www.cms.gov: Accessibility — week 2026-W35

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	1511	4	Component inconsistency
2.5.5	WCAG 2.5.5	986	1
1.4.1	Use of Color	677	2
1.3.1	Info and Relationships (semantic structure)	653	10
1.4.6	WCAG 1.4.6	479	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 9 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 ~914 finding(s) on 914 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	914	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 ~263 finding(s) on 263 page(s). XPath / selector: `html` `<html>`	Serious	263	Without vision, Limited cognitive, language, or learning ability	Add a lang attribute to <html> (e.g. lang="en").	pages (CSV)	Decision Assigned to Notes
Document should have one main landmark · unattributed component Fix one place, resolve ~263 finding(s) on 263 page(s). XPath / selector: `html` `<html>`	Moderate	263	Requires manual testing.	Each page should have exactly one <main> landmark.	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~276 finding(s) on 276 page(s). XPath / selector: `text: "Feedback"`	Moderate	276	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
Images must have alternative text · unattributed component Fix one place, resolve ~231 finding(s) on 231 page(s). XPath / selector: `img[src$="cms-site-logo.png"]` `<img src="cms-site-logo.png">`	Critical	231	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 ~32 finding(s) on 32 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	32	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
Document has a valid lang attribute · unattributed component Fix one place, resolve ~72 finding(s) on 72 page(s). XPath / selector: `<html>`	Moderate	72	Without vision, Limited cognitive, language, or learning ability	Add a valid lang attribute to <html>.	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~478 finding(s) on 478 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	478	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~407 finding(s) on 407 page(s). XPath / selector: `<a href="#" data-bs-toggle="collapse" id="aCollapseNavigation" aria-label="Collapse Document Navigation">`	Moderate	407	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
Page should contain a level-one heading · unattributed component Fix one place, resolve ~41 finding(s) on 41 page(s). XPath / selector: `html` `<html>`	Moderate	41	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

Bug reports

13 issue type(s) are shown by default out of 39 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 3 critical, 7 serious, 26 moderate, 3 minor. By WCAG category: 14 WCAG 2.0 A, 2 WCAG 2.0 AA, 1 WCAG 2.2 AA, 3 WCAG 2.x AAA, 13 Best Practice, 6 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 13 prioritized issue type(s); 26 more are available if you switch to "Show everything".

1 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) 263/7026 pages · 263 instances Likely template

Bug ID: VS-2b2e1673
Pattern ID: VS-c126b6a6
Combined ID: VS-2b2e1673 (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: http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0019.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W35 (12 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 263 of 7026 scanned pages (263 instances).

Steps to reproduce

Open http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0019.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 263 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) 235/7026 pages · 243 instances Likely template

Bug ID: VS-d4120ac4
Pattern ID: VS-9074b4dd
Combined ID: VS-d4120ac4 (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: http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0019.html
XPath / selector: img[src$="cms-site-logo.png"]
History: first seen 2026-W24, last seen 2026-W35 (11 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 235 of 7026 scanned pages (243 instances).

Steps to reproduce

Open http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0019.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 235 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) 32/7026 pages · 32 instances Likely template

Bug ID: VS-d5065361
Pattern ID: VS-fafffee0
Combined ID: VS-d5065361 (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/P0027.html
XPath / selector: #q
History: first seen 2026-W26, last seen 2026-W35 (10 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 32 of 7026 scanned pages (32 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0027.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

…and more — all 32 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: 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 color-contrast WCAG 2.0 AA Elements must meet minimum color contrast ratio thresholds (WCAG 1.4.3) 6/7026 pages · 95 instances Likely template

Bug ID: VS-ceb56fcf
Pattern ID: VS-be8d563e
Combined ID: VS-ceb56fcf (pattern VS-be8d563e) — 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: axe-core — Elements must meet minimum color contrast ratio thresholds [color-contrast]
Example URL: https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=N&sortBy=status&status=all
XPath / selector: font > p:nth-child(1) > strong > em
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

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

<em>2. Non-Invasive Biomarker Tests </em>

Description

Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 41 of 7026 scanned pages (394 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=N&sortBy=status&status=all.
Locate the element: font > p:nth-child(1) > strong > em
Confirm the axe-core finding for rule color-contrast against WCAG 1.4.3 Contrast (Minimum).

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

How to fix: Increase the contrast between text and its background to at least 4.5:1 (3:1 for large text). Check both light and dark modes.

