Australians Must Exhaust Treatment Options to Access NDIS Under Proposed Rules

Australians with a disability would need to exhaust “all appropriate” treatment options for their impairment before becoming eligible for the National Disability Insurance Scheme under proposed entry criteria. The test is expected to begin on 1 January 2028.

Existing participants could be removed from the scheme if they do not meet the requirement when progressively reassessed. The proposed rules form part of sweeping legislation to overhaul the $50 billion-a-year program. The legislation is set to be introduced to parliament on Thursday.

A government spokesperson said the NDIS was designed for people with permanent and significant disability, adding that if a person can access treatment that will treat or alleviate the impact of an impairment, the NDIS is not the appropriate service system.

The measures are forecast to save the federal budget about $36.2 billion through to 2030. They would reduce participant numbers to 600,000, down from a projected 900,000 at the end of the decade. There are currently about 760,000 participants on the scheme.

Opposition and crossbench MPs have been briefed on the legislation by the government, which wants it passed as soon as possible. Briefing documents show the bill will clarify the definition of “permanence” for disability, acting as a gateway test for access.

Changes to toughen the criteria were recommended in the 2023 review of the NDIS.

Participants and providers will need to retain records relating to claims by the end of May. Supported independent living providers will be required to register with the NDIS Quality and Safety Commission from June. The first foundational support program, Thriving Kids, is scheduled to begin rolling out from October for children aged nine and under with autism and developmental delays.

A reduction of the social and community participation budgets for participants will also begin from October. The major changes to how the NDIS works are scheduled to start in 2027. From February of that year, a new criteria to determine what supports the NDIS can offer will be introduced and unused money from budgets will no longer be rolled over.

In 2027, a new framework for how NDIS plans are reassessed and renewed will be introduced. The National Disability Insurance Agency will reduce its headcount by nearly 700 roles in the upcoming financial year. The budget papers indicate payments to participants would plateau at between $53 billion and $54 billion a year until 2030, with the average growth rate reduced to 3.6 percent over four years after peaking at 22.9 percent in 2022-23.