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Driving Real Change in NDIS Fraud Prevention

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When I look at the NDIS and NDIA, I see a system full of contradictions—balancing fraud prevention with accessibility has been a challenge since its inception. In this Estimates session, I focused on fraud and the work of the Fraud Fusion Taskforce. I raised concerns about the gap between over 7,000 tip-offs in the June 2024 quarter and only 16 prosecutions. While I understand investigations are complex, that disparity is striking. Officials explained that not every tip-off is valid; many are misunderstandings or even malicious.

Since November 2022, the taskforce has achieved over 300 compliance outcomes, including bans and revocations, and significantly increased enforcement activity. They highlight that prosecutions are a slow and unreliable metric, pointing instead to indicators such as 35 warrants executed in the first four months of this year—a twelvefold increase from previous years. Custodial sentences and asset seizures have occurred in cases involving millions of dollars and dozens of properties, including seizure orders on 33 houses and multiple vehicles. These results demonstrate that serious fraud is being tackled, even if the full impact takes time to show.

Mr Dardo stressed that success should not be measured by debts, prosecutions, or raids, but by prevention. The Crack Down on Fraud program focuses on identity verification, stronger evidence requirements, and advanced data analytics to detect risks early. These measures aim to make compliance easy and fraud difficult, safeguarding participants and ensuring sustainability. While prosecution remains a tool, the ultimate goal is to reduce fraud so effectively that legal action becomes rare. A recent survey revealed that 899 out of roughly 1,000 plan managers showed indicators of potential fraud, underscoring the need for these preventive systems.

I commend this approach because it makes sense: prevention first, enforcement when necessary. Still, some people will always try to bypass safeguards, and the scale of fraud remains daunting. Australians deserve confidence that the NDIS is fair, secure, and sustainable. We must continue improving systems while maintaining transparency and accountability. Striking the right balance—protecting participants while cracking down on fraud—is critical, and I will keep pressing for progress on both fronts.

The agency appears to be delivering every milestone of its Crack Down on Fraud program on time and under budget, with independent audits and ANAO oversight ensuring accountability. That level of scrutiny and systems uplift is encouraging, but the journey is far from over.

— Senate Estimates | December 2025

Transcript

Senator ROBERTS: Thank you for being here today. I have some questions. It’s very much a contradictory set of questions. I have questions about fraud and questions about how to make more people eligible. The whole NDIS, NDIA, seems to be full of contradictions, from the moment it started back in 2010 or whenever it was.  Could I ask questions about the Fraud Fusion Taskforce first, please. I have some NDIS data—I’m not sure exactly where it came from, but it’s from within the NDIS—that says that for the June 2024 quarter there were over 7,000 tip-offs, but only 16 prosecutions for fraud. Why has the taskforce achieved only 16 prosecutions in a quarter despite 7,000 tip-offs? Can you explain the gap? And I’m not pretending that it’s easy. 

Mr Dardo: The tip-offs that we receive may be treated through a range of mechanisms. It might be that we look at them and we’re able to engage with a provider or a participant and deal with them through education. The tip-off may require us to implement some sort of prepayment review where we would nudge a person to give us some evidence before we make a payment, and maybe we would do a post-payment review, a historic review. It may be that we do a more serious administrative compliance intervention and it may be that we implement manual payment reviews where we stop payments until we receive evidence for each claim. In the most extreme cases, we may revert to a criminal investigation and/or prosecution. It’s really important to note that there’s a spectrum of treatments, depending on the severity of the tip-off and the efficacy of the tip-off. In some cases, we look at the tip-off and it’s actually a misunderstanding, and there’s no substance underneath it that requires an intervention. 

Senator ROBERTS: So, the tip-off itself is wrong? 

Mr Dardo: It might be wrong, or it might be a misunderstanding. In some cases, it’s malicious—somebody having a go at someone else. So, it’s really important that, while we do measure tip-offs and while we have put in enormous programming to improve the way we capture, understand and process tip-offs, the volume of tip-offs alone does not indicate the requirement for a prosecution. While I am talking about tip-offs, once upon a time tip-offs used to be captured, effectively, on a spreadsheet. We have put in a range of system improvements to make the tip-offs more able to be captured in a codified way. So, whether it’s through the call centre or through our online systems, they’re able to be captured in a way where we can code and then analyse the content of the tip-offs. The beauty of that is that, as the volumes have increased—and they are increasing; they continue to increase—we’re more able to run  analytics over the top of them and understand whether the tip-off relates to previous tip-offs or previous treatments or previous risks, then cluster them or group them with associated intelligence or associated treatments. The systems continue to improve by the week, but I don’t want you to assume that every tip-off is going to lead to a prosecution. That would never be the case.  

Ms Myers: As members of the Fraud Fusion Taskforce who work very closely with the NDIA, since November 2022, we have executed over 306 compliance outcomes, including 179 banning orders, 38 revocations of registration and 89 other regulatory outcomes. So, in addition to the prosecutions undertaken, there have been a number of regulatory actions taken. 

Senator ROBERTS: So, restrictions have been imposed and bans et cetera. 

Ms Glanville: I think the really important piece of this is that it’s a very collaborative arrangement between the NDIA and the commission as well as other enforcement agencies. The development and growth of that, I think, has been particularly positive for being able to identify—better analyse, as Mr Dardo was saying—and understand what are the best actions that can be taken to address whatever is the nefarious or other action that has occurred. I think that’s a really important part of this process as well. 

Senator ROBERTS: So, it is a big issue to you, the NDIS and NDIA. 

Ms Glanville: To the commission and the agency, yes. 

Senator ROBERTS: It’s also a matter of restrictions, but I’ll go to total prosecutions and convictions for NDIS fraud. How many since the taskforce was established? 

Mr Dardo: I think, again, it’s really important that we step back. It’s a metric that has a significant lag effect. 

Senator ROBERTS: Due to the court system plus the investigation? 

Mr Dardo: Yes. You may start something and there may be interventions that are lower-level interventions or they may rapidly escalate. Before search warrants are executed—in some cases it’s very, very fast. It could be weeks or a month. In some cases it takes longer. But, even after search warrants are executed, sometimes there’s a charge on the day, sometimes there’s a court attendance notice, and sometimes it takes another six to 12 months to get to a charge and then to get in front of the courts. In some cases we’re seeing cases not getting in front of the courts for several years.  So can I just flag that the number of prosecutions is not a number that’s a great indicator of the level of activity that is occurring, and it’s certainly not a number that reflects the enormous collaborative effort that’s occurring across the agencies. Our colleagues at the commission have been phenomenal in partnering with us, as have been a number of other agencies—Services Australia and the tax office and so on. So sometimes the interventions are actually better administered by other agencies or in partnership with other agencies. If you want something that’s a more indicative number of activity at that sharp end, like the activity that you’re trying to get to, at the very tip of the iceberg—just in the first four calendar months of this year, we did 35 warrants. That’s more than were done in four whole years before the taskforce was established, and that was just in the first four months. So, if you’re looking for an indicator of sharp activity, we’re talking a 12-fold increase in activity in a taskforce. And that doesn’t even scratch the surface of the things that happen underneath investigations—the interventions that are going on.  

Senator ROBERTS: It’s pretty daunting. I don’t know if it was you—I think it may have been you—who, a year or so ago, told us that you were overwhelmed and that the court system would not handle it.  

