www.cms.gov: Accessibility — week 2026-W37

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	1023	4	Component inconsistency
2.5.5	WCAG 2.5.5	688	1
1.3.1	Info and Relationships (semantic structure)	452	7
1.4.1	Use of Color	441	2
3.1.1	Language of Page	325	2

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-spinner: 100% of sampled rule findings

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 ~615 finding(s) on 615 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	615	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61	pages (CSV)	Decision Assigned to Notes
Images must have alternative text · unattributed component Fix one place, resolve ~235 finding(s) on 235 page(s). XPath / selector: `img[src$="cms-site-logo.png"]` `<img src="cms-site-logo.png">`	Critical	235	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
<html> element must have a lang attribute · unattributed component Fix one place, resolve ~253 finding(s) on 253 page(s). XPath / selector: `html` `<html>`	Serious	253	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 ~253 finding(s) on 253 page(s). XPath / selector: `html` `<html>`	Moderate	253	Requires manual testing.	Each page should have exactly one <main> landmark.	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
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~208 finding(s) on 208 page(s). XPath / selector: `text: "Feedback"`	Moderate	208	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
Image has accessible name · unattributed component Fix one place, resolve ~65 finding(s) on 65 page(s). XPath / selector: `<img src="cms-site-logo.png">`	Moderate	65	Without vision, Limited vision, Limited cognitive, language, or learning ability	Give every <img> an accessible name (alt text), or alt="" if purely decorative.	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~299 finding(s) on 299 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	299	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
Form elements must have labels · unattributed component Fix one place, resolve ~18 finding(s) on 18 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	18	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
Text has enhanced contrast · unattributed component Fix one place, resolve ~299 finding(s) on 299 page(s). XPath / selector: `text: "Here's how you know"`	Moderate	299	Requires manual testing.	Increase text contrast to meet WCAG AAA (7:1).	pages (CSV)	Decision Assigned to Notes

Bug reports

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

Overall severity mix: 2 critical, 6 serious, 27 moderate, 3 minor. By WCAG category: 11 WCAG 2.0 A, 6 WCAG 2.0 AA, 1 WCAG 2.2 AA, 2 WCAG 2.x AAA, 10 Best Practice, 8 Undetermined. Ordered by severity, key-page impact, WCAG level, and prevalence. Following accessibility bug-reporting best practices. Download: Markdown · JSON (full archive) · JSON (AI diagnostic) · CSV (all findings) · Priority pages CSV · Priority pages JSON.

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

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

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

Findings needing review

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

Serious axe html-has-lang WCAG 2.0 A <html> element must have a lang attribute (WCAG 3.1.1) 253/4636 pages · 253 instances Likely template

Bug ID: VS-4b84756b
Pattern ID: VS-c126b6a6
Combined ID: VS-4b84756b (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://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W37 (14 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 253 of 4636 scanned pages (253 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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 253 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) 235/4636 pages · 235 instances Likely template

Bug ID: VS-031872fa
Pattern ID: VS-9074b4dd
Combined ID: VS-031872fa (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://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
XPath / selector: img[src$="cms-site-logo.png"]
History: first seen 2026-W24, last seen 2026-W37 (13 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 4636 scanned pages (235 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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) 18/4636 pages · 18 instances Likely template

Bug ID: VS-2311d8f5
Pattern ID: VS-fafffee0
Combined ID: VS-2311d8f5 (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/P1203.html
XPath / selector: #q
History: first seen 2026-W26, last seen 2026-W37 (12 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 18 of 4636 scanned pages (18 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.html.
Locate the element: #q
Confirm the axe-core finding for rule label against WCAG 4.1.2 Name, Role, Value.

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

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

Drupal tip: Use Drupal's form element "Label" setting. In Webform, every element has a Label field — ensure it's not empty or hidden. Check that twig templates don't strip <label> elements from form fields.

