www.cms.gov: Accessibility — week 2026-W32

Automated Accessibility Conformance Report (OpenACR): Download ACR. Machine-readable; compatible with GSA OpenACR tooling. Automated tools find ~⅓ of real barriers — supplement with manual AT testing.

Training priorities

Top WCAG success criteria by pages affected this week. Use these to focus team training on the highest-impact issues.

SC	Criterion	Pages	Rules	Notes
1.4.8	WCAG 1.4.8	1256	4	Component inconsistency
2.5.5	WCAG 2.5.5	822	1
1.4.1	Use of Color	566	2
1.3.1	Info and Relationships (semantic structure)	482	8
2.5.3	WCAG 2.5.3	386	1

Next 10 actions

Clusters are fingerprinted by normalized selector path + rule id + snippet shape. Rank score = (severity weight × pages affected) / distinct components for the rule. This supersedes the template threshold heuristic while still surfacing it as a validation signal.

Design-system alignment (cms-ds / default). ds-c-field: 100% of sampled rule findings · ds-c-spinner: 100% of sampled rule findings · ds-c-pagination: 20% of sampled rule findings 5 possible lookalike cluster(s) without system prefixes.

Top 10 clustered component fixes for this week.
Cluster	Severity	Pages	Who it affects	How to fix	Evidence	Decision
Form field label is visible · unattributed component Fix one place, resolve ~804 finding(s) on 804 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	804	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61	pages (CSV)	Decision Assigned to Notes
<html> element must have a lang attribute · unattributed component Fix one place, resolve ~71 finding(s) on 71 page(s). XPath / selector: `html` `<html>`	Serious	71	Without vision, Limited cognitive, language, or learning ability	Add a lang attribute to <html> (e.g. lang="en").	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~296 finding(s) on 296 page(s). XPath / selector: `text: "Feedback"`	Moderate	296	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
Document should have one main landmark · unattributed component Fix one place, resolve ~71 finding(s) on 71 page(s). XPath / selector: `html` `<html>`	Moderate	71	Requires manual testing.	Each page should have exactly one <main> landmark.	pages (CSV)	Decision Assigned to Notes
Images must have alternative text · unattributed component Fix one place, resolve ~52 finding(s) on 52 page(s). XPath / selector: `img[src$="cms-site-logo.png"]` `<img src="cms-site-logo.png">`	Critical	52	Without vision, Limited vision, Limited cognitive, language, or learning ability	Give every <img> a meaningful alt attribute. Use alt="" only for decorative images so screen readers skip them.	pages (CSV)	Decision Assigned to Notes
Form elements must have labels · unattributed component Fix one place, resolve ~19 finding(s) on 19 page(s). XPath / selector: `#q` `<input type="text" name="q" id="q" value="Search now" size="10" maxlength="50" class="srchbox" onfocus="this.value='';">`	Critical	19	Without vision, Limited vision, Limited manipulation/strength	Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.	pages (CSV)	Decision Assigned to Notes
Page should contain a level-one heading · unattributed component Fix one place, resolve ~34 finding(s) on 34 page(s). XPath / selector: `html` `<html>`	Moderate	34	Requires manual testing.	See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~383 finding(s) on 383 page(s). XPath / selector: `<a id="aBasketManuButton" class="basket-icon log-click " title="View documents in your Basket" data-page-action="Clicked the Basket navbar link.">`	Moderate	383	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
Element has required aria-owns · unattributed component Fix one place, resolve ~52 finding(s) on 34 page(s). XPath / selector: `<th scope="col">`	Moderate	34	Without vision, Limited vision, Limited cognitive, language, or learning ability	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r46	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~338 finding(s) on 338 page(s). XPath / selector: `<a href="#" data-bs-toggle="collapse" id="aCollapseNavigation" aria-label="Collapse Document Navigation">`	Moderate	338	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes

Bug reports

12 issue type(s) are shown by default out of 38 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 3 critical, 6 serious, 27 moderate, 2 minor. By WCAG category: 14 WCAG 2.0 A, 3 WCAG 2.0 AA, 1 WCAG 2.2 AA, 3 WCAG 2.x AAA, 10 Best Practice, 7 Undetermined. Ordered by severity, key-page impact, WCAG level, and prevalence. Following accessibility bug-reporting best practices. Download: Markdown · JSON (full archive) · JSON (AI diagnostic) · CSV (all findings) · Priority pages CSV · Priority pages JSON.

Automated testing does not establish full WCAG conformance. Findings in the verification lane require manual testing before they are treated as confirmed failures.

Default view shows 12 prioritized issue type(s); 26 more are available if you switch to "Show everything".

2 finding(s) marked "possible duplicate" — Alfa and axe-core both flagged the same WCAG SC on overlapping pages. If they target the same element, the axe-core report is authoritative. Filter the CSV by possible_duplicate_of to see these. Two engines flagging the same barrier reduces the chance of a false positive.

Findings needing review

These findings need manual verification before they can be treated as confirmed failures. Obligation remains visible for each finding.

Serious axe html-has-lang WCAG 2.0 A <html> element must have a lang attribute (WCAG 3.1.1) 71/6846 pages · 71 instances Likely template

Bug ID: VS-237e6a42
Pattern ID: VS-c126b6a6
Combined ID: VS-237e6a42 (pattern VS-c126b6a6) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 3.1.1 Language of Page (Level A, WCAG 2.0)
Rule: axe-core — <html> element must have a lang attribute [html-has-lang]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html>

Description

<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 71 of 6846 scanned pages (71 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html.
Locate the element: html
Confirm the axe-core finding for rule html-has-lang against WCAG 3.1.1 Language of Page.

Impact

Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

…and more — all 71 pages (CSV).

