers
- Registered NDIS providers
- Unregistered NDIS providers
What's changing in December?
From 1 December 2026, claims submitted 90 days or more after a support has been delivered will not be paid, unless exceptional circumstances apply.
Why is the NDIA reviewing older claims?
The expanded checks form part of the NDIA's broader approach to monitoring and verifying claims both before and after payment.
What does this mean for participants?
If a claim meets the NDIA's review criteria, it may be placed on hold for up to 28 days while additional assessments are completed.
As part of the review process, the NDIA may request supporting information to verify that:
- The support was delivered
- The support complies with NDIS requirements
- The claim has been lodged correctly
If a claim is not approved, the NDIA will provide an explanation for its decision.
How can delays be avoided?
To help minimise potential delays, participants, providers and plan managers are encouraged to submit claims as soon as possible after supports have been delivered.
Prompt claim submission can help ensure invoices and reimbursements are processed more efficiently and reduce the likelihood of a claim being subject to additional review.
We encourage anyone with outstanding claims with a service date older than 90 days to submit them now before the 1 December.
For more information, visit the NDIA announcement here.