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

Triage status Notes

Serious axe color-contrast WCAG 2.0 AA Elements must meet minimum color contrast ratio thresholds (WCAG 1.4.3) 9/4636 pages · 112 instances Likely template

Bug ID: VS-6772d6cb
Pattern ID: VS-be8d563e
Combined ID: VS-6772d6cb (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/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4
XPath / selector: font
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

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

<font color="FF0000">

Description

Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 31 of 4636 scanned pages (312 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4.
Locate the element: font
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 link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 3/4636 pages · 4 instances

Bug ID: VS-d1e7fd9e
Pattern ID: VS-e9fe47ac
Combined ID: VS-d1e7fd9e (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: http://www.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-W37 (14 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 3 of 4636 scanned pages (4 instances).

Steps to reproduce

Open http://www.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

Serious axe valid-lang WCAG 2.0 AA lang attribute must have a valid value (WCAG 3.1.2) 1/4636 pages · 1 instances Likely content

Bug ID: VS-8f470a84
Pattern ID: VS-dd1c019f
Combined ID: VS-8f470a84 (pattern VS-dd1c019f) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 3.1.2 Language of Parts (Level AA, WCAG 2.0)
Rule: axe-core — lang attribute must have a valid value [valid-lang]
Example URL: https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings
XPath / selector: a[href$="#_ftnref1"] > span[lang="X-NONE"]
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

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

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

Description

lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 4636 scanned pages (1 instances).

Steps to reproduce

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

Impact

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

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

Affected pages

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

Testing environment

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

Suggested fix

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

Triage status Notes

Serious axe 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) 1/4636 pages · 1 instances Likely content

Bug ID: VS-85bf0f09
Pattern ID: VS-07ba3b17
Combined ID: VS-85bf0f09 (pattern VS-07ba3b17) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: axe-core — Table cell headers attributes must refer to other <th> elements in the same tabl [td-headers-attr]
Example URL: https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&sort=desc
XPath / selector: .MsoTableGrid
History: first seen 2026-W25, last seen 2026-W37 (13 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 1 of 4636 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&sort=desc.
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

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

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 accesskeys Best Practice accesskey attribute value should be unique (WCAG criterion undetermined) 58/4636 pages · 172 instances Likely template

Bug ID: VS-c620910b
Pattern ID: VS-bd13f00a
Combined ID: VS-c620910b (pattern VS-bd13f00a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — accesskey attribute value should be unique [accesskeys]
Example URL: https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html
XPath / selector: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0187.html"]
History: first seen 2026-W25, last seen 2026-W37 (11 wk)

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

<a accesskey="p" id="prev_page" href="P0187.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 58 of 4636 scanned pages (172 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html.
Locate the element: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0187.html"]
Confirm the axe-core finding for rule accesskeys.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 58 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) 72/4636 pages · 72 instances Likely template

Bug ID: VS-5f58b846
Pattern ID: VS-7a0e5645
Combined ID: VS-5f58b846 (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: http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
XPath / selector: <html>
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 72 of 4636 scanned pages (72 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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) 66/4636 pages · 66 instances Likely template

Bug ID: VS-ff0ef49c
Pattern ID: VS-3c632d31
Combined ID: VS-ff0ef49c (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: http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
XPath / selector: <h1>
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 66 of 4636 scanned pages (66 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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

…and more — all 66 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-r64

Triage status Notes

Moderate alfa sia-r2 WCAG 2.0 A Image has accessible name (WCAG 1.1.1) 65/4636 pages · 65 instances Likely template

Bug ID: VS-46f31f8a
Pattern ID: VS-a24eaa8c
Combined ID: VS-46f31f8a (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: http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
XPath / selector: <img src="cms-site-logo.png">
History: first seen 2026-W24, last seen 2026-W37 (13 wk)

Description

Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 65 of 4636 scanned pages (65 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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

…and more — all 65 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: 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-r113 WCAG 2.2 AA Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8) 10/4636 pages · 266 instances Likely template

Bug ID: VS-2d06859a
Pattern ID: VS-179ad9b3
Combined ID: VS-2d06859a (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/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
XPath / selector: <a href="http://www.hhs.gov">
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 154 of 4636 scanned pages (664 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html.
Locate the element: <a href="http://www.hhs.gov">
Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate axe region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 253/4636 pages · 4069 instances Likely template

