{
 "schema_version": "0.1",
 "site": "www.cms.gov",
 "scan_week": "2026-W24",
 "generated_at": "2026-09-30T18:09:01.616Z",
 "source_files": [
  "docs/reports/www.cms.gov/2026-W24/",
  "data/www.cms.gov/findings.json",
  "data/www.cms.gov/2026-W24/summary.json"
 ],
 "summary": {
  "pages_known": 59115,
  "pages_scanned_this_week": 2629,
  "pages_with_known_issues": 36959,
  "findings": 41,
  "clusters": 38,
  "new_findings": 41,
  "persistent_findings": 0,
  "high_priority_findings": 14
 },
 "top_risks": [
  {
   "finding_id": "VS-8ade3360",
   "rule_id": "link-in-text-block",
   "rule_label": "Links must be distinguishable without relying on color",
   "severity": "Serious",
   "priority": "p1",
   "trend": "new",
   "pages_affected": 32,
   "rationale": "Serious severity",
   "top_url": "https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239"
  },
  {
   "finding_id": "VS-9074b4dd",
   "rule_id": "image-alt",
   "rule_label": "Images must have alternative text",
   "severity": "Critical",
   "priority": "p1",
   "trend": "new",
   "pages_affected": 11,
   "rationale": "Critical severity",
   "top_url": "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html"
  },
  {
   "finding_id": "VS-c126b6a6",
   "rule_id": "html-has-lang",
   "rule_label": "<html> element must have a lang attribute",
   "severity": "Serious",
   "priority": "p1",
   "trend": "new",
   "pages_affected": 11,
   "rationale": "Serious severity",
   "top_url": "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html"
  },
  {
   "finding_id": "VS-a0bdbdf6",
   "rule_id": "list",
   "rule_label": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements",
   "severity": "Serious",
   "priority": "p1",
   "trend": "new",
   "pages_affected": 9,
   "rationale": "Serious severity",
   "top_url": "https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A46&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC"
  },
  {
   "finding_id": "VS-e9fe47ac",
   "rule_id": "link-name",
   "rule_label": "Links must have discernible text",
   "severity": "Serious",
   "priority": "p1",
   "trend": "new",
   "pages_affected": 8,
   "rationale": "Serious severity",
   "top_url": "https://www.cms.gov/medicare/payment/prospective-payment-systems/long-term-care-hospital"
  },
  {
   "finding_id": "VS-6175596b",
   "rule_id": "listitem",
   "rule_label": "<li> elements must be contained in a <ul> or <ol>",
   "severity": "Serious",
   "priority": "p1",
   "trend": "new",
   "pages_affected": 2,
   "rationale": "Serious severity",
   "top_url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=N"
  },
  {
   "finding_id": "VS-be8d563e",
   "rule_id": "color-contrast",
   "rule_label": "Elements must meet minimum color contrast ratio thresholds",
   "severity": "Serious",
   "priority": "p1",
   "trend": "new",
   "pages_affected": 1,
   "rationale": "Serious severity",
   "top_url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N"
  },
  {
   "finding_id": "VS-dd1c019f",
   "rule_id": "valid-lang",
   "rule_label": "lang attribute must have a valid value",
   "severity": "Serious",
   "priority": "p1",
   "trend": "new",
   "pages_affected": 1,
   "rationale": "Serious severity",
   "top_url": "https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings"
  },
  {
   "finding_id": "VS-2208081b",
   "rule_id": "sia-r73",
   "rule_label": "Text has minimum contrast ratio of 4.5:1",
   "severity": "Moderate",
   "priority": "p2",
   "trend": "new",
   "pages_affected": 1178,
   "rationale": "affects 1178 pages",
   "top_url": "https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19"
  },
  {
   "finding_id": "VS-cb53cc4d",
   "rule_id": "sia-r111",
   "rule_label": "Target size is at least 44×44 CSS pixels (Enhanced)",
   "severity": "Moderate",
   "priority": "p2",
   "trend": "new",
   "pages_affected": 1178,
   "rationale": "affects 1178 pages",
   "top_url": "https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19"
  }
 ],
 "findings": [
  {
   "finding_id": "VS-8ade3360",
   "fingerprint": "8bf51706",
   "rule_id": "link-in-text-block",
   "rule_label": "Links must be distinguishable without relying on color",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.4.1",
   "wcag_name": "Use of Color",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 32,
    "affected_pages_previous": 366
   },
   "frequency": {
    "instances": 76,
    "pages_affected": 32,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Links must be distinguishable without relying on color (WCAG 1.4.1)",
   "description": "Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 32 of 2629 scanned pages (76 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule link-in-text-block (WCAG 1.4.1).",
   "actual_behavior": "Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 32 of 2629 scanned pages (76 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239",
    "http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=179&sortBy=status&status=all",
    "http://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=218"
   ],
   "html_fragments": [
    {
     "fingerprint": "266fc49f",
     "html": "<a id=\"hplTrackingSheet\" href=\"/medicare-coverage-database/view/ncacal-tracking-sheet.aspx?ncaid=239\" class=\"document-view-section-text log-click system-link\" data-page-action=\"Clicked the Tracking Sh",
     "selectors": [
      "#hplTrackingSheet"
     ]
    },
    {
     "fingerprint": "5da23d7b",
     "html": "<a id=\"hplProposedDecisionMemo\" href=\"/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=Y&amp;ncaid=239\" class=\"document-view-section-text log-click system-link\" data-page-action=\"Cl",
     "selectors": [
      "#hplProposedDecisionMemo"
     ]
    },
    {
     "fingerprint": "2852f630",
     "html": "<a id=\"hplDecisionMemo\" href=\"/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=N&amp;ncaid=239\" class=\"document-view-section-text log-click system-link\" data-page-action=\"Clicked th",
     "selectors": [
      "#hplDecisionMemo"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/nca.aspx",
     "count": 21
    },
    {
     "pattern": "/medicare-coverage-database/view/cal.aspx",
     "count": 4
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without color perception (4.5%), Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-9074b4dd",
   "fingerprint": "f1846b41",
   "rule_id": "image-alt",
   "rule_label": "Images must have alternative text",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.1.1",
   "wcag_name": "Non-text Content",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI",
   "severity": "Critical",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Critical severity",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 11,
    "affected_pages_previous": 248
   },
   "frequency": {
    "instances": 11,
    "pages_affected": 11,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Images must have alternative text (WCAG 1.1.1)",
   "description": "Images must have alternative text. Detected by axe-core rule image-alt on 11 of 2629 scanned pages (11 instances).",
   "remediation_tip": "Give every <img> a meaningful alt attribute. Use alt=\"\" only for decorative images so screen readers skip them.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule image-alt (WCAG 1.1.1).",
   "actual_behavior": "Images must have alternative text. Detected by axe-core rule image-alt on 11 of 2629 scanned pages (11 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html",
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "6f85ea95",
     "html": "<img src=\"cms-site-logo.png\">",
     "selectors": [
      "img[src$=\"cms-site-logo.png\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-c126b6a6",
   "fingerprint": "b6dc10f1",
   "rule_id": "html-has-lang",
   "rule_label": "<html> element must have a lang attribute",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "3.1.1",
   "wcag_name": "Language of Page",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 11,
    "affected_pages_previous": 256
   },
   "frequency": {
    "instances": 11,
    "pages_affected": 11,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "<html> element must have a lang attribute (WCAG 3.1.1)",
   "description": "<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 11 of 2629 scanned pages (11 instances).",
   "remediation_tip": "Add a lang attribute to <html> (e.g. lang=\"en\").",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule html-has-lang (WCAG 3.1.1).",
   "actual_behavior": "<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 11 of 2629 scanned pages (11 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html",
