# Accessibility bug reports — www.cms.gov, week 2026-W29

56 issue type(s) from 8600 pages scanned. Generated 2026-07-24 by [vital-scans](https://github.com/mgifford/vital-core), following [accessibility bug-reporting best practices](https://mgifford.github.io/ACCESSIBILITY.md/examples/ACCESSIBILITY_BUG_REPORTING_BEST_PRACTICES.html).

> Automated checks find roughly a third of accessibility barriers. Fields marked "requires manual testing" cannot be observed by an automated scan and need a human with assistive technology.

---
## Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8)

**Bug ID:** `VS-05c10a41`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6  
**XPath / selector:** `<a href="#lblRelatedNationalSubheader" data-href="lblRelatedNationalSubheader" class="nav-link toc-link no-link log-click" title="Jump to Related National Coverage Documents">`  
**WCAG SC:** 2.5.8 — Target Size (Minimum) (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r113` ([reference](https://alfa.siteimprove.com/rules/sia-r113))  
**Severity:** Moderate  
**Frequency:** 718 instances; 443 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 443 of 8600 scanned pages (718 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6.
2. Locate the element: <a href="#lblRelatedNationalSubheader" data-href="lblRelatedNationalSubheader" class="nav-link toc-link no-link log-click" title="Jump to Related National Coverage Documents">
3. Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

### Impact
Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%).
- **Limited manipulation/strength** (13.0% of population)
- **Limited reach** (2.0% of population)
- **Limited vision** (2.4% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55936&ver=2
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57678&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35974&ver=28
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55584&articleStatus=all&bc=3&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56730&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=27
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57025&articleStatus=all&bc=3&sortBy=title&ver=21
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38223&ver=19
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57878&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=26
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59973&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57689&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=44
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56899&articleStatus=all&bc=3&sortBy=title&ver=11
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57307&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=58955&ver=4
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56607&articleStatus=all&bc=3&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56838&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=13
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57752&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=18
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=280&labOnly=allncd&ncdid=223&ncdver=1&sortBy=chapter
- http://www.cms.gov/priorities/health-equity/minority-health/research-data/mapping-medicare-disparities-tool-mmd
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57787&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=45
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=34424&ver=47

…and more — 443 pages total ([download CSV](csv/alfa__sia-r113.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r113

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55936&ver=2
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html

---

## Accessible name of link or button matches visible label (WCAG 2.5.3)

**Bug ID:** `VS-2b459b2c`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all  
**XPath / selector:** `<a id="aBasketManuButton" class="basket-icon log-click " title="View documents in your Basket" data-page-action="Clicked the Basket navbar link.">`  
**WCAG SC:** 2.5.3 — Label in Name (Level A)  
**Rule:** Siteimprove Alfa — `sia-r14` ([reference](https://alfa.siteimprove.com/rules/sia-r14))  
**Severity:** Moderate  
**Frequency:** 3109 instances; 1219 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 1219 of 8600 scanned pages (3109 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.
2. Locate the element: <a id="aBasketManuButton" class="basket-icon log-click " title="View documents in your Basket" data-page-action="Clicked the Basket navbar link.">
3. Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name.

### Impact
Affects Without vision (1.0%), Without speech (0.5%).
- **Without vision** (1.0% of population)
- **Without speech** (0.5% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=283
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55936&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59946&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59855&articleStatus=all&bc=3&sortBy=title&ver=4
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57928&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=6
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=221&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38615&lcdStatus=all&sortBy=title&ver=13
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56658&ver=42
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33667&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55909&ver=39
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58546&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35035&lcdStatus=all&sortBy=title&ver=74
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39084&lcdStatus=all&sortBy=title&ver=5
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57678&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59704&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35974&ver=28
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55584&articleStatus=all&bc=3&sortBy=title&ver=19
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37824&lcdStatus=all&sortBy=title&ver=18
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38816&lcdStatus=all&sortBy=title

…and more — 1219 pages total ([download CSV](csv/alfa__sia-r14.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-ad201d5b`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html  
**XPath / selector:** `img[src$="cms-site-logo.png"]`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** axe-core — `image-alt` ([reference](https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 40 instances; 40 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (5 weeks)

### HTML snippet
```html
<img src="cms-site-logo.png">
```

### Description
Images must have alternative text. Detected by axe-core rule image-alt on 40 of 8600 scanned pages (40 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html.
2. Locate the element: img[src$="cms-site-logo.png"]
3. Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0238.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0036.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0944.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0377.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0026.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0956.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0026.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0023.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0020.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0018.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0035.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0318.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0315.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0322.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0029.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0028.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0279.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0369.html

…and more — 40 pages total ([download CSV](csv/axe-core__image-alt.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Give every <img> a meaningful alt attribute. Use alt="" only for decorative images so screen readers skip them.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI

### Example pages
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0238.html

---

## Image has accessible name (WCAG 1.1.1)

**Bug ID:** `VS-15b564c9`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html  
**XPath / selector:** `<img src="cms-site-logo.png">`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** Siteimprove Alfa — `sia-r2` ([reference](https://alfa.siteimprove.com/rules/sia-r2))  
**Severity:** Moderate  
**Frequency:** 24 instances; 24 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (5 weeks)

### Description
Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 24 of 8600 scanned pages (24 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html.
2. Locate the element: <img src="cms-site-logo.png">
3. Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0944.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0956.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0023.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0018.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0035.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0318.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0315.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0322.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0028.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0279.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0942.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0325.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0373.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0320.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0332.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0248.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0249.html

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Give every <img> an accessible name (alt text), or alt="" if purely decorative.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r2

### Example pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html

---

## Certain ARIA roles must contain particular children (WCAG 1.3.1)

**Bug ID:** `VS-b7b8a7e9`  
**Pattern ID:** `VS-9429bb8d`  
**URL:** https://cms.gov/medicare/prevention/prevntiongeninfo/medicare-preventive-services/mps-quickreferencechart-1.html  
**XPath / selector:** `#SERVICES`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `aria-required-children` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 1 instances; 1 of 8600 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W29 (2 weeks)

### HTML snippet
```html
<ul id="SERVICES" class="closed openMenu" role="menu" tabindex="-1" style="background-color: rgb(255, 255, 255); margin-bottom: 60px;">
```

### Description
Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 1 of 8600 scanned pages (1 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare/prevention/prevntiongeninfo/medicare-preventive-services/mps-quickreferencechart-1.html.
2. Locate the element: #SERVICES
3. Confirm the axe-core finding for rule aria-required-children against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://cms.gov/medicare/prevention/prevntiongeninfo/medicare-preventive-services/mps-quickreferencechart-1.html

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Add the child roles this container role requires (e.g. a list needs listitem children).

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI

---

## <ul> and <ol> must only directly contain <li>, <script> or <template> elements (WCAG 1.3.1)

**Bug ID:** `VS-ff7aada4`  
**Pattern ID:** `VS-a0bdbdf6`  
**URL:** https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A41&items_per_page=10&sort_by=search_api_relevance&sort_order=DESC  
**XPath / selector:** `.pager__items`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `list` ([reference](https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 2152 instances; 608 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<ul class="pager__items js-pager__items cms-evo-unstyled-list ds-u-display--flex ds-u-justify-content--center">
```

### Description
<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 608 of 8600 scanned pages (2152 instances).

### Steps to reproduce
1. Open https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A41&items_per_page=10&sort_by=search_api_relevance&sort_order=DESC.
2. Locate the element: .pager__items
3. Confirm the axe-core finding for rule list against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A41&items_per_page=10&sort_by=search_api_relevance&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57836&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=3
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29581&f%5B1%5D=newsroom_article_type%3A29586&f%5B2%5D=newsroom_article_type%3A33316&f%5B3%5D=topic%3A66&f%5B4%5D=topic%3A161&f%5B5%5D=topic%3A231&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%3A29581&f%5B1%5D=newsroom_article_type%3A29586&f%5B2%5D=topic%3A356&items_per_page=10&sort_by=search_api_relevance&sort_order=DESC
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=newsroom_article_type%3A29601&f%5B2%5D=topic%3A101&f%5B3%5D=topic%3A231&items_per_page=10&page=0&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A186&f%5B1%5D=topic%3A436&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57040&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=25
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A61&items_per_page=10&page=2&sort_by=search_api_relevance&sort_order=DESC
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34181&lcdStatus=all&sortBy=title&ver=28
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56726&articleStatus=all&bc=3&sortBy=title&ver=42
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A21&f%5B1%5D=topic%3A61&f%5B2%5D=topic%3A71&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://cms.gov/newsroom/search?f%5B0%5D=topic%3A6076&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57678&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57025&articleStatus=all&bc=3&sortBy=title&ver=21
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33558&lcdStatus=all&sortBy=title&ver=32
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57609&ver=10
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55558&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=8
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35006&lcdStatus=all&sortBy=title&stateRegion=all&ver=119
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34056&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55239&articleStatus=all&bc=3&sortBy=title&ver=65
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=38803&sortBy=relevance&ver=17
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38773&lcdStatus=all&sortBy=title&ver=31
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36658&lcdStatus=all&sortBy=title&stateRegion=all&ver=22
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=177&ncdver=6&sortBy=title

…and more — 608 pages total ([download CSV](csv/axe-core__list.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Use <ul>/<ol> with only <li> children for lists; don't fake lists with <div>s.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI

### Example pages
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A41&items_per_page=10&sort_by=search_api_relevance&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57836&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=3

---

## <li> elements must be contained in a <ul> or <ol> (WCAG 1.3.1)

**Bug ID:** `VS-aeb2d85a`  
**Pattern ID:** `VS-6175596b`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y  
**XPath / selector:** `li:nth-child(280)`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `listitem` ([reference](https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 174 instances; 8 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<li> The Medicare Claims Processing Manual, Chapter 20, “Durable Medical Equipment, Prosthetics and Orthotics, and Supplies (DMEPOS).”<p></p>

<p></p></li>
```

### Description
<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 8 of 8600 scanned pages (174 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y.
2. Locate the element: li:nth-child(280)
3. Confirm the axe-core finding for rule listitem against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaId=315&proposed=N
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=78&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=366&ncdver=1
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=69&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&fromTracking=Y&ncacaldoctype=all&ncaid=309&proposed=Y&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=308&proposed=N

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** <li> must be inside a <ul> or <ol>.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaId=315&proposed=N