Bug ID: VS-8c392bc0
Pattern ID: VS-f18df681
Combined ID: VS-8c392bc0 (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://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
XPath / selector: .arrows > tbody > tr:nth-child(1)
History: first seen 2026-W24, last seen 2026-W37 (14 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 v36.0 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 253 of 4636 scanned pages (4069 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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 253 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) 253/4636 pages · 253 instances Likely template

Bug ID: VS-ce7b1b8f
Pattern ID: VS-d5d82446
Combined ID: VS-ce7b1b8f (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://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W37 (14 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 253 of 4636 scanned pages (253 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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 253 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Minor axe empty-heading Best Practice Headings should not be empty (WCAG criterion undetermined) 240/4636 pages · 240 instances Likely template

Bug ID: VS-f16c93ea
Pattern ID: VS-0066c67d
Combined ID: VS-f16c93ea (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://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
XPath / selector: h1:nth-child(2)
History: first seen 2026-W24, last seen 2026-W37 (14 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 240 of 4636 scanned pages (240 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html.
Locate the element: h1:nth-child(2)
Confirm the axe-core finding for rule empty-heading.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 240 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r57 Undetermined Scrolling content can be accessed by keyboard (WCAG criterion undetermined) 208/4636 pages · 210 instances Likely template

Bug ID: VS-abe7cb0f
Pattern ID: VS-c18be945
Combined ID: VS-abe7cb0f (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/medicare/regulations-guidance/transmittals/2023-transmittals?items_per_page=25&order=field_dyna_pe_number&page=1&sort=asc
XPath / selector: text: "Feedback"
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 208 of 4636 scanned pages (210 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2023-transmittals?items_per_page=25&order=field_dyna_pe_number&page=1&sort=asc.
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 208 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 page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 24/4636 pages · 24 instances Likely template

Bug ID: VS-fb5dfa13
Pattern ID: VS-fa44f293
Combined ID: VS-fb5dfa13 (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/P1203.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W37 (14 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 24 of 4636 scanned pages (24 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.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

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 16/4636 pages · 573 instances Likely template

Bug ID: VS-cceaa3f4
Pattern ID: VS-04a9d28c
Combined ID: VS-cceaa3f4 (pattern VS-04a9d28c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: deprecated-html — Presentational attribute (use CSS) [presentational-attr]
Example URL: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60274&ver=6
XPath / selector: table
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

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

<table style="border-collapse: collapse; border: none; height: 2197px;" border="1" width="591" cellspacing="0" cellpadding="0">
<tbody>
<tr style="height: 74px;">
<td style="width: 183.922px; border:

Description

Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 39 of 4636 scanned pages (895 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60274&ver=6.
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-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 14/4636 pages · 13027 instances Likely template

Bug ID: VS-4c909178
Pattern ID: VS-cb53cc4d
Combined ID: VS-4c909178 (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: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
XPath / selector: <a href="https://www.cms.gov" rel="noopener noreferrer" title="CMS.gov Centers for Medicare & Medicaid Services">
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 688 of 4636 scanned pages (23263 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
Locate the element: <a href="https://www.cms.gov" rel="noopener noreferrer" title="CMS.gov Centers for Medicare & Medicaid Services">
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) 14/4636 pages · 4467 instances Likely template

Bug ID: VS-d0cb1fc7
Pattern ID: VS-2208081b
Combined ID: VS-d0cb1fc7 (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: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
XPath / selector: <p class="usa-banner__header-text">
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 672 of 4636 scanned pages (7976 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
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 alfa sia-r61 Undetermined Form field label is visible (WCAG criterion undetermined) 13/4636 pages · 320 instances Likely template

Bug ID: VS-38116294
Pattern ID: VS-7118fead
Combined ID: VS-38116294 (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: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 615 of 4636 scanned pages (615 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r61.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r78 Undetermined Table header has scope (WCAG criterion undetermined) 8/4636 pages · 69 instances Likely template

