{
 "domain": "www.cms.gov",
 "week": "2026-W29",
 "generatedAt": "2026-07-24T13:06:46.084Z",
 "reports": [
  {
   "instance_id": "VS-05c10a41",
   "pattern_id": "VS-179ad9b3",
   "a11y_pattern_fingerprint": "4998798af0aa123f705d613e153e338c70a9a8742f28f31a3d5e1ccb0207358c",
   "a11y_pattern_display_id": "A11Y-PAT-4998798AF0AA",
   "a11y_occurrence_fingerprint": "6593fb752da9a8d4170fad4e4bdc5bbc1693a10194a78e52eeaca3c1ca718d0f",
   "a11y_occurrence_display_id": "A11Y-OCC-6593FB752DA9",
   "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6",
   "xpath": "<a href=\"#lblRelatedNationalSubheader\" data-href=\"lblRelatedNationalSubheader\" class=\"nav-link toc-link no-link log-click\" title=\"Jump to Related National Coverage Documents\">",
   "html_snippet": null,
   "wcag_sc": "2.5.8",
   "wcag_name": "Target Size (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.2",
   "wcag_category": "WCAG 2.2 AA",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r113",
   "rule_label": "Target size is at least 24×24 CSS pixels or has spacing (Minimum)",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r113",
   "severity": "Moderate",
   "frequency": {
    "instances": 718,
    "pages_affected": 443,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8)",
   "description": "Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 443 of 8600 scanned pages (718 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6",
     "xpath": "<a href=\"#lblRelatedNationalSubheader\" data-href=\"lblRelatedNationalSubheader\" class=\"nav-link toc-link no-link log-click\" title=\"Jump to Related National Coverage Documents\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55936&ver=2",
     "xpath": "<a href=\"#lblRelatedNationalSubheader\" data-href=\"lblRelatedNationalSubheader\" class=\"nav-link toc-link no-link log-click\" title=\"Jump to Related National Coverage Documents\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "<a href=\"http://www.hhs.gov\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "<a href=\"http://www.medicare.gov\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "<a href=\"http://www.usa.gov\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LR",
      "group": "Limited reach",
      "prevalence": 0.02,
      "percent": "2.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6.",
    "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\">",
    "Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum)."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r113",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r113.csv"
  },
  {
   "instance_id": "VS-2b459b2c",
   "pattern_id": "VS-f7dba940",
   "a11y_pattern_fingerprint": "714cfa2672abec642b191ae001c2d17ec37f8b0583bb71ecc7b42f9c7d1949ae",
   "a11y_pattern_display_id": "A11Y-PAT-714CFA2672AB",
   "a11y_occurrence_fingerprint": "76ff40f120bc15ac35af7a2f9845d402684990c7dc1c589076404e1b62f18792",
   "a11y_occurrence_display_id": "A11Y-OCC-76FF40F120BC",
   "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
   "xpath": "<a id=\"aBasketManuButton\" class=\"basket-icon log-click \" title=\"View documents in your Basket\" data-page-action=\"Clicked the Basket navbar link.\">",
   "html_snippet": null,
   "wcag_sc": "2.5.3",
   "wcag_name": "Label in Name",
   "wcag_level": "A",
   "wcag_version": "2.1",
   "wcag_category": "WCAG 2.1 A",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r14",
   "rule_label": "Accessible name of link or button matches visible label",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r14",
   "severity": "Moderate",
   "frequency": {
    "instances": 3109,
    "pages_affected": 1219,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Accessible name of link or button matches visible label (WCAG 2.5.3)",
   "description": "Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 1219 of 8600 scanned pages (3109 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "<a id=\"aBasketManuButton\" class=\"basket-icon log-click \" title=\"View documents in your Basket\" data-page-action=\"Clicked the Basket navbar link.\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "<a href=\"#\" data-bs-toggle=\"collapse\" id=\"aCollapseNavigation\" aria-label=\"Collapse Document Navigation\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6",
     "xpath": "<a id=\"aBasketManuButton\" class=\"basket-icon log-click \" title=\"View documents in your Basket\" data-page-action=\"Clicked the Basket navbar link.\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6",
     "xpath": "<a href=\"#\" data-bs-toggle=\"collapse\" id=\"aCollapseNavigation\" aria-label=\"Collapse Document Navigation\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26",
     "xpath": "<a id=\"aBasketManuButton\" class=\"basket-icon log-click \" title=\"View documents in your Basket\" data-page-action=\"Clicked the Basket navbar link.\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "WS",
      "group": "Without speech",
      "prevalence": 0.005,
      "percent": "0.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Without speech (0.5%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.",
    "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.\">",
    "Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r14.csv"
  },
  {
   "instance_id": "VS-ad201d5b",
   "pattern_id": "VS-9074b4dd",
   "a11y_pattern_fingerprint": "a978dea41024ecf3c2edc0da00aac9058166a8299fabb3a47324cc4a04812e96",
   "a11y_pattern_display_id": "A11Y-PAT-A978DEA41024",
   "a11y_occurrence_fingerprint": "46d6314cc36c8e2b099edc8115d3e8bae608030c1da0ae6b526eff203bd15746",
   "a11y_occurrence_display_id": "A11Y-OCC-46D6314CC36C",
   "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html",
   "xpath": "img[src$=\"cms-site-logo.png\"]",
   "html_snippet": "<img src=\"cms-site-logo.png\">",
   "wcag_sc": "1.1.1",
   "wcag_name": "Non-text Content",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "image-alt",
   "rule_label": "Images must have alternative text",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI",
   "severity": "Critical",
   "frequency": {
    "instances": 40,
    "pages_affected": 40,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Images must have alternative text (WCAG 1.1.1)",
   "description": "Images must have alternative text. Detected by axe-core rule image-alt on 40 of 8600 scanned pages (40 instances).",
   "examples": [
    {
     "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html",
     "xpath": "img[src$=\"cms-site-logo.png\"]",
     "html_snippet": "<img src=\"cms-site-logo.png\">"
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "img[src$=\"cms-site-logo.png\"]",
     "html_snippet": "<img src=\"cms-site-logo.png\">"
    },
    {
     "url": "https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0238.html",
     "xpath": "img[src$=\"cms-site-logo.png\"]",
     "html_snippet": "<img src=\"cms-site-logo.png\">"
    },
    {
     "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html",
     "xpath": "img[src$=\"cms-site-logo.png\"]",
     "html_snippet": "<img src=\"cms-site-logo.png\">"
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html",
     "xpath": "img[src$=\"cms-site-logo.png\"]",
     "html_snippet": "<img src=\"cms-site-logo.png\">"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html.",
    "Locate the element: img[src$=\"cms-site-logo.png\"]",
    "Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content."
   ],
   "remediation_tip": "Give every <img> a meaningful alt attribute. Use alt=\"\" only for decorative images so screen readers skip them.",
   "tech_name": "Drupal",
   "tech_remediation_tip": "In Drupal's Media Library, fill the \"Alternative text\" field when uploading or editing an image. For images in body fields, the CKEditor \"Image Properties\" dialog includes an Alt Text field.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/axe-core__image-alt.csv"
  },
  {
   "instance_id": "VS-15b564c9",
   "pattern_id": "VS-a24eaa8c",
   "a11y_pattern_fingerprint": "9706dec6d1fe236347283238777ae900c1508adec6284acb1378d2ccabf1a12d",
   "a11y_pattern_display_id": "A11Y-PAT-9706DEC6D1FE",
   "a11y_occurrence_fingerprint": "ce615a1f3d7eb9da3396ef0750af2608ac4a9b556694ff1cb2968498cb0e4ebe",
   "a11y_occurrence_display_id": "A11Y-OCC-CE615A1F3D7E",
   "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
   "xpath": "<img src=\"cms-site-logo.png\">",
   "html_snippet": null,
   "wcag_sc": "1.1.1",
   "wcag_name": "Non-text Content",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r2",
   "rule_label": "Image has accessible name",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r2",
   "severity": "Moderate",
   "frequency": {
    "instances": 24,
    "pages_affected": 24,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Image has accessible name (WCAG 1.1.1)",
   "description": "Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 24 of 8600 scanned pages (24 instances).",
   "examples": [
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "<img src=\"cms-site-logo.png\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html",
     "xpath": "<img src=\"cms-site-logo.png\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html",
     "xpath": "<img src=\"cms-site-logo.png\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0944.html",
     "xpath": "<img src=\"cms-site-logo.png\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0033.html",
     "xpath": "<img src=\"cms-site-logo.png\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html.",
    "Locate the element: <img src=\"cms-site-logo.png\">",
    "Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content."
   ],
   "remediation_tip": "Give every <img> an accessible name (alt text), or alt=\"\" if purely decorative.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r2",
   "possible_duplicate_of": "VS-ad201d5b",
   "possible_duplicate_pattern": "VS-9074b4dd",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/alfa__sia-r2.csv"
  },
  {
   "instance_id": "VS-b7b8a7e9",
   "pattern_id": "VS-9429bb8d",
   "a11y_pattern_fingerprint": "68758ae323f1c8ddf321150ffcfcf38666adb11b0907a67a1bf3d944a479ba35",
   "a11y_pattern_display_id": "A11Y-PAT-68758AE323F1",
   "a11y_occurrence_fingerprint": "3938f027d1a244a91070181fa4d8f50ab69519d8055140eec3cc5dc16961e978",
   "a11y_occurrence_display_id": "A11Y-OCC-3938F027D1A2",
   "url": "https://cms.gov/medicare/prevention/prevntiongeninfo/medicare-preventive-services/mps-quickreferencechart-1.html",
   "xpath": "#SERVICES",
   "html_snippet": "<ul id=\"SERVICES\" class=\"closed openMenu\" role=\"menu\" tabindex=\"-1\" style=\"background-color: rgb(255, 255, 255); margin-bottom: 60px;\">",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "aria-required-children",
   "rule_label": "Certain ARIA roles must contain particular children",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI",
   "severity": "Critical",
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 8600
   },
   "likely_source": "content",
   "summary": "Certain ARIA roles must contain particular children (WCAG 1.3.1)",
   "description": "Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 1 of 8600 scanned pages (1 instances).",
   "examples": [
    {
     "url": "https://cms.gov/medicare/prevention/prevntiongeninfo/medicare-preventive-services/mps-quickreferencechart-1.html",
     "xpath": "#SERVICES",
     "html_snippet": "<ul id=\"SERVICES\" class=\"closed openMenu\" role=\"menu\" tabindex=\"-1\" style=\"background-color: rgb(255, 255, 255); margin-bottom: 60px;\">"
    }
   ],
   "example_pages": [
    "https://cms.gov/medicare/prevention/prevntiongeninfo/medicare-preventive-services/mps-quickreferencechart-1.html"
   ],
   "affected_pages": [
    "https://cms.gov/medicare/prevention/prevntiongeninfo/medicare-preventive-services/mps-quickreferencechart-1.html"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://cms.gov/medicare/prevention/prevntiongeninfo/medicare-preventive-services/mps-quickreferencechart-1.html.",
    "Locate the element: #SERVICES",
    "Confirm the axe-core finding for rule aria-required-children against WCAG 1.3.1 Info and Relationships."
   ],
   "remediation_tip": "Add the child roles this container role requires (e.g. a list needs listitem children).",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W28",
   "last_seen": "2026-W29",
   "weeks_seen": 2,
   "affected_pages_csv": "csv/axe-core__aria-required-children.csv"
  },
  {
   "instance_id": "VS-ff7aada4",
   "pattern_id": "VS-a0bdbdf6",
   "a11y_pattern_fingerprint": "50fa0bbb036fd28c57bc5ee2b6fb73013dc820fbf44b86b2ef1f1dc50e546ca4",
   "a11y_pattern_display_id": "A11Y-PAT-50FA0BBB036F",
   "a11y_occurrence_fingerprint": "70ced513981ca7cd9c5dad1ee4847f558c353318283fb28f8b95f10d6ee638a7",
   "a11y_occurrence_display_id": "A11Y-OCC-70CED513981C",
   "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": ".pager__items",
   "html_snippet": "<ul class=\"pager__items js-pager__items cms-evo-unstyled-list ds-u-display--flex ds-u-justify-content--center\">",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "list",
   "rule_label": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI",
   "severity": "Serious",
   "frequency": {
    "instances": 2152,
    "pages_affected": 608,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements (WCAG 1.3.1)",
   "description": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 608 of 8600 scanned pages (2152 instances).",
   "examples": [
    {
     "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": ".pager__items",
     "html_snippet": "<ul class=\"pager__items js-pager__items cms-evo-unstyled-list ds-u-display--flex ds-u-justify-content--center\">"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6",
     "xpath": "ol[type=\"1\"][start=\"1\"]:nth-child(114)",
     "html_snippet": "<ol start=\"1\" type=\"1\">"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6",
     "xpath": "ol[type=\"1\"][start=\"1\"]:nth-child(116)",
     "html_snippet": "<ol start=\"1\" type=\"1\">"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6",
     "xpath": "ol[type=\"1\"][start=\"1\"]:nth-child(124)",
     "html_snippet": "<ol start=\"1\" type=\"1\">"
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57836&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=3",
     "xpath": "tr:nth-child(1) > td:nth-child(3) > ol",
     "html_snippet": "<ol style=\"list-style-type: upper-alpha;\">"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "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.",
    "Locate the element: .pager__items",
    "Confirm the axe-core finding for rule list against WCAG 1.3.1 Info and Relationships."
   ],
   "remediation_tip": "Use <ul>/<ol> with only <li> children for lists; don't fake lists with <div>s.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__list.csv"
  },
  {
   "instance_id": "VS-aeb2d85a",
   "pattern_id": "VS-6175596b",
   "a11y_pattern_fingerprint": "2da871dd34c1c701ddf0b2de494ab04eaecd3e5adddad3f0537c0c52c7b63dd1",
   "a11y_pattern_display_id": "A11Y-PAT-2DA871DD34C1",
   "a11y_occurrence_fingerprint": "e4c76c2fc267b62cd421997bbb8091e66779700566da794482466ae5f535ebf7",
   "a11y_occurrence_display_id": "A11Y-OCC-E4C76C2FC267",
   "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y",
   "xpath": "li:nth-child(280)",
   "html_snippet": "<li> The Medicare Claims Processing Manual, Chapter 20, “Durable Medical Equipment, Prosthetics and Orthotics, and Supplies (DMEPOS).”<p></p>\n\n<p></p></li>",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "listitem",
   "rule_label": "<li> elements must be contained in a <ul> or <ol>",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI",
   "severity": "Serious",
   "frequency": {
    "instances": 174,
    "pages_affected": 8,
    "total_pages_scanned": 8600
   },
   "likely_source": "unknown",
   "summary": "<li> elements must be contained in a <ul> or <ol> (WCAG 1.3.1)",
   "description": "<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 8 of 8600 scanned pages (174 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y",
     "xpath": "li:nth-child(280)",
     "html_snippet": "<li> The Medicare Claims Processing Manual, Chapter 20, “Durable Medical Equipment, Prosthetics and Orthotics, and Supplies (DMEPOS).”<p></p>\n\n<p></p></li>"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y",
     "xpath": "li:nth-child(281)",
     "html_snippet": "<li> Whether the item has been approved for marketing by the Food and Drug Administration (FDA) and is otherwise generally considered to be safe and effective for the purpose intended; and,<p></p>\n\n<p"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y",
     "xpath": "li:nth-child(282)",
     "html_snippet": "<li>Whether the item is reasonable and necessary for the individual patient.&nbsp; <p></p>\n\n<p>The term DME is defined as equipment which:</p>\n\n<p></p></li>"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N",
     "xpath": "tr:nth-child(2) > td[valign=\"top\"]:nth-child(4) > li:nth-child(1)",
     "html_snippet": "<li> pVO<sub>2</sub>\n  </li>"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N",
     "xpath": "tr:nth-child(2) > td[valign=\"top\"]:nth-child(4) > li:nth-child(2)",
     "html_snippet": "<li>  MLWHFQ\n</li>"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y.",
    "Locate the element: li:nth-child(280)",
    "Confirm the axe-core finding for rule listitem against WCAG 1.3.1 Info and Relationships."
