Payers need to conform to any HIPAA, federal and state regulations including continuity of care and the CMS final rule. To the extent that patient member preference is permitted, it should be taken into account where appropriate. The technical mechanism PCDE uses to allow the patient to initiate the request being made from old payer to new payer would not allow the patient to assert any constraints. If the patient wanted the old payer to limit disclosure (and regulations allowed this to occur), this would need to be conveyed to the old payer beforehand - and by mechanisms outside the scope of this specification.