This article is featured in ABC News and is republished with permission.
The success stories of the National Disability Insurance Scheme (NDIS) "are now at risk", health providers and regional clients warn, ahead of travel allowance payments being cut in half from next week.
Each fortnight, Tasmanian-based speech therapist Daniel Hommel makes the four-hour return trip from his Launceston office to visit client Callum Rawnsley at Scamander, on the state's east coast.
When Mr Rawnsley began therapy 18 months ago he could only say three sentences.
The 26-year-old, who has autism, had no expressive, spontaneous language and could only speak a learnt sequence of words said in a precise order.
His conversational partner would also have an exact set of responses to reply with.
If the script was not followed, Mr Rawnsley, would show behaviour escalation and distress.
Through regular access to speech pathology and by using an app on his phone that translates text to speech, Mr Rawnsley can now independently express what he needs.
"It's been wonderful to see what he's achieved, but these kinds of success stories are now at risk," Mr Hommel said.
Family worried of cuts 'because of your postcode'
The agency in charge of the NDIS released its annual pricing review earlier this month, revealing, among other changes, that from July 1 the travel subsidies for allied health professionals would be cut in half.
The National Disability Insurance Agency (NDIA) said the changes were needed to "encourage more efficient scheduling" by providers and to rein in travel costs that can drain clients' NDIS plans "faster than expected".
But Mr Hommel and other healthcare professionals have warned the cuts could make travelling to some clients in regional areas unviable.
"These NDIS cuts mean that we can't go and travel and see people like Callum anymore. And it's not just regional Tasmania, it's everywhere," Mr Hommel said.
Mr Rawnsley's mother, Karen, said the visits had been "life changing" but she was worried the cuts would put a stop to her son's progress.
"We would be devastated if that wasn't available, and all because of your postcode," Ms Rawnsley said.
"Callum's finally got a voice. Don't take that away from us."
NDIA 'failing Australia's most vulnerable'
Allied health industry bodies have launched an online petition that calls on the federal government to review the NDIA's pricing changes.
The petition — undersigned by the Australian Physiotherapy Association, Dietitians Australia, Australian Podiatry Association and Australian Psychological Society, among others — has more than 45,000 signatures.
It says the intended cuts will "make it financially unsustainable for many NDIS providers to deliver the complex, high-quality support participants need, especially in already under-served communities".
"The NDIA has a responsibility, and a moral obligation, to ensure it works to support, not obstruct, people with disability," the petition reads.
Peak industry bodies for healthcare professionals have said they were not consulted on this year's changes and the announcement had given them less than three weeks to adapt their business models to the new pricing rules.
NDIA says it's important participants pay 'fair' prices
The NDIA told the ABC it was "committed to improving access to NDIS support for Australians living in more regional and remote areas and is taking steps to address market gaps across Australia".
"These include working collaboratively with local communities in remote areas and focusing on a range of market interventions to improve participant access to the NDIS," a spokesperson said.
"The new NDIS price limit changes ensure NDIS participants, funded by Australian taxpayers, are not paying significantly higher rates for some services than those outside of the NDIS."
On its website, the NDIA said the latest adjustments to provider caps were informed by an annual pricing review to ensure the costs for NDIS participants were comparable with those for Australians receiving the same supports through Medicare or private health insurance.
"It's important that NDIS participants are paying prices that are fair and in line with industry standards. In some cases, NDIS price limits exceeded the market rate by up to 68 per cent," an NDIA spokesperson said.
"We heard from participants that excessive travel claims for therapy-related services are draining participants' plans faster than expected."
"The updated therapy travel claiming rules encourage more efficient scheduling by providers and provide clear cost expectations for participants to help them get better value from their funding."
The spokesperson said the price review recommended a cap on claimable travel rates and "some modest changes" to the hourly rate for some therapies.
The website states that therapy supports accounted for about 10 per cent of the total NDIS spend, with $2.4 billion in payments in the six months to December 2024. It counts nearly 413,000 participants.
The federal minister responsible for the NDIS, Mark Butler, told the ABC Radio National that the pricing determination was made independently by the NDIS board.
"It's one that I've analysed that I think is in the interests of participants themselves," Mr Butler said.
"But if there are representations in some areas about some of those consequences, of course I'll look at them closely."
Sessions for Tasmanian children at risk
Emerge Allied Health director and principal clinical psychologist Lyndsay Quarmby said the NDIA travel cuts "virtually makes [it] unsustainable for us to continue to provide outreach to communities that are in desperate need and have no access".
Dr Quarmby heads up a multidisciplinary team of more than 30 providers delivering intensive early intervention services to Tasmanian children and young people through access to psychology sessions, speech pathology, occupational therapy and physiotherapy.
About 420 children rely on the clinic's outreach services.
Dr Quarmby said she built her practice in line with NDIS guidelines to provide evidence-based care in the locations that work best for children and young people, which is "within their community and in their natural environments".
She said the cuts were "unbelievable" and "did not put people first".
"This completely undermines what we know the NDIS agree with around what is best practice in early intervention, and that they've got documented on their website," she said.
NDIA also removes some regional loadings
As part of the funding changes, the NDIA is moving to standardise provider costs, regardless of location.
It will mean a reduction to the hourly rates for some allied health services, including physiotherapy, dietetics, podiatry and psychology, which were part of the state and territory differentiated pricing arrangement.
Healthcare providers working in Tasmania, South Australia, Western Australia and the Northern Territory will be impacted.
Tasmanian healthcare provider St Giles said removing the rural loadings would threaten a workforce that already faced additional barriers.
It said the "triple whammy" of cuts would have a "catastrophic impact on provider sustainability and participant outcomes".
"Allied health providers are planning staffing reductions, site closures, ceasing community and school-based visits, and in many circumstances considering exiting the delivery of NDIS services entirely," a St Giles spokesperson said.
"Pricing changes are inevitable, but for the NDIA to simply cut the rate paid for these services without considering the impact on participants is simply irresponsible, if not reckless."
Tasmanian senator Jacqui Lambie said she had written to the federal and Tasmanian governments suggesting that they commit to supporting service providers "by establishing a pricing framework that accurately reflects the real costs of delivering community services".