---

## Table cell headers attributes must refer to other <th> elements in the same tabl (WCAG 1.3.1)

**Bug ID:** `VS-711f2857`  
**Pattern ID:** `VS-07ba3b17`  
**URL:** https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=7&sort=asc  
**XPath / selector:** `.MsoTableGrid`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `td-headers-attr` ([reference](https://dequeuniversity.com/rules/axe/4.12/td-headers-attr?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 7 instances; 7 of 8600 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W29 (5 weeks)

### HTML snippet
```html
<table class="MsoTableGrid">
```

### Description
Table cell headers attributes must refer to other <th> elements in the same tabl. Detected by axe-core rule td-headers-attr on 7 of 8600 scanned pages (7 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=7&sort=asc.
2. Locate the element: .MsoTableGrid
3. Confirm the axe-core finding for rule td-headers-attr against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=7&sort=asc
- https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc
- https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=6&sort=asc
- http://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_issue_date&page=2&sort=asc
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_release_date&page=9&sort=desc
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_release_date&page=3&sort=asc
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=6&sort=asc

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Associate data cells with their headers correctly using headers/id or scope.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/td-headers-attr?application=axeAPI

### Example pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=7&sort=asc
- https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc
- https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=6&sort=asc

---

## Presentational children of an element are not focusable (WCAG 1.3.1)

**Bug ID:** `VS-e3442ee9`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all  
**XPath / selector:** `<tfoot>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r68` ([reference](https://alfa.siteimprove.com/rules/sia-r68))  
**Severity:** Moderate  
**Frequency:** 839 instances; 235 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 235 of 8600 scanned pages (839 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all.
2. Locate the element: <tfoot>
3. Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=283
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33667&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38816&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34056&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=NCA&ncaid=293&sortBy=status&status=Open+for+Public+Comment
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33575&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38773&lcdStatus=all&sortBy=title&ver=31
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36658&lcdStatus=all&sortBy=title&stateRegion=all&ver=22
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=34394&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39314&lcdStatus=all&sortBy=title&ver=11
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=34087&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33631&lcdStatus=all&sortBy=title&ver=51
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35494&lcdStatus=all&sortBy=title
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=34082&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33930&lcdStatus=all&sortBy=title&ver=49
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33960&lcdStatus=all&sortBy=title&ver=27
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=39314&proposedStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=40351&ver=3
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38549&lcdStatus=all&sortBy=title&ver=17
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39812&ver=14
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=36975&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=38378&lcdStatus=all&sortBy=title

…and more — 235 pages total ([download CSV](csv/alfa__sia-r68.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r68

### Example pages
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=283
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html

---

## Element has required aria-owns (WCAG 1.3.1)

**Bug ID:** `VS-ed12f5a7`  
**Pattern ID:** `VS-4408605e`  
**URL:** http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57678&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11  
**XPath / selector:** `<th scope="col">`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r46` ([reference](https://alfa.siteimprove.com/rules/sia-r46))  
**Severity:** Moderate  
**Frequency:** 281 instances; 165 of 8600 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W29 (5 weeks)

### Description
Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 165 of 8600 scanned pages (281 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57678&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11.
2. Locate the element: <th scope="col">
3. Confirm the Siteimprove Alfa finding for rule sia-r46 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57678&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55584&articleStatus=all&bc=3&sortBy=title&ver=19
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57025&articleStatus=all&bc=3&sortBy=title&ver=21
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57689&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=44
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57307&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57752&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=18
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57787&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=45
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57433&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=8
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57118&articleStatus=all&bc=3&sortBy=title&ver=3
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57670&articleStatus=all&bc=3&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57195&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=29
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57215&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=36
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55675&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=25
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56423&ver=59
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57326&articleStatus=all&bc=3&sortBy=title&ver=40
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57205&articleStatus=all&bc=3&sortBy=title&ver=39
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56460&ver=14
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52432&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=14
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57644&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=16
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=22
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57686&ver=12
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57478&ver=40
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57424&ver=13
- http://cms.gov/about-cms/work-us/cms-grants-cooperative-agreements/how-apply-cms-grants/cms-guidance-preparing-budget-request-narrative

…and more — 165 pages total ([download CSV](csv/alfa__sia-r46.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r46

### Example pages
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57678&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55584&articleStatus=all&bc=3&sortBy=title&ver=19

---

## Element has required owned roles (WCAG 1.3.1)

**Bug ID:** `VS-e58339f8`  
**Pattern ID:** `VS-3c632d31`  
**URL:** https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html  
**XPath / selector:** `<h1>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r64` ([reference](https://alfa.siteimprove.com/rules/sia-r64))  
**Severity:** Moderate  
**Frequency:** 28 instances; 28 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 28 of 8600 scanned pages (28 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html.
2. Locate the element: <h1>
3. Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0944.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0956.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0023.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0018.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0035.html
- https://www.cms.gov/about-cms/what-we-do/nursing-homes
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59632&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=37244&ver=39
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0318.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0315.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0322.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0028.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0279.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0942.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0325.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0373.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0320.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0332.html

…and more — 28 pages total ([download CSV](csv/alfa__sia-r64.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r64

### Example pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html

---

## Table cell has header (WCAG 1.3.1)

**Bug ID:** `VS-4207d3ce`  
**Pattern ID:** `VS-3f067795`  
**URL:** http://cms.gov/newsroom/fact-sheets/proposed-pathways-success-medicare-shared-savings-program  
**XPath / selector:** `<td>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r77` ([reference](https://alfa.siteimprove.com/rules/sia-r77))  
**Severity:** Moderate  
**Frequency:** 43 instances; 6 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 6 of 8600 scanned pages (43 instances).

### Steps to reproduce
1. Open http://cms.gov/newsroom/fact-sheets/proposed-pathways-success-medicare-shared-savings-program.
2. Locate the element: <td>
3. Confirm the Siteimprove Alfa finding for rule sia-r77 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- http://cms.gov/newsroom/fact-sheets/proposed-pathways-success-medicare-shared-savings-program
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56104&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=17
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=55&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&fromTracking=Y&ncacaldoctype=all&ncaid=309&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?areaId=all&bc=1&contractOption=all&docType=NCA%2CCAL%2CNCD%2CMEDCAC%2CTA%2CMCD%2C6%2C3%2C5%2C1%2CF%2CP&fromTracking=Y&keyword=permanent+cardiac&keywordType=starts&ncaid=285&proposed=Y&sortBy=relevance

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r77

### Example pages
- http://cms.gov/newsroom/fact-sheets/proposed-pathways-success-medicare-shared-savings-program
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56104&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=17

---

## aria-hidden element is not exposed to assistive technology (WCAG 1.3.1)

**Bug ID:** `VS-38861985`  
**Pattern ID:** `VS-9207ed51`  
**URL:** https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc  
**XPath / selector:** `@headers="view-field-dyna-release-date-table-column"`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r45` ([reference](https://alfa.siteimprove.com/rules/sia-r45))  
**Severity:** Moderate  
**Frequency:** 290 instances; 2 of 8600 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W29 (3 weeks)

### Description
aria-hidden element is not exposed to assistive technology. Detected by Siteimprove Alfa rule sia-r45 on 2 of 8600 scanned pages (290 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc.
2. Locate the element: @headers="view-field-dyna-release-date-table-column"
3. Confirm the Siteimprove Alfa finding for rule sia-r45 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc
- http://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_issue_date&page=2&sort=asc

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r45

### Example pages
- https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc
- http://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_issue_date&page=2&sort=asc

---

## Links must be distinguishable without relying on color (WCAG 1.4.1)

**Bug ID:** `VS-3519595d`  
**Pattern ID:** `VS-8ade3360`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6  
**XPath / selector:** `#lblProposedLcd > .system-link.log-click[target="_blank"]`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** axe-core — `link-in-text-block` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1802 instances; 751 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<a href="https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39835&amp;ver=10" target="_blank" class="log-click system-link" data-page-action="Clicked the Source Proposed LCD link">DL39
```

### Description
Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 751 of 8600 scanned pages (1802 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6.
2. Locate the element: #lblProposedLcd > .system-link.log-click[target="_blank"]
3. Confirm the axe-core finding for rule link-in-text-block against WCAG 1.4.1 Use of Color.

### Impact
Affects Without color perception (4.5%), Limited vision (2.4%).
- **Without color perception** (4.5% of population)
- **Limited vision** (2.4% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39656&lcdStatus=all&sortBy=title&ver=9
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=33405&ver=25
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=38816&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=283
- http://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=199
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=33575&sortBy=relevance&ver=43
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38615&lcdStatus=all&sortBy=title&ver=13
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36267&lcdStatus=all&sortBy=title&stateRegion=all&ver=44
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37748&lcdStatus=all&sortBy=title&ver=31
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35457&lcdStatus=all&sortBy=title&ver=63
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55909&ver=39
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35035&lcdStatus=all&sortBy=title&ver=74
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39084&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35974&ver=28
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37824&lcdStatus=all&sortBy=title&ver=18
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=40260&proposedStatus=all&sortBy=title&stateRegion=all&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36267&lcdStatus=all&sortBy=title&ver=44
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33558&lcdStatus=all&sortBy=title&ver=32
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38223&ver=19
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55558&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=8
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35006&lcdStatus=all&sortBy=title&stateRegion=all&ver=119
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=NCA&ncaid=293&sortBy=status&status=Open+for+Public+Comment
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38284&lcdStatus=all&sortBy=title&ver=13

…and more — 751 pages total ([download CSV](csv/axe-core__link-in-text-block.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39656&lcdStatus=all&sortBy=title&ver=9
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=33405&ver=25

---

## Link in text block is visually distinguishable without color (WCAG 1.4.1)

**Bug ID:** `VS-61645127`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55909&ver=39  
**XPath / selector:** `<a href="#" data-bs-toggle="modal" data-bs-target="#MCDNoticeBoadModal" id="aBoardItemLink_2">`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** Siteimprove Alfa — `sia-r62` ([reference](https://alfa.siteimprove.com/rules/sia-r62))  
**Severity:** Moderate  
**Frequency:** 7 instances; 7 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 7 of 8600 scanned pages (7 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55909&ver=39.
2. Locate the element: <a href="#" data-bs-toggle="modal" data-bs-target="#MCDNoticeBoadModal" id="aBoardItemLink_2">
3. Confirm the Siteimprove Alfa finding for rule sia-r62 against WCAG 1.4.1 Use of Color.

### Impact
Affects Without color perception (4.5%), Limited vision (2.4%).
- **Without color perception** (4.5% of population)
- **Limited vision** (2.4% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55909&ver=39
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38435&lcdStatus=all&sortBy=title&ver=10
- http://cms.gov/newsroom/press-kit
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38678&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38997&lcdStatus=all&sortBy=title&ver=9
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33423&lcdStatus=all&sortBy=title&ver=55
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57120&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=19

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Make links visually distinguishable from surrounding text (not by color alone).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r62

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55909&ver=39
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38435&lcdStatus=all&sortBy=title&ver=10
- http://cms.gov/newsroom/press-kit

---

## Scrollable region must have keyboard access (WCAG 2.1.1)

**Bug ID:** `VS-97788d93`  
**Pattern ID:** `VS-c613c153`  
**URL:** http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=308&proposed=N  
**XPath / selector:** `pre`  
**WCAG SC:** 2.1.1 — Keyboard (Level A)  
**Rule:** axe-core — `scrollable-region-focusable` ([reference](https://dequeuniversity.com/rules/axe/4.12/scrollable-region-focusable?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1 instances; 1 of 8600 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W29 (2 weeks)

### HTML snippet
```html
<pre>TO:&nbsp;	Administrative File:&nbsp; CAG-00431R

