88.Title XIX of the Social Security Act establishes the federal-state Medicaid program. See 42 U.S.C. §§1396–1396w-5. The purpose of Medicaid is to furnish, as far as practicable, “medical assistance on behalf of . . . aged, blind or disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services” and “to help such families and individuals to attain or retain​ ​capability​ ​for​ ​independence​ ​or​ ​self-care.”​ ​42​ ​U.S.C.​ ​§1396-1.    89.Participation in the Medicaid program by states is voluntary. If a state elects to participate in the Medicaid program, it must “comply with detailed federally mandated standards.” ​Antrican v. Odom​, 290 F.3d 178, 183 n.2 (4th Cir. 2002). Participating states are reimbursed by the federal government for a majority of the costs​ ​of​ ​Medicaid​ ​benefits.​ ​See​ ​42​ ​U.S.C.​ ​§​ ​1396b.    90.Participating states must designate a “single state agency” to administer the Medicaid program. 42 U.S.C. § 1396a(a)(5). Oklahoma has elected to participate in Medicaid, and the state has designated the Oklahoma Health Care Authority I: VIOLATION OF