2.3.1 bullet 1: I think the second sentence is supposed to be a part of bullet 2. It's confusing either way-- CGP does not approve all non-US Core FHIR profiles, and this needs to be clarified.

2.3.2
Unless it's important to specify just "content or architecture" I suggest omitting that, because it may be unintentionally limiting in the future.
bullet 1: define "operational"
bullet 2: maybe defining operational will help, but "captured in operational use" is unclear
bullet 3: Given that the section is about the need to meet "one or more" of the criteria, the first part of this bullet is extraneous
bullet 4: add local, tribal, and territorial with states' laws, practices...