SUBJECT: 	National Coverage Determination Reconsideration for Beta Amyloid Positron Emission Tomography in Dementia and Neurodegenerative Disease

```

### Description
Scrollable region must have keyboard access. Detected by axe-core rule scrollable-region-focusable on 1 of 8600 scanned pages (1 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=308&proposed=N.
2. Locate the element: pre
3. Confirm the axe-core finding for rule scrollable-region-focusable against WCAG 2.1.1 Keyboard.

### Impact
Affects Without vision (1.0%), Limited manipulation/strength (13.0%), Limited reach (2.0%).
- **Without vision** (1.0% of population)
- **Limited manipulation/strength** (13.0% of population)
- **Limited reach** (2.0% of population)

### Affected pages
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=308&proposed=N

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Make scrollable regions keyboard-focusable (tabindex="0") so keyboard users can scroll them.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scrollable-region-focusable?application=axeAPI

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-45cff60e`  
**Pattern ID:** `VS-e9fe47ac`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N  
**XPath / selector:** `ol[type="I"] > a[href$="#3I6"]`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** axe-core — `link-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 9 instances; 7 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<a href="#3I6">

<strong></strong></a>
```

### Description
Links must have discernible text. Detected by axe-core rule link-name on 7 of 8600 scanned pages (9 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N.
2. Locate the element: ol[type="I"] > a[href$="#3I6"]
3. Confirm the axe-core finding for rule link-name against WCAG 2.4.4 Link Purpose (In Context).

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N
- https://www.cms.gov/newsroom/fact-sheets/cms-updates-nursing-home-guidance-revised-visitation-recommendations
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=14&doctype=all&ncaid=321&proposed=Y&sortBy=title&year=2026
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&fromTracking=Y&ncacaldoctype=NCA&ncaid=321&proposed=Y&sortBy=status&status=Open+for+Public+Comment
- http://www.cms.gov/about-cms/what-we-do/emergency-response/current-emergencies/ongoing-emergencies
- http://www.cms.gov/medicare/coverage/determination-process/basics/icd-10

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Give the link discernible text. Avoid empty links and icon-only links without an aria-label.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N
- https://www.cms.gov/newsroom/fact-sheets/cms-updates-nursing-home-guidance-revised-visitation-recommendations
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments

---

## Link has accessible name (WCAG 2.4.4)

**Bug ID:** `VS-a27f10b2`  
**Pattern ID:** `VS-28ebd979`  
**URL:** https://www.cms.gov/newsroom/fact-sheets/cms-updates-nursing-home-guidance-revised-visitation-recommendations  
**XPath / selector:** `<a href="#_bookmark0" data-once="linkMatch">`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** Siteimprove Alfa — `sia-r11` ([reference](https://alfa.siteimprove.com/rules/sia-r11))  
**Severity:** Moderate  
**Frequency:** 5 instances; 4 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 4 of 8600 scanned pages (5 instances).

### Steps to reproduce
1. Open https://www.cms.gov/newsroom/fact-sheets/cms-updates-nursing-home-guidance-revised-visitation-recommendations.
2. Locate the element: <a href="#_bookmark0" data-once="linkMatch">
3. Confirm the Siteimprove Alfa finding for rule sia-r11 against WCAG 2.4.4 Link Purpose (In Context).

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/newsroom/fact-sheets/cms-updates-nursing-home-guidance-revised-visitation-recommendations
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=14&doctype=all&ncaid=321&proposed=Y&sortBy=title&year=2026
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&fromTracking=Y&ncacaldoctype=NCA&ncaid=321&proposed=Y&sortBy=status&status=Open+for+Public+Comment

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Give the link an accessible name via text content or aria-label.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r11

### Example pages
- https://www.cms.gov/newsroom/fact-sheets/cms-updates-nursing-home-guidance-revised-visitation-recommendations
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=14&doctype=all&ncaid=321&proposed=Y&sortBy=title&year=2026

---

## <html> element must have a lang attribute (WCAG 3.1.1)

**Bug ID:** `VS-464d31ed`  
**Pattern ID:** `VS-c126b6a6`  
**URL:** https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html  
**XPath / selector:** `html`  
**WCAG SC:** 3.1.1 — Language of Page (Level A)  
**Rule:** axe-core — `html-has-lang` ([reference](https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 76 instances; 76 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<html>
```

### Description
<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 76 of 8600 scanned pages (76 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html.
2. Locate the element: html
3. Confirm the axe-core finding for rule html-has-lang against WCAG 3.1.1 Language of Page.

### Impact
Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0238.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1900.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1513.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0079.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0036.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0944.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0476.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0101.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0024.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0377.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0167.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0084.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0956.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0128.html

…and more — 76 pages total ([download CSV](csv/axe-core__html-has-lang.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Add a lang attribute to <html> (e.g. lang="en").

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI

### Example pages
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html

---

## Document has a valid lang attribute (WCAG 3.1.1)

**Bug ID:** `VS-843f0c6b`  
**Pattern ID:** `VS-7a0e5645`  
**URL:** https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html  
**XPath / selector:** `<html>`  
**WCAG SC:** 3.1.1 — Language of Page (Level A)  
**Rule:** Siteimprove Alfa — `sia-r4` ([reference](https://alfa.siteimprove.com/rules/sia-r4))  
**Severity:** Moderate  
**Frequency:** 39 instances; 39 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 39 of 8600 scanned pages (39 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html.
2. Locate the element: <html>
3. Confirm the Siteimprove Alfa finding for rule sia-r4 against WCAG 3.1.1 Language of Page.

### Impact
Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0944.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0084.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0956.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0128.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0023.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0019.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0018.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0035.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0318.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0315.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0322.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0028.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0075.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0495.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1517.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0279.html

…and more — 39 pages total ([download CSV](csv/alfa__sia-r4.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Add a valid lang attribute to <html>.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r4

### Example pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html

---

## Form elements must have labels (WCAG 4.1.2)

**Bug ID:** `VS-f4e76906`  
**Pattern ID:** `VS-fafffee0`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html  
**XPath / selector:** `#q`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `label` ([reference](https://dequeuniversity.com/rules/axe/4.12/label?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 36 instances; 36 of 8600 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W29 (4 weeks)

### HTML snippet
```html
<input type="text" name="q" id="q" value="Search now" size="10" maxlength="50" class="srchbox" onfocus="this.value='';">
```

### Description
Form elements must have labels. Detected by axe-core rule label on 36 of 8600 scanned pages (36 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html.
2. Locate the element: #q
3. Confirm the axe-core finding for rule label against WCAG 4.1.2 Name, Role, Value.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited manipulation/strength** (13.0% of population)

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1900.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1513.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0079.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0476.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0101.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0024.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0167.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0084.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0219.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0128.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0019.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1172.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0039.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0654.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0644.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1571.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1901.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0075.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0495.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1517.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0031.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1171.html

…and more — 36 pages total ([download CSV](csv/axe-core__label.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/label?application=axeAPI

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1900.html

---

## Select element must have an accessible name (WCAG 4.1.2)

**Bug ID:** `VS-62d736b5`  
**Pattern ID:** `VS-fab92378`  
**URL:** https://www.cms.gov/priorities/innovation/innovation-models/map  
**XPath / selector:** `#state-code-select`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `select-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/select-name?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 2 instances; 2 of 8600 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W29 (3 weeks)

### HTML snippet
```html
<select id="state-code-select" class="form-select ds-c-field">
```

### Description
Select element must have an accessible name. Detected by axe-core rule select-name on 2 of 8600 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/priorities/innovation/innovation-models/map.
2. Locate the element: #state-code-select
3. Confirm the axe-core finding for rule select-name against WCAG 4.1.2 Name, Role, Value.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited manipulation/strength** (13.0% of population)

### Affected pages
- https://www.cms.gov/priorities/innovation/innovation-models/map
- http://cms.gov/priorities/innovation/where-innovation-happening

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Give the <select> an accessible name via a <label> or aria-label.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/select-name?application=axeAPI

### Example pages
- https://www.cms.gov/priorities/innovation/innovation-models/map
- http://cms.gov/priorities/innovation/where-innovation-happening

---

## Elements must only use supported ARIA attributes (WCAG 4.1.2)

**Bug ID:** `VS-f4939545`  
**Pattern ID:** `VS-1467ea8a`  
**URL:** https://www.cms.gov/medicare/health-drug-plans/provider-complaints-form  
**XPath / selector:** `.choices__placeholder`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-allowed-attr` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 1 instances; 1 of 8600 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W29 (4 weeks)

### HTML snippet
```html
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="[object Object]" aria-selected="true">Start typing to filter li
```

### Description
Elements must only use supported ARIA attributes. Detected by axe-core rule aria-allowed-attr on 1 of 8600 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/health-drug-plans/provider-complaints-form.
2. Locate the element: .choices__placeholder
3. Confirm the axe-core finding for rule aria-allowed-attr against WCAG 4.1.2 Name, Role, Value.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited manipulation/strength** (13.0% of population)

### Affected pages
- https://www.cms.gov/medicare/health-drug-plans/provider-complaints-form

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Remove ARIA attributes that aren't allowed on this role/element.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI

---

## Form field has accessible name (WCAG 4.1.2)

**Bug ID:** `VS-02be4c2a`  
**Pattern ID:** `VS-a48e6078`  
**URL:** http://cms.gov/priorities/innovation/where-innovation-happening  
**XPath / selector:** `<select id="state-code-select" class="form-select ds-c-field">`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** Siteimprove Alfa — `sia-r8` ([reference](https://alfa.siteimprove.com/rules/sia-r8))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 8600 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W29 (5 weeks)

### Description
Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 1 of 8600 scanned pages (1 instances).

### Steps to reproduce
1. Open http://cms.gov/priorities/innovation/where-innovation-happening.
2. Locate the element: <select id="state-code-select" class="form-select ds-c-field">
3. Confirm the Siteimprove Alfa finding for rule sia-r8 against WCAG 4.1.2 Name, Role, Value.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited manipulation/strength** (13.0% of population)

### Affected pages
- http://cms.gov/priorities/innovation/where-innovation-happening

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Associate the form field with a label.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r8

---

## Elements must meet minimum color contrast ratio thresholds (WCAG 1.4.3)

**Bug ID:** `VS-f8fd4311`  
**Pattern ID:** `VS-be8d563e`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y  
**XPath / selector:** `p:nth-child(1) > strong > em`  
**WCAG SC:** 1.4.3 — Contrast (Minimum) (Level AA)  
**Rule:** axe-core — `color-contrast` ([reference](https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 380 instances; 47 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<em>280.16 Seat Elevation Equipment on Power Wheelchairs (Effective XXX, XXXX)</em>
```

### Description
Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 47 of 8600 scanned pages (380 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y.
2. Locate the element: p:nth-child(1) > strong > em
3. Confirm the axe-core finding for rule color-contrast against WCAG 1.4.3 Contrast (Minimum).