   ],
   "remediation_tip": "<li> must be inside a <ul> or <ol>.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__listitem.csv"
  },
  {
   "instance_id": "VS-711f2857",
   "pattern_id": "VS-07ba3b17",
   "a11y_pattern_fingerprint": "78f59582c1f82c5203ddb8b3ce067fb8e29de0f36b7bcb4b37491b2e71c7fe11",
   "a11y_pattern_display_id": "A11Y-PAT-78F59582C1F8",
   "a11y_occurrence_fingerprint": "567a4892456aa7808faa976ec5c7cc02e21c6b6c2a832890216d3edbafbef980",
   "a11y_occurrence_display_id": "A11Y-OCC-567A4892456A",
   "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": ".MsoTableGrid",
   "html_snippet": "<table class=\"MsoTableGrid\">",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "td-headers-attr",
   "rule_label": "Table cell headers attributes must refer to other <th> elements in the same tabl",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/td-headers-attr?application=axeAPI",
   "severity": "Serious",
   "frequency": {
    "instances": 7,
    "pages_affected": 7,
    "total_pages_scanned": 8600
   },
   "likely_source": "unknown",
   "summary": "Table cell headers attributes must refer to other <th> elements in the same tabl (WCAG 1.3.1)",
   "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).",
   "examples": [
    {
     "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": ".MsoTableGrid",
     "html_snippet": "<table class=\"MsoTableGrid\">"
    },
    {
     "url": "https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc",
     "xpath": ".MsoTableGrid",
     "html_snippet": "<table class=\"MsoTableGrid\">"
    },
    {
     "url": "https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=6&sort=asc",
     "xpath": ".MsoTableGrid",
     "html_snippet": "<table class=\"MsoTableGrid\">"
    },
    {
     "url": "http://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_issue_date&page=2&sort=asc",
     "xpath": ".MsoTableGrid",
     "html_snippet": "<table class=\"MsoTableGrid\">"
    },
    {
     "url": "https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_release_date&page=9&sort=desc",
     "xpath": ".MsoTableGrid",
     "html_snippet": "<table class=\"MsoTableGrid\">"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=7&sort=asc.",
    "Locate the element: .MsoTableGrid",
    "Confirm the axe-core finding for rule td-headers-attr against WCAG 1.3.1 Info and Relationships."
   ],
   "remediation_tip": "Associate data cells with their headers correctly using headers/id or scope.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/td-headers-attr?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W25",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/axe-core__td-headers-attr.csv"
  },
  {
   "instance_id": "VS-e3442ee9",
   "pattern_id": "VS-d6097011",
   "a11y_pattern_fingerprint": "7e088a64e5c75865c775bc8d2ccec8c77ff9395e904dad87e418f284f0fda36c",
   "a11y_pattern_display_id": "A11Y-PAT-7E088A64E5C7",
   "a11y_occurrence_fingerprint": "5588a58ad961f2b1a843ce11c3e9644d7cda882de370639b7040f58d957b73a0",
   "a11y_occurrence_display_id": "A11Y-OCC-5588A58AD961",
   "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": "<tfoot>",
   "html_snippet": null,
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r68",
   "rule_label": "Presentational children of an element are not focusable",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r68",
   "severity": "Moderate",
   "frequency": {
    "instances": 839,
    "pages_affected": 235,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Presentational children of an element are not focusable (WCAG 1.3.1)",
   "description": "Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 235 of 8600 scanned pages (839 instances).",
   "examples": [
    {
     "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": "<tfoot>",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=283",
     "xpath": "<ul class=\"nav nav-pills flex-column\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "<tr>",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "<tr>",
     "html_snippet": null
    },
    {
     "url": "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",
     "xpath": "<tfoot>",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "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.",
    "Locate the element: <tfoot>",
    "Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r68",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r68.csv"
  },
  {
   "instance_id": "VS-ed12f5a7",
   "pattern_id": "VS-4408605e",
   "a11y_pattern_fingerprint": "7ffa87e4deb23583b3dbd939e3827738682c8ae8fcd1df96b4508a5a69724e29",
   "a11y_pattern_display_id": "A11Y-PAT-7FFA87E4DEB2",
   "a11y_occurrence_fingerprint": "bbad4d9f0e54e3046cd011b40f159b3ce3674f09fec3925c534de16519306fdb",
   "a11y_occurrence_display_id": "A11Y-OCC-BBAD4D9F0E54",
   "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": "<th scope=\"col\">",
   "html_snippet": null,
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r46",
   "rule_label": "Element has required aria-owns",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r46",
   "severity": "Moderate",
   "frequency": {
    "instances": 281,
    "pages_affected": 165,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Element has required aria-owns (WCAG 1.3.1)",
   "description": "Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 165 of 8600 scanned pages (281 instances).",
   "examples": [
    {
     "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": "<th scope=\"col\">",
     "html_snippet": null
    },
    {
     "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": "<th scope=\"col\">",
     "html_snippet": null
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22",
     "xpath": "<th scope=\"col\">",
     "html_snippet": null
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22",
     "xpath": "<th scope=\"col\">",
     "html_snippet": null
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55584&articleStatus=all&bc=3&sortBy=title&ver=19",
     "xpath": "<th scope=\"col\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57678&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11.",
    "Locate the element: <th scope=\"col\">",
    "Confirm the Siteimprove Alfa finding for rule sia-r46 against WCAG 1.3.1 Info and Relationships."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r46",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W25",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/alfa__sia-r46.csv"
  },
  {
   "instance_id": "VS-e58339f8",
   "pattern_id": "VS-3c632d31",
   "a11y_pattern_fingerprint": "fd43f9066b55fe488b573f7661d22622ce1c31584e1d586cddc6855a03471662",
   "a11y_pattern_display_id": "A11Y-PAT-FD43F9066B55",
   "a11y_occurrence_fingerprint": "c289699537ab7cff19509b92fe2d14d46f07e5b55e93000e1cb795a173695d84",
   "a11y_occurrence_display_id": "A11Y-OCC-C289699537AB",
   "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
   "xpath": "<h1>",
   "html_snippet": null,
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r64",
   "rule_label": "Element has required owned roles",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r64",
   "severity": "Moderate",
   "frequency": {
    "instances": 28,
    "pages_affected": 28,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Element has required owned roles (WCAG 1.3.1)",
   "description": "Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 28 of 8600 scanned pages (28 instances).",
   "examples": [
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "<h1>",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html",
     "xpath": "<h1>",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html",
     "xpath": "<h1>",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0944.html",
     "xpath": "<h1>",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0033.html",
     "xpath": "<h1>",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html.",
    "Locate the element: <h1>",
    "Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r64",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r64.csv"
  },
  {
   "instance_id": "VS-4207d3ce",
   "pattern_id": "VS-3f067795",
   "a11y_pattern_fingerprint": "81f747badb881b493f8e2cef95d34d39eac0fb08588e651098babfb0e6e3db6d",
   "a11y_pattern_display_id": "A11Y-PAT-81F747BADB88",
   "a11y_occurrence_fingerprint": "dccd4268ae55554ff1f13bb9d4f2d3afe100e631e95729b7ce7e847ae91f4dcc",
   "a11y_occurrence_display_id": "A11Y-OCC-DCCD4268AE55",
   "url": "http://cms.gov/newsroom/fact-sheets/proposed-pathways-success-medicare-shared-savings-program",
   "xpath": "<td>",
   "html_snippet": null,
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r77",
   "rule_label": "Table cell has header",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r77",
   "severity": "Moderate",
   "frequency": {
    "instances": 43,
    "pages_affected": 6,
    "total_pages_scanned": 8600
   },
   "likely_source": "unknown",
   "summary": "Table cell has header (WCAG 1.3.1)",
   "description": "Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 6 of 8600 scanned pages (43 instances).",
   "examples": [
    {
     "url": "http://cms.gov/newsroom/fact-sheets/proposed-pathways-success-medicare-shared-savings-program",
     "xpath": "<td>",
     "html_snippet": null
    },
    {
     "url": "http://cms.gov/newsroom/fact-sheets/proposed-pathways-success-medicare-shared-savings-program",
     "xpath": "<td>",
     "html_snippet": null
    },
    {
     "url": "http://cms.gov/newsroom/fact-sheets/proposed-pathways-success-medicare-shared-savings-program",
     "xpath": "<td>",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y",
     "xpath": "<td valign=\"top\" scope=\"row\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y",
     "xpath": "<td valign=\"top\" scope=\"row\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open http://cms.gov/newsroom/fact-sheets/proposed-pathways-success-medicare-shared-savings-program.",
    "Locate the element: <td>",
    "Confirm the Siteimprove Alfa finding for rule sia-r77 against WCAG 1.3.1 Info and Relationships."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r77",
   "possible_duplicate_of": "VS-711f2857",
   "possible_duplicate_pattern": "VS-07ba3b17",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r77.csv"
  },
  {
   "instance_id": "VS-38861985",
   "pattern_id": "VS-9207ed51",
   "a11y_pattern_fingerprint": "ab6764c9f3e1f1309001b7309f75a3aff2567748f92ca6b91f7252ef962c235a",
   "a11y_pattern_display_id": "A11Y-PAT-AB6764C9F3E1",
   "a11y_occurrence_fingerprint": "de42559e15e37c5349727279a942df63781a4e6c5bda7d2ded51740c61c66c3a",
   "a11y_occurrence_display_id": "A11Y-OCC-DE42559E15E3",
   "url": "https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc",
   "xpath": "@headers=\"view-field-dyna-release-date-table-column\"",
   "html_snippet": null,
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r45",
   "rule_label": "aria-hidden element is not exposed to assistive technology",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r45",
   "severity": "Moderate",
   "frequency": {
    "instances": 290,
    "pages_affected": 2,
    "total_pages_scanned": 8600
   },
   "likely_source": "content",
   "summary": "aria-hidden element is not exposed to assistive technology (WCAG 1.3.1)",
   "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).",
   "examples": [
    {
     "url": "https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc",
     "xpath": "@headers=\"view-field-dyna-release-date-table-column\"",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc",
     "xpath": "@headers=\"view-field-dyna-release-date-table-column\"",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc",
     "xpath": "@headers=\"view-field-dyna-revision-date-table-column\"",
     "html_snippet": null
    },
    {
     "url": "http://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_issue_date&page=2&sort=asc",
     "xpath": "@headers=\"view-field-dyna-pe-number-table-column\"",
     "html_snippet": null
    },
    {
     "url": "http://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_issue_date&page=2&sort=asc",
     "xpath": "@headers=\"view-field-dyna-cr-number-table-column\"",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc.",
    "Locate the element: @headers=\"view-field-dyna-release-date-table-column\"",
    "Confirm the Siteimprove Alfa finding for rule sia-r45 against WCAG 1.3.1 Info and Relationships."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r45",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W26",
   "last_seen": "2026-W29",
   "weeks_seen": 3,
   "affected_pages_csv": "csv/alfa__sia-r45.csv"
  },
  {
   "instance_id": "VS-3519595d",
   "pattern_id": "VS-8ade3360",
   "a11y_pattern_fingerprint": "c133a2fff5696d812e0401fb5dc714dd5cd1be550d65eb40b13b35c72a83c94d",
   "a11y_pattern_display_id": "A11Y-PAT-C133A2FFF569",
   "a11y_occurrence_fingerprint": "e005ee32e4b7c570382fc7789a8f83b19ea942d9956aeb35cae45a80feb6fd59",
   "a11y_occurrence_display_id": "A11Y-OCC-E005EE32E4B7",
   "url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6",
   "xpath": "#lblProposedLcd > .system-link.log-click[target=\"_blank\"]",
   "html_snippet": "<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",
   "wcag_sc": "1.4.1",
   "wcag_name": "Use of Color",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "link-in-text-block",
   "rule_label": "Links must be distinguishable without relying on color",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI",
   "severity": "Serious",
   "frequency": {
    "instances": 1802,
    "pages_affected": 751,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Links must be distinguishable without relying on color (WCAG 1.4.1)",
   "description": "Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 751 of 8600 scanned pages (1802 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6",
     "xpath": "#lblProposedLcd > .system-link.log-click[target=\"_blank\"]",
     "html_snippet": "<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"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6",
     "xpath": "ol[type=\"1\"][start=\"1\"]:nth-child(64) > li:nth-child(1) > a[rel=\"noopener\"][target=\"_blank\"]",
     "html_snippet": "<a href=\"https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/125360s097lbl.pdf\" target=\"_blank\" rel=\"noopener\">"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6",
     "xpath": "ol[type=\"1\"][start=\"1\"]:nth-child(100) > li:nth-child(1) > a[rel=\"noopener\"][target=\"_blank\"]",
     "html_snippet": "<a href=\"https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/125274s125lbl.pdf#page=30\" target=\"_blank\" rel=\"noopener\">"
    },
    {
     "url": "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39656&lcdStatus=all&sortBy=title&ver=9",
     "xpath": "#lblProposedLcd > .system-link.log-click[target=\"_blank\"]",
     "html_snippet": "<a href=\"https://localcoverage.cms.gov/mcd_archive/view/lcd.aspx?lcdInfo=39655:8\" target=\"_blank\" class=\"log-click system-link\" data-page-action=\"Clicked the Source Proposed LCD link\">DL39656</a>"
    },
    {
     "url": "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39656&lcdStatus=all&sortBy=title&ver=9",
     "xpath": "#lblBibliography > ol > li:nth-child(2) > a",
     "html_snippet": "<a href=\"https://www.ssa.gov/OP_Home/ssact/title18/1861.htm#ft495\">"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without color perception (4.5%), Limited vision (2.4%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39836&ver=6.",
    "Locate the element: #lblProposedLcd > .system-link.log-click[target=\"_blank\"]",
    "Confirm the axe-core finding for rule link-in-text-block against WCAG 1.4.1 Use of Color."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__link-in-text-block.csv"
  },
  {
   "instance_id": "VS-61645127",
   "pattern_id": "VS-efd91fdd",
   "a11y_pattern_fingerprint": "4de5ba4dbb23095845021d527ac4c9e27dcf3074f9971ad6d8e5b199ff163fb9",
   "a11y_pattern_display_id": "A11Y-PAT-4DE5BA4DBB23",
   "a11y_occurrence_fingerprint": "e7b8da2c533416117f4b8474ce731c652ac1bb7741db1fee35672f57be34741b",
   "a11y_occurrence_display_id": "A11Y-OCC-E7B8DA2C5334",
   "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55909&ver=39",
   "xpath": "<a href=\"#\" data-bs-toggle=\"modal\" data-bs-target=\"#MCDNoticeBoadModal\" id=\"aBoardItemLink_2\">",
   "html_snippet": null,
   "wcag_sc": "1.4.1",
   "wcag_name": "Use of Color",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r62",
   "rule_label": "Link in text block is visually distinguishable without color",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r62",
   "severity": "Moderate",
   "frequency": {
    "instances": 7,
    "pages_affected": 7,
    "total_pages_scanned": 8600
   },
   "likely_source": "unknown",
   "summary": "Link in text block is visually distinguishable without color (WCAG 1.4.1)",
   "description": "Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 7 of 8600 scanned pages (7 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55909&ver=39",
     "xpath": "<a href=\"#\" data-bs-toggle=\"modal\" data-bs-target=\"#MCDNoticeBoadModal\" id=\"aBoardItemLink_2\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38435&lcdStatus=all&sortBy=title&ver=10",
     "xpath": "<a href=\"#\" data-bs-toggle=\"modal\" data-bs-target=\"#MCDNoticeBoadModal\" id=\"aBoardItemLink_2\">",
     "html_snippet": null
    },
    {
     "url": "http://cms.gov/newsroom/press-kit",
     "xpath": "<a href=\"https://data.cms.gov/fact-sheet/cms-fast-facts\" data-once=\"linkMatch\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38678&lcdStatus=all&sortBy=title&ver=5",
     "xpath": "<a href=\"#\" data-bs-toggle=\"modal\" data-bs-target=\"#MCDNoticeBoadModal\" id=\"aBoardItemLink_2\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38997&lcdStatus=all&sortBy=title&ver=9",
     "xpath": "<a href=\"#\" data-bs-toggle=\"modal\" data-bs-target=\"#MCDNoticeBoadModal\" id=\"aBoardItemLink_2\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without color perception (4.5%), Limited vision (2.4%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55909&ver=39.",
    "Locate the element: <a href=\"#\" data-bs-toggle=\"modal\" data-bs-target=\"#MCDNoticeBoadModal\" id=\"aBoardItemLink_2\">",
    "Confirm the Siteimprove Alfa finding for rule sia-r62 against WCAG 1.4.1 Use of Color."
