The new Short Notice Cancellation requirements

There was a lot to unpack in the July 2024 Pricing Arrangements and Price Limits (PAPL) update, so the major changes to Short Notice Cancellation (SNCs) rules slide under the radar a bit.

The NDIS rules around Short Notice Cancellations determine when a provider can bill for a service that’s cancelled, or the participant didn’t show up for.

Up until 1 July 2024, this period of time was 7 calendar days. Broadly, this rule aligned with the SCHADS Award, which requires employers to give workers advanced notice of a cancelled shift.

But those rules changed in the latest PAPL…for some services. Let’s take a closer look.

7 calendar days vs 2 clear business days

In this update, the new Short Notice Cancellation notice period was cut from 7 days down to 2 clear business days. But the kicker is that this new notice period doesn’t apply to all services.

The NDIA has made a distinction between services covered by the Disability Support Worker Cost Model (generally these are delivered by workers under the SCHADS Award) and all other services. The NDIA refers to these two approaches as DSW Cost Model Services and Non-DSW Cost Model Services. Typically, this is playing out as a split between Core supports which are usually under the DSW model, and Capacity Building supports which are not. Although there are a handful of exceptions.

Services covered by the Disability Support Worker Cost Model remain subject to the 7 days’ notice period. But all other services can now be cancelled up to 2 clear business days before without charge. The reasons for this were laid out pretty clearly by the NDIA:

The Annual Price Review Consultation Report stated that in the last three years, costs attributed to SNC claims have nearly doubled from around $60million to $120million.
Therapy supports and Early Childhood supports account for 37% of all Short Notice Cancellation claims.
Generally, these services have more providers entering the market each year, longer wait lists, more opportunities for redeployment and higher hourly rates (to absorb unexpected cancellations).

This means if a provider delivering a Non-DSW Cost Model Services (such as Support Coordination, therapy, specialist behavioural intervention support, dietician services, etc.) has a support scheduled for 9am on Thursday, then the participant can cancel anytime before close of business Monday without being charged a cancellation fee.

Calendar days vs business days

This change introduces a change in yardstick for DSW Cost Model Services and Non-DSW Cost Model Services: calendar days vs clear business days.

The 7-day notice period refers to ‘days’, meaning calendar days. Though confusingly, the NDIA actually once refers to ‘7 business days’ in the PAPL, but I'm 99% sure that’s just a typo (who let the work experience kid loose on the PAPL!) as in every other instance they reinforce calendar days.

However, for the Non-DSW Cost Model Services requirement is for 2 clear business days. Business days are 9am to 5pm, Monday to Friday in the state or territory where the service is being delivered. So providers delivering both DSW Cost Model Services and Non-DSW Cost Model Services will need to be alert to the different notice periods. And providers delivering in multiple states & territories that will have to be across different public holidays throughout the year.

We will ignore the irony of the NDIA using the word “clear” to make things significantly less clear. And the example scenarios in the PAPL only make things less clear.

Extra scrutiny on providers billing for SNCs

The NDIA has reminded providers that they will be monitoring claims for cancellations and “may contact providers who have…an unusual number of cancellations”. The NDIA has also reminded the sector of the existing rules about billing for SNCs. The PAPL states that a SNCs should only be claimed if:

The provider cannot find alternative billable work for the worker affected by the cancellation.
The provider is required to pay the worker for the time scheduled for the service.
SNCs terms have be agreed to by the participant and documented, like in a Service Agreement.
Providers have a duty of care to check in with participants who have an unusual number or frequency of cancellations.
SNCs must be claimed using the relevant ‘cancellation charge’ Claim Type in the Portal. For those providers using Bulk Upload Template, the Claim Type is Column N.

The logic follows that an average in-demand speech pathologist with a waiting list a mile long and lots of Non-Face-to-Face tasks can more easily find other billable work than a support worker with fewer tasks that can be picked up at the last minute. Providers should make sure they document all their attempts to find other billable work when a client cancels a service within the SNC notice periods, both for transparency and in case of an NDIS Payment Integrity Audit.

A provider always has the discretion to waive a SNC claim. If a participant was on their way to meet a worker and got hit by a bus, that provider might want to reconsider whether they add insult to serious injury by charging for a SNCs.

Anomalies

Make sure you don’t fall into the trap of thinking all Core supports are DSW Cost Model Services, and all Capacity Building supports are non-DSW Cost Model Services. There are some outliers that seem to fall outside the logic of the DSW Cost Model Services and Non-DSW Cost Model Services:

Psychosocial Recovery Coaching sits in the Support Coordination Support Category in Capacity Building. But is subject to the 7-day SNC. Recovery Coaching has always been based on the Cost Model, hence why the price cap has increased while Support Coordination (which isn’t covered by the Cost Model) has remained static.
Assistance with Personal Domestic Activities is in Core, and likely to be delivered by a Support Worker covered under the SCHADS Award but is covered by the 2 clear business days rule.
Community Engagement Assistance in Improved Daily Living (Capacity Building) is very likely to be delivered by a Support Worker covered by SCHADS but is subject to the 2 clear business days rule.

It’s hard to tell if these were reasoned decisions by the NDIA, or they just got so busy getting the PAPL out at 11am on the Friday before it came into effect on the Monday that they forgot about these items. So we’ll wait to see if they change in the future.

What providers need to do to ensure they are compliant

I’m surprised this change has slipped in with so little fanfare. It fundamentally changes many parts of a provider’s business, ranging from service design and budgeting through to Service Agreements and then billing & compliance. It’s going to take some getting used to, but there are a few things providers can do:

Review all Service Agreements to make sure they are reflective of the new rules.
Consider creating examples and case studies to help people understand the impact and requirements of the new rules.
Do an internal audit on the evidence collected to demonstrate the attempts made to find alternative billable work in the event of a cancellation. If you can’t find much evidence, then the NDIA Payment Integrity Team won’t be able to either and you may be subject to compliance action.
Make a list of all the tasks workers might be able to do to avoid having to charge an SNC.
Double and triple check your Industrial Relations obligations regarding re-arranging shifts, whether this is through the SCHADS Award or an Enterprise Bargaining Agreement.
If you have to charge a SNC but still want workers to do something productive, take a look at our elearning on-demand library. We have many modules covering the skills and knowledge frontline workers need to excel in the role.