### Impact
Affects Limited vision (2.4%), Without color perception (4.5%).
- **Limited vision** (2.4% of population)
- **Without color perception** (4.5% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33828&lcdStatus=all&sortBy=title&ver=27
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33803&proposedStatus=all&sortBy=title&stateRegion=all&ver=47
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52487&articleStatus=all&bc=3&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52508&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=39
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=33393&sortBy=relevance&ver=9
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=52461&ver=21
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39402&ver=14
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36704&lcdStatus=all&sortBy=title&stateRegion=all&ver=22
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33624&lcdStatus=all&sortBy=title&ver=33
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=14&doctype=all&ncdid=291&ncdver=2&sortBy=title&year=2026
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39464&sortBy=relevance&ver=8
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52489&articleStatus=all&bc=3&sortBy=title&ver=24
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=EAAAAAgAAAAA&DocID=180.2&kq=true&ncdid=242&ncdver=2&SearchType=Advanced
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33370&lcdStatus=all&sortBy=title&ver=58
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39462&lcdStatus=all&sortBy=title&ver=9
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33370&proposedStatus=all&sortBy=title&stateRegion=all&ver=55
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaId=315&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37899&lcdStatus=all&sortBy=title&stateRegion=all&ver=14
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52487&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37921&lcdStatus=all&sortBy=title&ver=16
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37921&lcdStatus=all&sortBy=title&ver=18
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33611&lcdStatus=all&sortBy=title&ver=25

…and more — 47 pages total ([download CSV](csv/axe-core__color-contrast.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** 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.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33828&lcdStatus=all&sortBy=title&ver=27
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33803&proposedStatus=all&sortBy=title&stateRegion=all&ver=47

---

## Text has sufficient color contrast (Enhanced) (WCAG 1.4.3)

**Bug ID:** `VS-28e3ed59`  
**Pattern ID:** `VS-f7e99f4b`  
**URL:** http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33828&lcdStatus=all&sortBy=title&ver=27  
**XPath / selector:** `text: "Code"`  
**WCAG SC:** 1.4.3 — Contrast (Minimum) (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r69` ([reference](https://alfa.siteimprove.com/rules/sia-r69))  
**Severity:** Moderate  
**Frequency:** 164 instances; 25 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 25 of 8600 scanned pages (164 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33828&lcdStatus=all&sortBy=title&ver=27.
2. Locate the element: text: "Code"
3. Confirm the Siteimprove Alfa finding for rule sia-r69 against WCAG 1.4.3 Contrast (Minimum).

### Impact
Affects Limited vision (2.4%), Without color perception (4.5%).
- **Limited vision** (2.4% of population)
- **Without color perception** (4.5% of population)

### Affected pages
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33828&lcdStatus=all&sortBy=title&ver=27
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33803&proposedStatus=all&sortBy=title&stateRegion=all&ver=47
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52508&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=39
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33624&lcdStatus=all&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52489&articleStatus=all&bc=3&sortBy=title&ver=24
- http://cms.gov/priorities/innovation/innovation-models/ahcm
- https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39462&lcdStatus=all&sortBy=title&ver=9
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33370&proposedStatus=all&sortBy=title&stateRegion=all&ver=55
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37899&lcdStatus=all&sortBy=title&stateRegion=all&ver=14
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52487&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=33
- https://www.cms.gov/priorities/innovation/innovation-models/md-tccm
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52492&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52503&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=26
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33803&lcdStatus=all&sortBy=title&ver=61
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33370&ver=58
- https://cms.gov/priorities/innovation/innovation-models/comprehensive-esrd-care
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33803&proposedStatus=all&sortBy=title&stateRegion=all&ver=61
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39455&lcdStatus=all&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=52487&ver=33
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33803&proposedStatus=all&sortBy=title&stateRegion=all&ver=53
- http://cms.gov/priorities/innovation/innovation-models/vermont-all-payer-aco-model
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=33393&sortBy=relevance&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33318&ver=57
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39462&lcdStatus=all&sortBy=title&ver=8

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Increase text contrast to meet WCAG AA (4.5:1, or 3:1 for large text).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r69

### Example pages
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33828&lcdStatus=all&sortBy=title&ver=27
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33803&proposedStatus=all&sortBy=title&stateRegion=all&ver=47
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52508&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=39