Mr Dardo: It’s really important to note—and I’ve said this a number of times on the record in this house—that debts, prosecutions and raids are the wrong metrics for a successful system. What we really are trying to build through all our big investments is how you prevent those bad things from happening. If you look at the big system investments we’re making, they’re trying to figure out how you make it easy for people to get it right and really hard for them to get it wrong. That means that all the people trying to do the right thing, which is the majority, are having a better experience. It’s more streamlined, it’s easier for them to get paid the right amount, and they’re less likely to get themselves into a misunderstanding and less likely to be abused by a non-compliant provider. That upfront prevention is, overwhelmingly, our mission. Everything we’re building in the Crack Down on Fraud program is about building prevention upfront so that you can safeguard participants and get sustainability—whether it be improving the identity systems for the people that log in, which we’ve delivered; whether it be improving the identity systems for the providers, which we’ve now delivered; whether it be improving the evidence requirements for claiming so we’re more confident people are getting it right, which we have partially delivered and continue to improve; whether it be building a data analytics system that allows all that data to be pooled together so we can identify risks and stop at prepayment where we can; or whether it be working with our partners to have those risk detections so that we can identify problematic providers and exit them from the system at the earliest opportunity. All those things that prevent bad things happening have to be the focus. You’ll never get rid of the need to raise debt or prosecute; that will always be something in the arsenal. We will need to be good at it, but it should be the last resort. You would hope whoever replaces me in two or three or four years time is sitting here, saying, ‘Actually, we only had to do five prosecutions because the systems work so well that we didn’t have to prosecute.’ 

Senator ROBERTS: What you’re saying makes perfect sense. Nonetheless, some people will deliberately bypass just about everything. 

Mr Dardo: Yes. 

Senator ROBERTS: Deliberately.  Have there been any custodial sentences handed out? 

Mr Dardo: There have been, absolutely. Not only have there been custodial sentences; there have also been successful confiscations of assets. There are people that have gone to jail and are serving custodial time. There are people we’ve grabbed $4 million or $5 million worth of assets from. We have cases in progress right now where we’ve worked with partners, whether it be state or federal, to put seizure orders on, in one case, 33 houses and three cars. Let me emphasise: that was a provider. Custodial is in the toolset, but remember: custodial has got to be an outcome from the courts. We don’t get— 

Senator ROBERTS: Which can take months and months. 

Mr Dardo: It can take years. At the end of the day, the court makes the decision about custodial. We put our best case in the brief, the CDPP puts the best case in front of the courts, and the courts make the decision. 

Senator ROBERTS: I’ll say it again on the record: what you’re saying makes perfect sense. I commend you for that. I don’t know whether you’re doing a good job or not, but it sounds like the right approach to me. 

CHAIR: How much more time do you need, Senator Roberts? 

Senator ROBERTS: Probably five minutes, please, Chair. 

CHAIR: Okay, no problem. 

Senator ROBERTS: My subsequent questions are not really necessary because of the comprehensiveness of your answer. 

CHAIR: Can you put them on notice then? Is that what you mean? That’s a no. 

Senator ROBERTS: Apparently, you stated that a survey showed 90 per cent of a group of plan managers exhibited signs of fraud. 

Mr Dardo: Absolutely. 

Senator ROBERTS: How many of those cases have been referred for criminal prosecution? 

Mr Dardo: That was a discussion that I’m pretty sure we had in a previous Senate estimates. It was a particular subset of plan managers, so it wasn’t every plan manager. It was the plan managers that had between zero and 100 clients. I know that sounds weird, but you can have zero clients because you had clients and you’re not claiming for them right now. There were roughly a thousand plan managers with between zero and 100 clients in that sample, and about 899, to be exact, at the time we did the analysis had indicators that we would think are associated with potentially fraudulent behaviour. Again, there are a range of interventions that we’ve applied there. In some cases we have put prepayment reviews on them, where they can’t be paid unless they provide evidence for their claims. If those prepayment reviews turn up and provide evidence that’s problematic—we look at it and we go, ‘That looks like you’re falsifying your invoices, claiming for things that are not remotely connected to the scheme or claiming for participants that are not getting a service’—then we will work with the commission to remove them from the scheme. That’s an intervention that may or may not go to a prosecution. The other intervention we’ve applied is that we’ve made requests for information for historic claiming and we’ve gone back and looked at their historic claiming. We’ve just done another sample of 47 where the majority of those have problematic claims, so either we’ve referred them to the commission for banning or we have removed their ability to claim from us. We’re working through those.  In some cases we executed search warrants with our partner agencies. In one case, we, the commission, the tax office and some other regulators targeted the plan manager. We got access through a search warrant, a tax debt was raised, and there were banning orders from the commission and other regulators to remove them from multiple schemes. That case may proceed to prosecution, and we’ll work our way through it. In that case, debts were also raised from multiple agencies.  So there’s a spectrum of treatments. We are not going to prosecute every single plan manager that we said had fraud indicators, and there may be some where we look at them and we go, ‘The fraud indicators are there, but they didn’t lead to anything.’ 

Senator ROBERTS: Final question—how will you know you’re being effective, and how will we know you’re being effective? How will we know when fraud is out of the NDIA? 

Mr Dardo: Fraud will never be completely out of the NDIA, just like it’s never out of any scheme. There will always be a level of it that just exists. You have to continue to innovate because it’s an arms race to stay ahead. 

Senator ROBERTS: But, right now, the stories are rife. 

Mr Dardo: They are. It’s about continuing that work for prevention. That has to be the overwhelming focus. 

Senator ROBERTS: How will we know if Mr Dardo has done a good job? It sounds good. I’m not being patronising. I sincerely mean that. It sounds good. What you’re saying makes perfect sense in managing the process. It is what very few managers understand. How will we know that the process has good outcomes? 

Mr Dardo: The first time I came here representing this agency, I sat in this room, and we rattled off the half a-dozen things that needed to be built out as capabilities. We talked about the vulnerabilities in the scheme and about identity, the way claiming was working and the way providers were interacting. We rattled those things off.  When we sat down and imagined the program of work that addressed those things, which government funded, that program of work clearly articulated those layers of capability that needed to be built and delivered. You build 

the foundations, and then you’ve got to keep building. But we laid that out as a program of work called the Crackdown on Fraud program—the systems uplift. That systems uplift was funded by government. In February 2024, it commenced. We delivered every single milestone in that program of work between February 2024 and now, on time and under budget. Let me rephrase that slightly—within the timeframes that we promised we would build it. We started two months later than we said we would, so a couple of things have finished a couple of months later than we said they would. But it was built within the timeframe we said we would build it.  One indicator for you that we’re doing a proper job is we are building those layers of defence on time, and, as they go into production, we can actually see that we’re stopping things from happening that used to happen or that used to be completely invisible. We are now more confident that some of those things we promised would be there are there. The journey is not finished; we’ve got a long way to go. But it’s about how we deliver on those promised uplifts so that the system is less likely to be open to abuse by those who want to abuse it. 

Senator ROBERTS: Would you include in that an audit of the systems, to make sure the systems are working as you say? 

Mr Dardo: I can assure you that we’ve got eyes—not just our eyes but everyone else’s eyes—on it. The ANAO comes and looks at us and makes sure that we’re actually building what we said we were going to build and building it on time. The Department of Finance gateway reviewers come and look at us and say: ‘You promised this. Did you build it? Has it been delivered on time?’ So, there is an enormous amount of independent assurers coming and looking at what we promised for the money that we got and whether we’ve built it to the standard that we said we would. In addition to that, we’ve got independent assurers that work on the program with us who write reports for government about whether we’ve delivered what we said we would on time and on budget. The scrutiny is impeccable. 

Senator ROBERTS: Thank you. Thanks, Chair. 

CHAIR: Thank you, Senator Roberts. 

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NDIS Blackhole

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During this session with officials of the NDIS, I was told that there are currently between 270,000 and 280,000 NDIS providers, with 93% of them being unregistered.

This is a massive number and makes it almost impossible to monitor. Astoundingly, there is no set timeframe for when providers must become registered.

The Minister COULD NOT tell us exactly how much taxpayers were being ripped off by fraudulent operators – however stated that all providers are required to comply with the Code of Conduct. This “compliance” with the Code of Conduct means little to fraudulent operators.

I was not comforted by the responses to this massive waste of money – which is predicted to soon cost more than the entire Australian defence budget.

— Senate Estimates | October 2025

Transcript

Senator ROBERTS: How many providers are now registered with NDIS?

Ms Glanville: The number changes all of the time very rapidly, but we have around 270,000 to 280,000 providers. About seven to eight per cent of those are registered.