Bug ID: VS-f670d905
Pattern ID: VS-2cd767ca
Combined ID: VS-f670d905 (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=33573&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-W37 (14 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 183 of 4636 scanned pages (217 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&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 heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 7/4636 pages · 83 instances Likely template

Bug ID: VS-f282b7bf
Pattern ID: VS-d25f622d
Combined ID: VS-f282b7bf (pattern VS-d25f622d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Heading levels should only increase by one [heading-order]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39810&lcdStatus=all&sortBy=title&stateRegion=all
XPath / selector: #navStickyHeader
History: first seen 2026-W24, last seen 2026-W37 (14 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 287 of 4636 scanned pages (295 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39810&lcdStatus=all&sortBy=title&stateRegion=all.
Locate the element: #navStickyHeader
Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Drupal tip: Drupal Views and blocks can insert headings at arbitrary levels. In the Views UI, set "Title tag" for each display. For block titles, configure the heading level in the block's layout settings.

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

Triage status Notes

Moderate alfa sia-r75 Undetermined Form field error is identified and described (WCAG criterion undetermined) 7/4636 pages · 14 instances

Bug ID: VS-0abc2dd7
Pattern ID: VS-e43903a1
Combined ID: VS-0abc2dd7 (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/P0599.html
XPath / selector: <ul id="globar">
History: first seen 2026-W26, last seen 2026-W37 (11 wk)

Description

Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 7 of 4636 scanned pages (14 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0599.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) 7/4636 pages · 7 instances

Bug ID: VS-c34275a2
Pattern ID: VS-7fbb8b20
Combined ID: VS-c34275a2 (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/P0599.html
XPath / selector: {"type":"document","children":[{"type":"element","children":[{"type":"element","
History: first seen 2026-W26, last seen 2026-W37 (11 wk)

Description

Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 7 of 4636 scanned pages (7 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0599.html.
Locate the element: {"type":"document","children":[{"type":"element","children":[{"type":"element","
Confirm the Siteimprove Alfa finding for rule sia-r59.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate axe landmark-unique Best Practice Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined) 2/4636 pages · 2 instances Likely content

Bug ID: VS-a60d40b4
Pattern ID: VS-8806389c
Combined ID: VS-a60d40b4 (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: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-07-03-2.html
XPath / selector: .views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)
History: first seen 2026-W25, last seen 2026-W37 (13 wk)

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

<span class="views-field views-field-field-topic" role="region" aria-label="Related search topics">
<a href="/newsroom/search?about[]=33506&amp;keys= " data-once="linkMatch">Administration</a>
</span>

Description

Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 2 of 4636 scanned pages (2 instances).

Steps to reproduce

Open http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-07-03-2.html.
Locate the element: .views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)
Confirm the axe-core finding for rule landmark-unique.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate axe meta-viewport WCAG 2.0 AA Zooming and scaling must not be disabled (WCAG 1.4.4) 2/4636 pages · 2 instances Likely content

Bug ID: VS-892e36bd
Pattern ID: VS-6c86a43a
Combined ID: VS-892e36bd (pattern VS-6c86a43a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.4 Resize Text (Level AA, WCAG 2.0)
Rule: axe-core — Zooming and scaling must not be disabled [meta-viewport]
Example URL: http://cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html
XPath / selector: meta[name="viewport"]
History: first seen 2026-W24, last seen 2026-W37 (7 wk)

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

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

Description

Zooming and scaling must not be disabled. Detected by axe-core rule meta-viewport on 2 of 4636 scanned pages (2 instances).

Steps to reproduce

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

Impact

Affects Limited vision (2.4%).

