Helping Hands Residential Assisted Living and National Disability Insurance Agency

This matter concerned an application by Helping Hands Residential Assisted Living (Helping Hands) to the Administrative Appeals Tribunal (AAT) for review of a decision by the National Disability Insurance Agency (NDIA). The dispute arose from the NDIA's refusal to pay an invoice submitted by Helping Hands for emergency accommodation provided to a participant, Mr. Mitchell. Helping Hands contended that the accommodation was necessary due to Mr. Mitchell's risk of homelessness and that they had assumed the cost would be met under his National Disability Insurance Scheme (NDIS) plan. The NDIA rejected the invoice, stating that the participant's plan budget was consumed and the supports were not deemed reasonable and necessary, further noting that retrospective approval of supports outside the plan was not permissible.

The primary legal issue before the AAT was whether the NDIA's decision not to pay Helping Hands' invoice constituted a "reviewable decision" under the National Disability Insurance Scheme Act 2013 (Cth) (the Act), thereby conferring jurisdiction on the Tribunal to hear the application. A secondary consideration, though ultimately not determinative, was whether Helping Hands, as an unpaid provider, possessed standing to seek an internal review of the decision to approve the participant's statement of supports.

The Tribunal, constituted by K Bean M, reasoned that the Act specifies which decisions are reviewable by the Tribunal, as outlined in section 99. While decisions regarding the approval or variation of a participant's plan are reviewable, the Act does not extend reviewability to decisions not to pay a particular expense. Consequently, the NDIA's refusal to pay the invoice was not a reviewable decision under the Act. The Tribunal noted that while an unpaid provider might arguably have standing as a "person directly affected" by a funding decision, this point was unnecessary to resolve given the more fundamental jurisdictional issue.

For the reasons stated, the Tribunal concluded that it lacked jurisdiction to review the decision that was the subject of the application. Accordingly, the application was dismissed.