{
 "schema_version": "0.1",
 "site": "www.cms.gov",
 "scan_week": "2026-W38",
 "generated_at": "2026-09-30T18:09:03.041Z",
 "source_files": [
  "docs/reports/www.cms.gov/2026-W38/",
  "data/www.cms.gov/findings.json",
  "data/www.cms.gov/2026-W38/summary.json"
 ],
 "summary": {
  "pages_known": 59115,
  "pages_scanned_this_week": 4664,
  "pages_with_known_issues": 36959,
  "findings": 51,
  "clusters": 40,
  "new_findings": 0,
  "persistent_findings": 46,
  "high_priority_findings": 32
 },
 "top_risks": [
  {
   "finding_id": "VS-8ade3360",
   "rule_id": "link-in-text-block",
   "rule_label": "Links must be distinguishable without relying on color",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 424,
   "rationale": "Serious severity; affects 424 pages; persistent across weeks",
   "top_url": "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39770&lcdStatus=all&sortBy=title&ver=13"
  },
  {
   "finding_id": "VS-c126b6a6",
   "rule_id": "html-has-lang",
   "rule_label": "<html> element must have a lang attribute",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 305,
   "rationale": "Serious severity; affects 305 pages; persistent across weeks",
   "top_url": "http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html"
  },
  {
   "finding_id": "VS-9074b4dd",
   "rule_id": "image-alt",
   "rule_label": "Images must have alternative text",
   "severity": "Critical",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 294,
   "rationale": "Critical severity; affects 294 pages; persistent across weeks",
   "top_url": "http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html"
  },
  {
   "finding_id": "VS-a0bdbdf6",
   "rule_id": "list",
   "rule_label": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 254,
   "rationale": "Serious severity; affects 254 pages; persistent across weeks",
   "top_url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&stateRegion=all&ver=19"
  },
  {
   "finding_id": "VS-bd13f00a",
   "rule_id": "accesskeys",
   "rule_label": "accesskey attribute value should be unique",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 98,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html"
  },
  {
   "finding_id": "VS-be8d563e",
   "rule_id": "color-contrast",
   "rule_label": "Elements must meet minimum color contrast ratio thresholds",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 34,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39464&sortBy=relevance&ver=7"
  },
  {
   "finding_id": "VS-fafffee0",
   "rule_id": "label",
   "rule_label": "Form elements must have labels",
   "severity": "Critical",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 12,
   "rationale": "Critical severity; persistent across weeks",
   "top_url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1462.html"
  },
  {
   "finding_id": "VS-6175596b",
   "rule_id": "listitem",
   "rule_label": "<li> elements must be contained in a <ul> or <ol>",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 5,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&stateRegion=all&ver=19"
  },
  {
   "finding_id": "VS-e9fe47ac",
   "rule_id": "link-name",
   "rule_label": "Links must have discernible text",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 4,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "http://cms.gov/data-research/cms-data/learn-more-about-cms-data"
  },
  {
   "finding_id": "VS-07ba3b17",
   "rule_id": "td-headers-attr",
   "rule_label": "Table cell headers attributes must refer to other <th> elements in the same tabl",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 2,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc"
  }
 ],
 "findings": [
  {
   "finding_id": "VS-8ade3360",
   "fingerprint": "8bf51706",
   "rule_id": "link-in-text-block",
   "rule_label": "Links must be distinguishable without relying on color",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.4.1",
   "wcag_name": "Use of Color",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity; affects 424 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 424,
    "affected_pages_previous": 366
   },
   "frequency": {
    "instances": 965,
    "pages_affected": 424,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Links must be distinguishable without relying on color (WCAG 1.4.1)",
   "description": "Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 424 of 4664 scanned pages (965 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule link-in-text-block (WCAG 1.4.1).",
   "actual_behavior": "Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 424 of 4664 scanned pages (965 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39770&lcdStatus=all&sortBy=title&ver=13",
    "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37779&lcdStatus=all&sortBy=title&stateRegion=all&ver=16",
    "http://cms.gov/medicare-coverage-database/view/cal.aspx?calid=185"
   ],
   "html_fragments": [
    {
     "fingerprint": "07e4e98e",
     "html": "<a href=\"https://localcoverage.cms.gov/mcd_archive/view/lcd.aspx?lcdInfo=39769:5\" target=\"_blank\" class=\"log-click system-link\" data-page-action=\"Clicked the Source Proposed LCD link\">DL39770</a>",