   ],
   "remediation_tip": "Make links visually distinguishable from surrounding text (not by color alone).",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r62",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r62.csv"
  },
  {
   "instance_id": "VS-97788d93",
   "pattern_id": "VS-c613c153",
   "a11y_pattern_fingerprint": "c5dc98480035da248214117a8da33e9344f8dc8320600f229fd4acab0bed1699",
   "a11y_pattern_display_id": "A11Y-PAT-C5DC98480035",
   "a11y_occurrence_fingerprint": "735566b44fb1332ee5cff580ba26bfcca6335d01993cc0b84c7ec2454f9d5a44",
   "a11y_occurrence_display_id": "A11Y-OCC-735566B44FB1",
   "url": "http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=308&proposed=N",
   "xpath": "pre",
   "html_snippet": "<pre>TO:&nbsp;\tAdministrative File:&nbsp; CAG-00431R\n\nSUBJECT: \tNational Coverage Determination Reconsideration for Beta Amyloid Positron Emission Tomography in Dementia and Neurodegenerative Disease\n",
   "wcag_sc": "2.1.1",
   "wcag_name": "Keyboard",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "scrollable-region-focusable",
   "rule_label": "Scrollable region must have keyboard access",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/scrollable-region-focusable?application=axeAPI",
   "severity": "Serious",
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 8600
   },
   "likely_source": "content",
   "summary": "Scrollable region must have keyboard access (WCAG 2.1.1)",
   "description": "Scrollable region must have keyboard access. Detected by axe-core rule scrollable-region-focusable on 1 of 8600 scanned pages (1 instances).",
   "examples": [
    {
     "url": "http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=308&proposed=N",
     "xpath": "pre",
     "html_snippet": "<pre>TO:&nbsp;\tAdministrative File:&nbsp; CAG-00431R\n\nSUBJECT: \tNational Coverage Determination Reconsideration for Beta Amyloid Positron Emission Tomography in Dementia and Neurodegenerative Disease\n"
    }
   ],
   "example_pages": [
    "http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=308&proposed=N"
   ],
   "affected_pages": [
    "http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=308&proposed=N"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LR",
      "group": "Limited reach",
      "prevalence": 0.02,
      "percent": "2.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited manipulation/strength (13.0%), Limited reach (2.0%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=308&proposed=N.",
    "Locate the element: pre",
    "Confirm the axe-core finding for rule scrollable-region-focusable against WCAG 2.1.1 Keyboard."
   ],
   "remediation_tip": "Make scrollable regions keyboard-focusable (tabindex=\"0\") so keyboard users can scroll them.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scrollable-region-focusable?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W25",
   "last_seen": "2026-W29",
   "weeks_seen": 2,
   "affected_pages_csv": "csv/axe-core__scrollable-region-focusable.csv"
  },
  {
   "instance_id": "VS-45cff60e",
   "pattern_id": "VS-e9fe47ac",
   "a11y_pattern_fingerprint": "efb5891464ff3f92c77958dfdd40c06a525674629dfbb9e87812b90efe29e4fa",
   "a11y_pattern_display_id": "A11Y-PAT-EFB5891464FF",
   "a11y_occurrence_fingerprint": "9ef02a316606869a08e8e93943ab01fec4d205bfce6720b70721df271d8971b4",
   "a11y_occurrence_display_id": "A11Y-OCC-9EF02A316606",
   "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N",
   "xpath": "ol[type=\"I\"] > a[href$=\"#3I6\"]",
   "html_snippet": "<a href=\"#3I6\">\n\n<strong></strong></a>",
   "wcag_sc": "2.4.4",
   "wcag_name": "Link Purpose (In Context)",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "link-name",
   "rule_label": "Links must have discernible text",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI",
   "severity": "Serious",
   "frequency": {
    "instances": 9,
    "pages_affected": 7,
    "total_pages_scanned": 8600
   },
   "likely_source": "unknown",
   "summary": "Links must have discernible text (WCAG 2.4.4)",
   "description": "Links must have discernible text. Detected by axe-core rule link-name on 7 of 8600 scanned pages (9 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N",
     "xpath": "ol[type=\"I\"] > a[href$=\"#3I6\"]",
     "html_snippet": "<a href=\"#3I6\">\n\n<strong></strong></a>"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N",
     "xpath": "strong:nth-child(1) > a[href$=\"#3I6\"]",
     "html_snippet": "<a href=\"#3I6\"></a>"
    },
    {
     "url": "https://www.cms.gov/newsroom/fact-sheets/cms-updates-nursing-home-guidance-revised-visitation-recommendations",
     "xpath": "a[href$=\"#_bookmark0\"]",
     "html_snippet": "<a href=\"#_bookmark0\" data-once=\"linkMatch\"> </a>"
    },
    {
     "url": "https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments",
     "xpath": "div > a[data-entity-type=\"media\"][data-entity-substitution=\"canonical\"][data-once=\"linkMatch\"]",
     "html_snippet": "<a href=\"/files/document/clia-cert-quick-start-guide.pdf\" data-entity-substitution=\"canonical\" data-entity-type=\"media\" data-entity-uuid=\"27ce5119-858b-44f2-bbc6-c5d2d56ce4f0\" data-once=\"linkMatch\"></"
    },
    {
     "url": "https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments",
     "xpath": ".align-left.media--view-mode-embedded.media--type-image > a[data-entity-type=\"media\"][data-entity-substitution=\"canonical\"][data-once=\"linkMatch\"]",
     "html_snippet": "<a href=\"/files/document/clia-cert-quick-start-guide.pdf\" data-entity-substitution=\"canonical\" data-entity-type=\"media\" data-entity-uuid=\"27ce5119-858b-44f2-bbc6-c5d2d56ce4f0\" data-once=\"linkMatch\">\n "
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=317&proposed=N.",
    "Locate the element: ol[type=\"I\"] > a[href$=\"#3I6\"]",
    "Confirm the axe-core finding for rule link-name against WCAG 2.4.4 Link Purpose (In Context)."
   ],
   "remediation_tip": "Give the link discernible text. Avoid empty links and icon-only links without an aria-label.",
   "tech_name": "Drupal",
   "tech_remediation_tip": "\"Read more\" links from Drupal Views should use the \"Link text\" rewrite field to add context, or add aria-label via the Views rewrite output.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__link-name.csv"
  },
  {
   "instance_id": "VS-a27f10b2",
   "pattern_id": "VS-28ebd979",
   "a11y_pattern_fingerprint": "3c5c84c27aab7add8e62f919b654127f9fc8080f2242144fa65efe9323ac3bcd",
   "a11y_pattern_display_id": "A11Y-PAT-3C5C84C27AAB",
   "a11y_occurrence_fingerprint": "1ca69c81659c133f4f857e955ae77f877a5838f8f47428d8604676f139e32a4b",
   "a11y_occurrence_display_id": "A11Y-OCC-1CA69C81659C",
   "url": "https://www.cms.gov/newsroom/fact-sheets/cms-updates-nursing-home-guidance-revised-visitation-recommendations",
   "xpath": "<a href=\"#_bookmark0\" data-once=\"linkMatch\">",
   "html_snippet": null,
   "wcag_sc": "2.4.4",
   "wcag_name": "Link Purpose (In Context)",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r11",
   "rule_label": "Link has accessible name",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r11",
   "severity": "Moderate",
   "frequency": {
    "instances": 5,
    "pages_affected": 4,
    "total_pages_scanned": 8600
   },
   "likely_source": "unknown",
   "summary": "Link has accessible name (WCAG 2.4.4)",
   "description": "Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 4 of 8600 scanned pages (5 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/newsroom/fact-sheets/cms-updates-nursing-home-guidance-revised-visitation-recommendations",
     "xpath": "<a href=\"#_bookmark0\" data-once=\"linkMatch\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments",
     "xpath": "<a href=\"/files/document/clia-cert-quick-start-guide.pdf\" data-entity-substitution=\"canonical\" data-entity-type=\"media\" data-entity-uuid=\"27ce5119-858b-44f2-bbc6-c5d2d56ce4f0\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments",
     "xpath": "<a href=\"/files/document/clia-cert-quick-start-guide.pdf\" data-entity-substitution=\"canonical\" data-entity-type=\"media\" data-entity-uuid=\"27ce5119-858b-44f2-bbc6-c5d2d56ce4f0\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=14&doctype=all&ncaid=321&proposed=Y&sortBy=title&year=2026",
     "xpath": "<a href=\"#4\">",
     "html_snippet": null
    },
    {
     "url": "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",
     "xpath": "<a href=\"#4\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/newsroom/fact-sheets/cms-updates-nursing-home-guidance-revised-visitation-recommendations.",
    "Locate the element: <a href=\"#_bookmark0\" data-once=\"linkMatch\">",
    "Confirm the Siteimprove Alfa finding for rule sia-r11 against WCAG 2.4.4 Link Purpose (In Context)."
   ],
   "remediation_tip": "Give the link an accessible name via text content or aria-label.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r11",
   "possible_duplicate_of": "VS-45cff60e",
   "possible_duplicate_pattern": "VS-e9fe47ac",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r11.csv"
  },
  {
   "instance_id": "VS-464d31ed",
   "pattern_id": "VS-c126b6a6",
   "a11y_pattern_fingerprint": "b7442ecec422c9ea5529350523f7782c182cdaa20f17a6b784c1a6cc960ebc51",
   "a11y_pattern_display_id": "A11Y-PAT-B7442ECEC422",
   "a11y_occurrence_fingerprint": "d2d894066c9dd3cf43d7b5ff0cd578821ef3af57482629aae90ab9ec567ff5ca",
   "a11y_occurrence_display_id": "A11Y-OCC-D2D894066C9D",
   "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html",
   "xpath": "html",
   "html_snippet": "<html>",
   "wcag_sc": "3.1.1",
   "wcag_name": "Language of Page",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "html-has-lang",
   "rule_label": "<html> element must have a lang attribute",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI",
   "severity": "Serious",
   "frequency": {
    "instances": 76,
    "pages_affected": 76,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "<html> element must have a lang attribute (WCAG 3.1.1)",
   "description": "<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 76 of 8600 scanned pages (76 instances).",
   "examples": [
    {
     "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html",
     "xpath": "html",
     "html_snippet": "<html>"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html",
     "xpath": "html",
     "html_snippet": "<html>"
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "html",
     "html_snippet": "<html>"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html",
     "xpath": "html",
     "html_snippet": "<html>"
    },
    {
     "url": "https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0238.html",
     "xpath": "html",
     "html_snippet": "<html>"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html.",
    "Locate the element: html",
    "Confirm the axe-core finding for rule html-has-lang against WCAG 3.1.1 Language of Page."
   ],
   "remediation_tip": "Add a lang attribute to <html> (e.g. lang=\"en\").",
   "tech_name": "Drupal",
   "tech_remediation_tip": "Drupal sets the page lang attribute from Admin › Configuration › Regional and Language › Languages. Ensure the default language is configured.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__html-has-lang.csv"
  },
  {
   "instance_id": "VS-843f0c6b",
   "pattern_id": "VS-7a0e5645",
   "a11y_pattern_fingerprint": "54500cbd05eb59c8569f8bd8ecb39fd022278602bbe3fafb15344d45cc2f686d",
   "a11y_pattern_display_id": "A11Y-PAT-54500CBD05EB",
   "a11y_occurrence_fingerprint": "2a1b19dfc9842f043d6225ec89decd6859e1b43e08c2f0e5749b95e39857b080",
   "a11y_occurrence_display_id": "A11Y-OCC-2A1B19DFC984",
   "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
   "xpath": "<html>",
   "html_snippet": null,
   "wcag_sc": "3.1.1",
   "wcag_name": "Language of Page",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r4",
   "rule_label": "Document has a valid lang attribute",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r4",
   "severity": "Moderate",
   "frequency": {
    "instances": 39,
    "pages_affected": 39,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Document has a valid lang attribute (WCAG 3.1.1)",
   "description": "Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 39 of 8600 scanned pages (39 instances).",
   "examples": [
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "<html>",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html",
     "xpath": "<html>",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html",
     "xpath": "<html>",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html",
     "xpath": "<html>",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0944.html",
     "xpath": "<html>",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html.",
    "Locate the element: <html>",
    "Confirm the Siteimprove Alfa finding for rule sia-r4 against WCAG 3.1.1 Language of Page."