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "3e866d4c",
     "html": "<html>",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-a0bdbdf6",
   "fingerprint": "ca0fa40f",
   "rule_id": "list",
   "rule_label": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "medium",
   "rationale": "Serious severity",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 9,
    "affected_pages_previous": 210
   },
   "frequency": {
    "instances": 17,
    "pages_affected": 9,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements (WCAG 1.3.1)",
   "description": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 9 of 2629 scanned pages (17 instances).",
   "remediation_tip": "Use <ul>/<ol> with only <li> children for lists; don't fake lists with <div>s.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule list (WCAG 1.3.1).",
   "actual_behavior": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 9 of 2629 scanned pages (17 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A46&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC",
    "https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A196&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC",
    "https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A111&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC"
   ],
   "html_fragments": [
    {
     "fingerprint": "c313f7a4",
     "html": "<ul class=\"pager__items js-pager__items cms-evo-unstyled-list ds-u-display--flex ds-u-justify-content--center\">",
     "selectors": [
      ".pager__items"
     ]
    },
    {
     "fingerprint": "d2447140",
     "html": "<ol type=\"I\">",
     "selectors": [
      "strong:nth-child(2) > ol[type=\"I\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/newsroom/search",
     "count": 7
    },
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 1
    },
    {
     "pattern": "/medicare-coverage-database/view/ncd.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-e9fe47ac",
   "fingerprint": "f85a6839",
   "rule_id": "link-name",
   "rule_label": "Links must have discernible text",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "2.4.4",
   "wcag_name": "Link Purpose (In Context)",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "medium",
   "rationale": "Serious severity",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 8,
    "affected_pages_previous": 3
   },
   "frequency": {
    "instances": 15,
    "pages_affected": 8,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Links must have discernible text (WCAG 2.4.4)",
   "description": "Links must have discernible text. Detected by axe-core rule link-name on 8 of 2629 scanned pages (15 instances).",
   "remediation_tip": "Give the link discernible text. Avoid empty links and icon-only links without an aria-label.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule link-name (WCAG 2.4.4).",
   "actual_behavior": "Links must have discernible text. Detected by axe-core rule link-name on 8 of 2629 scanned pages (15 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/payment/prospective-payment-systems/long-term-care-hospital",
    "https://www.cms.gov/medicare/medicaid-coordination/about/dsnps",
    "http://cms.gov/medicare/enrollment-renewal/providers-suppliers/hospitals-center"
   ],
   "html_fragments": [
    {
     "fingerprint": "6aa32fa6",
     "html": "<a href=\"/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2026-ipps-proposed-rule-home-page\" data-entity-substitution=\"canonical\" data-entity-type=\"node\" data-entity-uuid=\"e2075c13",
     "selectors": [
      "p:nth-child(2) > a[data-entity-substitution=\"canonical\"][data-entity-type=\"node\"][data-once=\"linkMatch\"]:nth-child(1)",
      "p:nth-child(2) > a[data-entity-type=\"node\"][data-entity-substitution=\"canonical\"][data-once=\"linkMatch\"]:nth-child(1)"
     ]
    },
    {
     "fingerprint": "d8d112d1",
     "html": "<a href=\"/medicare/payment/prospective-payment-systems/long-term-care-hospital/regulations-notices/cms-1833-p\" data-entity-substitution=\"canonical\" data-entity-type=\"node\" data-entity-uuid=\"7088550f-9",
     "selectors": [
      "a[data-entity-substitution=\"canonical\"][data-entity-type=\"node\"][data-once=\"linkMatch\"]:nth-child(3)",
      "p:nth-child(2) > a[data-entity-type=\"node\"][data-entity-substitution=\"canonical\"][data-once=\"linkMatch\"]:nth-child(3)"
     ]
    },
    {
     "fingerprint": "556af1be",
     "html": "<a data-entity-type=\"media\" data-entity-uuid=\"c3d790c3-6ce7-4c9e-8624-03b88a3cb6ff\" data-entity-substitution=\"canonical\" href=\"/files/document/dsnpcoveragedecisionlettermemocy2024.pdf\" data-once=\"link",
     "selectors": [
      "a[data-entity-type=\"media\"][data-entity-substitution=\"canonical\"][data-once=\"linkMatch\"]:nth-child(5)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare/enrollment-renewal/providers-suppliers/hospitals-center",
     "count": 2
    },
    {
     "pattern": "/medicare/payment/prospective-payment-systems/long-term-care-hospital",
     "count": 1
    },
    {
     "pattern": "/medicare/medicaid-coordination/about/dsnps",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-6175596b",
   "fingerprint": "7ac6b8df",
   "rule_id": "listitem",
   "rule_label": "<li> elements must be contained in a <ul> or <ol>",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "low",
   "rationale": "Serious severity",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 2,
    "affected_pages_previous": 11
   },
   "frequency": {
    "instances": 40,
    "pages_affected": 2,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "<li> elements must be contained in a <ul> or <ol> (WCAG 1.3.1)",
   "description": "<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 2 of 2629 scanned pages (40 instances).",
   "remediation_tip": "<li> must be inside a <ul> or <ol>.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule listitem (WCAG 1.3.1).",
   "actual_behavior": "<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 2 of 2629 scanned pages (40 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=N",
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N"
   ],
   "html_fragments": [
    {
     "fingerprint": "0d30af87",
     "html": "<li> STS, mitral valve repair, mean (SD) %: 7.4 (5.3)\n</li>",
     "selectors": [
      "td[scope=\"column\"][valign=\"top\"]:nth-child(2) > li:nth-child(12)"
     ]
    },
    {
     "fingerprint": "c87ad76c",
     "html": "<li>",
     "selectors": [
      "td[scope=\"column\"][valign=\"top\"]:nth-child(2) > li:nth-child(13)"
     ]
    },
    {
     "fingerprint": "6d328472",
     "html": "<li>STS, mitral valve repair, mean (SD) %: 7.7 (5.3) \n</li>",
     "selectors": [
      "td[valign=\"top\"]:nth-child(2) > li:nth-child(11)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-be8d563e",
   "fingerprint": "1820bc84",
   "rule_id": "color-contrast",
   "rule_label": "Elements must meet minimum color contrast ratio thresholds",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.4.3",
   "wcag_name": "Contrast (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "low",
   "rationale": "Serious severity",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1,
    "affected_pages_previous": 43
   },
   "frequency": {
    "instances": 37,
    "pages_affected": 1,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Elements must meet minimum color contrast ratio thresholds (WCAG 1.4.3)",
   "description": "Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 1 of 2629 scanned pages (37 instances).",
   "remediation_tip": "Increase the contrast between text and its background to at least 4.5:1 (3:1 for large text). Check both light and dark modes.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule color-contrast (WCAG 1.4.3).",
   "actual_behavior": "Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 1 of 2629 scanned pages (37 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N"
   ],
   "html_fragments": [
    {
     "fingerprint": "24c3fd22",
     "html": "<font color=\"FF0000\">[XXX.X]</font>",
     "selectors": [
      "p:nth-child(328) > font"
     ]
    },
    {
     "fingerprint": "bdb83461",
     "html": "<strong>Nationally Covered Indication</strong>",
     "selectors": [
      "font > p:nth-child(1) > strong"
     ]
    },
    {
     "fingerprint": "164ad2bd",
     "html": "<p>",
     "selectors": [
      "font > div > p:nth-child(1)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited vision (2.4%), Without color perception (4.5%)."
