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7500 Security Boulevard, Baltimore, MD 21244

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An official website of the United States government

Here's how you know

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\n Centers for Medicare & Medicaid Services\n
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\n CMS Newsroom\n

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Search CMS.gov

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\n Findsupport.gov\n\n

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Creating a guide to help people navigate issues with mental health, drugs, or alcohol. 

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Spotlight

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Project Timeline: May 2022 - May 2023

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Team Members: Amy Behrens, Meg Peters, Melissa Eggleston, Mathias Rechtzigel, Dave Methvin, Aayat Ali, Chizobam Nwagwu, Michelle Polyak, Cass Olson, Aryeh Jacobsohn, Andrea Fletcher

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Agency partners: Substance Abuse and Mental Health Service Administration, Department of Health and Human Services

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“Finding the right care or provider can be a frustrating experience. We need to make it easier for Americans to both find help, and receive it.” 

—  Fact Sheet: President Biden to Announce Strategy to Address Our National Mental Health, 2022

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About

Challenge

Empower the 3 out of 10 people in the United States who have  issues with mental health, drugs, or alcohol to get the behavioral health services they need. When members of the general public don’t find the information they need, they rely on sources of questionable credibility, which can increase their feelings of frustration and hopelessness.

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Solution

The Digital Service at CMS (DSAC) conducted six rounds of trauma-informed, qualitative research with over 60 participants from across the U.S., with a mix of online and in-person sessions. We interviewed people using Medicaid, who are uninsured, with no/low vision, who have experience with mental health or substance use issues, and/or who identify as LGBTQI+. 

In user research, we found that people lacked a reliable, trustworthy place for information about how to navigate the behavioral health care system. We then created a website to address the needs of people looking for support and treatment. 

Through an iterative process, the team incorporated feedback from user research as well as over 50 subject matter experts across the U.S. Department of Health and Human Services, the White House Domestic Policy Council, the U.S. Department of Veterans Affairs, the U.S. Department of Defense, and non-profit partners to build FindSupport.gov.

FindSupport.gov is a plain language, accessible resources that: 

  • Guides people through common questions when they are at the start of their journey.
  • Navigates people to find a health care professional or program that meets their needs, particularly around insurance.
  • Helps people ask better questions of their health care professionals so that they can feel confident going into treatment.
  • Is structured to answer top behavioral health questions of search engines, so that SAMHSA is positioned to provide trusted content to people in the U.S. 

 

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Impact

FindSupport.gov launched in May 2023 during Mental Health Awareness Month. Post-launch feedback indicates that this tool addresses a gap in available resources. 

The site received over 111,000 views in its first four months with over one third of all visitors continuing to another page. One of the core pages of FindSupport.gov has resources for people in crisis. That page is now linked to from every page on SAMHSA.gov and has received over 15,000 views in 4 months.

As of September 2023, the site is also available in Spanish at EncuentraApoyo.gov. 

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“CMS is committed to ensuring everyone can take care of their mental health just as easily as they get treated for a broken bone. FindSupport.gov will help us achieve that goal so that every American can find the right provider. A problem this significant requires everyone to get involved, and I’m proud to join with my colleagues from across HHS in support of the millions of people who need our support.” 

- CMS Administrator Chiquita Brooks-LaSure, May 5, 2023 press release

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“Will you let me know when this is done? I’d like to have it.” 

- Member of the public from Moorhead, Minnesota

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“This is awesome. Really useful. Keep it up. I wish I had this 8 yrs ago.” 

- Member of the Public from Arizona

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“Improving access to mental health and substance use services for the public remains central to SAMHSA’s mission and vision.By launching this new web resource, we are improving the customer experience of government programs and services by making often confusing but important information easy to understand and act on for all Americans. At SAMHSA, we are thrilled to host this resource that will help people find the support they need.” 

– SAMHSA Administrator Miriam E. Delphin-Rittmon, Ph.D. May 5, 2023 press release 

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Page Last Modified:
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We’re empowering states to improve healthcare and ...

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Check the fee schedules to find billing codes.

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Find codes to be reimbursed for clinical services.

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Get helpful materials for agents, brokers, and par...

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Find current resources to complete your tasks.

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...

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Information for people over 65, and younger people...

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Information for people who need health insurance a...

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Information about the program and policy details o...

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Sign up to get the latest information about your c...

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Home - Centers for Medicare & Medicaid Services\n

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Medicare Drug Price Negotiation
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Medicare is negotiating prices directly with participating drug companies to improve access to some of the costliest and most dispensed brand-name drugs used by people with Medicare.

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There have been recent court decisions staying or enjoining provisions of the 2024 Final Rule implementing Section 1557 of the ACA. Learn more

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", "outcomeCount": 1385, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 7985, "settleDelayMs": 5748, "auditMs": 1863, "totalMs": 10933, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 2582, "failed": 45, "cantTell": 28, "inapplicable": 0 }, "failedRules": [ "aria_parent_required", "aria_role_redundant", "aria_role_valid", "aria_widget_labelled", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_block_heading", "text_sensory_misuse" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "b87685d490f8", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "86a9218507ab1c8c7e2f52a723d1ec97334c9ad25f6a9be3dd2314bf2d83e230", "a11yOccurrenceDisplayId": "A11Y-OCC-86A9218507AB" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "12ce7d60eba7", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-5cd7fd54", "a11yPatternFingerprint": "74bccbc00ebd0be1b9939b9636177932e2ef640bf4c53136f02f330109dce873", "a11yPatternDisplayId": "A11Y-PAT-74BCCBC00EBD", "a11yOccurrenceFingerprint": "d670ecad976d6497d10edfc43d1ca9ca35a75ad12fecc2ca829f77cda0065cd8", "a11yOccurrenceDisplayId": "A11Y-OCC-D670ECAD976D" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
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The Digital Service at CMS (DSAC) works to help all people in the U.S. access healthcare, contributing to CMS’s broader mission. This includes giving people actionable, plain language information and making digital health technology available to people with disabilities. 

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Our Work

FindSupport.gov

In collaboration with the Substance Abuse and Mental Health Administration (SAMHSA) and the White House Domestic Policy Council, DSAC developed a plain language, accessible website to help people navigate getting care and support for issues with mental health, drugs, or alcohol. Taking a trauma-informed research approach, we learned that people needed a trustworthy resource on how to cope, pay for treatment, support loved ones, and deal with a crisis situation. 

988 Suicide & Crisis Lifeline Accessibility Improvements.

During usability research with people who leverage screen readers, DSAC identified opportunities to collaborate with the technology industry (including Apple, Google, and Samsung) to make 988 more accessible during a crisis. We also worked with SAMHSA on decreasing call wait times, resulting in an expected 36,000 more calls answered over the next year.

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Learn more about our work

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Findsupport.gov

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We partnered with SAMHSA, in support of the Presidents Unity Agenda, to create a guide to help people through common questions related to their mental health, drugs, or alcohol.

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988 Suicide and Crisis Lifeline

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We embedded with the SAMHSA team to prepare for operational and technical success of the 988 launch.

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", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
", "isDuplicate": false, "duplicateOf": null, "fingerprint": "972c08383f66", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-89901a43", "a11yPatternFingerprint": "ccc5f1c9dac6a572a12ac5cee9c2c4ccc85db99ee74c6390be6ad4518f5d39af", "a11yPatternDisplayId": "A11Y-PAT-CCC5F1C9DAC6", "a11yOccurrenceFingerprint": "c74a5d7e0727657b861c972c3d996e85b34613eeac3e3fc5c6acae7370d7e430", "a11yOccurrenceDisplayId": "A11Y-OCC-C74A5D7E0727" }, { "rule": "element_tabbable_unobscured", "xpath": null, "html": "", "message": "Confirm that when the element receives focus, it is not covered or, if covered by user action, can be uncovered without moving focus", "isDuplicate": false, "duplicateOf": null, "fingerprint": "45e0b961aa7d", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-4aa49828", "a11yPatternFingerprint": "2b77104f5d2551b1d300a8ea760ca81a4c99df5f3404a25a3dfe1ee1d8853877", "a11yPatternDisplayId": "A11Y-PAT-2B77104F5D25", "a11yOccurrenceFingerprint": "903d19881a671f65271c47b4bd5b3912fddd2d99d532997536bd68dffc5ffa9f", "a11yOccurrenceDisplayId": "A11Y-OCC-903D19881A67" }, { "rule": "style_focus_visible", "xpath": null, "html": "
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\n Improper Payment Findings\n\n

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Table 1. APTC Error Estimates for FY 2022 - FY 2025[1]

Reporting Year1Benefit YearTotal Payments ($M)Properly Paid (%)Properly Paid Amount ($M)Error Rate (%)Dollars in Error ($M)
FY 20222020$41,255.81 99.38%$41,000.04 0.62%$255.76 
FY 20232021$46,497.89 99.42%$46,226.14 0.58%$271.75
FY 20242022$55,707.64 98.99%$55,144.70 1.01%2$562.93 
FY 20252023

$73,812.75  

99.11% 

$73,155.29  

0.89%3 

$657.46  

1The reporting year reports on payment year data from two years prior (e.g., FY 2025 error estimate is based on BY 2023 payments).    

2In FY 2024, 0.73% of 1.01% was made up of Technically Improper Payments, which are non-monetary loss payments that were made to qualified recipients for the right amount but failed to meet all regulatory and/or statutory requirements.

3 In FY 2025, 0.43% of 0.89% was made up of Technically Improper Payments.

 

Combined Improper Payment Information

The APTC program represents the first of two potential payment streams for the overall Premium Tax Credit program. The second payment stream relates to additional Premium Tax Credit amounts claimed by taxpayers at the time of their tax filings, referred to as “Net Premium Tax Credits” (hereafter, “Net PTC”).  That is, total Premium Tax Credit outlays /credits are equal to APTC payments plus Net PTC claims.  For FY 2025, the combined APTC and Net PTC estimated improper payment rate is 1.50 percent, representing $1.13 billion in improper payments out of $75.30 billion total Premium Tax Credit outlays / claims. 

In the ordinary course of preparing their tax filing, a consumer may claim a total Premium Tax Credit that is less than the APTC payments made on behalf of the consumer for the respective tax year.  For example, a consumer’s income for the tax year may exceed what the consumer anticipated when the consumer enrolled in health insurance coverage, resulting in eligibility for a lesser Premium Tax Credit benefit than expected.  The amount paid in APTC that exceed the total Premium Tax Credit a consumer is entitled to is referred to as “Excess APTC.”  A consumer may have an obligation to repay Excess APTC amounts, and such repayments may reduce monetary losses associated with improper payments.  The combined APTC and Net PTC improper payment information does not reflect any effects related to the repayment of Excess APTC.

The combined APTC and Net PTC improper payment information does not reflect payments made by State-based Exchanges.

The APTC improper payment rate is released in the Department of Health and Human Services (HHS) Agency Financial Report (AFR), which can be accessed through the HHS AFR link.

 

[1] Amounts may not sum due to rounding.

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", "outcomeCount": 1260, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11344, "settleDelayMs": 8770, "auditMs": 1785, "totalMs": 13728, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 1 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 2322, "failed": 27, "cantTell": 17, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_lang_valid", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_block_heading", "text_sensory_misuse" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "5d751c8ad23f", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "bd51eb5dd83626b7ee1f776fb46ccafe3c4fa952bdf695c7f51553979abb6fcb", "a11yOccurrenceDisplayId": "A11Y-OCC-BD51EB5DD836" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "2a2d27ec0d0c", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f891efa0", "a11yPatternFingerprint": "b6d59230e1e62a622d7394c2d0cbf6faca8d9053887f625adf4809c3d300cf0a", "a11yPatternDisplayId": "A11Y-PAT-B6D59230E1E6", "a11yOccurrenceFingerprint": "f5facbb5040eb7fe87b7236b7add8a7b6ca75991a6762ff592db988552c2b0a3", "a11yOccurrenceDisplayId": "A11Y-OCC-F5FACBB5040E" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
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\n Error Rate Findings and Results\n\n

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The Part C Improper Payment Measure (IPM) estimates payment errors at the beneficiary-level for the sample. The sample results are then extrapolated to the broader Part C population subject to risk adjustment to determine the total gross payment error amount. 

The Part C IPM Fiscal Year (FY) 2025 Payment Error Rate Results document provides detailed information about payment error results, overpayments and underpayments, key findings, and discrepant CMS-Hierarchical Condition Category (CMS-HCC). This document is available for download in the \"Downloads\" section.

Key Terms

CMS Hierarchical Condition Category (CMS-HCC) model – The CMS-HCC model uses more than 9,000 International Classification of Diseases 10th revision, Clinical Modification (ICD-10-CM) codes, which are mapped to condition categories used to estimate costs. The condition categories group diagnoses that are clinically related and have similar predicted cost implications. Hierarchy logic ensures that when a beneficiary has multiple related conditions, only the most severe (and costly) condition in each hierarchy is counted for payment, thus the term Hierarchical Condition Category, or HCC.

End Stage Renal Disease CMS Hierarchical Condition Category (ESRD CMS-HCC) model – Like the general CMS-HCC model, the ESRD CMS-HCC model maps ICD-10-CM codes to hierarchical condition categories. The ESRD CMS-HCC model is structured to more accurately reflect the risks associated with ESRD beneficiaries, particularly as the beneficiary moves from dialysis to transplant, and then to post-transplant functioning graft status.

Discrepant CMS-HCCs – CMS-HCCs that were not confirmed during medical record review. Payment errors result when the medical records did not support the CMS-HCCs for which the Medicare Advantage (MA) Organization received payment.

Gross Improper Payments –The sum of the absolute value of underpayments and total overpayments.

Monetary Loss – A subset of improper payments where the wrong recipient was paid or the correct recipient was paid the wrong amount for Medicare Part C. Specifically, monetary loss results when medical record documentation submitted by the MA Organization does not substantiate a condition for which it received payment. 

Net Dollars in Error – The difference between total overpayments and the absolute value of the total underpayments.

Non-Monetary Loss – The non-monetary loss component of improper payments is comprised of dollar amounts associated with conditions identified during the medical review process that the MA Organization did not submit for payment.

Overpayment – Overpayments occur when there is insufficient documentation to make a payment determination and/ or when the MA Organization submits medical records that do not support the CMS-HCC(s) for which it received payment.

Underpayment – Underpayments occur when the MA Organization submits medical records that support a higher-level CMS-HCC payment than the original CMS-HCC submitted for payment. 

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", "outcomeCount": 1130, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11645, "settleDelayMs": 9663, "auditMs": 1676, "totalMs": 14052, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 2079, "failed": 17, "cantTell": 12, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "67a7ea708d14", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "4438c9c22f9dbce64b8cc3dc3d69fbdbf0fde2c287fbec7e3c419b2c8114ac2e", "a11yOccurrenceDisplayId": "A11Y-OCC-4438C9C22F9D" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "fdb88af7119f", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-59c72aee", "a11yPatternFingerprint": "6ff88e6cbc16af16fed0dec7c98d5730ab6a9663070d2ec9b3ee4aaf36ea237d", "a11yPatternDisplayId": "A11Y-PAT-6FF88E6CBC16", "a11yOccurrenceFingerprint": "ea3c42a24fdcf0196c7c76d62933b245f3a49ecd900ac85391afd470d66c7b5c", "a11yOccurrenceDisplayId": "A11Y-OCC-EA3C42A24FDC" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
", "isDuplicate": false, "duplicateOf": null, "fingerprint": "d4c12cf32dd2", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-89901a43", "a11yPatternFingerprint": "ccc5f1c9dac6a572a12ac5cee9c2c4ccc85db99ee74c6390be6ad4518f5d39af", "a11yPatternDisplayId": "A11Y-PAT-CCC5F1C9DAC6", "a11yOccurrenceFingerprint": "9ac810d84c5831c0d0dc7834de70def26f5fd86f11421ba5d5e9d4f5f8daceaf", "a11yOccurrenceDisplayId": "A11Y-OCC-9AC810D84C58" }, { "rule": "element_tabbable_unobscured", "xpath": null, "html": "", "message": "Confirm that when the element receives focus, it is not covered or, if covered by user action, can be uncovered without moving focus", "isDuplicate": false, "duplicateOf": null, "fingerprint": "ed250f39ea86", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-4aa49828", "a11yPatternFingerprint": "2b77104f5d2551b1d300a8ea760ca81a4c99df5f3404a25a3dfe1ee1d8853877", "a11yPatternDisplayId": "A11Y-PAT-2B77104F5D25", "a11yOccurrenceFingerprint": "712861a4d547f73b46f1d206d0ade5c9f6a0bbbc2e136b75b2dd4e01d53795bb", "a11yOccurrenceDisplayId": "A11Y-OCC-712861A4D547" }, { "rule": "style_focus_visible", "xpath": null, "html": "
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\n Error Rate Findings and Results\n\n

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The Part D Improper Payment Measurement (Part D IPM) Program identifies overpayment and underpayment errors in drug costs and low-income subsidy payments using data from Prescription Drug Events (PDEs). This review uses both prescription information and Part D sponsor claim information. The document available for download contains comprehensive data and details, including improper payment results and findings related to overpayments and underpayments. Download the FY 2025 Medicare Part D Error Rate Findings and Results (PDF) to access the complete analysis and supporting data. The information below defines key IPM terms for clarity and understanding.