Senator ROBERTS: When will the commission extend mandatory registration to all providers, and how long will it take for all providers to be registered?

Ms Glanville: The issue of registration and regulation is a matter for government. We’re very pleased to be talking to government about these issues and we will await the outcomes from those discussions.

Senator ROBERTS: You don’t know yet?

Ms Glanville: No.

Senator ROBERTS: How many sole traders are unregistered?

Ms Glanville: No, we can’t answer that question, but we can take that away and come back to you.

Senator ROBERTS: On notice? Thank you. How much funding has been claimed by unregistered providers from the NDIS since the scheme began and specifically in the 2024 financial year?

Ms Glanville: That’s a question for Mr McNaughton.

Mr McNaughton: Let me take that on notice and see if I get that during the hearing. To confirm, in what financial year was that?

Senator ROBERTS: How much funding has been claimed by unregistered providers from the NDIS since it began?

Mr McNaughton: I’ll need to take that on notice.

Senator ROBERTS: Do you know of any other government funded schemes where regulation or compliance is optional, similar to NDIS provider registration?

Ms Glanville: I think there is a whole range of different regulatory systems across government. That’s probably the most accurate thing I can say. We maintain a position of the importance of regulation and registration in the way in which the scheme works. We note the differences about this scheme than perhaps other regulatory regimes that do exist in the Commonwealth.

Senator ROBERTS: What financial risks does the presence of a large unregulated provider base pose to the NDIS?

Ms Glanville: Our main interest is in the quality and safeguards issue. As a human rights regulator, we are keen to see people with disability receiving very safe and quality services to enable them to live their ordinary lives. Questions about the funding is something perhaps Mr McNaughton could address.

Senator McAllister: The government is very committed to dealing with any questions of fraud or noncompliance in the scheme. The ANAO has made the point that prior to our coming to government there were very limited financial compliance arrangements in place within the NDIA. We’ve made substantial investments to improve that. I can ask Mr McNaughton to talk you through some of those, if that assists you.

Mr McNaughton: It’s also important to talk about the fact the market is a quite diverse market. When we talk about unregistered sole providers, it could be an allied health professional or it could be a clinical psychologist who isn’t registered for the NDIS but is registered in all of their other industry bodies and governed by that process. Sometimes they choose not to register for the NDIS for their own purposes because they have other registration requirements. The market is quite diverse in that range. Through our fraud and integrity work, we are doing a lot of work across government. Mr Dardo can talk to some of the work they’re doing to match everything from ABNs to tax file to pay-as-you-go information so we can see if there are challenges around integrity relating to a provider, whether registered or unregistered. We are agnostic to that in our fraud and our integrity work. We are absolutely committed to preserving this scheme and eradicating fraud. This is something that—

Senator ROBERTS: Excuse me, sir, that was the point I was getting to. The scheme itself is at risk if it’s not brought under control and quickly.

Mr McNaughton: The government has invested significantly. I’ll get Mr Dardo to talk through some of the government investment over the past couple years and some of the great work that’s been underway to put better assurance processes in around the scheme to really tackle those fraudulent providers and make sure all disability funding is going to participants who require it.

Senator ROBERTS: Thank you for the offer, but we heard from Mr Dardo in the previous session of Senate estimates and what he said was compelling. It stunned a lot of people in the room, including me, so I don’t think we need to revisit that again. What percentage of providers are now made up by unregistered providers?

Ms Glanville: I think I answered that earlier. Do you want to give a bit more detail on that, Ms Wade?

Ms Wade: We anticipate that approximately 93 per cent of providers do not elect to register. As at 30 June 2025, we have 22,955 registered providers. It’s important to note that, whether you are registered or unregistered, you are still required to comply with the code of conduct. The regulator can still ban and take compliance and enforcement action against you, which includes bringing matters before the Federal Court, which is an important part of our regulatory approach to ensure we are clear that the NDIS delivers quality and safe services. During today’s hearing, the Federal Court of Australia delivered a judgement with respect to a matter where a registered provider had a participant die in their care. As a result of their failures under the NDIS Act, they have incurred a $2.2 million penalty, which is the highest penalty that the Federal Court has brought to a provider to date. This is an important reflection on the role that registration but also regulation plays for the NDIS market.

Senator ROBERTS: I think the evidence in a previous session was that the Federal Court would be overwhelmed if you dumped it all on the Federal Court. There’s a lot at stake. I understand that.

Ms Glanville: I can also add to Ms Wade’s comments that the result today is very good because of the quantum in that it is the highest amount that’s been awarded. In the regulatory sense, it also acts as a deterrent to others to think very carefully about what they are doing potentially in relation to the services that they provide to people with disability, and to look at the action that will be taken if they’re found to be wanting in that regard.

Senator ROBERTS: I have examples, but I don’t have the time to go through them of carers who provide massive unpaid support who are not receiving their rightful remuneration and of others who deserve care but are not getting that care. There’s quite a lot at stake. Are you aware of the massive overcharging by some people, for example, for cleaners and nurses. A cleaner is charged at $40 an hour normally. We know this from someone in our staff. When they charge out that cleaner to the NDIS it’s $130 an hour—same job.

Senator McAllister: This is mostly a question to the NDIA in relation to pricing, but we touched on this earlier. The board makes decisions about pricing, but one of the things they have been very clear about in their discussions with me is the importance of making sure people with disability do not pay more for services than do other Australians. I’ll pass to Ms McKay and Mr McNaughton to answer your questions.

Mr McNaughton: We issue what we call our pricing guide, and it sets out what are the maximum rates that can be claimed for certain services. We regularly monitor that as part of annual pricing review. We are always trying to benchmark so that you’re not paying more just because you’re an NDIS participant. We want to make sure we’re paying market rates, whether you’re a private citizen, NDIS participant, Department of Veterans’ Affairs or whatever that might be. That’s what we’re continuing to do. Where we do receive a tip-off that a person may be charging higher than that, that will be referred to our integrity and fraud team, who would then be investigating those matters. I can assure you that’s what they do.

Senator ROBERTS: Is it true that $2 billion is lost annually to NDIS fraud? Is that acceptable to the government? Would it be better that the NDIS, which provides a decent service, be returned to the states for competitive federalism to develop accountability? We’ve just got to look at every way of getting this monster under control.

Senator McAllister: The policy you just referenced now is not something that the government is considering. However, the issue around fraud and integrity in the system is a matter that the government takes very seriously. Since coming to government in 2022, we have essentially needed to build an antifraud and compliance framework almost from scratch. We have made a $500 million investment into the NDIA to support them in building this capability. You heard, as you’ve indicated, from Mr Dardo previously about some of the outcomes of that investment. We will continue to back those processes, because these are not really victimless crimes. Aside from taxpayer impacts, when we see fraud we often see other harms to participants. We certainly see money being spent on things which should be being provided to people with disability. This is a matter that the government takes very seriously and is something which we are backing with investment.

Mr McNaughton: I echo those comments. What we have through our Fraud Fusion Taskforce is at least 25 or 26 Commonwealth agencies involved in looking at and cracking down on fraud and investigating fraud related matters to the NDIS. We all agree that, as I said earlier, this scheme should be protected for people with disability who require it. There are unfortunately some unscrupulous providers trying to access the scheme. We want to come from a participant safeguarding perspective to make sure we’re removing those providers from the scheme and safeguarding participants so they can access the genuine disability related supports from good service providers. I should say 99.9 per cent of service providers are really good providers. But there are some bad actors who are trying to get on the scheme. We have very good systems in place through our integrity and fraud teams doing some great work. As I said, I could get Mr Dardo to talk through the work of the Fraud Fusion Taskforce, but in the interests of time—

Senator ROBERTS: I know he’s doing a good job. Fundamentally, Mr McNaughton, how do you eat an elephant? One mouthful at a time? Can we break it down into states again? The other thing is this was started without bones. There was no skeleton even. When Julia Gillard promised the NDIS it was to win an election. She didn’t win the election. The Liberals came in and they were stunned at what they saw. I’m not defending the Liberals, by the way.