Limited vision — 2.4% of population

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Minor axe empty-table-header Best Practice Table header text should not be empty (WCAG criterion undetermined) 2/4636 pages · 5 instances Likely template

Bug ID: VS-7e400642
Pattern ID: VS-d69fc059
Combined ID: VS-7e400642 (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?fromTracking=Y&ncaid=218&proposed=N
XPath / selector: table[border="1"]:nth-child(99) > tbody > tr:nth-child(1) > th:nth-child(1)
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

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

<th valign="top" scope="col">&nbsp;</th>

Description

Table header text should not be empty. Detected by axe-core rule empty-table-header on 22 of 4636 scanned pages (58 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=218&proposed=N.
Locate the element: table[border="1"]:nth-child(99) > tbody > tr: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

Minor axe aria-allowed-role Best Practice ARIA role should be appropriate for the element (WCAG criterion undetermined) 2/4636 pages · 2 instances Likely content

Bug ID: VS-8ff1e81c
Pattern ID: VS-4fac2f41
Combined ID: VS-8ff1e81c (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: http://cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html
XPath / selector: body
History: first seen 2026-W24, last seen 2026-W37 (8 wk)

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

<body style="background: #072137" class="cs-HTML theme-unified view-desktop is-landscape ff-on ff-drop-in-base ff-multiple-quiz-tracking ff-player-size-option sidebar-left zoom-mode timeline-playing n

Description

ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 2 of 4636 scanned pages (2 instances).

Steps to reproduce

Open http://cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html.
Locate the element: body
Confirm the axe-core finding for rule aria-allowed-role.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate axe scope-attr-valid Best Practice scope attribute should be used correctly (WCAG criterion undetermined) 1/4636 pages · 47 instances Likely template

Bug ID: VS-a55634bd
Pattern ID: VS-0ba8ce9d
Combined ID: VS-a55634bd (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://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4
XPath / selector: td[width="25%"][scope="row"]
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

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

<td width="25%" scope="row"> <a name="ac" id="ac"></a>Air Cleaners</td>

Description

scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 34 of 4636 scanned pages (1171 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4.
Locate the element: td[width="25%"][scope="row"]
Confirm the axe-core finding for rule scope-attr-valid.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1198.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/scope-attr-valid?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) 1/4636 pages · 9 instances Likely template

Bug ID: VS-796cd800
Pattern ID: VS-d6097011
Combined ID: VS-796cd800 (pattern VS-d6097011) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Presentational children of an element are not focusable [sia-r68]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
XPath / selector: <tfoot>
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 94 of 4636 scanned pages (215 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
Locate the element: <tfoot>
Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

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

/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0251.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-r68

Triage status Notes

Moderate alfa sia-r69 WCAG 2.0 AA Text has sufficient color contrast (Enhanced) (WCAG 1.4.3) 1/4636 pages · 5 instances

Bug ID: VS-9c1c85b1
Pattern ID: VS-f7e99f4b
Combined ID: VS-9c1c85b1 (pattern VS-f7e99f4b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.3 Contrast (Minimum) (Level AA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has sufficient color contrast (Enhanced) [sia-r69]
Example URL: http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
XPath / selector: text: "Situation"
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 4 of 4636 scanned pages (19 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52.
Locate the element: text: "Situation"
Confirm the Siteimprove Alfa finding for rule sia-r69 against WCAG 1.4.3 Contrast (Minimum).

Impact

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

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

Affected pages

/medical-bill-rights/help/submit-a-complaint/get-started

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r62 WCAG 2.0 A Link in text block is visually distinguishable without color (WCAG 1.4.1) 1/4636 pages · 2 instances

Bug ID: VS-79a863b0
Pattern ID: VS-efd91fdd
Combined ID: VS-79a863b0 (pattern VS-efd91fdd) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.4.1 Use of Color (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Link in text block is visually distinguishable without color [sia-r62]
Example URL: https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56973&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=63
XPath / selector: <a href="#" data-bs-toggle="modal" data-bs-target="#MCDNoticeBoadModal" id="aBoardItemLink_33">
History: first seen 2026-W24, last seen 2026-W37 (13 wk)

Description

Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 7 of 4636 scanned pages (13 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56973&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=63.
Locate the element: <a href="#" data-bs-toggle="modal" data-bs-target="#MCDNoticeBoadModal" id="aBoardItemLink_33">
Confirm the Siteimprove Alfa finding for rule sia-r62 against WCAG 1.4.1 Use of Color.

