NDIS Legislation Changes: Approved vs. Non-Approved NDIS Supports
General
Can I use my funding to pay for something on the non-approved list if I think it is reasonable and necessary?
No, participants are unable to claim supports from the non-approved supports list unless:
- It is a replacement support (please note, this has a set process to follow)
Or
- It is funded in your current plan or supported by a letter from the Administrative Review Tribunal (ART).
Or
- You receive written permission from the NDIA to allow the purchase of the non-approved item.
What is a replacement support?
In some situations, the NDIA will approve the claim of a replacement support. This has set criteria, and only a few things are able to be claimed as a replacement support.
The NDIA has a formal process to request a replacement support. You can learn more about replacement supports on the NDIA website.
How can I ask for written permission to claim a non-approved support?
This request needs to be sent to the NDIA. You can contact the NDIA through:
- Your MyNDIS contact or planner (written on your NDIS plan)
- Email to enquiries@ndis.gov.au
If the NDIA or planner told me on the phone it was okay, can I purchase the item?
No, unfortunately, the NDIA has confirmed that written authorisation or approval is required to support the claim of items that are no longer approved.
We cannot process the claim until your plan manager receives written approval from the NDIS. This is to make sure that you are not asked to pay money back to the NDIS or face other compliance action.
My support coordinator, or provider has written a support letter for this non-approved item; can I purchase it?
Unfortunately, letters of support from providers, even therapists, is not sufficient evidence to claim the item through NDIS funding.
The NDIA or planner told me that my plan manager can decide if it is okay to be claimed. Why won’t you process the claim?
Plan managers are not able to approve a non-approved support claim.
This is because these supports are not available from NDIS funding, and claiming the invoice can put the plan management organisation and the participant at risk of being asked to pay the money back.
What happens if a non-approved support is claimed?
The NDIA is increasing their audits on invoices, and it is becoming more common for claims to be checked. If your invoice is checked and the NDIA decides it is not an appropriate use of NDIS funding, they can take compliance action.
This can include:
- Cancelling your claims before the money is sent to the provider.
- Asking you to pay the money back.
- Changing how your plan is managed (i.e. making your funding NDIA managed).
My plan manager has claimed this before; why not now?
The changes to the legislation are continuously being updated, and all providers, including plan managers, are working to update our systems and processes as quickly as we can.
This means that there may be times a plan manager needs to ask you or your providers for clarification.
As the NDIA shares more information about updates, P2P will do our best to continue to provide you with updates about supports that the NDIS no longer funds.
If you would like to read more about the changes, the NDIA is regularly publishing new information on their frequently asked questions page
What if a support is not listed in my plan?
The NDIS is releasing updates to the plan document format to provide more detailed information for participants about what has been funded in your NDIS plan.
You may be asked for a copy of the plan, or a new copy to allow your plan manager to review the supports and make sure that purchases are in line with your budget.
Short-term Accommodation
Have there been changes to the rules around Short-Term Accommodation (STA)?
Yes, new information about STA was published in late November 2024. New operational guidelines are expected to be published in early December 2024.
STA allows participants to stay away from their homes and informal supports for a short time. It can be funded for up to 14 days at a time to a maximum of 28 days per calendar year.
STA funding can be used for assistance with self-care or community access and short-term accommodation. It cannot be used to pay for day-to-day living costs such as food and groceries, lifestyle costs or travel.
Can everyone access 1 on 1 STA?
Some participants are funded for STA in a group only. For more information you can speak with your NDIS planner about what has been included.
Can I use STA if I live alone or in supported independent living (SIL)?
The NDIA has published more information regarding the use of STA for participants living alone or in SIL.
This shows that participants who live alone or in SIL are unable to use STA supports. This is because if a participant is living alone or in a supported independent living arrangement, they already have time apart from family and informal supports.
Can STA be used for holidays?
No. STA is not for holidays or tourist travel. It is designed to provide participants and their informal supports time apart.
If a participant requires support while on holiday, they can continue to use their usual non-STA supports from their NDIS plan for periods up to 6 weeks.
Community Support & Activities
My goal is to attend lessons/activities/groups, can the NDIS pay for my classes?
