Cracking Down on Registered Providers; Cheat Sheet Edition
- anna4284
- May 8, 2024
- 4 min read
The NDIS Commission and the Australian Competition & Consumer Commission (ACCC) are collaborating to tackle businesses that overcharge NDIS participants due to their goods or services being funded by the NDIS. Last year, the Albanese Government augmented funding to the ACCC, allocating $6.7 million over a four-year period. This boost enables the ACCC to aid the NDIS Commission and pursue actions against unscrupulous providers who make deceptive claims about their offerings.
Minister Bill Shorten MP, have raised their guards to protect NDIS participants from unlawful acts of fraud and false claims. In the past 12 months there has been a total of 12.5 years of total imprisonment and investigations into syndicates have uncovered:
1. Deceiving vulnerable individuals with inaccurate information about the NDIS processes and fund usage.
2. Recruiting vulnerable individuals by offering cash, vouchers, or gifts to gain access to the Scheme.
3. Coercing individuals to access the Scheme through fabricated medical evidence and diagnoses, including altering genuine medical records to inflate NDIS budgets falsely.
4. Falsely claiming for services that were never provided.
5. Utilizing multiple ABNs, false ABNs, fictitious identities, contact details, or addresses to conceal their activities.
Auditors are being urged to include more detailed reports during Verification, Certification, Mid-Term/Surveillance, Provisional, and Re-Certification audits mainly focused on the participant's experience, safety, goal attainment, and participant inclusion in planning and decision-making.
How to stay compliant
To ensure compliance and fairness, auditors are now encouraged to conduct more thorough assessments during various auditing processes, including Verification, Certification, Mid-Term/Surveillance, Provisional, and Re-Certification audits. These audits will focus extensively on factors such as the participant's overall experience, safety, achievement of goals, and their involvement in planning and decision-making processes.
To remain compliant with these standards, providers and quality teams must strengthen their risk management systems and structures to identify and rectify any potential gaps. Internal auditing, training initiatives, and systematic reviews are crucial steps to uphold participant safety and maintain provider accreditation. By implementing these measures, providers can ensure that NDIS participants receive fair treatment and quality services while mitigating risks associated with non-compliance.
Audit Reporting
The audit reporting process for NDIS provider certification involves several key steps and requirements:
1. Following stage two audits, the audit team must submit a comprehensive written report using the NDIS Commission's template and complete all necessary fields in the Commission's system. As a provider, be ready and aim for best practice (3) to ensure your documents not only meet the requirements but go beyond.
2. The certification audit report will cover various aspects, including recommendations for full certification or conditions, an executive summary, corroboration of evidence, documented records and stakeholder interviews, assessment of actual versus expected outcomes, attainment ratings, finding statements, corrective action requests, opportunities for improvement, and certification recommendations against NDIS Practice Standards.
3. Certification or verification can only be recommended if the NDIS provider meets all criteria in the relevant NDIS Practice Standards at the level of 'Conformity,' except in specific circumstances.
4. Certification or verification may still be recommended if minor non-conformities are identified, provided the NDIS provider presents an acceptable corrective plan.
5. Major non-conformities will preclude certification.
6. Verification audits also require completion of relevant fields in the Commission's system.
7. Immediate notification to the Commission and relevant authorities is required if critical risks related to criminal acts or child protection concerns are identified.
8. Other critical risks must be reported to the Commission within 24 hours.
9. Reporting to the Commission should preferably be done through its system.
10. If internet access is unavailable, reporting can be done by phone initially, followed by using the Commission's system or email.
11. The Commission determines the appropriate action in response to critical risks.
Adhering to NDIS Rules
Adhere to NDIS guidelines: By adhering to the rules and regulations of the NDIS, the likelihood of committing fraud decreases. Despite seeming straightforward, many service providers are unfamiliar with the intricate NDIS regulations. Given their complexity and potential for change, we recommend taking the time to understand them fully and seeking assistance for any uncertainties.
Ensure accurate invoicing: Even when following NDIS pricing guidelines, it's crucial to accurately document your invoices to validate compliance. Thoroughly completing each invoice section, including customer details, service dates, line items, and rates, can prevent future complications.
Establish service agreements: Implementing service agreements is a straightforward and effective means for both providers and participants to safeguard their interests. These agreements outline the services provided, frequency, pricing, and other pertinent details, minimizing misunderstandings. It's essential to maintain organized records of these agreements for reference.
Maintain comprehensive records: Compliance mandates that all NDIS providers maintain meticulous records documenting the support provided to participants. In addition to invoices, preserving any relevant documentation strengthens your position in case of scrutiny by the NDIA. Employing digital methods like photographing receipts for efficient record-keeping is advisable.
Take warnings seriously: Any suspicion of non-compliance may prompt the NDIA to issue warnings. It's imperative to address these promptly, either rectifying the issue or providing substantiating evidence to support your position. Ignoring warnings can exacerbate the situation, so prompt action is crucial.
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