   ],
   "remediation_tip": "Add a valid lang attribute to <html>.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r4",
   "possible_duplicate_of": "VS-464d31ed",
   "possible_duplicate_pattern": "VS-c126b6a6",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r4.csv"
  },
  {
   "instance_id": "VS-f4e76906",
   "pattern_id": "VS-fafffee0",
   "a11y_pattern_fingerprint": "55d019f5d10bd994cd8723d95b7b051b17c038a1fa605b765999d78f39974789",
   "a11y_pattern_display_id": "A11Y-PAT-55D019F5D10B",
   "a11y_occurrence_fingerprint": "b9e270e81272120489792812d1a507e3db5be653008eea9f5c572908644cd9b3",
   "a11y_occurrence_display_id": "A11Y-OCC-B9E270E81272",
   "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html",
   "xpath": "#q",
   "html_snippet": "<input type=\"text\" name=\"q\" id=\"q\" value=\"Search now\" size=\"10\" maxlength=\"50\" class=\"srchbox\" onfocus=\"this.value='';\">",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "label",
   "rule_label": "Form elements must have labels",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/label?application=axeAPI",
   "severity": "Critical",
   "frequency": {
    "instances": 36,
    "pages_affected": 36,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Form elements must have labels (WCAG 4.1.2)",
   "description": "Form elements must have labels. Detected by axe-core rule label on 36 of 8600 scanned pages (36 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html",
     "xpath": "#q",
     "html_snippet": "<input type=\"text\" name=\"q\" id=\"q\" value=\"Search now\" size=\"10\" maxlength=\"50\" class=\"srchbox\" onfocus=\"this.value='';\">"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html",
     "xpath": "#q",
     "html_snippet": "<input type=\"text\" name=\"q\" id=\"q\" value=\"Search now\" size=\"10\" maxlength=\"50\" class=\"srchbox\" onfocus=\"this.value='';\">"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1900.html",
     "xpath": "#q",
     "html_snippet": "<input type=\"text\" name=\"q\" id=\"q\" value=\"Search now\" size=\"10\" maxlength=\"50\" class=\"srchbox\" onfocus=\"this.value='';\">"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1513.html",
     "xpath": "#q",
     "html_snippet": "<input type=\"text\" name=\"q\" id=\"q\" value=\"Search now\" size=\"10\" maxlength=\"50\" class=\"srchbox\" onfocus=\"this.value='';\">"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0079.html",
     "xpath": "#q",
     "html_snippet": "<input type=\"text\" name=\"q\" id=\"q\" value=\"Search now\" size=\"10\" maxlength=\"50\" class=\"srchbox\" onfocus=\"this.value='';\">"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html.",
    "Locate the element: #q",
    "Confirm the axe-core finding for rule label against WCAG 4.1.2 Name, Role, Value."
   ],
   "remediation_tip": "Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.",
   "tech_name": "Drupal",
   "tech_remediation_tip": "Use Drupal's form element \"Label\" setting. In Webform, every element has a Label field — ensure it's not empty or hidden. Check that twig templates don't strip <label> elements from form fields.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/label?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W26",
   "last_seen": "2026-W29",
   "weeks_seen": 4,
   "affected_pages_csv": "csv/axe-core__label.csv"
  },
  {
   "instance_id": "VS-62d736b5",
   "pattern_id": "VS-fab92378",
   "a11y_pattern_fingerprint": "e94ccc463fe178b1e7144088da4b4d30ae36e3a5d169354b452fa1d43ccbc60c",
   "a11y_pattern_display_id": "A11Y-PAT-E94CCC463FE1",
   "a11y_occurrence_fingerprint": "97872f23810536bb7df348f6c7d103d4ccf1bf6827202a88cf1987ad21c4f10c",
   "a11y_occurrence_display_id": "A11Y-OCC-97872F238105",
   "url": "https://www.cms.gov/priorities/innovation/innovation-models/map",
   "xpath": "#state-code-select",
   "html_snippet": "<select id=\"state-code-select\" class=\"form-select ds-c-field\">",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "select-name",
   "rule_label": "Select element must have an accessible name",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/select-name?application=axeAPI",
   "severity": "Critical",
   "frequency": {
    "instances": 2,
    "pages_affected": 2,
    "total_pages_scanned": 8600
   },
   "likely_source": "content",
   "summary": "Select element must have an accessible name (WCAG 4.1.2)",
   "description": "Select element must have an accessible name. Detected by axe-core rule select-name on 2 of 8600 scanned pages (2 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/priorities/innovation/innovation-models/map",
     "xpath": "#state-code-select",
     "html_snippet": "<select id=\"state-code-select\" class=\"form-select ds-c-field\">"
    },
    {
     "url": "http://cms.gov/priorities/innovation/where-innovation-happening",
     "xpath": "#state-code-select",
     "html_snippet": "<select id=\"state-code-select\" class=\"form-select ds-c-field\">"
    }
   ],
   "example_pages": [
    "https://www.cms.gov/priorities/innovation/innovation-models/map",
    "http://cms.gov/priorities/innovation/where-innovation-happening"
   ],
   "affected_pages": [
    "https://www.cms.gov/priorities/innovation/innovation-models/map",
    "http://cms.gov/priorities/innovation/where-innovation-happening"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/priorities/innovation/innovation-models/map.",
    "Locate the element: #state-code-select",
    "Confirm the axe-core finding for rule select-name against WCAG 4.1.2 Name, Role, Value."
   ],
   "remediation_tip": "Give the <select> an accessible name via a <label> or aria-label.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/select-name?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W26",
   "last_seen": "2026-W29",
   "weeks_seen": 3,
   "affected_pages_csv": "csv/axe-core__select-name.csv"
  },
  {
   "instance_id": "VS-f4939545",
   "pattern_id": "VS-1467ea8a",
   "a11y_pattern_fingerprint": "bf04f2c85e1ab8307c37b97474c5ec891b38631f49da15063345ee5c8ebae4e3",
   "a11y_pattern_display_id": "A11Y-PAT-BF04F2C85E1A",
   "a11y_occurrence_fingerprint": "13bc95646c24bf0d44044332bd9ca2b583176f04f516b2ecb0c93453392e0367",
   "a11y_occurrence_display_id": "A11Y-OCC-13BC95646C24",
   "url": "https://www.cms.gov/medicare/health-drug-plans/provider-complaints-form",
   "xpath": ".choices__placeholder",
   "html_snippet": "<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",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "aria-allowed-attr",
   "rule_label": "Elements must only use supported ARIA attributes",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI",
   "severity": "Critical",
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 8600
   },
   "likely_source": "content",
   "summary": "Elements must only use supported ARIA attributes (WCAG 4.1.2)",
   "description": "Elements must only use supported ARIA attributes. Detected by axe-core rule aria-allowed-attr on 1 of 8600 scanned pages (1 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare/health-drug-plans/provider-complaints-form",
     "xpath": ".choices__placeholder",
     "html_snippet": "<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"
    }
   ],
   "example_pages": [
    "https://www.cms.gov/medicare/health-drug-plans/provider-complaints-form"
   ],
   "affected_pages": [
    "https://www.cms.gov/medicare/health-drug-plans/provider-complaints-form"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare/health-drug-plans/provider-complaints-form.",
    "Locate the element: .choices__placeholder",
    "Confirm the axe-core finding for rule aria-allowed-attr against WCAG 4.1.2 Name, Role, Value."
   ],
   "remediation_tip": "Remove ARIA attributes that aren't allowed on this role/element.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W25",
   "last_seen": "2026-W29",
   "weeks_seen": 4,
   "affected_pages_csv": "csv/axe-core__aria-allowed-attr.csv"
  },
  {
   "instance_id": "VS-02be4c2a",
   "pattern_id": "VS-a48e6078",
   "a11y_pattern_fingerprint": "59e35743a05549a3dab8d701b6f6e6ff4f7e10ac561823a9c3a1129c3621ac0f",
   "a11y_pattern_display_id": "A11Y-PAT-59E35743A055",
   "a11y_occurrence_fingerprint": "6726a3998300f073af24c574d65dcdf427edeaa1d95bb6ff9b8c8f19114fd90d",
   "a11y_occurrence_display_id": "A11Y-OCC-6726A3998300",
   "url": "http://cms.gov/priorities/innovation/where-innovation-happening",
   "xpath": "<select id=\"state-code-select\" class=\"form-select ds-c-field\">",
   "html_snippet": null,
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r8",
   "rule_label": "Form field has accessible name",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r8",
   "severity": "Moderate",
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 8600
   },
   "likely_source": "content",
   "summary": "Form field has accessible name (WCAG 4.1.2)",
   "description": "Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 1 of 8600 scanned pages (1 instances).",
   "examples": [
    {
     "url": "http://cms.gov/priorities/innovation/where-innovation-happening",
     "xpath": "<select id=\"state-code-select\" class=\"form-select ds-c-field\">",
     "html_snippet": null
    }
   ],
   "example_pages": [
    "http://cms.gov/priorities/innovation/where-innovation-happening"
   ],
   "affected_pages": [
    "http://cms.gov/priorities/innovation/where-innovation-happening"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open http://cms.gov/priorities/innovation/where-innovation-happening.",
    "Locate the element: <select id=\"state-code-select\" class=\"form-select ds-c-field\">",
    "Confirm the Siteimprove Alfa finding for rule sia-r8 against WCAG 4.1.2 Name, Role, Value."
   ],
   "remediation_tip": "Associate the form field with a label.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r8",
   "possible_duplicate_of": "VS-f4939545",
   "possible_duplicate_pattern": "VS-1467ea8a",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W25",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/alfa__sia-r8.csv"
  },
  {
   "instance_id": "VS-f8fd4311",
   "pattern_id": "VS-be8d563e",
   "a11y_pattern_fingerprint": "a6854a3368678eaf39b98a65ed51133ddc2acdc82ca75e78ad5745629f743cd3",
   "a11y_pattern_display_id": "A11Y-PAT-A6854A336867",
   "a11y_occurrence_fingerprint": "36300876a21329a38c32d31c64a052c9a6938d25bae16856daa2f9715fb6bb2d",
   "a11y_occurrence_display_id": "A11Y-OCC-36300876A213",
   "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y",
   "xpath": "p:nth-child(1) > strong > em",
   "html_snippet": "<em>280.16 Seat Elevation Equipment on Power Wheelchairs (Effective XXX, XXXX)</em>",
   "wcag_sc": "1.4.3",
   "wcag_name": "Contrast (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "evidence_status": "automated-indicator",
   "rule_id": "color-contrast",
   "rule_label": "Elements must meet minimum color contrast ratio thresholds",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI",
   "severity": "Serious",
   "frequency": {
    "instances": 380,
    "pages_affected": 47,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Elements must meet minimum color contrast ratio thresholds (WCAG 1.4.3)",
   "description": "Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 47 of 8600 scanned pages (380 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y",
     "xpath": "p:nth-child(1) > strong > em",
     "html_snippet": "<em>280.16 Seat Elevation Equipment on Power Wheelchairs (Effective XXX, XXXX)</em>"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y",
     "xpath": "p:nth-child(2) > strong > em",
     "html_snippet": "<em>A. General</em>"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y",
     "xpath": "p:nth-child(3) > em",
     "html_snippet": "<em>"
    },
    {
     "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": "table[border=\"1\"][cellpadding=\"0\"]:nth-child(4) > tbody > tr:nth-child(1) > td[width=\"50%\"]:nth-child(1) > p",
     "html_snippet": "<p style=\"line-height: normal;\">Code</p>"
    },
    {
     "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": "table[border=\"1\"][cellpadding=\"0\"]:nth-child(4) > tbody > tr:nth-child(1) > td[width=\"50%\"]:nth-child(2) > p",
     "html_snippet": "<p style=\"text-align: center; line-height: normal;\"># per Month</p>"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited vision (2.4%), Without color perception (4.5%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y.",
    "Locate the element: p:nth-child(1) > strong > em",
    "Confirm the axe-core finding for rule color-contrast against WCAG 1.4.3 Contrast (Minimum)."
   ],
   "remediation_tip": "Increase the contrast between text and its background to at least 4.5:1 (3:1 for large text). Check both light and dark modes.",
   "tech_name": "Drupal",
   "tech_remediation_tip": "Check your Drupal theme's base CSS. Themes like Olivero and Bartik have contrast issues in default color schemes — override failing color pairs in your subtheme's style.css.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__color-contrast.csv"
  },
  {
   "instance_id": "VS-28e3ed59",
   "pattern_id": "VS-f7e99f4b",
   "a11y_pattern_fingerprint": "6ee20319b8731b671e41657ba49814970eac8d219cb0165d3e25dd06e25ae712",
   "a11y_pattern_display_id": "A11Y-PAT-6EE20319B873",
   "a11y_occurrence_fingerprint": "2ad233ce8185092ae442ea1866169434be51dc971d4b24a05fd9c2fe264f9ec7",
   "a11y_occurrence_display_id": "A11Y-OCC-2AD233CE8185",
   "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": "text: \"Code\"",
   "html_snippet": null,
   "wcag_sc": "1.4.3",
   "wcag_name": "Contrast (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r69",
   "rule_label": "Text has sufficient color contrast (Enhanced)",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r69",
   "severity": "Moderate",
   "frequency": {
    "instances": 164,
    "pages_affected": 25,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Text has sufficient color contrast (Enhanced) (WCAG 1.4.3)",
   "description": "Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 25 of 8600 scanned pages (164 instances).",
   "examples": [
    {
     "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": "text: \"Code\"",
     "html_snippet": null
    },
    {
     "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": "text: \"# per Month\"",
     "html_snippet": null
    },
    {
     "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": "text: \"Code\"",
     "html_snippet": null
    },
    {
     "url": "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33803&proposedStatus=all&sortBy=title&stateRegion=all&ver=47",
     "xpath": "text: \"Code\"",
     "html_snippet": null
    },
    {
     "url": "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33803&proposedStatus=all&sortBy=title&stateRegion=all&ver=47",
     "xpath": "text: \"Number per month\"",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited vision (2.4%), Without color perception (4.5%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33828&lcdStatus=all&sortBy=title&ver=27.",
    "Locate the element: text: \"Code\"",
    "Confirm the Siteimprove Alfa finding for rule sia-r69 against WCAG 1.4.3 Contrast (Minimum)."