     "selectors": [
      "#lblProposedLcd > .system-link.log-click[target=\"_blank\"]"
     ]
    },
    {
     "fingerprint": "b869f44b",
     "html": "<a href=\"https://www.ncbi.nlm.nih.gov/books/NBK482312/\">",
     "selectors": [
      "ol > li:nth-child(11) > a"
     ]
    },
    {
     "fingerprint": "7453d06f",
     "html": "<a href=\"https://www.uptodate.com/\">",
     "selectors": [
      "a[href$=\"uptodate.com/\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 23
    },
    {
     "pattern": "/medicare-coverage-database/view/cal.aspx",
     "count": 1
    },
    {
     "pattern": "/medicare-coverage-database/view/nca.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without color perception (4.5%), Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-c126b6a6",
   "fingerprint": "b6dc10f1",
   "rule_id": "html-has-lang",
   "rule_label": "<html> element must have a lang attribute",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "3.1.1",
   "wcag_name": "Language of Page",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity; affects 305 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 305,
    "affected_pages_previous": 256
   },
   "frequency": {
    "instances": 305,
    "pages_affected": 305,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "<html> element must have a lang attribute (WCAG 3.1.1)",
   "description": "<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 305 of 4664 scanned pages (305 instances).",
   "remediation_tip": "Add a lang attribute to <html> (e.g. lang=\"en\").",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule html-has-lang (WCAG 3.1.1).",
   "actual_behavior": "<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 305 of 4664 scanned pages (305 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html",
    "http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html",
    "http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "3e866d4c",
     "html": "<html>",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-9074b4dd",
   "fingerprint": "f1846b41",
   "rule_id": "image-alt",
   "rule_label": "Images must have alternative text",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.1.1",
   "wcag_name": "Non-text Content",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI",
   "severity": "Critical",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Critical severity; affects 294 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 14,
    "affected_pages_current": 294,
    "affected_pages_previous": 248
   },
   "frequency": {
    "instances": 295,
    "pages_affected": 294,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Images must have alternative text (WCAG 1.1.1)",
   "description": "Images must have alternative text. Detected by axe-core rule image-alt on 294 of 4664 scanned pages (295 instances).",
   "remediation_tip": "Give every <img> a meaningful alt attribute. Use alt=\"\" only for decorative images so screen readers skip them.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule image-alt (WCAG 1.1.1).",
   "actual_behavior": "Images must have alternative text. Detected by axe-core rule image-alt on 294 of 4664 scanned pages (295 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html",
    "http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html",
    "http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "6f85ea95",
     "html": "<img src=\"cms-site-logo.png\">",
     "selectors": [
      "img[src$=\"cms-site-logo.png\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-a0bdbdf6",
   "fingerprint": "ca0fa40f",
   "rule_id": "list",
   "rule_label": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity; affects 254 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 254,
    "affected_pages_previous": 210
   },
   "frequency": {
    "instances": 1344,
    "pages_affected": 254,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements (WCAG 1.3.1)",
   "description": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 254 of 4664 scanned pages (1344 instances).",
   "remediation_tip": "Use <ul>/<ol> with only <li> children for lists; don't fake lists with <div>s.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule list (WCAG 1.3.1).",
   "actual_behavior": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 254 of 4664 scanned pages (1344 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&stateRegion=all&ver=19",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53033&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=139",
    "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34520&lcdStatus=all&sortBy=title&ver=32"
   ],
   "html_fragments": [
    {
     "fingerprint": "ef042962",
     "html": "<ul>10 Certification and Recertification by Physicians for Hospital Services - General</ul>",
     "selectors": [
      "#lblCmsNationalCoveragePolicy > ul:nth-child(2)"
     ]
    },
    {
     "fingerprint": "83f46a19",
