Abuse: For
purposes of this section 5.3, includes both physical and sexual abuse.
Provider
practices that are inconsistent with sound fiscal business, or medical
practices, and result in an unnecessary cost to the AHCCCS program,
the State of Arizona or in reimbursement for services that are not medically
necessary or that fail to meet professionally recognized standards for
health care. It also includes behavioral health recipient practices
that result in
unnecessary costs to the AHCCCS program and/or the State of Arizona
(Section 7.1).
The
infliction of, or allowing another person to inflict or cause physical
pain or injury, impairment of bodily function, disfigurement or serious
emotional damage which may be evidenced by severe anxiety, depression,
withdrawal or untoward aggressive behavior. Such abuse may be caused
by acts or omissions of an individual having responsibility for the
care, custody or control of a client receiving behavioral health services
or community services. Abuse shall also include sexual misconduct, assault,
molestation, incest, or prostitution of, or with, a client under the
care of personnel of a mental health agency (Section 7.4) which may
occur under circumstances outside of a licensed sponsored activity.