Brokers advising employer clients on NSW workers compensation claims should check whether their referred service providers are subject to new regulatory action after the State Insurance Regulatory Authority (SIRA) issued direction notices to seven health and rehabilitation providers for billing non-compliance.
Six SIRA-approved workplace rehabilitation providers have been issued directions following investigations that identified non-compliance with invoicing requirements under the workers compensation scheme. The providers named are Actual Rehab Pty Ltd, Ability Group Pty Ltd (trading as Health Ability), Ipar Rehabilitation Pty Ltd, Platinum Rehabilitation Group Pty Ltd, Rehabilitation Services Pty Ltd, and Workplace O H & S Solutions Pty Ltd. Each received a direction under section 26D(1)(a) of the State Insurance and Care Governance Act 2015, requiring it to provide SIRA with invoicing data for rehabilitation services. The directions took effect on October 1, 2026, and remain in force until October 30, 2027, unless revoked by SIRA.
Separately, diagnostic imaging provider I-MED New South Wales Pty Ltd received a direction requiring it to provide invoices and evidence for reimbursement for all magnetic resonance imaging (MRI) services charged to the NSW Workers Compensation Scheme. That direction took effect on September 1, 2026, and remains in force until July 30, 2027.
Read more: SIRA action puts provider checks on brokers’ radar
The enforcement action matters beyond the individual providers because late billing distorts insurers’ estimates of outstanding claims liabilities, which in turn feeds into the premium calculations that brokers negotiate on behalf of employer clients. SIRA identified almost $175 million in delayed payments across NSW personal injury schemes, Insurance Business reported in April 2026.
SIRA said timely invoicing is important to “support transparency and oversight of scheme expenditure and reduce the risk of delayed, duplicate or inappropriate payments, which can increase scheme costs and make it more difficult to identify potential fraud or other non-compliance.”
The annual cost of health services within NSW personal injury schemes is now above $1.8 billion per year, according to the Health Provider Regulation Implementation Roadmap published by independent reviewer Sue Dawson in March 2026. Dawson, a former NSW Health Care Complaints Commissioner who was commissioned by SIRA to review health provider regulation in the state’s personal injury schemes, recommended a new regulatory model with more than 40 regulatory instruments.
Read more: Delayed NSW injury scheme payments near $175 million - SIRA
The direction notices form part of SIRA’s Supervision Assurance Program examining compliance with the Guidelines for the Provision of Relevant Services (Health and Related Services). The regulator’s quarterly update for the period ending December 31, 2025, recorded 89 penalty infringement notices issued to employers and another 21 remediation plans remaining open with workers compensation insurers.
On the premium side, the state’s nominal insurer icare confirmed an 8% average workers compensation premium rate increase for the 2025-26 financial year, affecting more than 338,000 employers and 3.5 million workers across NSW.
SIRA chief executive Mandy Young signalled health provider oversight as a regulatory focus for the year, stating that the regulator’s published priorities “set a clear signal to regulated entities and service providers of where our efforts will be concentrated, and how they can align with our expectations,” according to SIRA’s regulatory priorities announcement for FY2025-26.
The National Insurance Brokers Association (NIBA) has highlighted the role brokers play in claims outcomes. In a May 2025 parliamentary submission on NSW workers compensation, NIBA chief executive Richard Klipin outlined that brokers contribute by “liaising with insurers, allied-health professionals and service providers to facilitate timely outcomes.”
Brokers can verify a provider’s regulatory standing through SIRA’s public register of directions and penalties. They may also want to discuss invoicing compliance with insurer partners and review whether provider delays have affected any open claims for their employer clients.