   }
  },
  {
   "finding_id": "VS-dd1c019f",
   "fingerprint": "dec2d038",
   "rule_id": "valid-lang",
   "rule_label": "lang attribute must have a valid value",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "3.1.2",
   "wcag_name": "Language of Parts",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "low",
   "rationale": "Serious severity",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1,
    "affected_pages_previous": 1
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "lang attribute must have a valid value (WCAG 3.1.2)",
   "description": "lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 2629 scanned pages (1 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule valid-lang (WCAG 3.1.2).",
   "actual_behavior": "lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 2629 scanned pages (1 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings"
   ],
   "html_fragments": [
    {
     "fingerprint": "f05b811b",
     "html": "<span lang=\"X-NONE\">[1]</span>",
     "selectors": [
      "a[href$=\"#_ftnref1\"] > span[lang=\"X-NONE\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-2208081b",
   "fingerprint": "40bbca09",
   "rule_id": "sia-r73",
   "rule_label": "Text has minimum contrast ratio of 4.5:1",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r73",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 1178 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1178,
    "affected_pages_previous": 367
   },
   "frequency": {
    "instances": 18945,
    "pages_affected": 1178,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8)",
   "description": "Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 1178 of 2629 scanned pages (18945 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r73 (WCAG 1.4.8).",
   "actual_behavior": "Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 1178 of 2629 scanned pages (18945 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19",
    "http://cms.gov/priorities/innovation/models",
    "https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19",
     "count": 1
    },
    {
     "pattern": "/priorities/innovation/models",
     "count": 1
    },
    {
     "pattern": "/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-cb53cc4d",
   "fingerprint": "1738fa81",
   "rule_id": "sia-r111",
   "rule_label": "Target size is at least 44×44 CSS pixels (Enhanced)",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.5",
   "wcag_name": "Target Size (Enhanced)",
   "wcag_level": "AAA",
   "wcag_version": "2.1",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r111",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 1178 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1178,
    "affected_pages_previous": 377
   },
   "frequency": {
    "instances": 61216,
    "pages_affected": 1178,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5)",
   "description": "Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 1178 of 2629 scanned pages (61216 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r111 (WCAG 2.5.5).",
   "actual_behavior": "Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 1178 of 2629 scanned pages (61216 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19",
    "http://cms.gov/priorities/innovation/models",
    "https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19",
     "count": 1
    },
    {
     "pattern": "/priorities/innovation/models",
     "count": 1
    },
    {
     "pattern": "/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-7118fead",
   "fingerprint": "0d932ac9",
   "rule_id": "sia-r61",
   "rule_label": "Form field label is visible",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r61",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 1175 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1175,
    "affected_pages_previous": 346
   },
   "frequency": {
    "instances": 1175,
    "pages_affected": 1175,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Form field label is visible (WCAG criterion undetermined)",
   "description": "Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 1175 of 2629 scanned pages (1175 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r61.",
   "actual_behavior": "Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 1175 of 2629 scanned pages (1175 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19",
    "http://cms.gov/priorities/innovation/models",
    "https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19",
     "count": 1
    },
    {
     "pattern": "/priorities/innovation/models",
     "count": 1
    },
    {
     "pattern": "/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-c18be945",
   "fingerprint": "8634e2fd",
   "rule_id": "sia-r57",
   "rule_label": "Scrolling content can be accessed by keyboard",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r57",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 731 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 731,
    "affected_pages_previous": 109
   },
   "frequency": {
    "instances": 731,
    "pages_affected": 731,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Scrolling content can be accessed by keyboard (WCAG criterion undetermined)",
   "description": "Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 731 of 2629 scanned pages (731 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r57.",
   "actual_behavior": "Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 731 of 2629 scanned pages (731 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19",
    "http://cms.gov/priorities/innovation/models",
    "https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19",
     "count": 1
    },
    {
     "pattern": "/priorities/innovation/models",
     "count": 1
    },
    {
     "pattern": "/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d25f622d",
   "fingerprint": "98ff321a",
   "rule_id": "heading-order",
   "rule_label": "Heading levels should only increase by one",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 223 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 223,
    "affected_pages_previous": 265
   },
   "frequency": {
    "instances": 259,
    "pages_affected": 223,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Heading levels should only increase by one (WCAG criterion undetermined)",
   "description": "Heading levels should only increase by one. Detected by axe-core rule heading-order on 223 of 2629 scanned pages (259 instances).",
   "remediation_tip": "Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule heading-order.",
   "actual_behavior": "Heading levels should only increase by one. Detected by axe-core rule heading-order on 223 of 2629 scanned pages (259 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index",
    "https://www.cms.gov/About-CMS/Agency-information/History/index",
    "http://cms.gov/medicare/physician-fee-schedule/search/overview"
   ],
   "html_fragments": [
    {
     "fingerprint": "bf00014e",
     "html": "<h3><strong>FY 2027 Geographic Reclassification Deadlines</strong></h3>",
     "selectors": [
      ".rxbodyfield > h3"
     ]
    },
    {
     "fingerprint": "9e82b11d",
     "html": "<h3>CMS’ program history</h3>",
     "selectors": [
      ".rxbodyfield > h3"
     ]
    },
    {
     "fingerprint": "3055e10b",
     "html": "<h3 class=\"field field--name-field-title-title-description field--type-string-long field--label-hidden field__item\">\n    What is the PFS Look-Up Tool?\n  </h3>",
     "selectors": [
      "#accordion-60675200__button > .field--name-field-title-title-description.field--type-string-long.field--label-hidden"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/apps/ama/license.asp",
     "count": 7
    },
    {
     "pattern": "/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index",
     "count": 1
    },
    {
     "pattern": "/About-CMS/Agency-information/History/index",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f054f4a4",
   "fingerprint": "5fa3b5a6",
   "rule_id": "sia-r53",
   "rule_label": "Headings are structured hierarchically",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r53",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 128 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 128,
    "affected_pages_previous": 167
   },
   "frequency": {
    "instances": 162,
    "pages_affected": 128,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Headings are structured hierarchically (WCAG criterion undetermined)",
   "description": "Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 128 of 2629 scanned pages (162 instances).",
   "remediation_tip": "Use headings in a logical, non-skipping order.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r53",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r53.",
   "actual_behavior": "Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 128 of 2629 scanned pages (162 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index",
    "https://www.cms.gov/medicare/coverage/summary-notice",
    "https://www.cms.gov/medicare/medicaid-coordination/about/quality"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/apps/ama/license.asp",
     "count": 4
    },
    {
     "pattern": "/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index",
     "count": 1
    },
    {
     "pattern": "/medicare/coverage/summary-notice",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-2cd767ca",
   "fingerprint": "3123e4f3",
   "rule_id": "sia-r78",
   "rule_label": "Table header has scope",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r78",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "Moderate severity on 34 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 34,
    "affected_pages_previous": 101
   },
   "frequency": {
    "instances": 41,
    "pages_affected": 34,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Table header has scope (WCAG criterion undetermined)",
