Concourse Sentinel

Medicaid Integrity Analytics

๐Ÿ“ŠOverview๐ŸงฎSpend Reconciliation๐ŸฅProviders๐Ÿ’ŠProcedures๐Ÿ“Rate Benchmarks๐ŸšจWatchlist๐Ÿ”Statistical Outliers๐Ÿ—‚๏ธReports๐Ÿ‘ฅPopulation Healthโš–๏ธCompare๐Ÿ“ˆTrends๐Ÿ—บ๏ธGeography

Cross-Dataset

๐Ÿ•ธ๏ธControl Clusters๐Ÿ Home Healthโ›”Exclusions (LEIE)๐Ÿ“‹Context & Disclaimers
๐Ÿ‡บ๐Ÿ‡ธAll States

Federal Compliance (AR)

๐Ÿ›๏ธOverview๐Ÿ“ŠOIG QSR๐Ÿ”„Monthly Screeningโธ๏ธยง455.23 Suspensionsโ›”OIG Exclusion Refs๐ŸงพRAC Coordination๐ŸŽฏPERM Sample
by Concourse

Data: CMS T-MSIS 2018-2024

Source: opendata.hhs.gov

Updated: Oct 19, 2026

How Arkansas compares

Against 23 peers โ€” similar data coverage. Comparing to a named peer set rather than a 51-state average.

19%Low coverageFull benchmarks

Spending per member/month

$861

โˆ’16.0% vs peer median

16th highest of 24 similar states

CMS-64 total รท CMS enrollment

Total Medicaid spending

$7,789,473,294

32nd highest of 51 states

CMS-64 Total Net, FY2024

Medicaid enrollment

712,971

30th highest of 51 states

Most recent CMS monthly report

Visible in claims

18.9%

โˆ’10.1% vs peer median

17th highest of 24 similar states

Share of program these claims see

Published figures are FY2024 CMS-64 and CMS enrollment. Claims figures cover 2018โ€“2024.

Public-record research has been run on 30 flagged Arkansas providers. One referral rests on an Arkansas Attorney General conviction already on the public record; none of 33 recent Arkansas enforcement actions names a billing provider present in the source data. Methodology

Arkansas Medicaid Provider Spending

CMS T-MSIS data, 2018-2024

Concourse Sentinel connects to large-scale healthcare billing datasets โ€” including CMS T-MSIS claims, provider enrollment (PECOS), and federal exclusion lists โ€” and runs millions of automated statistical analyses to surface billing anomalies and areas warranting further review.

Cross-Dataset Analysis Available

Watchlist

18 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Control Clusters

NPPES Associations

shared officials and addresses, unscored

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$8.5B

Cumulative, Jan 2018 โ€“ Oct 2024 (6.8 years)

โ‰ˆ $1.2B / year

Total Claims

170.1M

Cumulative, Jan 2018 โ€“ Oct 2024 (6.8 years)

โ‰ˆ 24.9M / year

Unique Providers

6.9K

Distinct billing NPIs, Jan 2018 โ€“ Oct 2024

Watchlist

310

18 highest/critical risk

Current (as of latest ETL)

Monthly Spending Trend
Top 10 Providers by Spending
View all providers โ†’
Spending by Category
Top 10 Procedures by Spending
CodeDescriptionTotal PaidClaims
T1015Clinic service$1.4B19.7M
H2016Comp comm supp svc, per diem$661.7M2.8M
92507Tx sp lang voice comm indiv$454.4M7.0M
97530Therapeutic activities$414.1M7.0M
T1019Personal care ser per 15 min$352.2M5.5M
90837Psytx w pt 60 minutes$299.9M3.6M
97110Therapeutic exercises$261.2M4.6M
99214Office o/p est mod 30 min$198.2M4.4M
H2019Ther behav svc, per 15 min$189.4M2.4M
H0019Behavioral health; long-term residential (non-medical, non-acute care in a$187.5M719.9K
View all procedures โ†’