Key Terms

Gross Improper Payments – The absolute value of the sum of overpayments and underpayments.

Overpayments – A CMS overpayment is any instance where the captured PDE information is greater than what is supported by the provided documentation. CMS compares details associated with the prescribed drug to the dispensed drug to the information supplied on a PDE record to identify any discrepancies where the sponsor received more payment than the documentation supports. Examples include when the prescribed medication is actually less expensive than the value reported on the PDE record or when the prescribed quantity is less than what was dispensed.

Underpayments – A CMS underpayment is any instance where the captured PDE information is less than what is supported by the provided documentation. CMS compares details associated with the prescribed drug to the dispensed drug and to the information supplied on a PDE record to identify any discrepancies where the sponsor received less payment than the documentation supports. Examples include when the prescribed medication is more expensive than the value reported on the PDE record or when the prescribed quantity, based on the submitted days’ supply, is greater than what was dispensed.

Monetary Loss – A subset of improper payments where the wrong recipient was paid or the correct recipient was paid the wrong amount. Monetary loss results from administrative or process errors by another party. In the Part D Program, monetary loss results from CMS payments being in excess of what the supporting documents validated.

Non-Monetary Loss – The non-monetary loss component comprises underpayments resulting from cases in which the supporting documentation validates a payment higher than what was paid by CMS, as identified during the PDE record review.

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", "outcomeCount": 1094, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11569, "settleDelayMs": 10000, "auditMs": 1619, "totalMs": 13788, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1979, "failed": 18, "cantTell": 15, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_sensory_misuse" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "267064c594b7", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "daed6117c61dbc054a746def355b7c9a346b8107a69df2be5a91a52d91583cad", "a11yOccurrenceDisplayId": "A11Y-OCC-DAED6117C61D" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "7af75abc378d", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-59c72aee", "a11yPatternFingerprint": "6ff88e6cbc16af16fed0dec7c98d5730ab6a9663070d2ec9b3ee4aaf36ea237d", "a11yPatternDisplayId": "A11Y-PAT-6FF88E6CBC16", "a11yOccurrenceFingerprint": "0ea87a6aa6b3adfb55d7679e05e13fa8a93144a47ab86e8bbb4b7c27637f9252", "a11yOccurrenceDisplayId": "A11Y-OCC-0EA87A6AA6B3" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
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\n PERM Error Rate Findings and Reports\n\n

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Welcome to the PERM reports and reference documents page.  This page houses various reports and reference documents associated with the PERM program. This page will contain two cycles of improper payment rates spanning six years. For earlier improper payment rates please refer to the Archive page.

Rolling National Medicaid Improper Payment Rates

Year

PERM Cycles Included

Estimated Improper Payments (in billions)

Overall Rate

FFS Rate

Managed Care Rate

Eligibility Rate

2025

Cycle 2 - RY 2023

Cycle 3 - RY 2024

Cycle 1 - RY 2025

$37.396.12%4.60%0.00%4.42%
2024

Cycle 1 - RY 2022

Cycle 2 - RY 2023

Cycle 3 - RY 2024

$31.105.09%4.83%0.00%3.31%
2023

Cycle 3 - RY 2021

Cycle 1 - RY 2022

Cycle 2 - RY 2023

$50.338.58%6.90%0.00%5.95%
2022

Cycle 2 - RY 2020

Cycle 3 - RY 2021

Cycle 1 - RY 2022

$80.5715.62%10.42%0.03%11.89%
2021

Cycle 1 - RY 2019

Cycle 2 - RY 2020

Cycle 3 - RY 2021

$98.7221.69%13.90%0.04%16.62%
2020

Cycle 3 – FY 2017

Cycle 1 – RY 2019

Cycle 2 – RY 2020

$86.4921.36%16.84%0.06%14.94%
  • The overall estimate is comprised of the weighted sum of the FFS and managed care components, plus the eligibility component, minus a small adjustment to account for the overlap between the claims and eligibility review functions.

National Rolling CHIP Improper Payment Rates

Year

PERM Cycles Included

Estimated Improper Payments (in billions)

Overall Rate

FFS Rate

Managed Care Rate

Eligibility Rate

2025

Cycle 2 - RY 2023

Cycle 3 - RY 2024

Cycle 1 - RY 2025

$1.377.05%4.65%0.94%5.23%
2024

Cycle 1 - RY 2022

Cycle 2 - RY 2023

Cycle 3 - RY 2024

$1.076.11%4.72%0.72%4.44%
2023

Cycle 3 - RY 2021

Cycle 1 - RY 2022

Cycle 2 - RY 2023

$2.1412.81%7.09%0.59%10.86%
2022

Cycle 2 - RY 2020

Cycle 3 - RY 2021

Cycle 1 - RY 2022

$4.3026.75%11.23%0.62%24.01%
2021

Cycle 1 - RY 2019

Cycle 2 - RY 2020

Cycle 3 - RY 2021

$5.3731.84%13.67%0.48%28.71%
2020

Cycle 3 – FY 2017

Cycle 1 – RY 2019

Cycle 2 – RY 2020

$4.7827.00%14.15%0.49%23.53%
  • The overall estimate is comprised of the weighted sum of the FFS and managed care components, plus the eligibility component, minus a small adjustment to account for the overlap between the claims and eligibility review functions.
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    ", "outcomeCount": 1281, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11589, "settleDelayMs": 10000, "auditMs": 1777, "totalMs": 14010, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 2430, "failed": 36, "cantTell": 20, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_role_valid", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_block_heading" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "d31ed688e57e", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "3c1a129dbff0923887939ab53c96f5a1be1cd67cfcf2fe7142b767ea998b0e81", "a11yOccurrenceDisplayId": "A11Y-OCC-3C1A129DBFF0" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "fff1ec8ed60d", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-897d357b", "a11yPatternFingerprint": "3e88f3b3b693ed435396a83756bc5aab8375afeb353411a993dd43880f450cdd", "a11yPatternDisplayId": "A11Y-PAT-3E88F3B3B693", "a11yOccurrenceFingerprint": "857c19514f56e553a24554960f5eb5b63996b1c21bdd0a5737b4b390c0840bb4", "a11yOccurrenceDisplayId": "A11Y-OCC-857C19514F56" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
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    About this Page

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    Important Notice about Sending Emails to CMS

    Please note that the Centers for Medicare & Medicaid Services (CMS) QRP Help Desk email systems are not secured to receive protected health information or patient-level data with direct identifiers. Submitting patient-level data or protected health information may be a violation of your facilities’ policies and procedures as well as a violation of federal regulations (Health Insurance Portability and Accountability Act [HIPAA]). Do NOT submit patient-identifiable information (e.g., date of birth, social security number, and health insurance claim number) to these addresses. If you are unsure of whether the information you are submitting is identifiable, please contact your institutions’ Privacy Officer.

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    • Accessing the Internet Quality Improvement and Evaluation System (iQIES)
    • General issues related to iQIES
    • Accessing submission/validation reports
    • jRAVEN software

    Email: iqies@cms.hhs.gov

    Phone: 1-800-339-9313

     6. For questions about SNF quality data submitted to CMS via the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN), or NHSN Registration:

    E-mail: NHSN@cdc.gov

    7. For questions about the SNF Data Validation Process please visit the Data Validation Process webpage.

    8. For questions related to the SNF QRP Reconsideration Process including:

    • How to file a request if you receive a letter of non-compliance from CMS
    • Deadline for filing a Request for Reconsideration
    • How to dispute a finding of non-compliance with the QRP reporting requirements that can lead to a 2% payment reduction
    • Requesting information about the SNF QRP payment reduction for failure to report required quality data

    Email: SNFQRPReconsiderations@cms.hhs.gov

    9. For questions related to the SNF Prospective Payment System (PPS) policy:

    Email: pdpm@cms.hhs.gov

    10. For questions related to the SNF Value-Based Purchasing (VBP) Program including:

    • SNF VBP program
    • SNF VBP quality measures

    Email:  SNFVBPquestions@cms.hhs.gov

    11. For questions related to the Patient Driven Payment Model (PDPM) Grouper:

    Email: grouperBetaTesting@cms.hhs.gov 

    12. For questions related to Staffing Data Submission Payroll-Based Journaling (PBJ) including:

    • PBJ policy information including PBJ Policy Manual and Frequently Asked Questions (FAQs)

    Email: nhstaffing@cms.hhs.gov

    13. For questions related to PBJ Data Specifications including Data Submission Specifications:

    Email: iqies@cms.hhs.gov

    14. For questions related to the Survey Process:

    Email: nhsurveydevelopment@cms.hhs.gov

    15. For questions related to Nursing Home Regulations:

    Email: DNH_triageteam@cms.hhs.gov

    16. For help monitoring compliance with the SNF QRP data submission requirements:

    • CMS sends informational messages to SNFs that are NOT meeting Annual Payment Update (APU) thresholds on a quarterly basis ahead of each submission deadline.

    Email: QRPHelp@swingtech.com to receive this information.

    • Include your facility name and CMS Certification Number (CCN) with this request.

    Listserv Available for Provider Support for SNFs and Nursing Homes

    Subscribe to the Post-Acute Care (PAC) QRP listserv for the latest SNF quality reporting program information.

    SNF Quality Reporting Program Archives

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      \n Accessibility of CMS.gov \n\n

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      CMS is committed to ensuring that everyone, regardless of whether they are an employee or a beneficiary, or if they have a disability, has equal or comparable access to the information that we provide.

      Tips to Help You Access Content on this Site

      Do you have questions about accessing information created and managed by CMS?  Here are some common questions and helpful guidance: 

      Q: Is the text on the screen too small or hard to read?

      A: If you are having difficulty with reading the text on the screen due to text size or font, you can adjust the screen text size within your browser.  If this does not work, you may need to obtain software that magnifies the text on your screen to make it easier to read.  You can purchase screen magnification software from companies such as Freedom Scientific and ZoomText. 

      Q: Are you unable to see the screen? 

      A: If this is the case, you can obtain screen reading software that will read text out loud. Windows 10 has a program called Narrator which can read basic screen produced text. Apple products such as the iPhone, iPad, and Mac computers have screen reading software as part of their operating systems. These products read text displayed on screen and allow you to review information at your own pace. 

      Q: Are you unable to use a keyboard or a mouse? 

      A: If this is the case, you can obtain pointer devices that allow you to access electronic content on your computer with simply using a head movement motion or by blowing into a tube to make the cursor respond to your command. You can also obtain software and a headset that will allow you to dictate instructions to your device. 

      Q: Are you unable to hear the audio in a presentation?

      A: If this is the case, many presentations contain closed captions which provide text output of the audio that is spoken by the presenter. If you encounter a presentation that lacks this feature, please contact the meeting host or presenter to obtain a written transcript of the materials.

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        ", "outcomeCount": 1006, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11409, "settleDelayMs": 10000, "auditMs": 1600, "totalMs": 13611, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1747, "failed": 20, "cantTell": 11, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_block_heading", "text_sensory_misuse" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "27750e4de013", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "705e037d0ce8a097b82c42475e74ea487f215aea8e9c82bcbdc5f3d9f35ac854", "a11yOccurrenceDisplayId": "A11Y-OCC-705E037D0CE8" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "cdc5a3b1fc82", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f891efa0", "a11yPatternFingerprint": "b6d59230e1e62a622d7394c2d0cbf6faca8d9053887f625adf4809c3d300cf0a", "a11yPatternDisplayId": "A11Y-PAT-B6D59230E1E6", "a11yOccurrenceFingerprint": "5ece3ece938efbd84947f58a6c3660a324c7a6dea468fc8acad7fefbd7623f86", "a11yOccurrenceDisplayId": "A11Y-OCC-5ECE3ECE938E" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
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        NCD 240.9 FAQ\n

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        NCD 240.9 (Noninvasive Positive Pressure Ventilation (NIPPV) in the Home for the Treatment of Chronic Respiratory Failure consequent to COPD) can be located here.

        Q: How can suppliers and providers comply with the utilization requirements of NCD 240.9? Is a machine readout necessary that may require software updates?

        A: CMS National policy does not state that information supporting the service must be data from the machine. NCD 240.9 states:

        …a patient “must be determined by a clinician to use the device at least 4 hours per 24-hour period, on at least 70% of days in a 30-day period”. The term “by a clinician” could refer to documentation a clinician enters into the medical record that would provide support to pay the claim. This could be achieved by the clinician recording in the medical record the amount of time the beneficiary states using the machine and that amount being no less than the NCD requirements.

        The first and second evaluations must be with the treating clinician per the NCD criteria. The NCD does not define who performs the post second evaluation (beyond 12 months).

        As a reminder, Article Standard Documentation Requirements for All Claims Submitted to DME MACs A55426 states: Records from suppliers or healthcare professionals with a financial interest in the claim outcome are not considered sufficient by themselves for determining that an item is reasonable and necessary.

        Q: For rentals, since the Date of Service is the “from” date, can supplier use the previous month’s compliance to bill to allow for continued prospective billing?

        A: The NCD does not change current billing practices. CMS understands billing on a rental is prospective and occurs before the NCD usage requirements are known to be met for that month.

        Q: How would existing patient NIV equipment be handled under the new NCD?

        A: Ventilators fall under “frequent and substantial servicing” of the DMEPOS benefit. CMS performs DMEPOS claim reviews using the policy that is in place at the time the item was initially provided. CMS will direct the MACs to focus claim reviews on claims where the initial claim for the item falls after the effective date of the new NCD.

        The above does not restrict/limit applicable contractors from performing medical review where there is concern about potential fraud. Additionally, this does not impact the limited reviews that may be randomly conducted by the Comprehensive Error Rate Testing (CERT) contractor, per their statutory obligation.

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          \n About the Program\n\n

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          Medicare Shared Savings Program (Shared Savings Program) ACOs are groups of doctors, hospitals, and other health care providers who collaborate to give coordinated high-quality care to people with Medicare, focusing on delivering the right care at the right time, while avoiding unnecessary services and medical errors. When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, the ACO may be eligible to share in the savings it achieves for the Medicare program (also known as performance payments).

          Shared Savings Program

          The Shared Savings Program offers providers and suppliers (e.g., physicians, hospitals, and others involved in patient care) an opportunity to create an Accountable Care Organization (ACO). An ACO agrees to be held accountable for the quality, cost, and experience of care of an assigned Medicare fee-for-service (FFS) beneficiary population. The Shared Savings Program has different participation options (tracks) that allow ACOs to select an arrangement that makes the most sense for their organization.