---

## lang attribute must have a valid value (WCAG 3.1.2)

**Bug ID:** `VS-5c1f6bbb`  
**Pattern ID:** `VS-dd1c019f`  
**URL:** https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-home-health-prospective-payment-system-proposed-rule-fact-sheet-cms-1828-p  
**XPath / selector:** `span[lang="X-NONE"]`  
**WCAG SC:** 3.1.2 — Language of Parts (Level AA)  
**Rule:** axe-core — `valid-lang` ([reference](https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 2 instances; 2 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<span lang="X-NONE">HHVBP</span>
```

### Description
lang attribute must have a valid value. Detected by axe-core rule valid-lang on 2 of 8600 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-home-health-prospective-payment-system-proposed-rule-fact-sheet-cms-1828-p.
2. Locate the element: span[lang="X-NONE"]
3. Confirm the axe-core finding for rule valid-lang against WCAG 3.1.2 Language of Parts.

### Impact
Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-home-health-prospective-payment-system-proposed-rule-fact-sheet-cms-1828-p
- https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI

### Example pages
- https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-home-health-prospective-payment-system-proposed-rule-fact-sheet-cms-1828-p
- https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings

---

## Element with lang attribute has correct language (WCAG 3.1.2)

**Bug ID:** `VS-b6b9637c`  
**Pattern ID:** `VS-400f3a18`  
**URL:** https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-home-health-prospective-payment-system-proposed-rule-fact-sheet-cms-1828-p  
**XPath / selector:** `@lang="X-NONE"`  
**WCAG SC:** 3.1.2 — Language of Parts (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r7` ([reference](https://alfa.siteimprove.com/rules/sia-r7))  
**Severity:** Moderate  
**Frequency:** 2 instances; 2 of 8600 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W29 (3 weeks)

### Description
Element with lang attribute has correct language. Detected by Siteimprove Alfa rule sia-r7 on 2 of 8600 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-home-health-prospective-payment-system-proposed-rule-fact-sheet-cms-1828-p.
2. Locate the element: @lang="X-NONE"
3. Confirm the Siteimprove Alfa finding for rule sia-r7 against WCAG 3.1.2 Language of Parts.

### Impact
Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-home-health-prospective-payment-system-proposed-rule-fact-sheet-cms-1828-p
- https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r7

### Example pages
- https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-home-health-prospective-payment-system-proposed-rule-fact-sheet-cms-1828-p
- https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-74b2a38d`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all  
**XPath / selector:** `text: "Here's how you know"`  
**WCAG SC:** 1.4.6 — Contrast (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r66` ([reference](https://alfa.siteimprove.com/rules/sia-r66))  
**Severity:** Moderate  
**Frequency:** 6564 instances; 1224 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 1224 of 8600 scanned pages (6564 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.
2. Locate the element: text: "Here's how you know"
3. Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced).

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=283
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55936&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59946&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59855&articleStatus=all&bc=3&sortBy=title&ver=4
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57928&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=6
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=221&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38615&lcdStatus=all&sortBy=title&ver=13
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56658&ver=42
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33667&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55909&ver=39
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58546&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35035&lcdStatus=all&sortBy=title&ver=74
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39084&lcdStatus=all&sortBy=title&ver=5
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57678&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59704&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35974&ver=28
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55584&articleStatus=all&bc=3&sortBy=title&ver=19
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37824&lcdStatus=all&sortBy=title&ver=18
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38816&lcdStatus=all&sortBy=title

…and more — 1224 pages total ([download CSV](csv/alfa__sia-r66.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Increase text contrast to meet WCAG AAA (7:1).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26

---

## Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8)

**Bug ID:** `VS-fadd2eaf`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc  
**XPath / selector:** `<p class="ds-c-usa-banner__header-text">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r73` ([reference](https://alfa.siteimprove.com/rules/sia-r73))  
**Severity:** Moderate  
**Frequency:** 39920 instances; 3674 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 3674 of 8600 scanned pages (39920 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc.
2. Locate the element: <p class="ds-c-usa-banner__header-text">
3. Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc
- https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=newsroom_article_type%3A29601&f%5B2%5D=topic%3A61&f%5B3%5D=topic%3A161&f%5B4%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2Fascpayment%2Fdownloads%2F09ASC.zip
- https://cms.gov/newsroom/press-releases/600000-north-carolinians-now-have-access-medicaid-expansion-coverage
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A46&f%5B1%5D=topic%3A66&f%5B2%5D=topic%3A71&f%5B3%5D=topic%3A76&f%5B4%5D=topic%3A121&f%5B5%5D=topic%3A231&f%5B6%5D=topic%3A671&f%5B7%5D=topic%3A841&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%3A51&f%5B1%5D=topic%3A56&f%5B2%5D=topic%3A61&f%5B3%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_revision_date&page=9&sort=asc
- http://www.cms.gov/training-education/medicare-learning-networkr-mln/compliance/medicare-provider-compliance-tips/inpatient-rehabilitation-hospitals
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26
- http://cms.gov/priorities/health-equity/minority-health/resource-center/language
- https://cms.gov/medicare/regulations-guidance/transmittals/2014-transmittals?items_per_page=25&order=field_dyna_transmittal_number&sort=asc
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2016-transmittals-items/r3495cp
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=283
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=newsroom_article_type%3A29601&f%5B2%5D=topic%3A1&f%5B3%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55936&ver=2
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A21&f%5B2%5D=topic%3A56&f%5B3%5D=topic%3A66&f%5B4%5D=topic%3A161&f%5B5%5D=topic%3A426&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/priorities/key-initiatives/nursing-home-careers/licensed-practical-nurse-licensed-vocational-nurse
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59946&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59855&articleStatus=all&bc=3&sortBy=title&ver=4
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29581&f%5B1%5D=newsroom_article_type%3A29586&f%5B2%5D=newsroom_article_type%3A33316&f%5B3%5D=topic%3A66&f%5B4%5D=topic%3A161&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A671&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%3A21&f%5B1%5D=topic%3A46&f%5B2%5D=topic%3A76&f%5B3%5D=topic%3A176&f%5B4%5D=topic%3A221&f%5B5%5D=topic%3A446&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC

…and more — 3674 pages total ([download CSV](csv/alfa__sia-r73.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73

### Example pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc
- https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all

---

## Link is distinguishable without relying on color (WCAG 1.4.8)

**Bug ID:** `VS-c6f5f0cb`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all  
**XPath / selector:** `<p class="MsoTitle" align="center" style="text-align:center">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r74` ([reference](https://alfa.siteimprove.com/rules/sia-r74))  
**Severity:** Moderate  
**Frequency:** 92167 instances; 1223 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 1223 of 8600 scanned pages (92167 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.
2. Locate the element: <p class="MsoTitle" align="center" style="text-align:center">
3. Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=283
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55936&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59946&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59855&articleStatus=all&bc=3&sortBy=title&ver=4
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57928&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=6
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=221&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38615&lcdStatus=all&sortBy=title&ver=13
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56658&ver=42
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33667&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55909&ver=39
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58546&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35035&lcdStatus=all&sortBy=title&ver=74
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39084&lcdStatus=all&sortBy=title&ver=5
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57678&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59704&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35974&ver=28
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55584&articleStatus=all&bc=3&sortBy=title&ver=19
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37824&lcdStatus=all&sortBy=title&ver=18
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38816&lcdStatus=all&sortBy=title

…and more — 1223 pages total ([download CSV](csv/alfa__sia-r74.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r74

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26

---

## Scrollable element is keyboard accessible (WCAG 1.4.8)

**Bug ID:** `VS-3376480b`  
**Pattern ID:** `VS-388b5438`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38615&lcdStatus=all&sortBy=title&ver=13  
**XPath / selector:** `<p style="text-align: left; color: #212529; text-transform: none; line-height: 14.2pt; text-indent: 0px; letter-spacing: normal; font-family: Verdana, 'Helvetica Neue', Helvetica, Arial, sans-serif; f`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r80` ([reference](https://alfa.siteimprove.com/rules/sia-r80))  
**Severity:** Moderate  
**Frequency:** 1137 instances; 75 of 8600 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W29 (5 weeks)

### Description
Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 75 of 8600 scanned pages (1137 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38615&lcdStatus=all&sortBy=title&ver=13.
2. Locate the element: <p style="text-align: left; color: #212529; text-transform: none; line-height: 14.2pt; text-indent: 0px; letter-spacing: normal; font-family: Verdana, 'Helvetica Neue', Helvetica, Arial, sans-serif; f
3. Confirm the Siteimprove Alfa finding for rule sia-r80 against WCAG 1.4.8 Visual Presentation.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38615&lcdStatus=all&sortBy=title&ver=13
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37824&lcdStatus=all&sortBy=title&ver=18
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38773&lcdStatus=all&sortBy=title&ver=31
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39656&lcdStatus=all&sortBy=title&ver=9
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=40224&proposedStatus=all&sortBy=title&stateRegion=all&ver=3
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33930&lcdStatus=all&sortBy=title&ver=49
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35076&ver=56
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58170&articleStatus=all&bc=3&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57644&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=16
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=58828&ver=15
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59866&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39770&lcdStatus=all&sortBy=title&ver=13
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38615&lcdStatus=all&sortBy=title&ver=11
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38645&lcdStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37295&lcdStatus=all&sortBy=title&ver=21
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59672&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38341&lcdStatus=all&sortBy=title&stateRegion=all&ver=14
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38997&ver=12
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34541&lcdStatus=all&sortBy=title&stateRegion=all&ver=21
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39003&lcdStatus=all&sortBy=title&ver=15
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=34892&ver=123
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33930&lcdStatus=all&sortBy=title&stateRegion=all&ver=47
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39770&lcdStatus=all&sortBy=title&ver=13
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37913&lcdStatus=all&sortBy=title&ver=17

…and more — 75 pages total ([download CSV](csv/alfa__sia-r80.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r80

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38615&lcdStatus=all&sortBy=title&ver=13
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37824&lcdStatus=all&sortBy=title&ver=18

---

## iframe element is not empty (WCAG 1.4.8)

**Bug ID:** `VS-cf5e24f8`  
**Pattern ID:** `VS-48291402`  
**URL:** https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12  
**XPath / selector:** `<p style="text-align: justify;">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r71` ([reference](https://alfa.siteimprove.com/rules/sia-r71))  
**Severity:** Moderate  
**Frequency:** 710 instances; 47 of 8600 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W29 (5 weeks)

### Description
iframe element is not empty. Detected by Siteimprove Alfa rule sia-r71 on 47 of 8600 scanned pages (710 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12.
2. Locate the element: <p style="text-align: justify;">
3. Confirm the Siteimprove Alfa finding for rule sia-r71 against WCAG 1.4.8 Visual Presentation.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59651&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38773&lcdStatus=all&sortBy=title&ver=31
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39656&lcdStatus=all&sortBy=title&ver=9
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=36186&ver=37
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39770&lcdStatus=all&sortBy=title&ver=13
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59079&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=3
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39264&lcdStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39226&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38341&lcdStatus=all&sortBy=title&stateRegion=all&ver=14
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38997&ver=12
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39003&lcdStatus=all&sortBy=title&ver=15
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38920&lcdStatus=all&sortBy=title&ver=15
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39770&lcdStatus=all&sortBy=title&ver=13
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38988&lcdStatus=all&sortBy=title&ver=18
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39832&sortBy=relevance&ver=13
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35936&lcdStatus=all&sortBy=title&stateRegion=all&ver=58
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38111&lcdStatus=all&sortBy=title&ver=10
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58183&articleStatus=all&bc=3&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39462&lcdStatus=all&sortBy=title&ver=9
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58996&articleStatus=all&bc=3&sortBy=title&ver=31
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59652&articleStatus=all&bc=3&sortBy=title&ver=3
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56344&articleStatus=all&bc=3&sortBy=title&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39799&ver=9

…and more — 47 pages total ([download CSV](csv/alfa__sia-r71.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r71

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59651&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2

---

## Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5)

**Bug ID:** `VS-97d08a8f`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc  
**XPath / selector:** `<a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">`  
**WCAG SC:** 2.5.5 — Target Size (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r111` ([reference](https://alfa.siteimprove.com/rules/sia-r111))  
**Severity:** Moderate  
**Frequency:** 134864 instances; 3686 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3686 of 8600 scanned pages (134864 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc.
2. Locate the element: <a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">
3. Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc
- https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=newsroom_article_type%3A29601&f%5B2%5D=topic%3A61&f%5B3%5D=topic%3A161&f%5B4%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2Fascpayment%2Fdownloads%2F09ASC.zip
- https://cms.gov/newsroom/press-releases/600000-north-carolinians-now-have-access-medicaid-expansion-coverage
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A46&f%5B1%5D=topic%3A66&f%5B2%5D=topic%3A71&f%5B3%5D=topic%3A76&f%5B4%5D=topic%3A121&f%5B5%5D=topic%3A231&f%5B6%5D=topic%3A671&f%5B7%5D=topic%3A841&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%3A51&f%5B1%5D=topic%3A56&f%5B2%5D=topic%3A61&f%5B3%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_revision_date&page=9&sort=asc
- http://www.cms.gov/training-education/medicare-learning-networkr-mln/compliance/medicare-provider-compliance-tips/inpatient-rehabilitation-hospitals
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26
- http://cms.gov/priorities/health-equity/minority-health/resource-center/language
- https://cms.gov/medicare/regulations-guidance/transmittals/2014-transmittals?items_per_page=25&order=field_dyna_transmittal_number&sort=asc
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2016-transmittals-items/r3495cp
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=283
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=newsroom_article_type%3A29601&f%5B2%5D=topic%3A1&f%5B3%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55936&ver=2
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A21&f%5B2%5D=topic%3A56&f%5B3%5D=topic%3A66&f%5B4%5D=topic%3A161&f%5B5%5D=topic%3A426&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/priorities/key-initiatives/nursing-home-careers/licensed-practical-nurse-licensed-vocational-nurse
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59946&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59855&articleStatus=all&bc=3&sortBy=title&ver=4
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29581&f%5B1%5D=newsroom_article_type%3A29586&f%5B2%5D=newsroom_article_type%3A33316&f%5B3%5D=topic%3A66&f%5B4%5D=topic%3A161&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A671&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%3A21&f%5B1%5D=topic%3A46&f%5B2%5D=topic%3A76&f%5B3%5D=topic%3A176&f%5B4%5D=topic%3A221&f%5B5%5D=topic%3A446&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC

…and more — 3686 pages total ([download CSV](csv/alfa__sia-r111.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111

### Example pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc
- https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all

---

## Heading levels should only increase by one (WCAG criterion undetermined)

**Bug ID:** `VS-34b03321`  
**Pattern ID:** `VS-d25f622d`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all  
**XPath / selector:** `h4:nth-child(16)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 839 instances; 810 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<h4><a name="preamble">Preamble</a></h4>
```

