NDIS changes slammed as 'unsustainable' as clinic moves away from scheme

The Advertiser

19 hours ago

An occupational therapy practice has started transitioning away from the NDIS as pricing decisions make it more "unsustainable" to provide services.
The National Disability Insurance Agency's (NDIA) annual pricing review of the scheme has frozen the cost for occupational therapy sessions provided to NDIS participants for a seventh year and halved travel subsidies for allied health professionals.
Price caps for other allied health therapies have also changed.
Bryony Clark, an occupational therapist and co-director of Corrimal-based Facilitate OT alongside Carla Widloecher, said that while the fee payable for OT sessions had remained unchanged, business costs had gone up about 30 per cent and wages by about 25 per cent.
"It really is virtually unsustainable to remain working in the NDIS," Ms Clark said.
Ms Clark said the travel subsidy reduction meant it was not viable for the clinic to send out allied health assistants to see NDIS participants for certain therapies, because it no longer covered the cost of the service.
Travel subsidies were also important, she said, because OTs needed to assess people in their homes, workplaces and schools - not only for the best outcomes for the participants, but because it was required for NDIS accreditation.
A person with disability approved for an NDIS plan receives funding for appropriate supports, which can include therapies and services, as well as equipment.
Each year, the NDIA conducts a pricing review and sets limits for what providers can charge for therapies and services for NDIS participants.
From July 1, the cap for occupational therapy was again set at $193.99 per hour.
The limit for physiotherapy has dropped by $10 to $183.99 per hour, and for podiatry and dietetics by $5 to $188.99 per hour.
Psychology has increased by $10 to $232.99 an hour.
Therapists are now limited to billing travel time at 50 per cent of their hourly rate.
The NDIA says the new prices better match what people without an NDIS plan pay for these therapies.
When participants get a new plan, their funding will be set according to the revised rates.
National peak bodies for allied health professionals and health advocacy groups have called on the NDIA to review its pricing decision out of concern that the changes will force providers out of the NDIS and result in less support for participants.
Facilitate OT has 260 active NDIS participants on its books, but Ms Clark and Ms Widloecher have made the difficult decision to begin transition out of the NDIS due to what they say is the uncertainty and difficulty of working in the system.
"We've really soldiered on for a very long time, hoping things will get better, and not wanting to leave out participants without support," Ms Clark said.
They have already ceased outreach driving assessments, which evaluate an NDIS participant's ability to drive and any modifications they might need, because of the travel fee changes.
An NDIA spokesperson said therapy supports represented a "significant" portion of NDIS funding, amounting to over $4 billion in payments each year.
"A comprehensive review of prices found NDIS participants were paying different prices to what other Australians pay for those therapies," the spokesperson said.
"We also heard from participants that excessive travel claims for therapy-related services drain participants' plans faster than expected and reducing the amount of support a participant could access."
The spokesperson said the new rule encouraged providers to schedule more effectively.
Ms Clark argued that there was a difference between the NDIS hourly rates and the subsidised rebate system under which Medicare and private health insurance operated, the latter of which providers could add a gap fee.
She also pointed to some government schemes (which the NDIA considered in its review) that paid higher rates than the NDIS for occupational therapy.
Ms Clark fears a loss of support for NDIS participants will cost the health system, as individuals will need more intensive care down the line, and impose a social cost as carers shoulder a heavier load in lieu of allied health therapies.
The NDIA has said it would monitor markets to ensure participants had continued access to supports.
The spokesperson said NDIS data showed the number of providers continued to grow and had increased by almost 58,000 in a year.
An occupational therapy practice has started transitioning away from the NDIS as pricing decisions make it more "unsustainable" to provide services.
The National Disability Insurance Agency's (NDIA) annual pricing review of the scheme has frozen the cost for occupational therapy sessions provided to NDIS participants for a seventh year and halved travel subsidies for allied health professionals.
Price caps for other allied health therapies have also changed.
Bryony Clark, an occupational therapist and co-director of Corrimal-based Facilitate OT alongside Carla Widloecher, said that while the fee payable for OT sessions had remained unchanged, business costs had gone up about 30 per cent and wages by about 25 per cent.
"It really is virtually unsustainable to remain working in the NDIS," Ms Clark said.
Ms Clark said the travel subsidy reduction meant it was not viable for the clinic to send out allied health assistants to see NDIS participants for certain therapies, because it no longer covered the cost of the service.
Travel subsidies were also important, she said, because OTs needed to assess people in their homes, workplaces and schools - not only for the best outcomes for the participants, but because it was required for NDIS accreditation.