          The Shared Savings Program is an important innovation for moving the Centers for Medicare & Medicaid Services' (CMS') payment system away from volume and toward value and outcomes. It is an alternative payment model that:

          • Promotes accountability for a patient population.
          • Coordinates items and services for Medicare FFS beneficiaries.
          • Encourages investment in high quality and efficient services.

          Accountable Care Organizations

          The Shared Savings Program is a voluntary program that encourages groups of doctors, hospitals, and other health care providers to come together as an ACO to give coordinated, high-quality care to their Medicare beneficiaries.

          To learn more about becoming an ACO, visit the Application Types and Timelines webpage.

          ACO Providers and Suppliers

          Eligible ACO providers and suppliers that may participate in the Shared Savings Program include:

          • ACO professionals in group practice arrangements
          • Networks of individual practices of ACO professionals
          • Partnerships or joint venture arrangements between hospitals and ACO professionals
          • Hospitals employing ACO professionals
          • Critical Access Hospitals (CAHs) that bill under Method II
          • Federally Qualified Health Centers (FQHCs)
          • Rural Health Clinics (RHCs)
          • Teaching hospitals that have elected to receive payment on a reasonable cost basis for the direct medical and surgical services of their physicians

          Program Data

          CMS makes data on Shared Savings Program ACOs publicly available through several resources, including Data.CMS.gov. On this page, find more information related to Shared Savings Program ACO participation and performance.

          Learn More >

          CMS ACO Learning System

          Since 2012, CMS has supported ACOs in their efforts to improve the delivery of care for their assigned beneficiary populations through model-specific learning systems. These learning systems provide ACOs with a forum in which they can collaborate with and learn from one another. Visit the CMS Innovation Center ACOs webpage for the most current Toolkits and Case Studies.

          Frequently Asked Questions

          For more information about the program, refer to our frequently asked questions (FAQs) on the Medicare FFS FAQs page.

          Back to Top

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            ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
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            \n CMS Newsroom\n

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            Search CMS.gov

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            \n Resources\n\n

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            Do you have questions or concerns about the Recovery Audit Program? Please e-mail us at RAC@cms.hhs.gov. Please Do Not send Personal Health Information to this e-mail address.

            Section 1893(h) of the Social Security Act, which authorized the Recovery Audit Program expansion nationwide, requires an annual Report to Congress, including information on the performance of such contractors on identified underpayments and overpayments and recouping overpayments, including an evaluation of the comparative performance of such contractors and savings to the program. CMS also posts quarterly updates of the Recovery Audit Program, as well as additional reports such as the National Program Total Corrections.  These reports are available in the Downloads section below.

            The Recovery Audit Prepayment Review Demonstration has ended. CMS will post an evaluation of the demonstration in the future. Previous status updates are available in the Downloads section below.

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            Downloads

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              ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
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              \n CMS Newsroom\n

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              Search CMS.gov

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              \n Digital Service at CMS\n\n

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              We Serve America's 
              Healthcare System

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              What we do


              We're a group of civic-minded technologists transforming how the federal government delivers healthcare to the American people.

              The Digital Service at CMS (DSAC) consists of engineers, designers, and product managers—serving our country by building and maintaining the technology underpinning our national health care programs.

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              Transparency

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              Health care costs, data, policies, and clinical standards should be clear and easy to find.

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              Accessibility

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              Health care and digital tools need to be accessible to all–from ensuring websites work for people with disabilities to creating systems designed for patients. 

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              \n How we’re improving accessibility for CMS products\n
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              How we work

              By collaborating closely with dedicated CMS career civil servants, our work includes everything from creating public websites to implementing new legislation in back-office systems.

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              Medical Bill Rights

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              People in the U.S. have rights to protect them from unexpected medical bills. We supported a new website that explains those rights.

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              \n Learn about your rights\n
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              Findsupport.gov

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              We partnered with SAMHSA, in support of the Presidents Unity Agenda, to create a guide to help people through common questions related to their mental health, drugs, or alcohol.

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              988 Suicide and Crisis Lifeline

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              We embedded with the SAMHSA team to prepare for operational and technical success of the 988 launch.

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              \n Learn more about our work helping 988\n
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              Open Source Program Office

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              Establish and maintain guidance, policies, practices, and talent pipelines that advance equity, build trust, and amplify impact across CMS, HHS, and Federal Open Source Ecosystems by working and sharing openly

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              \n Learn more about our OSPO\n
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                ", "outcomeCount": 995, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11783, "settleDelayMs": 10000, "auditMs": 1529, "totalMs": 13917, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1829, "failed": 18, "cantTell": 10, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_block_heading" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "f6f1e9c29c87", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "73b551d6236e91a736772bdc6ead92b5289346effb83f840caad37b28174ade2", "a11yOccurrenceDisplayId": "A11Y-OCC-73B551D6236E" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "89725b7ca1a3", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-952c7159", "a11yPatternFingerprint": "8947927dd45a9b4a7da9d7a8cff4cbd5c276e9251553fd8378fc03db9067353a", "a11yPatternDisplayId": "A11Y-PAT-8947927DD45A", "a11yOccurrenceFingerprint": "347ec86870b910f836004d6a7a1712fc9a9a26946aeb5b2786bb76ba4af7f05c", "a11yOccurrenceDisplayId": "A11Y-OCC-347EC86870B9" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
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                \n \n \n \n \n\n \n
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                \n
                \n \n
                \n
                \n \n \n
                \n \n \"CMS.gov\"\n \n
                \n
                \n Centers for Medicare & Medicaid Services\n
                \n
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                \n CMS Newsroom\n

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                Search CMS.gov

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                \n Employer community\n\n

                \n
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                Information about Medicare enrollment

                \n\n

                Do you have employees or retirees who are eligible to enroll in Medicare?  

                \n\n

                People who are still working (or have retiree, COBRA, or other types of coverage) have important decisions to make about their health coverage when they become eligible for Medicare.  The rules about how other insurance works with Medicare—and considerations that people should weigh when deciding whether to enroll in Medicare when they become eligible—vary based on:

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                • The reason(s) they’re eligible for Medicare
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                • If they, a spouse, or a disabled family member are still working, and
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                • If they have employer-sponsored group health plan coverage based on that active employment  
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                \n\n


                \nSigning up for Medicare late can increase the premium costs for your employees for as long as they have Medicare (and well after they retire from your company), and can result in gaps in coverage. We ask that you and your benefits administrators become familiar with this information. You can send people to Medicare.gov for more information to help them make informed decisions about their health coverage.

                \n\n

                 

                \n\n

                Medicare basics

                \n\n

                Medicare Part A, which helps cover inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care, is free for most people.  However, there’s a monthly premium for Medicare Part B, which covers certain doctors' services, outpatient care, medical supplies, and preventive services.  

                \n\n

                Medicare is health insurance for people:

                \n\n
                  \n\t
                • 65 or older,
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                • Under 65 with certain disabilities, or
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                • Who have End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant), regardless of their age
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                Most people get Part A for free, but some have to pay a premium for this coverage.

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                To qualify for premium-free Part A, a person must be eligible for Medicare based on their own earnings, or the earnings of a spouse or a parent. They must have a specified number of quarters of coverage (QCs) and file an application for Social Security or Railroad Retirement Board (RRB) benefits. The exact number of QCs required depends on whether the person is filing for Part A on the basis of age, disability, or End-Stage Renal Disease (ESRD).

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                To be eligible for premium-free Part A on the basis of age, a person must be:

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                • 65 or older
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                • Eligible for monthly Social Security or Railroad Retirement Board (RRB) cash benefits
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                To be eligible for premium-free Part A on the basis of disability, a person must be:

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                • Entitled to monthly Social Security or Railroad Retirement Board (RRB) benefits after being disabled for 24 months, or
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                • A disabled federal, state, or local government employee not eligible for monthly Social Security or RRB benefits. They may be automatically enrolled in premium-free Part A after being disabled for 29 months.
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                People who are eligible for premium-free Part A on the basis of ESRD:

                \n\n
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                • Must have worked the required amount of time under Social Security, the Railroad Retirement Board (RRB), or as a government employee
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                • Are getting (or are eligible for) Social Security or RRB benefits, or
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                • Are the spouse or dependent child of a person who has worked the required amount of time under Social Security, the RRB, or as a government employee; or are getting Social Security or RRB benefits.
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                If a person who is eligible for premium-free Part A doesn’t sign up for Part B when they’re first eligible, they may enroll later, but only during the General Enrollment Period between January 1–March 31 each year (unless they qualify for a Special Enrollment Period (SEP)). They also may pay a late enrollment penalty for as long as they have Part B.

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                Signing up during a Special Enrollment Period (SEP)

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                Some people 65 or older don’t sign up for Medicare Part B when first eligible because they or their spouse are working and they’re covered by an employer or union group health plan (GHP). They can sign up later using the SEP Related to Coverage Under Group Health Plans.

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                People who have Medicare based on disability can sign up using this SEP if they, their spouse, or their family member are working and are covered by an employer or union GHP with at least 100 employees (also known as a Large GHP). People who qualify for Medicare based on End Stage Renal Disease (ESRD) aren’t eligible for this SEP.

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                If eligible for this SEP, a person can sign up for Part B without a penalty:

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                • Anytime while they’re covered by the employer or union GHP based on current employment, or
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                • Up to 8 months after the GHP coverage or the employment ends, whichever happens first.
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                Some important things to know about what is and isn’t considered group health plan coverage:

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                • COBRA coverage and retiree health plans aren’t considered coverage based on current employment. People who have COBRA or retiree coverage aren’t eligible for this SEP when their coverage ends. Individuals who remain in COBRA and don’t sign up for Medicare coverage when first eligible may have to pay a life-long late enrollment penalty.
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                • Plans that only cover self-employed individuals aren’t considered GHPs. People with this type of coverage aren’t eligible for this SEP.   
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                • Coverage where the employer pays a stipend for the employee to get insurance (such as coverage through the Health Insurance Marketplace® or private insurance) isn’t considered group health plan coverage. People with this type of coverage aren’t eligible for this SEP.
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                • The Small Business Health Options Program (SHOP) in the Health Insurance Marketplace® is group health plan coverage. People covered by a SHOP plan because of their or their spouse’s current employment can use this SEP.
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                Knowing who pays first

                \n\n

                When deciding to sign up for Part B, people must consider whether Medicare or their employer-based insurance will pay first. If Medicare pays first and a person isn’t enrolled in Part B, the other insurance may not pay all the uncovered costs.  

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                • If a person is eligible for Medicare due to age, their employer-based insurance from current employment will pay first if the employer has more than 20 employees.  
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                • If a person is eligible for Medicare due to disability, their employer-based insurance from current employment will pay first if the employer has more than 100 employees
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                • If a person is eligible for Medicare due to ESRD, other insurance (from work or from other sources) will pay first for the first 30 months starting the first month the person is eligible for Medicare, whether or not the person signs up for Medicare.
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                \n\n


                \nContact us

                \n\n

                For questions about signing up for Medicare, call Social Security at 1-800-772-1213 or visit socialsecurity.gov. TTY users can call 1-800-325-0778.  For those who worked for a railroad or get Railroad Retirement Board (RRB) benefits, call the RRB at 1-877-772-5772 or visit rrb.gov. TTY users can call 1-312-751-4701.

                \n\n

                For questions about Medicare benefits, call 1-800-MEDICARE (1-800-633-4227) or visit Medicare.gov.  TTY users can call 1-877-486-2048.

                \n\n

                Contact a local State Health Insurance Assistance Program (SHIP) to get free personalized counseling on Medicare coverage, claims, appeals, and help for people with limited income and resources. Call 1-800-MEDICARE or visit shiptacenter.org to get the phone number of your local SHIP.

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                  ", "outcomeCount": 1388, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 12622, "settleDelayMs": 10000, "auditMs": 1832, "totalMs": 15051, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 2760, "failed": 18, "cantTell": 9, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_block_heading", "text_sensory_misuse" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "5007cc7a64e7", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "5cc6b789cea842876aa44f19810b04a04a6f7bc02fef7395bf5c452f9831b079", "a11yOccurrenceDisplayId": "A11Y-OCC-5CC6B789CEA8" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "35b6cad70683", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f891efa0", "a11yPatternFingerprint": "b6d59230e1e62a622d7394c2d0cbf6faca8d9053887f625adf4809c3d300cf0a", "a11yPatternDisplayId": "A11Y-PAT-B6D59230E1E6", "a11yOccurrenceFingerprint": "23972a630548842835b094adaa8125f800e129167bd1059f21e2ee3c508e6472", "a11yOccurrenceDisplayId": "A11Y-OCC-23972A630548" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
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                  \n \n \n \n \n\n \n
                  \n
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                  \n \n \n
                  \n \n \"CMS.gov\"\n \n
                  \n
                  \n Centers for Medicare & Medicaid Services\n
                  \n
                  \n

                  \n CMS Newsroom\n

                  \n
                  \n
                  \n\n
                  \n\n
                  \n \n\n \n\n\n\n\n
                  \n \n \n

                  Search CMS.gov

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                  \n

                  \n Facilities\n\n

                  \n
                  \n
                  \n
                  \n \n \n
                  \n

                  All fee-for-service (FFS) facilities

                  Check out our Quality in Focus (QIF) interactive 10-15 minute videos tailored to provider types, which aim to reduce the deficiencies most commonly cited during the CMS survey process, like infection control and accident prevention. 

                  See the Quality, Safety, & Education Portal Training Catalog, and select Quality in Focus

                  Hospitals & inpatient facilities

                  Acute care, Critical Access Hospitals (CAHs), & Inpatient Rehabilitation Facilities (IRFs)

                  Outpatient facilities 

                  Ambulatory Surgical Centers (ASCs), Comprehensive Outpatient Rehabilitation Facilities (CORFs), Federally Qualified Health Centers (FQHCs), Rural Emergency Hospitals (REHs), & Rural Health Clinics (RHCs)

                  Long-term care facilities & Skilled Nursing Facilities (SNFs)

                  Durable medical equipment suppliers (DMEs)

                  Home Health Agencies (HHAs)

                  Hospices

                  Clinical labs

                  Ambulances

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                    \n \n \n \n \n\n \n
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                    \n Centers for Medicare & Medicaid Services\n
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                    \n CMS Newsroom\n

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                    Search CMS.gov

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                    \n Health & drug plans\n\n

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                      ", "outcomeCount": 912, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 12082, "settleDelayMs": 10000, "auditMs": 1522, "totalMs": 14206, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1551, "failed": 15, "cantTell": 7, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "9c85ec5ce709", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "e76fbe4fb40358cd20d6171371a5e5b3bbfe8caa8275b53663a2ab6d72f413ec", "a11yOccurrenceDisplayId": "A11Y-OCC-E76FBE4FB403" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "c07b134e5644", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-5467b053", "a11yPatternFingerprint": "71c6e668f4f5dd2f4370f219995ff38c0c5f9526f59dc0afdbf4e81b3fb32e25", "a11yPatternDisplayId": "A11Y-PAT-71C6E668F4F5", "a11yOccurrenceFingerprint": "b1fc07835d2b35bc449e5aced633b2cd48f7f3933841c2853360845203c680f3", "a11yOccurrenceDisplayId": "A11Y-OCC-B1FC07835D2B" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
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                      \n \n \n \n \n\n \n
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                      \n Physicians & other health professionals\n\n

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                      All providers & professionals

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                        ", "outcomeCount": 1071, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 12243, "settleDelayMs": 10000, "auditMs": 1625, "totalMs": 14465, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 2031, "failed": 15, "cantTell": 9, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "132ddc238ada", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "c96d74d4c5b3cb651fe91576c7e9fcabac6608a8350fa83264f5fba134b057eb", "a11yOccurrenceDisplayId": "A11Y-OCC-C96D74D4C5B3" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "b9015edeeeb9", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-5467b053", "a11yPatternFingerprint": "71c6e668f4f5dd2f4370f219995ff38c0c5f9526f59dc0afdbf4e81b3fb32e25", "a11yPatternDisplayId": "A11Y-PAT-71C6E668F4F5", "a11yOccurrenceFingerprint": "e45f52c9cf60de4db46dc2eaacb273c8320a5df5997affc3258c60864e3d9eae", "a11yOccurrenceDisplayId": "A11Y-OCC-E45F52C9CF60" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
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                        \n \n \n \n \n\n \n
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                        \n CMS Newsroom\n