     "html": "<ul>10.1 Failure to Certify or Recertify for Hospital Services</ul>",
     "selectors": [
      "#lblCmsNationalCoveragePolicy > ul:nth-child(3)"
     ]
    },
    {
     "fingerprint": "6a7a85ec",
     "html": "<ul>10.2 Who May Sign Certification or Recertification</ul>",
     "selectors": [
      "ul:nth-child(4)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 18
    },
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 6
    },
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-bd13f00a",
   "fingerprint": "952edfaf",
   "rule_id": "accesskeys",
   "rule_label": "accesskey attribute value should be unique",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/accesskeys?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W38",
    "weeks_observed": 12,
    "affected_pages_current": 98,
    "affected_pages_previous": 87
   },
   "frequency": {
    "instances": 288,
    "pages_affected": 98,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "accesskey attribute value should be unique (WCAG criterion undetermined)",
   "description": "accesskey attribute value should be unique. Detected by axe-core rule accesskeys on 98 of 4664 scanned pages (288 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/accesskeys?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule accesskeys.",
   "actual_behavior": "accesskey attribute value should be unique. Detected by axe-core rule accesskeys on 98 of 4664 scanned pages (288 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html",
    "http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1212.html",
    "http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0027.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "b527f785",
     "html": "<a accesskey=\"p\" id=\"prev_page\" href=\"P0368.html\"><img src=\"bakpg.png\" alt=\"Previous Page [Alt-p]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a>",
     "selectors": [
      "td[width=\"31\"]:nth-child(3) > a[accesskey=\"p\"][href$=\"P0368.html\"]"
     ]
    },
    {
     "fingerprint": "1090480c",
     "html": "<a accesskey=\"u\" id=\"up_level\" href=\"P0026.html\"><img src=\"uptop.png\" alt=\"Up a level [Alt-u]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a>",
     "selectors": [
      "td[width=\"31\"]:nth-child(4) > a[accesskey=\"u\"][href$=\"P0026.html\"]"
     ]
    },
    {
     "fingerprint": "17bca71e",
     "html": "<a accesskey=\"n\" id=\"next_page\" href=\"P0955.html\"><img src=\"fwdpg.png\" alt=\"Next Page [Alt-n]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a>",
     "selectors": [
      "td[width=\"31\"]:nth-child(5) > a[accesskey=\"n\"][href$=\"P0955.html\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1212.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0027.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-be8d563e",
   "fingerprint": "1820bc84",
   "rule_id": "color-contrast",
   "rule_label": "Elements must meet minimum color contrast ratio thresholds",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.4.3",
   "wcag_name": "Contrast (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 34,
    "affected_pages_previous": 43
   },
   "frequency": {
    "instances": 510,
    "pages_affected": 34,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Elements must meet minimum color contrast ratio thresholds (WCAG 1.4.3)",
   "description": "Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 34 of 4664 scanned pages (510 instances).",
   "remediation_tip": "Increase the contrast between text and its background to at least 4.5:1 (3:1 for large text). Check both light and dark modes.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule color-contrast (WCAG 1.4.3).",
   "actual_behavior": "Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 34 of 4664 scanned pages (510 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39464&sortBy=relevance&ver=7",
    "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=33318&proposedStatus=all&sortBy=title&ver=63",
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39402&lcdStatus=all&sortBy=title&ver=14"
   ],
   "html_fragments": [
    {
     "fingerprint": "63a0d295",
     "html": "<p style=\"text-align: center;\">Outcomes</p>",
     "selectors": [
      "td[rowspan=\"2\"]:nth-child(1) > p"
     ]
    },
    {
     "fingerprint": "d93331c6",
     "html": "<p style=\"text-align: center;\">Comments</p>",
     "selectors": [
      "td[width=\"26%\"][rowspan=\"2\"] > p"
     ]
    },
    {
     "fingerprint": "328111d9",
     "html": "<strong>Base Code</strong>",
     "selectors": [
      "table[border=\"black\"]:nth-child(24) > tbody > tr:nth-child(1) > td:nth-child(1) > strong",
      "table[border=\"black\"]:nth-child(26) > tbody > tr:nth-child(1) > td:nth-child(1) > strong"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 11
    },
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 6
    },
    {
     "pattern": "/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0211.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited vision (2.4%), Without color perception (4.5%)."