Testing environment

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

Suggested fix

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

Drupal tip: Drupal sets the page lang attribute from Admin › Configuration › Regional and Language › Languages. Ensure the default language is configured.

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

Triage status Notes

Critical axe image-alt WCAG 2.0 A Images must have alternative text (WCAG 1.1.1) 53/6846 pages · 53 instances Likely template

Bug ID: VS-f85889d4
Pattern ID: VS-9074b4dd
Combined ID: VS-f85889d4 (pattern VS-9074b4dd) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: axe-core — Images must have alternative text [image-alt]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html
XPath / selector: img[src$="cms-site-logo.png"]
History: first seen 2026-W24, last seen 2026-W32 (8 wk)

HTML snippet — use this to validate the finding without re-running the tool

<img src="cms-site-logo.png">

Description

Images must have alternative text. Detected by axe-core rule image-alt on 53 of 6846 scanned pages (53 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.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.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

…and more — all 53 pages (CSV).

Testing environment

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

Suggested fix

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

Drupal 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.

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

Triage status Notes

Critical axe label WCAG 2.0 A Form elements must have labels (WCAG 4.1.2) 19/6846 pages · 19 instances Likely template

Bug ID: VS-be87463f
Pattern ID: VS-fafffee0
Combined ID: VS-be87463f (pattern VS-fafffee0) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — Form elements must have labels [label]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1230.html
XPath / selector: #q
History: first seen 2026-W26, last seen 2026-W32 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

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

Description

Form elements must have labels. Detected by axe-core rule label on 19 of 6846 scanned pages (19 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1230.html.
Locate the element: #q
Confirm the axe-core finding for rule label against WCAG 4.1.2 Name, Role, Value.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

Testing environment

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

Suggested fix

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

Drupal 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.

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

Triage status Notes

Serious axe link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 2/6846 pages · 5 instances

Bug ID: VS-5133e587
Pattern ID: VS-e9fe47ac
Combined ID: VS-5133e587 (pattern VS-e9fe47ac) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.4 Link Purpose (In Context) (Level A, WCAG 2.0)
Rule: axe-core — Links must have discernible text [link-name]
Example URL: https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=14&doctype=all&fromTracking=Y&ncaid=320&proposed=Y&sortBy=title&year=2026
XPath / selector: ol[type="A"] > a[href$="#5A"]
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

HTML snippet — use this to validate the finding without re-running the tool

<a href="#5A">
</a>

Description

Links must have discernible text. Detected by axe-core rule link-name on 3 of 6846 scanned pages (7 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=14&doctype=all&fromTracking=Y&ncaid=320&proposed=Y&sortBy=title&year=2026.
Locate the element: ol[type="A"] > a[href$="#5A"]
Confirm the axe-core finding for rule link-name against WCAG 2.4.4 Link Purpose (In Context).

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

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

Suggested fix

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

Drupal 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.

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

Triage status Notes

Serious axe td-headers-attr WCAG 2.0 A Table cell headers attributes must refer to other <th> elements in the same tabl (WCAG 1.3.1) 2/6846 pages · 2 instances Likely content

Bug ID: VS-0aa01f63
Pattern ID: VS-07ba3b17
Combined ID: VS-0aa01f63 (pattern VS-07ba3b17) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: axe-core — Table cell headers attributes must refer to other <th> elements in the same tabl [td-headers-attr]
Example URL: https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=12&sort=asc
XPath / selector: .MsoTableGrid
History: first seen 2026-W25, last seen 2026-W32 (8 wk)

HTML snippet — use this to validate the finding without re-running the tool

<table class="MsoTableGrid">

Description

Table cell headers attributes must refer to other <th> elements in the same tabl. Detected by axe-core rule td-headers-attr on 2 of 6846 scanned pages (2 instances).

Steps to reproduce

Open https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=12&sort=asc.
Locate the element: .MsoTableGrid
Confirm the axe-core finding for rule td-headers-attr against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Critical axe select-name WCAG 2.0 A Select element must have an accessible name (WCAG 4.1.2) 1/6846 pages · 1 instances Likely content

Bug ID: VS-7f4423f1
Pattern ID: VS-fab92378
Combined ID: VS-7f4423f1 (pattern VS-fab92378) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — Select element must have an accessible name [select-name]
Example URL: http://www.cms.gov/priorities/innovation/innovation-models/map
XPath / selector: #state-code-select
History: first seen 2026-W26, last seen 2026-W32 (4 wk)

HTML snippet — use this to validate the finding without re-running the tool

<select id="state-code-select" class="form-select ds-c-field">

Description

Select element must have an accessible name. Detected by axe-core rule select-name on 1 of 6846 scanned pages (1 instances).

Steps to reproduce

Open http://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.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

/priorities/innovation/innovation-models/map

Testing environment

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

Suggested fix

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

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

Triage status Notes

Serious axe listitem WCAG 2.0 A <li> elements must be contained in a <ul> or <ol> (WCAG 1.3.1) 1/6846 pages · 9 instances Likely template

Bug ID: VS-e8f4f9e1
Pattern ID: VS-6175596b
Combined ID: VS-e8f4f9e1 (pattern VS-6175596b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: axe-core — <li> elements must be contained in a <ul> or <ol> [listitem]
Example URL: http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=291&proposed=N
XPath / selector: li:nth-child(198)
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

HTML snippet — use this to validate the finding without re-running the tool

<li>

Description

<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 13 of 6846 scanned pages (117 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=291&proposed=N.
Locate the element: li:nth-child(198)
Confirm the axe-core finding for rule listitem against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/MMS-Blueprint

Testing environment

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

Suggested fix

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

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

Triage status Notes

Serious axe valid-lang WCAG 2.0 AA lang attribute must have a valid value (WCAG 3.1.2) 1/6846 pages · 1 instances Likely content

Bug ID: VS-8f470a84
Pattern ID: VS-dd1c019f
Combined ID: VS-8f470a84 (pattern VS-dd1c019f) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 3.1.2 Language of Parts (Level AA, WCAG 2.0)
Rule: axe-core — lang attribute must have a valid value [valid-lang]
Example URL: https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings
XPath / selector: a[href$="#_ftnref1"] > span[lang="X-NONE"]
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

HTML snippet — use this to validate the finding without re-running the tool

<span lang="X-NONE">[1]</span>

Description

lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 6846 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings.
Locate the element: a[href$="#_ftnref1"] > span[lang="X-NONE"]
Confirm the axe-core finding for rule valid-lang against WCAG 3.1.2 Language of Parts.