   ],
   "remediation_tip": "Increase text contrast to meet WCAG AA (4.5:1, or 3:1 for large text).",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r69",
   "possible_duplicate_of": "VS-f8fd4311",
   "possible_duplicate_pattern": "VS-be8d563e",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r69.csv"
  },
  {
   "instance_id": "VS-5c1f6bbb",
   "pattern_id": "VS-dd1c019f",
   "a11y_pattern_fingerprint": "d9a19a9116f624224d860ea0902f17a2688afd1bc0f1fbe00fddf854aecf886f",
   "a11y_pattern_display_id": "A11Y-PAT-D9A19A9116F6",
   "a11y_occurrence_fingerprint": "4aac023154c72a4e371cc9dbe7a20904af7110d3463cf3cfb1a96c004bdb2482",
   "a11y_occurrence_display_id": "A11Y-OCC-4AAC023154C7",
   "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": "span[lang=\"X-NONE\"]",
   "html_snippet": "<span lang=\"X-NONE\">HHVBP</span>",
   "wcag_sc": "3.1.2",
   "wcag_name": "Language of Parts",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "evidence_status": "automated-indicator",
   "rule_id": "valid-lang",
   "rule_label": "lang attribute must have a valid value",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI",
   "severity": "Serious",
   "frequency": {
    "instances": 2,
    "pages_affected": 2,
    "total_pages_scanned": 8600
   },
   "likely_source": "content",
   "summary": "lang attribute must have a valid value (WCAG 3.1.2)",
   "description": "lang attribute must have a valid value. Detected by axe-core rule valid-lang on 2 of 8600 scanned pages (2 instances).",
   "examples": [
    {
     "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": "span[lang=\"X-NONE\"]",
     "html_snippet": "<span lang=\"X-NONE\">HHVBP</span>"
    },
    {
     "url": "https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings",
     "xpath": "a[href$=\"#_ftnref1\"] > span[lang=\"X-NONE\"]",
     "html_snippet": "<span lang=\"X-NONE\">[1]</span>"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-home-health-prospective-payment-system-proposed-rule-fact-sheet-cms-1828-p.",
    "Locate the element: span[lang=\"X-NONE\"]",
    "Confirm the axe-core finding for rule valid-lang against WCAG 3.1.2 Language of Parts."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__valid-lang.csv"
  },
  {
   "instance_id": "VS-b6b9637c",
   "pattern_id": "VS-400f3a18",
   "a11y_pattern_fingerprint": "bd73d41316c6d02e3e3383f68363f2e28b68efe322455f09cf6ec8ce0416b68c",
   "a11y_pattern_display_id": "A11Y-PAT-BD73D41316C6",
   "a11y_occurrence_fingerprint": "96c093ffa398558f4a063930e990e068d458898ab03ed6345ad4af1268843f3d",
   "a11y_occurrence_display_id": "A11Y-OCC-96C093FFA398",
   "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": "@lang=\"X-NONE\"",
   "html_snippet": null,
   "wcag_sc": "3.1.2",
   "wcag_name": "Language of Parts",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r7",
   "rule_label": "Element with lang attribute has correct language",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r7",
   "severity": "Moderate",
   "frequency": {
    "instances": 2,
    "pages_affected": 2,
    "total_pages_scanned": 8600
   },
   "likely_source": "content",
   "summary": "Element with lang attribute has correct language (WCAG 3.1.2)",
   "description": "Element with lang attribute has correct language. Detected by Siteimprove Alfa rule sia-r7 on 2 of 8600 scanned pages (2 instances).",
   "examples": [
    {
     "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": "@lang=\"X-NONE\"",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings",
     "xpath": "@lang=\"X-NONE\"",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-home-health-prospective-payment-system-proposed-rule-fact-sheet-cms-1828-p.",
    "Locate the element: @lang=\"X-NONE\"",
    "Confirm the Siteimprove Alfa finding for rule sia-r7 against WCAG 3.1.2 Language of Parts."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r7",
   "possible_duplicate_of": "VS-5c1f6bbb",
   "possible_duplicate_pattern": "VS-dd1c019f",
   "obligation": "required",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W26",
   "last_seen": "2026-W29",
   "weeks_seen": 3,
   "affected_pages_csv": "csv/alfa__sia-r7.csv"
  },
  {
   "instance_id": "VS-74b2a38d",
   "pattern_id": "VS-646b1e0b",
   "a11y_pattern_fingerprint": "5929371356b55a1fba56b949ddad597773c25422956e52c78cd24c553029d68b",
   "a11y_pattern_display_id": "A11Y-PAT-5929371356B5",
   "a11y_occurrence_fingerprint": "938cab828043fc511aa651a1ddebf541b2bd1985e7102a74c6a212cfe4b32797",
   "a11y_occurrence_display_id": "A11Y-OCC-938CAB828043",
   "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
   "xpath": "text: \"Here's how you know\"",
   "html_snippet": null,
   "wcag_sc": "1.4.6",
   "wcag_name": "Contrast (Enhanced)",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r66",
   "rule_label": "Text has enhanced contrast",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r66",
   "severity": "Moderate",
   "frequency": {
    "instances": 6564,
    "pages_affected": 1224,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Text has enhanced contrast (WCAG 1.4.6)",
   "description": "Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 1224 of 8600 scanned pages (6564 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "text: \"Here's how you know\"",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "text: \"Centers for Medicare & Medicaid Services\"",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6",
     "xpath": "text: \"Here's how you know\"",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6",
     "xpath": "text: \"Centers for Medicare & Medicaid Services\"",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6",
     "xpath": "text: \"I Accept\"",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.",
    "Locate the element: text: \"Here's how you know\"",
    "Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced)."
   ],
   "remediation_tip": "Increase text contrast to meet WCAG AAA (7:1).",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66",
   "obligation": "aspirational",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r66.csv"
  },
  {
   "instance_id": "VS-fadd2eaf",
   "pattern_id": "VS-2208081b",
   "a11y_pattern_fingerprint": "c4e42ec5cae7b113932037749f48183030838206af72062c9b757d8053dd7f19",
   "a11y_pattern_display_id": "A11Y-PAT-C4E42EC5CAE7",
   "a11y_occurrence_fingerprint": "ba348b0b7f277df0e33d0dcb7f40418615cb5c8228092a0da7df42fba814641a",
   "a11y_occurrence_display_id": "A11Y-OCC-BA348B0B7F27",
   "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": "<p class=\"ds-c-usa-banner__header-text\">",
   "html_snippet": null,
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r73",
   "rule_label": "Text has minimum contrast ratio of 4.5:1",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r73",
   "severity": "Moderate",
   "frequency": {
    "instances": 39920,
    "pages_affected": 3674,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8)",
   "description": "Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 3674 of 8600 scanned pages (39920 instances).",
   "examples": [
    {
     "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": "<p class=\"ds-c-usa-banner__header-text\">",
     "html_snippet": null
    },
    {
     "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": "<p class=\"ds-c-usa-banner__action ds-u-align-items--center ds-u-md-display--none ds-u-display--flex\">",
     "html_snippet": null
    },
    {
     "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": "<p>",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update",
     "xpath": "<p class=\"ds-c-usa-banner__header-text\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update",
     "xpath": "<p class=\"ds-c-usa-banner__action ds-u-align-items--center ds-u-md-display--none ds-u-display--flex\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc.",
    "Locate the element: <p class=\"ds-c-usa-banner__header-text\">",
    "Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73",
   "obligation": "aspirational",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r73.csv"
  },
  {
   "instance_id": "VS-c6f5f0cb",
   "pattern_id": "VS-fbf54eba",
   "a11y_pattern_fingerprint": "9e5074b4feb5510b8f3f0c3d5396e627076c1776e77e16f0117e2a5e9da60dbe",
   "a11y_pattern_display_id": "A11Y-PAT-9E5074B4FEB5",
   "a11y_occurrence_fingerprint": "06e3f01b56744271eddb4091e4978e0eb1851f7111f0679608f6939334db6734",
   "a11y_occurrence_display_id": "A11Y-OCC-06E3F01B5674",
   "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
   "xpath": "<p class=\"MsoTitle\" align=\"center\" style=\"text-align:center\">",
   "html_snippet": null,
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r74",
   "rule_label": "Link is distinguishable without relying on color",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r74",
   "severity": "Moderate",
   "frequency": {
    "instances": 92167,
    "pages_affected": 1223,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Link is distinguishable without relying on color (WCAG 1.4.8)",
   "description": "Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 1223 of 8600 scanned pages (92167 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "<p class=\"MsoTitle\" align=\"center\" style=\"text-align:center\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "<p>",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "<p>",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6",
     "xpath": "<p class=\"mb-2\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6",
     "xpath": "<p>",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.",
    "Locate the element: <p class=\"MsoTitle\" align=\"center\" style=\"text-align:center\">",
    "Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r74",
   "obligation": "aspirational",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r74.csv"
  },
  {
   "instance_id": "VS-3376480b",
   "pattern_id": "VS-388b5438",
   "a11y_pattern_fingerprint": "8305e36414fb6fdc6dac7f2ac507acab909f475e7604bc37c2a0267a084bb29f",
   "a11y_pattern_display_id": "A11Y-PAT-8305E36414FB",
   "a11y_occurrence_fingerprint": "e84c82c774fc35e2bf10a9a171203c8fda0423cd28c64c9c1b44b94fdb36c991",
   "a11y_occurrence_display_id": "A11Y-OCC-E84C82C774FC",
   "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": "<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",
   "html_snippet": null,
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r80",
   "rule_label": "Scrollable element is keyboard accessible",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r80",
   "severity": "Moderate",
   "frequency": {
    "instances": 1137,
    "pages_affected": 75,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Scrollable element is keyboard accessible (WCAG 1.4.8)",
   "description": "Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 75 of 8600 scanned pages (1137 instances).",
   "examples": [
    {
     "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": "<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",
     "html_snippet": null
    },
    {
     "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": "<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",
     "html_snippet": null
    },
    {
     "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": "<p style=\"text-align: left; color: #212529; text-transform: none; line-height: 14.15pt; text-indent: 0px; letter-spacing: normal; font-family: Verdana, 'Helvetica Neue', Helvetica, Arial, sans-serif; ",
     "html_snippet": null
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22",
     "xpath": "<p style=\"background: white; line-height: 14.4pt;\">",
     "html_snippet": null
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22",
     "xpath": "<p style=\"background: white; line-height: 14.4pt;\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "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.",
    "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",
    "Confirm the Siteimprove Alfa finding for rule sia-r80 against WCAG 1.4.8 Visual Presentation."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r80",
   "obligation": "aspirational",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W25",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/alfa__sia-r80.csv"
  },
  {
   "instance_id": "VS-cf5e24f8",
   "pattern_id": "VS-48291402",
   "a11y_pattern_fingerprint": "3e4e79331c3a65603496091bf53f3a23e5f1ab908f4e970a777b2a028356c4d2",
   "a11y_pattern_display_id": "A11Y-PAT-3E4E79331C3A",
   "a11y_occurrence_fingerprint": "956161e31ccc4f2a35cf3e66bc42c633213631b500e5235046e259e233570498",
   "a11y_occurrence_display_id": "A11Y-OCC-956161E31CCC",
   "url": "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12",
   "xpath": "<p style=\"text-align: justify;\">",
   "html_snippet": null,
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r71",
   "rule_label": "iframe element is not empty",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r71",
   "severity": "Moderate",
   "frequency": {
    "instances": 710,
    "pages_affected": 47,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "iframe element is not empty (WCAG 1.4.8)",
   "description": "iframe element is not empty. Detected by Siteimprove Alfa rule sia-r71 on 47 of 8600 scanned pages (710 instances).",
   "examples": [
    {
     "url": "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12",
     "xpath": "<p style=\"text-align: justify;\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12",
     "xpath": "<p style=\"text-align: justify;\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12",
     "xpath": "<p style=\"box-sizing: border-box; margin-top: 0px; margin-bottom: 1rem; color: #212529; font-family: Verdana, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 14px; font-style: normal; font-",
     "html_snippet": null
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58405&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22",
     "xpath": "<p style=\"text-align: justify; line-height: 12.95pt;\">",
     "html_snippet": null
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59651&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2",
     "xpath": "<p style=\"text-align: justify; background: white;\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38647&lcdStatus=all&sortBy=title&ver=12.",
    "Locate the element: <p style=\"text-align: justify;\">",
    "Confirm the Siteimprove Alfa finding for rule sia-r71 against WCAG 1.4.8 Visual Presentation."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r71",
   "obligation": "aspirational",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W25",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/alfa__sia-r71.csv"
  },
  {
   "instance_id": "VS-97d08a8f",
   "pattern_id": "VS-cb53cc4d",
   "a11y_pattern_fingerprint": "a435874d5bfac4e401b42e33ca22cd5c87717574c15531eaa7239ebce17a743e",
   "a11y_pattern_display_id": "A11Y-PAT-A435874D5BFA",
   "a11y_occurrence_fingerprint": "9429c826247c7cd58614f4b7730553da4c3818d2d2846cc7da16e37211c2c24e",
   "a11y_occurrence_display_id": "A11Y-OCC-9429C826247C",
   "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": "<a href=\"/about-cms\" class=\"menu-item-link\" data-drupal-link-system-path=\"node/132926\" data-once=\"navigationLinkMatch\">",
   "html_snippet": null,
   "wcag_sc": "2.5.5",
   "wcag_name": "Target Size (Enhanced)",
   "wcag_level": "AAA",
   "wcag_version": "2.1",
   "wcag_category": "WCAG 2.x AAA",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r111",
   "rule_label": "Target size is at least 44×44 CSS pixels (Enhanced)",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r111",
   "severity": "Moderate",
   "frequency": {
    "instances": 134864,
    "pages_affected": 3686,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5)",
   "description": "Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3686 of 8600 scanned pages (134864 instances).",
   "examples": [
    {
     "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": "<a href=\"/about-cms\" class=\"menu-item-link\" data-drupal-link-system-path=\"node/132926\" data-once=\"navigationLinkMatch\">",
     "html_snippet": null
    },
    {
     "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": "<a href=\"/about-cms/contact/newsroom\" class=\"menu-item-link\" data-drupal-link-system-path=\"node/43871\" data-once=\"navigationLinkMatch\">",
     "html_snippet": null
    },
    {
     "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": "<a href=\"/data-research\" class=\"menu-item-link\" data-drupal-link-system-path=\"node/132891\" data-once=\"navigationLinkMatch\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update",
     "xpath": "<a href=\"/about-cms\" class=\"menu-item-link\" data-drupal-link-system-path=\"node/132926\" data-once=\"navigationLinkMatch\">",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update",
     "xpath": "<a href=\"/about-cms/contact/newsroom\" class=\"menu-item-link\" data-drupal-link-system-path=\"node/43871\" data-once=\"navigationLinkMatch\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc.",
    "Locate the element: <a href=\"/about-cms\" class=\"menu-item-link\" data-drupal-link-system-path=\"node/132926\" data-once=\"navigationLinkMatch\">",
    "Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced)."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111",
   "obligation": "aspirational",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r111.csv"
  },
  {
   "instance_id": "VS-34b03321",
   "pattern_id": "VS-d25f622d",
   "a11y_pattern_fingerprint": "8a90912b53688baee59e05d62994f69e1d400a4661b3ce3ff4e089f755b439d9",
   "a11y_pattern_display_id": "A11Y-PAT-8A90912B5368",
   "a11y_occurrence_fingerprint": "f499691294cfc4c958b7b4694972a21413d3850a2632b6dad6f79046bc2dfb0d",
   "a11y_occurrence_display_id": "A11Y-OCC-F499691294CF",
   "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
   "xpath": "h4:nth-child(16)",
   "html_snippet": "<h4><a name=\"preamble\">Preamble</a></h4>",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "evidence_status": "automated-indicator",
   "rule_id": "heading-order",
   "rule_label": "Heading levels should only increase by one",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI",
   "severity": "Moderate",
   "frequency": {
    "instances": 839,
    "pages_affected": 810,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Heading levels should only increase by one (WCAG criterion undetermined)",
   "description": "Heading levels should only increase by one. Detected by axe-core rule heading-order on 810 of 8600 scanned pages (839 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "h4:nth-child(16)",
     "html_snippet": "<h4><a name=\"preamble\">Preamble</a></h4>"
    },
    {
     "url": "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",
     "xpath": "h3",
     "html_snippet": "<h3 class=\"ds-u-font-size--2xl ds-u-font-weight--bold\">Searches related to <q></q></h3>"
    },
    {
     "url": "https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2Fascpayment%2Fdownloads%2F09ASC.zip",
     "xpath": ".content > h3:nth-child(2)",
     "html_snippet": "<h3>End User Point and Click Agreement:</h3>"
    },
    {
     "url": "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",
     "xpath": "h3",
     "html_snippet": "<h3 class=\"ds-u-font-size--2xl ds-u-font-weight--bold\">Searches related to <q></q></h3>"
    },
    {
     "url": "http://cms.gov/priorities/health-equity/minority-health/resource-center/language",
     "xpath": "h4",
     "html_snippet": "<h4>Spotlight</h4>"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.",
    "Locate the element: h4:nth-child(16)",
    "Confirm the axe-core finding for rule heading-order."
