130 CMR, § 450.248
If the provider has made a written request for a copy of the proposed decision prior to its issuance, the provider has seven calendar days from its receipt of the proposed decision to file written objections with the Medicaid director. The Medicaid director may adopt or modify the proposed decision, or return the matter to the hearing officer for further consideration, based on evidence already in the record or, if necessary, additional evidence to be included in the reopened record. The hearing officer will resubmit the proposed decision to the Medicaid director, as modified pursuant to 130 CMR 450.247 and 450.248. The provider is notified of the Medicaid director's action. When the Medicaid director has adopted or modified the proposed decision, the Medicaid director's decision is a final agency action reviewable pursuant to M.G.L. c. 30A.
130 CMR, § 450.248