CHAIR: Senator Roberts, I do need to share the call. I do enjoy the history lesson, but we’re very short on time.

Senator ROBERTS: Should it be sent back to the states where we’ve got competitive federalism which will give us accountability and each state can improve?

Senator McAllister: That’s not a policy that we’re contemplating.

/2 Comments/by

Urgent Reforms Are Needed to Address NDIS Fraud and Inefficiencies

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During the November Senate Estimates, I raised significant concerns about the National Disability Insurance Scheme (NDIS). Since its inception, the NDIS has faced numerous challenges, including ineffective costing and planning, resulting in unmet needs for vulnerable individuals. The program is plagued by massive fraud and a forecasted budget cost of $90 to $100 billion.

I questioned why many direct care providers remain unpaid while fraudsters exploit the system for millions. Despite the scheme’s noble intentions, it is clear that implementation issues need urgent attention. I emphasised the need for effective measures to address these problems and ensure that every dollar benefits those who need it most.

The NDIS agency acknowledged the challenges and highlighted initiatives like the Fraud Fusion Taskforce, which aims to crack down on unscrupulous providers. I stressed the importance of fixing these systemic issues to restore public trust and ensure the scheme’s integrity.

I remain committed to advocating for a well-implemented NDIS that truly serves the needs of Australians with disabilities.

Transcript

Senator ROBERTS: Thank you, Chair. Thank you for appearing today. The NDIS has been a problematic program since inception. That doesn’t reflect on you guys. It is not effectively costed or thought through. At the
time, it seemed to be a headline looking for a preselection buzz for the Labor Party under Julia Gillard. The program is failing on multiple levels resulting in the needs of vulnerable people remaining unmet and other
stakeholders being ignored. There is massive fraud plus a forecast budget cost of around $90 billion to $100 billion. That is what people are telling us. Why is it that many direct care providers remain unpaid while at the same time many rorters and unscrupulous fraudsters are able to rip off the system to the tune of millions of dollars? It seems to be systematic, rife, organised ripping off. The public is being taken for a ride for billions of dollars yet some agencies pay the bare minimum to untrained carers. Some carers are not paid at all. Why is that?

Senator Ayres: I suppose, Senator Roberts, the first thing to do is to respond to the initial set of assertions. Of course, you will be unsurprised to learn that’s not the government’s view at all about the value of the scheme for Australians. There are many families in Queensland who rely upon—

Senator ROBERTS: Minister, that’s not what my questions—

CHAIR: Senator Roberts. Senator Ayres, continue your answer. I will listen carefully if there is a point of order.

Senator ROBERTS: I did not say the scheme was not worthy.

Senator Ayres: They rely upon the scheme and whose lives have been changed fundamentally by the scheme. The government supports the scheme. We support it because it improves the lives of people who have a disability, particularly children who have a disability. It improves the lives of families of people who look after those people. It has a demonstrably positive effect in communities. It is often not just families who look after and support people with a disability; it’s communities. We want to see workers in the disability sector paid more, paid fairly and firms engage on an ethical basis in the activities around the scheme. Almost all of them are. We want to see productivity in a real sense—that is, more and better quality services offered to Australians who are participants in the scheme. We have committed to the scheme growing, in cooperation with the state and territory governments, at eight per cent per year. That is more than the increases in inflation. We anticipate—we traversed some of these issues in the committee—that there are other sources of growth beyond just what happens in terms of the broader inflationary impact. So that is an eight per cent commitment to growth of the scheme. It is completely legitimate for government and, indeed, members of this committee to be focused upon value for money questions, compliance questions and constantly improving the focus of the governance of the scheme to deliver better outcomes. You are right to point to some of the compliance challenges that the scheme and the government must deal with. That is very much the focus of the minister. I just doesn’t think it’s fair to denigrate the overall scheme or its value for Australians. What you do is a matter for you. It is certainly the government’s position that this is a scheme that is in the interests of Australians, in the interests of disabled Australians and in the national interest.

Senator ROBERTS: Thank you for that, Senator Ayres. The NDIS is a scheme that is needed. It’s very badly implemented. I am asking the people at the table what they are doing to fix it, because I believe they can fix it. I deny your assertions that I am against it. I wonder why you need to make assertions like that, because it just detracts from my answering time.

Senator Ayres: You were the one who started with the preamble, Senator Roberts.

Senator ROBERTS: I will ask the question: why is it that many direct care providers remain unpaid while at the same time many rorters and unscrupulous fraudsters are able to rip off the system to the tune of billions of
dollars? What is the core problem?

Mr McNaughton: We agree that what we would like to see—we see it in the majority of cases—is very good support providers providing the necessary disability supports to people who need those supports. That’s what makes this scheme such a very important scheme in the landscape of the country. I will ask Ms McKay in a moment to talk through some of the work that government has invested into the Fraud Fusion Taskforce and the crackdown on fraud. We know that there is—

Senator ROBERTS: Excuse me. Is that one of your big initiatives?

Mr McNaughton: It is a big initiative.

Senator ROBERTS: That is pretty important in the scheme of things?

Mr McNaughton: It is very important. I will hand over to Ms McKay to talk that through. That is around cracking down on those unscrupulous providers who are doing the wrong thing by participants. We want to
eradicate that from the scheme because we want to make sure that every dollar is going to a person with disability who requires it. I will hand to Ms McKay, who will talk through those initiatives.

Ms McKay: I want to talk about the Fraud Fusion Taskforce as well as other initiatives that the agency is undertaking to ensure, first and foremost, the safety and continuity of services for participants and to ensure that
the integrity of this scheme remains as strong and robust as we can ensure it can be.

Senator ROBERTS: Excuse me, Ms McKay. The integrity of the scheme would be essential for the other prerequisites—the safety and continuity of services—right?

Ms McKay: Absolutely.

Senator ROBERTS: I’m with you.

Ms McKay: I will talk firstly about the Fraud Fusion Taskforce. The Fraud Fusion Taskforce was established in November 2022 with an initial investment of $126.3 million over four years. An additional investment was made for Services Australia of $26.5 million, which brings the total investment to $152.8 million. The Fraud Fusion Taskforce is co-led by the NDIA and Services Australia. It has 19 other members, which are other government bodies. The Fraud Fusion Taskforce is focused on—

Senator ROBERTS: Excuse me. Does it have any law enforcement agencies as member?

Mr McNaughton: The Australian Federal Police are on it.

Ms McKay: I apologise. I am using the captions. Sometimes I am a bit delayed in my response or understanding of your questions. As Scott mentioned, enforcement agencies are part of the process. There are 95
active fraud operations being led. We’ve got over 500 active investigations currently underway with many cases there. That is one tranche of what the agency is doing. It is working across government to ensure that fraud and organised crime are dealt with in an absolute way that shows no tolerance for those behaviours within the scheme. The second tranche of initiatives that we’re doing is uplifting our system capability through a crackdown on a fraud systems uplift approach. The government has invested $83.9 million for the 2024 calendar year to focus on that work. That work absolutely complements the work of the Fraud Fusion Taskforce by ensuring that we can implement new systems that have the uplift capability we need to make sure that it’s easier to get things right and harder to get things wrong. The types of programs that we have been investing in include identity proofing systems; improving systems that check payment claims; making sure that our new IT systems are connected; and making sure that we have a fraud case management approach. I have a whole program of work that is being undertaken as part of that process. We’re also ensuring that the work we do in relation to this is co-designed and discussed with participants as well as with the sector more generally. This is so that, as we make changes to our systems, participants can have confidence that they’ve been consulted on the changes and they are going to have their safety first and foremost and continuity of care always as principles that will govern those changes that we introduce.

Senator ROBERTS: Thank you very much. That was clear and succinct.