Drupal 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.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/color-contrast?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) 3/7026 pages · 3 instances

Bug ID: VS-a681180e
Pattern ID: VS-07ba3b17
Combined ID: VS-a681180e (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: http://www.cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_revision_date&page=5&sort=asc
XPath / selector: .MsoTableGrid
History: first seen 2026-W25, last seen 2026-W35 (11 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 3 of 7026 scanned pages (3 instances).

Steps to reproduce

Open http://www.cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_revision_date&page=5&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

Serious axe link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 2/7026 pages · 3 instances

Bug ID: VS-76a525a9
Pattern ID: VS-e9fe47ac
Combined ID: VS-76a525a9 (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://cms.gov/medicare/medicaid-coordination/about/dsnps
XPath / selector: a[data-entity-type="media"][data-entity-substitution="canonical"][data-once="linkMatch"]:nth-child(5)
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

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

<a data-entity-type="media" data-entity-uuid="c3d790c3-6ce7-4c9e-8624-03b88a3cb6ff" data-entity-substitution="canonical" href="/files/document/dsnpcoveragedecisionlettermemocy2024.pdf" data-once="link

Description

Links must have discernible text. Detected by axe-core rule link-name on 4 of 7026 scanned pages (6 instances).

Steps to reproduce

Open https://cms.gov/medicare/medicaid-coordination/about/dsnps.
Locate the element: a[data-entity-type="media"][data-entity-substitution="canonical"][data-once="linkMatch"]:nth-child(5)
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

Critical axe select-name WCAG 2.0 A Select element must have an accessible name (WCAG 4.1.2) 1/7026 pages · 1 instances Likely content

Bug ID: VS-121932d5
Pattern ID: VS-fab92378
Combined ID: VS-121932d5 (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: https://www.cms.gov/priorities/innovation/where-innovation-happening
XPath / selector: #state-code-select
History: first seen 2026-W26, last seen 2026-W35 (5 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 7026 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/priorities/innovation/where-innovation-happening.
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/where-innovation-happening

Testing environment

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

Suggested fix

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

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

Triage status Notes

Serious axe listitem WCAG 2.0 A <li> elements must be contained in a <ul> or <ol> (WCAG 1.3.1) 1/7026 pages · 23 instances Likely template

Bug ID: VS-0e838752
Pattern ID: VS-6175596b
Combined ID: VS-0e838752 (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: https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=N&sortBy=status&status=all
XPath / selector: tr[valign="top"]:nth-child(2) > td:nth-child(2) > li:nth-child(1)
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

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

<li> Adults 45 years or older
	  </li>

Description

<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 13 of 7026 scanned pages (293 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=N&sortBy=status&status=all.
Locate the element: tr[valign="top"]:nth-child(2) > td:nth-child(2) > li:nth-child(1)
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/TEP-Currently-Accepting-Nominations.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: <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) 1/7026 pages · 6 instances

Bug ID: VS-01e25ef8
Pattern ID: VS-dd1c019f
Combined ID: VS-01e25ef8 (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://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33609&lcdStatus=all&sortBy=title&stateRegion=all&ver=14
XPath / selector: li:nth-child(1) > span[lang="X-NONE"]
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

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

<span lang="X-NONE">

Description

lang attribute must have a valid value. Detected by axe-core rule valid-lang on 3 of 7026 scanned pages (19 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33609&lcdStatus=all&sortBy=title&stateRegion=all&ver=14.
Locate the element: li:nth-child(1) > 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) 83/7026 pages · 245 instances Likely template

Bug ID: VS-39c0aa14
Pattern ID: VS-bd13f00a
Combined ID: VS-39c0aa14 (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: http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0375.html
XPath / selector: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0374.html"]
History: first seen 2026-W25, last seen 2026-W35 (9 wk)

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

<a accesskey="p" id="prev_page" href="P0374.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 83 of 7026 scanned pages (245 instances).