   "description": "Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 34 of 2629 scanned pages (41 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r78",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r78.",
   "actual_behavior": "Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 34 of 2629 scanned pages (41 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
    "https://www.cms.gov/medicare/quality/cms-national-quality-strategy/meaningful-measures-2-0",
    "https://www.cms.gov/"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/roster-billing",
     "count": 2
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
     "count": 1
    },
    {
     "pattern": "/medicare/quality/cms-national-quality-strategy/meaningful-measures-2-0",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-fa44f293",
   "fingerprint": "a01b2a6c",
   "rule_id": "page-has-heading-one",
   "rule_label": "Page should contain a level-one heading",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "Moderate severity on 25 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 25,
    "affected_pages_previous": 17
   },
   "frequency": {
    "instances": 25,
    "pages_affected": 25,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Page should contain a level-one heading (WCAG criterion undetermined)",
   "description": "Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 25 of 2629 scanned pages (25 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule page-has-heading-one.",
   "actual_behavior": "Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 25 of 2629 scanned pages (25 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-payment-rates-addenda",
    "https://www.cms.gov/priorities/crushing-fraud-waste-abuse/overview/cms-idea-challenge-strategies-securing-member-ids",
    "https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/about/security-privacy"
   ],
   "html_fragments": [
    {
     "fingerprint": "75add23f",
     "html": "<html lang=\"en\" dir=\"ltr\" class=\" js\" style=\"--vw: 12.8px; --vh: 8px;\">",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-payment-rates-addenda",
     "count": 1
    },
    {
     "pattern": "/priorities/crushing-fraud-waste-abuse/overview/cms-idea-challenge-strategies-securing-member-ids",
     "count": 1
    },
    {
     "pattern": "/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/about/security-privacy",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f7dba940",
   "fingerprint": "477d8088",
   "rule_id": "sia-r14",
   "rule_label": "Accessible name of link or button matches visible label",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.3",
   "wcag_name": "Label in Name",
   "wcag_level": "A",
   "wcag_version": "2.1",
   "wcag_category": "WCAG 2.1 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r14",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "Moderate severity on 20 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 20,
    "affected_pages_previous": 182
   },
   "frequency": {
    "instances": 36,
    "pages_affected": 20,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Accessible name of link or button matches visible label (WCAG 2.5.3)",
   "description": "Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 20 of 2629 scanned pages (36 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r14 (WCAG 2.5.3).",
   "actual_behavior": "Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 20 of 2629 scanned pages (36 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/priorities/innovation/models",
    "https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter",
    "https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/nca.aspx",
     "count": 8
    },
    {
     "pattern": "/medicare-coverage-database/view/cal.aspx",
     "count": 3
    },
    {
     "pattern": "/medicare-coverage-database/view/ncd.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "WS",
      "group": "Without speech",
      "prevalence": 0.005,
      "percent": "0.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Without speech (0.5%)."
   }
  },
  {
   "finding_id": "VS-fbf54eba",
   "fingerprint": "773d6316",
   "rule_id": "sia-r74",
   "rule_label": "Link is distinguishable without relying on color",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r74",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "Moderate severity on 20 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 20,
    "affected_pages_previous": 181
   },
   "frequency": {
    "instances": 548,
    "pages_affected": 20,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Link is distinguishable without relying on color (WCAG 1.4.8)",
   "description": "Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 20 of 2629 scanned pages (548 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r74",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r74 (WCAG 1.4.8).",
   "actual_behavior": "Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 20 of 2629 scanned pages (548 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter",
    "https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239",
    "http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=7&sortBy=status&status=all"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/nca.aspx",
     "count": 8
    },
    {
     "pattern": "/medicare-coverage-database/view/cal.aspx",
     "count": 3
    },
    {
     "pattern": "/medicare-coverage-database/view/ncd.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-646b1e0b",
   "fingerprint": "afad441e",
   "rule_id": "sia-r66",
   "rule_label": "Text has enhanced contrast",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.6",
   "wcag_name": "Contrast (Enhanced)",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r66",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "Moderate severity on 19 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 19,
    "affected_pages_previous": 182
   },
   "frequency": {
    "instances": 87,
    "pages_affected": 19,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Text has enhanced contrast (WCAG 1.4.6)",
   "description": "Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 19 of 2629 scanned pages (87 instances).",
   "remediation_tip": "Increase text contrast to meet WCAG AAA (7:1).",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r66 (WCAG 1.4.6).",
   "actual_behavior": "Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 19 of 2629 scanned pages (87 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter",
    "https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/events",
    "https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/nca.aspx",
     "count": 8
    },
    {
     "pattern": "/medicare-coverage-database/view/cal.aspx",
     "count": 3
    },
    {
     "pattern": "/medicare-coverage-database/view/ncd.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-04a9d28c",
   "fingerprint": "02cfba82",
   "rule_id": "presentational-attr",
   "rule_label": "Presentational attribute (use CSS)",
   "engine": "deprecated-html",
   "tool": "deprecated-html",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": null,
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "Moderate severity on 19 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 19,
    "affected_pages_previous": 40
   },
   "frequency": {
    "instances": 1171,
    "pages_affected": 19,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Presentational attribute (use CSS) (WCAG criterion undetermined)",
   "description": "Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 19 of 2629 scanned pages (1171 instances).",
   "remediation_tip": null,
   "suggested_fix": "Not captured by automated scan — requires manual testing.",
   "expected_behavior": "Element passes deprecated-html rule presentational-attr.",
   "actual_behavior": "Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 19 of 2629 scanned pages (1171 instances).",
   "testing_environment": "Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
    "http://www.cms.gov/medicare-coverage-database/view/technology-assessments.aspx?taid=15",
    "https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=10"
   ],
   "html_fragments": [
    {
     "fingerprint": "9c73fd4b",
     "html": "<img src=\"bakpg.png\" alt=\"Previous Page [Alt-p]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\">",
     "selectors": [
      "img"
     ]
    },
    {
     "fingerprint": "f9ef1f44",
     "html": "<img src=\"uptop.png\" alt=\"Up a level [Alt-u]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\">",
     "selectors": [
      "img"
     ]
    },
    {
     "fingerprint": "1cc6b28a",
     "html": "<img src=\"fwdpg.png\" alt=\"Next Page [Alt-n]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\">",
     "selectors": [
      "img"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/details/medicare-coverage-document-details.aspx",
     "count": 2
    },
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 2
    },
    {
     "pattern": "/medicare-coverage-database/details/nca-decision-memo.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d5d82446",
   "fingerprint": "3627341e",
   "rule_id": "landmark-one-main",
   "rule_label": "Document should have one main landmark",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "Moderate severity on 11 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 11,
    "affected_pages_previous": 256
   },
   "frequency": {
    "instances": 11,
    "pages_affected": 11,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Document should have one main landmark (WCAG criterion undetermined)",
   "description": "Document should have one main landmark. Detected by axe-core rule landmark-one-main on 11 of 2629 scanned pages (11 instances).",
   "remediation_tip": "Each page should have exactly one <main> landmark.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-one-main.",
