White Papers & Research
Original research and analysis from Sentinel Integrity Group on program integrity, government efficiency, and managed-care accountability.
Original Research
Original research and analysis from Sentinel Integrity Group on program integrity, government efficiency, and managed-care accountability.
Washington Proved It, Then Prescribed It. The Clock for State Medicaid Program Integrity Runs Out in 2027.
In a single week, the federal government proved and then prescribed the future of Medicaid oversight. The largest health care fraud takedown in U.S. history was driven by data analytics, and MACPAC told Congress that states need better tools to hold their plans accountable. With six-month redeterminations and PERM eligibility penalties converging, 2027 is the deadline for states to build the capability.
Author: David Thorne, CEO · Date: July 2026
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, and federal auditors identify $174 million in unrecouped payments and nothing changes, that is not underperformance. It is systemic failure. A forensic analysis of every pillar of New Mexico's integrity system, with lessons for every state.
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.
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.
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.
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.
If you have a specific program integrity question you would like Sentinel to analyze, schedule a conversation with David.
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