Steps to reproduce

Open http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0375.html.
Locate the element: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0374.html"]
Confirm the axe-core finding for rule accesskeys.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 83 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/accesskeys?application=axeAPI

Triage status Notes

Moderate alfa sia-r4 WCAG 2.0 A Document has a valid lang attribute (WCAG 3.1.1) 72/7026 pages · 72 instances Likely template

Bug ID: VS-abfd1a61
Pattern ID: VS-7a0e5645
Combined ID: VS-abfd1a61 (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://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0645.html
XPath / selector: <html>
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

Description

Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 72 of 7026 scanned pages (72 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0645.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

…and more — all 72 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r64 WCAG 2.0 A Element has required owned roles (WCAG 1.3.1) 24/7026 pages · 62 instances Likely template

Bug ID: VS-43433388
Pattern ID: VS-3c632d31
Combined ID: VS-43433388 (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/FY2023-version40-fullcode-cms/fullcode_cms/P0321.html
XPath / selector: <h1>
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

Description

Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 65 of 7026 scanned pages (65 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0321.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) 24/7026 pages · 59 instances Likely template

Bug ID: VS-85777c99
Pattern ID: VS-a24eaa8c
Combined ID: VS-85777c99 (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/FY2023-version40-fullcode-cms/fullcode_cms/P0321.html
XPath / selector: <img src="cms-site-logo.png">
History: first seen 2026-W24, last seen 2026-W35 (11 wk)

Description

Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 61 of 7026 scanned pages (61 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0321.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) 277/7026 pages · 277 instances Likely template

Bug ID: VS-fcaa935d
Pattern ID: VS-c18be945
Combined ID: VS-fcaa935d (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: https://www.cms.gov/about-cms/information-systems/privacy/vulnerability-disclosure-policy
XPath / selector: text: "Feedback"
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 277 of 7026 scanned pages (277 instances).

Steps to reproduce

Open https://www.cms.gov/about-cms/information-systems/privacy/vulnerability-disclosure-policy.
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 277 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) 265/7026 pages · 6213 instances Likely template

Bug ID: VS-d5f023c2
Pattern ID: VS-f18df681
Combined ID: VS-d5f023c2 (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: http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0019.html
XPath / selector: .arrows > tbody > tr:nth-child(1)
History: first seen 2026-W24, last seen 2026-W35 (12 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 v37.0 Definitions Manual</h1><h1></h1></td>
		<td></td>
		<td></td>
		<td></td>
	</tr>

Description

All page content should be contained by landmarks. Detected by axe-core rule region on 265 of 7026 scanned pages (6213 instances).

Steps to reproduce

Open http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0019.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 265 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) 263/7026 pages · 263 instances Likely template

Bug ID: VS-3d085870
Pattern ID: VS-d5d82446
Combined ID: VS-3d085870 (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: http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0019.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W35 (12 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 263 of 7026 scanned pages (263 instances).

Steps to reproduce

Open http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0019.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 263 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

Moderate axe page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 41/7026 pages · 41 instances Likely template

Bug ID: VS-235e8e8d
Pattern ID: VS-fa44f293
Combined ID: VS-235e8e8d (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/P0027.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W35 (12 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 41 of 7026 scanned pages (41 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0027.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 41 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

Minor axe empty-heading Best Practice Headings should not be empty (WCAG criterion undetermined) 24/7026 pages · 240 instances Likely template

Bug ID: VS-0b7c0a0e
Pattern ID: VS-0066c67d
Combined ID: VS-0b7c0a0e (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: http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0019.html
XPath / selector: h1:nth-child(2)
History: first seen 2026-W24, last seen 2026-W35 (12 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 250 of 7026 scanned pages (250 instances).

Steps to reproduce

Open http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0019.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

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 alfa sia-r75 Undetermined Form field error is identified and described (WCAG criterion undetermined) 12/7026 pages · 24 instances Likely template

Bug ID: VS-652d1e83
Pattern ID: VS-e43903a1
Combined ID: VS-652d1e83 (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/P0645.html
XPath / selector: <ul id="globar">
History: first seen 2026-W26, last seen 2026-W35 (10 wk)

Description

Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 12 of 7026 scanned pages (24 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0645.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) 12/7026 pages · 12 instances Likely template

Bug ID: VS-1144c86b
Pattern ID: VS-7fbb8b20
Combined ID: VS-1144c86b (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/P0645.html
XPath / selector: {"type":"document","children":[{"type":"element","children":[{"type":"element","
History: first seen 2026-W26, last seen 2026-W35 (10 wk)

Description

Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 12 of 7026 scanned pages (12 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0645.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 alfa sia-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 11/7026 pages · 13850 instances Likely template