   "actual_behavior": "Document should have one main landmark. Detected by axe-core rule landmark-one-main on 11 of 2629 scanned pages (11 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html",
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "3e866d4c",
     "html": "<html>",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f18df681",
   "fingerprint": "09987718",
   "rule_id": "region",
   "rule_label": "All page content should be contained by landmarks",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "Moderate severity on 11 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 11,
    "affected_pages_previous": 256
   },
   "frequency": {
    "instances": 288,
    "pages_affected": 11,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "All page content should be contained by landmarks (WCAG criterion undetermined)",
   "description": "All page content should be contained by landmarks. Detected by axe-core rule region on 11 of 2629 scanned pages (288 instances).",
   "remediation_tip": "Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule region.",
   "actual_behavior": "All page content should be contained by landmarks. Detected by axe-core rule region on 11 of 2629 scanned pages (288 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html",
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "fe9426f1",
     "html": "<tr>\n\t\t<td><img src=\"cms-site-logo.png\"></td>\n\t\t<td style=\"text-align:center;\"><h1>ICD-10-CM/PCS MS-DRG v38.0 R1 Definitions Manual</h1><h1></h1></td>\n\t\t<td></td>\n\t\t<td></td>\n\t\t<td></td>\n\t</tr>",
     "selectors": [
      ".arrows > tbody > tr:nth-child(1)"
     ]
    },
    {
     "fingerprint": "bac31258",
     "html": "<td width=\"31\"><a accesskey=\"p\" id=\"prev_page\" href=\"P0182.html\"><img src=\"bakpg.png\" alt=\"Previous Page [Alt-p]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a></td>",
     "selectors": [
      "td[width=\"31\"]:nth-child(3)"
     ]
    },
    {
     "fingerprint": "69d3578c",
     "html": "<td width=\"31\"><a accesskey=\"u\" id=\"up_level\" href=\"P0010.html\"><img src=\"uptop.png\" alt=\"Up a level [Alt-u]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a></td>",
     "selectors": [
      "td[width=\"31\"]:nth-child(4)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d6097011",
   "fingerprint": "b46c5395",
   "rule_id": "sia-r68",
   "rule_label": "Presentational children of an element are not focusable",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r68",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "Moderate severity on 10 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 10,
    "affected_pages_previous": 45
   },
   "frequency": {
    "instances": 10,
    "pages_affected": 10,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Presentational children of an element are not focusable (WCAG 1.3.1)",
   "description": "Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 10 of 2629 scanned pages (10 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r68",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r68 (WCAG 1.3.1).",
   "actual_behavior": "Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 10 of 2629 scanned pages (10 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239",
    "http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=7&sortBy=status&status=all",
    "http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=26&sortBy=status&status=all"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/nca.aspx",
     "count": 8
    },
    {
     "pattern": "/medicaid-chip/medicare-coordination/avoidable-hospitalizations",
     "count": 1
    },
    {
     "pattern": "/medicare-coverage-database/reports/national-coverage-ncacal-status-report.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-28ebd979",
   "fingerprint": "032345cc",
   "rule_id": "sia-r11",
   "rule_label": "Link has accessible name",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.4.4",
   "wcag_name": "Link Purpose (In Context)",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r11",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "Moderate severity on 7 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 7,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 11,
    "pages_affected": 7,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Link has accessible name (WCAG 2.4.4)",
   "description": "Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 7 of 2629 scanned pages (11 instances).",
   "remediation_tip": "Give the link an accessible name via text content or aria-label.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r11",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r11 (WCAG 2.4.4).",
   "actual_behavior": "Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 7 of 2629 scanned pages (11 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/payment/prospective-payment-systems/long-term-care-hospital",
    "https://www.cms.gov/medicare/medicaid-coordination/about/dsnps",
    "http://cms.gov/medicare/enrollment-renewal/providers-suppliers/hospitals-center"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare/enrollment-renewal/providers-suppliers/hospitals-center",
     "count": 2
    },
    {
     "pattern": "/medicare/payment/prospective-payment-systems/long-term-care-hospital",
     "count": 1
    },
    {
     "pattern": "/medicare/medicaid-coordination/about/dsnps",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-179ad9b3",
   "fingerprint": "0e001fcc",
   "rule_id": "sia-r113",
   "rule_label": "Target size is at least 24×24 CSS pixels or has spacing (Minimum)",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.8",
   "wcag_name": "Target Size (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.2",
   "wcag_category": "WCAG 2.2 AA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r113",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "Moderate severity on 6 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 6,
    "affected_pages_previous": 79
   },
   "frequency": {
    "instances": 32,
    "pages_affected": 6,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8)",
   "description": "Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 6 of 2629 scanned pages (32 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r113",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r113 (WCAG 2.5.8).",
   "actual_behavior": "Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 6 of 2629 scanned pages (32 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
    "https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/about/current-partners",
    "https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/chain-ownership-system-pecos"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
     "count": 1
    },
    {
     "pattern": "/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/about/current-partners",
     "count": 1
    },
    {
     "pattern": "/medicare/enrollment-renewal/providers-suppliers/chain-ownership-system-pecos",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LR",
      "group": "Limited reach",
      "prevalence": 0.02,
      "percent": "2.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-3c632d31",
   "fingerprint": "7d010b8c",
   "rule_id": "sia-r64",
   "rule_label": "Element has required owned roles",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r64",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "Moderate severity on 6 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 6,
    "affected_pages_previous": 30
   },
   "frequency": {
    "instances": 6,
    "pages_affected": 6,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Element has required owned roles (WCAG 1.3.1)",
   "description": "Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 6 of 2629 scanned pages (6 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r64",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r64 (WCAG 1.3.1).",
   "actual_behavior": "Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 6 of 2629 scanned pages (6 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
    "https://www.cms.gov/medicare/quality/nursing-home-improvement/resident-assessment-instrument-manual",
    "https://www.cms.gov/medicare/quality/nursing-home-improvement/announcements"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
     "count": 1
    },
    {
     "pattern": "/medicare/quality/nursing-home-improvement/resident-assessment-instrument-manual",
     "count": 1
    },
    {
     "pattern": "/medicare/quality/nursing-home-improvement/announcements",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-0ba8ce9d",
   "fingerprint": "1b1ae391",
   "rule_id": "scope-attr-valid",
   "rule_label": "scope attribute should be used correctly",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "Moderate severity on 6 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 6,
    "affected_pages_previous": 38
   },
   "frequency": {
    "instances": 72,
    "pages_affected": 6,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "scope attribute should be used correctly (WCAG criterion undetermined)",
   "description": "scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 6 of 2629 scanned pages (72 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule scope-attr-valid.",
   "actual_behavior": "scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 6 of 2629 scanned pages (72 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/medicare-coverage-database/view/technology-assessments.aspx?taid=15",
    "http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=31",
    "http://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=331&ncdver=4"
   ],
   "html_fragments": [
    {
     "fingerprint": "5a97efe3",
     "html": "<td valign=\"top\" scope=\"row\"> <p>Koller et al, 2001</p> </td>",
     "selectors": [
      "tr:nth-child(2) > td[scope=\"row\"]"
     ]
    },
    {
     "fingerprint": "3faa8741",
     "html": "<td valign=\"top\" scope=\"row\"> <p>Krauss et al, 2001</p> </td>",