Impact

Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings

Testing environment

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

Suggested fix

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

Triage status Notes

Serious axe accesskeys Best Practice accesskey attribute value should be unique (WCAG criterion undetermined) 8/6846 pages · 24 instances

Bug ID: VS-e45efc3a
Pattern ID: VS-bd13f00a
Combined ID: VS-e45efc3a (pattern VS-bd13f00a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — accesskey attribute value should be unique [accesskeys]
Example URL: https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0249.html
XPath / selector: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0248.html"]
History: first seen 2026-W25, last seen 2026-W32 (6 wk)

HTML snippet — use this to validate the finding without re-running the tool

<a accesskey="p" id="prev_page" href="P0248.html"><img src="bakpg.png" alt="Previous Page [Alt-p]" height="14" width="31" vspace="0" hspace="0" align="bottom" border="0"></a>

Description

accesskey attribute value should be unique. Detected by axe-core rule accesskeys on 8 of 6846 scanned pages (24 instances).

Steps to reproduce

Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0249.html.
Locate the element: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0248.html"]
Confirm the axe-core finding for rule accesskeys.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r4 WCAG 2.0 A Document has a valid lang attribute (WCAG 3.1.1) 17/6846 pages · 17 instances Likely template

Bug ID: VS-7927e1fb
Pattern ID: VS-7a0e5645
Combined ID: VS-7927e1fb (pattern VS-7a0e5645) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 3.1.1 Language of Page (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Document has a valid lang attribute [sia-r4]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html
XPath / selector: <html>
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 17 of 6846 scanned pages (17 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html.
Locate the element: <html>
Confirm the Siteimprove Alfa finding for rule sia-r4 against WCAG 3.1.1 Language of Page.

Impact

Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r64 WCAG 2.0 A Element has required owned roles (WCAG 1.3.1) 14/6846 pages · 14 instances Likely template

Bug ID: VS-bd73d1a9
Pattern ID: VS-3c632d31
Combined ID: VS-bd73d1a9 (pattern VS-3c632d31) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Element has required owned roles [sia-r64]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html
XPath / selector: <h1>
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 14 of 6846 scanned pages (14 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html.
Locate the element: <h1>
Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r2 WCAG 2.0 A Image has accessible name (WCAG 1.1.1) 12/6846 pages · 12 instances Likely template

Bug ID: VS-8da3d128
Pattern ID: VS-a24eaa8c
Combined ID: VS-8da3d128 (pattern VS-a24eaa8c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Image has accessible name [sia-r2]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html
XPath / selector: <img src="cms-site-logo.png">
History: first seen 2026-W24, last seen 2026-W32 (8 wk)

Description

Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 12 of 6846 scanned pages (12 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.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.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r57 Undetermined Scrolling content can be accessed by keyboard (WCAG criterion undetermined) 297/6846 pages · 298 instances Likely template

Bug ID: VS-492b05b2
Pattern ID: VS-c18be945
Combined ID: VS-492b05b2 (pattern VS-c18be945) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Scrolling content can be accessed by keyboard [sia-r57]
Example URL: http://www.cms.gov/medicare/regulations-guidance/legislation/economic-recovery-act-2009
XPath / selector: text: "Feedback"
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 297 of 6846 scanned pages (298 instances).

Steps to reproduce

Open http://www.cms.gov/medicare/regulations-guidance/legislation/economic-recovery-act-2009.
Locate the element: text: "Feedback"
Confirm the Siteimprove Alfa finding for rule sia-r57.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 297 pages (CSV).

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate axe region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 73/6846 pages · 1359 instances Likely template

Bug ID: VS-b1b50222
Pattern ID: VS-f18df681
Combined ID: VS-b1b50222 (pattern VS-f18df681) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — All page content should be contained by landmarks [region]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html
XPath / selector: .arrows > tbody > tr:nth-child(1)
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

HTML snippet — use this to validate the finding without re-running the tool

<tr>
		<td><img src="cms-site-logo.png"></td>
		<td style="text-align:center;"><h1>ICD-10-CM/PCS MS-DRG v38.0 R1 Definitions Manual</h1><h1></h1></td>
		<td></td>
		<td></td>
		<td></td>
	</tr>

Description

All page content should be contained by landmarks. Detected by axe-core rule region on 73 of 6846 scanned pages (1359 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html.
Locate the element: .arrows > tbody > tr:nth-child(1)
Confirm the axe-core finding for rule region.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 73 pages (CSV).

Testing environment

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

Suggested fix

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

Drupal 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.

