I am putting this here because I feel like this is impacting both providers and participants in very different ways. Someone posted this article in Reddit and it was an interesting read.
I myself have been impacted by payment locks as a provider. I know many who have in different ways. Mine lasted 8 weeks. I submitted the requested documents a week after the lock because that is the week NDIA finally contacted me to provide them. In the 7 weeks that followed I had no communication or feedback despite reaching out and in the 8th week I was just suddenly paid. No more lock.
There are many reasons locks are applied:
- Some are triggered by complaints made against the provider.
- Some are triggered by a sudden increase in budget use.
- Some are triggered because a participant has had suspicious activity flagged causing their previous provider to be put under payment lock and did not wait for that to be resolved before engaging another provider who was then also put under payment lock.
- Some are triggered by the plan manager being investigated.
- Some are completely random.
The common theme is a serious lack of communication from NDIA, except them releasing a statement that businesses should be holding enough savings in reserve to cover costs until payment locks are released. But the payment locks are lasting anywhere from 1 week to indefinitely. I know two providers who have now shut up shop and have still not been paid from last year. The bigger issue is that the locks don’t just affect the invoice in question, they lock all currently pending and future submitted invoices too.
The impact this is having on the industry is a reduction in providers, especially larger providers, who simply could not financially survive the wait. One of the main impacts it is having on participants is that they are losing supports because most businesses have a “no pay, no work policy”. This policy is actually against the code of conduct because the code says providers can’t abandon participants without supports and without helping them transition to someone else. This isn’t really feasible or reasonable when you have no money to pay staff. Last financial year 49% of providers ran at a loss so the expectation of savings to cover the costs during these periods is an interesting one.
NDIA maintains the stance that this action is reasonable and necessary to weed out “bad providers”. They have been using the tactic far more since last years legislation changes. It is having the biggest impact on registered providers handling complex and high needs participants as their invoices can run easily into the thousands every week. It is also heavily affecting new, small independents who don’t have secondary income sources to rely on.
Prior to the legislation changes getting out of payment lock was relatively easy. You were notified there was a lock, you provided the relevant documents. NDIA said thank you and released the lock. You only ran into trouble if an investigation of allegations was required, if you didn’t have the relevant documents or if you had actually done something wrong. And people were found doing the wrong thing. Not always deliberately, but the NDIA is always clear that ignorance is not an excuse. Falling afoul of the code of conduct is pretty easy if you have not read and understood it, the sharp practices policies can be confusing and too many people trying to run NDIS businesses lack business skills or technical knowledge or both. Depending on the issue, NDIA would give the majority of people the opportunity to correct their mistakes and keep operating.
Since the changes, there does not seem to be a hard and fast rule about what is needed to get out of payment locks, the lack of communication and lack of resolution in a timely manner are having huge impacts, and the choice and control of participants when it comes to who their provider will be is being reduced.
The more interesting thing about this is that complaints to the government appear to be falling on deaf ears. You get referred back to the NDIA. As you can see from the article it is at a point where providers are now suing the NDIA for payment with mixed results. It will be interesting to see how it all plays out.
Has anyone else in the forum been impacted by payment locks as a provider or participant?