     "selectors": [
      "tr:nth-child(3) > td[scope=\"row\"]"
     ]
    },
    {
     "fingerprint": "92991b9e",
     "html": "<td valign=\"top\" scope=\"row\"> <p>Lyons et al, 2001</p> </td>",
     "selectors": [
      "tr:nth-child(4) > td[scope=\"row\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/details/nca-decision-memo.aspx",
     "count": 2
    },
    {
     "pattern": "/medicare-coverage-database/view/technology-assessments.aspx",
     "count": 1
    },
    {
     "pattern": "/medicare-coverage-database/details/medicare-coverage-document-details.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-a24eaa8c",
   "fingerprint": "8d462fe1",
   "rule_id": "sia-r2",
   "rule_label": "Image has accessible name",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.1.1",
   "wcag_name": "Non-text Content",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r2",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "Moderate severity on 3 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 3,
    "affected_pages_previous": 31
   },
   "frequency": {
    "instances": 3,
    "pages_affected": 3,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Image has accessible name (WCAG 1.1.1)",
   "description": "Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 3 of 2629 scanned pages (3 instances).",
   "remediation_tip": "Give every <img> an accessible name (alt text), or alt=\"\" if purely decorative.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r2",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r2 (WCAG 1.1.1).",
   "actual_behavior": "Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 3 of 2629 scanned pages (3 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html",
    "https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-7a0e5645",
   "fingerprint": "15da996e",
   "rule_id": "sia-r4",
   "rule_label": "Document has a valid lang attribute",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "3.1.1",
   "wcag_name": "Language of Page",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r4",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "Moderate severity on 3 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 3,
    "affected_pages_previous": 32
   },
   "frequency": {
    "instances": 3,
    "pages_affected": 3,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Document has a valid lang attribute (WCAG 3.1.1)",
   "description": "Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 3 of 2629 scanned pages (3 instances).",
   "remediation_tip": "Add a valid lang attribute to <html>.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r4",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r4 (WCAG 3.1.1).",
   "actual_behavior": "Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 3 of 2629 scanned pages (3 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html",
    "https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-f2542d87",
   "fingerprint": "9cf75a1e",
   "rule_id": "sia-r79",
   "rule_label": "Duplicate role landmark is labeled",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r79",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "Moderate severity on 3 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 3,
    "affected_pages_previous": 5
   },
   "frequency": {
    "instances": 3,
    "pages_affected": 3,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Duplicate role landmark is labeled (WCAG criterion undetermined)",
   "description": "Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 3 of 2629 scanned pages (3 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r79",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r79.",
   "actual_behavior": "Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 3 of 2629 scanned pages (3 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=31",
    "https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=13",
    "https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=104"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/details/medicare-coverage-document-details.aspx",
     "count": 2
    },
    {
     "pattern": "/medicare-coverage-database/details/nca-decision-memo.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-0ddc2ac6",
   "fingerprint": "04fff361",
   "rule_id": "sia-r42",
   "rule_label": "Element in required WAI-ARIA context role",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r42",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "Moderate severity on 1 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 5,
    "pages_affected": 1,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Element in required WAI-ARIA context role (WCAG 1.3.1)",
   "description": "Element in required WAI-ARIA context role. Detected by Siteimprove Alfa rule sia-r42 on 1 of 2629 scanned pages (5 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r42",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r42 (WCAG 1.3.1).",
   "actual_behavior": "Element in required WAI-ARIA context role. Detected by Siteimprove Alfa rule sia-r42 on 1 of 2629 scanned pages (5 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-3f067795",
   "fingerprint": "f9bf7824",
   "rule_id": "sia-r77",
   "rule_label": "Table cell has header",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r77",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "Moderate severity on 1 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1,
    "affected_pages_previous": 5
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Table cell has header (WCAG 1.3.1)",
   "description": "Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 1 of 2629 scanned pages (1 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r77",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r77 (WCAG 1.3.1).",
   "actual_behavior": "Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 1 of 2629 scanned pages (1 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/coverage/determination-process/basics/icd-10"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare/coverage/determination-process/basics/icd-10",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-efd91fdd",
   "fingerprint": "12434796",
   "rule_id": "sia-r62",
   "rule_label": "Link in text block is visually distinguishable without color",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.1",
   "wcag_name": "Use of Color",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r62",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "Moderate severity on 1 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1,
    "affected_pages_previous": 6
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Link in text block is visually distinguishable without color (WCAG 1.4.1)",
   "description": "Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 1 of 2629 scanned pages (1 instances).",
   "remediation_tip": "Make links visually distinguishable from surrounding text (not by color alone).",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r62",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r62 (WCAG 1.4.1).",
   "actual_behavior": "Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 1 of 2629 scanned pages (1 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/newsroom/data"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/newsroom/data",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without color perception (4.5%), Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-f6cf30ff",
   "fingerprint": "f8fe8a49",
   "rule_id": "sia-r17",
   "rule_label": "aria-hidden element does not contain focusable elements",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r17",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "Moderate severity on 1 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 3,
    "pages_affected": 1,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "aria-hidden element does not contain focusable elements (WCAG 4.1.2)",
   "description": "aria-hidden element does not contain focusable elements. Detected by Siteimprove Alfa rule sia-r17 on 1 of 2629 scanned pages (3 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r17",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r17 (WCAG 4.1.2).",
   "actual_behavior": "aria-hidden element does not contain focusable elements. Detected by Siteimprove Alfa rule sia-r17 on 1 of 2629 scanned pages (3 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/priorities/innovation/models"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/priorities/innovation/models",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   }
  },
  {
   "finding_id": "VS-f7e99f4b",
   "fingerprint": "863d1000",
   "rule_id": "sia-r69",
   "rule_label": "Text has sufficient color contrast (Enhanced)",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.3",
   "wcag_name": "Contrast (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r69",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "Moderate severity on 1 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1,
    "affected_pages_previous": 5
   },
   "frequency": {
    "instances": 28,
    "pages_affected": 1,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Text has sufficient color contrast (Enhanced) (WCAG 1.4.3)",
   "description": "Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 1 of 2629 scanned pages (28 instances).",
   "remediation_tip": "Increase text contrast to meet WCAG AA (4.5:1, or 3:1 for large text).",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r69",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r69 (WCAG 1.4.3).",
   "actual_behavior": "Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 1 of 2629 scanned pages (28 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/events"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/events",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited vision (2.4%), Without color perception (4.5%)."
