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Participant, or their respective counsel any privity of contract with, or other right to institute any action against, any Claims Administrator.", "The Contractor will receive two monthly capitation payments for each Dual <strong>Eligible Enrollee</strong>: one amount from Medicare and a second amount from MassHealth.", "If, in an extenuating circumstance, a Medicaid or CHIP <strong>Eligible Enrollee</strong> incurs out-of-pocket expenses for Emergency Services provided in the United States, ASES shall reimburse the Enrollee for such expenses within thirty (30) days of receipt of such expenses, and the reimbursement shall be considered a Covered Service.", "If, in an extenuating circumstance, a Medicaid or CHIP <strong>Eligible Enrollee</strong> incurs out-of-pocket expenses for Emergency Transportation Services provided in the United States, the Contractor shall reimburse the Enrollee for such expenses within 30 days of receipt of such expenses, and the reimbursement shall be considered a Covered Service.", "Once the Department has determined that an individual is an <strong>Eligible Enrollee</strong> and after the <strong>Eligible Enrollee</strong> has selected the Contractor&#x27;s Plan, such individual shall become a Prospective Beneficiary.", "The Contractor shall subsequently contact the <strong>Eligible Enrollee</strong>, assist the <strong>Eligible Enrollee</strong> in selecting a Site, Primary Care Provider or Women&#x27;s Health Care Provider and provide education in accordance with this Article IV, Section 4.1(d).", "An adult <strong>Eligible Enrollee</strong>, who is not a caretaker relative, may enroll himself only.", "Where the language is other than English, the Contractor shall offer and, if accepted by the <strong>Eligible Enrollee</strong>, Prospective Beneficiary or Beneficiary, shall supply interpretive services.", "If the Department determines that the Contractor has misrepresented or falsified information furnished to an 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