   }
  },
  {
   "finding_id": "VS-fafffee0",
   "fingerprint": "d5e15238",
   "rule_id": "label",
   "rule_label": "Form elements must have labels",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/label?application=axeAPI",
   "severity": "Critical",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Critical severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W26",
    "last_observed": "2026-W38",
    "weeks_observed": 13,
    "affected_pages_current": 12,
    "affected_pages_previous": 11
   },
   "frequency": {
    "instances": 12,
    "pages_affected": 12,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Form elements must have labels (WCAG 4.1.2)",
   "description": "Form elements must have labels. Detected by axe-core rule label on 12 of 4664 scanned pages (12 instances).",
   "remediation_tip": "Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/label?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule label (WCAG 4.1.2).",
   "actual_behavior": "Form elements must have labels. Detected by axe-core rule label on 12 of 4664 scanned pages (12 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1462.html",
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0113.html",
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0384.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "b2d78865",
     "html": "<input type=\"text\" name=\"q\" id=\"q\" value=\"Search now\" size=\"10\" maxlength=\"50\" class=\"srchbox\" onfocus=\"this.value='';\">",
     "selectors": [
      "#q"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P1462.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P0113.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P0384.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   }
  },
  {
   "finding_id": "VS-6175596b",
   "fingerprint": "7ac6b8df",
   "rule_id": "listitem",
   "rule_label": "<li> elements must be contained in a <ul> or <ol>",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "medium",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 5,
    "affected_pages_previous": 11
   },
   "frequency": {
    "instances": 198,
    "pages_affected": 5,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "<li> elements must be contained in a <ul> or <ol> (WCAG 1.3.1)",
   "description": "<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 5 of 4664 scanned pages (198 instances).",
   "remediation_tip": "<li> must be inside a <ul> or <ol>.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule listitem (WCAG 1.3.1).",
   "actual_behavior": "<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 5 of 4664 scanned pages (198 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&stateRegion=all&ver=19",
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=282&proposed=N&sortBy=status&status=all",
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=NCA&ncaid=293&proposed=N&sortBy=status&status=Open+for+Public+Comment"
   ],
   "html_fragments": [
    {
     "fingerprint": "c87ad76c",
     "html": "<li>",
     "selectors": [
      "i > li:nth-child(1)"
     ]
    },
    {
     "fingerprint": "46a55366",
     "html": "<li> The hospital records indicate that the services furnished were either intensive treatment services, admission and related services necessary for diagnostic study, or equivalent services, and <br>",
     "selectors": [
      "i > li:nth-child(2)"
     ]
    },
    {
     "fingerprint": "ea37bef0",
     "html": "<li> e.g., cross-dressing not for the purposes of sexual excitement<br>Gender Identity Disorder Not Otherwise Specified 302.6<br></li>",
     "selectors": [
      "tr:nth-child(3) > td[valign=\"top\"]:nth-child(5) > li:nth-child(3)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 3
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 1
    },
    {
     "pattern": "/medicare-coverage-database/details/nca-proposed-decision-memo.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-e9fe47ac",
   "fingerprint": "f85a6839",
   "rule_id": "link-name",
   "rule_label": "Links must have discernible text",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "2.4.4",
   "wcag_name": "Link Purpose (In Context)",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "medium",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 4,
    "affected_pages_previous": 3
   },
   "frequency": {
    "instances": 6,
    "pages_affected": 4,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Links must have discernible text (WCAG 2.4.4)",
   "description": "Links must have discernible text. Detected by axe-core rule link-name on 4 of 4664 scanned pages (6 instances).",
   "remediation_tip": "Give the link discernible text. Avoid empty links and icon-only links without an aria-label.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule link-name (WCAG 2.4.4).",
   "actual_behavior": "Links must have discernible text. Detected by axe-core rule link-name on 4 of 4664 scanned pages (6 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/data-research/cms-data/learn-more-about-cms-data",
    "https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments",
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=317&proposed=N&sortBy=status&status=all"
   ],
   "html_fragments": [
    {
     "fingerprint": "7d91a5ec",
     "html": "<a href=\"/data-research/cms-data/qualified-entity-program\" target=\"_blank\" data-entity-substitution=\"canonical\" data-entity-type=\"node\" data-entity-uuid=\"bc2a682a-8a5c-4bf6-ab96-775413fb703f\" data-onc",
     "selectors": [