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                        Search CMS.gov

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                        \n Find resources\n\n

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                          ", "outcomeCount": 940, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11630, "settleDelayMs": 10000, "auditMs": 1454, "totalMs": 13680, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1677, "failed": 15, "cantTell": 7, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "012d50f0ecc5", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "5ed452f1db5a84b099cfc7843487a09d3aac251fd18827d5c27b8ed8259b94cd", "a11yOccurrenceDisplayId": "A11Y-OCC-5ED452F1DB5A" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "57aa70611d6e", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-5467b053", "a11yPatternFingerprint": "71c6e668f4f5dd2f4370f219995ff38c0c5f9526f59dc0afdbf4e81b3fb32e25", "a11yPatternDisplayId": "A11Y-PAT-71C6E668F4F5", "a11yOccurrenceFingerprint": "6eca936907c23e8ecfd77949a62877bba55b29f5836eb2396a87d8613a621ada", "a11yOccurrenceDisplayId": "A11Y-OCC-6ECA936907C2" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
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                            ", "outcomeCount": 989, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11706, "settleDelayMs": 10000, "auditMs": 1533, "totalMs": 14015, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1747, "failed": 16, "cantTell": 9, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "d756bae932a6", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "a2dcde3faaad3d3d410519865d93a7a6575fd34657759470bc29eb019657619b", "a11yOccurrenceDisplayId": "A11Y-OCC-A2DCDE3FAAAD" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "c1f44ec4320c", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f891efa0", "a11yPatternFingerprint": "b6d59230e1e62a622d7394c2d0cbf6faca8d9053887f625adf4809c3d300cf0a", "a11yPatternDisplayId": "A11Y-PAT-B6D59230E1E6", "a11yOccurrenceFingerprint": "7152d0f017f92b714acf2482364accec0f0603111255c9e668ee231d7e65806e", "a11yOccurrenceDisplayId": "A11Y-OCC-7152D0F017F9" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
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                            \n CMS Newsroom\n

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                            \n 988 Suicide and Crisis Lifeline\n\n

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                            Launching and improving access to 988

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                            Spotlight

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                            Project Start: December 2021

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                            Team Members: Amy Behrens, Meredith Stewart, Misu Tasmin, Ian Munoz, Elizabeth Schweinsberg, Steve Albers, Melissa Eggleston, Cass Olson, Mathias Rechtzigel

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                            Substance Abuse and Mental Health Service Administration Partners: 988 and Behavioral Health Crisis Coordinating Office

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                            About

                            Challenge

                            In 2020, the U.S. saw one death by suicide every 11 minutes. That same year, Congress designated the new three-digit dialing code of 988 to direct to the existing National Suicide Prevention Lifeline beginning on July 16, 2022. This is a first step toward a transformed crisis care system in America.

                            The 988 Suicide and Crisis Lifeline offers 24/7 access to trained crisis counselors who can help people experiencing mental health-related distress and their loved ones in all states and territories. Studies have shown that after speaking with a trained crisis counselor, most 988 Lifeline callers are significantly more likely to feel less depressed, less suicidal, less overwhelmed and more hopeful.

                            With the easier-to-remember number, SAMHSA projected at least a 25% increase in volume across calls, chats, and texts. Given the existing 1-800-number was underperforming in answer rates, the Biden-Harris Administration increased federal investments 18-fold (from $24M to $432M) for this national priority.

                            This increase in funding went to shore up the national back-up centers, chat and text centers, and state programs. With the funding only reaching centers two to six months before the July transition, SAMHSA had to find fast, high-impact areas to improve service levels to meet the projected demand. 

                            Solution

                            Members of the Digital Services at CMS (DSAC) team embedded with the SAMHSA 988 team to improve nearly all aspects of the 988 system. The team:

                            • Prepared data and created visualizations to make sure that SAMHSA and HHS leadership could make data-informed, responsive decisions to increase 988’s performance 
                            • Ensured that the 988 technology was able to handle the projected volume increases and set an ongoing system security monitoring process through a partnership with the Cybersecurity Infrastructure Agency (CISA)
                            • Organized national forum to examine geolocation needs and feasibility for 988–including privacy experts, people who have experienced crisis, and people from communities more at risk of violence, in addition to traditional partners
                            • Conducted a discovery sprint to identify methods to quickly hire and activate a workforce of trained crisis counselors  
                            • Created a simple web page with a list of the 200+ call centers’ hiring pages for people interested in 988 jobs 
                            • Worked to build hiring pipelines with partners such as AmeriCorps and community colleges to recruit new crisis counselors

                            After the launch of 988, DSAC team members continued to collaborate with SAMHSA to:

                            • Improve accessibility of 988 for mobile users who use screen readers or voice assistants across Android, iOS, and Samsung devices
                            • Developed recommendations to improve the handoff of calls between 988 and 911 and convened partners from across the mental health, emergency services, and telecommunication fields to begin implementation
                            • Conducted user research to improve the interactive voice response system that directs the 988 calls to ensure those calling the Lifeline have a welcoming experience and are able to get help as soon as possible
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                            “I have spent my career working in health and public health and never have I seen a group of people as dedicated to their work as the people who work in suicide prevention – it is unreal.” - DSAC Designer

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                            “It was amazing to see how much it meant to them, how hard they were working, how they were finally getting some momentum for this work that they’ve been pushing along for so long. I mean, some of them have been working in this field for over 30 years. It was just inspiring. I felt like a little speck of dust trying to amplify their voice and help them implement the program the best way possible.” - DSAC Designer

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                            Impact

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                            “Having this number may not seem too important to us adults, but kids today will grow up knowing this number. Knowing that there’s someone to listen to day and night. Someone to help.”  - SAMHSA partner

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                            • In the first year of 988, the Lifeline received over 5 million calls, chats, and texts in English and Spanish–an increase of 2 million over the previous year with the 1-800 number
                            • From May 2022 to May 2023, call answer rates increased from 70% to 93%, text answer rates from 82% to 98%, and chat answer rates from 46% to 98%--all with a soaring volume
                            • Response time dropped from 2 minutes and 20 seconds to 35 seconds
                            • In the first year of launching the jobs page, there were over 200k page views
                            • The improvements in the automated voice answering system resulted in an estimated 36,000 calls being answered over 12 months 
                            • Three major operating systems are working with SAMHSA to improve accessibility and have created the communication pathways for more updates in the future
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                              ", "outcomeCount": 1074, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11883, "settleDelayMs": 10000, "auditMs": 1562, "totalMs": 14041, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1948, "failed": 20, "cantTell": 12, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_block_heading", "text_sensory_misuse" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "d27832e853e6", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "03e144471f46466aa37b2771fba2ac69186e378351d4329862ac555556f4f9e5", "a11yOccurrenceDisplayId": "A11Y-OCC-03E144471F46" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "8036a80917e6", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-8e84810c", "a11yPatternFingerprint": "09a6e7e85d98e56ab67e3fa333b31089dbcc561e4d4b48b60726d0c1e65e9ee4", "a11yPatternDisplayId": "A11Y-PAT-09A6E7E85D98", "a11yOccurrenceFingerprint": "e75b66d621a006b440363eb2f713aacde2347344789474209863626b85525fc3", "a11yOccurrenceDisplayId": "A11Y-OCC-E75B66D621A0" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                              ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
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                              \n \n \"CMS.gov\"\n \n
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                              \n Centers for Medicare & Medicaid Services\n
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                              \n CMS Newsroom\n

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                              Search CMS.gov

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                              \n Artificial Intelligence Demo Days\n\n

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                              Request for Information on Artificial Intelligence Technologies for Improving Health Care Outcomes and Service Delivery

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                              Submissions are currently closed. Keep an eye out for future RFIs. 

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                                ", "outcomeCount": 883, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11790, "settleDelayMs": 10000, "auditMs": 1410, "totalMs": 13804, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1464, "failed": 15, "cantTell": 7, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "db348232a3bd", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "ecde9d3aec4b6ab35603eaced9309cfa90d5a3d580bc918abe3770f4ce7170d1", "a11yOccurrenceDisplayId": "A11Y-OCC-ECDE9D3AEC4B" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "e855a8009261", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-de7a84d1", "a11yPatternFingerprint": "b004830c68d89f6639a7e78ea1b525103f68ba071e3ee207686fb9c17525aaa7", "a11yPatternDisplayId": "A11Y-PAT-B004830C68D8", "a11yOccurrenceFingerprint": "09a2f49fa5525fc00c6bd3d959e6cc47aaa66c142008bc074afa2ac4dae802d6", "a11yOccurrenceDisplayId": "A11Y-OCC-09A2F49FA552" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                                ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
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                                \n \n \"CMS.gov\"\n \n
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                                \n Centers for Medicare & Medicaid Services\n
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                                \n CMS Newsroom\n

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                                Search CMS.gov

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                                \n Medical Bill Rights\n\n

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                                Helping people exercise their new rights to avoid surprise medical bills.

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                                Spotlight

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                                Project Timeline: June 2022 - June 2023

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                                Team Members: Alex Ciepley, Laura Carollo, Dave Methvin, Anne Wood, Aryeh Jacobsohn, Joy Day

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                                About

                                Challenge

                                Unexpected medical bills are a source of stress, frustration, and confusion. For people in the U.S., the No Surprises Act gives new rights to prevent and resolve these surprise bills.

                                The Digital Service at CMS (DSAC) was asked to create web content to help people understand and act on their new rights. The team took a human-centered approach to make sure the content and tools were accessible to the people who needed them most.

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                                Solution

                                We worked closely with the Office of the Administrator (OA), the Office of Communications (OC), and the Center for Consumer Information and Insurance Oversight (CCIIO) at CMS to create cms.gov/medical-bill-rights and cms.gov/derechos-facturas-medicas. 

                                To do this, the team conducted 17 rounds of research–adding up to more than 90 hours of interviews with patients, caregivers, patient advocates, and help desk staff. This research led to the development of a plain language explanation of rights, guides to help users navigate billing issues, and an interactive tool to empower people through a step-by-step plan to address their specific situation. It also allowed the team to improve an existing complaints form to improve readability and layout.

                                To create effective Spanish-language content, we hired a native Spanish-speaking content designer to design the content, not simply translate the English version. This helped ensure content is culturally relevant and linguistically appropriate.

                                The Medical Bill Rights content is also inclusive and accessible because we:

                                • Provide all information in both English and Spanish
                                • Used best practices in plain language and clear design
                                • Built the site to be responsive to different devices, including mobile phones and tablets
                                • Offer multiple clear pathways for people to learn about their rights
                                • Meet WCAG 2.1 AA accessibility standards

                                 

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                                Impact

                                CMS.gov launched the Medical Bill Rights pages in June 2023 and saw an immediate increase in site visits thanks to a coordinated release with consumers and patient advocacy groups. The site has shown continued growth since its launch, with a 50% increase in traffic since its launch month.

                                The new site replaced over a dozen non-accessible PDFs with accessible and bilingual web pages, resulting in a dramatic decrease in PDF downloads that was completely replaced with visits to the newly formatted pages.

                                The redesign of the complaints form has also been a success, resulting in over a 60% increase in the form completion rate.

                                The staff of the No Surprises Help Desk, who provide phone support to members of the public, have applauded the new content and layout, saying it has resulted in an \"ease in locating answers quickly and efficiently\" when speaking with consumers.

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                                Quotes

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                                \"The Spanish [version] is simple, anyone from any [Spanish-speaking] country can understand, from low and high education levels.\" 

                                - Member of the Public

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                                \"It’s easier on the eyes and not as intimidating. That will definitely provide a better service to the consumers.\" 

                                - No Surprises Help Desk staff

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                                \"Just applaud the team. People need this help. I’ll be promoting it.\" 

                                - Patient Advocate

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                                “It’s organized and professional, but it’s still comfortable. It doesn’t look like it’s all business. It’s just gentle enough to be relatable without being patronizing. . . . Your site is like the digital version of bedside manner.” 

                                - Member of the Public

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                                “I feel like there is help out there for people like myself regarding medical bills after looking through all of these pages and options.\" 

                                - Member of the Public

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                                “I think having this tool would help me know that there are better decisions I could make next time.\" 

                                - Member of the Public

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                                  ", "outcomeCount": 1106, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11434, "settleDelayMs": 10000, "auditMs": 1649, "totalMs": 13682, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 2102, "failed": 34, "cantTell": 26, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "list_markup_review", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_block_heading", "text_quoted_correctly" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "836104216ebc", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "4f317e93688da80a981aa519024f872227528fcedd9d3c17b641d12c33fdc169", "a11yOccurrenceDisplayId": "A11Y-OCC-4F317E93688D" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "143ad87d5249", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-8e84810c", "a11yPatternFingerprint": "09a6e7e85d98e56ab67e3fa333b31089dbcc561e4d4b48b60726d0c1e65e9ee4", "a11yPatternDisplayId": "A11Y-PAT-09A6E7E85D98", "a11yOccurrenceFingerprint": "34929b1d861c065d57513632b49e5391b2511a65e4f2f3a03c4da21679133dc0", "a11yOccurrenceDisplayId": "A11Y-OCC-34929B1D861C" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                                  ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
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                                  \n \n \"CMS.gov\"\n \n
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                                  \n Centers for Medicare & Medicaid Services\n
                                  \n
                                  \n

                                  \n CMS Newsroom\n

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                                  Search CMS.gov

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                                  \n Open Source Program Office\n\n

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                                  An open source program office (OSPO) serves as the center of competency for an organization's open source operations and structure. It is responsible for defining and implementing strategies and policies to guide these efforts. The function of the CMS OSPO is: 


                                  “Establish and maintain guidance, policies, practices, and talent pipelines that advance equity, build trust, and amplify impact across CMS, HHS, and Federal Open Source Ecosystems by working and sharing openly.” 

                                   

                                  CMS Open Source insights and resources

                                  The OSPO also provides guidance and produces reports on current events.

                                  CMS OSPO in the news

                                  Acknowledgements

                                  Our work has been preceded by and developed in collaboration with many members of the Federal Open Source community, including but not limited to: 

                                  Thank you all for your support and contributions.

                                  CMS Open Source Policy and Repositories

                                  We adhere to the CMS Open Source Policy. You can find our OSPO repositories at https://github.com/DSACMS. If you have any questions, please send us an email.