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

Triage status Notes

Moderate axe landmark-one-main Best Practice Document should have one main landmark (WCAG criterion undetermined) 71/6846 pages · 71 instances Likely template

Bug ID: VS-994d8a02
Pattern ID: VS-d5d82446
Combined ID: VS-994d8a02 (pattern VS-d5d82446) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Document should have one main landmark [landmark-one-main]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html>

Description

Document should have one main landmark. Detected by axe-core rule landmark-one-main on 71 of 6846 scanned pages (71 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html.
Locate the element: html
Confirm the axe-core finding for rule landmark-one-main.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 71 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Minor axe empty-heading Best Practice Headings should not be empty (WCAG criterion undetermined) 59/6846 pages · 59 instances Likely template

Bug ID: VS-d6a1ce6c
Pattern ID: VS-0066c67d
Combined ID: VS-d6a1ce6c (pattern VS-0066c67d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Headings should not be empty [empty-heading]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html
XPath / selector: h1:nth-child(2)
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

HTML snippet — use this to validate the finding without re-running the tool

<h1></h1>

Description

Headings should not be empty. Detected by axe-core rule empty-heading on 59 of 6846 scanned pages (59 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html.
Locate the element: h1:nth-child(2)
Confirm the axe-core finding for rule empty-heading.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 59 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate axe page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 34/6846 pages · 34 instances Likely template

Bug ID: VS-d0b80e01
Pattern ID: VS-fa44f293
Combined ID: VS-d0b80e01 (pattern VS-fa44f293) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Page should contain a level-one heading [page-has-heading-one]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1230.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html>

Description

Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 34 of 6846 scanned pages (34 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1230.html.
Locate the element: html
Confirm the axe-core finding for rule page-has-heading-one.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 34 pages (CSV).

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 13/6846 pages · 15442 instances Likely template

Bug ID: VS-83124642
Pattern ID: VS-cb53cc4d
Combined ID: VS-83124642 (pattern VS-cb53cc4d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 2.5.5 Target Size (Enhanced) (Level AAA, WCAG 2.1)
Rule: Siteimprove Alfa — Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]
Example URL: http://www.cms.gov/medicare/regulations-guidance/legislation/economic-recovery-act-2009
XPath / selector: <a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 822 of 6846 scanned pages (29697 instances).

Steps to reproduce

Open http://www.cms.gov/medicare/regulations-guidance/legislation/economic-recovery-act-2009.
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).

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r73 WCAG 2.x AAA Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8) 13/6846 pages · 5384 instances Likely template

Bug ID: VS-dc3f5ce0
Pattern ID: VS-2208081b
Combined ID: VS-dc3f5ce0 (pattern VS-2208081b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has minimum contrast ratio of 4.5:1 [sia-r73]
Example URL: http://www.cms.gov/medicare/regulations-guidance/legislation/economic-recovery-act-2009
XPath / selector: <p class="ds-c-usa-banner__header-text">
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 820 of 6846 scanned pages (10353 instances).

Steps to reproduce

Open http://www.cms.gov/medicare/regulations-guidance/legislation/economic-recovery-act-2009.
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.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r61 Undetermined Form field label is visible (WCAG criterion undetermined) 12/6846 pages · 386 instances Likely template

Bug ID: VS-35890150
Pattern ID: VS-7118fead
Combined ID: VS-35890150 (pattern VS-7118fead) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field label is visible [sia-r61]
Example URL: http://www.cms.gov/medicare/regulations-guidance/legislation/economic-recovery-act-2009
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 804 of 6846 scanned pages (804 instances).

Steps to reproduce

Open http://www.cms.gov/medicare/regulations-guidance/legislation/economic-recovery-act-2009.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r61.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 10/6846 pages · 476 instances Likely template

Bug ID: VS-7fc8d4e2
Pattern ID: VS-04a9d28c
Combined ID: VS-7fc8d4e2 (pattern VS-04a9d28c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: deprecated-html — Presentational attribute (use CSS) [presentational-attr]
Example URL: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=52521&ver=55
XPath / selector: table
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

HTML snippet — use this to validate the finding without re-running the tool

<table style="width: 515.583px;" border="1" cellspacing="3" cellpadding="0">
<tbody>
<tr>
<td style="width: 81px; background: gray none repeat scroll 0% 0%; padding: 0.75pt;">
<p style="line-height: n

Description

Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 34 of 6846 scanned pages (1189 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=52521&ver=55.
Locate the element: table
Confirm the deprecated-html finding for rule presentational-attr.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

Not captured by automated scan — requires manual testing.

Triage status Notes

Moderate alfa sia-r78 Undetermined Table header has scope (WCAG criterion undetermined) 6/6846 pages · 50 instances Likely template

Bug ID: VS-a7e9d000
Pattern ID: VS-2cd767ca
Combined ID: VS-a7e9d000 (pattern VS-2cd767ca) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Table header has scope [sia-r78]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html
XPath / selector: <h1>
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 149 of 6846 scanned pages (208 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html.
Locate the element: <h1>
Confirm the Siteimprove Alfa finding for rule sia-r78.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r113 WCAG 2.2 AA Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8) 5/6846 pages · 47 instances Likely template

Bug ID: VS-11cc7348
Pattern ID: VS-179ad9b3
Combined ID: VS-11cc7348 (pattern VS-179ad9b3) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.2 AA
Obligation: required
Handling: review
WCAG SC: 2.5.8 Target Size (Minimum) (Level AA, WCAG 2.2)
Rule: Siteimprove Alfa — Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html
XPath / selector: <a href="http://www.hhs.gov">
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 121 of 6846 scanned pages (236 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html.
Locate the element: <a href="http://www.hhs.gov">
Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

Impact

Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%).

