‘It’s the Wild West’: Gift cards, free holidays and annual payments for NDIS referrals

National Disability Insurance Scheme providers are spruiking free interstate getaways and charging companies up to $3000 for lucrative referrals of disabled clients.

The revelations have prompted the watchdog overseeing the multibillion-dollar program to investigate the referral payments practice and warn providers against offering or accepting incentives.

Concerns have been raised about NDIS providers offering incentives to health practitioners to refer clients. Credit: Shutterstock

“Any provider practice that commodifies participants is not supported by the NDIS Commission or the NDIS code of conduct,” a spokeswoman from the NDIS Quality and Safeguards Commission said.

Speedy Care Health, an NDIS provider operating in Melbourne’s western suburbs, emailed health practitioners last month to advertise its new referral reward program.

“For each successful referral, you’ll receive a $20 voucher to redeem at your choice of Amazon, Starbucks, Myer, David Jones, Sephora, or Mecca,” the email read.

“When you refer five participants, we’ll offer you a free flight to either Sydney or the Gold Coast ... for 10 or more referrals, you’ll enjoy an all-expenses-paid weekend getaway, including flight and hotel accommodation in Sydney or the Gold Coast.”

A Speedy Care Health spokeswoman said the provider had successfully sought permission from the National Disability Insurance Agency, which implements the scheme, before promoting the inducements. An NDIA spokesman denied this, and said the agency had not approved the practice.

The spokesperson for Speedy Care Health said: “We understand that this may not align perfectly with the NDIA’s guidelines, though we made the offer using our own resources, with no direct involvement of participants or their funding.”

The spokesperson said Speedy Care was a relatively new business and its primary goal was to “build professional relationships and friendships”.

“While we would love to meet everyone in person for a coffee or lunch, the demands of running a business, along with marketing, advertising, and attending industry events can make this difficult,” the spokesperson said.

“The small gesture was our way of saying thank you and initiating a connection.”

Speedy Care Health said it had discontinued its offer following questions from this masthead and concerns from five recipients about the ethics of incentives. The provider said no one took up its offers.

Jacqui Brown, a psychologist who was forwarded the Speedy Care Health email from a concerned NDIS provider, said she was shocked by its contents.

“These are some of our most vulnerable community members,” Brown said. “I’m concerned that referral decisions could be based on incentives and the participant has no say.”

Brown, the director of registered NDIS provider Complex Psychology, said she received about three emails a day from NDIS providers wanting her to refer clients to them.

“Decisions are not being made about what is best for the client, but about profit and building a service,” she said.

Karista, a company that runs an online service that connects people with home care and disability services, was last year charging other NDIS providers annual fees of up to $3000 to access clients.

Reg Vitnell, the director of support provider Australian Carers, said he was concerned about Karista’s pricing structure for referrals.

A September 2023 email from Karista details how Australian Carers would have to pay an ongoing monthly subscription fee of at least $198 and then an annual fee for each client referred to it.

If Australian Carers provided up to four hours per week of core services to a client, it would have to pay an annual fee of $750 to Karista. It would have to pay $3000 a year for a client who received 20 hours per week of core services.

“They sell them off like it’s a cattle sale,” Vitnell said. “This is the Wild West.”

Vitnell said he had previously paid Karista a referral fee of between $100 and $400 per participant, but had refused to sign up to Karista’s new payment structure because it placed a dollar figure on participants based on how high their needs were.

NDIS Minister Bill Shorten is trying to rein in the scheme’s spending.Credit: Justin McManus

A spokeswoman for Karista said she was reluctant to respond to an anonymous complaint raising unarticulated concerns.

Megan Spindler-Smith, the deputy chief executive of advocate organisation People with Disability Australia, said inducements could create a conflict of interest and undermine participants’ choice and control.

“Decisions should be made by participants based on what’s best for them, and not by any sort of financial incentive that a provider may receive,” Spindler-Smith said.

Spindler-Smith called for greater transparency around referral fees so that participants could make an informed decision about the providers they signed up to.

An NDIS Quality and Safeguards Commission spokeswoman said this masthead’s inquiries had alerted the commission to the issue of referral payments for the first time.

“We will look into it more broadly to ensure that providers operating this kind of model are in full compliance with their obligations under the NDIS code of conduct, including acting with honesty, integrity and transparency,” she said.

“While we do not wish to discourage innovative ways of setting up and delivering important services, we acknowledge that there needs to be close oversight of new business models to ensure that NDIS participants are safe and receiving high quality supports and services.”

She said NDIS providers should not give, ask for, or accept any inducement or gift that impacts or might impact on the way supports or services are provided under the NDIS, including any referral arrangements with other providers.

The federal government is trying to rein in spending on the NDIS, as the scheme is on track to cost $100 billion a year by 2032 without changes.

This masthead revealed last week that the NDIS spent millions of dollars sending participants on African safaris, international cruises and other overseas holidays.

NDIS Minister Bill Shorten announced earlier this month that travel, sex therapy and drug services would be banned from the scheme, in an attempt to wind back annual growth in NDIS spending from 20 to 8 per cent.

Shorten said the scheme would also increase compliance checks.

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