   ],
   "remediation_tip": "Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.",
   "tech_name": "Drupal",
   "tech_remediation_tip": "Drupal Views and blocks can insert headings at arbitrary levels. In the Views UI, set \"Title tag\" for each display. For block titles, configure the heading level in the block's layout settings.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI",
   "obligation": "advisory",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__heading-order.csv"
  },
  {
   "instance_id": "VS-9259d965",
   "pattern_id": "VS-d5d82446",
   "a11y_pattern_fingerprint": "52a7c3a9a1882fc2863a3420d1896e0b93df91a4d98a8dd156f924d061887f61",
   "a11y_pattern_display_id": "A11Y-PAT-52A7C3A9A188",
   "a11y_occurrence_fingerprint": "35ee3c3e6862fb87d9f3ee1695596bccb5b151fcf28ca134cd346068750004f7",
   "a11y_occurrence_display_id": "A11Y-OCC-35EE3C3E6862",
   "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html",
   "xpath": "html",
   "html_snippet": "<html>",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "evidence_status": "automated-indicator",
   "rule_id": "landmark-one-main",
   "rule_label": "Document should have one main landmark",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI",
   "severity": "Moderate",
   "frequency": {
    "instances": 76,
    "pages_affected": 76,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Document should have one main landmark (WCAG criterion undetermined)",
   "description": "Document should have one main landmark. Detected by axe-core rule landmark-one-main on 76 of 8600 scanned pages (76 instances).",
   "examples": [
    {
     "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html",
     "xpath": "html",
     "html_snippet": "<html>"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html",
     "xpath": "html",
     "html_snippet": "<html>"
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "html",
     "html_snippet": "<html>"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html",
     "xpath": "html",
     "html_snippet": "<html>"
    },
    {
     "url": "https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0238.html",
     "xpath": "html",
     "html_snippet": "<html>"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html.",
    "Locate the element: html",
    "Confirm the axe-core finding for rule landmark-one-main."
   ],
   "remediation_tip": "Each page should have exactly one <main> landmark.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI",
   "obligation": "advisory",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__landmark-one-main.csv"
  },
  {
   "instance_id": "VS-cdf9845d",
   "pattern_id": "VS-f18df681",
   "a11y_pattern_fingerprint": "9cdd7037be60c66d5bff567f6650333bf0f7045fa83503e4e441425dbf4f4568",
   "a11y_pattern_display_id": "A11Y-PAT-9CDD7037BE60",
   "a11y_occurrence_fingerprint": "1fc08071c567ee6d7713eeca3ea7260e60aec8a22440a52988c80830c37acd94",
   "a11y_occurrence_display_id": "A11Y-OCC-1FC08071C567",
   "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html",
   "xpath": ".arrows > tbody > tr:nth-child(1)",
   "html_snippet": "<tr>\n\t\t<td><img src=\"cms-site-logo.png\"></td>\n\t\t<td style=\"text-align:center;\"><h1>ICD-10-CM/PCS MS-DRG v39.0 Definitions Manual</h1><h1></h1></td>\n\t\t<td></td>\n\t\t<td></td>\n\t\t<td></td>\n\t</tr>",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "evidence_status": "automated-indicator",
   "rule_id": "region",
   "rule_label": "All page content should be contained by landmarks",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI",
   "severity": "Moderate",
   "frequency": {
    "instances": 1404,
    "pages_affected": 76,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "All page content should be contained by landmarks (WCAG criterion undetermined)",
   "description": "All page content should be contained by landmarks. Detected by axe-core rule region on 76 of 8600 scanned pages (1404 instances).",
   "examples": [
    {
     "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html",
     "xpath": ".arrows > tbody > tr:nth-child(1)",
     "html_snippet": "<tr>\n\t\t<td><img src=\"cms-site-logo.png\"></td>\n\t\t<td style=\"text-align:center;\"><h1>ICD-10-CM/PCS MS-DRG v39.0 Definitions Manual</h1><h1></h1></td>\n\t\t<td></td>\n\t\t<td></td>\n\t\t<td></td>\n\t</tr>"
    },
    {
     "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html",
     "xpath": "td[width=\"31\"]:nth-child(3)",
     "html_snippet": "<td width=\"31\"><a accesskey=\"p\" id=\"prev_page\" href=\"P0031.html\"><img src=\"bakpg.png\" alt=\"Previous Page [Alt-p]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a></td>"
    },
    {
     "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html",
     "xpath": "td[width=\"31\"]:nth-child(4)",
     "html_snippet": "<td width=\"31\"><a accesskey=\"u\" id=\"up_level\" href=\"P0001.html\"><img src=\"uptop.png\" alt=\"Up a level [Alt-u]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a></td>"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html",
     "xpath": ".hhshead[cellpadding=\"0\"][cellspacing=\"0\"]:nth-child(1)",
     "html_snippet": "<table class=\"hhshead\" cellpadding=\"0\" cellspacing=\"0\" summary=\"HHS Header. Table for formatting only.\">"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html",
     "xpath": ".masthead > a[href$=\"cms.gov/\"]",
     "html_snippet": "<a href=\"http://www.cms.gov/\" title=\"Centers for Medicare &amp; Medicaid Services\"> \n        <img class=\"hhsimg\" src=\"banner-text.jpg\" width=\"650\" height=\"60\" alt=\"Centers for Medicare &amp; Medicaid "
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html.",
    "Locate the element: .arrows > tbody > tr:nth-child(1)",
    "Confirm the axe-core finding for rule region."
   ],
   "remediation_tip": "Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.",
   "tech_name": "Drupal",
   "tech_remediation_tip": "Use Drupal's region system (header, navigation, main, sidebar, footer) and map each to an HTML5 landmark element in your theme's page.html.twig.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI",
   "obligation": "advisory",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__region.csv"
  },
  {
   "instance_id": "VS-302dafd5",
   "pattern_id": "VS-fa44f293",
   "a11y_pattern_fingerprint": "153387593f99913345b282b0ea387f236c6a129942c41d961f0ed36776eb998d",
   "a11y_pattern_display_id": "A11Y-PAT-153387593F99",
   "a11y_occurrence_fingerprint": "c6fc6c7fe8ed9d4cdb397dfb5ae0e15e917bf60f1bf08f3381e075c35adf407c",
   "a11y_occurrence_display_id": "A11Y-OCC-C6FC6C7FE8ED",
   "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html",
   "xpath": "html",
   "html_snippet": "<html>",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "evidence_status": "automated-indicator",
   "rule_id": "page-has-heading-one",
   "rule_label": "Page should contain a level-one heading",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI",
   "severity": "Moderate",
   "frequency": {
    "instances": 65,
    "pages_affected": 65,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Page should contain a level-one heading (WCAG criterion undetermined)",
   "description": "Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 65 of 8600 scanned pages (65 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html",
     "xpath": "html",
     "html_snippet": "<html>"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html",
     "xpath": "html",
     "html_snippet": "<html>"
    },
    {
     "url": "https://www.cms.gov/derechos-facturas-medicas/ayuda/guias/que-tipo-de-seguro",
     "xpath": "html",
     "html_snippet": "<html lang=\"en\" dir=\"ltr\" class=\" js\" style=\"--vw: 12.8px; --vh: 8px;\">"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1900.html",
     "xpath": "html",
     "html_snippet": "<html>"
    },
    {
     "url": "https://cms.gov/derechos-facturas-medicas/ayuda/guias/errores-de-facturas",
     "xpath": "html",
     "html_snippet": "<html lang=\"en\" dir=\"ltr\" class=\" js\" style=\"--vw: 12.8px; --vh: 8px;\">"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0389.html.",
    "Locate the element: html",
    "Confirm the axe-core finding for rule page-has-heading-one."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI",
   "obligation": "advisory",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__page-has-heading-one.csv"
  },
  {
   "instance_id": "VS-2e505a6c",
   "pattern_id": "VS-0ba8ce9d",
   "a11y_pattern_fingerprint": "063aedad662e75ed94d8732bef8a3fbeca91bf7a8adc1c93911bec115bffdf33",
   "a11y_pattern_display_id": "A11Y-PAT-063AEDAD662E",
   "a11y_occurrence_fingerprint": "618dd00765e0f4fe2c88cd2f24bc41b4501dfe5da6b34bac237fcd63331aa31c",
   "a11y_occurrence_display_id": "A11Y-OCC-618DD00765E0",
   "url": "https://cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=24&sortBy=title&status=all",
   "xpath": "tr:nth-child(2) > td[width=\"162\"][scope=\"row\"]",
   "html_snippet": "<td width=\"162\" valign=\"top\" scope=\"row\"><p>20.17</p></td>",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "evidence_status": "automated-indicator",
   "rule_id": "scope-attr-valid",
   "rule_label": "scope attribute should be used correctly",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI",
   "severity": "Moderate",
   "frequency": {
    "instances": 467,
    "pages_affected": 24,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "scope attribute should be used correctly (WCAG criterion undetermined)",
   "description": "scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 24 of 8600 scanned pages (467 instances).",
   "examples": [
    {
     "url": "https://cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=24&sortBy=title&status=all",
     "xpath": "tr:nth-child(2) > td[width=\"162\"][scope=\"row\"]",
     "html_snippet": "<td width=\"162\" valign=\"top\" scope=\"row\"><p>20.17</p></td>"
    },
    {
     "url": "https://cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=24&sortBy=title&status=all",
     "xpath": "tr:nth-child(3) > td[width=\"162\"][scope=\"row\"]",
     "html_snippet": "<td width=\"162\" valign=\"top\" scope=\"row\">  <p>50.6 </p>  </td>"
    },
    {
     "url": "https://cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=24&sortBy=title&status=all",
     "xpath": "tr:nth-child(4) > td[width=\"162\"][scope=\"row\"]",
     "html_snippet": "<td width=\"162\" valign=\"top\" scope=\"row\">  <p>140.5</p>  </td>"
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38571&lcdStatus=all&sortBy=title&ver=8",
     "xpath": "td[scope=\"row\"]",
     "html_snippet": "<td style=\"width: 149.84px; height: 207.75pt; vertical-align: top; border-top-color: currentColor; border-top-width: medium; border-top-style: none;\" scope=\"row\" height=\"277\">Rex (2015) Accuracy of Ca"
    },
    {
     "url": "https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=8&sortBy=meetingdate&year=all",
     "xpath": "tr:nth-child(2) > td[scope=\"row\"][width=\"33%\"][valign=\"top\"]",
     "html_snippet": "<td valign=\"top\" width=\"33%\" scope=\"row\">The study subjects are consecutive patients seen in a typical clinical setting with a chief complaint.</td>"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=24&sortBy=title&status=all.",
    "Locate the element: tr:nth-child(2) > td[width=\"162\"][scope=\"row\"]",
    "Confirm the axe-core finding for rule scope-attr-valid."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI",
   "obligation": "advisory",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__scope-attr-valid.csv"
  },
  {
   "instance_id": "VS-e684a6a8",
   "pattern_id": "VS-8806389c",
   "a11y_pattern_fingerprint": "2ad8158e1466b5cbc75957fed3b69b67a37affafe662013ea7d19e32aa5d1ed0",
   "a11y_pattern_display_id": "A11Y-PAT-2AD8158E1466",
   "a11y_occurrence_fingerprint": "6d09a8aa0fb5107f0082ba4e3dc7a14009b852368c6cc9d7ae6cfcdfc6bdcfee",
   "a11y_occurrence_display_id": "A11Y-OCC-6D09A8AA0FB5",
   "url": "https://www.cms.gov/about-cms/contact/newsroom?page=3",
   "xpath": ".views-field-field-topic[aria-label=\"Related search topics\"][role=\"region\"]:nth-child(1)",
   "html_snippet": "<span class=\"views-field views-field-field-topic\" role=\"region\" aria-label=\"Related search topics\">\n<a href=\"/newsroom/search?sort_by=search_api_relevance&amp;sort_order=DESC&amp;items_per_page=10&amp",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "evidence_status": "automated-indicator",
   "rule_id": "landmark-unique",
   "rule_label": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI",
   "severity": "Moderate",
   "frequency": {
    "instances": 10,
    "pages_affected": 10,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined)",
   "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).",
   "examples": [
    {
     "url": "https://www.cms.gov/about-cms/contact/newsroom?page=3",
     "xpath": ".views-field-field-topic[aria-label=\"Related search topics\"][role=\"region\"]:nth-child(1)",
     "html_snippet": "<span class=\"views-field views-field-field-topic\" role=\"region\" aria-label=\"Related search topics\">\n<a href=\"/newsroom/search?sort_by=search_api_relevance&amp;sort_order=DESC&amp;items_per_page=10&amp"
    },
    {
     "url": "https://cms.gov/priorities/innovation/evaluation-research-reports",
     "xpath": "nav[aria-labelledby=\"pagination-heading--9\"]",
     "html_snippet": "<nav class=\"ds-c-pagination\" aria-labelledby=\"pagination-heading--9\">"
    },
    {
     "url": "http://www.cms.gov/about-cms/contact/newsroom",
     "xpath": ".views-field-field-topic[aria-label=\"Related search topics\"][role=\"region\"]:nth-child(1)",
     "html_snippet": "<span class=\"views-field views-field-field-topic\" role=\"region\" aria-label=\"Related search topics\">\n<a href=\"/newsroom/search?sort_by=search_api_relevance&amp;sort_order=DESC&amp;items_per_page=10&amp"
    },
    {
     "url": "https://www.cms.gov/priorities/innovation/innovation-models/map",
     "xpath": "#non-state-table_wrapper > .dt-layout-row:nth-child(3) > .dt-layout-end.dt-layout-cell > .dt-paging > nav[aria-label=\"pagination\"]",
     "html_snippet": "<nav aria-label=\"pagination\">"
    },
    {
     "url": "https://www.cms.gov/apps/media/press/release.asp?Counter=3888",
     "xpath": ".views-field-field-topic[aria-label=\"Related search topics\"][role=\"region\"]:nth-child(1)",
     "html_snippet": "<span class=\"views-field views-field-field-topic\" role=\"region\" aria-label=\"Related search topics\">\n<a href=\"/newsroom/search?sort_by=search_api_relevance&amp;sort_order=DESC&amp;items_per_page=10&amp"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/about-cms/contact/newsroom?page=3.",
    "Locate the element: .views-field-field-topic[aria-label=\"Related search topics\"][role=\"region\"]:nth-child(1)",
    "Confirm the axe-core finding for rule landmark-unique."
