diff --git a/src/Hl7.Fhir.WebApi.AspNetCore/FhirMediaTypeFormatter.cs b/src/Hl7.Fhir.WebApi.AspNetCore/FhirMediaTypeFormatter.cs
index 22dd2a0c..ae656029 100644
--- a/src/Hl7.Fhir.WebApi.AspNetCore/FhirMediaTypeFormatter.cs
+++ b/src/Hl7.Fhir.WebApi.AspNetCore/FhirMediaTypeFormatter.cs
@@ -16,6 +16,8 @@
 using System.Linq;
 using Hl7.Fhir.Serialization;
 using Hl7.Fhir.Utility;
+using Microsoft.Extensions.Primitives;
+using System.Resources;
 
 namespace Hl7.Fhir.WebApi
 {
@@ -120,6 +122,71 @@ protected override bool CanWriteType(Type type)
             return false;
         }
 
+        /// <inheritdoc />
+        public override bool CanWriteResult(OutputFormatterCanWriteContext context)
+        {
+            if (context == null)
+            {
+                throw new ArgumentNullException(nameof(context));
+            }
+
+            if (SupportedMediaTypes.Count == 0)
+            {
+                var message = $"No media types found in '{GetType().FullName}.{nameof(SupportedMediaTypes)}'. Add at least one media type to the list of supported media types.";
+
+                throw new InvalidOperationException(message);
+            }
+
+            if (!CanWriteType(context.ObjectType))
+            {
+                return false;
+            }
+
+            if (!context.ContentType.HasValue)
+            {
+                // If the desired content type is set to null, then the current formatter can write anything
+                // it wants.
+                context.ContentType = new StringSegment(SupportedMediaTypes[0]);
+                return true;
+            }
+            else
+            {
+                var parsedContentType = new MediaType(context.ContentType);
+                for (var i = 0; i < SupportedMediaTypes.Count; i++)
+                {
+                    var supportedMediaType = new MediaType(SupportedMediaTypes[i]);
+                    if (supportedMediaType.HasWildcard)
+                    {
+                        // For supported media types that are wildcard patterns, confirm that the requested
+                        // media type satisfies the wildcard pattern (e.g., if "text/entity+json;v=2" requested
+                        // and formatter supports "text/*+json").
+                        // We only do this when comparing against server-defined content types (e.g., those
+                        // from [Produces] or Response.ContentType), otherwise we'd potentially be reflecting
+                        // back arbitrary Accept header values.
+                        if (context.ContentTypeIsServerDefined
+                            && parsedContentType.IsSubsetOf(supportedMediaType))
+                        {
+                            return true;
+                        }
+                    }
+                    else
+                    {
+                        // For supported media types that are not wildcard patterns, confirm that this formatter
+                        // supports a more specific media type than requested e.g. OK if "text/*" requested and
+                        // formatter supports "text/plain".
+                        // contentType is typically what we got in an Accept header.
+                        if (supportedMediaType.IsSubsetOfIgnoreParameters(parsedContentType))
+                        {
+                            context.ContentType = new StringSegment(SupportedMediaTypes[i]);
+                            return true;
+                        }
+                    }
+                }
+            }
+
+            return false;
+        }
+
         const string x_correlation_id = "X-Correlation-Id";
         public override void WriteResponseHeaders(OutputFormatterWriteContext context)
         {
diff --git a/src/Hl7.Fhir.WebApi.AspNetCore/Utility.cs b/src/Hl7.Fhir.WebApi.AspNetCore/Utility.cs
index 57b6d561..735a5f17 100644
--- a/src/Hl7.Fhir.WebApi.AspNetCore/Utility.cs
+++ b/src/Hl7.Fhir.WebApi.AspNetCore/Utility.cs
@@ -17,6 +17,7 @@
 using System.Net;
 using System.Net.Http;
 using System.Text;
+using Microsoft.AspNetCore.Mvc.Formatters;
 
 namespace Hl7.Fhir.WebApi
 {
@@ -185,5 +186,67 @@ public static string ToFhirDateTime(this System.DateTime? me)
         }
         #endregion
 