      "p:nth-child(12) > a[target=\"_blank\"][data-entity-substitution=\"canonical\"][data-entity-type=\"node\"]"
     ]
    },
    {
     "fingerprint": "ebdf89ab",
     "html": "<a href=\"/media/665791\" data-once=\"linkMatch\"></a>",
     "selectors": [
      ".field--name-field-description.field--type-text-long.cms-text--prominent > a[href=\"/media/665791\"][data-once=\"linkMatch\"]"
     ]
    },
    {
     "fingerprint": "ca127ce9",
     "html": "<a href=\"/media/665791\" data-once=\"linkMatch\">\n        </a>",
     "selectors": [
      ".align-left.media--view-mode-embedded > a[href=\"/media/665791\"][data-once=\"linkMatch\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 2
    },
    {
     "pattern": "/data-research/cms-data/learn-more-about-cms-data",
     "count": 1
    },
    {
     "pattern": "/medicare/quality/clinical-laboratory-improvement-amendments",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-07ba3b17",
   "fingerprint": "993f6ba8",
   "rule_id": "td-headers-attr",
   "rule_label": "Table cell headers attributes must refer to other <th> elements in the same tabl",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/td-headers-attr?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "low",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W38",
    "weeks_observed": 14,
    "affected_pages_current": 2,
    "affected_pages_previous": 3
   },
   "frequency": {
    "instances": 2,
    "pages_affected": 2,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Table cell headers attributes must refer to other <th> elements in the same tabl (WCAG 1.3.1)",
   "description": "Table cell headers attributes must refer to other <th> elements in the same tabl. Detected by axe-core rule td-headers-attr on 2 of 4664 scanned pages (2 instances).",
   "remediation_tip": "Associate data cells with their headers correctly using headers/id or scope.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/td-headers-attr?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule td-headers-attr (WCAG 1.3.1).",
   "actual_behavior": "Table cell headers attributes must refer to other <th> elements in the same tabl. Detected by axe-core rule td-headers-attr on 2 of 4664 scanned pages (2 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc",
    "https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=5&sort=desc"
   ],
   "html_fragments": [
    {
     "fingerprint": "7e037dac",
     "html": "<table class=\"MsoTableGrid\">",
     "selectors": [
      ".MsoTableGrid"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-9429bb8d",
   "fingerprint": "d9ef25ac",
   "rule_id": "aria-required-children",
   "rule_label": "Certain ARIA roles must contain particular children",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI",
   "severity": "Critical",
   "priority": "p1",
   "confidence": "low",
   "rationale": "Critical severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W28",
    "last_observed": "2026-W38",
    "weeks_observed": 3,
    "affected_pages_current": 1,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Certain ARIA roles must contain particular children (WCAG 1.3.1)",
   "description": "Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 1 of 4664 scanned pages (1 instances).",
   "remediation_tip": "Add the child roles this container role requires (e.g. a list needs listitem children).",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule aria-required-children (WCAG 1.3.1).",
   "actual_behavior": "Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 1 of 4664 scanned pages (1 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "91ab35cd",
     "html": "<ul id=\"SERVICES\" class=\"closed openMenu\" role=\"menu\" tabindex=\"-1\" style=\"background-color: rgb(255, 255, 255); margin-bottom: 60px;\">",
     "selectors": [
      "#SERVICES"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-c613c153",
   "fingerprint": "364ee5cc",
   "rule_id": "scrollable-region-focusable",
   "rule_label": "Scrollable region must have keyboard access",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "2.1.1",
   "wcag_name": "Keyboard",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/scrollable-region-focusable?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "low",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W38",
    "weeks_observed": 10,
    "affected_pages_current": 1,
    "affected_pages_previous": 2
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Scrollable region must have keyboard access (WCAG 2.1.1)",
   "description": "Scrollable region must have keyboard access. Detected by axe-core rule scrollable-region-focusable on 1 of 4664 scanned pages (1 instances).",
   "remediation_tip": "Make scrollable regions keyboard-focusable (tabindex=\"0\") so keyboard users can scroll them.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scrollable-region-focusable?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule scrollable-region-focusable (WCAG 2.1.1).",
   "actual_behavior": "Scrollable region must have keyboard access. Detected by axe-core rule scrollable-region-focusable on 1 of 4664 scanned pages (1 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=230&proposed=N"
   ],
   "html_fragments": [
    {
     "fingerprint": "4cf6e3a7",
     "html": "<pre>",
     "selectors": [
      "pre"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LR",
      "group": "Limited reach",
      "prevalence": 0.02,
      "percent": "2.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited manipulation/strength (13.0%), Limited reach (2.0%)."