Limited manipulation/strength — 13.0% of population
Limited reach — 2.0% of population
Limited vision — 2.4% of population

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r75 Undetermined Form field error is identified and described (WCAG criterion undetermined) 5/6846 pages · 10 instances

Bug ID: VS-284cf53e
Pattern ID: VS-e43903a1
Combined ID: VS-284cf53e (pattern VS-e43903a1) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field error is identified and described [sia-r75]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0161.html
XPath / selector: <ul id="globar">
History: first seen 2026-W26, last seen 2026-W32 (7 wk)

Description

Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 5 of 6846 scanned pages (10 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0161.html.
Locate the element: <ul id="globar">
Confirm the Siteimprove Alfa finding for rule sia-r75.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r59 Undetermined Element with orientation is not locked (WCAG criterion undetermined) 5/6846 pages · 5 instances

Bug ID: VS-0fbdc6b2
Pattern ID: VS-7fbb8b20
Combined ID: VS-0fbdc6b2 (pattern VS-7fbb8b20) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Element with orientation is not locked [sia-r59]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0161.html
XPath / selector: {"type":"document","children":[{"type":"element","children":[{"type":"element","
History: first seen 2026-W26, last seen 2026-W32 (7 wk)

Description

Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 5 of 6846 scanned pages (5 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0161.html.
Locate the element: {"type":"document","children":[{"type":"element","children":[{"type":"element","
Confirm the Siteimprove Alfa finding for rule sia-r59.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate axe landmark-unique Best Practice Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined) 5/6846 pages · 5 instances

Bug ID: VS-326ec43c
Pattern ID: VS-8806389c
Combined ID: VS-326ec43c (pattern VS-8806389c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Landmarks should have a unique role or role/label/title (i.e. accessible name) c [landmark-unique]
Example URL: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/MMS-Blueprint
XPath / selector: .usa-nav
History: first seen 2026-W25, last seen 2026-W32 (8 wk)

HTML snippet — use this to validate the finding without re-running the tool

<nav class="usa-nav">

Description

Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 5 of 6846 scanned pages (5 instances).

Steps to reproduce

Open https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/MMS-Blueprint.
Locate the element: .usa-nav
Confirm the axe-core finding for rule landmark-unique.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 4/6846 pages · 44 instances Likely template

Bug ID: VS-95702c52
Pattern ID: VS-d25f622d
Combined ID: VS-95702c52 (pattern VS-d25f622d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Heading levels should only increase by one [heading-order]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37919&lcdStatus=all&sortBy=title
XPath / selector: #navStickyHeader
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

HTML snippet — use this to validate the finding without re-running the tool

<h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">Report Information</h3>

Description

Heading levels should only increase by one. Detected by axe-core rule heading-order on 272 of 6846 scanned pages (278 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37919&lcdStatus=all&sortBy=title.
Locate the element: #navStickyHeader
Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Drupal 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.

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

Triage status Notes

Moderate alfa sia-r45 WCAG 2.0 A aria-hidden element is not exposed to assistive technology (WCAG 1.3.1) 2/6846 pages · 138 instances · possible duplicate Likely content

Bug ID: VS-a4592ce0
Pattern ID: VS-9207ed51
Combined ID: VS-a4592ce0 (pattern VS-9207ed51) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — aria-hidden element is not exposed to assistive technology [sia-r45]
Example URL: https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=12&sort=asc
XPath / selector: @headers="view-field-dyna-transmittal-number-table-column"
History: first seen 2026-W26, last seen 2026-W32 (5 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-0aa01f63 (pattern VS-07ba3b17). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

aria-hidden element is not exposed to assistive technology. Detected by Siteimprove Alfa rule sia-r45 on 2 of 6846 scanned pages (138 instances).

Steps to reproduce

Open https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=12&sort=asc.
Locate the element: @headers="view-field-dyna-transmittal-number-table-column"
Confirm the Siteimprove Alfa finding for rule sia-r45 against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r68 WCAG 2.0 A Presentational children of an element are not focusable (WCAG 1.3.1) 2/6846 pages · 25 instances Likely template

Bug ID: VS-40687a31
Pattern ID: VS-d6097011
Combined ID: VS-40687a31 (pattern VS-d6097011) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Presentational children of an element are not focusable [sia-r68]
Example URL: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35007&lcdStatus=all&sortBy=title&ver=81
XPath / selector: <ul type="disc">
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 99 of 6846 scanned pages (310 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35007&lcdStatus=all&sortBy=title&ver=81.
Locate the element: <ul type="disc">
Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Minor axe aria-allowed-role Best Practice ARIA role should be appropriate for the element (WCAG criterion undetermined) 2/6846 pages · 2 instances Likely content

Bug ID: VS-e6a0b5f2
Pattern ID: VS-4fac2f41
Combined ID: VS-e6a0b5f2 (pattern VS-4fac2f41) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — ARIA role should be appropriate for the element [aria-allowed-role]
Example URL: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/MMS-Blueprint
XPath / selector: .usa-nav__primary
History: first seen 2026-W24, last seen 2026-W32 (6 wk)

HTML snippet — use this to validate the finding without re-running the tool

<ul class="usa-nav__primary usa-accordion" role="navigation">

Description

ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 2 of 6846 scanned pages (2 instances).

Steps to reproduce

Open https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/MMS-Blueprint.
Locate the element: .usa-nav__primary
Confirm the axe-core finding for rule aria-allowed-role.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

How to fix: Remove or change the ARIA role — it isn't allowed on this element type.