Ms Glanville: We are also a member of the taskforce. I can perhaps give you a sense of the regulatory actions that connect to that. That would be quite useful. I will quote from our 2023-24 end of financial year figures. This is in the context of there being terrific providers out there doing great work with people with disabilities and supporting them to live the ordinary lives that they require, as recognised in the Every Australian Counts
campaign from all those years ago.

Senator ROBERTS: That’s important. The good ones at the moment are being drowned out by a focus on the unscrupulous ones.

Ms Glanville: There are many good providers out there, so I agree with you that it is important to recognise them. I will give you some quick figures. The regulatory chill is that we have banning orders. There were 142 in the 2023-24 financial year. Civil penalties—

Senator ROBERTS: What is a banning order?

Ms Glanville: When someone is not allowed to provide services into the future. Civil penalties proceedings might be before courts. There were three of them. There are, of course, some other matters that I can’t talk about here but which are before the Federal Court in terms of practices and behaviours that we would find unacceptable.

Senator ROBERTS: Criminal activities?

Ms Glanville: Sometimes these can involve criminal activities, yes. There were 52 compliance notices. That is where a provider is asked to comply in certain ways with certain code of conduct or other matters. That is a significant power we have. Of course, education remains very important. We did over 21,985 sessions that relate to that. There were five enforceable undertakings and 147 infringement notices. The number refused
registration—I think this goes to the core of some of the issues are you raising—is 11,952.

Senator ROBERTS: So 11,952 registrations were refused?

Ms Glanville: Where there was a refusal of registration, yes.

Senator ROBERTS: Is that for providers or agencies?

Ms Glanville: That’s for providers, people providing services.

Senator ROBERTS: What about agencies? How many of them have been prohibited?

Ms Glanville: I can’t make that distinction, but I’m happy to take that away and see if we can get any information for you on that.

Senator ROBERTS: If you could, please.

Ms Glanville: Revocation of registration was 192. Suspended registration was 12. Warning letters was 3½ thousand-odd. That gives you a sense of about 38,000 different types of enforcement actions that we took and the outcomes of those. This is in the service of trying to lift the quality overall to ensure that people with disability have the opportunity to make good choices in terms of who provides services to them. It also ensures that we have a strong regulator where the sorts of concerns that you are raising in some of your questioning can be addressed very thoroughly by the commission and others.

Senator ROBERTS: I would like to know on notice the agencies that you have taken on. I understand that there are some very good providers and there are some unscrupulous providers. There are some very good
agencies and there are some unscrupulous agencies. The agencies that are unscrupulous magnify the problem because there is not just one or two people in those agencies. There are sometimes many people in those agencies.

Ms Glanville: We’ll certainly take that on notice and come back to you.

Senator ROBERTS: I will cede the call there because I’ve had my 10 minutes. I would like to come back and drill into some of the details.

CHAIR: I will put you on the list, Senator Roberts, for a crossbench rotation.

Senator ROBERTS: Thank you

/5 Comments/by

NDIS Overlooks Fair Compensation for Family Caregivers

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During this Estimate session in November, I inquired about the potential streamlining of payments to care workers and received responses primarily related to care providers (agencies). It appears that not all care providers are registered, and the registered ones must meet minimum standards. I also asked about the possibility of family or friends providing care being properly compensated for their extensive services. I was informed that these individuals may receive allowances, but that these amounts would be small compared to fair remuneration for their services. The NDIS views these supports as beneficial, yet is not willing to pay unless they are provided on a professional basis by individuals trained to a specific standard.

It seems that the NDIS is not prepared to offer support to family members providing vital care; rather, they will only support workers affiliated with recognised care providers. They seem to overlook the fact that many families make significant sacrifices to care for a disabled relative in a home setting, yet are not entitled to fair remuneration for the many hours of unpaid work they contribute.

Transcript

Senator ROBERTS: Thank you, Chair. What is being done to streamline the payment system for care providers?

Ms C McKenzie: As Ms McKay was talking about before, we have a range of improvements underway through a significant program of work, particularly the crackdown on fraud program of work. That will include
progressive improvements to the provider platform and a range of other payment systems to improve and support the continued improvement of the payment system through to providers.

Senator ROBERTS: Does that mean the IT focus?

Ms C McKenzie: It is predominantly IT focused. Yes, that’s right. So it is upgrading systems that are at the end of their life or are approaching the end of their life. It is also developments in improving both the integrity of the data that we are able to capture and our ability to move more quickly and with more confidence in the payment to providers.

Senator ROBERTS: What is being done to set up a scheme to ensure that family members who provide constant care to a family member are compensated for the time and care put in to deal with high level basic care?
I understand that families like to take care of other family members; I’m not arguing against that. In one case, we had a pensioner on a low income looking after their 60-year-old son who is disabled. They were very concerned about him. There are some extenuating circumstances where families need to be compensated.

Mr McNaughton: There are a couple of components to that question. First of all, obviously through other portfolios, there are income support payments and carers payments and carer allowances in recognition of some of those activities. That is an important part of that. We also recognise that informal care is a really important part of the NDIS. Parents provide informal care for their children with disability. Ageing parents often do the same. There does come a time where that needs to be a paid care role. That is when the NDIS supports having paid, trained carers to come in and support that person with a disability. It is a combination of both. Who do you feel comfortable with providing that level of informal care and support and decision-making and assistance in your daily activities? There is the carer allowance and carer payments through the social security portfolio. The NDIS pays for the funded support workers to provide that trained specialist care for the person with disability as well. It is an ecosystem, a combination of all those things. It really does depend on the individual circumstance of the participant.

Senator ROBERTS: I presume, then, that a very formal assessment is required before moving from one to the other?

Mr McNaughton: Yes. But we know that participants like to have their families and informal supports around them. That is a really important thing. We don’t want to detract from that at all. Some participants also need
additional funded carers. There are regulations for being a qualified carer and a registered provider as part of the NDIS system. Those things need to work hand in glove to provide that support for the person with a disability.

Senator ROBERTS: Are all direct care providers to be registered if they wish to be paid under the NDIS?

Mr McNaughton: They don’t have to be.

Senator ROBERTS: What is registration? What does it involve?

Mr McNaughton: I might defer to the commission, who can talk through registration guidelines. There are differences in terms of pricing within the NDIS and registration criteria. I am not sure if the commission wants to respond about the registration of providers.

Ms Myers: The registration relates to providers. When it comes to workers, there is screening that occurs for workers.

Senator ROBERTS: So you’re looking at their capabilities and their skills?

Ms Myers: Worker screening is about suitability. Worker screening is for people who are in risk assessed roles. Worker screening checks are conducted by the state and territory worker screening units. The NDIS Quality and Safeguards Commission is responsible for maintaining the database. Registered providers can link their workers who have a worker screening check. That is another safeguarding measure so that participants can see which workers have a worker screening check. In fact, we’ve had record numbers of unregistered providers also seeking access to the worker screening database so that they can also link their workers.

Senator ROBERTS: So direct care providers don’t have to be registered, but for some circumstances they must be?

Ms Myers: For some circumstances, they need a worker screening check.

Senator ROBERTS: Are those reforms you both discussed complete?

Ms Glanville: I wonder whether, on the registration topic, Associate Commissioner Wade would like to speak on this, if she is there?

Ms Wade: Yes. Thank you, Commissioner Glanville. Registered providers are an important part of the disability care system. There is also provision for the regulator, which is the NDIS Commission, to regulate both
unregistered and registered providers. Registration status indicates compliance requirements of a provider, but that does not leave providers unregulated if they are not registered. All providers that receive funding from the NDIS are required to comply with a code of conduct. Failure to comply with that code of conduct can see regulatory action brought against the provider by the commission as the regulator.

Senator ROBERTS: Thank you. This is my final question. What monitoring is involved for both registered and unregistered providers?

Ms Myers: The Quality and Safeguards Commission is responsible for the monitoring of both registered and unregistered providers. Much of our work is conducted as a result of either complaints received to the commission or reportable incidents where we need to make further inquiries around the circumstances of particular incidents. Registered providers have obligations that they are required to report certain matters to us, including certain changes of circumstances. The commission utilises that information to determine what regulatory action it might take.