The general costs of your social and recreational activities are considered an everyday cost. This means you’ll pay for things like membership, basic equipment or entrance fees.
If you need extra help to participate in social and recreation activities because of your disability, the NDIS may be able to fund this.
This might include: support to attend and participate in the activities or some specialised equipment.
More information can be found in the Operational Guidelines for Social and recreational supports.
Can specialised equipment be claimed?
If you need modifications or specialised equipment to participate in an activity, the NDIS may be able to claim this.
Typically, if you are participating as a professional, for example competitive sports, this is not able to be claimed.
Therapy
What therapy supports can be claimed?
There are a number of therapy supports that can be claimed. This may depend on your plan and your funded supports.
Therapy should be delivered by professionals with an allied health registration and qualification.
A few examples of therapy supports that may be able to be claimed include: occupational therapy, speech therapy, physiotherapy, psychology etc.
What about other therapies that the NDIS does not include as ‘evidence based’?
The non-approved support list provides some examples of therapies that the NDIS believes are not evidence-based. These are not to be claimed.
A few examples include: animal therapy, cuddle therapy, hair therapy, yoga therapy etc.
Are art and music therapy NDIS supports?
The NDIS has determined that while art and music therapy remain allowed, there is insufficient evidence of the effectiveness of these therapies to improve disability-related function.
Participants may be able to access these supports, but not at the level previously allowed as a therapy support. More changes are expected to be released for these supports in February 2025.
Section 10
What are the changes to the NDIS legislation?
There are a number of changes to the NDIS Legislation.
These include:
- Changes to access and reassessments
- Changes to how plans are created and funded
- Changes to the supports that can and cannot be claimed
Most of these changes start from 3 October 2024, but some will start later or in early 2025.
What are the new definitions of NDIS supports (NDIS Support Lists)?
The NDIS has released new definitions of what is and is not and NDIS support. This is in the form of three lists.
- Approved NDIS supports
- Non-Approved NDIS supports
- Replacement Supports
You can find the lists and more information on the NDIS website here:
https://ourguidelines.ndis.gov.au/would-we-fund-it/what-does-ndis-fund
Participants will only be able to use their NDIS funds for items listed as approved or replacement supports.
What if a therapist or professional has recommended an item or support that is on the non-approved list?
Unfortunately, a recommendation from a therapist or other provider is not sufficient to allow a non-approved item to be claimed.
The support or item may be able to be purchased; however, this is unable to be claimed from your plan without permission from the NDIA in writing.
What about reasonable and necessary?
This criteria is still applicable, but this only applies to approved NDIS supports and replacement supports.
Even if you agree that a support meets the reasonable and necessary criteria, it cannot be on the list of non-approved supports to be able to be claimed.
How can I get advice from the NDIA?
You can speak with your NDIS planner if you are unsure of something. You can also chat with the NDIA online using this link https://www.ndis.gov.au/contact
There is also a lot of information available on the NDIS website including in Easy Read. https://ndis.gov.au/changes-ndis-legislation
What about supports that are currently funded in my plan?
If an item or support is funded and clearly listed in your plan budget, this may be able to be claimed until the plan is reviewed or replaced.
The support must be mentioned in the funding amounts or budget section. If your goal is around a certain support, it may still not be able to be claimed if it is not funded.
I have gone through an administrative appeals tribunal (AAT) process and had specific support funded, what about these items?
If you have had specific supports funded or approved through an AAT process, these can continue to be claimed unless this changes.
To help the plan management team, it would be appreciated if you can share this with us so that we can make a note of this in our records.
What are the approved and non-approved NDIS supports?
You can find the lists of approved and non-approved NDIS supports here: https://ourguidelines.ndis.gov.au/would-we-fund-it/what-does-ndis-fund
Each plan is different for all participants, so it is important to check with your planner to ensure that approved supports are funded in your plan.
What are the replacement supports?
In some specific situations, the NDIA may fund a support that is typically non-approved.
This is in two categories only:
- Smart devices
- Standard household items
There are criteria and a process that must be followed to allow these to be claimed and must be approved by the NDIS to allow this to go ahead. You can read more about replacement supports here: https://ourguidelines.ndis.gov.au/would-we-fund-it/what-does-ndis-fund