NDIS recipients sued by service providers

CHOICE has found evidence that NDIS recipients are being sued by their service providers. Read @jblakkarly’s investigation here:

5 Likes

This is a great article about a big problem that’s under-reported - thank you

It’s all very well for NDIS to say that everybody is supposed to be responsible here but the entire design of the system makes it easy for the NDIS clients - the person with the disability - to be left having to pay large sums of money out of our meagre disability pension when we’ve done nothing wrong.

I have a friend for example who has a plan managed NDIS setup, where her physiotherapist charges her plan manager directly for services and the plan manager charges the NDIS. In this type of system there’s a maximum charge the physio is allowed to charge per hour, NDIS sets the amount. Now the physio has been charging more than this maximum per hour for some many months - which they should not have done - and the Plan Manager - who should have picked this up and refused to pay the invalid invoice - had been paying the invoices for the whole time. Who’s left having to repay the amount? My friend whose only income is a disability pension

For many of us, the amounts in our NDIS plans are many multiples of our disability pensions, even orders of magnitude bigger, so the ramifications of making mistakes can end up being amounts we could never ever hope to pay back. This can leave people afraid to use their funds for legitimate needs, because they aren’t 100% certain it’s OK - and NDIS will almost never give you a straight answer about whether something is 100% OK.

There need to be more safeguards here
r

9 Likes

Absolutely horrendous that this has been allowed to happen. NDIS needs a good overhaul, almost not fit for purpose at the moment.

8 Likes

I’m a sole trader working under the NDIS and I trusted the system to pay me for the support I provided. I don’t invoice every week so when the Coordinator called me to tell me that a participants funding had run out two months before a new plan would start I was stunned and out of pocket almost $2000. I work alongside two large providers who had the clout to take the last of the funds so in good faith I continued to work in the hope that working under the Government funded program it would be sorted.
The result of all this was I worked for nothing for two months and was told by the Plan Manager ( a big one) to sort it out with the Participant to get my money. Of course I know the person has no money to spend on himself never alone me so I just have to swallow the bitter pill of doing a great job and ending up with my family suffering a loss of income but still working.
There are two sides to this story but the coordinator and Plan Manager are really to blame as they are both privy to the amount left in a Package but all too often so busy making money they do not check what is happening.

10 Likes

For people with Plan Managers it is very easy to overspend when costs vary due to time based charging.

Invoices generally to go straight to the Plan Manager. The client will not be aware of how much time or cost is being charged for any given visit.

Invoices from providers may take weeks to be sent in to the Plan Manager. On occasions, the Plan Manager may be paying invoices for services from months ago.

Plan Managers are required to prepare and send out a statement monthly delineating the preceding month’s expenditure authorised by Plan Manager on behalf of the client. Their statement may come out in the middle of the next month listing day by day how much was paid to a provider(s). Who remembers exactly how much time was spent on a visit even 6 weeks or months ago. Clients are not informed of the hourly fee being charged or the time being claimed.

There is no such thing as time sheets signed off by clients to prove that the provider was actually there for any period of time. Clients just have to trust that things are being done honestly and correctly.

And how many clients and their carers are capable of really understanding these statements, or have the time to validate the charges.

Consequently, unscrupulous providers can easily overcharge and the client may not be aware for months.

Then add to the mix that due to delays within the NDIA, funds may not be approved until months into the next year’s plan. meaning that participants and providers have to trust that the NDIA will eventually catch up and start paying for the approved goods and services.

So if a client unknowingly overspends towards the end of their plan year, they may be without any approved funding for months. No wonder the providers get antsy.

It should be noted that NDIA clients have had to go through the wringer to prove that the goods and services they are claiming for are essential before plans are approved and funding provided, so stopping the spending is not an option, and continuing the services may be a matter of life and death.

Responsibility for this debacle needs to rest with the Federal Government, as once again they have not adequately protected or resourced one of the most vulnerable sections of our society.

8 Likes

I’m a 43yr old NDIS Participant who read the recent Choice Article on Participants being pursued (topic deleted by our services for unpaid invoices and I’ve got to tell you that I agree with the Services!
For many years we have sought to become Empowered and now that we have the opportunity to take charge of our Care Package Funding and associated care plans, some of us are now flying the helpless disability flag screaming blue murder for being held responsible for our actions!
I believe we can’t have our cake and eat it too!
My budget is and has been in a small surplus every care plan review timeframe and I never get any praise for it, not do I want any either for I believe I’m doing what should be the standard best practice!
In life the hard truth is that we make decisions for ourselves and our lives and those decisions and real life outcomes and consequences!
NDIS Participants like myself can’t pick and choose just the good bits of being Empowered without taking on the not so nice bits as well.
if we want a free disability support services marketplace where we have custom power, then we as customers in that marketplace need to know that we can’t purchase what we aren’t able to pay for, it’s simple buyer & seller dynamics!!!
I’d say it’s what having “Real Choice” as Customers is all about in the NDIS!

​ ​ ​ ​

1 Like

I have moved your post to another topic which is specifically about the Choice article on NDIS participants being sued by providers.

I agree with you about taking control and being empowered, and yes NDIS participants should be active in sticking with what was approved in their plan. You are clearly lucky to have adequate funding for your needs.

Too often factors beyond the participant’s control result in budget overspend. In addition to what I wrote above, it may even be that without explanation the NDIA does not provide the full amount of money that was approved in the plan; and then, apart from a curt acknowledgment of receipt does not respond to a request for a review. The LNP has systematically cut resources to the NDIA meaning the NDIA have to exclude more disabled people who would otherwise qualify for funding, but there isn’t enough money in their budget. The NDIA staff are doing their best within the constraints put on them by the Government.

Even before COVID, NDIA was quite slow in responding. Since COVID, they have become glacial.

NDIS participants are finding it increasingly difficult to have funds topped up if providers’ rates go up, or extra needs are identified. So what do they do if they can not function without aid and their budget has been used up through no fault of theirs? That is disempowering those participants.

5 Likes

Well that is a good outcome for you.

However, a vast number of NDIA participants are not as lucky as you to be able to do so. They lack the ability to monitor these payments due to, you guessed it, their disability!!

4 Likes