Provider compliance monitoring

Provider compliance letters

The NDIS is carefully monitored to make sure participants get the supports they need and providers are paid correctly.

From August 2021, the Compliance Response Taskforce are reviewing potential overcharging and sending letters to providers who have submitted claims for payment that look incorrect or unusual. 

If you get a provider compliance letter, you should read the letter fully to understand what it’s asking you to do.

If you need help, contact the Compliance Response Taskforce directly by the phone or email address included in your letter. You can also contact the National Contact Centre on 1800 800 110.

Correct and incorrect claims for payment

Your letter may ask you to check some claims for payment and cancel them if they’re overcharged.

All claims need to accurately reflect the actual supports or services delivered.

A correct claim shows the:

  • participant details
  • exact number of hours, supports or services delivered, including their line item 
  • exact payment amount
  • the date the services were delivered (not the date the payment is being claimed).

As part of our compliance monitoring, we might contact you  and ask you to provide information about supports and services you’ve been paid for. 

See the fraud strategy for details about the NDIA’s compliance approach, including what other actions may be taken.

Record keeping

To show your claims are correct you must keep complete and accurate records of supports delivered to Scheme participants. These include:

  • invoices
  • service agreements
  • other documents that can validate the claim for supports provided.

Providing these records helps the NDIA verify the quantity, type and duration of the support delivered in a compliance review.

The NDIA monitors and assures provider compliance through a range of activities, including:

  • regular payment testing
  • field based assurance activities
  • working with the NDIS Quality and Safeguards Commission to protect participants.

We’re constantly improving our ability to find errors and non-compliance with the latest tools and resources available. Doing this protects the integrity of the Scheme and ensures it‘s available now and into the future.

Where to go for more information

If you have received a provider compliance letter you can contact us for further information on 1800 800 110.

This page current as of
22 October 2021
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