Bug ID: VS-5036b8be
Pattern ID: VS-cb53cc4d
Combined ID: VS-5036b8be (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://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36460&lcdStatus=all&sortBy=title&stateRegion=all&ver=25
XPath / selector: <a href="#h3IssueHeader" data-href="h3IssueHeader" class="nav-link toc-link no-link log-click" title="Jump to Issue">
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 986 of 7026 scanned pages (31477 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36460&lcdStatus=all&sortBy=title&stateRegion=all&ver=25.
Locate the element: <a href="#h3IssueHeader" data-href="h3IssueHeader" class="nav-link toc-link no-link log-click" title="Jump to Issue">
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) 11/7026 pages · 5001 instances Likely template

Bug ID: VS-a3e11cbf
Pattern ID: VS-2208081b
Combined ID: VS-a3e11cbf (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://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36460&lcdStatus=all&sortBy=title&stateRegion=all&ver=25
XPath / selector: <p class="usa-banner__header-text">
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 975 of 7026 scanned pages (11366 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36460&lcdStatus=all&sortBy=title&stateRegion=all&ver=25.
Locate the element: <p class="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 deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 11/7026 pages · 541 instances Likely template

Bug ID: VS-ebeb1896
Pattern ID: VS-04a9d28c
Combined ID: VS-ebeb1896 (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: http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52855&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=30
XPath / selector: table
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

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

<table id="table1" class="MsoTableGrid" style="border-collapse: collapse;" border="1" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="width: 49.05pt; border: 1.0pt solid windowtext; padding:

Description

Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 53 of 7026 scanned pages (1229 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52855&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=30.
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-r61 Undetermined Form field label is visible (WCAG criterion undetermined) 11/7026 pages · 402 instances Likely template

Bug ID: VS-e441d70d
Pattern ID: VS-7118fead
Combined ID: VS-e441d70d (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://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36460&lcdStatus=all&sortBy=title&stateRegion=all&ver=25
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 914 of 7026 scanned pages (914 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36460&lcdStatus=all&sortBy=title&stateRegion=all&ver=25.
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

Minor axe empty-table-header Best Practice Table header text should not be empty (WCAG criterion undetermined) 7/7026 pages · 16 instances Likely template

Bug ID: VS-0ca925cb
Pattern ID: VS-d69fc059
Combined ID: VS-0ca925cb (pattern VS-d69fc059) — 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 — Table header text should not be empty [empty-table-header]
Example URL: https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=N&sortBy=status&status=all
XPath / selector: div:nth-child(10) > .MsoTableGrid[border="1"] > tbody > tr[valign="top"]:nth-child(1) > th:nth-child(1)
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

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

<th valign="top"></th>

Description

Table header text should not be empty. Detected by axe-core rule empty-table-header on 28 of 7026 scanned pages (58 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=N&sortBy=status&status=all.
Locate the element: div:nth-child(10) > .MsoTableGrid[border="1"] > tbody > tr[valign="top"]:nth-child(1) > th:nth-child(1)
Confirm the axe-core finding for rule empty-table-header.

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/empty-table-header?application=axeAPI

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) 6/7026 pages · 159 instances Likely template

Bug ID: VS-7ae53b8a
Pattern ID: VS-179ad9b3
Combined ID: VS-7ae53b8a (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: http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57497&articleStatus=all&bc=3&sortBy=title&ver=14
XPath / selector: <a href="#h3HcpcsCodesHeader" data-href="h3HcpcsCodesHeader" class="nav-link toc-link no-link log-click" title="Jump to CPT/HCPCS Codes">
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 196 of 7026 scanned pages (663 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57497&articleStatus=all&bc=3&sortBy=title&ver=14.
Locate the element: <a href="#h3HcpcsCodesHeader" data-href="h3HcpcsCodesHeader" class="nav-link toc-link no-link log-click" title="Jump to CPT/HCPCS Codes">
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 axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 6/7026 pages · 93 instances Likely template

Bug ID: VS-636748a1
Pattern ID: VS-d25f622d
Combined ID: VS-636748a1 (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://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=34427&lcdStatus=all&sortBy=title
XPath / selector: #navStickyHeader
History: first seen 2026-W24, last seen 2026-W35 (12 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 384 of 7026 scanned pages (389 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=34427&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 axe scope-attr-valid Best Practice scope attribute should be used correctly (WCAG criterion undetermined) 4/7026 pages · 121 instances Likely template

Bug ID: VS-c9e6fe2e
Pattern ID: VS-0ba8ce9d
Combined ID: VS-c9e6fe2e (pattern VS-0ba8ce9d) — 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 — scope attribute should be used correctly [scope-attr-valid]
Example URL: https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1154.html
XPath / selector: th[scope="col width="]
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

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

<th scope="col width=" 10"="">&nbsp;</th>

Description

scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 42 of 7026 scanned pages (759 instances).

