Okta, Ping Identity and Citrix decide who gets in, what agents may access, and re-check risk as session context changes. MagenTrust adds a deterministic PASS, CHALLENGE or INTERRUPT decision before each consequential action, confirming a live human is behind it, running inside your perimeter with no data egress. It deploys two ways: alongside an existing identity provider such as Okta or Ping, or as the identity provider and PKI itself, with smart card and certificate-based authentication using the hospital's existing CA or MagenTrust's embedded CA, including on air-gapped networks. The comparison covers primary role, when verification happens, signals used, human versus AI agent verification, session hijacking, biometric data, and deployment, based on each vendor's public documentation as of September 24, 2026.