Impact

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

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

Affected pages

/newsroom/press-contacts

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r20 Undetermined aria attribute is defined in WAI-ARIA (WCAG criterion undetermined) 1/4636 pages · 1 instances Likely content

Bug ID: VS-deaceced
Pattern ID: VS-7f897be7
Combined ID: VS-deaceced (pattern VS-7f897be7) — 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 — aria attribute is defined in WAI-ARIA [sia-r20]
Example URL: https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html
XPath / selector: @aria-role="scrollbar"
History: first seen 2026-W26, last seen 2026-W37 (3 wk)

Description

aria attribute is defined in WAI-ARIA. Detected by Siteimprove Alfa rule sia-r20 on 1 of 4636 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html.
Locate the element: @aria-role="scrollbar"
Confirm the Siteimprove Alfa finding for rule sia-r20.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.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-r20

Triage status Notes

Moderate alfa sia-r7 WCAG 2.0 AA Element with lang attribute has correct language (WCAG 3.1.2) 1/4636 pages · 1 instances · possible duplicate Likely content

Bug ID: VS-765760a0
Pattern ID: VS-400f3a18
Combined ID: VS-765760a0 (pattern VS-400f3a18) — 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: Siteimprove Alfa — Element with lang attribute has correct language [sia-r7]
Example URL: https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings
XPath / selector: @lang="X-NONE"
History: first seen 2026-W26, last seen 2026-W37 (6 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-8f470a84 (pattern VS-dd1c019f). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Element with lang attribute has correct language. Detected by Siteimprove Alfa rule sia-r7 on 1 of 4636 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings.
Locate the element: @lang="X-NONE"
Confirm the Siteimprove Alfa finding for rule sia-r7 against WCAG 3.1.2 Language of Parts.

Impact

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

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

Affected pages

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

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r87 Undetermined First focusable element is link to main content (WCAG criterion undetermined) 1/4636 pages · 1 instances Likely content

Bug ID: VS-d976eafa
Pattern ID: VS-aa242c2d
Combined ID: VS-d976eafa (pattern VS-aa242c2d) — 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 — First focusable element is link to main content [sia-r87]
Example URL: https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W25, last seen 2026-W37 (9 wk)

Description

First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 1 of 4636 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r87.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.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-r87

Triage status Notes

Moderate alfa sia-r11 WCAG 2.0 A Link has accessible name (WCAG 2.4.4) 1/4636 pages · 1 instances Likely content

Bug ID: VS-66f1c424
Pattern ID: VS-28ebd979
Combined ID: VS-66f1c424 (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: http://www.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-W37 (12 wk)

Description

Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 4636 scanned pages (1 instances).

Steps to reproduce

Open http://www.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

/medicare/medicaid-coordination/about/dsnps

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-r47 WCAG 2.0 AA Text is not too small to read (WCAG 1.4.4) 1/4636 pages · 1 instances · possible duplicate Likely content

Bug ID: VS-cb4f0373
Pattern ID: VS-3a9437f7
Combined ID: VS-cb4f0373 (pattern VS-3a9437f7) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.4 Resize Text (Level AA, WCAG 2.0)
Rule: Siteimprove Alfa — Text is not too small to read [sia-r47]
Example URL: https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html
XPath / selector: <meta name="viewport" content="width=device-width,initial-scale=1,user-scalable=no,shrink-to-fit=no,minimal-ui">
History: first seen 2026-W26, last seen 2026-W37 (3 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-892e36bd (pattern VS-6c86a43a). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Text is not too small to read. Detected by Siteimprove Alfa rule sia-r47 on 1 of 4636 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html.
Locate the element: <meta name="viewport" content="width=device-width,initial-scale=1,user-scalable=no,shrink-to-fit=no,minimal-ui">
Confirm the Siteimprove Alfa finding for rule sia-r47 against WCAG 1.4.4 Resize Text.

Impact

Affects Limited vision (2.4%).

