Update to NDIS Code of Conduct and Price Differentiation Rules

Acacia Plan Management NDIS price differentiation
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If you are an NDIS participant, you may have encountered instances where you’ve been quoted for a good or service related to your disability that seemed higher than ‘normal’.  This isn’t an unusual practice.  The NDIS called this ‘price differentiation’ or a ‘twin pricing regime’. It is when a provider charges a participant a higher price than they charge a person who’s not in the NDIS.

Australia’s Competition and Consumer Act makes it illegal for a business to engage in unfair pricing. Therefore the NDIS Quality and Safeguards Commission has announced a focus on these pricing practices making providers accountable under new rules announced at the end of 2023.  A new rule added to the NDIS Code of Conduct states that an NDIA participant must not be charged more for the supply of goods than a non-NDIS participant without a reasonable justification.

New rules apply to goods not services

It is important to note that this update relates specifically to goods and not services, for example the purchase of a wheelchair.  That being said, services are not an exception to this new rule.  In the guidance provided by the NDIS Commission they explain that providers of services should not without ‘reasonable justification’ charge more to NDIS participants than other customers. If they do so it may be deemed as failing to meet the principle of acting with honesty, integrity and transparency.

At this stage, while the Commission has not extended its rules beyond products, it has indicated further considerations are likely to be made in the future, including services such as allied health or in-home supports.

It is important to note that services for some people with disability have more complex requirements than other users and therefore providers may attach a higher price to servicing people with more extensive needs.

What are the new pricing rules?

1. Providers must not charge a higher price for goods to an NDIS participant than to a person who is not an NDIS participant.
2. Providers cannot advertise or tell others they charge a higher price to NDIS participants.

How can a participant avoid this happening to them?

If you require a product or service to be funded by your NDIS plan, you are encouraged to gain several quotes from different providers.  It is common practice in life to seek a minimum of three quotes to help you compare prices and inclusions to determine which is the best value for money.

This can often be more difficult to do with services, because unlike comparing two identical products, there are a many variables at play including the provider’s experience, location, service offering and whether they’re a good fit for you.  All these factors may impact a purchasing decision and may justify charging a higher price.

What happens if a provider does charge the participant more?

The Commission are clear in stating that if a price difference cannot be justified, it may breach the Code of Conduct and be considered a ‘sharp practice’. the consequences may include compliance action such as:

  • Referral to the fraud fusion taskforce, if the conduct appears to be fraudulent
  • Unscheduled site visits
  • Issuing compliance notices
  • Requiring providers to enter into court enforceable undertakings
  • Issuing infringement notices
  • Varying, suspending or revoking registration
  • Issuing banning orders
  • Commencing court proceedings, seeking civil penalties and injunctions

To learn more about the updated NDIS price differentiation rules, click here.