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

Triage status Notes

Moderate alfa sia-r80 WCAG 2.x AAA Scrollable element is keyboard accessible (WCAG 1.4.8) 1/6846 pages · 20 instances Likely template

Bug ID: VS-45d1a70a
Pattern ID: VS-388b5438
Combined ID: VS-45d1a70a (pattern VS-388b5438) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Scrollable element is keyboard accessible [sia-r80]
Example URL: http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39015&lcdStatus=all&sortBy=title&ver=16
XPath / selector: <p style="line-height: 14.3pt;">
History: first seen 2026-W25, last seen 2026-W32 (8 wk)

Description

Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 37 of 6846 scanned pages (493 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39015&lcdStatus=all&sortBy=title&ver=16.
Locate the element: <p style="line-height: 14.3pt;">
Confirm the Siteimprove Alfa finding for rule sia-r80 against WCAG 1.4.8 Visual Presentation.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/cms20033-reconsideration-request-form

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r53 Undetermined Headings are structured hierarchically (WCAG criterion undetermined) 1/6846 pages · 15 instances Likely template

Bug ID: VS-d8e88713
Pattern ID: VS-f054f4a4
Combined ID: VS-d8e88713 (pattern VS-f054f4a4) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Headings are structured hierarchically [sia-r53]
Example URL: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35007&lcdStatus=all&sortBy=title&ver=81
XPath / selector: <h3 id="h3DocumentInformationHeader" class="document-view-section-header">
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 366 of 6846 scanned pages (367 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35007&lcdStatus=all&sortBy=title&ver=81.
Locate the element: <h3 id="h3DocumentInformationHeader" class="document-view-section-header">
Confirm the Siteimprove Alfa finding for rule sia-r53.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/initiatives/medicare-prescription-drug-affordability/overview/medicare-drug-price-negotiation-program/pharmacy-dispensing-entity-resources

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r69 WCAG 2.0 AA Text has sufficient color contrast (Enhanced) (WCAG 1.4.3) 1/6846 pages · 9 instances

Bug ID: VS-0752f71c
Pattern ID: VS-f7e99f4b
Combined ID: VS-0752f71c (pattern VS-f7e99f4b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.3 Contrast (Minimum) (Level AA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has sufficient color contrast (Enhanced) [sia-r69]
Example URL: http://cms.gov/priorities/innovation/innovation-models/chart-model
XPath / selector: text: "State & Community-Based Models"
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 5 of 6846 scanned pages (43 instances).

Steps to reproduce

Open http://cms.gov/priorities/innovation/innovation-models/chart-model.
Locate the element: text: "State & Community-Based Models"
Confirm the Siteimprove Alfa finding for rule sia-r69 against WCAG 1.4.3 Contrast (Minimum).

Impact

Affects Limited vision (2.4%), Without color perception (4.5%).

Limited vision — 2.4% of population
Without color perception — 4.5% of population

Affected pages

/priorities/innovation/innovation-models/chart-model

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r11 WCAG 2.0 A Link has accessible name (WCAG 2.4.4) 1/6846 pages · 2 instances Likely content

Bug ID: VS-65ff71a0
Pattern ID: VS-28ebd979
Combined ID: VS-65ff71a0 (pattern VS-28ebd979) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.4 Link Purpose (In Context) (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Link has accessible name [sia-r11]
Example URL: https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
XPath / selector: <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">
History: first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 6846 scanned pages (2 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments.
Locate the element: <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">
Confirm the Siteimprove Alfa finding for rule sia-r11 against WCAG 2.4.4 Link Purpose (In Context).

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/medicare/quality/clinical-laboratory-improvement-amendments

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate axe landmark-no-duplicate-main Best Practice Document should not have more than one main landmark (WCAG criterion undetermined) 1/6846 pages · 1 instances Likely content

Bug ID: VS-4e669f32
Pattern ID: VS-cd69be3a
Combined ID: VS-4e669f32 (pattern VS-cd69be3a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Document should not have more than one main landmark [landmark-no-duplicate-main]
Example URL: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/EnrollmentResources/provider-resources/provider-enrolment/Med-Prov-Enroll-MLN9658742.html
XPath / selector: main
History: first seen 2026-W25, last seen 2026-W32 (3 wk)

HTML snippet — use this to validate the finding without re-running the tool

<main>

Description

Document should not have more than one main landmark. Detected by axe-core rule landmark-no-duplicate-main on 1 of 6846 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/EnrollmentResources/provider-resources/provider-enrolment/Med-Prov-Enroll-MLN9658742.html.
Locate the element: main
Confirm the axe-core finding for rule landmark-no-duplicate-main.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/EnrollmentResources/provider-resources/provider-enrolment/Med-Prov-Enroll-MLN9658742.html

Testing environment

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

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-no-duplicate-main?application=axeAPI

Triage status Notes

Moderate alfa sia-r8 WCAG 2.0 A Form field has accessible name (WCAG 4.1.2) 1/6846 pages · 1 instances · possible duplicate Likely content

Bug ID: VS-4aa85a1d
Pattern ID: VS-a48e6078
Combined ID: VS-4aa85a1d (pattern VS-a48e6078) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Form field has accessible name [sia-r8]
Example URL: http://www.cms.gov/priorities/innovation/innovation-models/map
XPath / selector: <select id="state-code-select" class="form-select ds-c-field">
History: first seen 2026-W25, last seen 2026-W32 (6 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-7f4423f1 (pattern VS-fab92378). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 1 of 6846 scanned pages (1 instances).

Steps to reproduce

Open http://www.cms.gov/priorities/innovation/innovation-models/map.
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.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

/priorities/innovation/innovation-models/map

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate axe landmark-main-is-top-level Best Practice Main landmark should not be contained in another landmark (WCAG criterion undetermined) 1/6846 pages · 1 instances Likely content

Bug ID: VS-59726dc1
Pattern ID: VS-ff3ceb19
Combined ID: VS-59726dc1 (pattern VS-ff3ceb19) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Main landmark should not be contained in another landmark [landmark-main-is-top-level]
Example URL: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/EnrollmentResources/provider-resources/provider-enrolment/Med-Prov-Enroll-MLN9658742.html
XPath / selector: #NAV_MAIN
History: first seen 2026-W25, last seen 2026-W32 (3 wk)