   }
  },
  {
   "finding_id": "VS-6c86a43a",
   "fingerprint": "e18a49c1",
   "rule_id": "meta-viewport",
   "rule_label": "Zooming and scaling must not be disabled",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.4.4",
   "wcag_name": "Resize Text",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/meta-viewport?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "Moderate severity on 1 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Zooming and scaling must not be disabled (WCAG 1.4.4)",
   "description": "Zooming and scaling must not be disabled. Detected by axe-core rule meta-viewport on 1 of 2629 scanned pages (1 instances).",
   "remediation_tip": "Don't disable zoom (user-scalable=no / maximum-scale=1); low-vision users need to zoom.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/meta-viewport?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule meta-viewport (WCAG 1.4.4).",
   "actual_behavior": "Zooming and scaling must not be disabled. Detected by axe-core rule meta-viewport on 1 of 2629 scanned pages (1 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "e5bc0123",
     "html": "<meta name=\"viewport\" content=\"width=device-width,initial-scale=1,user-scalable=no,shrink-to-fit=no,minimal-ui\">",
     "selectors": [
      "meta[name=\"viewport\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-30db094d",
   "fingerprint": "c8a85210",
   "rule_id": "landmark-banner-is-top-level",
   "rule_label": "Banner landmark should not be contained in another landmark",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-banner-is-top-level?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "Moderate severity on 1 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1,
    "affected_pages_previous": 1
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Banner landmark should not be contained in another landmark (WCAG criterion undetermined)",
   "description": "Banner landmark should not be contained in another landmark. Detected by axe-core rule landmark-banner-is-top-level on 1 of 2629 scanned pages (1 instances).",
   "remediation_tip": "Put the banner landmark (<header>) at the top level, not nested inside another landmark.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-banner-is-top-level?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-banner-is-top-level.",
   "actual_behavior": "Banner landmark should not be contained in another landmark. Detected by axe-core rule landmark-banner-is-top-level on 1 of 2629 scanned pages (1 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Outpatient.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "469795af",
     "html": "<header class=\"Header\" style=\"position: sticky;\">",
     "selectors": [
      ".Header"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Outpatient.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-91d2294a",
   "fingerprint": "648c7ef8",
   "rule_id": "font-element",
   "rule_label": "Obsolete <font> element (use CSS)",
   "engine": "deprecated-html",
   "tool": "deprecated-html",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": null,
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "Moderate severity on 1 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1,
    "affected_pages_previous": 2
   },
   "frequency": {
    "instances": 2,
    "pages_affected": 1,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Obsolete <font> element (use CSS) (WCAG criterion undetermined)",
   "description": "Obsolete <font> element (use CSS). Detected by deprecated-html rule font-element on 1 of 2629 scanned pages (2 instances).",
   "remediation_tip": null,
   "suggested_fix": "Not captured by automated scan — requires manual testing.",
   "expected_behavior": "Element passes deprecated-html rule font-element.",
   "actual_behavior": "Obsolete <font> element (use CSS). Detected by deprecated-html rule font-element on 1 of 2629 scanned pages (2 instances).",
   "testing_environment": "Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N"
   ],
   "html_fragments": [
    {
     "fingerprint": "24c3fd22",
     "html": "<font color=\"FF0000\">[XXX.X]</font>",
     "selectors": [
      "font"
     ]
    },
    {
     "fingerprint": "d8086eb3",
     "html": "<font color=\"FF0000\">\n\n<p><strong>Nationally Covered Indication</strong></p>\n<div style=\"margin-left: 1cm;\">\n\n<p>The Centers for Medicare &amp; Medicaid Services (CMS) covers Food and Drug Administrat",
     "selectors": [
      "font"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-0066c67d",
   "fingerprint": "67db3700",
   "rule_id": "empty-heading",
   "rule_label": "Headings should not be empty",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI",
   "severity": "Minor",
   "priority": "p4",
   "confidence": "high",
   "rationale": "Minor severity on 18 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 18,
    "affected_pages_previous": 247
   },
   "frequency": {
    "instances": 18,
    "pages_affected": 18,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Headings should not be empty (WCAG criterion undetermined)",
   "description": "Headings should not be empty. Detected by axe-core rule empty-heading on 18 of 2629 scanned pages (18 instances).",
   "remediation_tip": "Remove empty headings or give them text. Don't use heading tags for spacing.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule empty-heading.",
   "actual_behavior": "Headings should not be empty. Detected by axe-core rule empty-heading on 18 of 2629 scanned pages (18 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
    "https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html",
    "https://www.cms.gov/priorities/health-equity/minority-health/resource-center/health-care-professionals-researchers/quality-improvement-interventions"
   ],
   "html_fragments": [
    {
     "fingerprint": "c6c37699",
     "html": "<h1></h1>",
     "selectors": [
      "h1:nth-child(2)"
     ]
    },
    {
     "fingerprint": "4f3b84b0",
     "html": "<h3 class=\"ds-u-color--primary ds-u-margin-bottom--1\">&nbsp;</h3>",
     "selectors": [
      ".ds-u-lg-padding--0.ds-u-margin-y--2.ds-u-lg-margin-y--4:nth-child(30) > .ds-u-lg-padding-x--2.ds-u-padding-top--1.ds-u-lg-padding-top--0 > .ds-u-color--primary.ds-u-margin-bottom--1"
     ]
    },
    {
     "fingerprint": "120e25ba",
     "html": "<h3>&nbsp;</h3>",
     "selectors": [
      ".field--name-body > h3"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html",
     "count": 1
    },
    {
     "pattern": "/priorities/health-equity/minority-health/resource-center/health-care-professionals-researchers/quality-improvement-interventions",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d69fc059",
   "fingerprint": "c827d812",
   "rule_id": "empty-table-header",
   "rule_label": "Table header text should not be empty",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI",
   "severity": "Minor",
   "priority": "p4",
   "confidence": "low",
   "rationale": "Minor severity on 1 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1,
    "affected_pages_previous": 28
   },
   "frequency": {
    "instances": 2,
    "pages_affected": 1,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "Table header text should not be empty (WCAG criterion undetermined)",
   "description": "Table header text should not be empty. Detected by axe-core rule empty-table-header on 1 of 2629 scanned pages (2 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule empty-table-header.",
   "actual_behavior": "Table header text should not be empty. Detected by axe-core rule empty-table-header on 1 of 2629 scanned pages (2 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/application-information"
   ],
   "html_fragments": [
    {
     "fingerprint": "eb95c57f",
     "html": "<th><img src=\"/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/other-content-types/for-acos-types-and-timeline.png\" alt=\"\" data-entity-type=\"media\" data-entity-uuid=\"9dd5a361-1bdf-40f4-",
     "selectors": [
      "th:nth-child(1)"
     ]
    },
    {
     "fingerprint": "3064b2ee",
     "html": "<th><img src=\"/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/other-content-types/for-acos-toolkit.png\" alt=\"\" data-entity-type=\"media\" data-entity-uuid=\"1cd6374f-e738-4daf-b48e-e9fec4",
     "selectors": [
      "th:nth-child(2)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/application-information",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-4fac2f41",
