NDIA update: Claiming across funding periods

The NDIA has changed how self-managed participants can claim for supports across funding periods.

A participant's support needs can rise and fall over time, so they may not line up with the funding periods in their plan. Self-managed participants and their providers can now agree to claim for a support in the next funding period if:

• the participant has enough total funding in their plan
• the provider agrees to hold their payment until the next funding period.

What this means for occupational therapists

This arrangement is optional. If a participant asks you to hold your payment, consider:

• whether the claim can still be submitted within the approved claiming period
• when the participant's current plan ends, as funding must be spent within that plan and will not roll over to a new one
• how you will record the agreement, including the support delivered, the amount and the expected payment date.

A clear written agreement protects your business and gives the participant certainty about their budget.

For more information, visit the NDIS website.

Have your say on 2027–28 NDIS pricing

The NDIA is seeking provider feedback through its Annual Pricing Review (APR) for 2027–28 prices. The review will inform advice to the Minister on NDIS price limits from 1 July 2027.

Occupational therapy pricing has now been frozen at $193 per hour for eight consecutive years. Meanwhile, the cost of running a practice continues to climb. The APR survey is your chance to tell the NDIA directly what this means for your practice and the participants you support.

OTA is preparing its own submission, calling for pricing that reflects the real cost of delivering occupational therapy. Strong responses from members will reinforce our case. Every survey response adds to the evidence base the NDIA uses to set prices.

The survey closes on 1 November. We encourage all occupational therapists who are NDIS providers to complete it.

Complete the survey here.

OTA submits to consultation on NDIS access reform

OTA has lodged a submission in response to the consultation on the design of a new NDIS access process, including how functional capacity and permanence will be assessed under the amended NDIS Act. The changes will take effect from 1 January 2028.

We support the Department's goal of a more consistent, evidence-based access process. Our 27 recommendations focus on getting access decisions right the first time, so people with disability receive the supports they need and the Scheme remains sustainable.

Our key positions include:

• access assessments conducted or overseen by appropriately qualified allied health professionals, including occupational therapists
• input from professionals already working with the applicant, with existing clinical reports accepted as evidence
• safeguards for independent decision-making, including independent review of declined applications
• permanence tests based on functional improvement and real-world access to treatment
• assessments that work for First Nations and culturally and linguistically diverse communities, and for people with complex, fluctuating or episodic disability
• access changes timed to the readiness of foundational and mainstream supports.

Throughout the submission, we linked each recommendation to the Government's own objectives. Accurate, well-evidenced decisions reduce appeals and reassessments, contain costs and build confidence in the reform. We also drew directly on the clinical expertise OTs bring to understanding how people function in their daily lives.

Read the full submission here.

OTA submits to consultation on Support Coordination and Connection reform

Support coordination is also changing. From 1 July 2028, a new commissioned Support Coordination and Connection (SCC) service will replace the current open market. We have lodged our response to the Department of Health, Disability and Ageing's consultation on the model's design.

Occupational therapists already work in support coordination roles and alongside coordinators across the NDIS. That gives our profession a clear view of where coordination works, where it breaks down and what that means for participants. Our submission puts this experience at the centre of the new service.

Our 16 recommendations ask the Department to:

• give SCC+ participants access to qualified allied health professionals, including OTs, with allied health leadership where needs are complex
• measure success by whether participants are taking part in supports that work for them
• embed participant-led planning that brings treating professionals into coordination
• set national quality, workforce and safeguarding standards that draw on Ahpra registration
• fund functional and environmental assessment time within SCC+
• work with OTA and other allied health peak bodies to design a transition pathway that recognises existing qualifications and experience.

Our recommendations are realistic about workforce pressures. They give participants access to OT expertise through employment, subcontracting or consultation and call for SCC+ pay and conditions that can attract and retain allied health professionals.

Read the full submission here.

Have your say on Support at Home

Are you an OTA member working in the Support at Home program? The Department
of Health, Disability and Ageing is asking health workforce professionals who deliver services in the program to share feedback about their experiences. You can participate by completing the survey here. It asks for feedback on how Support at Home is working in practice, including workforce capability and support, service delivery experience, workload and administrative requirements and workforce sustainability. The Senate inquiry into Support at Home (to which OTA provided testimony in August) will be tabled in Parliament on 24 November.

Are you an OT working with WorkCover Queensland?

WorkCover Queensland is reviewing its Private Hospital Services Table of Costs to ensure fees remain current and support the delivery of quality care to injured workers. Allied health fees, including occupational therapy fees, can be reviewed here. If you would like to provide feedback, please email providerengagement@workcoverqld.com.au by 30 October.