Limited vision — 2.4% of population

Affected pages

/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.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-r47

Triage status Notes

Deque axe-core findings

Rule-level axe-core summary (23 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-W37, 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	434	962	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 434 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	287	295	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx	all 287 pages (CSV)
<ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]	serious	256	970	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 256 pages (CSV)
All page content should be contained by landmarks [region]	moderate	253	4069	/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html /icd10m/version33-fullcode-cms/fullcode_cms/P1203.html	all 253 pages (CSV)
<html> element must have a lang attribute [html-has-lang]	serious	253	253	/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html /icd10m/version33-fullcode-cms/fullcode_cms/P1203.html	all 253 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	253	253	/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html /icd10m/version33-fullcode-cms/fullcode_cms/P1203.html	all 253 pages (CSV)
Headings should not be empty [empty-heading]	minor	240	240	/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html	all 240 pages (CSV)
Images must have alternative text [image-alt]	critical	235	235	/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html	all 235 pages (CSV)
accesskey attribute value should be unique [accesskeys]	serious	58	172	/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0136.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0148.html	all 58 pages (CSV)
scope attribute should be used correctly [scope-attr-valid]	moderate	34	1171	/medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 34 pages (CSV)
Elements must meet minimum color contrast ratio thresholds [color-contrast]	serious	31	312	/medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 31 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	24	24	/icd10m/version33-fullcode-cms/fullcode_cms/P1203.html /icd10m/version33-fullcode-cms/fullcode_cms/P1876.html /icd10m/version33-fullcode-cms/fullcode_cms/P1313.html	all 24 pages (CSV)
Table header text should not be empty [empty-table-header]	minor	22	58	/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 22 pages (CSV)
Form elements must have labels [label]	critical	18	18	/icd10m/version33-fullcode-cms/fullcode_cms/P1203.html /icd10m/version33-fullcode-cms/fullcode_cms/P1876.html /icd10m/version33-fullcode-cms/fullcode_cms/P1313.html	all 18 pages (CSV)
<li> elements must be contained in a <ul> or <ol> [listitem]	serious	8	63	/medicare-coverage-database/view/ncacal-tracking-sheet.aspx /medicare-coverage-database/view/medcac-meeting.aspx /medicare-coverage-database/details/nca-decision-memo.aspx	all 8 pages (CSV)
Links must have discernible text [link-name]	serious	3	4	/medicare/medicaid-coordination/about/dsnps /newsroom/press-releases/trump-administration-finalizes-transformative-medicare-payment-changes-support-innovation-kidney /medicare/quality/clinical-laboratory-improvement-amendments	all 3 pages (CSV)
ARIA role should be appropriate for the element [aria-allowed-role]	minor	2	2	/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html /Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html	all 2 pages (CSV)
Zooming and scaling must not be disabled [meta-viewport]	moderate	2	2	/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html /Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html	all 2 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	2	2	/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-07-03-2.html /about-cms/contact/newsroom	all 2 pages (CSV)
Scrollable region must have keyboard access [scrollable-region-focusable]	serious	2	2	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 2 pages (CSV)
Table cell headers attributes must refer to other <th> elements in the same table [td-headers-attr]	serious	1	1	/medicare/regulations-guidance/transmittals/2022-transmittals	all 1 pages (CSV)
ARIA progressbar nodes must have an accessible name [aria-progressbar-name]	serious	1	1	/medicare-coverage-database/search-results.aspx	all 1 pages (CSV)
lang attribute must have a valid value [valid-lang]	serious	1	1	/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings	all 1 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (30 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-W37, 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	688	23263	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 688 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	672	7976	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 672 pages (CSV)
Form field label is visible [sia-r61]	n/a	615	615	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 615 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	300	21057	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 300 pages (CSV)