A person with disability approved for an NDIS plan receives funding for appropriate supports, which can include therapies and services, as well as equipment.
Each year, the NDIA conducts a pricing review and sets limits for what providers can charge for therapies and services for NDIS participants.
From July 1, the cap for occupational therapy was again set at $193.99 per hour.
The limit for physiotherapy has dropped by $10 to $183.99 per hour, and for podiatry and dietetics by $5 to $188.99 per hour.
Psychology has increased by $10 to $232.99 an hour.
Therapists are now limited to billing travel time at 50 per cent of their hourly rate.
The NDIA says the new prices better match what people without an NDIS plan pay for these therapies.
When participants get a new plan, their funding will be set according to the revised rates.
National peak bodies for allied health professionals and health advocacy groups have called on the NDIA to review its pricing decision out of concern that the changes will force providers out of the NDIS and result in less support for participants.
Facilitate OT has 260 active NDIS participants on its books, but Ms Clark and Ms Widloecher have made the difficult decision to begin transition out of the NDIS due to what they say is the uncertainty and difficulty of working in the system.
"We've really soldiered on for a very long time, hoping things will get better, and not wanting to leave out participants without support," Ms Clark said.
They have already ceased outreach driving assessments, which evaluate an NDIS participant's ability to drive and any modifications they might need, because of the travel fee changes.
An NDIA spokesperson said therapy supports represented a "significant" portion of NDIS funding, amounting to over $4 billion in payments each year.
"A comprehensive review of prices found NDIS participants were paying different prices to what other Australians pay for those therapies," the spokesperson said.
"We also heard from participants that excessive travel claims for therapy-related services drain participants' plans faster than expected and reducing the amount of support a participant could access."
The spokesperson said the new rule encouraged providers to schedule more effectively.
Ms Clark argued that there was a difference between the NDIS hourly rates and the subsidised rebate system under which Medicare and private health insurance operated, the latter of which providers could add a gap fee.
She also pointed to some government schemes (which the NDIA considered in its review) that paid higher rates than the NDIS for occupational therapy.
Ms Clark fears a loss of support for NDIS participants will cost the health system, as individuals will need more intensive care down the line, and impose a social cost as carers shoulder a heavier load in lieu of allied health therapies.
The NDIA has said it would monitor markets to ensure participants had continued access to supports.
The spokesperson said NDIS data showed the number of providers continued to grow and had increased by almost 58,000 in a year.
An occupational therapy practice has started transitioning away from the NDIS as pricing decisions make it more "unsustainable" to provide services.
The National Disability Insurance Agency's (NDIA) annual pricing review of the scheme has frozen the cost for occupational therapy sessions provided to NDIS participants for a seventh year and halved travel subsidies for allied health professionals.
Price caps for other allied health therapies have also changed.
Bryony Clark, an occupational therapist and co-director of Corrimal-based Facilitate OT alongside Carla Widloecher, said that while the fee payable for OT sessions had remained unchanged, business costs had gone up about 30 per cent and wages by about 25 per cent.
"It really is virtually unsustainable to remain working in the NDIS," Ms Clark said.
Ms Clark said the travel subsidy reduction meant it was not viable for the clinic to send out allied health assistants to see NDIS participants for certain therapies, because it no longer covered the cost of the service.
Travel subsidies were also important, she said, because OTs needed to assess people in their homes, workplaces and schools - not only for the best outcomes for the participants, but because it was required for NDIS accreditation.
A person with disability approved for an NDIS plan receives funding for appropriate supports, which can include therapies and services, as well as equipment.
Each year, the NDIA conducts a pricing review and sets limits for what providers can charge for therapies and services for NDIS participants.
From July 1, the cap for occupational therapy was again set at $193.99 per hour.
The limit for physiotherapy has dropped by $10 to $183.99 per hour, and for podiatry and dietetics by $5 to $188.99 per hour.
Psychology has increased by $10 to $232.99 an hour.
Therapists are now limited to billing travel time at 50 per cent of their hourly rate.
The NDIA says the new prices better match what people without an NDIS plan pay for these therapies.
When participants get a new plan, their funding will be set according to the revised rates.
National peak bodies for allied health professionals and health advocacy groups have called on the NDIA to review its pricing decision out of concern that the changes will force providers out of the NDIS and result in less support for participants.
Facilitate OT has 260 active NDIS participants on its books, but Ms Clark and Ms Widloecher have made the difficult decision to begin transition out of the NDIS due to what they say is the uncertainty and difficulty of working in the system.
"We've really soldiered on for a very long time, hoping things will get better, and not wanting to leave out participants without support," Ms Clark said.