Senator ROBERTS: Are there audits of this? It’s not just self-reporting?

Ms Myers: We do some proactive compliance monitoring work. They also have audit processes tied to their registration. The audit process relates to the standards they must meet in order to maintain their registration.

Senator ROBERTS: Thank you, Chair.

/1 Comment/by

The NDIS System is Broken

During recent Estimates, NDIS Integrity Chief, Mr. John Dardo, stated that 90% of plan managers showed significant signs of fraud, and 87% of service providers were unregistered and unmonitored, lacking adequate training for their responsibilities. Mr Dardo said, “we have no idea what they do when putting in their invoices.” This underscores the broken state of the NDIS, stemming from an ill-considered election promise devoid of data, reminiscent of the Gillard government’s hasty policy announcements without sufficient planning.

I proposed that an inquiry should evaluate the merits of returning responsibility for these services back to the states from which they originated. I pointed out that an unintended consequence has been a shortage of workers in the health and aged care sectors due to the excessively high pay NDIS service providers receive—often triple what they would earn in equivalent roles within these sectors.

Labor’s penchant for wasteful spending was exemplified by the squandering of $430 million on “the Voice,” funds that could have been more effectively allocated to NDIS services. 

Ultimately, taxpayers foot the bill for this waste. I advocate for a shift away from the costly and ineffective centralised service model towards competitive federalism.

Transcript

At the recent Senate estimates hearings, the NDIS integrity chief, Mr John Dardo, admirably confirmed that 90 per cent of plan managers displayed significant indicators of fraud. The level of fraud it is now so high that there are dozens of examples of organised crime groups abusing the systems, with millions of dollars being rorted. The system is so out of control that 87 per cent of service providers are unregistered and unmonitored. I quote words that appeared in an article about Mr Dardo: 

We have no idea of knowing what they do when they put in their invoices. 

It’s taxpayers’ money, spent on something they have no idea of. He had the courage to admit that. He said that existing cases exceeded Australia’s judicial capacity, without finding more. 

NDIS funds must not be used to pay for sex workers, expensive holidays or new cars that other taxpayers cannot afford. Projections are for a blowout of NDIS spending to $90 billion within a decade; it must be prevented. Using the system to peddle drugs is happening extensively. The name of this bill says what we already know about the NDIS. It’s broken and getting worse. It’s a licence for criminals and fraudsters to print money. It’s so far off track that the hope that this bill will get things back on track is a pigs-can-fly pipedream. 

Since the Gillard Labor government’s NDIS inception, there has never been a track. It was hatched with no meaningful metrics or plan. It was simply an election slogan to desperately buy votes in an election that Prime Minister Gillard lost. It was hatched as a headline grabber and a vote harvester. Typical of ‘uniparty’ initiatives—and of policies and legislation in our parliament over recent decades—it lacks the discipline of a system based on hard data and a focus on customer needs. It was done to look good, not to do good. A hastily cobbled together election policy, it had holes in it a mile wide that clearly enabled fraudulent claims to be made with little chance of being picked up and stopped. 

As servants to the people of Queensland and Australia, Senator Pauline Hanson and I have been calling out the NDIS fraud model since 2016. A significant effort is now needed to remove dodgy plan managers and service providers and to protect capable and honest plan managers and providers, using stricter laws to prevent participants from being defrauded, to prevent unscrupulous service providers from abusing vulnerable people and to save NDIS for genuinely disabled people with real needs. If we really care, we’ll clean up this mess. If we really care for disabled people, then we’ll have to get tough and sort out the criminals and the rorters. Providers, managers and recipients who commit fraud under this NDIS scheme must be heavily penalised and banned from any involvement in the scheme again. Wasted money through overspending has cost taxpayers well in excess of $8 billion already, and it’s essential to ensure that the current 150,000 unregistered care or service providers become registered and then are monitored for effective compliance. 

The Gillard Labor government introduced the NDIS. In their election loss, they handed the incoming coalition government an illegitimate, loose and sloppy mishmash of slogans and empty titles, lacking discipline, coherence, focus and care, and lacking solid systems. If they’d cared, Labor would have put together a proper system, but they didn’t. They should have put together a system to provide effective care and to protect taxpayers’ hard-earned money. The Liberal and National parties tried to refine the monster, and now the NDIS is back in Labor hands for more mismanagement. The NDIS must be reconsidered and protections against mismanagement and abuse strengthened.  

But who should be responsible for management? References to the non-constitutional National Cabinet are just a poor joke. National Cabinet is a mere grouping of state ministers responsible for similar portfolios, with no statutory authority or constitutional recognition of its existence or authority. It’s toothless—all mouth and no accountability. There’s no accountability in the current system. Right at the very top there’s the bogus unconstitutional National Cabinet. In such cabinets the state and federal government ministers just go, ‘They’re responsible.’ That means no-one is responsible. There is no accountability. It’s fundamentally structurally flawed. 

I suggest an inquiry to consider the alternative model: putting the responsibility for providing for the needs of people living with a disability back to the states and territories, where it was stolen from. Clearly, each state is responsible. The states would work to ensure that services were monitored, reasonable and meeting client needs under a model reflecting the proven benefits of competitive federalism, the foundation under which our Constitution and government is made. This will provide the level of accountability that has been missing to date. Centralising doesn’t work; decentralising closer to the surface does. One of the unintended consequences of Labor’s mismanagement of NDIS funds is the shortage of aged-care and healthcare workers who migrated to work in the lucrative NDIS model. This is because NDIS wages are so overinflated that a worker can receive three times the rate of pay for the same work done in other sectors. This is not just hurting the NDIS. This rorting, mismanagement and waste of taxpayer funds is hurting aged-care and healthcare workers. 

Labor wastes money in other areas, too. Look at the wasted $430 million plus that the doomed referendum cost Australians—just like the Gillard government’s NDIS facade, which was based on slogans and empty promises lacking substance. Just think how that $430 million could have been spent directly to improve the lives of remote Australians living in need or spent on improving NDIS services and security for people who are disabled in some way. Then there are the follies of government cutbacks, such as when psychological services were cut from 20 appointments to a relatively useless 10 appointments for needy participants. Just think about what could have been supported with the wasted money—health, education and child protection are a few. Frontline staff are in short supply now, partly because of poor pay, inadequate training and lack of support and partly because of NDIS rorts and sloppiness. Many NDIS carers and support staff have little or no training in basic personal caring skills. Many recipients have physical health needs and their carers should have sound skills in lifting, mobility, feeding, toileting and showering. Expecting NDIS carers to do these things with no, or inadequate, training is unfair and dangerous for the recipient and the carer. 

I have described a support system in crisis. This bill tinkers around the edges. As it is, this bill will not make significant positive differences, and who pays for all of this waste? Always, it’s we the people. Instead of tinkering around the edges of a broken system, do the work! I call on the government to do the work to define disabled people’s needs for service and taxpayers’ needs for protection. Instead of the ubiquitous fraud under low levels of accountability, consider returning to the original system of state governance. One Nation knows what history repeatedly proves: administration and services are of higher quality when services are closer to recipients. That enables understanding of needs, which is core to effective service. Replacing centralisation with competitive federalism provides a marketplace in governance. That’s what we all want. That’s what we need because improved governance provides accountability, effective service and better care. 

/1 Comment/by

Fraud is Overwhelming in the NDIS Sector

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At the recent estimates in June, the head of the Fraud Investigations Unit revealed that the volume of fraud cases reaching the courts is so high that the country’s judiciary is overwhelmed. This significant issue is driving up the cost of services. 

I then enquired about the services provided to individuals with autism and was told that there are 200,000 people on the program with autism as their primary diagnosis. 

No commitment was made to increase allowances for care providers.