HTML snippet — use this to validate the finding without re-running the tool

<div id="NAV_MAIN" role="main">

Description

Main landmark should not be contained in another landmark. Detected by axe-core rule landmark-main-is-top-level on 1 of 6846 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/EnrollmentResources/provider-resources/provider-enrolment/Med-Prov-Enroll-MLN9658742.html.
Locate the element: #NAV_MAIN
Confirm the axe-core finding for rule landmark-main-is-top-level.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/EnrollmentResources/provider-resources/provider-enrolment/Med-Prov-Enroll-MLN9658742.html

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate axe meta-viewport WCAG 2.0 AA Zooming and scaling must not be disabled (WCAG 1.4.4) 1/6846 pages · 1 instances Likely content

Bug ID: VS-13cd516f
Pattern ID: VS-6c86a43a
Combined ID: VS-13cd516f (pattern VS-6c86a43a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.4 Resize Text (Level AA, WCAG 2.0)
Rule: axe-core — Zooming and scaling must not be disabled [meta-viewport]
Example URL: https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html
XPath / selector: meta[name="viewport"]
History: first seen 2026-W24, last seen 2026-W32 (6 wk)

HTML snippet — use this to validate the finding without re-running the tool

<meta name="viewport" content="width=device-width,initial-scale=1,user-scalable=no,shrink-to-fit=no,minimal-ui">

Description

Zooming and scaling must not be disabled. Detected by axe-core rule meta-viewport on 1 of 6846 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html.
Locate the element: meta[name="viewport"]
Confirm the axe-core finding for rule meta-viewport against WCAG 1.4.4 Resize Text.

Impact

Affects Limited vision (2.4%).

Limited vision — 2.4% of population

Affected pages

/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html

Testing environment

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

Suggested fix

How to fix: Don't disable zoom (user-scalable=no / maximum-scale=1); low-vision users need to zoom.

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

Triage status Notes

Deque axe-core findings

Rule-level axe-core summary (26 rule type(s))

Each failing rule links out to the axe-core documentation. For full element-level detail including HTML snippets and XPaths, see the bug reports above.

axe-core rules failing in 2026-W32, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Links must be distinguishable without relying on color [link-in-text-block]	serious	562	1186	/medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 562 pages (CSV)
<ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]	serious	317	1672	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 317 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	272	278	/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx	all 272 pages (CSV)
All page content should be contained by landmarks [region]	moderate	73	1359	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0249.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0526.html	all 73 pages (CSV)
<html> element must have a lang attribute [html-has-lang]	serious	71	71	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0249.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0526.html	all 71 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	71	71	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0249.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0526.html	all 71 pages (CSV)
Headings should not be empty [empty-heading]	minor	59	59	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0249.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0526.html	all 59 pages (CSV)
Images must have alternative text [image-alt]	critical	53	53	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0249.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0526.html	all 53 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	34	34	/icd10m/version33-fullcode-cms/fullcode_cms/P1230.html /medicaid-chip/community-engagement-support/eligibility-made-easy /priorities/key-initiatives/hospital-price-transparency/enforcement-actions	all 34 pages (CSV)
scope attribute should be used correctly [scope-attr-valid]	moderate	20	448	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/view/ncd.aspx	all 20 pages (CSV)
Elements must meet minimum color contrast ratio thresholds [color-contrast]	serious	19	238	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 19 pages (CSV)
Form elements must have labels [label]	critical	19	19	/icd10m/version33-fullcode-cms/fullcode_cms/P1230.html /icd10m/version33-fullcode-cms/fullcode_cms/P0436.html /icd10m/version33-fullcode-cms/fullcode_cms/P1549.html	all 19 pages (CSV)
<li> elements must be contained in a <ul> or <ol> [listitem]	serious	13	117	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/details/nca-decision-memo.aspx	all 13 pages (CSV)
Table header text should not be empty [empty-table-header]	minor	10	17	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/view/lcd.aspx	all 10 pages (CSV)
accesskey attribute value should be unique [accesskeys]	serious	8	24	/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0249.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0526.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0008.html	all 8 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	5	5	/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/MMS-Blueprint /priorities/innovation/innovation-models/map /about-cms/contact/newsroom	all 5 pages (CSV)
Links must have discernible text [link-name]	serious	3	7	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare/quality/clinical-laboratory-improvement-amendments /medicare/medicaid-coordination/about/resources-integrated-care	all 3 pages (CSV)
ARIA role should be appropriate for the element [aria-allowed-role]	minor	2	2	/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/MMS-Blueprint /Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html	all 2 pages (CSV)
Table cell headers attributes must refer to other <th> elements in the same table [td-headers-attr]	serious	2	2	/medicare/regulations-guidance/transmittals/2020-transmittals /medicare/regulations-guidance/transmittals/2022-transmittals	all 2 pages (CSV)
Scrollable region must have keyboard access [scrollable-region-focusable]	serious	1	1	/medicare-coverage-database/view/ncacal-decision-memo.aspx	all 1 pages (CSV)
lang attribute must have a valid value [valid-lang]	serious	1	1	/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings	all 1 pages (CSV)
Select element must have an accessible name [select-name]	critical	1	1	/priorities/innovation/innovation-models/map	all 1 pages (CSV)
Zooming and scaling must not be disabled [meta-viewport]	moderate	1	1	/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html	all 1 pages (CSV)
Main landmark should not be contained in another landmark [landmark-main-is-top-level]	moderate	1	1	/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/EnrollmentResources/provider-resources/provider-enrolment/Med-Prov-Enroll-MLN9658742.html	all 1 pages (CSV)
Document should not have more than one main landmark [landmark-no-duplicate-main]	moderate	1	1	/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/EnrollmentResources/provider-resources/provider-enrolment/Med-Prov-Enroll-MLN9658742.html	all 1 pages (CSV)
ARIA progressbar nodes must have an accessible name [aria-progressbar-name]	serious	1	1	/medicare-coverage-database/search-results.aspx	all 1 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (28 rule type(s))

Rule-level summary from Siteimprove Alfa (W3C ACT-based). Findings that overlap with axe-core on the same WCAG success criterion are noted as possible duplicates in the bug reports above.