They have already ceased outreach driving assessments, which evaluate an NDIS participant's ability to drive and any modifications they might need, because of the travel fee changes.
An NDIA spokesperson said therapy supports represented a "significant" portion of NDIS funding, amounting to over $4 billion in payments each year.
"A comprehensive review of prices found NDIS participants were paying different prices to what other Australians pay for those therapies," the spokesperson said.
"We also heard from participants that excessive travel claims for therapy-related services drain participants' plans faster than expected and reducing the amount of support a participant could access."
The spokesperson said the new rule encouraged providers to schedule more effectively.
Ms Clark argued that there was a difference between the NDIS hourly rates and the subsidised rebate system under which Medicare and private health insurance operated, the latter of which providers could add a gap fee.
She also pointed to some government schemes (which the NDIA considered in its review) that paid higher rates than the NDIS for occupational therapy.
Ms Clark fears a loss of support for NDIS participants will cost the health system, as individuals will need more intensive care down the line, and impose a social cost as carers shoulder a heavier load in lieu of allied health therapies.
The NDIA has said it would monitor markets to ensure participants had continued access to supports.
The spokesperson said NDIS data showed the number of providers continued to grow and had increased by almost 58,000 in a year.
An occupational therapy practice has started transitioning away from the NDIS as pricing decisions make it more "unsustainable" to provide services.
The National Disability Insurance Agency's (NDIA) annual pricing review of the scheme has frozen the cost for occupational therapy sessions provided to NDIS participants for a seventh year and halved travel subsidies for allied health professionals.
Price caps for other allied health therapies have also changed.
Bryony Clark, an occupational therapist and co-director of Corrimal-based Facilitate OT alongside Carla Widloecher, said that while the fee payable for OT sessions had remained unchanged, business costs had gone up about 30 per cent and wages by about 25 per cent.
"It really is virtually unsustainable to remain working in the NDIS," Ms Clark said.
Ms Clark said the travel subsidy reduction meant it was not viable for the clinic to send out allied health assistants to see NDIS participants for certain therapies, because it no longer covered the cost of the service.
Travel subsidies were also important, she said, because OTs needed to assess people in their homes, workplaces and schools - not only for the best outcomes for the participants, but because it was required for NDIS accreditation.
A person with disability approved for an NDIS plan receives funding for appropriate supports, which can include therapies and services, as well as equipment.
Each year, the NDIA conducts a pricing review and sets limits for what providers can charge for therapies and services for NDIS participants.
From July 1, the cap for occupational therapy was again set at $193.99 per hour.
The limit for physiotherapy has dropped by $10 to $183.99 per hour, and for podiatry and dietetics by $5 to $188.99 per hour.
Psychology has increased by $10 to $232.99 an hour.
Therapists are now limited to billing travel time at 50 per cent of their hourly rate.
The NDIA says the new prices better match what people without an NDIS plan pay for these therapies.
When participants get a new plan, their funding will be set according to the revised rates.
National peak bodies for allied health professionals and health advocacy groups have called on the NDIA to review its pricing decision out of concern that the changes will force providers out of the NDIS and result in less support for participants.
Facilitate OT has 260 active NDIS participants on its books, but Ms Clark and Ms Widloecher have made the difficult decision to begin transition out of the NDIS due to what they say is the uncertainty and difficulty of working in the system.
"We've really soldiered on for a very long time, hoping things will get better, and not wanting to leave out participants without support," Ms Clark said.
They have already ceased outreach driving assessments, which evaluate an NDIS participant's ability to drive and any modifications they might need, because of the travel fee changes.
An NDIA spokesperson said therapy supports represented a "significant" portion of NDIS funding, amounting to over $4 billion in payments each year.
"A comprehensive review of prices found NDIS participants were paying different prices to what other Australians pay for those therapies," the spokesperson said.
"We also heard from participants that excessive travel claims for therapy-related services drain participants' plans faster than expected and reducing the amount of support a participant could access."
The spokesperson said the new rule encouraged providers to schedule more effectively.
Ms Clark argued that there was a difference between the NDIS hourly rates and the subsidised rebate system under which Medicare and private health insurance operated, the latter of which providers could add a gap fee.
She also pointed to some government schemes (which the NDIA considered in its review) that paid higher rates than the NDIS for occupational therapy.
Ms Clark fears a loss of support for NDIS participants will cost the health system, as individuals will need more intensive care down the line, and impose a social cost as carers shoulder a heavier load in lieu of allied health therapies.
The NDIA has said it would monitor markets to ensure participants had continued access to supports.
The spokesperson said NDIS data showed the number of providers continued to grow and had increased by almost 58,000 in a year.