ProcureSure’s Post

A disability provider has been accused of billing $1 million in fraudulent #ndis claims in a month, using coercive tactics to facilitate the #claims through legitimate NDIS participants and a network of 50 separate ABNs to charge for fake services. Former boss of the Australian Criminal Intelligence Commission, Michael Phelan APM, starts work as the interim NDIS Quality and Safeguards Commissioner on Tuesday and he has previously estimated #fraud in the NDIS could be as much as 20 per cent - more than $8 billion a year. National Disability Insurance Agency Sophisticated supplier and payment profiling, combined with a unique database of suppliers and unmatched fraudulent #kyb indicators are the only way to provide early warning identification and prevention of these types of losses. If you're not keeping an eye on the transactions, how much fraud do you think is happening in your business? #accountspayable #accountsreceivable #embezzlement #supplierfraud #supplierrisk #invoicefraud #invoiceprocessing #collusion #corruption #scam #paymentfraud #healthindustry #healthinsurance #falsebilling #claimsmanagement #claimsfraud #ndisprovider #cfo #financialcontrol #localgovernment #federalgovernment #stategovernment

Great to see Minister Bill Shorten discussing the ongoing consultation with the disability community for a smooth system transition. Is certainly has been a long time coming! The National Disability Insurance Agency (NDIA) has just allocated $83.9 million in new funding for IT systems aimed at fraud detection, claims assessment, and identity proofing within the "Crack Down on Fraud" program. The changes align with recommendations from an independent NDIS review, signaling a very positive step toward improved digital systems. #allyourchecksononeplatform #ndisapproved #nds #vetting #antifraud #idverification https://lnkd.in/gUwDcWst

Open-Source Intelligence tools are a valuable asset to any insurance company’s fraud division - as the winner of the Irish International Christmas Tree Throwing Championship found out when she lost a $800k lawsuit after pictures of her were found online of the [impressive] winning toss of a 5-foot spruce. The Federal Bureau of Investigation (FBI) pegs “the total cost of insurance fraud (non-health insurance) is estimated to be more than $40 billion per year. That means Insurance Fraud costs the average U.S. family between $400 and $700 per year in the form of increased premiums.” Talk to us to find out how you can use OSINT effectively in your investigations: contact@shadowdragon.io #OSINTforGood Association of Certified Fraud Examiners (ACFE) Insurance Fraud Enforcement Department Allianz Partners State Farm MetLife Travelers Allstate Progressive Insurance Nationwide #InsuranceFraud #Fraud #Fraudinvestigations #investigations New York Post https://lnkd.in/gABGaBRN

I am sick and tired of people ripping off NDIS participants. I'm pleased to announce we've set up a new taskforce to crackdown on unfair price hikes and overcharging for National Disability Insurance Scheme (NDIS) participants. The new taskforce is now operational, and it's part of a broader plan to close loopholes and defend the NDIS. I've worked together with the Assistant Minister for Competition, Charities, and Treasury, Andrew Leigh MP, to set up the taskforce. The ACCC will chair the taskforce, together with the NDIS Commission and the NDIA. The NDIS Commission will tackle illegal overcharging of NDIS participants. The ACCC will focus on investigating and clamping down on misleading conduct, unfair contract terms and anti-competitive agreements that might impact NDIS participants, while supporting the taskforce’s work. The Albanese Government increased funding to the ACCC last year, announcing $6.7 million dollars to be invested over four years. This will ensure that they can support the NDIS Commission, as well as investigate and act against dodgy providers who make false or misleading representations about their products or services. Those found in breach of this federal law could face severe action imposed by the NDIS Commission. Penalties include permanent banning, infringement and compliance notices, civil financial penalties and/or injunctions imposed and, where fraud is suspected, urgent referral to the fraud fusion taskforce for criminal sanctions against the provider found guilty of rip-offs.