Steps to reproduce

Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1154.html.
Locate the element: th[scope="col width="]
Confirm the axe-core finding for rule scope-attr-valid.

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/scope-attr-valid?application=axeAPI

Triage status Notes

Moderate alfa sia-r78 Undetermined Table header has scope (WCAG criterion undetermined) 4/7026 pages · 51 instances Likely template

Bug ID: VS-4f662fa0
Pattern ID: VS-2cd767ca
Combined ID: VS-4f662fa0 (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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=37798&lcdStatus=all&sortBy=title&stateRegion=all
XPath / selector: <h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 251 of 7026 scanned pages (318 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=37798&lcdStatus=all&sortBy=title&stateRegion=all.
Locate the element: <h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">
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 axe landmark-unique Best Practice Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined) 3/7026 pages · 3 instances

Bug ID: VS-9623653a
Pattern ID: VS-8806389c
Combined ID: VS-9623653a (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/priorities/innovation/where-innovation-happening
XPath / selector: #non-state-table_wrapper > .dt-layout-row:nth-child(3) > .dt-layout-end.dt-layout-cell > .dt-paging > nav[aria-label="pagination"]
History: first seen 2026-W25, last seen 2026-W35 (11 wk)

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

<nav aria-label="pagination">

Description

Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 3 of 7026 scanned pages (3 instances).

Steps to reproduce

Open https://www.cms.gov/priorities/innovation/where-innovation-happening.
Locate the element: #non-state-table_wrapper > .dt-layout-row:nth-child(3) > .dt-layout-end.dt-layout-cell > .dt-paging > nav[aria-label="pagination"]
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 alfa sia-r68 WCAG 2.0 A Presentational children of an element are not focusable (WCAG 1.3.1) 2/7026 pages · 42 instances Likely template

Bug ID: VS-45a585ef
Pattern ID: VS-d6097011
Combined ID: VS-45a585ef (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://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34196&lcdStatus=all&sortBy=title&ver=30
XPath / selector: <ul>
History: first seen 2026-W24, last seen 2026-W35 (12 wk)

Description

Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 134 of 7026 scanned pages (523 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34196&lcdStatus=all&sortBy=title&ver=30.
Locate the element: <ul>
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

Moderate alfa sia-r11 WCAG 2.0 A Link has accessible name (WCAG 2.4.4) 2/7026 pages · 3 instances · possible duplicate

Bug ID: VS-e1c10ade
Pattern ID: VS-28ebd979
Combined ID: VS-e1c10ade (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://cms.gov/medicare/medicaid-coordination/about/dsnps
XPath / selector: <a data-entity-type="media" data-entity-uuid="c3d790c3-6ce7-4c9e-8624-03b88a3cb6ff" data-entity-substitution="canonical" href="/files/document/dsnpcoveragedecisionlettermemocy2024.pdf">
History: first seen 2026-W24, last seen 2026-W35 (10 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-76a525a9 (pattern VS-e9fe47ac). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 3 of 7026 scanned pages (5 instances).

Steps to reproduce

Open https://cms.gov/medicare/medicaid-coordination/about/dsnps.
Locate the element: <a data-entity-type="media" data-entity-uuid="c3d790c3-6ce7-4c9e-8624-03b88a3cb6ff" data-entity-substitution="canonical" href="/files/document/dsnpcoveragedecisionlettermemocy2024.pdf">
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

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 alfa sia-r45 WCAG 2.0 A aria-hidden element is not exposed to assistive technology (WCAG 1.3.1) 1/7026 pages · 149 instances Likely content

Bug ID: VS-49202c18
Pattern ID: VS-9207ed51
Combined ID: VS-49202c18 (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: http://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=0&sort=asc
XPath / selector: @headers="view-field-dyna-pe-number-table-column"
History: first seen 2026-W26, last seen 2026-W35 (7 wk)

Description

aria-hidden element is not exposed to assistive technology. Detected by Siteimprove Alfa rule sia-r45 on 1 of 7026 scanned pages (149 instances).