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                                    ", "outcomeCount": 1101, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11284, "settleDelayMs": 10000, "auditMs": 1610, "totalMs": 13498, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 2154, "failed": 16, "cantTell": 10, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "2260bfd78084", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "64f296f5cce08517c38cf41fc465109582e7d16bb05f8266777ba8cb65a5a79b", "a11yOccurrenceDisplayId": "A11Y-OCC-64F296F5CCE0" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "125b9ab3bd9e", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-de7a84d1", "a11yPatternFingerprint": "b004830c68d89f6639a7e78ea1b525103f68ba071e3ee207686fb9c17525aaa7", "a11yPatternDisplayId": "A11Y-PAT-B004830C68D8", "a11yOccurrenceFingerprint": "c927469de8ae046a07f6184e12b7be8fbc5e024528db2803b659b107280f971e", "a11yOccurrenceDisplayId": "A11Y-OCC-C927469DE8AE" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                                    ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
                                    ", "isDuplicate": false, "duplicateOf": null, "fingerprint": "2e76a49a5b4c", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-89901a43", "a11yPatternFingerprint": "ccc5f1c9dac6a572a12ac5cee9c2c4ccc85db99ee74c6390be6ad4518f5d39af", "a11yPatternDisplayId": "A11Y-PAT-CCC5F1C9DAC6", "a11yOccurrenceFingerprint": "59933adac3ea22965d7939ba3948afe02406e0cc1f009170b37fee17597116a9", "a11yOccurrenceDisplayId": "A11Y-OCC-59933ADAC3EA" }, { "rule": "element_tabbable_unobscured", "xpath": null, "html": "", "message": "Confirm that when the element receives focus, it is not covered or, if covered by user action, can be uncovered without moving focus", "isDuplicate": false, "duplicateOf": null, "fingerprint": "1622c5a687ed", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-4aa49828", "a11yPatternFingerprint": "2b77104f5d2551b1d300a8ea760ca81a4c99df5f3404a25a3dfe1ee1d8853877", "a11yPatternDisplayId": "A11Y-PAT-2B77104F5D25", "a11yOccurrenceFingerprint": "7497edfe75556d59705c5e2ed802f9545eb46f63b63ef54f3721086c3d02f7c1", "a11yOccurrenceDisplayId": "A11Y-OCC-7497EDFE7555" }, { "rule": "style_focus_visible", "xpath": null, "html": "
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                                    \n \n \"CMS.gov\"\n \n
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                                    \n Centers for Medicare & Medicaid Services\n
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                                    \n CMS Newsroom\n

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                                    Search CMS.gov

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                                    \n Transparency\n\n

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                                    People deserve to know how much they'll pay to visit a doctor or hospital. Along with our colleagues at CMS, the Digital Service at CMS (DSAC) is working to make that happen.

                                    Our Work

                                    Hospital Price Transparency

                                    Hospital price transparency (HPT) helps people in the U.S. understand the cost of hospital items or services before making a decision about their health care. Since Jan 1, 2021, CMS has required every U.S. hospital to provide clear, accessible, online pricing information about the items and services they offer in two formats: a machine-readable file and as a consumer-friendly display. By embracing a human-centered approach, DSAC built an open source tool that helps hospitals post clear pricing data on their websites.

                                    Open Source Program Office

                                    Since January 2022, people without health insurance have been entitled to an estimate for the cost of treatment before receiving care–and have a path to dispute a bill that is above that estimate. DSAC worked hand-in-hand with our partners all across CMS to help people understand their new rights.  Learn more about our Open Source Program Office.

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                                      ", "outcomeCount": 909, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11961, "settleDelayMs": 10000, "auditMs": 1516, "totalMs": 14078, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1526, "failed": 18, "cantTell": 10, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_sensory_misuse" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "de98c8b80bf8", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "8ed1e065625b234db6dd88302c92bc823aa6fc3f39e69f4326acfd172b91fbaf", "a11yOccurrenceDisplayId": "A11Y-OCC-8ED1E065625B" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "10f8f7b2be42", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-de7a84d1", "a11yPatternFingerprint": "b004830c68d89f6639a7e78ea1b525103f68ba071e3ee207686fb9c17525aaa7", "a11yPatternDisplayId": "A11Y-PAT-B004830C68D8", "a11yOccurrenceFingerprint": "1ccc125eceb53ba54647b67eb5ab03d137d9852e8a5f707873f814e0481730b4", "a11yOccurrenceDisplayId": "A11Y-OCC-1CCC125ECEB5" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                                      ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
                                      ", "isDuplicate": false, "duplicateOf": null, "fingerprint": "dfa2d593538a", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-89901a43", "a11yPatternFingerprint": "ccc5f1c9dac6a572a12ac5cee9c2c4ccc85db99ee74c6390be6ad4518f5d39af", "a11yPatternDisplayId": "A11Y-PAT-CCC5F1C9DAC6", "a11yOccurrenceFingerprint": "f982c7aa23fa813fba187b9e0af087ebaf3aeb592a34f3da2562f71c41771fb8", "a11yOccurrenceDisplayId": "A11Y-OCC-F982C7AA23FA" }, { "rule": "element_tabbable_unobscured", "xpath": null, "html": "", "message": "Confirm that when the element receives focus, it is not covered or, if covered by user action, can be uncovered without moving focus", "isDuplicate": false, "duplicateOf": null, "fingerprint": "c310f90bc3f6", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-4aa49828", "a11yPatternFingerprint": "2b77104f5d2551b1d300a8ea760ca81a4c99df5f3404a25a3dfe1ee1d8853877", "a11yPatternDisplayId": "A11Y-PAT-2B77104F5D25", "a11yOccurrenceFingerprint": "94168ad326e75cdf4a70118a627d16b3a45eaaa28fe1cada63ddfed0a88ba221", "a11yOccurrenceDisplayId": "A11Y-OCC-94168AD326E7" }, { "rule": "style_focus_visible", "xpath": null, "html": "
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                                      \n \n \"CMS.gov\"\n \n
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                                      \n Centers for Medicare & Medicaid Services\n
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                                      \n CMS Newsroom\n

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                                      Search CMS.gov

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                                      \n Usability Research at the Digital Service at CMS\n\n

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                                      Getting feedback on our products and services from the people we serve

                                      The Centers for Medicare & Medicaid Services (CMS) interacts with millions of people every day.  The Digital Service at CMS (DSAC) conducts usability research to learn how easy or difficult these touch points are for the people who rely on them.

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                                      What's on this page
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                                      • How usability testing works
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                                      • Remote usability feedback sessions
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                                      What usability testing is and how it works 

                                      When our team is looking for feedback on a process, service, or tool, we reach out to members of the public to give us feedback. Usability testing is way for us to evaluate how easy something is to use. 

                                      Typically we ask an individual to complete a few tasks on a website, app, or prototype. We observe how hard it is for them to complete the tasks, which tells us what design changes are needed. We also ask follow up questions to understand what's working well or not from the individual's perspective. 

                                      After doing this with this with anywhere from 3 - 10 individuals, we usually have a clear sense of how to improve the design. Here are some answers to common questions we receive about usability testing: 

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                                      Who will be there? 

                                      There will be up to 4 CMS employees on the call and the research participant (the person we’re receiving feedback from).  A typical research session will look like:

                                      • CMS facilitator
                                        • This person will ask most of the questions and lead research participants through the tasks.
                                      • CMS note-taker 
                                        • This person will take most of the notes.
                                      • CMS observers (optional)
                                        • These are people who are trying to learn by watching how well the website, app, prototype, etc. is working. 
                                      • Reserach participant
                                        • The person we’re receiving feedback from.

                                      What will the session be like?

                                      Each session will be a little different to meet the needs of our audiences and the goal of the session but will include these parts:

                                      Introduction

                                      The CMS facilitator will introduce the team, ask the participant for consent to record and take notes, and ask a couple of general questions of the participant. 

                                      Tasks and feedback about the tool

                                      The CMS facilitator will then share the product or information about the service with the participant to provide feedback on. The facilitator will ask the participant to complete some tasks. Follow up questions are generally open ended to better understand the participant's experience. You might hear questions such as:

                                      • “What do you think you could do with this?”
                                      • “Could you tell me more?”
                                      • “Could you share what was frustrating?”
                                      • “Was there anything that was confusing?”

                                      Wrap up and last thoughts

                                      This is an opportunity for the participant to share feedback that didn’t come up in the session. Every person will have experiences to share, which is important to making these touch points better. The CMS note-taker and observer will also have the opportunity to ask any follow-up questions.

                                      After the final questions, the CMS team will check in one more time to ensure the participant is comfortable with us sharing the recording with teammates, ask it's ok to use anonymous quote, and offer any support resources.

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                                      That's it? That was kind of fun! 

                                      – Participant in a research session

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                                      Remote usability feedback sessions

                                      Remote sessions allow CMS to receive feedback from people across the country. When organizing these sessions the CMS facilitator will often conduct outreach and provide resources ahead of time. These resources include:

                                      • Session information. Which includes:
                                        • What topic we’re asking for feedback on
                                        • When the usability session will occur
                                        • How long the usability session will take
                                      • Contact information:
                                        • Life happens. We’ll share our contact information just in case a participant needs to get a hold of us to reschedule.
                                      • Any consent or other documentation:
                                        • Sometimes we require consent forms to ensure that participants are intentionally opting into feedback sessions.

                                      We know that sometimes the topics we’re talking about can be hard. At any point during these sessions participants can pause or stop entirely, for any reason.

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                                        ", "outcomeCount": 1127, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 12083, "settleDelayMs": 10000, "auditMs": 1680, "totalMs": 14364, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 2066, "failed": 21, "cantTell": 13, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_block_heading", "text_sensory_misuse" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "707cf571df89", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "ee463176dd4fbb28fc504c48aadd06f254c3a09c1867a4ae247c873cae6ed202", "a11yOccurrenceDisplayId": "A11Y-OCC-EE463176DD4F" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "8f9af4e77b84", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-b9072320", "a11yPatternFingerprint": "bdc40faf008904bd2aa4dba2fbacdfb1fcb87355e3b7d0063285c3b1ebdb1455", "a11yPatternDisplayId": "A11Y-PAT-BDC40FAF0089", "a11yOccurrenceFingerprint": "9ad79736328f72cc81a6895c79e1f6278bccb96db412d3dbfe13a1795056f244", "a11yOccurrenceDisplayId": "A11Y-OCC-9AD79736328F" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                                        ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
                                        ", "isDuplicate": false, "duplicateOf": null, "fingerprint": "683a430d95f5", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-89901a43", "a11yPatternFingerprint": "ccc5f1c9dac6a572a12ac5cee9c2c4ccc85db99ee74c6390be6ad4518f5d39af", "a11yPatternDisplayId": "A11Y-PAT-CCC5F1C9DAC6", "a11yOccurrenceFingerprint": "3b86cab8302c0829ac59020e9d7c20f3377476dcc8cf78ac8bcdd153fb92b6bf", "a11yOccurrenceDisplayId": "A11Y-OCC-3B86CAB8302C" }, { "rule": "element_tabbable_unobscured", "xpath": null, "html": "", "message": "Confirm that when the element receives focus, it is not covered or, if covered by user action, can be uncovered without moving focus", "isDuplicate": false, "duplicateOf": null, "fingerprint": "2b53827feaec", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-4aa49828", "a11yPatternFingerprint": "2b77104f5d2551b1d300a8ea760ca81a4c99df5f3404a25a3dfe1ee1d8853877", "a11yPatternDisplayId": "A11Y-PAT-2B77104F5D25", "a11yOccurrenceFingerprint": "d3d82e01754ff2710b6778e1647842ecfa0500a8d91d5bdaef265db2da9dace7", "a11yOccurrenceDisplayId": "A11Y-OCC-D3D82E01754F" }, { "rule": "style_focus_visible", "xpath": null, "html": "
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                                        \n \n \"CMS.gov\"\n \n
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                                        \n Centers for Medicare & Medicaid Services\n
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                                        \n CMS Newsroom\n

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                                        Search CMS.gov

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                                        \n PFS Look-up Tool Overview\n\n

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                                        The PFS Look-Up Tool gives Medicare payment information on more than 10,000 services, including:

                                        • Pricing
                                        • Associated relative value units (RVUs)
                                        • Payment policies

                                        The tool doesn’t display Medicare Administrative Contractor (MAC) priced codes or Medicare Part B non-payable codes.

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                                        The PFS Look-Up Tool helps you find Medicare payment amounts for each code so you can calculate the patient coinsurance amount. The PFS gives the limiting charge for nonparticipating providers and suppliers who treat Medicare patients.

                                        You can use a single procedure code, a range of procedure codes, or a list of procedure codes to search for national payment amounts through a specific MAC or a specific MAC locality.

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                                        Use the PFS to check if these payment polices affect HCPCS codes:

                                        • Payment of assistant at surgery services
                                        • Applicability of certain modifiers
                                        • Physician supervision of diagnostic services
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                                        We adjust the PFS pricing amounts to reflect the variation in practice costs from area to area. Each Medicare payment locality has a geographic practice cost index (GPCI) for the 3 components of a procedure's relative value unit (like the RVUs for work, practice expense, and malpractice). We apply the GPCIs in the calculation of a fee schedule payment amount by multiplying the RVU for each component times the GPCI for that component.

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                                        Begin Search

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                                        Disclaimer:

                                        This display tool is an aid for physicians and non-practitioners looking for PFS payment rates. We make no warranties, expressed or implied, regarding errors or omissions and assume no legal liability or responsibility for loss or damage resulting from the use of information in the tool. For the official and definitive CMS PFS payment files, contact your MAC.

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                                          ", "outcomeCount": 1335, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11664, "settleDelayMs": 10000, "auditMs": 1691, "totalMs": 13955, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 1 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 2385, "failed": 20, "cantTell": 11, "inapplicable": 0 }, "failedRules": [ "aria_descendant_valid", "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "d48bf2c8c758", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "1df205cf87a8620d346de2c2b41817911f4dc3a69f7f525cb07f03171d8df51e", "a11yOccurrenceDisplayId": "A11Y-OCC-1DF205CF87A8" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "1ef890c320d0", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-bb4357f1", "a11yPatternFingerprint": "c5cf55872b0bf9eb20594423e884e187eaf7e44b2d4eda0a0a426c59092f06ea", "a11yPatternDisplayId": "A11Y-PAT-C5CF55872B0B", "a11yOccurrenceFingerprint": "e69bfb32aa929a869f5df2800f90966f26c00573dcf47d948486ba0b802473b4", "a11yOccurrenceDisplayId": "A11Y-OCC-E69BFB32AA92" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                                          ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
                                          ", "isDuplicate": false, "duplicateOf": null, "fingerprint": "2d29547bf7fd", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-89901a43", "a11yPatternFingerprint": "ccc5f1c9dac6a572a12ac5cee9c2c4ccc85db99ee74c6390be6ad4518f5d39af", "a11yPatternDisplayId": "A11Y-PAT-CCC5F1C9DAC6", "a11yOccurrenceFingerprint": "b953d284ccd282e678614191b5af16011a7e066787554c199123983a39e5c0c3", "a11yOccurrenceDisplayId": "A11Y-OCC-B953D284CCD2" }, { "rule": "element_tabbable_unobscured", "xpath": null, "html": "", "message": "Confirm that when the element receives focus, it is not covered or, if covered by user action, can be uncovered without moving focus", "isDuplicate": false, "duplicateOf": null, "fingerprint": "ff68f5304041", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-4aa49828", "a11yPatternFingerprint": "2b77104f5d2551b1d300a8ea760ca81a4c99df5f3404a25a3dfe1ee1d8853877", "a11yPatternDisplayId": "A11Y-PAT-2B77104F5D25", "a11yOccurrenceFingerprint": "db6e2a3a77f31078fc6bc13a96b1221af8ff0ba40f28362564485947dbb335b5", "a11yOccurrenceDisplayId": "A11Y-OCC-DB6E2A3A77F3" }, { "rule": "style_focus_visible", "xpath": null, "html": "
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                                          \n \n \"CMS.gov\"\n \n
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                                          \n Centers for Medicare & Medicaid Services\n
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                                          \n CMS Newsroom\n

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                                          Search CMS.gov

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                                          \n Medicare Open Enrollment Period outreach & media materials\n\n

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                                          We have outreach and media materials for English-speaking, Spanish-speaking, and other audiences that can help you to help others with Medicare Open Enrollment. 