   "fingerprint": "550210da",
   "rule_id": "aria-allowed-role",
   "rule_label": "ARIA role should be appropriate for the element",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI",
   "severity": "Minor",
   "priority": "p4",
   "confidence": "low",
   "rationale": "Minor severity on 1 pages",
   "trend": {
    "status": "new",
    "first_observed": "2026-W24",
    "last_observed": "2026-W24",
    "weeks_observed": 1,
    "affected_pages_current": 1,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 2629
   },
   "on_key_page": false,
   "summary": "ARIA role should be appropriate for the element (WCAG criterion undetermined)",
   "description": "ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 1 of 2629 scanned pages (1 instances).",
   "remediation_tip": "Remove or change the ARIA role — it isn't allowed on this element type.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule aria-allowed-role.",
   "actual_behavior": "ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 1 of 2629 scanned pages (1 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "3407e2e5",
     "html": "<body style=\"background: #072137\" class=\"cs-HTML theme-unified view-desktop is-landscape ff-on ff-drop-in-base ff-multiple-quiz-tracking ff-player-size-option sidebar-left zoom-mode timeline-playing n",
     "selectors": [
      "body"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  }
 ],
 "clusters": {
  "by_wcag_criterion": [
   {
    "cluster_id": "140fec0b",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.8",
    "wcag_name": "Visual Presentation",
    "wcag_level": "AAA",
    "findings": [
     "VS-2208081b",
     "VS-fbf54eba"
    ],
    "total_pages_affected": 1198,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "b393058c",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.5",
    "wcag_name": "Target Size (Enhanced)",
    "wcag_level": "AAA",
    "findings": [
     "VS-cb53cc4d"
    ],
    "total_pages_affected": 1178,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "75cf28e4",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-7118fead"
    ],
    "total_pages_affected": 1175,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "36ac08de",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-c18be945"
    ],
    "total_pages_affected": 731,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "e08c8d69",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-d25f622d"
    ],
    "total_pages_affected": 223,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "b05da4e9",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-f054f4a4"
    ],
    "total_pages_affected": 128,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "4b43ba23",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-2cd767ca"
    ],
    "total_pages_affected": 34,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "77bde739",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.1",
    "wcag_name": "Use of Color",
    "wcag_level": "A",
    "findings": [
     "VS-8ade3360",
     "VS-efd91fdd"
    ],
    "total_pages_affected": 33,
    "max_severity": "Serious"
   },
   {
    "cluster_id": "423bd52e",
    "type": "wcag_criterion",
    "wcag_sc": "1.3.1",
    "wcag_name": "Info and Relationships",
    "wcag_level": "A",
    "findings": [
     "VS-a0bdbdf6",
     "VS-6175596b",
     "VS-d6097011",
     "VS-3c632d31",
     "VS-0ddc2ac6",
     "VS-3f067795"
    ],
    "total_pages_affected": 29,
    "max_severity": "Serious"
   },
   {
    "cluster_id": "b8f97020",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-fa44f293"
    ],
    "total_pages_affected": 25,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "fd9ed1c5",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.3",
    "wcag_name": "Label in Name",
    "wcag_level": "A",
    "findings": [
     "VS-f7dba940"
    ],
    "total_pages_affected": 20,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "71f257a8",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.6",
    "wcag_name": "Contrast (Enhanced)",
    "wcag_level": "AAA",
    "findings": [
     "VS-646b1e0b"
    ],
    "total_pages_affected": 19,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "66669a92",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-04a9d28c"
    ],
    "total_pages_affected": 19,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "7774d667",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-0066c67d"
    ],
    "total_pages_affected": 18,
    "max_severity": "Minor"
   },
   {
    "cluster_id": "3b489eee",
    "type": "wcag_criterion",
    "wcag_sc": "2.4.4",
    "wcag_name": "Link Purpose (In Context)",
    "wcag_level": "A",
    "findings": [
     "VS-e9fe47ac",
     "VS-28ebd979"
    ],
    "total_pages_affected": 15,
    "max_severity": "Serious"
   },
   {
    "cluster_id": "945c7205",
    "type": "wcag_criterion",
    "wcag_sc": "1.1.1",
    "wcag_name": "Non-text Content",
    "wcag_level": "A",
    "findings": [
     "VS-9074b4dd",
     "VS-a24eaa8c"
    ],
    "total_pages_affected": 14,
    "max_severity": "Critical"
   },
   {
    "cluster_id": "8af1f05d",
    "type": "wcag_criterion",
    "wcag_sc": "3.1.1",
    "wcag_name": "Language of Page",
    "wcag_level": "A",
    "findings": [
     "VS-c126b6a6",
     "VS-7a0e5645"
    ],
    "total_pages_affected": 14,
    "max_severity": "Serious"
   },
   {
    "cluster_id": "91fd3b4c",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-d5d82446"
    ],
    "total_pages_affected": 11,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "0649d9b9",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-f18df681"
    ],
    "total_pages_affected": 11,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "24c4a455",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.8",
    "wcag_name": "Target Size (Minimum)",
    "wcag_level": "AA",
    "findings": [
     "VS-179ad9b3"
    ],
    "total_pages_affected": 6,
    "max_severity": "Moderate"
   }
  ],
  "by_url_pattern": [
   {
    "cluster_id": "08e4251f",
    "type": "url_pattern",
    "pattern": "/medicare-coverage-database/view/nca.aspx",
    "findings": [
     "VS-8ade3360",
     "VS-f7dba940",
     "VS-fbf54eba",
     "VS-646b1e0b",
     "VS-d6097011"
    ],
    "total_pages": 53
   },
   {
    "cluster_id": "426f2c9d",
    "type": "url_pattern",
    "pattern": "/medicare/enrollment-renewal/providers-suppliers/hospitals-center",
    "findings": [
     "VS-e9fe47ac",
     "VS-28ebd979"
    ],
    "total_pages": 4
   },
   {
    "cluster_id": "034daebc",
    "type": "url_pattern",
    "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
    "findings": [
     "VS-6175596b",
     "VS-be8d563e",
     "VS-91d2294a"
    ],
    "total_pages": 4
   },
   {
    "cluster_id": "ac0064c3",
    "type": "url_pattern",
    "pattern": "/medicare-coverage-database/details/nca-decision-memo.aspx",
    "findings": [
     "VS-0ba8ce9d",
     "VS-f2542d87"
    ],
    "total_pages": 3
   },
   {
    "cluster_id": "9b3693a3",
    "type": "url_pattern",
    "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html",
    "findings": [
     "VS-a24eaa8c",
     "VS-7a0e5645"
    ],
    "total_pages": 2
   },
   {
    "cluster_id": "f5edde83",
    "type": "url_pattern",
    "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html",
    "findings": [
     "VS-a24eaa8c",
     "VS-7a0e5645"
    ],
    "total_pages": 2
   },
   {
    "cluster_id": "57243d0d",
    "type": "url_pattern",
    "pattern": "/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html",
    "findings": [
     "VS-a24eaa8c",
     "VS-7a0e5645"
    ],
    "total_pages": 2
   },
   {
    "cluster_id": "06601396",
    "type": "url_pattern",
    "pattern": "/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html",
    "findings": [
     "VS-6c86a43a",
     "VS-4fac2f41"
    ],
    "total_pages": 2
   }
  ]
 },
 "technology_findings": [],
 "third_party_findings": [],
 "metadata": {
  "generator": "vital-core",
  "schema_version": "0.1",
  "total_pages_scanned": 2629,
  "notes": [
   "Healthy pages (no known issues) are intentionally excluded.",
   "Representative examples are used instead of complete occurrence lists.",
   "Fingerprints are stable hashes for tracking recurring patterns over time.",
   "Fragment fingerprints normalize volatile attributes (id, style, data-*) before hashing.",
   "Technology lift values indicate association, not causation.",
   "Confidence reflects sample size: high=10+ affected pages, medium=3-9, low=1-2."
  ]
 }
}