National Disability Insurance Scheme Act does not create an automatic right to payment: court
The Federal Court dismissed a case brought by an unregistered National Disability Insurance Scheme (NDIS) provider seeking payment and challenging the National Disability Insurance Agency’s (NDIA) manual review of claims.
The applicant sought payment of $216,571.99, challenged the agency’s payment review processes, and argued that a manual review decision unlawfully disrupted its operations.
The applicant has provided services under the NDIS since July 2022, primarily to plan-managed participants, and relied solely on payments from the NDIA for income. Normally, the NDIA processes payment claims automatically within three days. However, on August 9, the NDIA's deputy CEO directed that all claims related to the applicant undergo manual review to validate their integrity. Automated payments were halted, and the applicant was required to submit documentation substantiating its claims. This change was communicated through a detailed Request for Information (RTP0811), which applied to 724 transactions across 129 invoices.
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The applicant alleged that the NDIA’s actions amounted to a “payment freeze” that unlawfully withheld funds, causing severe financial strain and likely insolvency. It also argued that the NDIA had unjustly retained the benefit of its services and challenged RTP0811 as overly burdensome and beyond the agency’s authority. The provider sought judicial review under the Administrative Decisions (Judicial Review) Act 1977 (Cth) claiming the NDIA’s conduct was unauthorised and unreasonable.
The Federal Court ruled that the applicant’s claim for restitutionary relief was misconceived, finding no unjust enrichment by the NDIA. The court emphasized that the services provided by the applicant benefited NDIS participants, not the agency. The court also clarified that s. 45 of the NDIS Act does not create an automatic right to payment. Instead, it requires the NDIA to determine whether payments are appropriate under the law.
The claim regarding the alleged “payment freeze” was also dismissed. The court found no evidence that the NDIA had withheld funds belonging to the applicant. Rather, the NDIA’s decision to manually review claims constituted a legitimate exercise of its authority under the NDIS Act to ensure the integrity of payment processes.
The challenge to RTP0811 was similarly rejected. While the applicant argued that the request for documentation was oppressive and impossible to fulfill, the court determined that the NDIA acted within its statutory powers to request information. The court noted that the applicant’s operational limitations did not render the NDIA’s actions unlawful.
Concluding that the applicant had failed to substantiate its claims, the court dismissed the case and ordered the applicant to pay the NDIA’s legal costs.