Home Care Packages pricing audit: compliance with pricing changes

Introduction

We do audits to check if providers understand and comply with their governance, financial and prudential responsibilities.

Audits identify opportunities for us to help providers meet their responsibilities.

This audit checked home care providers’ compliance with changes made to pricing rules for Home Care Packages.

This report shares our findings from the audit. 

Background

Providers of home services must comply with:

• Aged Care Act1997 Section 56-2
• User Rights Principles 2014Part 3, Division 3B

When requested by the Commission, providers must provide specific information on how they manage fees and charging. 

On 1 January 2023, the Aged Care Act was updated to make pricing for Home Care Packages fair and transparent. Changes included capping fees for administration and management.

To check if providers are complying with the new pricing requirements, we audited 54 home care providers across Australia. The audit ran from November 2023 to June 2024.

We asked providers to share documents for us to review, including:

• Home Care Agreements
• pricing fees and schedules (including changes)
• information for people receiving care
• care plans
• information from My Aged Care website
• budgets for people receiving care
• monthly financial statements
• governance processes and policies
• general communications.

The audit helped us identify compliance risks and support providers to understand and meet their responsibilities.

Our approach

The way we respond to any risks to compliance that we find depends on the level of risk for older people. We explain this in our Compliance and Enforcement Policy.

We expect providers to reduce risks and show that they comply. Providers who don’t manage risks or show how they will address them may face enforcement actions. 

Our findings

The audit found that most providers complied with the new pricing rules. This meant that they were charging older people correctly.

We found some non-compliance, such as charging above the pricing cap. In these cases, we worked with the provider to give refunds to people receiving care and improve their systems to stop this happening again.

We found some gaps in providers’ knowledge and errors in administration. In these cases, we provided support and training. This helped providers understand their pricing responsibilities and what strong governance and best practice look like.

Things for you to consider

Pricing

1. Make sure pricing information on the My Aged Care website is correct, up to date and matches the information on your website.
2. Make sure fees are clearly communicated and there are no hidden charges, so people understand what they’re paying for.
3. Respond to feedback from us and other regulatory bodies on pricing practices.
4. Adjust prices as subsidies increase but avoid unnecessary high charges.
5. Refund any money you owe to people quickly. This is fair, supports trust and positive relationships, and shows that you want to be transparent. It can also help avoid disputes.

Governance

1. Make sure information on the My Aged Care website matches your documents, such as pricing schedules and handbooks for people who use your aged care services.
2. Regularly check and update pricing to comply with the Aged Care Act and User Rights Principles.
3. Keep detailed records of pricing decisions for future audits.
4. Provide regular training for staff on the pricing rules, the rights of older people and best practice.
5. Set specific staff responsibilities for managing compliance.

Communicate with people receiving care

1. Provide clear, consistent and up to date information on fees so people understand what they’re paying for.
2. Explain what each fee is for and how you calculated it.
3. Provide information so people understand their rights under the new rules.
4. Make it easy for people to give you feedback and raise concerns.

Commission actions

1. We will provide extra information and resources to help providers understand the pricing requirements.
2. We will use findings from our audits to better identify and respond to compliance risks.

More information

• Targeted Review and Audits Webpage
• Pricing for Home Care Packages
• Home Services Pricing and agreements – Navigating changes the right way guidance document
• Home Care Program – Inclusions and Exclusions (FAQ)
• Home Care Manual

Contact us

If you have any questions or feedback, email us at F&P.reviews&audits@agedcarequality.gov.au 

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