What To Do If You Experience Or Spot NDIS Fraud

An experienced individual carefully spotting NDIS fraud, holding up a sign that says fraud.

The past two years has thankfully seen Disability Services Minister Bill Shorten propose a radical reboot of Australia’s National Disability Insurance Scheme (NDIS). Part of this is a crackdown on service providers who commit NDIS fraud by either massively overinflating their prices or claiming from the scheme for services they never delivered.

So what exactly is the NDIS crackdown, what will it involve, and what can you do if you suspect a service provider has been committing NDIS fraud? Read below to find out more.

What is NDIS fraud?

The NDIS, a government funding program designed to help those living with disabilities access services and support for more independent and fulfilling lives, unfortunately faces frequent abuse.

Unscrupulous service providers often exploit it by exorbitantly inflating their prices to profit from the scheme.

Read about NDIS mark-ups here, where some participants say their services are double or even triple the price of services provided when compared to those not on the scheme. 

Estimates suggest that the NDIS lost around $1.4 billion last financial year due to this type of fraud and overclaiming. Some of society’s most vulnerable people are not only being taken advantage of, but it also hampers access to support services for those who truly need them.

NDIS fraud in the news

New reports of NDIS fraud have become far too common. For instance, in November 2022, authorities charged five people in Melbourne with defrauding both the NDIS and the Child Care Subsidy of $800,000.

The main culprit is a mother of seven, one who is on an NDIS plan. She stands accused of not only using her child’s NDIS support money for herself but also of setting up NDIS provider businesses to exploit people with disabilities for profit.

In another alarming and significant case in June 2022, the NDIS Fraud Taskforce, a multi-agency partnership, arrested four people linked to Middle Eastern organised crime entities in Western Sydney. They were charged with wrongfully claiming up to $10 million from NDIS participants for non-existent services.

The case highlighted the involvement of organised crime in defrauding the scheme. The individuals charged also allegedly threatened violence towards participants and witnesses.

What is the NDIS crackdown?

The NDIS crackdown is part of Shorten’s wider vision of a complete NDIS reboot.

It will involve a series of measures and initiatives to combat fraud and abuse and come down hard on providers ripping off the scheme. Service providers found guilty of fraud could face huge fines or even criminal penalties.

The NDIS and Australian Competition and Consumer Commission (ACCC) will be working together to compare pricing information on disability equipment and services. Through this, there will be more conclusive data on the average cost of services for comparison purposes.

The government’s also trying to teach everyone involved – including people living with disabilities, their families, and service providers – about what’s okay and what’s not when it comes to using NDIS money.

The NDIS crackdown is expected to cost somewhat $6 million to execute. However, it’s expected to claw back millions in ill-begotten funds and prevent fund misuse in the future.

The NDIS banned list

Individuals and organisations that’ve been barred from providing services under the NDIS have been placed on a list by the NDIS Quality and Safeguards Commission.

You can access the list (last updated 10 March 2023) – here.

The aim of it is to protect participants from those who’ve committed fraud, provided substandard care, or otherwise failed to meet the NDIS’s strict standards.

The transparency of the list being accessible to the public helps participants, their families, and caregivers make informed decisions about the providers they choose for NDIS-funded services.

What does it mean if a provider is on the list? It means the NDIS Quality and Safeguards Commission has served them a banning order, prohibiting them from delivering NDIS-funded services. The NDIS regularly monitors the list for compliance and can take action against those who attempt to circumvent its ban.

How to report NDIS fraud

So, what do you do if you suspect a provider engages in price gouging or other forms of NDIS fraud? It’s vital to take the right steps and report it. Here are some actions you can take:

Gather information

Firstly, document any details that support your suspicion. This might include dates, services billed but not provided, discrepancies in billing, or any other irregularities.

Contact the NDIS

Get in touch with the NDIS Fraud Reporting and Scams Helpline. You can report suspected fraud by calling 1800 650 717. This helpline is specifically set up for such reports. If you prefer, you can email the details of your suspicion to [email protected].

Report it to the NDIS Quality and Safeguards Commission

For issues relating to service quality, safety, or non-compliance with NDIS rules, contact the NDIS Commission via its website or by phone.

Remain anonymous if desired

If you wish to keep your identity confidential, you can choose to report anonymously. Just specify this when you contact the helpline or omit your personal details in the email.

Contact local law enforcement

If the fraud seems to involve criminal activities, you might also consider reporting it to the Australian Federal Police.

Keep records

Finally, keep a record of any communications you have regarding your report, including whom you spoke with and when.

It’s essential to report any suspected NDIS fraud promptly. This helps protect the program’s integrity and ensures the people who need it get the services they need. Reporting fraud not only safeguards the system; it helps prevent further harm to vulnerable people and misuse of public funds.

A person carefully writing on a paper with a pen, ensuring there is no spot left untouched.

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