We'll get this out of the way first: The NDIS is deeply flawed. But it is one of the best things our country has done to take steps towards inclusion. I don't know how diverse the disabled workforce is inside the NDIS contributing and being heard. Without the NDIS anyone with a disability is at a participation disadvantage. Before its implementation we had to pay for our own mobility aids, vehicle modifications (which can easily exceed $100k), support workers, etc. Now contrast that with the fact that people with disabilities typically have a harder time getting hired in higher paying jobs because we can't afford the supports we need to escape our circumstances. There was this MASSIVE barrier to societal participation. There are still many barriers: I live in regional NSW because it was the place I could afford to build a house with the necessary disability features for my independence. (Note: The NDIS only contributed to the installation of some handrails in the bathroom. I didn't get a free house.) I CANNOT move to a city so I can comply with your 3 days in the office policy. I'm a disabled millenial who grew up on the internet: I do my best work remotely. I even met my partner of 14 years online 😉 The NDIS has helped me participate in the world according to my needs and goals and has made it possible for me to do things I never would have been able to do. So yes, the NDIS is flawed, it's bleeding money, the corrupt exploitation of people with disabilities has a new shape in the providers ripping it off. But please don't think for a second that it hasn't helped or that it's a failure and needs to be scrapped for something else. We need this, maybe bring our voices in and let us help?

Bill Shorten Please don't lose sight of the good providers who have to struggle every day just to get paid for legitimate supports they have provided. While it is long overdue that the rorts are stopped, every single day we have to battle the NDIA to have our participants funding match their legitimate support needs, dealing with bureacrats who clearly have no understanding of disability at all and who are following opaque policy directives that are more secretive than the KGB. The number of times I have been told they don't even understand is scary. I have now surpassed $300,000 personally funding our participants supports because their plans do not cover their basic needs. We provide them because without the support our participants would be homeless, in pain or traumatised by unnecessary hospital admissions. We also still see the discriminatory practice of pushing people into institutional nursing home aged care as soon as they hit 65 simply because it is a "cheaper option". Unfortunately, the serious problems in the NDIS are not limited to rorts. #ndis Dementia Australia COTA Australia Older Persons Advocacy Network NDIS Quality and Safeguards Commission National Disability Insurance Agency

Snippet 39 What is Gender Based Violence? More than you think!!! NOT INTENDED HARM. JUST STIPULATING THE CIRCUMSTANCES IN WHICH INSURERS W I L L N O T P A Y Y O U R V A L I D C L A I M How, Mister Director, do you justify this? and the WOMEN DIRECTORS... HOW... Discovery Limited Altrisk Hollard Insurance Discovery Limited United Nations Financial Ombudsman Service Adrian Gore Lee Holmes Hollard Insurance Altrisk Gerald Diepeveen CA(SA) Willie Lategan Dirk Viljoen Nash Omar Besa Ruele Pravin Kalpage Mari Janzen Masafumi Mayumi Hazel Chimhandamba (MBA) Financial Ombudsman Service How did you / or do you / protect the women and mothers of our Nation? And the OMBUD, because of fantastic legal representation on the companies' part found AGAINST a claimant who is too sick to fight back. What is the UN definition of GBV? The United Nations defines violence against women as "any act of gender-based violence that results in, or is likely to result in, physical, sexual, or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life." Definition of arbitrary detention: The notion of 'arbitrary' includes both the requirement that a particular form of deprivation of liberty is taken in accordance with the applicable law and procedure and that it is proportional to the aim sought, reasonable and necessary. Also means where a woman is being deprived of her right to: a. Withhold a disability / terminal illness pay-out;- b. and then…. WAIT FOR IT after YOUR REPUDIATION OF A VALID CLAIM FOR ILLNESS/ DISABILITY, which she was ASSURED / Insured AGAINST, strip her from the right to earn an income;- c. How, Human Rights Organizations is this right;- d.National Prosecuting Authority. So it’s a double whammy. 1. Disabled cannot work EVER AGAIN;- 2. Repudiation of VALID CLAIM. One lady was purportedly told: ‘Take us to the Ombud and see how far you get ….’ and “take us to court ?” ha-ha “you don’t have the money…” Another claimant who suffers from TBI, PTSD, CROHNS and FIBROMYLGIA,was told : " you are the one person I will never pay.." Hein Human Shane Chatz aboutfear #discoveryshinannigans #discoverylife #discoveryholdings #disabilitypolicy #reputationcancellation #heinhuman #headoflegaldiscoverylife #adriangore #nodutyofcare #negligence #leeholmes #barryschwartzberg #shanechatz #woutersnyman #insuranceindustry #lifeinsurancebrokers #libertylife #brokarage #investments #throwthebrokerunderthebus #ombudsmanforlongterminsurance #hermanbosman #sollykrok #kabelokhumalo #hollard #altrisk