Text has enhanced contrast [sia-r66]	n/a	300	1792	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 300 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	299	781	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 299 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	279	281	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 279 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	208	210	/medicare/regulations-guidance/transmittals/2023-transmittals /priorities/innovation-center/value-based-care-spotlight/patient-provider-voices/whole-person-care-stories/improving-health-access-care-rural-areas-one-pennsylvania-couples-story /about-cms/contact/directory/aging-center/1560246	all 208 pages (CSV)
Table header has scope [sia-r78]	n/a	183	217	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /icd10m/version36-fullcode-cms/fullcode_cms/P0362.html /medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx	all 183 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	154	664	/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 154 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	94	215	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/view/nca.aspx /medicare-coverage-database/view/article.aspx	all 94 pages (CSV)
Document has a valid lang attribute [sia-r4]	n/a	72	72	/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html /icd10m/version39-fullcode-cms/fullcode_cms/P0712.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html	all 72 pages (CSV)
Element has required owned roles [sia-r64]	n/a	66	66	/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html /icd10m/version39-fullcode-cms/fullcode_cms/P0712.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html	all 66 pages (CSV)
Image has accessible name [sia-r2]	n/a	65	65	/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html /icd10m/version39-fullcode-cms/fullcode_cms/P0712.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html	all 65 pages (CSV)
Scrollable element is keyboard accessible [sia-r80]	n/a	32	400	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 32 pages (CSV)
Element has required aria-owns [sia-r46]	n/a	23	36	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 23 pages (CSV)
iframe element is not empty [sia-r71]	n/a	19	227	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 19 pages (CSV)
Form field error is identified and described [sia-r75]	n/a	7	14	/icd10m/version33-fullcode-cms/fullcode_cms/P0599.html /icd10m/version33-fullcode-cms/fullcode_cms/P0598.html /icd10m/version33-fullcode-cms/fullcode_cms/P1189.html	all 7 pages (CSV)
Link in text block is visually distinguishable without color [sia-r62]	n/a	7	13	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 7 pages (CSV)
Element with orientation is not locked [sia-r59]	n/a	7	7	/icd10m/version33-fullcode-cms/fullcode_cms/P0599.html /icd10m/version33-fullcode-cms/fullcode_cms/P0598.html /icd10m/version33-fullcode-cms/fullcode_cms/P1189.html	all 7 pages (CSV)
Table cell has header [sia-r77]	n/a	4	146	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/ncd.aspx	all 4 pages (CSV)
Text has sufficient color contrast (Enhanced) [sia-r69]	n/a	4	19	/medicare-coverage-database/view/lcd.aspx /medical-bill-rights/help/submit-a-complaint/get-started /medicare-coverage-database/view/lcd.aspx	all 4 pages (CSV)
Keyboard trap does not exist [sia-r85]	n/a	4	12	/medicare-coverage-database/view/ncacal-public-comments.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-public-comments.aspx	all 4 pages (CSV)
Duplicate role landmark is labeled [sia-r79]	n/a	3	3	/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 3 pages (CSV)
No obsolete or deprecated elements are used [sia-r70]	n/a	3	3	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/ncd.aspx	all 3 pages (CSV)
Link has accessible name [sia-r11]	n/a	1	1	/medicare/medicaid-coordination/about/dsnps	all 1 pages (CSV)
Element with lang attribute has correct language [sia-r7]	n/a	1	1	/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings	all 1 pages (CSV)
aria attribute is defined in WAI-ARIA [sia-r20]	n/a	1	1	/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html	all 1 pages (CSV)
Text is not too small to read [sia-r47]	n/a	1	1	/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html	all 1 pages (CSV)
First focusable element is link to main content [sia-r87]	n/a	1	1	/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html	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 (6533 raw engine findings → 6327 unique).

Unique issues (rule × page): 6327
Caught by both engines: 206 highest confidence
axe only: 2214
Alfa only: 3907

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

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

Rules flagged by both axe-core and Alfa in 2026-W37, by pages affected.
Issue	Pages	Rule references
<html> element must have a lang attribute	253	axe html-has-lang · Alfa sia-r4 · ACT b5c3f8
Headings should not be empty	240	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	3	axe link-name · Alfa sia-r11 · ACT c487ae
Zooming and scaling must not be disabled	2	axe meta-viewport · Alfa sia-r47 · ACT b4f0c3
lang attribute must have a valid value	1	axe valid-lang · Alfa sia-r7 · ACT de46e4