Australia's National Disability Insurance Scheme (NDIS) is one of the most ambitious social reforms in our history. But at a projected $46.2 billion annual spend in 2026,¹ the question is no longer whether we're spending enough, it's whether the money is reaching the people who need it.

The NDIS was built on a profound promise: that people with disabilities would have the funding, choice, and control to live the lives they want. More than a decade later, that promise has changed the lives of over 760,000 Australians.² It has meant a child accessing therapy can unlock their potential. A young adult can live independently for the first time. A family no longer has to carry everything alone. The NDIS, at its best, is one of the most humane things this country has ever built.

But at its worst, at the level of the systems, the claims, the payment rails, and the compliance machinery that sits between a participant and their support, it is letting those same people down. Quietly. Consistently. And at scale.

The scale of fraud within the NDIS is startling. In 2022, the Australian Criminal Intelligence Commission (ACIC) estimated that up to $6 billion annually was flowing to fraudulent or misused claims.³ Providers could register and begin claiming with limited verification, supports could be billed without evidence of delivery, and participant plans worth hundreds of thousands of dollars were managed with minimal oversight. The scheme had been built for access and scale. Integrity had not kept pace.

The government responded with force. The NDIS Fraud Fusion Taskforce (FFT) was established in 2022 in direct response to mounting evidence that the scheme's rapid expansion had created significant vulnerabilities, which led to leakage and fraud. This led to more than $550 million invested in integrity and compliance and over 800 specialists hired to detect and pursue fraud. ⁴

But even as enforcement intensified, the Australian National Audit Office (ANAO) found in its 2024–25 audit that the NDIA's (National Disability Insurance Agency) approach remains only "partly effective." ⁵ In 2026, the NDIS revealed up to 10 percent of claims were inappropriate or criminal, costing Australian taxpayers up to $5 billion a year. ⁶ The investment is significant. The problem is larger.

The failure points are consistent and well-documented. Duplicate claims where the same service is billed across multiple providers. Billing for services never delivered. Overcharging. Claims submitted against ineligible supports or expired participant plans.⁷ Each is individually a compliance problem. Collectively, they expose something that no amount of enforcement spending alone can fix: a payment model that was never designed to catch fraud before it happens.

NDIS payments are fundamentally retrospective. A service is delivered, a claim is submitted, the claim is processed, and funds are released. In theory, a reasonable sequence. In practice, it means compliance happens after money moves, not before.

To compensate, the system applies manual payment reviews to check all claims made by a provider or person before they are paid when there are concerns about misuse of NDIS funds, non-compliance, or fraud. ⁸ The scale of that problem is stark: in 2024, 53.7% of NDIS claims subject to manual pre-payment review were cancelled due to non-compliance by dollar value.⁹ That is over 265,000 claims daily that require manual review.

While these controls are warranted given that up to 10% of claims may be inappropriate or criminal,¹⁰ they carry an unavoidable cost: the stronger the controls, the slower legitimate payments flow.

When the NDIA processes 500,000 claims per day,¹¹ even a fraction of delays translates into thousands of providers absorbing cash flow gaps at any given moment. The result is a payment structure that is simultaneously too slow for the providers who depend on it and not fast enough at stopping the fraud it was redesigned to catch.

The consequences of an inefficient payment model are not contained within the NDIS's systems. They move through real organisations, real livelihoods, and real lives, and at every step, the people most vulnerable are the ones who feel it most.
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Providers: absorbing working capital strain

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For providers, the payment model creates a fundamental mismatch between when money goes out and when it comes back in. Staff are paid weekly. Operational costs fall monthly. But reimbursement arrives days later at best, and weeks later when claims are queried or rejected.

The State of the Disability Sector Report 2025 found nearly half of all NDIS providers operating at a loss, while others broke even or gained only a small surplus.¹² On margins as low as 2%,¹³ a single payment hold is not a cash flow inconvenience. It is a crisis.

Smaller providers feel this most acutely. They cannot draw on reserves or spread risk across multiple revenue streams. For them, a run of delayed claims is not an inconvenience, it is an existential threat. And when small providers exit the market, the participants who relied on them lose access to care that is rarely easy to replace.
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Carers and suppliers: downstream instability

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Behind every provider is a workforce already stretched to its limit. Disability support workers are among the most underpaid professionals in the country, caring for some of our most vulnerable citizens for wages that barely reflect the weight of that responsibility.¹⁴ When providers are absorbing payment delays, the first thing that gets cut is hours. The first people to feel it are the carers who depend on those hours to pay their own bills.

This is not an abstract workforce challenge. It is a person, often working multiple jobs, often carrying the emotional weight of deeply personal care, being told their shift has been reduced because the organisation they work for is still waiting on last month's claims. The NDIS workforce turnover rate already sits well above the national average.¹⁵ Financial instability within the provider sector is accelerating a crisis the scheme can ill afford.
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Participants: the ultimate impact

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And then there are the participants. The people the entire scheme was designed to serve. They do not see the payment holds or the rejected claims. What they experience is simpler and crueller than that: a phone call to say their regular support worker is no longer available. A waiting list that didn't exist six months ago. A service that has quietly stopped taking new referrals in their area.

For a child who has finally found a therapy routine that works, that disruption is not administrative. It is devastating. For an adult with complex needs who has spent months building trust with a support worker, losing that relationship is not an inconvenience. It is a setback that can take years to recover from. For a family already managing everything; the appointments, the advocacy, the exhaustion of navigating a system that was supposed to make their lives easier, it is one more thing they should never have had to carry.

The cruellest part of all of this is that the funding often exists. The plan is approved. The support is covered. It is not a lack of money that is failing these people. It is a payment system that cannot move that money reliably, quickly, or safely enough to make the promise of the NDIS real.

If the core issue is how money flows, the solution is not more compliance layered onto a broken sequence. It is rebuilding the payment infrastructure itself.

The current model asks one question after the money has already moved: was this claim legitimate?

A better model asks the question before the transaction clears. A pre-authorised, rule-based payment mechanism that embeds policy directly into transactions. Participant budgets are pre-configured. When a service is delivered, payment is initiated in real time and either approved or rejected instantly. Duplicates are blocked before they occur. Fraud is prevented, not detected.

The technology to do this already exists. It operates at scale across global payment networks every day. The question is not whether it can be built, it is why a $46.2 billion scheme is still processing half a million daily claims through infrastructure that was never designed to catch fraud before it happens.

The gains from real-time, pre-authorized payments are not speculative. They are the direct inverse of every documented failure in the current system.

Providers move from payment cycles measured in weeks to settlement at the point of service. The administrative burden of invoicing, claims submission, and reconciliation drops sharply when transactions validate themselves in real time. Staff time spent chasing payments becomes staff time spent delivering care.

On integrity, the shift is more fundamental. Fraud is not detected after funds have moved; it is prevented before they do. By moving the compliance to the point of transaction, the window that fraud depends on disappears and the $5 billion annual leakage in the NDIS shrinks.

Most importantly, this enhances participant outcomes. This shift permits faster, more reliable access to the supports participants’ plans already fund. Not because more money has been allocated but because the money that exists finally flows without friction.