Steps to reproduce

Open http://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=0&sort=asc.
Locate the element: @headers="view-field-dyna-pe-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

/medicare/regulations-guidance/transmittals/2022-transmittals

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-r80 WCAG 2.x AAA Scrollable element is keyboard accessible (WCAG 1.4.8) 1/7026 pages · 17 instances Likely template

Bug ID: VS-612ab402
Pattern ID: VS-388b5438
Combined ID: VS-612ab402 (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: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37824&lcdStatus=all&sortBy=title&stateRegion=all&ver=18
XPath / selector: <p style="background: white; line-height: 14.4pt;">
History: first seen 2026-W25, last seen 2026-W35 (11 wk)

Description

Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 40 of 7026 scanned pages (434 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37824&lcdStatus=all&sortBy=title&stateRegion=all&ver=18.
Locate the element: <p style="background: white; line-height: 14.4pt;">
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

/sf5510-authorization-agreement-preauthorized-payments

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-r42 WCAG 2.0 A Element in required WAI-ARIA context role (WCAG 1.3.1) 1/7026 pages · 10 instances Likely content

Bug ID: VS-1cc8f861
Pattern ID: VS-0ddc2ac6
Combined ID: VS-1cc8f861 (pattern VS-0ddc2ac6) — 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 in required WAI-ARIA context role [sia-r42]
Example URL: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/TEP-Currently-Accepting-Nominations.html
XPath / selector: <li class="usa-nav__primary-item">
History: first seen 2026-W24, last seen 2026-W35 (6 wk)

Description

Element in required WAI-ARIA context role. Detected by Siteimprove Alfa rule sia-r42 on 1 of 7026 scanned pages (10 instances).

Steps to reproduce

Open https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/TEP-Currently-Accepting-Nominations.html.
Locate the element: <li class="usa-nav__primary-item">
Confirm the Siteimprove Alfa finding for rule sia-r42 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/TEP-Currently-Accepting-Nominations.html

Testing environment

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

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r42

Triage status Notes

Moderate axe landmark-banner-is-top-level Best Practice Banner landmark should not be contained in another landmark (WCAG criterion undetermined) 1/7026 pages · 1 instances Likely content

Bug ID: VS-eaf475f4
Pattern ID: VS-30db094d
Combined ID: VS-eaf475f4 (pattern VS-30db094d) — 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 — Banner landmark should not be contained in another landmark [landmark-banner-is-top-level]
Example URL: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient.html
XPath / selector: .Header
History: first seen 2026-W24, last seen 2026-W35 (9 wk)

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

<header class="Header" style="position: sticky;">

Description

Banner landmark should not be contained in another landmark. Detected by axe-core rule landmark-banner-is-top-level on 1 of 7026 scanned pages (1 instances).

Steps to reproduce

Open http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient.html.
Locate the element: .Header
Confirm the axe-core finding for rule landmark-banner-is-top-level.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient.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: Put the banner landmark (<header>) at the top level, not nested inside another landmark.

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

Triage status Notes

Moderate axe landmark-no-duplicate-main Best Practice Document should not have more than one main landmark (WCAG criterion undetermined) 1/7026 pages · 1 instances Likely content

Bug ID: VS-a1419a22
Pattern ID: VS-cd69be3a
Combined ID: VS-a1419a22 (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: http://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-W35 (4 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 7026 scanned pages (1 instances).

Steps to reproduce

Open http://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 axe landmark-main-is-top-level Best Practice Main landmark should not be contained in another landmark (WCAG criterion undetermined) 1/7026 pages · 1 instances Likely content

Bug ID: VS-84a491d1
Pattern ID: VS-ff3ceb19
Combined ID: VS-84a491d1 (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: http://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-W35 (4 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 7026 scanned pages (1 instances).

Steps to reproduce

Open http://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

Minor axe aria-allowed-role Best Practice ARIA role should be appropriate for the element (WCAG criterion undetermined) 1/7026 pages · 2 instances Likely content

Bug ID: VS-bb920fac
Pattern ID: VS-4fac2f41
Combined ID: VS-bb920fac (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/TEP-Currently-Accepting-Nominations.html
XPath / selector: .usa-nav > .usa-nav__inner > .usa-nav__primary.usa-accordion[role="navigation"]
History: first seen 2026-W24, last seen 2026-W35 (7 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 1 of 7026 scanned pages (2 instances).