### Description
Heading levels should only increase by one. Detected by axe-core rule heading-order on 810 of 8600 scanned pages (839 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.
2. Locate the element: h4:nth-child(16)
3. Confirm the axe-core finding for rule heading-order.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A33316&f%5B1%5D=topic%3A76&f%5B2%5D=topic%3A126&f%5B3%5D=topic%3A161&f%5B4%5D=topic%3A231&f%5B5%5D=topic%3A446&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2Fascpayment%2Fdownloads%2F09ASC.zip
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A51&f%5B1%5D=topic%3A56&f%5B2%5D=topic%3A61&f%5B3%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- http://cms.gov/priorities/health-equity/minority-health/resource-center/language
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=newsroom_article_type%3A29601&f%5B2%5D=topic%3A1&f%5B3%5D=topic%3A231&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%3A106&f%5B1%5D=topic%3A231&f%5B2%5D=topic%3A436&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%3A66&f%5B1%5D=topic%3A71&f%5B2%5D=topic%3A101&f%5B3%5D=topic%3A231&f%5B4%5D=topic%3A671&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=38775&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare/payment/fee-schedules/durable-medical-equipment-prosthetic-devices-prosthetics-orthotics-supplies/dmepos-payment-determinations-new-items-services
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A21&f%5B1%5D=topic%3A51&f%5B2%5D=topic%3A671&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- http://cms.gov/priorities/health-equity/minority-health/resource-center/language/french-francais
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33667&lcdStatus=all&sortBy=title
- https://cms.gov/newsroom/search?f%5B0%5D=topic%3A56&f%5B1%5D=topic%3A231&f%5B2%5D=topic%3A331&f%5B3%5D=topic%3A456&f%5B4%5D=topic%3A671&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%3A46&f%5B1%5D=topic%3A81&f%5B2%5D=topic%3A101&f%5B3%5D=topic%3A106&f%5B4%5D=topic%3A111&f%5B5%5D=topic%3A446&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%3A66&f%5B1%5D=topic%3A176&f%5B2%5D=topic%3A186&f%5B3%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38816&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=34633&lcdStatus=all&sortBy=title
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A61&f%5B1%5D=topic%3A66&f%5B2%5D=topic%3A76&f%5B3%5D=topic%3A116&f%5B4%5D=topic%3A356&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%3A141&f%5B1%5D=topic%3A176&f%5B2%5D=topic%3A231&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%3A51&f%5B1%5D=topic%3A81&f%5B2%5D=topic%3A356&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29581&f%5B1%5D=newsroom_article_type%3A29586&f%5B2%5D=topic%3A101&f%5B3%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33393&lcdStatus=all&sortBy=title

…and more — 810 pages total ([download CSV](csv/axe-core__heading-order.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A33316&f%5B1%5D=topic%3A76&f%5B2%5D=topic%3A126&f%5B3%5D=topic%3A161&f%5B4%5D=topic%3A231&f%5B5%5D=topic%3A446&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2Fascpayment%2Fdownloads%2F09ASC.zip

---

## Document should have one main landmark (WCAG criterion undetermined)

**Bug ID:** `VS-9259d965`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-one-main` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 76 instances; 76 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<html>
```

### Description
Document should have one main landmark. Detected by axe-core rule landmark-one-main on 76 of 8600 scanned pages (76 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html.
2. Locate the element: html
3. Confirm the axe-core finding for rule landmark-one-main.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0238.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1900.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1513.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0079.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0036.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0944.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0476.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0101.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0024.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0377.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0167.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0084.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0956.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0128.html

…and more — 76 pages total ([download CSV](csv/axe-core__landmark-one-main.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Each page should have exactly one <main> landmark.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI

### Example pages
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html

---

## All page content should be contained by landmarks (WCAG criterion undetermined)

**Bug ID:** `VS-cdf9845d`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html  
**XPath / selector:** `.arrows > tbody > tr:nth-child(1)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1404 instances; 76 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<tr>
		<td><img src="cms-site-logo.png"></td>
		<td style="text-align:center;"><h1>ICD-10-CM/PCS MS-DRG v39.0 Definitions Manual</h1><h1></h1></td>
		<td></td>
		<td></td>
		<td></td>
	</tr>
```

### Description
All page content should be contained by landmarks. Detected by axe-core rule region on 76 of 8600 scanned pages (1404 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html.
2. Locate the element: .arrows > tbody > tr:nth-child(1)
3. Confirm the axe-core finding for rule region.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0238.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1900.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1513.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0079.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0036.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0944.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0476.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0101.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0024.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0377.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0167.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0084.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0956.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0128.html

…and more — 76 pages total ([download CSV](csv/axe-core__region.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI

### Example pages
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html

---

## Page should contain a level-one heading (WCAG criterion undetermined)

**Bug ID:** `VS-302dafd5`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `page-has-heading-one` ([reference](https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 65 instances; 65 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<html>
```

### Description
Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 65 of 8600 scanned pages (65 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html.
2. Locate the element: html
3. Confirm the axe-core finding for rule page-has-heading-one.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://www.cms.gov/derechos-facturas-medicas/ayuda/guias/que-tipo-de-seguro
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1900.html
- https://cms.gov/derechos-facturas-medicas/ayuda/guias/errores-de-facturas
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1513.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0079.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0476.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0101.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0024.html
- https://cms.gov/derechos-facturas-medicas/ayuda/dispute-una-factura
- https://www.cms.gov/priorities/health-equity/grants-awards/minority-research-grant-program/prior-grantees
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0167.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0084.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0219.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0128.html
- https://www.cms.gov/derechos-facturas-medicas/ayuda/guias/explicacion-de-beneficios
- https://www.cms.gov/data-research/cms-information-technology/tlc
- https://www.cms.gov/medicare/medicaid-coordination/center-program-integrity
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0019.html
- https://cms.gov/derechos-facturas-medicas/ayuda/guias/como-leer-una-factura
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1172.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0039.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0654.html

…and more — 65 pages total ([download CSV](csv/axe-core__page-has-heading-one.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://www.cms.gov/derechos-facturas-medicas/ayuda/guias/que-tipo-de-seguro

---

## scope attribute should be used correctly (WCAG criterion undetermined)

**Bug ID:** `VS-2e505a6c`  
**Pattern ID:** `VS-0ba8ce9d`  
**URL:** https://cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=24&sortBy=title&status=all  
**XPath / selector:** `tr:nth-child(2) > td[width="162"][scope="row"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `scope-attr-valid` ([reference](https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 467 instances; 24 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<td width="162" valign="top" scope="row"><p>20.17</p></td>
```

### Description
scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 24 of 8600 scanned pages (467 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=24&sortBy=title&status=all.
2. Locate the element: tr:nth-child(2) > td[width="162"][scope="row"]
3. Confirm the axe-core finding for rule scope-attr-valid.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=24&sortBy=title&status=all
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38571&lcdStatus=all&sortBy=title&ver=8
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=8&sortBy=meetingdate&year=all
- http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=ACAAAAAACAAAAA&NCAId=16&NcaName=Cardiac+Pacemakers
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?bc=AgAAAQAAEAAA&DocType=NCA%7CCAL&fromdb=true&NCAId=224&NcaName=Pharmacogenomic+Testing+for+Warfarin+Response&ver=11&year=2009
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=190&ncdver=3&sortBy=title
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?fromdb=true&NCAId=40
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=40&proposed=N
- https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=24
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?+proposed=N&bc=17&ncacaldoctype=all&ncaid=90&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=199&proposed=N
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=265&proposed=Y
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=55&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAEACA&docName=Decision+Memo+for+Cardiac+Pacemakers+%28CAG-00063R2%29&NCAId=16&NcaName=Cardiac+Pacemakers+%282nd+Recon%29&proposed=N
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=39122&proposedStatus=all&sortBy=title&stateRegion=all&ver=3
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=90
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=30&sortBy=title&status=all
- https://www.cms.gov/medicare-coverage-database/view/technology-assessments.aspx?bc=20&sortBy=title&taid=6&year=0
- https://www.cms.gov/medicare-coverage-database/view/technology-assessments.aspx?bc=20&sortBy=title&taid=19&year=0
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=11&sortBy=title&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=181&NCDver=1
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?areaId=all&bc=1&contractOption=all&docType=NCA%2CCAL%2CNCD%2CMEDCAC%2CTA%2CMCD%2C6%2C3%2C5%2C1%2CF%2CP&fromTracking=Y&keyword=permanent+cardiac&keywordType=starts&ncaid=285&proposed=Y&sortBy=relevance
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AiAAAAAAEACA&docName=Decision+Memo+for+Cardiac+Pacemakers+%28CAG-00063R2%29&NCAId=16&NcaName=Cardiac+Pacemakers+%282nd+Recon%29

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI

### Example pages
- https://cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=24&sortBy=title&status=all
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38571&lcdStatus=all&sortBy=title&ver=8
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=8&sortBy=meetingdate&year=all

---

## Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined)

**Bug ID:** `VS-e684a6a8`  
**Pattern ID:** `VS-8806389c`  
**URL:** https://www.cms.gov/about-cms/contact/newsroom?page=3  
**XPath / selector:** `.views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-unique` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 10 instances; 10 of 8600 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W29 (5 weeks)

### HTML snippet
```html
<span class="views-field views-field-field-topic" role="region" aria-label="Related search topics">
<a href="/newsroom/search?sort_by=search_api_relevance&amp;sort_order=DESC&amp;items_per_page=10&amp
```

### Description
Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 10 of 8600 scanned pages (10 instances).

### Steps to reproduce
1. Open https://www.cms.gov/about-cms/contact/newsroom?page=3.
2. Locate the element: .views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)
3. Confirm the axe-core finding for rule landmark-unique.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/about-cms/contact/newsroom?page=3
- https://cms.gov/priorities/innovation/evaluation-research-reports
- http://www.cms.gov/about-cms/contact/newsroom
- https://www.cms.gov/priorities/innovation/innovation-models/map
- https://www.cms.gov/apps/media/press/release.asp?Counter=3888
- http://cms.gov/priorities/innovation/where-innovation-happening
- http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4474
- https://www.cms.gov/about-cms/contact/newsroom
- http://www.cms.gov/apps/media/press/release.asp?Counter=1907
- http://cms.gov/about-cms/contact/newsroom

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** When a landmark role/type repeats (e.g. two <nav>s), give each a distinct accessible name with aria-label or aria-labelledby (e.g. "Primary" and "Footer" navigation) so screen-reader users can tell them apart.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI

### Example pages
- https://www.cms.gov/about-cms/contact/newsroom?page=3
- https://cms.gov/priorities/innovation/evaluation-research-reports
- http://www.cms.gov/about-cms/contact/newsroom

---

## Banner landmark should not be contained in another landmark (WCAG criterion undetermined)

**Bug ID:** `VS-73aab097`  
**Pattern ID:** `VS-30db094d`  
**URL:** https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation  
**XPath / selector:** `.Header`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-banner-is-top-level` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-banner-is-top-level?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (5 weeks)