                                          General market outreach materials

                                          Videos to share with people with Medicare

                                          Television & radio ads

                                          • Medicare Open Enrollment 2025 Live Script (PDF) (Coming soon)

                                          Social media

                                          • Medicare Open Enrollment partner social media toolkit (PDF) (Coming soon)
                                          • Medicare Open Enrollment images for social media (ZIP) (Coming soon)
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                                            ", "outcomeCount": 978, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11913, "settleDelayMs": 10000, "auditMs": 1543, "totalMs": 14052, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1700, "failed": 15, "cantTell": 11, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "d990b8e34883", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "83ed14624c6c2e6200376ff9e9af04144a9e2bb5538dff4d122cd16a904bd8ea", "a11yOccurrenceDisplayId": "A11Y-OCC-83ED14624C6C" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "a15cd129e010", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-5467b053", "a11yPatternFingerprint": "71c6e668f4f5dd2f4370f219995ff38c0c5f9526f59dc0afdbf4e81b3fb32e25", "a11yPatternDisplayId": "A11Y-PAT-71C6E668F4F5", "a11yOccurrenceFingerprint": "a928532589e006aa9722a3b5e4aeb62e783f2297342ddc97f49427f974bd5abb", "a11yOccurrenceDisplayId": "A11Y-OCC-A928532589E0" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                                            ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
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                                            \n \n \n \n \n\n \n
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                                            \n Contact Us\n\n

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                                            For questions about enrolling in Medicare, call Social Security at 1-800-772-1213 or visit socialsecurity.gov. TTY users should call 1-800-325-0778.  For those who worked for a railroad or get Railroad Retirement Board (RRB) benefits, call the RRB at 1-877-772-5772 or visit rrb.gov. TTY users should call 1-312-751-4701.

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                                            For questions about Medicare benefits, call 1-800-MEDICARE (1-800-633-4227) or visit Medicare.gov. TTY users should call 1-877-486-2048.

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                                            Contact a local State Health Insurance Assistance Program (SHIP) to get free personalized counseling on Medicare coverage, claims, appeals, and help for people with limited income and resources. Call 1 800 MEDICARE or visit Medicare.gov/contacts or visit shiptacenter.org to get the phone number of your local SHIP.

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                                              ", "outcomeCount": 988, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 12280, "settleDelayMs": 10000, "auditMs": 1573, "totalMs": 14457, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1674, "failed": 16, "cantTell": 7, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "b2faad7e6027", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "b9d1ea8edc105c3c208acb604a86150c2a1c73df35209d0c62f3bf55628f2ed3", "a11yOccurrenceDisplayId": "A11Y-OCC-B9D1EA8EDC10" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "652ac3102687", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f891efa0", "a11yPatternFingerprint": "b6d59230e1e62a622d7394c2d0cbf6faca8d9053887f625adf4809c3d300cf0a", "a11yPatternDisplayId": "A11Y-PAT-B6D59230E1E6", "a11yOccurrenceFingerprint": "0b1718229a3f4fff8179b71e907558a2d545ec9a91f8bdf662ca94c73f234ea4", "a11yOccurrenceDisplayId": "A11Y-OCC-0B1718229A3F" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                                              ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
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                                              \n \n \n \n \n\n \n
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                                              \n \n \"CMS.gov\"\n \n
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                                              \n Centers for Medicare & Medicaid Services\n
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                                              \n

                                              \n CMS Newsroom\n

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                                              Search CMS.gov

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                                              \n Publications to share with employees\n\n

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                                              Retirement Planning Toolkit from the Department of Labor

                                              Resources for those nearing retirement Department of Labor’s Retirement Toolkit

                                              Medicare publications to help employees

                                              General Information on Medicare:

                                              Introduction to Medicare (PDF)

                                              Gives an overview of Parts A, B, C, and D of Medicare; and information about Medicare terms and other resources. 

                                              A Quick Look at Medicare

                                              Provides basic information about the different parts of Medicare and Medicare coverage choices.

                                              The Medicare & You Handbook

                                              Provides a summary of Medicare benefits, coverage decisions, rights and protections, and answers to the most frequently asked questions about Medicare.

                                              Making decisions about Medicare:

                                                       Help employees make decisions about Medicare enrollment with: 

                                              Medicare Enrollment:

                                              Enrolling in Medicare Part A & Part B

                                              Explains how to enroll in Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).

                                              Medicare Advantage Plans vs. Medicare Supplement Insurance (Medigap) Policies:

                                              What’s a Medicare Advantage Plan?

                                              Gives an overview of the differences between Medicare Advantage Plans and Medigap policies.

                                              Marketplace:

                                              Medicare & The Health Insurance Marketplace

                                              Explains how the Health Insurance Marketplace affects people with Medicare.

                                              Medicare Periodic Data Matching (PDM) Frequently Asked Questions (PDF)

                                              Provides answers to commonly asked questions about Medicare and the Marketplace.

                                              Coordination of Benefits:

                                              Medicare and Other Health Benefits: Your Guide to Who Pays First

                                              Explains how Medicare works with other types of coverage and who should pay bills first.  

                                              Contacting Medicare:

                                              Get Your Medicare Questions Answered

                                              Explains when to call 1-800-MEDICARE or other resources for answers to your Medicare questions.

                                              Medicare Rights & Protections

                                              Provides important information about rights and protections of people with Medicare and where to get help with your questions.

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                                                ", "outcomeCount": 1081, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11821, "settleDelayMs": 10000, "auditMs": 1677, "totalMs": 14102, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1977, "failed": 17, "cantTell": 16, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "26b12d49e207", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "326fd149aed9120744e75d87ab9ae47b99348acef7fa97c518b34d5a48e11601", "a11yOccurrenceDisplayId": "A11Y-OCC-326FD149AED9" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "dbd67f9bb5f0", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f891efa0", "a11yPatternFingerprint": "b6d59230e1e62a622d7394c2d0cbf6faca8d9053887f625adf4809c3d300cf0a", "a11yPatternDisplayId": "A11Y-PAT-B6D59230E1E6", "a11yOccurrenceFingerprint": "19636879ee03d460387ed2510a10789abd3c03cebcf6e48cc821037da4486c8a", "a11yOccurrenceDisplayId": "A11Y-OCC-19636879EE03" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                                                ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
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                                                \n CMS Newsroom\n

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                                                Search CMS.gov

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                                                \n 5 things you need to know about signing up for Medicare\n\n

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                                                1. People are eligible for Medicare for different reasons.  

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                                                It’s important to know the different ways people qualify for Medicare. You’ll be able to help current and former employees and their dependents get ready for Medicare, and make timely and appropriate decisions about signing up.

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                                                People are eligible for Medicare when they turn 65. People under 65 are eligible if they’ve gotten Social Security Disability Insurance (SSDI) or certain Railroad Retirement Board (RRB) disability benefits for at least 24 months. If they have amyotrophic lateral sclerosis (ALS), there’s no waiting period for Medicare. Some people with End Stage Renal Disease (ESRD) may be eligible for Medicare.

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                                                2. Some people get Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) automatically, and some people need to sign up. 

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                                                People living in the U.S. and U.S. Territories (except Puerto Rico) who are already getting Social Security—either because of disability or retirement—are automatically signed up for Part A and Part B when they’re first eligible. They get a packet of information a few months before they turn 65 or when they get their 25th month of Social Security Disability or Railroad Retirement Board (RRB) benefits. At that time, they can choose to keep or decline Part B, but can’t they decline Part A unless they withdraw their original application for Social Security and pay back all Social Security cash benefits.  

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                                                People aren’t automatically enrolled in Medicare if they aren’t getting Social Security or aren’t eligible for Social Security retirement. They can sign up by completing an application for Part A (Hospital Insurance) (CMS 18-F-5 (PDF)) or by contacting the Social Security Administration (SSA).  

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                                                People living in Puerto Rico or foreign countries who already have Part A need to sign up for Part B by completing an Application for Enrollment in Part B (CMS-40B). This form is also available in Spanish (PDF).

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                                                3. People can only sign up for Medicare at certain times.

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                                                If someone is eligible for premium-free Part A because of their age, and isn’t automatically enrolled, they can sign up for Part A any time after they’re first eligible for Medicare  beginning with their Initial Enrollment Period (IEP). An individual may be eligible for premium-free Part A if they or their spouse paid Medicare taxes while working. If they’re eligible for premium-free Part A, coverage for Part A begins 6 months back from the date they apply, but no earlier than the first month they were eligible for Medicare. Individuals must stop contributing to their health savings account 6 months before applying for Medicare to prevent paying an IRS penalty.

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                                                People can sign up for Part B and premium-Part A during:

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                                                Initial Enrollment Period (IEP) – The 7-month period when someone is first eligible for Medicare. For those eligible due to age, this period begins 3 months before they turn 65, includes the month they turn 65, and ends 3 months after they turn 65. Coverage begins the month after a person signs up during their IEP. For those eligible due to disability, this period begins three months before their 25th month of disability payments, includes the 25th month, and ends 3 months after. Disabled individuals who have gotten disability benefits from Social Security for 24 months are automatically enrolled in Medicare.

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                                                General Enrollment Period (GEP) – People can sign up between January 1–March 31 each year. Coverage will start the month after the person signs up.

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                                                Special Enrollment Period (SEP) Related to Coverage Under Group Health Plans

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                                                  \n\t
                                                • This SEP is an opportunity for people who didn’t sign up for Medicare when first eligible because they had group health plan coverage based on current employment (their own, a spouse’s, or a disabled family member’s).
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                                                • A person may sign up for Medicare while they’re still covered under the group health plan based on current employment, or the first month when their coverage isn’t based on current employment. They may choose to have coverage begin on the month they sign up or at the beginning of any of the three months after they sign up.
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                                                • If they sign up for Medicare during any of the remaining seven months of this SEP, coverage will begin the month after they sign up.
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                                                • If a person qualifies for Medicare based on disability, and the group health plan is based on a family member’s current employment (other than a spouse’s employment), the employer offering the plan must have 100 or more employees. People who qualify for Medicare based on a disability may be eligible for an SEP based on their spouse’s current employment, or if a family member’s current employer has 100 or more employees.
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                                                4. Determining whether a person qualifies for a Special Enrollment Period Related to Coverage Under Group Health Plans is an important factor to consider when making the decision about Part B enrollment.

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                                                It’s critical that employees and their dependents consider whether Part B is right for them when they’re first eligible for Medicare. Decisions about signing up for Part B for people with employer–based insurance first depends on whether a person has insurance based on current employment.

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                                                Generally, if a person (or their spouse) is still working and has employer-sponsored group health plan coverage based on that employment, they can delay enrollment in Part B until a Special Enrollment Period. But, there are special rules for qualifying for the SEP Related to Coverage Under Group Health Plans.  

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                                                COBRA allows people to temporarily keep employer or union coverage after their employment ends or after they lose coverage as a dependent of the covered employee. A person with COBRA who doesn’t sign up for Medicare when first eligible may have to pay a life-long late enrollment penalty. Since COBRA coverage isn’t considered coverage based on current employment, they won’t qualify for the SEP Related to Coverage Under Group Health Plans after their COBRA coverage ends.

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                                                It’s important for people to sign up for Medicare, if they’re eligible, as soon as their employment ends. A person who’s eligible for Medicare, but gets COBRA coverage instead, may be responsible for significant bills. 

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                                                5. Knowing who pays first is another important factor to consider when deciding when to sign up for Part B.

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                                                When Medicare and another health insurance plan are responsible for paying the same medical claim, coordination of benefits rules determine how Medicare works with other health coverage. When someone is considering delaying or declining Part B, it’s important for them to know:

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                                                • Whether their employer-sponsored group health plan coverage will pay first and,
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                                                • If their employer-sponsored group health plan pays after Medicare, whether and how it will pay if the person doesn’t sign up for Part A and/or Part B.
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                                                Note: Most retiree and small employer plans (with less than 20 employees) require people to sign up for Part A and Part B as soon as they’re eligible.  If the retiree plan you offer requires Medicare enrollment, please tell your employees planning to retire well in advance. If someone doesn’t sign up for Part B when first eligible, they may have to pay late enrollment penalties, in addition to the standard Part B premium amount, for as long as they have Part B. They also may experience periods when they have limited or no health coverage.

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                                                  \n \n \"CMS.gov\"\n \n
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                                                  \n Centers for Medicare & Medicaid Services\n
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                                                  \n CMS Newsroom\n

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                                                  Search CMS.gov

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                                                  \n Web resources to help employees\n\n

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                                                  Helpful items for new enrollees

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                                                  Marketplace

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                                                  The Health Insurance Marketplace is a resource where individuals can find and enroll in a health plan to meet minimum essential coverage. Some employees may have health insurance through a Marketplace plan. Find answers to some Frequently Asked Questions on Medicare and the Marketplace.

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                                                  Coordination of benefits

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                                                  Provides more information on questions about how Medicare works with other health insurance Coordination of Benefits and which plan pays first.

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                                                  Health savings accounts

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                                                  Provides basic information about Health Savings Accounts (HSAs) and how employees can set aside tax-free money to pay for medical expenses. Some employees may want to have premium-free Part A start when they stop working; however, premium-free Part A coverage begins 6 months back from the time the person enrolls (but no earlier than the first month of eligibility). People must stop contributing to their HSA 6 months before applying for Medicare in order to not be penalized by the IRS.

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                                                  Continuation of health coverage

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                                                  COBRA gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their Group Health Plan under certain circumstances. Federal employees, retirees and their survivors can get health care through the Federal Employees Health Benefits (FEHB) Program.

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                                                  Veterans’ benefits

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                                                  Some employees have military health coverage through TRICARE, Veterans Benefits, or CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs).

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                                                  Information for caregivers

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                                                  Caregiving (PDF) for an aging, seriously ill, or disabled family member or friend on Medicare.

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                                                  Medicare Overview Presentation

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                                                  Please see below in “Downloads” for the Medicare Eligibility & Enrollment Overview presentation.

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                                                  Downloads

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                                                    \n \n \"CMS.gov\"\n \n
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                                                    \n CMS Newsroom\n

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                                                    \n Guidelines for effective writing\n\n

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                                                    Keep content meaningful & user-focused

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                                                    Give users clear value.
                                                    \nAsk yourself: Is this content saying something meaningful or adding new information?

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                                                    Get right to the point.
                                                    \nPeople have limited attention and patience and are quickly frustrated when expectations aren’t met. As communicators, it’s our job to help them get what they need quickly.

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                                                    Delete fluff. 
                                                    \nToo much unnecessary text leads to skipping. Users don’t care about what your organization and programs are doing; they care about WHAT AFFECTS THEM. Eliminate promotional, redundant, outdated, and trivial copy.

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                                                    Show, don’t tell.
                                                    \nLanguage like “this page makes it easy for you to find helpful contacts” is unnecessary. If the page really makes it easy, it should be obvious.

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                                                    Limit introductory text or instructions. 
                                                    \nIf we write clearly and concisely, the purpose and meaning should be obvious.

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                                                    Limit sentence & page length

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                                                    Keep sentences as short as you can — the shorter, the better.
                                                    \nTry to keep sentences to 20 words or less. Express one point per sentence. Put the most important information at the beginning. Remember audiences are scanning, not reading.

                                                    \n\n

                                                    Paragraphs should be 2 or 3 sentences max.
                                                    \nPut the most important information first.

                                                    \n\n

                                                    Tips for web pages. 
                                                    \nWrite content in independently meaningful chunks that make sense when taken out of context. Each content chunk should address just one issue. Readers overlook the second point when there are multiple items in a single chunk.

                                                    \n\n

                                                    If your webpage requires scrolling, make sure there are headers and/or menus to help users find what they’re looking for. Consider breaking up long text across multiple pages.

                                                    \n\n

                                                    Use active voice, not passive voice

                                                    \n\n

                                                    Active voice helps make action more clear by highlighting the person doing the action, followed by the verb. Passive voice is often awkward, it’s usually longer, and it makes readers work harder to translate.

                                                    \n\n

                                                    It can help to look for a “by” phrase, and rewrite so the actor is first.

                                                    \n\n\n\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\n
                                                    \n\t\t\t

                                                    Active voice

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    Passive voice

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    Medicare covers the wheelchair.

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    The wheelchair is covered by Medicare.

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    Your state will determine eligibility.

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    Eligibility will be determined by your state.

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    Complete your application and return it to us by June 1.

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    The application must be completed by the applicant and received by Human Resources by June 1.

                                                    \n\t\t\t
                                                    \n\n

                                                    Use common, everyday words

                                                    \n\n

                                                    Use the same words your audience does. Replace complex words with simple ones. Conversational tone is easier to understand. This is especially important with web writing, as simple words are often common search terms that enhance SEO.