   }
  },
  {
   "finding_id": "VS-58301a87",
   "fingerprint": "345a6415",
   "rule_id": "nested-interactive",
   "rule_label": "Interactive controls must not be nested",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/nested-interactive?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "low",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W33",
    "last_observed": "2026-W38",
    "weeks_observed": 2,
    "affected_pages_current": 1,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Interactive controls must not be nested (WCAG 4.1.2)",
   "description": "Interactive controls must not be nested. Detected by axe-core rule nested-interactive on 1 of 4664 scanned pages (1 instances).",
   "remediation_tip": "Don't nest interactive controls (e.g. a button inside a link); split them apart.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/nested-interactive?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule nested-interactive (WCAG 4.1.2).",
   "actual_behavior": "Interactive controls must not be nested. Detected by axe-core rule nested-interactive on 1 of 4664 scanned pages (1 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/files/linked-video-files/new-features-medicare-gov"
   ],
   "html_fragments": [
    {
     "fingerprint": "5b98a019",
     "html": "<yt-avatar-stack-view-model class=\"ytAvatarStackViewModelHost ytContentMetadataViewModelAvatarStack ytAvatarStackViewModelTappable ytAvatarStackViewModelIsOverlay\" tabindex=\"0\" role=\"button\" aria-labe",
     "selectors": [
      ".ytPageHeaderViewModelScrollContainer > .ytPageHeaderViewModelContent > .ytPageHeaderViewModelHeadline > .ytPageHeaderViewModelHeadlineInfo > .ytPageHeaderViewModelContentMetadata.ytPageHeaderViewModelContentMetadataOverlay > .ytContentMetadataViewModelMetadataRow[role=\"group\"]:nth-child(1) > yt-avatar-stack-view-model"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/files/linked-video-files/new-features-medicare-gov",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   }
  },
  {
   "finding_id": "VS-dd1c019f",
   "fingerprint": "dec2d038",
   "rule_id": "valid-lang",
   "rule_label": "lang attribute must have a valid value",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "3.1.2",
   "wcag_name": "Language of Parts",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "low",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 1,
    "affected_pages_previous": 1
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "lang attribute must have a valid value (WCAG 3.1.2)",
   "description": "lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 4664 scanned pages (1 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule valid-lang (WCAG 3.1.2).",
   "actual_behavior": "lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 4664 scanned pages (1 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings"
   ],
   "html_fragments": [
    {
     "fingerprint": "f05b811b",
     "html": "<span lang=\"X-NONE\">[1]</span>",
     "selectors": [
      "a[href$=\"#_ftnref1\"] > span[lang=\"X-NONE\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-cb53cc4d",
   "fingerprint": "1738fa81",
   "rule_id": "sia-r111",
   "rule_label": "Target size is at least 44×44 CSS pixels (Enhanced)",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.5",
   "wcag_name": "Target Size (Enhanced)",
   "wcag_level": "AAA",
   "wcag_version": "2.1",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r111",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 491 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 491,
    "affected_pages_previous": 377
   },
   "frequency": {
    "instances": 16513,
    "pages_affected": 491,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5)",
   "description": "Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 491 of 4664 scanned pages (16513 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r111 (WCAG 2.5.5).",
   "actual_behavior": "Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 491 of 4664 scanned pages (16513 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc",
    "https://cms.gov/about-cms/work-with-us/careers/positions",
    "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 5
    },
    {
     "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals",
     "count": 2
    },
    {
     "pattern": "/about-cms/work-with-us/careers/positions",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-2208081b",
   "fingerprint": "40bbca09",
   "rule_id": "sia-r73",
