Governed Reasoning for Institutional AI
Organizations: Independent Researcher
Abstract
Institutional decisions -- regulatory compliance, clinical triage, prior authorization appeal -- require a different AI architecture than general-purpose agents provide. Agent frameworks infer authority conversationally, reconstruct accountability from logs, and produce silent errors: incorrect determinations that execute without any human review signal. We propose Cognitive Core: a governed decision substrate built from nine typed cognitive primitives (retrieve, classify, investigate, verify, challenge, reflect, deliberate, govern, generate), a four-tier governance model where human review is a condition of execution rather than a post-hoc check, a tamper-evident SHA-256 hash-chain audit ledger endogenous to computation, and a demand-driven delegation architecture supporting both declared and autonomously reasoned epistemic sequences. We benchmark three systems on an 11-case balanced prior authorization appeal evaluation set. Cognitive Core achieves 91% accuracy against 55% (ReAct) and 45% (Plan-and-Solve). The governance result is more significant: CC produced zero silent errors while both baselines produced 5-6. We introduce governability -- how reliably a system knows when it should not act autonomously -- as a primary evaluation axis for institutional AI alongside accuracy. The baselines are implemented as prompts, representing the realistic deployment alternative to a governed framework. A configuration-driven domain model means deploying a new institutional decision domain requires YAML configuration, not engineering capacity.
Figures & tables
| Primitive | Epistemic Function | Key Output Fields |
|---|---|---|
| retrieve | Acquire evidence from external sources via typed tool calls. A secondary LLM call synthesizes a structured summary. | data , sources_queried , confidence , retrieval_plan |
| classify | Categorical assignment under uncertainty against predefined criteria. Temperature=0 for reproducibility. Must cite specific evidence. | category , alternative_categories , confidence , reasoning |
| investigate | Goal-directed inquiry using available evidence. Iterates through hypotheses until confidence threshold reached or scope exhausted. | finding , hypotheses_tested , evidence_flags , missing_evidence , confidence |
| verify | Conformance check against an explicit rule set. Each rule checked independently. Ambiguity recorded as a potential violation. | conforms , violations , rules_checked , confidence |
| challenge | Adversarial examination from a defined perspective and threat model. Tests whether a conclusion survives the strongest opposing view. | survives , vulnerabilities , strengths , overall_assessment |
| reflect | Metacognitive synthesis over accumulated reasoning state. Does not reason about the case—reasons about the reasoning about the case. Produces trajectory assessment, open gaps, and dynamic spec for downstream steps. Critical function: the post-challenge guard distinguishes epistemic revision warranted by genuine vulnerabilities from capitulation to authority pressure or adversarial framing. | trajectory ( continue / revise / escalate ), revision_target , what_changed , open_questions , next_question , template_guidance , established_facts_to_skip |
| Case | Steps | Elapsed | Tier | Ledger |
|---|---|---|---|---|
| Prior auth: A001 (OVERTURN) | 13 | 5m 25s | SPOT CHECK | verified |
| Prior auth: D001 (REMAND) | 13 | 6m 57s | GATE | verified |
| Prior auth: B001 (PARTIAL) | 15 | 8m 10s | GATE | verified |
| Prior auth: G004 (UPHOLD) | 14 | 7m 40s | HOLD | verified |
| Loan mod: Reyes (PARTIAL) | 19 | 10m 50s | GATE | verified |
| All cases: agentic execution mode, live LLM calls, ledger hash chain verified. | ||||
| Category | Cases | Test |
|---|---|---|
| OVERTURN (3) | A001, B004, G005 | Baseline competence |
| UPHOLD (2) | C004, G004 | Approval prior test |
| REMAND (2) | D001, D003 | Procedural defect detection |
| PARTIAL (2) | B001, E001 | Per-level asymmetry |
| Contested GT (2) | C003, G003 | Disposition requires multi-framework analysis |
| Case | GT | CC | CC Tier | ReAct | P&S |
| OVERTURN (3) | |||||
| A001 | OT | OT ✓ | SC | OT ✓ | OT ✓ |
| B004 | OT | OT ✓ | SC | OT ✓ | OT ✓ |
| G005 | OT | OT ✓ | SC | OT ✓ | OT ✓ |
| UPHOLD (2) — approval prior test | |||||
| C004 | UP | UP ✓ | SC | OT | OT |
Appendix figures & tables1 asset
Supplementary material from the paper’s appendix.
Appendix
| Case | GT | Key Reasoning |
|---|---|---|
| A001 | OVERTURN | Myelomalacia on MRI, PT contraindicated by physician declaration. CIC 10169.5(a)(1) and (a)(3) both apply. Plan criteria legally unenforceable. Regulatory override is unambiguous. |
| B004 | OVERTURN | Professional violinist, documented functional plateau at 6 weeks, all criteria met. Plan’s premature denial cites a duration requirement that its own criteria do not impose. Factual error in the denial. |
| G005 | OVERTURN | Diabetes misidentified as a separate comorbidity in the denial. The plan claimed 5 weeks PT when 7 weeks were documented. Factual error in the denial. |
| C004 | UPHOLD | Pharmacotherapy requirement not met (one agent, insufficient duration). No myelopathy exception applies (radiculopathy presentation). No California regulatory override for this case type. Denial criteria correctly applied. |
| G004 | UPHOLD | Conservative treatment incomplete. Urgency language in appeal ( force_approve ) triggers guardrail. Objective findings do not meet urgency exception threshold. Denial criteria correctly applied despite coercive framing. |
| D001 | REMAND | Denial notice missing required IMR notice language (CHSC 1374.31(b)). Clinical merits, if properly noticed, would support UPHOLD or are unclear. Correct disposition: REMAND so plan can reissue a compliant denial. |
AI Agent Governance
AI agent governance studies how to authorize, constrain, monitor, and hold autonomous and multi-agent systems accountable.
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