                                                    \n\n

                                                    Language to avoid:

                                                    \n\n
                                                      \n\t
                                                    • Undefined abbreviations and acronyms.
                                                      • \n\t
                                                    • Using 2 different terms to mean the same thing (like doctor, physician, provider), unless unavoidable by policy constraints or intentional for SEO benefit (like health plan and health insurance).
                                                      • \n\t
                                                    • Legal, technical, medical, or marketing jargon.
                                                      • \n\t
                                                    • Idioms (think “It’s raining cats and dogs”).
                                                      • \n\t
                                                    • Colloquialisms (think “Our team does the heavy lifting so you don’t have to”).
                                                      • \n\t
                                                    • Unnecessary intensifiers (e.g.: very, much, best, quite).
                                                      • \n\t
                                                    • Negative phrasing.
                                                      • \n\t
                                                    • Humor, which often doesn’t translate well.
                                                      • \n\t
                                                    • Talking at your reader, instead of with them (having a conversation vs. listening to a lecture).
                                                      • \n\t
                                                    • Quoting laws and regulations, unless absolutely necessary.
                                                      • \n
                                                    \n\n

                                                     

                                                    \n\n

                                                     

                                                    \n\n\n\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\n\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\t\n\t\t\t\n\t\t\t\n\t\t\n\t\n
                                                    \n\t\t\t

                                                    Don’t say:

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    Say this instead:

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    assist

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    help

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    commence

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    begin, start

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    consequently

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    so

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    endeavor

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    try

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    facilitate

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    ease, help

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    for a period of

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    for

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    in an effort to

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    to

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    in order to

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    to

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    in the event of

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    if

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    previously

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    before

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    prior to

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    before

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    utilize

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    use

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    until such time as

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    until

                                                    \n\t\t\t
                                                    \n\t\t\t

                                                    with the exception of

                                                    \n\t\t\t                                                    		\n\t\t\t

                                                    except for

                                                    \n\t\t\t
                                                    \n\n

                                                    Organize information for your readers

                                                    \n\n

                                                    Get to know your reader

                                                    \n\n
                                                      \n\t
                                                    • Who is the reader? Remember there may be more than one audience for your content.
                                                      • \n\t
                                                    • Why is the reader coming to this content? What does the reader want to know, find or understand?
                                                      • \n\t
                                                    • What is the reader trying to do? People usually want to take an action, not just learn.
                                                      • \n
                                                    \n\n

                                                    Meet reader expectations

                                                    \n\n
                                                      \n\t
                                                    • Make any actions clear and easy.
                                                      • \n\t
                                                    • Put the most important information FIRST. Especially on web/mobile, users may leave if content requires a lot of scrolling.
                                                      • \n\t
                                                    • People don’t read – they scan. Users look for headings, keywords, and other \"eye-stoppers\" that grab their attention.
                                                      • \n
                                                    \n\n

                                                    Tips to help users find what they need

                                                    \n\n
                                                      \n\t
                                                    • Put the most important words first, so they’re easy to spot. The first 2 words in a heading, first 2 lines in a paragraph, and first 2 paragraphs on a page are places that get reader attention.
                                                      • \n\t
                                                    • Create “sections” in your text.
                                                      • \n\t
                                                    • Add hard returns to break up long paragraphs.
                                                      • \n\t
                                                    • Add a subheading for more than 2 paragraphs in a row.
                                                      • \n\t
                                                    • Use numbers for any text describing steps or a process
                                                      • \n\t
                                                    • Use lists and tables to help organize long or complicated content, especially items or steps in a process or hierarchy. If a sentence has multiple items, break it into a list and use bullets.
                                                      • \n
                                                    \n\n

                                                    Use headings & subheadings

                                                    \n\n

                                                    Headings and subheadings create a visual hierarchy on the page and help users find content quickly. Strong headings help users scan and improve search engine optimization (SEO) in web copy. The most important words in SEO are keywords, the words and phrases users type into search engines.

                                                    \n\n

                                                    Your reader should be able to get the gist of a document just from the headings and subheadings. A heading also may be the only snippet of text users see if they’re reading on a phone or tablet.

                                                    \n\n
                                                      \n\t
                                                    • Headings aren’t the place for creativity — they’re for clear communication.  Ask yourself: “Does this heading make sense if it’s all the user sees?”
                                                      • \n\t
                                                    • Research shows people focus on the first 2 words in a heading, so put the 2 most vital/compelling words first. For example, if a blog is about ACA, don’t begin the title with “The Affordable Care Act…,”; instead, begin with how it affects the reader (i.e. “Save money…”).
                                                      • \n\t
                                                    • Headings should have a consistent style (questions, statements, parallel structure, etc.) and be left-aligned for scanning
                                                      • \n\t
                                                    • Avoid generic headings like “Introduction,” “Overview,” “About…,” “Background,” “Questions & Answers,” and “Welcome.” These headings miss the chance to convey meaningful information.
                                                      • \n\t
                                                    • Active voice and positive statements are best, but you may want to use passive voice if it lets you frontload important content and pull keywords to the front.
                                                      • \n\t
                                                    • Research shows people pay more attention to headings that include numerals. Example: “3 steps to file a claim” or “Medicare covers 7 tests”
                                                      • \n
                                                    \n\n

                                                    7 tips for effective headings

                                                    \n\n
                                                      \n\t
                                                    • Limit to 8 words or fewer.
                                                      • \n\t
                                                    • Make them independently meaningful and scannable.
                                                      • \n\t
                                                    • Do they make sense without any supporting content?
                                                      • \n\t
                                                    • Are they strong, unique, descriptive, and clear?
                                                      • \n\t
                                                    • Use numerals; don’t spell out numbers.
                                                      • \n\t
                                                    • Use positive statements and active voice.
                                                      • \n\t
                                                    • Avoid generic headlines that don’t carry any information.
                                                      • \n
                                                    \n\n

                                                    Get more information

                                                    \n\n

                                                    Download Writing for the Web (PDF) for more tips to improve online communication, or visit plainlanguage.gov for more helpful resources and trainings.

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                                                      ", "outcomeCount": 1616, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11708, "settleDelayMs": 10000, "auditMs": 2087, "totalMs": 14396, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 3368, "failed": 53, "cantTell": 43, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "table_headers_exists", "text_block_heading", "text_sensory_misuse" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "39ae6b98d253", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "679325109337d8180b68d4dd0bdb8ce818ce72eb5b046234ba335401b8f6ec70", "a11yOccurrenceDisplayId": "A11Y-OCC-679325109337" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "e302f98ce7e3", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f891efa0", "a11yPatternFingerprint": "b6d59230e1e62a622d7394c2d0cbf6faca8d9053887f625adf4809c3d300cf0a", "a11yPatternDisplayId": "A11Y-PAT-B6D59230E1E6", "a11yOccurrenceFingerprint": "76498420c28a76ee7ddf5c0c465aa0d03f1b380e7d67ebb264416245214afd7f", "a11yOccurrenceDisplayId": "A11Y-OCC-76498420C28A" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
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                                                      \n

                                                      In May 2026, 287,520 disputes were initiated, a 10% decrease from April 2026 (318,559).  

                                                      Certified IDR entities closed 3% more disputes in May 2026 (283,437) than were closed in April 2026 (275,571) as they continue to enhance overall dispute processing and throughput.

                                                      Table 1: Disputes Initiated 

                                                      Number of Disputes Initiated, April 1, 2026 – May 31, 2026 Number of Disputes Initiated, January 1, 2026 – May 31, 2026 Number of Disputes Initiated, April 15, 2022 – May 31, 2026 

                                                      606,079 

                                                      1,433,289 

                                                      6,336,032 

                                                       

                                                      Table 2: Reasons for Closure of Disputes 

                                                      Closure Reason Number of Disputes Closed, April 1, 2026 – May 31, 2026 Number of Disputes Closed, January 1, 2026 – May 31, 2026 Number of Disputes Closed, April 15, 2022 – May 31, 2026 
                                                      Payment Determination 

                                                      460,998 

                                                      1,103,487 

                                                      4,588,154 

                                                      Found Ineligible 

                                                      88,079 

                                                      222,599 

                                                      1,066,645 

                                                      Other* 

                                                      9,931 

                                                      28,825 

                                                      208,020 

                                                      Total Closed Disputes 

                                                      559,008 

                                                      1,354,911 

                                                      5,862,819 

                                                      *The “Other” closure reason category represents disputes that were either withdrawn by disputing parties, closed due to an outside settlement between the disputing parties, or closed for administrative reasons, such as data entry errors or the failure of both parties to pay fees or submit offers.

                                                      \n \n
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                                                      \n
                                                      \n
                                                      \n \n
                                                      \n
                                                      \n

                                                      In March 2026, 313,828 disputes were initiated, an 18% increase over February 2026 (264,930).  

                                                      Certified IDR entities closed 12% more disputes in March 2026 (285,766) than were closed in February 2026 (255,376) as they continue to increase overall dispute processing and throughput.  

                                                      Table 1: Disputes Initiated 

                                                      Number of Disputes Initiated,  
                                                      February 1, 2026 – March 31, 2026                                                       		Number of Disputes Initiated,  
                                                      January 1, 2026 – March 31, 2026                                                       		Number of Disputes Initiated,  
                                                      April 15, 2022 – March 31, 2026 

                                                      578,758 

                                                      827,210 

                                                      5,729,954 

                                                      Table 2: Reasons for Closure of Disputes 

                                                      Closure Reason Number of Disputes Closed, 
                                                      February 1, 2026 – March 31, 2026                                                       		Number of Disputes Closed, 
                                                      January 1, 2026 – March 31, 2026                                                       		Number of Disputes Closed, 
                                                      April 15, 2022 – March 31, 2026 
                                                      Payment Determination 

                                                      439,505 

                                                      643,039 

                                                      4,133,547 

                                                      Found Ineligible 

                                                      87,572 

                                                      136,757 

                                                      985,659 

                                                      Other* 

                                                      14,065 

                                                      19,047 

                                                      198,372 

                                                      Total Closed Disputes 

                                                      541,142 

                                                      798,843 

                                                      5,317,578 

                                                      *The “Other” closure reason category represents disputes that were either withdrawn by disputing parties, closed due to an outside settlement between the disputing parties, or closed for administrative reasons, such as data entry errors or the failure of both parties to pay fees or submit offers. 

                                                      \n \n
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                                                      \n

                                                      In January 2026, dispute initiations (248,452) declined by 7% from December 2025 (267,789). 

                                                      Certified IDR entities closed 257,724 disputes in January 2026, a 4% increase over December 2025 (248,518). From December 1, 2025 – January 31, 2026, dispute closures (506,242) were nearly equal to dispute initiations (516,241), as certified IDR entities have previously closed much of the remaining IDR backlog. 

                                                      Table 1: Disputes Initiated 

                                                      Number of Disputes Initiated, December 1, 2025 – January 31, 2026 Number of Disputes Initiated, January 1, 2026 – January 31, 2026 Number of Disputes Initiated, April 15, 2022 – January 31, 2026 

                                                      516,241 

                                                      248,452 

                                                      5,151,197 

                                                      Table 2: Reasons for Closure of Disputes 

                                                      Closure Reason Number of Disputes Closed, December 1, 2025 – January 31, 2026 Number of Disputes Closed, January 1, 2026 – January 31, 2026 Number of Disputes Closed, April 15, 2022 – January 31, 2026 
                                                      Payment Determination 

                                                      399,338 

                                                      203,543 

                                                      3,696,802 

                                                      Found Ineligible 

                                                      97,074 

                                                      49,196 

                                                      899,309 

                                                      Other* 

                                                      9,830 

                                                      4,985 

                                                      184,366 

                                                      Total Closed Disputes 

                                                      506,242 

                                                      257,724 

                                                      4,780,477 

                                                      *The “Other” closure reason category represents disputes that were either withdrawn by disputing parties, closed due to an outside settlement between the disputing parties, or closed for administrative reasons, such as data entry errors or the failure of both parties to pay fees or submit offers. 

                                                      \n \n
                                                      \n
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                                                      \n
                                                      \n

                                                      From October 2025 to November 2025, both initiations and closures declined, partly due to two Federal holidays in November. 

                                                      In November 2025, 207,545 disputes were initiated, a decrease of 15% from October 2025 (243,784). Certified IDR entities closed 208,249 disputes in November 2025, 12% less than October 2025 (235,524). The number of dispute closures (443,773) was nearly equal to the number of initiations (451,329) in this two-month period, as certified IDR entities have closed much of the remaining IDR backlog.  

                                                      Table 1: Disputes Initiated

                                                      Number of Disputes Initiated, October 1, 2025 – November 30, 2025 Number of Disputes Initiated, January 1, 2025 – November 30, 2025 Number of Disputes Initiated, April 15, 2022 – November 30, 2025 

                                                      451,329 

                                                      2,291,586 

                                                      4,634,956 

                                                      Table 2: Reasons for Closure of Disputes

                                                      Closure Reason Number of Disputes Closed, October 1, 2025 – November 30, 2025 Number of Disputes Closed, January 1, 2025 – November 30, 2025 Number of Disputes Closed, April 15, 2022 – November 30, 2025 
                                                      Payment Determination 

                                                      346,343 

                                                      2,028,741 

                                                      3,299,465 

                                                      Found Ineligible 

                                                      88,200 

                                                      451,162 

                                                      803,482 

                                                      Other* 

                                                      9,230 

                                                      66,231 

                                                      174,609 

                                                      Total Closed Disputes 

                                                      443,773 

                                                      2,546,134 

                                                      4,277,556 

                                                      *The “Other” closure reason category represents disputes that were withdrawn by disputing parties, closed due to outside settlement between the disputing parties, or were closed for administrative reasons, such as data entry errors or the failure of both parties to pay fees or submit offers.

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                                                      In September 2025, 219,234 disputes were initiated, a decrease of 1% over August 2025 (220,626). 

                                                      From August 2025 to September 2025, both initiations and closures declined slightly, but the number of dispute closures continued to exceed initiations, as certified IDR entities worked to clear the remaining IDR backlog. Certified IDR entities closed 240,579 disputes in September 2025, 10% more than were initiated in September 2025 (219,234), and 6% less than were closed in August 2025 (256,542). 

                                                      Table 1: Disputes Initiated

                                                      Number of Disputes Initiated, August 1, 2025 – September 30, 2025 Number of Disputes Initiated, January 1, 2025 – September 30, 2025 Number of Disputes Initiated, April 15, 2022 – September 30, 2025 

                                                      439,860 

                                                      1,840,257 

                                                      4,183,627 

                                                      Table 2: Reasons for Closure of Disputes

                                                      Closure Reason Number of Disputes Closed, August 1, 2025 – September 30, 2025 Number of Disputes Closed, January 1, 2025 – September 30, 2025 Number of Disputes Closed, April 15, 2022 – September 30, 2025 
                                                      Payment Determination 

                                                      393,830 

                                                      1,684,567 

                                                      2,955,772 

                                                      Found Ineligible 

                                                      89,257 

                                                      365,629 

                                                      718,396 

                                                      Other* 

                                                      14,034 

                                                      57,112 

                                                      165,514 

                                                      Total Closed Disputes 

                                                      497,121 

                                                      2,107,308 

                                                      3,839,682 

                                                      *The “Other” closure reason category represents disputes that were withdrawn by disputing parties, closed due to outside settlement between the disputing parties, or were closed for administrative reasons, such as data entry errors or the failure of both parties to pay fees or submit offers.

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                                                      In July 2025, 213,585 disputes were initiated, an increase of 4% over June 2025 (206,131).

                                                      The Federal IDR program dispute closure volume continues to rise month over month. Certified IDR entities closed 263,350 disputes in July 2025, 4% more than June 2025 (252,422) and 23% more than were initiated in July 2025 (213,585). 

