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Plan review updates for existing providers

As part of the national roll out of the NDIS the NDIA will implement a nationally consistent plan review approach from 1 July 2017. The NDIA recognises that policies, procedures, systems and structure continue to evolve and this is an important change that will make sure that all NDIS participants have a consistent experience with NDIS and that NDIA is collecting the same information from people, regardless of when they entered the NDIS and where they live.

A small number of NDIS participants have a gap between their current plan’s start date and the previous plan’s end date.

Providers should continue to provide services to a participant during this gap period in a plan. Previously when a provider attempted to claim for these services, their claims got rejected.

To address this problem, old plans will be automatically extended to the day before the start of the next plan. This will enable providers to submit payment requests for services that were provided under the old plan during the gap period.

For further information on how to make a Payment Request, refer to the Provider Toolkit section 2.8.4 Payment Requests, and the Participant Fact Sheet.

Both the NDIA and providers have a shared interest in the success of the NDIS and setting goals to increase a participant’s skills and independence will continue to be a key focus of the NDIS.

Equal access is a central goal of the NDIS and having a balance of funding to help participant’s achieve their goals. It is expected that participant’s funding amounts will change and in some circumstances, reduce over time. For some participants who joined the Scheme during trial we may no longer fund some of the activities which we were able to fund as Scheme grows nationally. The funding in a participant’s next plan may look different following their next plan review. A plan review is an opportunity for participants to look at their progress and set new goals to increase their skills and independence.

It is expected that plan funding amounts will change and in some circumstances, reduce over time as the participant achieves increased social and economic participation.

Independent Price Review

The NDIA is committed to helping providers transition to this new way of working, at the same time ensuring that the NDIS is both financially sustainable and delivers on its promise to Australians living with disability. As part of that commitment the NDIA have commissioned McKinsey & Company to conduct an Independent Pricing Review of NDIS supports. The Review will assess the NDIA’s pricing strategy and approach, as well as specific price settings for supports and services that are critical to the Scheme’s market stewardship role and the path to price deregulation.

Given the vital role providers play in delivering the NDIS, a key component of the Review is provider engagement and consultation. As such, the Review team will be conducting a series of open provider forums throughout September 2017 and we invite providers to attend. The forums represent an opportunity for providers to give feedback on NDIS support pricing and its impact on provider economics and the Transition to Full Scheme. Providers should not feel the need to resubmit feedback that they may have already provided.

More information on the Independent Pricing Review can be found in the pricing section of the NDIS website.

Support Coordinators

Support coordination is a capacity building support to implement all supports in a participant’s plan, including informal, mainstream, community and funded supports.

Watch this short video to see how support coordinators are helping participants to understand their NDIS plan and exercise their choice and control and achieve outcomes and meet their goals.

 


Last modified 1/12/2017

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