Blank cheques. The problem and the fix for the NDIS

Billions of dollars are spent without oversight on capital items such as assistive technology, home renovations and vehicle upgrades for NDIS customers. Claudia Weisenberger reports.

A podiatrist has just completed the evaluation. The patient is an NDIS participant who requires custom orthotics. Over the next few minutes the same podiatrist will prepare a quote, set the price and submit it to the NDIA for approval.

There are no published criteria for what these orthotics should cost. The NDIA will approve the proposal without independent verification and the participant’s plan budget will cover the full cost.

As one support coordinator said ABC’s Four Corners“It’s actually very easy to overcharge… No one verifies that the actual work is being done.”

Limited budget, endless spending

An NDIS client has a limited budget. If an overpriced pair of orthotics consumes a disproportionate share of a participant’s Capital Support allocation, there may be nothing left over for that wheelchair assessment, home change or communication device they need.

Excessive pricing is invisible to the participant, but its consequences are not.

This is not a rogue operator. This is a structural feature of the NDIS Capital Supports budget, a category that covers specialist disability equipment, home modifications and vehicle adaptations for approximately 274,000 Australians annually, representing 36% of all NDIS participants. From now on, it is not fraud. It is a system that works exactly as designed.

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NDIS funds provide support across three budget categories.

• Basic Supports It covers the daily assistance needed by participants (disability support workers, social and community participation, transportation and supplies).

• Capacity Building Supports Includes therapy, support coordination, behavioral support and plan management.

For both the Basic Support and Capacity Building categories, the government publishes strict annual price caps. A physical therapist cannot charge more than $183.99 per hour. A disability support worker cannot exceed $70.23 per hour on weekdays. These are precise boundaries that are publicly available and independently reviewed.

• Capital Supports – covering assistive technology, home modifications, and vehicle modifications – has no equivalent. There is no price limit. There is no published reference price. A provider sends a quote; The NDIA assesses this against a ‘reasonable and necessary’ standard; and the offer was approved. The provider’s own figure is the only reference point in the transaction.

Capital Supports has none of these guardrails.

The mechanism is the same regardless of whether the item is a pair of orthotics, a power wheelchair, a bathroom modification, or a vehicle adaptation. Seven steps, no published benchmarks, no independent cost verification at any stage:

Overpricing of assistive technology

Five structural features make overpricing of Capital Support invisible. The two most important reinforce each other.

The price difference continues because the two features of Capital Supports reinforce each other.

The first flaw is a conflict of interest built into the evaluation process. In some parts of the Assistive Technology industry (particularly in orthotic, prosthetic, and custom seating), the clinician who determines what a participant needs is routinely the same entity that provides it and profits from the transaction. The more expensive the prescription, the greater the demand.

NDIA’s 2025-26 Pricing Regulations added conflict of interest declaration requirement; This is a remarkable acknowledgment that the problem exists more than a decade after the scheme was launched.

The second flaw strengthens the first. The participant’s plan budget covers the entire cost; Nothing comes from your own pocket. Without a personal financial interest in the transaction, most participants have no practical way of knowing whether the price is fair or whether a benchmark exists to tell them so.

Each defect would be manageable on its own. They are not together; because the only party that can object has no reason to object, and the only party that can control has no criteria to control.

Scale of the problem

according to Australian Institute of Health and Welfare36% of NDIS participants (approximately 274,000 Australians) received assistive technology support in 2024-25. When home renovations and vehicle renovations are added, the number of Capital Support recipients becomes even higher. Across the category, the NDIS spends around $2 billion a year.

The NDIA’s Chief Integrity Officer confirmed: Parliamentary inquiry in May 2026 There is no statistically valid way to measure how much of the leak in the system is due to fraud. The problem goes further in terms of Capital Supports; Structural overpricing is legal and produces no fraud statistics. Money gets lost in the gap between what things cost and what providers charge.

Without a published reference price, no one can calculate how wide this difference is.

The NDIS does not publish detailed spending data on Capital Supports at item level. Without this, neither the NDIA nor independent analysts can calculate how wide the gap between market cost and actual claims actually is. The first step towards a reference pricing framework is not to create a framework, but to publish data that shows how urgently it is needed.

Correction

The solution is simple in principle: a published reference pricing framework for Capital Support items created from market data, updated annually and integrated into the NDIA’s advance payment claims process.

New Zealand’s disability support system publishes reference prices for disability equipment and home improvements, giving the regulator an independent basis for assessing the reasonableness of a quoted price before payment is made. Australia’s NDIS has failed to build anything equivalent after thirteen years and a plan estimated to cost $54 billion in 2026-27.

There is no published cost database for custom orthotics, power wheelchairs, bathroom modifications, or vehicle adaptations. The provider’s bid remains the only reference point available to the NDIA for approaching $2 billion in annual spend. Until these changes are made, it will remain impossible to measure and close the gap between the cost of Capital Support items and what the NDIA pays for them.

NDIA knows this. Productivity Commission defined it. Parliament was informed about this. Comparative infrastructure was never built.

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Claudia Weisenberger is a management consultant with deep experience in pharmaceutical, hospital transformations and strategic due diligence on four continents. It combines keen analysis with hands-on application.