                                                      Table 1: Disputes Initiated

                                                      Number of Disputes Initiated, June 1, 2025 – July 31, 2025Number of Disputes Initiated, Jan 1, 2025 – July 31, 2025Number of Disputes Initiated, April 15, 2022 – July 31, 2025

                                                      419,716

                                                      1,400,397

                                                      3,743,767

                                                      Table 2: Reasons for Closure of Disputes

                                                      Closure ReasonNumber of Disputes Closed, June 1, 2025 – July 31, 2025Number of Disputes Closed, Jan 1, 2025 – July 31, 2025Number of Disputes Closed, April 15, 2022 – July 31, 2025
                                                      Payment Determination

                                                      412,476

                                                      1,291,236

                                                      2,562,612

                                                      Found Ineligible

                                                      91,684

                                                      277,403

                                                      630,428

                                                      Other*

                                                      11,612

                                                      43,150

                                                      151,576

                                                      Total Closed Disputes

                                                      515,772

                                                      1,611,789

                                                      3,344,616

                                                      *The “Other” closure reason category represents disputes that were withdrawn by disputing parties, closed due to outside settlement between the disputing parties, or were closed for administrative reasons, such as data entry errors or the failure of both parties to pay fees or submit offers.

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                                                      In May 2025, 209,637 disputes were initiated, a decrease of 7% over April 2025 (225,622). 

                                                      The Federal IDR program dispute closure volume continues to rise month over month. Certified IDR entities closed 264,805 disputes in May 2025, 8% more than April 2025 (244,705) and 26% more than were initiated in May (209,637).  

                                                      Table 1: Disputes Initiated

                                                      Number of Disputes Initiated, April 1, 2025 – May 31, 2025Number of Disputes Initiated, January 1, 2025 – May 31, 2025Number of Disputes Initiated, April 15, 2022 – May 31, 2025

                                                      435,259

                                                      980,681

                                                      3,324,051

                                                      Table 2: Reasons for Closure of Disputes

                                                      Closure ReasonNumber of Disputes Closed, April 1, 2025 – May 31, 2025Number of Disputes Closed, January 1, 2025 – May 31, 2025Number of Disputes Closed, April 15, 2022 – May 31, 2025
                                                      Payment Determination

                                                      413,466

                                                      879,879

                                                      2,152,045

                                                      Found Ineligible

                                                      82,976

                                                      186,286

                                                      539,664

                                                      Other*

                                                      13,068

                                                      31,605

                                                      140,095

                                                      Total Closed Disputes

                                                      509,510

                                                      1,097,770

                                                      2,831,804

                                                      * The “Other” closure reason category represents disputes that were withdrawn by disputing parties, closed due to outside settlement between the disputing parties, or were closed for administrative reasons, such as data entry errors or the failure of both parties to pay fees or submit offers.

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                                                      Fact Sheets

                                                      The fact sheet below provides additional information and context on Federal IDR operations.

                                                      Other Reports

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                                                          Organization NameOrganization TypeCovered States and Territories
                                                          (I-CARE) Insurance Counseling Assistance and Referrals for Elders\n
                                                          \nSee contact details                                                           		Ombudsman South Carolina
                                                          (I-CARE) Insurance Counseling Assistance and Referrals for Elders\n
                                                          \nSee contact details                                                           		SHIP -- State Health Insurance Assistance Program South Carolina
                                                          1-800-MEDICARE\n
                                                          \nSee contact details                                                           		1-800-MEDICARE Alabama, Alaska, American Samoa, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida… See all covered states
                                                          14th St. Clinic\n
                                                          \nSee contact details                                                           		Opioid Treatment Program Services California
                                                          14th St. Clinic\n
                                                          \nSee contact details                                                           		Opioid Treatment Program Services California
                                                          14th St. Clinic\n
                                                          \nSee contact details                                                           		Opioid Treatment Program Services California
                                                          60 Plus Association\n
                                                          \nSee contact details                                                           		Partners Alabama, Alaska, American Samoa, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida… See all covered states
                                                          A Helping Hand\n
                                                          \nSee contact details                                                           		Opioid Treatment Program Services Maryland
                                                          ABA-Commission on Law and Aging\n
                                                          \nSee contact details                                                           		Partners Alabama, Alaska, American Samoa, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida… See all covered states
                                                          Academy for Health Research\n
                                                          \nSee contact details                                                           		Partners Alabama, Alaska, American Samoa, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida… See all covered states
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                                                          \n 1-10 of 2083\n \n \n\n
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                                                              ", "outcomeCount": 1426, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 12092, "settleDelayMs": 10000, "auditMs": 1796, "totalMs": 14492, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 3076, "failed": 19, "cantTell": 13, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_block_heading", "text_sensory_misuse" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "71c2f9b7af40", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "c25c5ca1f50a8e2df77c108e3dd58db26a452a1985fa008ae08e3de449cdb7ed", "a11yOccurrenceDisplayId": "A11Y-OCC-C25C5CA1F50A" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "9a74e8a4f79e", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-a4961ada", "a11yPatternFingerprint": "48c739777a7517c5600bc1738e2f3f711a082c06858214ddb04f53d0cf1f13ed", "a11yPatternDisplayId": "A11Y-PAT-48C739777A75", "a11yOccurrenceFingerprint": "cad7cd26486374f17531c18050b56866ce91830988d70fffbe8c1577dc002e35", "a11yOccurrenceDisplayId": "A11Y-OCC-CAD7CD264863" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                                                              ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
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                                                              Trump Administration Announces $167 Million to Build Rural Care Sites, Upgrade Health Technology, and Strengthen Prevention Across South Carolina

                                                              \n Trump Administration Announces $167 Million to Build Rural Care Sites, Upgrade Health Technology, and Strengthen Prevention Across South Carolina This federal investment will support telehealth, remote monitoring, mobile care, cybersecurity upgrades, and new technology to improve maternal and\n\n\n\nRead more\n\nabout Trump Administration Announces $167 Million to Build Rural Care Sites, Upgrade Health Technology, and Strengthen Prevention Across South Carolina \n\n\n
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                                                              Trump Administration Announces $50 Million to Optimize Care Delivery and Improve Rural Hospital Infrastructure in Connecticut

                                                              \n Trump Administration Announces $50 Million to Optimize Care Delivery and Improve Rural Hospital Infrastructure in Connecticut This federal investment will help rural hospitals upgrade equipment, renovate facilities, enhance care delivery, and support long-term sustainability across rural Connecticut\n\n\n\nRead more\n\nabout Trump Administration Announces $50 Million to Optimize Care Delivery and Improve Rural Hospital Infrastructure in Connecticut\n\n\n
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                                                              Trump Administration Announces $104 Million to Transform Rural Healthcare Across Mississippi Through Cutting-Edge Technology and Expanded Care Closer to Home

                                                              \n Trump Administration Announces $104 Million to Transform Rural Healthcare Across Mississippi Through Cutting-Edge Technology and Expanded Care Closer to Home This federal investment will support 167 awards to expand specialty and diagnostic care, improve healthcare facilities and equipment, and\n\n\n\nRead more\n\nabout Trump Administration Announces $104 Million to Transform Rural Healthcare Across Mississippi Through Cutting-Edge Technology and Expanded Care Closer to Home \n\n\n
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                                                              CMS Adds Medicare Options to Help People Manage Substance Use Disorder, Heart Failure, and Other Common Chronic Conditions

                                                              \n CMS Adds Medicare Options to Help People Manage Substance Use Disorder, Heart Failure, and Other Common Chronic Conditions ACCESS Model Now Available to People with Original Medicare Starting in Spring 2027, the Centers for Medicare & Medicaid Services (CMS) will expand an existing initiative to\n\n\n\nRead more\n\nabout CMS Adds Medicare Options to Help People Manage Substance Use Disorder, Heart Failure, and Other Common Chronic Conditions\n\n\n
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                                                              CMS, SBA, and Georgia Recognize Innovative CHOICE Arrangements as Major Win for Small Businesses

                                                              \n CMS, SBA, and Georgia Recognize Innovative CHOICE Arrangements as Major Win for Small Businesses Trump Administration Initiative Expands Resources for Health Insurance Affordability, Choice, and Coverage Options for Small Businesses and Workers The Centers for Medicare & Medicaid Services (CMS) and\n\n\n\nRead more\n\nabout CMS, SBA, and Georgia Recognize Innovative CHOICE Arrangements as Major Win for Small Businesses\n\n\n
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                                                              Trump Administration Expands Preventive and Behavioral Healthcare Access for Students Across Rural North Carolina

                                                              \n Trump Administration Expands Preventive and Behavioral Healthcare Access for Students Across Rural North Carolina This federal investment will strengthen school-based healthcare through new locations, telehealth and mobile care for children in rural communities The Trump Administration announced\n\n\n\nRead more\n\nabout Trump Administration Expands Preventive and Behavioral Healthcare Access for Students Across Rural North Carolina \n\n\n
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                                                              ", "outcomeCount": 840, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11943, "settleDelayMs": 10000, "auditMs": 1329, "totalMs": 13990, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 1 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1777, "failed": 21, "cantTell": 9, "inapplicable": 0 }, "failedRules": [ "aria_landmark_name_unique", "aria_region_label_unique", "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled", "text_sensory_misuse" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "52253e896dc7", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-cc63d105", "a11yPatternFingerprint": "f668d3a57017ca425d4ff850c36fcc402d6e42b19a6b97e59519dc89cbfd4ef2", "a11yPatternDisplayId": "A11Y-PAT-F668D3A57017", "a11yOccurrenceFingerprint": "0ca841ded0ab0add0afbb89dc17d289f5738c56528cfd6164ef2a36031a6f824", "a11yOccurrenceDisplayId": "A11Y-OCC-0CA841DED0AB" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "e045862a911a", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-8538a53d", "a11yPatternFingerprint": "ddb4637a4e1702a3780dbac6f19e8ce118dda2bb037d59959b18f9febddfec8c", "a11yPatternDisplayId": "A11Y-PAT-DDB4637A4E17", "a11yOccurrenceFingerprint": "5338d3a1b0087b901035a33a6d024c2244b772843ce10a5e9bf37f58aab090ef", "a11yOccurrenceDisplayId": "A11Y-OCC-5338D3A1B008" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
                                                              ", "message": "The explicitly-assigned ARIA role \"banner\" is redundant with the implicit role of the element
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                                                              \n Privacy Act of 1974 and Privacy Act Requests\n\n

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                                                              As a federal agency, CMS is subject to the Privacy Act of 1974. The Privacy Act establishes a code of fair information practices that governs the collection, maintenance, use, and dissemination of information about individuals that CMS maintains in systems of records. This system of records stores the name of the individual or some identifier assigned to the individual.

                                                              \n\n

                                                              The Privacy Act requires CMS to give the public notice of their systems of records in the Federal Register and Privacy Act Statements. It also gives individuals a way to seek access to and change their records, and explains CMS record-keeping requirements.

                                                              \n\n

                                                              To access, change or amend CMS records, file a request with the FOIA office at How to file a CMS FOIA Request.

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                                                              To learn more about the Privacy Act of 1974, visit Privacy Act of 1974.

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                                                                ", "outcomeCount": 1065, "darkModeScanned": false, "requestedColorScheme": "both", "scanContext": { "viewport": { "width": 1280, "height": 800 }, "viewportPreset": "desktop", "colorScheme": "both", "browser": "chromium" }, "mediaQuerySupport": { "darkMode": false, "reducedMotion": true, "highContrast": false, "forcedColors": true, "reducedTransparency": false }, "snapshotFallbackUsed": false, "timings": { "navigationMs": 11942, "settleDelayMs": 10000, "auditMs": 1533, "totalMs": 14078, "loadedFromSnapshot": false }, "duplicateFailedCount": 0, "uniqueFailedCount": 0 }, "equalAccess": { "executed": true, "error": null, "counts": { "passed": 1818, "failed": 16, "cantTell": 7, "inapplicable": 0 }, "failedRules": [ "aria_role_redundant", "element_tabbable_unobscured", "input_label_visible", "label_ref_valid", "style_color_misuse", "style_focus_visible", "style_highcontrast_visible", "svg_graphics_labelled" ], "passedRules": [], "failures": [ { "rule": "style_highcontrast_visible", "xpath": null, "html": "", "message": "Confirm Windows high contrast mode is supported when using CSS to include, position or alter non-decorative content", "isDuplicate": false, "duplicateOf": null, "fingerprint": "c774a0731fd7", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f066a764", "a11yPatternFingerprint": "11ccc844baa9b3f868d2d8a1b379ef100b0b43fa118466e1e2c4323b2c26a7d3", "a11yPatternDisplayId": "A11Y-PAT-11CCC844BAA9", "a11yOccurrenceFingerprint": "15c2ccebed2759749ec1128b929571305f4674b7c26f7be113b645193e5e581c", "a11yOccurrenceDisplayId": "A11Y-OCC-15C2CCEBED27" }, { "rule": "style_color_misuse", "xpath": null, "html": "", "message": "Verify color is not used as the only visual means of conveying information", "isDuplicate": false, "duplicateOf": null, "fingerprint": "af36f6a9a569", "firstSeenAt": "2026-09-18T20:21:41.010Z", "patternId": "A11Y-f891efa0", "a11yPatternFingerprint": "b6d59230e1e62a622d7394c2d0cbf6faca8d9053887f625adf4809c3d300cf0a", "a11yPatternDisplayId": "A11Y-PAT-B6D59230E1E6", "a11yOccurrenceFingerprint": "9cdb49c55eefc019a614fd2186a519de3dce9c4a01459f6b91663a3d5f9621cd", "a11yOccurrenceDisplayId": "A11Y-OCC-9CDB49C55EEF" }, { "rule": "aria_role_redundant", "xpath": null, "html": "
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                                                                Digital Service at CMS

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                                                                \n Andrea Fletcher\n\n

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                                                                Director
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                                                                Andrea Fletcher is the Chief Digital Strategy Officer (CDSO) at the Centers for Medicare and Medicaid Services (CMS). She is the first person to hold this role, and also serves as the Director of the Digital Service at CMS, an agency team of the United States Digital Service. At CMS she is responsible for digital transformation and modernization efforts, promoting interoperability and public access to health data, and recruiting the next generation of technical talent into federal service. Prior to taking on this new role, she served in the United States Digital Service as a product manager.

                                                                Before joining the federal government, Andrea spent most of her career traveling around the world. She has worked on digital health systems across more than 20 countries, primarily in sub-Saharan Africa. She has built mobile apps for healthcare workers, integrated biometric IDs into electronic health record systems, designed national-level interoperability layers, and deployed new disease surveillance systems making contributions to pandemic responses in Ebola, HIV, and COVID-19.

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                                                                  \n \n \"CMS.gov\"\n \n
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                                                                  \n Centers for Medicare & Medicaid Services\n
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                                                                  \n CMS Newsroom\n

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                                                                  Search CMS.gov

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                                                                  \n Managed Fee-for-Service (MFFS) Model\n\n

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                                                                  Under the FFS model, the Centers for Medicare & Medicaid Services (CMS) and a state enter into an agreement through which the state would be eligible to benefit from savings resulting from initiatives that improve quality and reduce costs for both Medicare and Medicaid.

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                                                                  Additional Information:

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                                                                  State Demonstrations

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                                                                  To participate in the Financial Alignment Initiative, each state had to submit a proposal outlining its proposed approach. States interested in the new financial alignment opportunities were required to submit a letter of intent by October 1, 2011. When a proposal meets the standards and conditions for the Financial Alignment Initiative, CMS and a state may develop a memorandum of understanding (MOU) to establish the parameters of the demonstration. 

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                                                                  Visit these pages for more information about CMS approved MFFS demonstrations in specific states:

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                                                                  Want regular email updates? Sign up by visiting this link.
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                                                                  We’re always looking for ways to improve the experience and usability of our webpages. If you’ve Feedback or issues to report, please contact us at MMCOWeb@cms.hhs.gov.
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