NDIS fraud: What is it and how you can protect yourself.

Fraud is about intentionally doing the wrong thing. In the NDIS, this is called non-compliance and it can happen across all areas of the scheme.

The NDIA is very clear on what fraud is and how they view it:

“The National Disability Insurance Agency (NDIA) has zero tolerance for fraud against the National Disability Insurance Scheme (NDIS), participants and the NDIA. Any amount of fraud is unacceptable.

Fraud is a crime. It requires intent. People who commit fraud try to get benefits for themselves or others by being dishonest.

Fraud is more than carelessness or making mistakes. If someone unintentionally does the wrong thing, we call this non-compliance”.

With this in mind, it’s helpful to be aware of the most common types of fraud so you know what to look out for.

What does fraud look like?

Fraud is more than making a simple, one-off error. Fraudulent behaviour consists of:

• Untrue or misleading information such as providers claiming they are registered when in fact they are not.
• Unlawfully obtaining and using NDIA information or restricted data.
• Fake documents or invoices.
• Making claims for services or products that were not supplied.
• Providers using funds for a purpose different to that intended.
• Accounting fraud such as false invoices or overcharging.
• Misusing funds.

The NDIS works proactively to identify, investigate and act on fraud. A special task force called the “Fraud Fusion Taskforce” also investigates “organised fraud” which involves groups of people who work together to commit fraud.

You can actively protect yourself against fraud.

Keeping a close eye on how your NDIS funds are spent can help you identify possible fraud if it does happen to you.

When you receive an invoice, it’s a good idea to review it and ask yourself the following questions before approving payment:

• Did you agree to receive the services listed?
• Did you get the services on the days noted on the invoice?
• Do the hours of service for each day look correct?
• Is the total number of hours or items claimed correct?
• Do the charges on your invoice match your service agreement?
• Have you already paid for these services on these dates on another invoice?

Some other simple checks also include:

• Are the funds in your NDIS Plan running out faster than expected?

Check your My Budget section in the app where you can track your Plan funds in real time 24/7. You can also review your Budget Health Check that comes with your monthly statement.

• Have charges appeared in your Plan for items you are unsure about?

You can review past invoices in the My Budget section of the app.

• Are you working with any providers who refuse to draw up a service agreement with you?

It’s important to have a clear understanding for you and your provider of what is being provided and how much it costs.

• Are your contact details up-to-date with Leap in!?

You can call us on 1300 05 78 78

• Do you have an up-to-date list of the people who you have listed as ok to access your information with us?

You can check your consents and permissions in the L! app under your Crew section. And keep your details safe. Don’t share your log-in details with anyone, including your app sign-on and password details.

It’s always ok to ask questions!

If you’re unsure, ask for more information from the provider before approving the invoice for payment. You are in control of your NDIS Plan and how you spend your funds, so if in doubt get more details.

Top tip: If you’re a Leap in! Member, you have the choice to approve each invoice as it comes through or to set up automated approvals for providers. You decide which invoices you want to check in detail and can confirm the services received match the invoice. 

What to do if you suspect fraud.

Option 1: Contact the NDIS.

If you think someone is doing the wrong thing, you should report it to the NDIS. There are several ways to do this:

1. Call the NDIS Fraud Reporting and Scams Helplineon 1800 650 717
2. Email fraudreporting@ndis.gov.au.

We recommend including the following information:

• Who you are making the report about
• When did the issue occur and for how long
• What happened
• Why do you think it’s fraud
• How did you find out about it
• Have you reported the matter to anyone else?

Keep in mind that fraud can be complex and investigations take time. Investigators must respect the rule of law and presumption of innocence. You may not receive a direct response to your report but that doesn’t mean it has not been investigated. If you’re interested in finding out more, the NDIS website is a great resource that provides information about how to report suspicious behaviour.

Option 2: Contact Leap in!

If you suspect fraudulent activity and are not sure where to go or who to tell, call us. We’re here to help.

We can:

• Check directly with a provider on your behalf about an invoice you’re unsure of
• Investigate past activities and invoices, such as whether you have already been billed for a particular service.
• Report potential fraud on your behalf.

We will take your concern seriously and follow our internal checks and processes. According to our legal obligations, we will share any findings to the NDIA fraud team.

It’s really important to us.

At Leap in! maintaining the integrity of the NDIS is important to us. We have systems, procedures and controls in place to protect our Members and their NDIS funds.

We also have systems in place for Members to be able to report potential issues to us. You can feel confident and comfortable that we have proactive approaches and are working behind the scenes with the law or NDIS if necessary.

If you have any questions or need further advice, give our friendly crew a call on 1300 05 7878 or email crew@leapin.com.au.