+        #region << Static Helpers for Header Subset comparison that ignores Header parameters >>
+        public static bool IsSubsetOfIgnoreParameters(this MediaType supported, MediaType set)
+        {
+            return supported.MatchesType(set) &&
+                   supported.MatchesSubtype(set);
+        }
+
+        private static bool MatchesType(this MediaType supported, MediaType set)
+        {
+            return set.MatchesAllTypes ||
+                   set.Type.Equals(supported.Type, StringComparison.OrdinalIgnoreCase);
+        }
+
+        private static bool MatchesSubtype(this MediaType supported, MediaType set)
+        {
+            if (set.MatchesAllSubTypes)
+            {
+                return true;
+            }
+
+            if (set.SubTypeSuffix.HasValue)
+            {
+                if (supported.SubTypeSuffix.HasValue)
+                {
+                    // Both the set and the media type being checked have suffixes, so both parts must match.
+                    return supported.MatchesSubtypeWithoutSuffix(set) && supported.MatchesSubtypeSuffix(set);
+                }
+                else
+                {
+                    // The set has a suffix, but the media type being checked doesn't. We never consider this to match.
+                    return false;
+                }
+            }
+            else
+            {
+                // If this subtype or suffix matches the subtype of the set,
+                // it is considered a subtype.
+                // Ex: application/json > application/val+json
+                return supported.MatchesEitherSubtypeOrSuffix(set);
+            }
+        }
+
+        private static bool MatchesSubtypeWithoutSuffix(this MediaType supported, MediaType set)
+        {
+            return set.MatchesAllSubTypesWithoutSuffix ||
+                   set.SubTypeWithoutSuffix.Equals(supported.SubTypeWithoutSuffix, StringComparison.OrdinalIgnoreCase);
+        }
+
+        private static bool MatchesSubtypeSuffix(this MediaType supported, MediaType set)
+        {
+            // We don't have support for wildcards on suffixes alone (e.g., "application/entity+*")
+            // because there's no clear use case for it.
+            return set.SubTypeSuffix.Equals(supported.SubTypeSuffix, StringComparison.OrdinalIgnoreCase);
+        }
+
+        private static bool MatchesEitherSubtypeOrSuffix(this MediaType supported, MediaType set)
+        {
+            return set.SubType.Equals(supported.SubType, StringComparison.OrdinalIgnoreCase) ||
+                   set.SubType.Equals(supported.SubTypeSuffix, StringComparison.OrdinalIgnoreCase);
+        }
+
+        #endregion
     }
 }
diff --git a/src/Test.WebApi.AspNetCore/BasicTests.cs b/src/Test.WebApi.AspNetCore/BasicTests.cs
index 7c22731d..fde79ca6 100644
--- a/src/Test.WebApi.AspNetCore/BasicTests.cs
+++ b/src/Test.WebApi.AspNetCore/BasicTests.cs
@@ -6,6 +6,7 @@
 using Hl7.Fhir.Validation;
 using Hl7.Fhir.WebApi;
 using Microsoft.EntityFrameworkCore;
+using Microsoft.VisualStudio.TestPlatform.ObjectModel;
 using Microsoft.VisualStudio.TestTools.UnitTesting;
 using System;
 using System.Collections.Generic;
@@ -14,6 +15,7 @@
 using System.Net;
 using System.Net.Http;
 using System.Net.Http.Headers;
+using System.Text.Json;
 using System.Threading;
 using Task = System.Threading.Tasks.Task;
 
@@ -951,6 +953,79 @@ public async System.Threading.Tasks.Task ReadBinary()
 
         }
 
+        [TestMethod]
+        public async Task RequestAcceptJsonWithHeaderParameter()
+        {
+            var app = new UnitTestFhirServerApplication();
+            var httpClient = app.CreateClient();
+            var acceptHeader = "application/json+fhir";
+            var acceptHeaderWithEncoding = "application/json+fhir; charset=utf-8";
+            var acceptHeaderWithEncodingAndVersion = "application/json+fhir; carset=utf-8; fhirVersion=4.0";
+            var badAcceptHeader = "application/notjson+fhir";
+            var acceptXmlHeader = "application/xml+fhir";
+
+            httpClient.DefaultRequestHeaders.Add("Accept", acceptHeader);
+            var raw = await httpClient.GetStringAsync($"{app.Server.BaseAddress}Patient");
+            
+            try
+            {
+                await new FhirJsonParser().ParseAsync<Bundle>(raw);
+            }
+            catch (Exception ex)
+            {
+                Assert.Fail("Expected Json formatted bundle: " + ex.Message);
+            }
+
+            httpClient.DefaultRequestHeaders.Remove("Accept");
+            httpClient.DefaultRequestHeaders.Add("Accept", acceptHeaderWithEncoding);
+            raw = await httpClient.GetStringAsync($"{app.Server.BaseAddress}Patient");
+            try
+            {
+                await new FhirJsonParser().ParseAsync<Bundle>(raw);
+            }
+            catch (Exception ex)
+            {
+                Assert.Fail("Expected Json formatted bundle: " + ex.Message);
+            }
+
+            httpClient.DefaultRequestHeaders.Remove("Accept");
+            httpClient.DefaultRequestHeaders.Add("Accept", acceptHeaderWithEncodingAndVersion);
+            raw = await httpClient.GetStringAsync($"{app.Server.BaseAddress}Patient");
+            try
+            {
+                await new FhirJsonParser().ParseAsync<Bundle>(raw);
+            }
+            catch (Exception ex)
+            {
+                Assert.Fail("Expected Json formatted bundle: " + ex.Message);
+            }
+
+            httpClient.DefaultRequestHeaders.Remove("Accept");
+            httpClient.DefaultRequestHeaders.Add("Accept", badAcceptHeader);
+            raw = await httpClient.GetStringAsync($"{app.Server.BaseAddress}Patient");
+            try
+            {
+                await new FhirXmlParser().ParseAsync<Bundle>(raw);
+            }
+            catch (Exception ex)
+            {
+                Assert.Fail("Expected Xml formatted bundle: " + ex.Message);
+            }
+
+            httpClient.DefaultRequestHeaders.Remove("Accept");
+            httpClient.DefaultRequestHeaders.Add("Accept", acceptXmlHeader);
+            raw = await httpClient.GetStringAsync($"{app.Server.BaseAddress}Patient");
+            try
+            {
+                await new FhirXmlParser().ParseAsync<Bundle>(raw);
+            }
+            catch (Exception ex)
+            {
+                Assert.Fail("Expected Xml formatted bundle: " + ex.Message);
+            }
+
+        }
+
         private void ClientFhir_OnBeforeRequest(object sender, HttpRequestMessage msg)
         {
             System.Diagnostics.Trace.WriteLine("---------------------------------------------------");