Unless HealthcareService.program.extension:program-requirement is modified from 0..* to be 0..1, the search parameters against this element using the search parameters listed below, will not function as intended. Recommendation is to adjust cardinality, or offer additional guidance on searches. 

Current RESTful or FHIR search will return any HealthcareService where the elements match, but that matching does not require that all of the parameters in the search are true on a per instance base of the extension, only that there is a least one instance where the parameter matching exists within that resource.

Assuming that HealthcareService/1234

has three entries for program.program-requirement

1. birthsex = F, employment-status = unemployed

2. birthsex = M, insurance-status= insured

3. va-status = True, employment-status = employed

a search for HealthcareServices with birthsex = F and va-status=True, and insurance-status = insured  would return HealthcareService/1234 as a match even though there isn't a single entry with all three values.  

Search Parameters for element.

healthcareservice-program-requirement-age-group - ProgramRequirementAgeGroupSearchParameter    

healthcareservice-program-requirement-birthsex - HealthcareServiceProgramRequirementBirthsexSearchParameter    

healthcareservice-program-requirement-gender-identity - HealthcareServiceProgramRequirementGenderIdentitySearchParameter

healthcareservice-program-requirement-employment-status - HealthcareServiceProgramRequirementEmploymentStatusSearchParameter

healthcareservice-program-requirement-insurance-status - HealthcareServiceProgramRequirementInsuranceStatusSearchParameter

healthcareservice-program-requirement-va-status - HealthcareServiceProgramRequirementVaStatusSearchParameter    

healthcareservice-program-requirement-preferred-language - HealthcareServiceProgramRequirementPreferredLanguageSearchParameter