Steps to reproduce

Open https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/TEP-Currently-Accepting-Nominations.html.
Locate the element: .usa-nav > .usa-nav__inner > .usa-nav__primary.usa-accordion[role="navigation"]
Confirm the axe-core finding for rule aria-allowed-role.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/TEP-Currently-Accepting-Nominations.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: 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

Deque axe-core findings

Rule-level axe-core summary (24 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-W35, 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	670	1623	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 670 pages (CSV)
<ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]	serious	390	2075	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 390 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	384	389	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx	all 384 pages (CSV)
All page content should be contained by landmarks [region]	moderate	265	6213	/icd10m/version37-fullcode-cms/fullcode_cms/P0019.html /icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0375.html /icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0027.html	all 265 pages (CSV)
<html> element must have a lang attribute [html-has-lang]	serious	263	263	/icd10m/version37-fullcode-cms/fullcode_cms/P0019.html /icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0375.html /icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0027.html	all 263 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	263	263	/icd10m/version37-fullcode-cms/fullcode_cms/P0019.html /icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0375.html /icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0027.html	all 263 pages (CSV)
Headings should not be empty [empty-heading]	minor	250	250	/icd10m/version37-fullcode-cms/fullcode_cms/P0019.html /icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0375.html /icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0027.html	all 250 pages (CSV)
Images must have alternative text [image-alt]	critical	235	243	/icd10m/version37-fullcode-cms/fullcode_cms/P0019.html /icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0375.html /icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0027.html	all 235 pages (CSV)
accesskey attribute value should be unique [accesskeys]	serious	83	245	/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0375.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1154.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0455.html	all 83 pages (CSV)
scope attribute should be used correctly [scope-attr-valid]	moderate	42	759	/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1154.html /medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/details/nca-decision-memo.aspx	all 42 pages (CSV)
Elements must meet minimum color contrast ratio thresholds [color-contrast]	serious	41	394	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 41 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	41	41	/icd10m/version33-fullcode-cms/fullcode_cms/P0027.html /icd10m/version33-fullcode-cms/fullcode_cms/P0291.html /icd10m/version33-fullcode-cms/fullcode_cms/P0460.html	all 41 pages (CSV)
Form elements must have labels [label]	critical	32	32	/icd10m/version33-fullcode-cms/fullcode_cms/P0027.html /icd10m/version33-fullcode-cms/fullcode_cms/P0291.html /icd10m/version33-fullcode-cms/fullcode_cms/P0460.html	all 32 pages (CSV)
Table header text should not be empty [empty-table-header]	minor	28	58	/medicare-coverage-database/view/ncacal-decision-memo.aspx /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1154.html /medicare-coverage-database/view/ncd.aspx	all 28 pages (CSV)
<li> elements must be contained in a <ul> or <ol> [listitem]	serious	13	293	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/details/nca-decision-memo.aspx	all 13 pages (CSV)
Links must have discernible text [link-name]	serious	4	6	/medicare/medicaid-coordination/about/dsnps /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare/quality/clinical-laboratory-improvement-amendments	all 4 pages (CSV)
lang attribute must have a valid value [valid-lang]	serious	3	19	/medicare-coverage-database/view/lcd.aspx /data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings /medicare-coverage-database/view/lcd.aspx	all 3 pages (CSV)
Table cell headers attributes must refer to other <th> elements in the same table [td-headers-attr]	serious	3	3	/medicare/regulations-guidance/transmittals/2020-transmittals /medicare/regulations-guidance/transmittals/2022-transmittals /medicare/regulations-guidance/transmittals/2022-transmittals	all 3 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	3	3	/priorities/innovation/where-innovation-happening /Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/TEP-Currently-Accepting-Nominations.html /Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/EnrollmentResources/provider-resources/provider-enrolment/Med-Prov-Enroll-MLN9658742.html	all 3 pages (CSV)
ARIA role should be appropriate for the element [aria-allowed-role]	minor	1	2	/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/TEP-Currently-Accepting-Nominations.html	all 1 pages (CSV)
Select element must have an accessible name [select-name]	critical	1	1	/priorities/innovation/where-innovation-happening	all 1 pages (CSV)
Banner landmark should not be contained in another landmark [landmark-banner-is-top-level]	moderate	1	1	/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient.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)