   ],
   "remediation_tip": "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.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI",
   "obligation": "advisory",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W25",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/axe-core__landmark-unique.csv"
  },
  {
   "instance_id": "VS-73aab097",
   "pattern_id": "VS-30db094d",
   "a11y_pattern_fingerprint": "208b1cbfe7cece445b721bf4864c978824ef0123bc2ffe8e7121c5d13ab27e12",
   "a11y_pattern_display_id": "A11Y-PAT-208B1CBFE7CE",
   "a11y_occurrence_fingerprint": "96e0afeb8ce43568d310e0f07399372e3de8248227b89f5ae0b488cd77c8383a",
   "a11y_occurrence_display_id": "A11Y-OCC-96E0AFEB8CE4",
   "url": "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation",
   "xpath": ".Header",
   "html_snippet": "<header class=\"Header\" style=\"position: sticky;\">",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "evidence_status": "automated-indicator",
   "rule_id": "landmark-banner-is-top-level",
   "rule_label": "Banner landmark should not be contained in another landmark",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-banner-is-top-level?application=axeAPI",
   "severity": "Moderate",
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 8600
   },
   "likely_source": "content",
   "summary": "Banner landmark should not be contained in another landmark (WCAG criterion undetermined)",
   "description": "Banner landmark should not be contained in another landmark. Detected by axe-core rule landmark-banner-is-top-level on 1 of 8600 scanned pages (1 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation",
     "xpath": ".Header",
     "html_snippet": "<header class=\"Header\" style=\"position: sticky;\">"
    }
   ],
   "example_pages": [
    "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation"
   ],
   "affected_pages": [
    "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation.",
    "Locate the element: .Header",
    "Confirm the axe-core finding for rule landmark-banner-is-top-level."
   ],
   "remediation_tip": "Put the banner landmark (<header>) at the top level, not nested inside another landmark.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-banner-is-top-level?application=axeAPI",
   "obligation": "advisory",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/axe-core__landmark-banner-is-top-level.csv"
  },
  {
   "instance_id": "VS-d86c817e",
   "pattern_id": "VS-0066c67d",
   "a11y_pattern_fingerprint": "9f609d48d7978e0dfca1cb28e48c77bff0a9f30ec81609f6d78da35fe80816ff",
   "a11y_pattern_display_id": "A11Y-PAT-9F609D48D797",
   "a11y_occurrence_fingerprint": "d4c0004f1ba1b615a33c9e6a1b029457e377077b934157fc163e564fe8b38efa",
   "a11y_occurrence_display_id": "A11Y-OCC-D4C0004F1BA1",
   "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html",
   "xpath": "h1:nth-child(2)",
   "html_snippet": "<h1></h1>",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "evidence_status": "automated-indicator",
   "rule_id": "empty-heading",
   "rule_label": "Headings should not be empty",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI",
   "severity": "Minor",
   "frequency": {
    "instances": 48,
    "pages_affected": 48,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Headings should not be empty (WCAG criterion undetermined)",
   "description": "Headings should not be empty. Detected by axe-core rule empty-heading on 48 of 8600 scanned pages (48 instances).",
   "examples": [
    {
     "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html",
     "xpath": "h1:nth-child(2)",
     "html_snippet": "<h1></h1>"
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "h1:nth-child(2)",
     "html_snippet": "<h1></h1>"
    },
    {
     "url": "https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0238.html",
     "xpath": "h1:nth-child(2)",
     "html_snippet": "<h1></h1>"
    },
    {
     "url": "https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0025.html",
     "xpath": "h1:nth-child(2)",
     "html_snippet": "<h1></h1>"
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0361.html",
     "xpath": "h1:nth-child(2)",
     "html_snippet": "<h1></h1>"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0032.html.",
    "Locate the element: h1:nth-child(2)",
    "Confirm the axe-core finding for rule empty-heading."
   ],
   "remediation_tip": "Remove empty headings or give them text. Don't use heading tags for spacing.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI",
   "obligation": "advisory",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__empty-heading.csv"
  },
  {
   "instance_id": "VS-e5c53932",
   "pattern_id": "VS-d69fc059",
   "a11y_pattern_fingerprint": "7a599e436a04078aba45945d9e9285bf69e597e95c66dd4239a03023d157b142",
   "a11y_pattern_display_id": "A11Y-PAT-7A599E436A04",
   "a11y_occurrence_fingerprint": "7a778b93046cf0d1ab272dbc2ab36037e0014deca4329a93e817b12b0c220b07",
   "a11y_occurrence_display_id": "A11Y-OCC-7A778B93046C",
   "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y",
   "xpath": "li:nth-child(287) > table > tbody > tr:nth-child(1) > th:nth-child(1)",
   "html_snippet": "<th></th>",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "evidence_status": "automated-indicator",
   "rule_id": "empty-table-header",
   "rule_label": "Table header text should not be empty",
   "engine_key": "axe-core",
   "tool": "axe-core",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI",
   "severity": "Minor",
   "frequency": {
    "instances": 28,
    "pages_affected": 12,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Table header text should not be empty (WCAG criterion undetermined)",
   "description": "Table header text should not be empty. Detected by axe-core rule empty-table-header on 12 of 8600 scanned pages (28 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y",
     "xpath": "li:nth-child(287) > table > tbody > tr:nth-child(1) > th:nth-child(1)",
     "html_snippet": "<th></th>"
    },
    {
     "url": "http://cms.gov/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/application-information",
     "xpath": "th:nth-child(1)",
     "html_snippet": "<th><img src=\"/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/other-content-types/for-acos-types-and-timeline.png\" alt=\"\" data-entity-type=\"media\" data-entity-uuid=\"9dd5a361-1bdf-40f4-"
    },
    {
     "url": "http://cms.gov/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/application-information",
     "xpath": "th:nth-child(2)",
     "html_snippet": "<th><img src=\"/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/other-content-types/for-acos-toolkit.png\" alt=\"\" data-entity-type=\"media\" data-entity-uuid=\"1cd6374f-e738-4daf-b48e-e9fec4"
    },
    {
     "url": "https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=8&sortBy=meetingdate&year=all",
     "xpath": "div[align=\"center\"] > table > tbody:nth-child(1) > tr > th",
     "html_snippet": "<th></th>"
    },
    {
     "url": "https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=8&sortBy=meetingdate&year=all",
     "xpath": "table[cellspacing=\"0\"][cellpadding=\"7\"][border=\"1\"]:nth-child(42) > tbody > tr:nth-child(1) > th:nth-child(1)",
     "html_snippet": "<th scope=\"col\">&nbsp;</th>"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=309&proposed=Y.",
    "Locate the element: li:nth-child(287) > table > tbody > tr:nth-child(1) > th:nth-child(1)",
    "Confirm the axe-core finding for rule empty-table-header."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI",
   "obligation": "advisory",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/axe-core__empty-table-header.csv"
  },
  {
   "instance_id": "VS-493d75bf",
   "pattern_id": "VS-7118fead",
   "a11y_pattern_fingerprint": "4146fc8bd9bfddcfe5276de4597709da9dd61e9e69f451ddb610e46163d649aa",
   "a11y_pattern_display_id": "A11Y-PAT-4146FC8BD9BF",
   "a11y_occurrence_fingerprint": "c628b532b9b6a5e6721dc3cf68f874683fc60616f5997349d733d0a46340adaf",
   "a11y_occurrence_display_id": "A11Y-OCC-C628B532B9B6",
   "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": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
   "html_snippet": null,
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r61",
   "rule_label": "Form field label is visible",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r61",
   "severity": "Moderate",
   "frequency": {
    "instances": 3646,
    "pages_affected": 3646,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Form field label is visible (WCAG criterion undetermined)",
   "description": "Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 3646 of 8600 scanned pages (3646 instances).",
   "examples": [
    {
     "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": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
     "html_snippet": null
    },
    {
     "url": "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",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc.",
    "Locate the element: {\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
    "Confirm the Siteimprove Alfa finding for rule sia-r61."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61",
   "obligation": "unmapped",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r61.csv"
  },
  {
   "instance_id": "VS-d0cd8ea3",
   "pattern_id": "VS-c18be945",
   "a11y_pattern_fingerprint": "6f4836c6a670501b2b2ec4ef8720babc528ae6143bb2b672472287e13b3e9b0e",
   "a11y_pattern_display_id": "A11Y-PAT-6F4836C6A670",
   "a11y_occurrence_fingerprint": "341d0fa7f6702e7a29449aa2c97e1da72a17fff8ced6c7a49304f3266d054196",
   "a11y_occurrence_display_id": "A11Y-OCC-341D0FA7F670",
   "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": "text: \"Feedback\"",
   "html_snippet": null,
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r57",
   "rule_label": "Scrolling content can be accessed by keyboard",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r57",
   "severity": "Moderate",
   "frequency": {
    "instances": 1652,
    "pages_affected": 1652,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Scrolling content can be accessed by keyboard (WCAG criterion undetermined)",
   "description": "Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 1652 of 8600 scanned pages (1652 instances).",
   "examples": [
    {
     "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": "text: \"Feedback\"",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2020-part-b-mac-update",
     "xpath": "text: \"Feedback\"",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/newsroom/press-releases/600000-north-carolinians-now-have-access-medicaid-expansion-coverage",
     "xpath": "text: \"Feedback\"",
     "html_snippet": null
    },
    {
     "url": "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",
     "xpath": "text: \"Feedback\"",
     "html_snippet": null
    },
    {
     "url": "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",
     "xpath": "text: \"Feedback\"",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_issue_date&page=9&sort=asc.",
    "Locate the element: text: \"Feedback\"",
    "Confirm the Siteimprove Alfa finding for rule sia-r57."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57",
   "obligation": "unmapped",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r57.csv"
  },
  {
   "instance_id": "VS-f32b8b18",
   "pattern_id": "VS-f054f4a4",
   "a11y_pattern_fingerprint": "5355c8f41975ead3d1a8894c0f821b3cd75ca14b94f57eb210246cc290e14303",
   "a11y_pattern_display_id": "A11Y-PAT-5355C8F41975",
   "a11y_occurrence_fingerprint": "4563ccc06b0280801a061ecf492d5b80b99142f3f48e38f2e2212fcc454c2dc2",
   "a11y_occurrence_display_id": "A11Y-OCC-4563CCC06B02",
   "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
   "xpath": "<h4>",
   "html_snippet": null,
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r53",
   "rule_label": "Headings are structured hierarchically",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r53",
   "severity": "Moderate",
   "frequency": {
    "instances": 1416,
    "pages_affected": 1397,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Headings are structured hierarchically (WCAG criterion undetermined)",
   "description": "Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 1397 of 8600 scanned pages (1416 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "<h4>",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60191&ver=6",
     "xpath": "<h3 id=\"h3GeneralInformationHeader\" class=\"document-view-section-header\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2Fascpayment%2Fdownloads%2F09ASC.zip",
     "xpath": "<h3>",
     "html_snippet": null
    },
    {
     "url": "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",
     "xpath": "<h3 class=\"ds-u-font-size--2xl ds-u-font-weight--bold\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26",
     "xpath": "<h3 id=\"h3GeneralInformationHeader\" class=\"document-view-section-header\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.",
    "Locate the element: <h4>",
    "Confirm the Siteimprove Alfa finding for rule sia-r53."