NDIS participants affected by unfair price hikes can now report such instances to a newly established taskforce. The taskforce will be chaired by the Australian Competition and Consumer Commission, together with the NDIS Quality and Safeguards Commission and the National Disability Insurance Agency. NDIS participants, along with their carers, guardians, and nominees, will receive a letter explaining their rights and how to counter the NDIS ‘wedding tax’ (where prices are increased just because someone is on the NDIS). NDIS minister Bill Shorten said this taskforce is part of a larger strategy to eliminate loopholes and protect the NDIS. “Charging you more just because you are simply an NDIS participant is wrong and it is a breach of federal law. We have upgraded the NDIS rules to make it clear overcharging is prohibited and we have further legal changes coming to more strongly prohibit and punish such practices.” Those found in breach of this federal law could face severe action imposed by the NDIS Commission. Penalties include permanent banning, infringement and compliance notices, civil financial penalties and/or injunctions imposed and, where fraud is suspected, urgent referral to the fraud fusion taskforce for criminal sanctions against the provider found guilty of rip-offs. ------ I am one of only a few Australian accountants who understands the unique position of the disability sector and its complex regulations. DM me if you need help with bookkeeping, accounting, tax or business advisory services. #ndis #ndisaccountant #ndistaskforce

Further grasping at low hanging fruit from a minister who is more interested in posturing than addressing real issues. The NDIA themselves are a far bigger problem financially than people taking advantage of the system and they take from the sector far more than the sector take from them, so how about we look at that? Of course the rorters should be penalised but enough window dressing minister. How about some meaningful action.

The current dialogue surrounding the NDIS and its management has brought to light several critical issues that demand attention and resolution. While it's crucial to address fraudulent activities and maintain accountability, it's equally important to acknowledge and appreciate the significant contributions of ethical providers within the system. Many providers feel sidelined and unheard, as positive stories about their work are often overshadowed by negative narratives. It's time for a more balanced approach—one that not only addresses misconduct but also highlights the exemplary work done by the majority of providers who uphold ethical standards and strive for the well-being of participants. Moreover, the ongoing expectation for providers to operate at a loss in order to support participants effectively turns them into de facto government funding subsidies for the NDIS scheme. It's high time that providers receive significant financial considerations for the extraordinary efforts they have made to sustain the scheme and ensure adequate support for participants, often at their own financial risk. However, this cannot continue indefinitely. Proper funding is essential to maintain sustainability and fairness within the system. Additionally, there must be an end to allowing unregistered service provisions, as this undermines the compliance efforts required for registered providers, rendering them redundant. The challenges faced by providers, such as inadequate funding, operational hurdles, and the need for more expertise within the sector, require a comprehensive and collaborative strategy. The focus should shift towards fostering a sustainable and supportive environment that benefits both providers and participants. As we navigate these complexities, it's essential for policymakers (Bill Shorten & Team) and stakeholders to engage in constructive dialogue, listen to the concerns of those directly involved in the system, and work together towards meaningful reforms that prioritise quality care, ethical practices, and the well-being of all NDIS participants and providers. #ProperFundingForProviders #EndUnregisteredServices #FairNDISSupport