Siteimprove Alfa findings

Rule-level Alfa summary (29 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-W35, 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	986	31477	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx	all 986 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	975	11366	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx	all 975 pages (CSV)
Form field label is visible [sia-r61]	n/a	914	914	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx	all 914 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	483	38175	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx	all 483 pages (CSV)
Text has enhanced contrast [sia-r66]	n/a	479	3197	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx	all 479 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	478	1246	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx	all 478 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	424	426	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx	all 424 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	277	277	/about-cms/information-systems/privacy/vulnerability-disclosure-policy /data-research/computer-data-systems/minimum-data-sets-3.0-public-reports /newsroom/fact-sheets/calendar-year-2026-hospital-outpatient-prospective-payment-system-opps-ambulatory-surgical-center	all 277 pages (CSV)
Table header has scope [sia-r78]	n/a	251	318	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 251 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	196	663	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/article.aspx	all 196 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	134	523	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx	all 134 pages (CSV)
Document has a valid lang attribute [sia-r4]	n/a	72	72	/icd10m/version33-fullcode-cms/fullcode_cms/P0645.html /icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0321.html /icd10m/version39-fullcode-cms/fullcode_cms/P0143.html	all 72 pages (CSV)
Element has required owned roles [sia-r64]	n/a	65	65	/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0321.html /icd10m/version39-fullcode-cms/fullcode_cms/P0143.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0253.html	all 65 pages (CSV)
Image has accessible name [sia-r2]	n/a	61	61	/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0321.html /icd10m/version39-fullcode-cms/fullcode_cms/P0143.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0253.html	all 61 pages (CSV)
Scrollable element is keyboard accessible [sia-r80]	n/a	40	434	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 40 pages (CSV)
Element has required aria-owns [sia-r46]	n/a	39	64	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 39 pages (CSV)
iframe element is not empty [sia-r71]	n/a	13	129	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 13 pages (CSV)
Form field error is identified and described [sia-r75]	n/a	12	24	/icd10m/version33-fullcode-cms/fullcode_cms/P0645.html /icd10m/version33-fullcode-cms/fullcode_cms/P1782.html /icd10m/version33-fullcode-cms/fullcode_cms/P1085.html	all 12 pages (CSV)
Element with orientation is not locked [sia-r59]	n/a	12	12	/icd10m/version33-fullcode-cms/fullcode_cms/P0645.html /icd10m/version33-fullcode-cms/fullcode_cms/P1782.html /icd10m/version33-fullcode-cms/fullcode_cms/P1085.html	all 12 pages (CSV)
Duplicate role landmark is labeled [sia-r79]	n/a	10	10	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 10 pages (CSV)
Text has sufficient color contrast (Enhanced) [sia-r69]	n/a	8	32	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 8 pages (CSV)
Link in text block is visually distinguishable without color [sia-r62]	n/a	7	14	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 7 pages (CSV)
Table cell has header [sia-r77]	n/a	6	345	/medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 6 pages (CSV)
Keyboard trap does not exist [sia-r85]	n/a	4	18	/medicare-coverage-database/view/ncacal-public-comments.aspx /medicare-coverage-database/view/medcac-meeting.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 4 pages (CSV)
Link has accessible name [sia-r11]	n/a	3	5	/medicare/medicaid-coordination/about/dsnps /medicare/quality/clinical-laboratory-improvement-amendments /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 3 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)
aria-hidden element is not exposed to assistive technology [sia-r45]	n/a	1	149	/medicare/regulations-guidance/transmittals/2022-transmittals	all 1 pages (CSV)
Element in required WAI-ARIA context role [sia-r42]	n/a	1	10	/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/TEP-Currently-Accepting-Nominations.html	all 1 pages (CSV)
sia-r76	n/a	1	5	/medicare-coverage-database/view/ncacal-decision-memo.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 (8972 raw engine findings → 8770 unique).

Unique issues (rule × page): 8770
Caught by both engines: 202 highest confidence
axe only: 2816
Alfa only: 5752

5 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-W35, by pages affected.
Issue	Pages	Rule references
<html> element must have a lang attribute	263	axe html-has-lang · Alfa sia-r4 · ACT b5c3f8
Headings should not be empty	250	axe empty-heading · Alfa sia-r64 · ACT ffd0e9
Images must have alternative text	235	axe image-alt · Alfa sia-r2 · ACT 23a2a8
Links must have discernible text	4	axe link-name · Alfa sia-r11 · ACT c487ae
Table cell headers attributes must refer to other <th> elements in the same table	3	axe td-headers-attr · Alfa sia-r45 · ACT a25f45