A Participant is not permitted to Access HSSI for the purpose of selling the information it Accesses or Exchanges, whether the Participant uses its own technology, a QHIO, an Intermediary that has signed the DSA but is not a QHIO, or an Intermediary that has not signed the DSA:

Unless otherwise permitted by Applicable Law or a legally valid agreement, Participants shall not access Health and Social Services Information through the DSA in order to sell such information. (DxF Permitted, Required, and Prohibited Purposes P&P, Section II.3.a.)

Further, while a Participant may de-identify and use HSSI received from another Participant, they may not sell de-identified HSSI when it includes information received from another Participant.

Participant may de-identify and use Health and Social Services Information received from another Participant under the DSA and Use or Disclose such DeIdentified Health and Social Services Information so long as permitted by Applicable Law and consistent with this section…. Participants may not sell deidentified Health and Social Services Information when that de-identified Health and Social Services Information includes information received from another Participant. (DxF Privacy Standards and Security Safeguards P&P, Section III.1.a.ii)