Reporting suspected fraud

The Australian Government is committed to preventing fraud against its programs and services. The NDIA is serious about preventing, detecting and dealing with fraud against the Agency and the NDIS.

If you suspect someone may be committing fraud against the NDIA or NDIS you should report it.

What you have noticed may not be fraud, but we are still interested. The best way to report suspected fraud is to call the Fraud Reporting Hotline on 1800 650 717.

Fraud is defined as dishonestly obtaining a benefit or causing a loss by deception or other means.

We acknowledge that there are a range of behaviours that may seem suspicious, and that some of these might not be fraudulent, they might be mistakes or a misunderstanding – even if a mistake has been made, we need to hear about it so we can fix it.

We encourage you to report suspicious behaviour. Reports can be made anonymously and your rights are protected by law.

What to report – provider behaviour

Some examples of what you should report about providers of supports to NDIS participants include:

Concerns about how a provider conducts business, such as:

  • Falsification of invoices
  • Having unsuitable or unqualified personnel providing services
  • Using NDIA or NDIS branding to mislead Participants
  • Providing supports without the consent of the Participant

Encouraging misuse of funds, issues with spending and/or claiming:

  • Under-servicing a Participant (charging for one hour, but only delivering 40 minutes of support)
  • Altering the dates of supports provided (e.g. to a weekend) to increase the rate charged
  • Claiming for supports that were never provided
  • Charging for one-to-one rates for supports delivered to a group
  • Claiming for supports provided prior to plan approval
  • Charging unreasonable amounts/time for travel

Eligibility for registration as an NDIA Registered Provider

  • Provision of misleading information in order to obtain registration status (e.g. not holding the appropriate qualifications to provide the services offered, or falsely claiming to hold a higher intensity support qualification than is held).

Misuse of participant or Agency information

  • Inappropriate use of personal information without the consent of participant

Conflicts of interest

  • Suspected collusion with other parties (e.g. involving NDIA staff, Partners in the Community etc.) to gain an advantage
  • Attempts to in inappropriately influence participants to use services which result in a benefit to the provider.

What to report - NDIA employee (including Partners in the Community) behaviour

Some examples of what you should report about NDIA Employees (including Partners in the Community) are:

Misuse of Agency-held information

  • Unauthorised access and/or use of participant information
  • Disclosure of classified Agency information

Corruption, misconduct and abuse of power

  • Corruption (e.g. bribes, selling Agency information, preferential treatment of family members or friends or associates, theft or misappropriation of official equipment, blackmail etc.)
  • Improper use of Agency funds
  • Falsification of qualifications or experience to gain employment
  • Abuse of employee entitlements (e.g. incorrectly recording work hours, falsification of medical certificates to access leave etc.)
  • Inappropriate use of official resources (e.g. private commercial interests etc.)
  • Conflicts of interest (e.g. acceptance of gifts or benefits from stakeholders, promoting Providers in which they, or an associate has an interest)

What to report – participant behaviour

Some examples of what you should report in relation to NDIS participants include:

  • Misuse of funds, issues with spending and/or claiming:
    • Using NDIS plan funds for non-disability supports
    • Claiming for supports provided before the plan was approved
    • Multiple claims for the same support or service
    • Claims for services that may also be claimed through the health system (e.g. Medicare)
    • A carer accessing participant funding when they are not an authorised nominee
    • Falsification of documents to support claims
    • Relatives or Carers, including nominees, accessing NDIS funds for their personal use
  • Identity fraud
    • Individuals falsifying their identity and other details to gain access to the Scheme

How to report suspected fraud

The best way to report suspected fraud is to call the Fraud hotline on 1800 650 717

A dedicated team of employees will record the details of your report. Even the smallest piece of information may be relevant.

We keep the information you tell us confidential. You can report anonymously and your rights are protected by law.

When reporting suspected fraud, keep in mind the following questions:

  • Who is the subject of your suspicions? (e.g. provider, NDIA employee (including Partners in the Community), or participant name)
  • When did the matter occur? (e.g. relevant dates or an approximate period of time)
  • What happened? Including how the matter came to your attention
  • Where did it occur? (e.g. addresses, regions etc.)
  • Why does it seem suspicious?

It is helpful for us to know whether the matter been reported elsewhere by you, or another person (if you have this information).

If you would prefer that a member of the team contact you, you can complete the Contact Form and we will get back to you. Select the 'Other Enquiries' option and reference 'report suspected fraud' in your message / question section.

Alternatively, you can email us on fraudreporting@ndis.gov.au you can also use this email address to provide us with any documents to support your allegations or report.

If you are a TTY user – phone 1800 555 677 then ask for 1800 650 717

What we do with the information you provide

We take all reports of suspected fraud seriously and every allegation is assessed.

We know you may want to know about the progress and result of information you gave us. But we can't release individual details about our activities. This is due to the secrecy provisions in the laws we are bound by including the Privacy Act 1988.

Sometimes you may not see changes to someone's situation. The information you give us doesn't always result in changes to a person's, or entity's participation in the NDIS.

In some cases we may not take any further action. For example we may find:

  • the business or person you name doesn't provide services to the Scheme, or have involvement with the Scheme
  • the person you name isn't a participant of the Scheme
  • we can't properly identify the business or person (usually because we don't have enough detail in the allegation or report)
  • the information provided isn't relevant to the NDIA or the NDIS.

If we find evidence of criminal behaviour, we may take further steps. This means we may make a referral to the Commonwealth Director of Public Prosecutions, to pursue criminal prosecutions.

We may also take civil action, including for the recovery of any financial losses.

If you have concerns, but do not want to report them to NDIA

You may wish to report your concerns to:

NDIS Quality and Safeguards Commission (external) (External website)

Call: 1800 035 544

*Note: As of 1 July 2019, the NDIS Quality and Safeguards Commission operates in all Australian states and territories except Western Australia. For more information visit the Commission's website (external) (External website).

Australian Competition and Consumer Commission (external) (External website)

Call: 1300 302 502

Commonwealth Ombudsman (external) (External website)

Call: 1300 362 072

Australian Human Rights Commission (external) (External website)

Call: 1300 656 419

State and Territory contacts

Australian Capital Territory (ACT)

New South Wales (NSW)

Northern Territory (NT)

Queensland (QLD)

South Australia (SA)

Tasmania (TAS)

The Health Complaints Commissioner is also the State Ombudsman

Victoria (VIC)

Western Australia (WA) and the Indian Ocean Territories

If you have concerns that do not relate to activities within the NDIA, or the NDIS, you may wish to contact one of the Agencies below:

Scams

'SCAMwatch' is a website (external) (External website) run by the Australian Competition and Consumer Commission that helps to recognise, avoid and report scams.

Suspected fraud against Centrelink, Medicare or Child Support

If you suspect someone may be committing fraud against Centrelink, Medicare or Child Support, you can report it to the Department of Human Services (external) (External website)

Tax evasion

If you have information about someone you think may be deliberately evading tax, you can report it to the Australian Taxation Office (external) (External website)

This page current as of
12 July 2019