### HTML snippet
```html
<header class="Header" style="position: sticky;">
```

### Description
Banner landmark should not be contained in another landmark. Detected by axe-core rule landmark-banner-is-top-level on 1 of 8600 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation.
2. Locate the element: .Header
3. Confirm the axe-core finding for rule landmark-banner-is-top-level.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Put the banner landmark (<header>) at the top level, not nested inside another landmark.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-banner-is-top-level?application=axeAPI

---

## Headings should not be empty (WCAG criterion undetermined)

**Bug ID:** `VS-d86c817e`  
**Pattern ID:** `VS-0066c67d`  
**URL:** https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html  
**XPath / selector:** `h1:nth-child(2)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `empty-heading` ([reference](https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 48 instances; 48 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<h1></h1>
```

### Description
Headings should not be empty. Detected by axe-core rule empty-heading on 48 of 8600 scanned pages (48 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html.
2. Locate the element: h1:nth-child(2)
3. Confirm the axe-core finding for rule empty-heading.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0238.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0036.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0944.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0377.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0026.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0956.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0026.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0023.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0020.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0018.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0035.html
- https://www.cms.gov/about-cms/what-we-do/nursing-homes
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59632&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=37244&ver=39
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0318.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0315.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0322.html
- https://www.cms.gov/priorities/medicare-prescription-drug-affordability/overview/medicare-drug-price-negotiation-program/pharmacy-dispensing-entity-resources

…and more — 48 pages total ([download CSV](csv/axe-core__empty-heading.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Remove empty headings or give them text. Don't use heading tags for spacing.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI

### Example pages
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0238.html

---

## Table header text should not be empty (WCAG criterion undetermined)

**Bug ID:** `VS-e5c53932`  
**Pattern ID:** `VS-d69fc059`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y  
**XPath / selector:** `li:nth-child(287) > table > tbody > tr:nth-child(1) > th:nth-child(1)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `empty-table-header` ([reference](https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 28 instances; 12 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<th></th>
```

### Description
Table header text should not be empty. Detected by axe-core rule empty-table-header on 12 of 8600 scanned pages (28 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y.
2. Locate the element: li:nth-child(287) > table > tbody > tr:nth-child(1) > th:nth-child(1)
3. Confirm the axe-core finding for rule empty-table-header.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y
- http://cms.gov/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/application-information
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=8&sortBy=meetingdate&year=all
- http://cms.gov/newsroom/fact-sheets/proposed-pathways-success-medicare-shared-savings-program
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?bc=AgAAAQAAEAAA&DocType=NCA%7CCAL&fromdb=true&NCAId=224&NcaName=Pharmacogenomic+Testing+for+Warfarin+Response&ver=11&year=2009
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56104&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=17
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=14&doctype=all&ncaid=321&proposed=Y&sortBy=title&year=2026
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=55&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&fromTracking=Y&ncacaldoctype=all&ncaid=309&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&fromTracking=Y&ncacaldoctype=NCA&ncaid=321&proposed=Y&sortBy=status&status=Open+for+Public+Comment
- http://www.cms.gov/newsroom/fact-sheets/2025-medicare-advantage-part-d-star-ratings

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y
- http://cms.gov/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/application-information
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=8&sortBy=meetingdate&year=all

---

## Form field label is visible (WCAG criterion undetermined)

**Bug ID:** `VS-493d75bf`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r61` ([reference](https://alfa.siteimprove.com/rules/sia-r61))  
**Severity:** Moderate  
**Frequency:** 3646 instances; 3646 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 3646 of 8600 scanned pages (3646 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r61.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc
- https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=newsroom_article_type%3A29601&f%5B2%5D=topic%3A61&f%5B3%5D=topic%3A161&f%5B4%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2Fascpayment%2Fdownloads%2F09ASC.zip
- https://cms.gov/newsroom/press-releases/600000-north-carolinians-now-have-access-medicaid-expansion-coverage
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A46&f%5B1%5D=topic%3A66&f%5B2%5D=topic%3A71&f%5B3%5D=topic%3A76&f%5B4%5D=topic%3A121&f%5B5%5D=topic%3A231&f%5B6%5D=topic%3A671&f%5B7%5D=topic%3A841&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%3A51&f%5B1%5D=topic%3A56&f%5B2%5D=topic%3A61&f%5B3%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_revision_date&page=9&sort=asc
- http://www.cms.gov/training-education/medicare-learning-networkr-mln/compliance/medicare-provider-compliance-tips/inpatient-rehabilitation-hospitals
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26
- http://cms.gov/priorities/health-equity/minority-health/resource-center/language
- https://cms.gov/medicare/regulations-guidance/transmittals/2014-transmittals?items_per_page=25&order=field_dyna_transmittal_number&sort=asc
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2016-transmittals-items/r3495cp
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=283
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=newsroom_article_type%3A29601&f%5B2%5D=topic%3A1&f%5B3%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55936&ver=2
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A21&f%5B2%5D=topic%3A56&f%5B3%5D=topic%3A66&f%5B4%5D=topic%3A161&f%5B5%5D=topic%3A426&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/priorities/key-initiatives/nursing-home-careers/licensed-practical-nurse-licensed-vocational-nurse
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59946&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59855&articleStatus=all&bc=3&sortBy=title&ver=4
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29581&f%5B1%5D=newsroom_article_type%3A29586&f%5B2%5D=newsroom_article_type%3A33316&f%5B3%5D=topic%3A66&f%5B4%5D=topic%3A161&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A671&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%3A21&f%5B1%5D=topic%3A46&f%5B2%5D=topic%3A76&f%5B3%5D=topic%3A176&f%5B4%5D=topic%3A221&f%5B5%5D=topic%3A446&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC

…and more — 3646 pages total ([download CSV](csv/alfa__sia-r61.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61

### Example pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc
- https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all

---

## Scrolling content can be accessed by keyboard (WCAG criterion undetermined)

**Bug ID:** `VS-d0cd8ea3`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc  
**XPath / selector:** `text: "Feedback"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 1652 instances; 1652 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 1652 of 8600 scanned pages (1652 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc.
2. Locate the element: text: "Feedback"
3. Confirm the Siteimprove Alfa finding for rule sia-r57.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc
- https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update
- https://cms.gov/newsroom/press-releases/600000-north-carolinians-now-have-access-medicaid-expansion-coverage
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A46&f%5B1%5D=topic%3A66&f%5B2%5D=topic%3A71&f%5B3%5D=topic%3A76&f%5B4%5D=topic%3A121&f%5B5%5D=topic%3A231&f%5B6%5D=topic%3A671&f%5B7%5D=topic%3A841&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%3A51&f%5B1%5D=topic%3A56&f%5B2%5D=topic%3A61&f%5B3%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_revision_date&page=9&sort=asc
- http://www.cms.gov/training-education/medicare-learning-networkr-mln/compliance/medicare-provider-compliance-tips/inpatient-rehabilitation-hospitals
- http://cms.gov/priorities/health-equity/minority-health/resource-center/language
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A21&f%5B2%5D=topic%3A56&f%5B3%5D=topic%3A66&f%5B4%5D=topic%3A161&f%5B5%5D=topic%3A426&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%3A29581&f%5B1%5D=newsroom_article_type%3A29586&f%5B2%5D=newsroom_article_type%3A33316&f%5B3%5D=topic%3A66&f%5B4%5D=topic%3A161&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A671&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%3A106&f%5B1%5D=topic%3A231&f%5B2%5D=topic%3A436&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%3A29581&f%5B1%5D=newsroom_article_type%3A29586&f%5B2%5D=topic%3A61&f%5B3%5D=topic%3A66&f%5B4%5D=topic%3A116&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A436&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10943cp
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A66&f%5B1%5D=topic%3A71&f%5B2%5D=topic%3A101&f%5B3%5D=topic%3A231&f%5B4%5D=topic%3A671&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/newsroom/press-releases/new-drug-coverage-west-virginia-include-options-additional-benefits-and-saving-money
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2018-transmittals-items/r2210otn
- https://www.cms.gov/data-research/monitoring-programs/medicare-fee-service-compliance-programs/medicare-fee-service-recovery-audit-program/approved-rac-topics?items_per_page=25&order=field_dyna_date_only&page=2&sort=asc
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2015-transmittals-items/r2p243
- https://www.cms.gov/medicare/payment/fee-schedules/durable-medical-equipment-prosthetic-devices-prosthetics-orthotics-supplies/dmepos-payment-determinations-new-items-services
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A61&items_per_page=10&page=2&sort_by=search_api_relevance&sort_order=DESC
- https://cms.gov/training-education/cms-open-door-forums/end-stage-renal-disease-esrd-dialysis-facility-care-compare
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A21&f%5B1%5D=topic%3A46&f%5B2%5D=topic%3A176&f%5B3%5D=topic%3A221&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_cr_number&page=8&sort=asc
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A21&f%5B1%5D=topic%3A61&f%5B2%5D=topic%3A71&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2013-transmittals-items/r1264otn

…and more — 1652 pages total ([download CSV](csv/alfa__sia-r57.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57

### Example pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc
- https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update
- https://cms.gov/newsroom/press-releases/600000-north-carolinians-now-have-access-medicaid-expansion-coverage

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-f32b8b18`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all  
**XPath / selector:** `<h4>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 1416 instances; 1397 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 1397 of 8600 scanned pages (1416 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.
2. Locate the element: <h4>
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2Fascpayment%2Fdownloads%2F09ASC.zip
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A51&f%5B1%5D=topic%3A56&f%5B2%5D=topic%3A61&f%5B3%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26
- http://cms.gov/priorities/health-equity/minority-health/resource-center/language
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=newsroom_article_type%3A29601&f%5B2%5D=topic%3A1&f%5B3%5D=topic%3A231&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55936&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59946&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59855&articleStatus=all&bc=3&sortBy=title&ver=4
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A106&f%5B1%5D=topic%3A231&f%5B2%5D=topic%3A436&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%3A66&f%5B1%5D=topic%3A71&f%5B2%5D=topic%3A101&f%5B3%5D=topic%3A231&f%5B4%5D=topic%3A671&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57928&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38615&lcdStatus=all&sortBy=title&ver=13
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56658&ver=42
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33667&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58546&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35035&lcdStatus=all&sortBy=title&ver=74
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39084&lcdStatus=all&sortBy=title&ver=5
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57678&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59704&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35974&ver=28
- https://cms.gov/newsroom/search?f%5B0%5D=topic%3A56&f%5B1%5D=topic%3A231&f%5B2%5D=topic%3A331&f%5B3%5D=topic%3A456&f%5B4%5D=topic%3A671&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC

…and more — 1397 pages total ([download CSV](csv/alfa__sia-r53.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Use headings in a logical, non-skipping order.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r53

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2Fascpayment%2Fdownloads%2F09ASC.zip

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-d6f931f8`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26  
**XPath / selector:** `<h4>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r78` ([reference](https://alfa.siteimprove.com/rules/sia-r78))  
**Severity:** Moderate  
**Frequency:** 759 instances; 483 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 483 of 8600 scanned pages (759 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26.
2. Locate the element: <h4>
3. Confirm the Siteimprove Alfa finding for rule sia-r78.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26
- http://cms.gov/priorities/health-equity/minority-health/resource-center/language
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56658&ver=42
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33667&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57678&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://www.cms.gov/derechos-facturas-medicas/ayuda/guias/que-tipo-de-seguro
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55584&articleStatus=all&bc=3&sortBy=title&ver=19
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38816&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56730&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=27
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57025&articleStatus=all&bc=3&sortBy=title&ver=21
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57878&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=26
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33575&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59973&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=34394&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57689&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=44
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56899&articleStatus=all&bc=3&sortBy=title&ver=11
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=34087&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57307&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=33
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35494&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56607&articleStatus=all&bc=3&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56838&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=13
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57752&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=18

…and more — 483 pages total ([download CSV](csv/alfa__sia-r78.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r78

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26
- http://cms.gov/priorities/health-equity/minority-health/resource-center/language
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38684&lcdStatus=all&sortBy=title&stateRegion=all

---

## Presentational attribute (use CSS) (WCAG criterion undetermined)

**Bug ID:** `VS-a0050faf`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all  
**XPath / selector:** `p`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 250 instances; 29 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### HTML snippet
```html
<p class="MsoTitle" align="center" style="text-align:center">Proposed Guidance Document:<br>Study Protocols That Use Real-world Data<br>January 17, 2025</p>
```

### Description
Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 29 of 8600 scanned pages (250 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.
2. Locate the element: p
3. Confirm the deprecated-html finding for rule presentational-attr.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56607&articleStatus=all&bc=3&sortBy=title&ver=19
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0476.html
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=19&sortBy=meetingdate&year=all
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0101.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57385&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=39
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56607&articleStatus=all&bc=3&sortBy=title&ver=16
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?fromdb=true&NCAId=40
- https://cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=34&sortBy=title&status=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59624&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=15
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=54953&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=70
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59645&articleStatus=all&bc=3&sortBy=title&ver=16
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0318.html
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34823&lcdStatus=all&sortBy=title&ver=27
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58889&articleStatus=all&bc=3&sortBy=title&ver=5
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0315.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57957&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=53
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1901.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57478&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=40
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58511&articleStatus=all&bc=3&sortBy=title&ver=4
- http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=10
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37921&lcdStatus=all&sortBy=title&ver=18
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=58996&ver=31

…and more — 29 pages total ([download CSV](csv/deprecated-html__presentational-attr.csv)).

### Testing environment
Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
Not captured by automated scan — requires manual testing.

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56607&articleStatus=all&bc=3&sortBy=title&ver=19
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0476.html

---

## Element with orientation is not locked (WCAG criterion undetermined)

**Bug ID:** `VS-ceac3d33`  
**Pattern ID:** `VS-7fbb8b20`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html  
**XPath / selector:** `{"type":"document","children":[{"type":"element","children":[{"type":"element","`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r59` ([reference](https://alfa.siteimprove.com/rules/sia-r59))  
**Severity:** Moderate  
**Frequency:** 15 instances; 15 of 8600 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W29 (4 weeks)

### Description
Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 15 of 8600 scanned pages (15 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html.
2. Locate the element: {"type":"document","children":[{"type":"element","children":[{"type":"element","
3. Confirm the Siteimprove Alfa finding for rule sia-r59.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0084.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0219.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0128.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0019.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0075.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0495.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1517.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0021.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1132.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1570.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0156.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0604.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1510.html

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r59

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0084.html

---

## Form field error is identified and described (WCAG criterion undetermined)

**Bug ID:** `VS-2aa9bafb`  
**Pattern ID:** `VS-e43903a1`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html  
**XPath / selector:** `<ul id="globar">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r75` ([reference](https://alfa.siteimprove.com/rules/sia-r75))  
**Severity:** Moderate  
**Frequency:** 30 instances; 15 of 8600 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W29 (4 weeks)

### Description
Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 15 of 8600 scanned pages (30 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html.
2. Locate the element: <ul id="globar">
3. Confirm the Siteimprove Alfa finding for rule sia-r75.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0084.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0219.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0128.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0019.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0075.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0495.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1517.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0021.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1132.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1570.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0156.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0604.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1510.html

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r75

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0084.html

---

## Duplicate role landmark is labeled (WCAG criterion undetermined)

**Bug ID:** `VS-651827fe`  
**Pattern ID:** `VS-f2542d87`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y  
**XPath / selector:** `<pre>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r79` ([reference](https://alfa.siteimprove.com/rules/sia-r79))  
**Severity:** Moderate  
**Frequency:** 9 instances; 9 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (6 weeks)

### Description
Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 9 of 8600 scanned pages (9 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y.
2. Locate the element: <pre>
3. Confirm the Siteimprove Alfa finding for rule sia-r79.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?calid=201&proposed=N
- https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=17
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=40&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAEACA&docName=Decision+Memo+for+Cardiac+Pacemakers+%28CAG-00063R2%29&NCAId=16&NcaName=Cardiac+Pacemakers+%282nd+Recon%29&proposed=N
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=90
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&fromTracking=Y&ncacaldoctype=all&ncaid=309&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?areaId=all&bc=1&contractOption=all&docType=NCA%2CCAL%2CNCD%2CMEDCAC%2CTA%2CMCD%2C6%2C3%2C5%2C1%2CF%2CP&fromTracking=Y&keyword=permanent+cardiac&keywordType=starts&ncaid=285&proposed=Y&sortBy=relevance
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AiAAAAAAEACA&docName=Decision+Memo+for+Cardiac+Pacemakers+%28CAG-00063R2%29&NCAId=16&NcaName=Cardiac+Pacemakers+%282nd+Recon%29

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r79

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?calid=201&proposed=N
- https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=17

---

## No obsolete or deprecated elements are used (WCAG criterion undetermined)

**Bug ID:** `VS-c399476f`  
**Pattern ID:** `VS-3d033717`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r70` ([reference](https://alfa.siteimprove.com/rules/sia-r70))  
**Severity:** Moderate  
**Frequency:** 8 instances; 8 of 8600 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W29 (5 weeks)

### Description
No obsolete or deprecated elements are used. Detected by Siteimprove Alfa rule sia-r70 on 8 of 8600 scanned pages (8 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r70.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38396&ver=25
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=60&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=90
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&fromTracking=Y&ncacaldoctype=all&ncaid=309&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33942&lcdStatus=all&sortBy=title&ver=47
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?areaId=all&bc=1&contractOption=all&docType=NCA%2CCAL%2CNCD%2CMEDCAC%2CTA%2CMCD%2C6%2C3%2C5%2C1%2CF%2CP&fromTracking=Y&keyword=permanent+cardiac&keywordType=starts&ncaid=285&proposed=Y&sortBy=relevance
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=315&proposed=Y

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r70

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38396&ver=25
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=60&sortBy=meetingdate&year=all

---

## Keyboard trap does not exist (WCAG criterion undetermined)

**Bug ID:** `VS-e771f0e9`  
**Pattern ID:** `VS-4c341c77`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all  
**XPath / selector:** `<p>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r85` ([reference](https://alfa.siteimprove.com/rules/sia-r85))  
**Severity:** Moderate  
**Frequency:** 15 instances; 5 of 8600 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W29 (5 weeks)

### Description
Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 5 of 8600 scanned pages (15 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.
2. Locate the element: <p>
3. Confirm the Siteimprove Alfa finding for rule sia-r85.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=60&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaId=315&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=14&doctype=all&ncaid=321&proposed=Y&sortBy=title&year=2026
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&fromTracking=Y&ncacaldoctype=NCA&ncaid=321&proposed=Y&sortBy=status&status=Open+for+Public+Comment

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r85

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=60&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaId=315&proposed=N

---

## Obsolete <font> element (use CSS) (WCAG criterion undetermined)

**Bug ID:** `VS-b6421dd6`  
**Pattern ID:** `VS-91d2294a`  
**URL:** http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53064&articleStatus=all&bc=3&sortBy=title&ver=87  
**XPath / selector:** `font`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `font-element`  
**Severity:** Moderate  
**Frequency:** 8 instances; 2 of 8600 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W29 (5 weeks)

### HTML snippet
```html
<font face="Times New Roman" size="3"><span style="line-height: 115%; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; font-size: 12pt;">Under <b><i style="mso-bidi-font-style: normal;">CPT
```

### Description
Obsolete <font> element (use CSS). Detected by deprecated-html rule font-element on 2 of 8600 scanned pages (8 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53064&articleStatus=all&bc=3&sortBy=title&ver=87.
2. Locate the element: font
3. Confirm the deprecated-html finding for rule font-element.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53064&articleStatus=all&bc=3&sortBy=title&ver=87
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=379&ncdver=1&sortBy=title

### Testing environment
Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
Not captured by automated scan — requires manual testing.

### Example pages
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53064&articleStatus=all&bc=3&sortBy=title&ver=87
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=379&ncdver=1&sortBy=title

---

## aria attribute is permitted for element role (WCAG criterion undetermined)

**Bug ID:** `VS-7c656026`  
**Pattern ID:** `VS-e05344b9`  
**URL:** https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation  
**XPath / selector:** `@aria-label="Open Medicare Advantage Geographic Variation - National & State"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 3 instances; 1 of 8600 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W29 (5 weeks)

### Description
aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 1 of 8600 scanned pages (3 instances).

### Steps to reproduce
1. Open https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation.
2. Locate the element: @aria-label="Open Medicare Advantage Geographic Variation - National & State"
3. Confirm the Siteimprove Alfa finding for rule sia-r18.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Only use ARIA states/properties that are allowed on this element/role.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r18

---

## First focusable element is link to main content (WCAG criterion undetermined)

**Bug ID:** `VS-9a6b0c3e`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r87` ([reference](https://alfa.siteimprove.com/rules/sia-r87))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 8600 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W29 (5 weeks)

### Description
First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 1 of 8600 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r87.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r87