Transcripts | Part 1

Senator ROBERTS: Thank you, Chair. Thank you to witnesses for being here today. We have been receiving a lot of phone calls and emails from constituents about the NDIA and the NDIS. What’s the fundamental need for having an NDIA and an NDIS as separate agencies? While they have different functions, the functions of NDIA and NDIS could be combined, doing away with a whole department and host of bureaucracies currently costing the taxpayer millions of dollars. It’s confusing to people. Could you please explain them?  

Ms Falkingham: Yes, Senator. We have a scheme that’s set out under the act. There is only one agency, which is the National Disability Insurance Agency. We also have a commission. That might be what you’re referring to—the National Quality and Safeguards Commission. But the NDIS is not an agency, it’s not an entity of any type; it’s a scheme.  

Senator ROBERTS: Why are people so confused about it?  

Ms Falkingham: I think that over the course of the last 11 years we haven’t necessarily done the greatest job of explaining and communicating about the scheme—who it’s for, who it’s not for, what type of supports you can get on the NDIS and what supports you can get from outside the NDIS. Some of the confusion you might be speaking about goes to whether people have got an issue with their provider. If they have an issue with their provider, often it’s the National Quality and Safeguards Commission that they can make a complaint to, if it’s a registered provider. But, obviously, we also have things called local area coordinators. That’s a partnership we have with the community sector, which is often when people go in the first instance to speak to someone about getting onto the scheme. There are a lot of people involved in this scheme. One of the review’s recommendations is to really streamline that and have this concept of a navigator, and so we can start to have one person walk with a person with disability in an end-to-end kind of way along the planning process.  

Senator ROBERTS: What’s being done in relation to auditing agency service providers who are sucking the scheme dry through fraudulent claims for services overcharged or not actually even provided?  

Ms Falkingham: It’s an excellent question. I might ask John Dardo to come to the table. He can take you through all the work we’re doing on our crackdown on fraud.  

Mr Dardo: I’m the deputy CEO and I look after contact centres and the integrity functions as well.  

Senator ROBERTS: Sorry, what are the functions?  

Mr Dardo: The Integrity functions—things like compliance, fraud and integrity checks.  

Senator ROBERTS: Thank you.  

Mr Dardo: Before I give a bit of a summary about the work that we’re doing, there are a couple of things that are really important to note. The No. 1 priority we have when we do integrity work is to make sure that participants’ safety is looked after. As we talk about the stuff today, it’ll be easy for some people to assume that participant safety is not the No. 1 thing we do, but participant safety is actually the most critical thing we do as we do our integrity work. As we do that integrity work, obviously we also look at things like sustainability of the scheme and making sure that the community can have confidence that people are getting the right services from the right providers. If we do it well, we get a level playing field for the providers, because the good providers can compete on a level playing field; they don’t have to compete against dodgy providers. The work we’re doing has lots of layers. There is a lot of work that we doing to identify, with intelligence, the providers or the things that are bad for the scheme. As we do that work, we’re working with other agencies to build layers of defence. That is because there is no silver bullet to getting integrity right within the scheme. One thing that we have is the Fraud Fusion Taskforce. It’s now 19 agencies.  

Senator ROBERTS: The what taskforce?  

Mr Dardo: It’s the Fraud Fusion Taskforce. There are 19 government agencies. It includes us, Services Australia—we co-chair it—the tax office, Attorney-General’s, the Australian Criminal Intelligence Commission, and a raft of other delivery agencies that do government payments and programs, such as Education, Employment and Workplace Relations, ASQA, who look after registered training organisations, professional standards that look after the quality of the medical professionals, Health and Ageing—there are a lot of agencies involved. The reason we partner with those agencies is that the people that are doing the worst things against the scheme and the worst things against participants don’t just work against the NDIS; they rort other systems as well. They rort the tax system, the Medicare system or the VET, vocational education and training, system. The patterns they use to defraud the scheme are similar across those systems. So, when we work with the other agencies, we’re more likely to detect those people, and we’re building a preventive architecture that doesn’t just stop fraud against the NDIS; it is also reusable to stop fraud against Medicare, vocational education and training, family day care or child care. So that taskforce is going brilliantly. It has a regular rhythm. We do a lot of work together to develop intelligence. We have intelligence alerts that come out to all the relevant agencies about providers or schemes that seek to defraud. We then act on those to stop payments or we work with the commission, who are also on the taskforce, to prevent bad players from being registered providers. In some cases, we do operations together. ASQA, the guys that look after registered training organisations, only came on board in the last month or so. Within a week or two of coming on board, we worked with them, and the tax office provided some support and the commission provided support, and warrants were executed on a provider that was problematic. So we work together really well. 

Senator ROBERTS: How many service providers have been charged for falsely claiming fees for services not provided?  

Mr Dardo: There are many, many dozens. Right now, there are approximately 20 prosecutions in progress, as in right in front of the courts right now.  

Senator ROBERTS: That’s across Australia?  

Mr Dardo: Yes. There are also several that are imminent. The affidavits have been produced. The work has been done with law enforcement. It’s been done with CDPP to result in either search warrants or charges. So there are more in the pipeline that are imminent. In addition to that, we’ve got to keep in mind that prosecution is the last resort. What we want to do is build a scheme where they can’t even get to the point of doing dodgy claims.  

Senator ROBERTS: What I have seen and what I’ve concluded is that the NDIS was started as an election promise, it was cobbled together and flung out there—it wasn’t ready to go—and as a result there have been two things. Initially, there was a lot of corruption because the systems were loose, which is understandable, and then, as they tightened up, some people were missing out on services. Could you give me on notice, please, since the inception of the NDIS, the number of people charged for falsely claiming fees for services not provided, on an annual basis. I’d like to see if there’s a trend—if there’s a pick-up or a decrease. I mentioned the fact that, when you have a trend, it may be due to better enforcement or due to more—  

Mr Dardo: Keep in mind the charges that are laid aren’t phrased exactly the way you described them, but certainly we can give you, on notice, the trend. What I will say is we are detecting now more than we could ever detect before, because the systems were not mature. They have been matured as we invest more in building more mature systems. For example, certainly in the last six to eight years, payments would be going out the door, and there were some periods through the day or through a weekend where payments were being processed with no NDIA eyes, or human eyes, looking at those payments. So payments were walking out the door without any system knowing that the payments were going out the door, because the systems were not mature enough or built in a way to prevent those payments.  

Senator ROBERTS: We all know that the minister has been talking a lot about tightening up because ultimately the cost is getting out of control. What that means is that people who deserve good care don’t get it. So, by holding back the fraudsters, we’re protecting people to ensure they get their care in the future.  

Mr Dardo: Absolutely. To give you examples, there are the prosecutions, but, even more important than that, in terms of the volume of the response that we’re implementing at the moment, there are the stoppers. There’s the stopping of payments where the providers are problematic or the claims are problematic.  

Senator ROBERTS: So you’re making them jump through more hoops?  

Mr Dardo: We’re stopping the claims, and we’re saying, ‘We’re not confident that this claim is legitimate; you need to provide evidence that it’s legitimate.’ In some of our stopper work, we’re hitting 50 to 87 per cent stop rates on claims. We have providers that have put claims in. We’re saying, ‘Sorry; that doesn’t look quite right,’ and they’re either withdrawing or cancelling their claims, or not responding at all—they’re walking away completely, and in some cases they’re shutting down their businesses and walking away because they’ve realised the game is up. And we’re not talking at the margins for these claims. Some of these claims are in the hundreds of thousands of dollars—  

Senator ROBERTS: We’ve heard about them.  

