The plaintiffs in this case are providers and recipients of Medicaid services for individuals with intellectual and developmental disabilities who claim that the defendant administrative agencies and their commissioners failed to follow the required procedures before reducing the reimbursement rates paid to the providers and limiting the services available to the recipients. The plaintiffs did not submit their claims to the agencies for administrative review, instead filing this lawsuit in the trial court. The trial court granted the defendants’ motion to dismiss the case for failure to exhaust administrative remedies, but the Court of Appeals reversed that ruling. See United Cerebral Palsy of Ga., Inc. v. Georgia Dept. of Behavioral Health Developmental Disabilities, 331 Ga. App. 616 771 SE2d 251 2015. We granted certiorari to decide whether the Court of Appeals erred in holding that the defendants’ alleged failure to give the plaintiffs proper notice of adverse agency decisions excused the plaintiffs from the exhaustion requirement. As explained below, the plaintiffs were required to raise their defective notice claims in the administrative review process in the first instance. Accordingly, we reverse the judgment of the Court of Appeals.
1. a Congress created the Medicaid program in 1965 through amendments to the Social Security Act. See Pharmaceutical Researchers Mfrs. of Am. v. Walsh, 538 U.S. 644, 650 123 SCt 1855, 155 LE2d 889 2003. The program provides subsidies to the states to furnish medical assistance to families with dependent children and of aged, blind, or disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services. 42 USC § 1396-1. Although a state’s participation in the Medicaid program is voluntary, a state that elects to join must administer a state Medicaid plan that meets federal requirements. See Frew ex rel. Frew v. Hawkins, 540 U.S. 431, 433 124 SCt 899, 157 LE2d 855 2004. Georgia participates in the general Medicaid program, and the Department of Community Health DCH is the state agency charged with developing and administering Georgia’s Medicaid plan. See OCGA § 49-4-142.
