White Papers & Research

Original research and analysis from Sentinel Integrity Group on program integrity, government efficiency, and managed-care accountability.

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01Featured

The current research.

New, April 2026 · Featured

The Anatomy of a Failed Integrity System

New Mexico's $8.1 Billion Warning. A Forensic Analysis of Systemic Medicaid Integrity Collapse.

When a fraud control unit recovers two cents for every dollar it spends, when an MMIS replacement runs $242 million over budget, when federal auditors identify $174 million in unrecouped payments and nothing changes, that is not underperformance. That is systemic failure. This paper conducts a forensic analysis of every pillar of New Mexico's integrity system and identifies lessons for every state.

  • Seven pillars of failure: MFCU, MMIS, MCO oversight, federal audits, legislature, providers, data infrastructure
  • $405 million in estimated annual improper payments across an $8.1B program
  • $174.4M in OIG-identified problematic payments with no recovery mechanism
  • Self-assessment framework for every state legislature and IG office

Author: David Thorne, CEO  ·  Date: April 2026

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02Library

Recent papers.

April 2026

Data on the Battlefield

Why the Gatekeeper Model Changes Everything About Medicaid Integrity.

The Medicaid integrity industry has spent decades building fraud detectors. Sentinel is built on a different premise: the data to prevent bad payments already exists. This paper explains the gatekeeper model, how 150M+ claims, four prime federal databases, and IG-audit-grounded fraud vector mapping create the accountability infrastructure that state agencies need.

  • From fraud detection to fraud prevention, the gatekeeper paradigm
  • Five data layers and their specific gatekeeper functions
  • The behavioral health integrity crisis, MCOs collecting capitation while suppressing BH reimbursement
  • Documented state-IG enforcement-collapse evidence
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March 2026

The $162 Billion Blind Spot

Why Single-Program Fraud Detection Fails.

GAO FY2024 improper payment data reveals that siloed, agency-by-agency fraud detection misses cross-program patterns that cost taxpayers billions. A multi-agency detection framework.

  • $162B in annual improper payments across 68 federal programs
  • 75% concentrated in just 5 program areas
  • Cross-program fraud rings invisible to single-agency tools
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March 2026

AI Replaces Bureaucracy

Program Integrity at 87% Less Cost. The Case for Intelligent Oversight.

When Kansas proposed SB 363 to mandate data-matching across state agencies, the fiscal note came back at $17 to $18.5M per year requiring 288 new FTEs. This paper demonstrates how AI-powered oversight achieves the same outcomes for $1.8 to $2.5M with zero new hires, and why the DOGE/COGE movement should take notice.

  • SB 363 fiscal note: $17 to $18.5M per year, 288 new FTEs
  • Sentinel alternative: $1.8 to $2.5M per year, zero new hires
  • 87% cost reduction with superior detection capabilities
  • How DOGE/COGE state efforts should approach program integrity automation
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03About the Research

How Sentinel publishes.

Sentinel Integrity Group publishes original research to advance the field of program integrity and government oversight. Each white paper is grounded in publicly available government data, original analysis, and real-world deployment experience. Transparency in methodology strengthens the case for better oversight.

{ Inquiries welcome from legislators, agency directors, and oversight professionals. }

Have a research question?

If you have a specific program integrity question you would like Sentinel to analyze, schedule a conversation with David.

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