Mr Dardo: or in the millions of dollars. Our ability to now detect it is allowing us to stop it before it goes out. If we can stop it before it goes out, we then don’t have to try and recover the money or raise a debt to recover the money. We need to get better at stopping it. Before they even exist to make the claim, we need to get better at bringing that further forward in the supply chain. As we look at many of these claims and many of these providers, what we’re seeing is that the behaviours have been going on for years. It’s just that we’re better now at seeing them and preventing or stopping them. It is generating some angst, and I’ll describe that in more detail. There are providers that have been really bad in setting up their business model to take funds out of the system, with an understanding with participants or nominees that they would provide a certain set of services which maybe should not have been provided by the NDIS, whether it be rent subsidies, alcohol or other lifestyle expenses, gift vouchers or gift cards. The participants or their nominees have grown accustomed to a standard of living—they may have signed leases on the understanding that that was the lifestyle they would enjoy—and we’re now identifying that those providers are problematic, and we’re saying, ‘Sorry; you can’t keep claiming that money to subsidise that type of spend.’ You can imagine that some of our participants are having their standard of living disrupted. 

Senator ROBERTS: That is a recurring theme in some of the questions constituents put to us—that genuine care is not being considered but lifestyle choices are, and so money is going on that. This is another one that’s recurring: when will families or friends supporting a person with high-level needs be appropriately supported? They’re not adequately supported, but care providers are being overly supported.  

Mr Dardo: There are certainly some really black-and-white spaces. There are providers that are just providers—they’re brilliant and they’re awesome, and what they do is fantastic. There are some providers that have a mixed business model—they do some good work, but they do a whole bunch of dodgy stuff to supplement their income, their lifestyle or their business. There are some providers that are really just fraudsters, criminals or criminal syndicates, and they’re using the NDIS for cash flow. There are some participants and providers that are the same thing. We have participants who have set up businesses to pay themselves to look after themselves, or nominees who have set up businesses to look after their kids. We have examples of cases where it’s not clear that it’s a provider or a participant or a nominee, because it’s all intermingled. The family group has set up three entities, and they’re paying each other to look after each other, or a mother has drawn down $100,000 a year as an income to pay herself for looking after her child with disability. There are some things there that are very intermingled between a provider and a participant. The conflicts of interest are pretty extreme. Then you have participants who have not understood what they can and can’t agree to with a provider, so they’re accepting things that they shouldn’t be. Examples just in the last week: a $20,000 holiday, a $10,000 holiday. There are participants who are claiming things that they shouldn’t and in the past would probably not have been detected. We had a participant that bought a car, brand new, for $73,000. The money was processed overnight. Fortunately, when we were able to approach them, they understood that they shouldn’t have done that and they were willing to repay the money. We have other participants who haven’t understood what they should be claiming and when we approach them they cease contact and refuse to engage. Then there are the vast majority of participants that are trying to do the right thing, and we have to figure out how we get the balance right so that we help the people who are trying to do the right thing get it right more often. For the providers that are doing an awesome job, we need to help them survive and flourish. For the ones that are running mixed businesses, we need to exit them from the scheme, and, for the providers that are dodgy, we need to exit them from all government services, not just the scheme—we need to exit them from Medicare, AHPRA and everything else that they’re involved with.  

CHAIR: Senator, this will need to be the last question.  

Senator ROBERTS: Can you give us the number of providers per year, for the last five years, who have been exited from the system please.  

Mr Dardo: We can. There are some different metrics there, but we can see what we can get for you.  

Senator ROBERTS: It sounds like the agency is waking up to what’s happening, so thank you.

Transcript | Part 2

Senator ROBERTS: Before I continue with my questions—I think they will be to Ms Falkingham—Mr Dardo, I want to say I appreciate your candid nature and your openness. I’ve rarely seen someone in your position who, when confronted with a senator telling them about a problem, says: ‘That’s not the end of it. It’s worse than that, actually.’ It’s only by us understanding it and what you’re doing that we can help you. Thank you. I appreciate that. Ms Falkingham, why have many persons with autism or on the spectrum had their services cut, often with little explanation provided?  

Ms Falkingham: I am not aware of any evidence to support that claim. I will get the scheme actuary up and he can talk about the amount of money we invest in participants with autism.  

Mr Gifford: I don’t have the precise figure with me but I believe it would be more than 200,000 participants in the scheme who have autism as their primary disability. There’s no data that would suggest that people with autism are having their services cut. The growth in plans of participants with autism is different to the scheme population more broadly.  

Senator ROBERTS: What’s the plan to support older people currently receiving a support package that far exceeds the age pension yet their package will cease when they reach retirement age? Their needs will not diminish and may become more acute yet their support will be slashed.  

Ms Falkingham: It might be a question for our colleagues in DSS. The NDIS review has made a number of recommendations in relation to the interface between aged care and NDIS, so we can absolutely do better for ensuring that people are receiving that continuity of support if they have been on the NDIS, which we do now for people under 65. The NDIS review has made a recommendation around the interface and how we can improve upon that, but I will check if my colleague wants to add to that. 

 Mr Griggs: If you qualify before you’re 65, you don’t come off the scheme at 65.  

Senator ROBERTS: What happens? When they go on the pension, don’t they come off the scheme?  

Mr Griggs: No.  

Senator ROBERTS: Not at all?  

Mr Griggs: No, not if you qualified before 65.  

Senator ROBERTS: Remember, these are coming from a lot of our constituents via emails and personal calls. Are you aware of clients who own their own home being pressured to sell their own home by the service providers to move to group care?  

Ms Falkingham: I will check whether Deputy CEO Penelope McKay has any evidence. I do hear that anecdotally, but I’m not aware of whether we have any current cases. We can take that on notice for you.  

Senator ROBERTS: Why is the focus seemingly moving away from providing support based on practical needs like assistance with cooking, cleaning, showering and hygiene to non-essential services that are routinely overcharged? We’ve heard stories of fishing and so on. Is there a switch there from genuine need to—  

Ms Falkingham: Every decision we make is based on reasonable and necessary. The things you have outlined are absolutely the core of the scheme in terms of daily living and supporting daily living expenses, so I’m not sure. We can follow up for you, but some people will have goals in their plans that go to recreational goals and achievements, so obviously we will try to support a participant to achieve that goal by providing appropriate disability supports to enable them to do that. But things like building capacity, that’s what you’re speaking about in relation to cooking and cleaning and supporting people to live a good life. They are the core of our scheme and that’s predominantly what we fund now.  

Senator ROBERTS: We’ve heard from constituents saying they have someone who will take them fishing but he comes in, does a quick look around—that’s a welfare check—and leaves. Is that the kind of thing some people are paying for?  

Ms Falkingham: If you have evidence of that, I’m really happy to follow that up.  

Senator ROBERTS: Why do agency service providers apparently get priority to receive payment over actual care givers who do massive amounts of unpaid work? In other words, personal care givers, family, do a massive amount of work and don’t get paid but agency service providers do. 

Ms Falkingham: Obviously informal supports are a critical part of someone’s life and it is one of the things we discuss as part of the planning process. We fund paid supports under the scheme, but informal supports will always be a critical part of our community, and having family to be able to support loved ones is a really critical part of that. We obviously always provide respite services for families as well, who do provide a lot of informal supports, but that is the nature of our scheme. It is what we are funding under the NDIS.  

Senator ROBERTS: Why is the carers allowance so pitifully small relative to paid agencies when many carers provide ongoing personal support 24 hours per day all year?  

Ms Falkingham: I think that might be a question for DSS.  

Mr Griggs: Carers allowance is part of the social security system. It’s not part of the NDIS. We can talk about that tomorrow in outcome 1 of DSS, when my team will be here, and they can take you through that.  

Senator ROBERTS: When will care providers be remunerated appropriately because they put in more needed work hours than agency service providers? We’ll talk about that tomorrow. 

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Rampant NDIS Fraud Leaves Vulnerable Recipients in Need

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My questions to the NDIS Quality & Safeguards Commissioner was primarily about the quality and safety issues that render the system inefficient and hazardous. 

It became evident that fraud was rampant, leading to significant financial waste and leaving many recipients’ needs unmet. 

While some recipients received excessively extravagant packages with overvalued components, such as massages, fishing trips and cruises, others remained in dire need of basic assistance for eating, washing, toileting and dressing. 

Initially, the system functioned fairly well, but it has now expanded excessively, resulting in waste, unmet needs, and dangerous conditions for vulnerable recipients.

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