   ],
   "remediation_tip": "Use headings in a logical, non-skipping order.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r53",
   "obligation": "unmapped",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r53.csv"
  },
  {
   "instance_id": "VS-d6f931f8",
   "pattern_id": "VS-2cd767ca",
   "a11y_pattern_fingerprint": "54e0360444f665703af8cfdd5c85edcd0d0dcafc841ff411e6eba0aaedaa808a",
   "a11y_pattern_display_id": "A11Y-PAT-54E0360444F6",
   "a11y_occurrence_fingerprint": "c3bd586a77b5094b9e88071caa991d1f2cf373efec472c58a4a56ede8fa96890",
   "a11y_occurrence_display_id": "A11Y-OCC-C3BD586A77B5",
   "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26",
   "xpath": "<h4>",
   "html_snippet": null,
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r78",
   "rule_label": "Table header has scope",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r78",
   "severity": "Moderate",
   "frequency": {
    "instances": 759,
    "pages_affected": 483,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Table header has scope (WCAG criterion undetermined)",
   "description": "Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 483 of 8600 scanned pages (759 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26",
     "xpath": "<h4>",
     "html_snippet": null
    },
    {
     "url": "http://cms.gov/priorities/health-equity/minority-health/resource-center/language",
     "xpath": "<h4>",
     "html_snippet": null
    },
    {
     "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": "<h3 id=\"navStickyHeader\" class=\"bg-white d-inline expand-head-pad\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56658&ver=42",
     "xpath": "<h4>",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0027.html",
     "xpath": "<h1>",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57878&ver=26.",
    "Locate the element: <h4>",
    "Confirm the Siteimprove Alfa finding for rule sia-r78."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r78",
   "obligation": "unmapped",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r78.csv"
  },
  {
   "instance_id": "VS-a0050faf",
   "pattern_id": "VS-04a9d28c",
   "a11y_pattern_fingerprint": "dd74635c3faaeca20b6d9c9754e5c0de56bfa09e7a0f63859662b1f447876646",
   "a11y_pattern_display_id": "A11Y-PAT-DD74635C3FAA",
   "a11y_occurrence_fingerprint": "e9e397a9a162cd0d7d1bfa7a279c1cc39d6a42c0d1caddc8c44322ff094dbf80",
   "a11y_occurrence_display_id": "A11Y-OCC-E9E397A9A162",
   "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
   "xpath": "p",
   "html_snippet": "<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>",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "presentational-attr",
   "rule_label": "Presentational attribute (use CSS)",
   "engine_key": "deprecated-html",
   "tool": "deprecated-html",
   "rule_url": null,
   "severity": "Moderate",
   "frequency": {
    "instances": 250,
    "pages_affected": 29,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Presentational attribute (use CSS) (WCAG criterion undetermined)",
   "description": "Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 29 of 8600 scanned pages (250 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "p",
     "html_snippet": "<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>"
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "hr",
     "html_snippet": "<hr align=\"left\" size=\"1\" width=\"33%\">"
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56607&articleStatus=all&bc=3&sortBy=title&ver=19",
     "xpath": "p",
     "html_snippet": "<p align=\"LEFT\">Title XVIII of the Social Security Act, §1833(e) states that no payment shall be made to any provider for any claim which lacks the necessary information to process the claim.</p>"
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56607&articleStatus=all&bc=3&sortBy=title&ver=19",
     "xpath": "p",
     "html_snippet": "<p align=\"LEFT\">CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 23, §20.9 National Correct Coding Initiative (NCCI)</p>"
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0476.html",
     "xpath": "table",
     "html_snippet": "<table class=\"hhshead\" cellpadding=\"0\" cellspacing=\"0\" summary=\"HHS Header. Table for formatting only.\">\n\t<tbody><tr><td class=\"hhsbann\" align=\"left\">\n    <img class=\"hhsimg\" src=\"hhs_left.gif\" width="
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.",
    "Locate the element: p",
    "Confirm the deprecated-html finding for rule presentational-attr."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "Not captured by automated scan — requires manual testing.",
   "obligation": "unmapped",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/deprecated-html__presentational-attr.csv"
  },
  {
   "instance_id": "VS-ceac3d33",
   "pattern_id": "VS-7fbb8b20",
   "a11y_pattern_fingerprint": "77c6216fbd4e8110bb8f6de50772332d9f730709a2342d5799081c44df2e4371",
   "a11y_pattern_display_id": "A11Y-PAT-77C6216FBD4E",
   "a11y_occurrence_fingerprint": "e3dc16cc68608085b90f016131fb0b39f89399ad355f0d987cf1c37b5a4fda36",
   "a11y_occurrence_display_id": "A11Y-OCC-E3DC16CC6860",
   "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html",
   "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"element\",\"children\":[{\"type\":\"element\",\"",
   "html_snippet": null,
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r59",
   "rule_label": "Element with orientation is not locked",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r59",
   "severity": "Moderate",
   "frequency": {
    "instances": 15,
    "pages_affected": 15,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Element with orientation is not locked (WCAG criterion undetermined)",
   "description": "Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 15 of 8600 scanned pages (15 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"element\",\"children\":[{\"type\":\"element\",\"",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"element\",\"children\":[{\"type\":\"element\",\"",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0084.html",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"element\",\"children\":[{\"type\":\"element\",\"",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0219.html",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"element\",\"children\":[{\"type\":\"element\",\"",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0128.html",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"element\",\"children\":[{\"type\":\"element\",\"",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html.",
    "Locate the element: {\"type\":\"document\",\"children\":[{\"type\":\"element\",\"children\":[{\"type\":\"element\",\"",
    "Confirm the Siteimprove Alfa finding for rule sia-r59."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r59",
   "obligation": "unmapped",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W26",
   "last_seen": "2026-W29",
   "weeks_seen": 4,
   "affected_pages_csv": "csv/alfa__sia-r59.csv"
  },
  {
   "instance_id": "VS-2aa9bafb",
   "pattern_id": "VS-e43903a1",
   "a11y_pattern_fingerprint": "b65b940fea6fe2881d9be490f491626db32eb1ea900ed16ae1fa6f1c8fe62cd6",
   "a11y_pattern_display_id": "A11Y-PAT-B65B940FEA6F",
   "a11y_occurrence_fingerprint": "979445759b36654894172fd781e7107b06053d4ac8b4618f8edf354bdfbd59b7",
   "a11y_occurrence_display_id": "A11Y-OCC-979445759B36",
   "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html",
   "xpath": "<ul id=\"globar\">",
   "html_snippet": null,
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r75",
   "rule_label": "Form field error is identified and described",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r75",
   "severity": "Moderate",
   "frequency": {
    "instances": 30,
    "pages_affected": 15,
    "total_pages_scanned": 8600
   },
   "likely_source": "template",
   "summary": "Form field error is identified and described (WCAG criterion undetermined)",
   "description": "Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 15 of 8600 scanned pages (30 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html",
     "xpath": "<ul id=\"globar\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html",
     "xpath": "<ul id=\"supbar\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html",
     "xpath": "<ul id=\"globar\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0006.html",
     "xpath": "<ul id=\"supbar\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0084.html",
     "xpath": "<ul id=\"globar\">",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1511.html.",
    "Locate the element: <ul id=\"globar\">",
    "Confirm the Siteimprove Alfa finding for rule sia-r75."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r75",
   "obligation": "unmapped",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W26",
   "last_seen": "2026-W29",
   "weeks_seen": 4,
   "affected_pages_csv": "csv/alfa__sia-r75.csv"
  },
  {
   "instance_id": "VS-651827fe",
   "pattern_id": "VS-f2542d87",
   "a11y_pattern_fingerprint": "03e69dee9333d7e11cc03a3ed8ce4fd222caccb83cb87fed3b43425fb04123c7",
   "a11y_pattern_display_id": "A11Y-PAT-03E69DEE9333",
   "a11y_occurrence_fingerprint": "a888813410db871e2e80e505e62604b3eaf25c57e0ae4f17dfdf9688a9db7b6a",
   "a11y_occurrence_display_id": "A11Y-OCC-A888813410DB",
   "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y",
   "xpath": "<pre>",
   "html_snippet": null,
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r79",
   "rule_label": "Duplicate role landmark is labeled",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r79",
   "severity": "Moderate",
   "frequency": {
    "instances": 9,
    "pages_affected": 9,
    "total_pages_scanned": 8600
   },
   "likely_source": "unknown",
   "summary": "Duplicate role landmark is labeled (WCAG criterion undetermined)",
   "description": "Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 9 of 8600 scanned pages (9 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y",
     "xpath": "<pre>",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?calid=201&proposed=N",
     "xpath": "<pre>",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=17",
     "xpath": "<pre>",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=40&proposed=N",
     "xpath": "<pre>",
     "html_snippet": null
    },
    {
     "url": "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",
     "xpath": "<pre>",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y.",
    "Locate the element: <pre>",
    "Confirm the Siteimprove Alfa finding for rule sia-r79."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r79",
   "obligation": "unmapped",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 6,
   "affected_pages_csv": "csv/alfa__sia-r79.csv"
  },
  {
   "instance_id": "VS-c399476f",
   "pattern_id": "VS-3d033717",
   "a11y_pattern_fingerprint": "02e366b4c298b491412ec27d0aa31fac798f5695a402a7d261c17d3135bb7025",
   "a11y_pattern_display_id": "A11Y-PAT-02E366B4C298",
   "a11y_occurrence_fingerprint": "703e79b27044ba925da09421d367cb419d50def191d50b7db570c029b7f1524f",
   "a11y_occurrence_display_id": "A11Y-OCC-703E79B27044",
   "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y",
   "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
   "html_snippet": null,
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r70",
   "rule_label": "No obsolete or deprecated elements are used",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r70",
   "severity": "Moderate",
   "frequency": {
    "instances": 8,
    "pages_affected": 8,
    "total_pages_scanned": 8600
   },
   "likely_source": "unknown",
   "summary": "No obsolete or deprecated elements are used (WCAG criterion undetermined)",
   "description": "No obsolete or deprecated elements are used. Detected by Siteimprove Alfa rule sia-r70 on 8 of 8600 scanned pages (8 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38396&ver=25",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=60&sortBy=meetingdate&year=all",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=90",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
     "html_snippet": null
    },
    {
     "url": "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",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=285&proposed=Y.",
    "Locate the element: {\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
    "Confirm the Siteimprove Alfa finding for rule sia-r70."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r70",
   "obligation": "advisory",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W25",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/alfa__sia-r70.csv"
  },
  {
   "instance_id": "VS-e771f0e9",
   "pattern_id": "VS-4c341c77",
   "a11y_pattern_fingerprint": "b20456eab70e820eb40dcabd3947e1dac3a3a60b8b053518aeaece4f0d5edabd",
   "a11y_pattern_display_id": "A11Y-PAT-B20456EAB70E",
   "a11y_occurrence_fingerprint": "952ed23e7bd236ac89539dd149a8b2c813c78e728549c9d1341eff087f7d230d",
   "a11y_occurrence_display_id": "A11Y-OCC-952ED23E7BD2",
   "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
   "xpath": "<p>",
   "html_snippet": null,
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r85",
   "rule_label": "Keyboard trap does not exist",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r85",
   "severity": "Moderate",
   "frequency": {
    "instances": 15,
    "pages_affected": 5,
    "total_pages_scanned": 8600
   },
   "likely_source": "unknown",
   "summary": "Keyboard trap does not exist (WCAG criterion undetermined)",
   "description": "Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 5 of 8600 scanned pages (15 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all",
     "xpath": "<p>",
     "html_snippet": null
    },
    {
     "url": "https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=60&sortBy=meetingdate&year=all",
     "xpath": "<p>",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaId=315&proposed=N",
     "xpath": "<p class=\"MsoListParagraphCxSpMiddle\" style=\"margin-left:.75in;mso-add-space: auto;text-indent:0in;line-height:normal;mso-list:l20 level1 lfo32\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaId=315&proposed=N",
     "xpath": "<p class=\"MsoListParagraphCxSpLast\" style=\"margin-left:.75in;mso-add-space:auto; text-indent:0in;line-height:normal;mso-list:l20 level1 lfo32\">",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaId=315&proposed=N",
     "xpath": "<p>",
     "html_snippet": null
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=-1&mcdid=39&sortBy=title&status=all.",
    "Locate the element: <p>",
    "Confirm the Siteimprove Alfa finding for rule sia-r85."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r85",
   "obligation": "unmapped",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W25",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/alfa__sia-r85.csv"
  },
  {
   "instance_id": "VS-b6421dd6",
   "pattern_id": "VS-91d2294a",
   "a11y_pattern_fingerprint": "694557a2e6d5bc90eafe7b3a3c5b7b43bcc69e8bc86d88693bd71c134ecf0f0d",
   "a11y_pattern_display_id": "A11Y-PAT-694557A2E6D5",
   "a11y_occurrence_fingerprint": "a89ad922aa6d8e983ebdbbf48c41c926609086dc4eb85ab987e54cb70565e1e9",
   "a11y_occurrence_display_id": "A11Y-OCC-A89AD922AA6D",
   "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53064&articleStatus=all&bc=3&sortBy=title&ver=87",
   "xpath": "font",
   "html_snippet": "<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",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "font-element",
   "rule_label": "Obsolete <font> element (use CSS)",
   "engine_key": "deprecated-html",
   "tool": "deprecated-html",
   "rule_url": null,
   "severity": "Moderate",
   "frequency": {
    "instances": 8,
    "pages_affected": 2,
    "total_pages_scanned": 8600
   },
   "likely_source": "content",
   "summary": "Obsolete <font> element (use CSS) (WCAG criterion undetermined)",
   "description": "Obsolete <font> element (use CSS). Detected by deprecated-html rule font-element on 2 of 8600 scanned pages (8 instances).",
   "examples": [
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53064&articleStatus=all&bc=3&sortBy=title&ver=87",
     "xpath": "font",
     "html_snippet": "<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"
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53064&articleStatus=all&bc=3&sortBy=title&ver=87",
     "xpath": "font",
     "html_snippet": "<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; mso-bidi-font-family: &quot;Times New Roman&quot;; ms"
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53064&articleStatus=all&bc=3&sortBy=title&ver=87",
     "xpath": "font",
     "html_snippet": "<font face=\"Times New Roman\" size=\"3\"><i><span style=\"line-height: 115%; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; font-size: 12pt; mso-fareast-font-family: &quot;Times New Roman&quo"
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=379&ncdver=1&sortBy=title",
     "xpath": "font",
     "html_snippet": "<font color=\"FF0000\"><strong>A.&nbsp;&nbsp;&nbsp;General</strong></font>"
    },
    {
     "url": "http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=379&ncdver=1&sortBy=title",
     "xpath": "font",
     "html_snippet": "<font color=\"FF0000\"> \n\t<p>Transcatheter Tricuspid Valve Replacement (TTVR) is used in the treatment of tricuspid regurgitation. </p></font>"
    }
   ],
   "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"
   ],
   "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"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53064&articleStatus=all&bc=3&sortBy=title&ver=87.",
    "Locate the element: font",
    "Confirm the deprecated-html finding for rule font-element."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "Not captured by automated scan — requires manual testing.",
   "obligation": "unmapped",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W24",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/deprecated-html__font-element.csv"
  },
  {
   "instance_id": "VS-7c656026",
   "pattern_id": "VS-e05344b9",
   "a11y_pattern_fingerprint": "12a798cc9fda07a5088d311631e6fb09739b47324b14a4fa6dab0f6d98b4f738",
   "a11y_pattern_display_id": "A11Y-PAT-12A798CC9FDA",
   "a11y_occurrence_fingerprint": "736f8899abd424c268a62de904a12cd0f33856f97d877edced7d7f775fb27db3",
   "a11y_occurrence_display_id": "A11Y-OCC-736F8899ABD4",
   "url": "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation",
   "xpath": "@aria-label=\"Open Medicare Advantage Geographic Variation - National & State\"",
   "html_snippet": null,
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r18",
   "rule_label": "aria attribute is permitted for element role",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r18",
   "severity": "Moderate",
   "frequency": {
    "instances": 3,
    "pages_affected": 1,
    "total_pages_scanned": 8600
   },
   "likely_source": "content",
   "summary": "aria attribute is permitted for element role (WCAG criterion undetermined)",
   "description": "aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 1 of 8600 scanned pages (3 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation",
     "xpath": "@aria-label=\"Open Medicare Advantage Geographic Variation - National & State\"",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation",
     "xpath": "@aria-label=\"Open Medicare Geographic Variation - by National, State & County\"",
     "html_snippet": null
    },
    {
     "url": "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation",
     "xpath": "@aria-label=\"Open Medicare Geographic Variation - by Hospital Referral Region\"",
     "html_snippet": null
    }
   ],
   "example_pages": [
    "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation"
   ],
   "affected_pages": [
    "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation.",
    "Locate the element: @aria-label=\"Open Medicare Advantage Geographic Variation - National & State\"",
    "Confirm the Siteimprove Alfa finding for rule sia-r18."
   ],
   "remediation_tip": "Only use ARIA states/properties that are allowed on this element/role.",
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r18",
   "obligation": "unmapped",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W25",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/alfa__sia-r18.csv"
  },
  {
   "instance_id": "VS-9a6b0c3e",
   "pattern_id": "VS-aa242c2d",
   "a11y_pattern_fingerprint": "d3c0bd1ab62c73539ffd732c5242f82de13fea583f2ba6d1fd73e89a3275d35f",
   "a11y_pattern_display_id": "A11Y-PAT-D3C0BD1AB62C",
   "a11y_occurrence_fingerprint": "00f1eba512e8eca6bb29ee6239b644daaf1712e26b963eadebabe0ab48d57bea",
   "a11y_occurrence_display_id": "A11Y-OCC-00F1EBA512E8",
   "url": "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation",
   "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
   "html_snippet": null,
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "evidence_status": "automated-indicator",
   "rule_id": "sia-r87",
   "rule_label": "First focusable element is link to main content",
   "engine_key": "alfa",
   "tool": "Siteimprove Alfa",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r87",
   "severity": "Moderate",
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 8600
   },
   "likely_source": "content",
   "summary": "First focusable element is link to main content (WCAG criterion undetermined)",
   "description": "First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 1 of 8600 scanned pages (1 instances).",
   "examples": [
    {
     "url": "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation",
     "xpath": "{\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
     "html_snippet": null
    }
   ],
   "example_pages": [
    "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation"
   ],
   "affected_pages": [
    "https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation"
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   },
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "steps_to_reproduce": [
    "Open https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation.",
    "Locate the element: {\"type\":\"document\",\"children\":[{\"type\":\"type\",\"name\":\"html\",\"publicId\":null,\"sys",
    "Confirm the Siteimprove Alfa finding for rule sia-r87."
   ],
   "remediation_tip": null,
   "tech_name": null,
   "tech_remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r87",
   "obligation": "unmapped",
   "handling": "review",
   "policy_source": "default",
   "policy_reason": null,
   "policy_evidence": [],
   "policy_owner": null,
   "policy_expires": null,
   "included_in_primary_score": false,
   "first_seen": "2026-W25",
   "last_seen": "2026-W29",
   "weeks_seen": 5,
   "affected_pages_csv": "csv/alfa__sia-r87.csv"
  }
 ],
 "policy": {
  "suppression": {
   "patterns": 0,
   "pages": 0,
   "occurrences": 0,
   "entries": []
  }
 }
}