Under pressure NDIS providers dumping millions of dollars worth of claims

National Disability Insurance Agency CEO Martin Hoffman – photo courtesy of Canberra Times; photo credit Dion Georgopoulos 

  • By a Staff Correspondent

The head of the National Disability Insurance Agency says greater scrutiny has resulted in providers dropping many millions of dollars worth of claims for services.

Giving evidence to a parliamentary committee, National Disability Insurance Agency CEO Martin Hoffman said the agency’s decision to begin questioning unusually high claims from NDIS providers had resulted in many of them suddenly withdrawing claims worth tens of millions of dollars.

Signaling that the NDIA was determined to increase its scrutiny of billing for services, Mr. Hoffman told the Joint Standing Committee for the National Disability Insurance Scheme that the agency was cracking down on potentially fraudulent claims.

He said the NDIA had increased its actions against providers and is now querying claims that could be considered too high or questionable.

The NDIA is currently in the midst of a pricing review.

Mr. Hoffman said in cases where there is possible overcharging, the NDIA is going out directly to providers and questioning claims.

“Where there is mischarging, we are very active now in improving our capabilities all the time to be monitoring through data analytics, the claims flow,” Mr. Hoffman said.

“We have been going out to thousands of providers with letters saying the data says this is unusual, or words to that effect. That has been having a very strong impact in terms of tens of millions of dollars of withdrawn claims, and through behaviour model estimates, of even more significant avoided future claims that don’t meet standards.”

“We are very actively focused on the providers’ side of this question.”

The Committee also heard that the number of NDIS participants has risen to 500,000, up from 472,000 during the last reporting period.

Along with the NDIA, the Committee also heard from the Department of Social Services.

The Committee conducts regular inquiries into NDIS issues.

An inquiry into the Scheme Implementation and Forecasting for the NDIS is receiving submissions until February 28, 2022.

The inquiry into General issues around the implementation and performance of the NDIS is open for submissions until March 31, 2022. Committee link: Joint Standing Commit

Nic Stuart

Nicholas Stuart is an author (Kevin Rudd, an unauthorised political biography; What Goes Up, behind the 2007 election; Kevin Rudd, 2007 - 2011) and columnist with the Canberra Times. He was the ABC's Indochina Correspondent when he suffered a significant head injury in a car crash in Bangkok.

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