Alfa rules failing in 2026-W32, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]	n/a	822	29697	/medicare/regulations-guidance/legislation/economic-recovery-act-2009 /medicare-coverage-database/view/lcd.aspx /regulations-and-guidance/guidance/transmittals/transmittals/r10281demo	all 822 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	820	10353	/medicare/regulations-guidance/legislation/economic-recovery-act-2009 /medicare-coverage-database/view/lcd.aspx /regulations-and-guidance/guidance/transmittals/transmittals/r10281demo	all 820 pages (CSV)
Form field label is visible [sia-r61]	n/a	804	804	/medicare/regulations-guidance/legislation/economic-recovery-act-2009 /medicare-coverage-database/view/lcd.aspx /regulations-and-guidance/guidance/transmittals/transmittals/r10281demo	all 804 pages (CSV)
Text has enhanced contrast [sia-r66]	n/a	386	2642	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 386 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	386	992	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 386 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	385	30519	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 385 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	366	367	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 366 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	297	298	/medicare/regulations-guidance/legislation/economic-recovery-act-2009 /regulations-and-guidance/guidance/transmittals/transmittals/r10281demo /outreach-and-education/outreach/partnerships/publications-partners/3-tips-help-someone-who-lost-medicaid-or-chip-coverage	all 297 pages (CSV)
Table header has scope [sia-r78]	n/a	149	208	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 149 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	121	236	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 121 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	99	310	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 99 pages (CSV)
Scrollable element is keyboard accessible [sia-r80]	n/a	37	493	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 37 pages (CSV)
Element has required aria-owns [sia-r46]	n/a	34	52	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 34 pages (CSV)
Document has a valid lang attribute [sia-r4]	n/a	17	17	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0526.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0134.html	all 17 pages (CSV)
iframe element is not empty [sia-r71]	n/a	14	78	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 14 pages (CSV)
Element has required owned roles [sia-r64]	n/a	14	14	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0526.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0134.html	all 14 pages (CSV)
Image has accessible name [sia-r2]	n/a	12	12	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0320.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0526.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0134.html	all 12 pages (CSV)
Text has sufficient color contrast (Enhanced) [sia-r69]	n/a	5	43	/priorities/innovation/innovation-models/chart-model /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 5 pages (CSV)
Form field error is identified and described [sia-r75]	n/a	5	10	/icd10m/version33-fullcode-cms/fullcode_cms/P0161.html /icd10m/version33-fullcode-cms/fullcode_cms/P0280.html /icd10m/version33-fullcode-cms/fullcode_cms/P0365.html	all 5 pages (CSV)
Element with orientation is not locked [sia-r59]	n/a	5	5	/icd10m/version33-fullcode-cms/fullcode_cms/P0161.html /icd10m/version33-fullcode-cms/fullcode_cms/P0280.html /icd10m/version33-fullcode-cms/fullcode_cms/P0365.html	all 5 pages (CSV)
Link in text block is visually distinguishable without color [sia-r62]	n/a	4	4	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 4 pages (CSV)
aria-hidden element is not exposed to assistive technology [sia-r45]	n/a	2	138	/medicare/regulations-guidance/transmittals/2020-transmittals /medicare/regulations-guidance/transmittals/2022-transmittals	all 2 pages (CSV)
Keyboard trap does not exist [sia-r85]	n/a	2	3	/medicare-coverage-database/details/nca-view-public-comments.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 2 pages (CSV)
No obsolete or deprecated elements are used [sia-r70]	n/a	2	2	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/lcd.aspx	all 2 pages (CSV)
Link has accessible name [sia-r11]	n/a	1	2	/medicare/quality/clinical-laboratory-improvement-amendments	all 1 pages (CSV)
Form field has accessible name [sia-r8]	n/a	1	1	/priorities/innovation/innovation-models/map	all 1 pages (CSV)
Duplicate role landmark is labeled [sia-r79]	n/a	1	1	/medicare-coverage-database/view/ncacal-decision-memo.aspx	all 1 pages (CSV)
Table cell has header [sia-r77]	n/a	1	1	/medicare-coverage-database/view/medcac-meeting.aspx	all 1 pages (CSV)

Unique accessibility issues (axe + Alfa consolidated)

axe and Alfa both implement W3C ACT rules, so the same issue is often caught by both. These are deduplicated by ACT rule and page, so a shared finding counts once (6412 raw engine findings → 6365 unique).

Unique issues (rule × page): 6365
Caught by both engines: 47 highest confidence
axe only: 1573
Alfa only: 4745

6 rule type(s) caught by both engines — highest confidence

Two independent ACT-rule implementations (Deque axe-core and Siteimprove Alfa) flagged the same issue on the same pages. Agreement between separate engines is strong evidence the barrier is real, not a single-tool false positive — the best place to start.

Rules flagged by both axe-core and Alfa in 2026-W32, by pages affected.
Issue	Pages	Rule references
<html> element must have a lang attribute	71	axe html-has-lang · Alfa sia-r4 · ACT b5c3f8
Headings should not be empty	59	axe empty-heading · Alfa sia-r64 · ACT ffd0e9
Images must have alternative text	53	axe image-alt · Alfa sia-r2 · ACT 23a2a8
Form elements must have labels	20	axe label · Alfa sia-r8 · ACT e086e5
Links must have discernible text	3	axe link-name · Alfa sia-r11 · ACT c487ae
Table cell headers attributes must refer to other <th> elements in the same table	2	axe td-headers-attr · Alfa sia-r45 · ACT a25f45