What you need to know about non-compliance

Types of non-compliance

There are different types of non-compliance activities. These include:

An error or mistake: when a person does the wrong thing without meaning to and without hoping to gain something for themselves.
Misuse: when a person uses NDIS funds in ways that are not in line with the participant’s plan or the law.
Conflict of interest: when a person or organisation has an opportunity to put what will benefit them (their own interests) ahead of in the interests of the people they support.
Dishonest behaviour: when someone uses NDIS funds when they know it’s the wrong thing to do. When someone behaves dishonestly, they are taking advantage of participants, their families or carers.

How to do the right thing

Doing the right thing means following the rules and standards of the NDIS and Australian laws. Sometimes we call this compliance.

Your plan funding must only be used to buy NDIS supports. Read more about what supports can be funded by the NDIS.

You can be compliant by using your NDIS funds for the NDIS supports that best help you work towards your goals and meet your needs.

Shopping around to find the right supports that offer the best value for money and quality will also help you to be compliant.

Learn more about doing the right thing to protect your plan from fraud and non-compliance.

Transcript for 'Non-compliance and the NDIS'

Types of fraud and non-compliance fact sheet

Types of fraud and non-compliance fact sheet (DOCX 310KB)

Non-compliance case studies

Participant profile:

Isabella is 30 years old. She has Down syndrome.
Isabella is living in a unit near her parents’ house.
To help Isabella build her independent living skills, her NDIS plan has funding for a support coordinator.

Isabella has a support worker who comes each day to help her plan and cook her meals, do grocery shopping and help with the housework. The support worker also takes Isabella to cooking lessons.

Isabella has been decorating and buying things for her new home. One purchase is an air fryer. Isabella uses her core supports budget, thinking this appliance will help build her cooking skills between lessons. Isabella tells her support coordinator about her new air fryer and how she plans to use it.

What good looks like

Isabella’s support coordinator explains to Isabella she can’t use her core supports budget to buy everyday household items like an air fryer. They talk about the difference between the personal expenses Isabella needs to use her own money for, and the kinds of supports she can use her NDIS funds to buy.

Isabella asks her support coordinator to help her cancel the claim for the air fryer. Together, they contact the NDIA to explain the mistake and describe what they’ve done to fix it.

Participant profile:

Annie is 39 years old. She has a psychosocial disability and cerebral palsy.
Annie’s NDIS plan includes funding for support coordination, social and community participation and allied health support.
Sam is Annie’s NDIS support coordinator.

Annie already has an occupational therapist and physiotherapist, but she would like to find a psychologist to help build her social skills to participate in community activities. Sam and Annie meet to discuss what Annie wants in a psychologist and the types of community groups and activities she’s interested in.

What good looks like

Sam has a brother who is a psychologist he thinks could be a good fit for Annie.

Sam wants Annie to make her own decision about the psychologist she wants to work with. He prepares a list and makes sure to tell Annie his brother is on the list and who he is. Sam leaves the decision about who she wants to see to Annie.

Sam has given Annie choice and control to decide which psychologist is best for her. He has also met his provider obligations by identifying and telling Annie about a provider he has a professional and personal relationship with.

Provider profile

Sally is the owner of a registered NDIS provider.
Her business offers support coordination services and support workers to NDIS participants.
Sally has met her obligations as a provider and has made sure the business complies with the NDIS Code of Conduct and NDIS Rules and Legislation.

Sally is looking at ways to promote her business and gain new clients. She has a website and social media but would like to engage face to face with people with disability.

Sally is involved in a small business network of NDIS providers. Some of them suggest sharing a booth at an upcoming disability expo.

What good looks like

At the expo, Sally connects with many participants who are new to the NDIS. She is also approached by John, a participant who is unhappy with his current provider and is shopping around for a different one.

Sally doesn’t make any commitments or offer any incentives to John. Instead, she asks to meet him a few days after the expo. At their meeting, John explains what he is looking for, and Sally asks some questions to make sure her business is the best fit for his needs.

Sally does not charge John for this meeting. Sally knows she can only charge John after he decides she is the right support coordinator for him and they have signed a service agreement.

Provider profile

XYZ Plan Manager is Daniel’s NDIS plan manager.
XYZ is responsible for paying Daniel’s providers, helping him keep track of his NDIS funds, as well as his financial reporting and record keeping.
XYZ works with Daniel to help build his financial management skills.

XYZ processes the claims from Daniel’s providers for payment as the invoices are received. XYZ notices four separate claims for physiotherapy have been received at once. XYZ can see from Daniel’s claim history that Daniel usually has only one physiotherapy session each month.

What good looks like

XYZ takes a closer look at these claims and realises that it is the same invoice for physiotherapy, submitted four times.

XYZ contacts Daniel, who tells them that he only had one physiotherapist visit last month. XYZ then contact the physiotherapist. The physiotherapist apologises and admits three of the invoices are duplicates. They say they made a mistake and will fix their processes to ensure it doesn't happen again. XYZ submits the correct invoice to the portal for payment. XYZ adds a flag to their claiming system so that in future all the invoices from this physiotherapist will receive extra checks.

XYZ sends Daniel an email to explain what they have found out. They let Daniel know he helped the provider fix the mistake and they will both need to have some extra oversight of invoices in the future for this provider. XYZ reminds Daniel that he can shop around for another physiotherapist if he is concerned this provider was acting dishonestly.

What you need to know about non-compliance

On this page:

Types of non-compliance

How to do the right thing

Participant profile:

What good looks like

Participant profile:

What good looks like

Provider profile

What good looks like

What good looks like