   "rule_label": "Text has minimum contrast ratio of 4.5:1",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r73",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 484 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 484,
    "affected_pages_previous": 367
   },
   "frequency": {
    "instances": 5866,
    "pages_affected": 484,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8)",
   "description": "Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 484 of 4664 scanned pages (5866 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r73 (WCAG 1.4.8).",
   "actual_behavior": "Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 484 of 4664 scanned pages (5866 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc",
    "https://cms.gov/about-cms/work-with-us/careers/positions",
    "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 5
    },
    {
     "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals",
     "count": 2
    },
    {
     "pattern": "/about-cms/work-with-us/careers/positions",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-7118fead",
   "fingerprint": "0d932ac9",
   "rule_id": "sia-r61",
   "rule_label": "Form field label is visible",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r61",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 435 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 435,
    "affected_pages_previous": 346
   },
   "frequency": {
    "instances": 435,
    "pages_affected": 435,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Form field label is visible (WCAG criterion undetermined)",
   "description": "Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 435 of 4664 scanned pages (435 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r61.",
   "actual_behavior": "Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 435 of 4664 scanned pages (435 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc",
    "https://cms.gov/about-cms/work-with-us/careers/positions",
    "https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 7
    },
    {
     "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals",
     "count": 2
    },
    {
     "pattern": "/about-cms/work-with-us/careers/positions",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f18df681",
   "fingerprint": "09987718",
   "rule_id": "region",
   "rule_label": "All page content should be contained by landmarks",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 307 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 307,
    "affected_pages_previous": 256
   },
   "frequency": {
    "instances": 5687,
    "pages_affected": 307,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "All page content should be contained by landmarks (WCAG criterion undetermined)",
   "description": "All page content should be contained by landmarks. Detected by axe-core rule region on 307 of 4664 scanned pages (5687 instances).",
   "remediation_tip": "Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule region.",
   "actual_behavior": "All page content should be contained by landmarks. Detected by axe-core rule region on 307 of 4664 scanned pages (5687 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html",
    "http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html",
    "http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "1dc30021",
     "html": "<tr>\n\t\t<td><img src=\"cms-site-logo.png\"></td>\n\t\t<td style=\"text-align:center;\"><h1>ICD-10-CM/PCS MS-DRG v40.1 Definitions Manual</h1><h1></h1></td>\n\t\t<td></td>\n\t\t<td></td>\n\t\t<td></td>\n\t</tr>",
     "selectors": [
      ".arrows > tbody > tr:nth-child(1)"
     ]
    },
    {
     "fingerprint": "9511f3c9",
     "html": "<td width=\"31\"><a accesskey=\"p\" id=\"prev_page\" href=\"P0092.html\"><img src=\"bakpg.png\" alt=\"Previous Page [Alt-p]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a></td>",
     "selectors": [
      "td[width=\"31\"]:nth-child(3)"
     ]
    },
    {
     "fingerprint": "40b348ac",
     "html": "<td width=\"31\"><a accesskey=\"u\" id=\"up_level\" href=\"P0006.html\"><img src=\"uptop.png\" alt=\"Up a level [Alt-u]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a></td>",
     "selectors": [
      "td[width=\"31\"]:nth-child(4)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d5d82446",
   "fingerprint": "3627341e",
   "rule_id": "landmark-one-main",
   "rule_label": "Document should have one main landmark",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 305 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 305,
    "affected_pages_previous": 256
   },
   "frequency": {
    "instances": 305,
    "pages_affected": 305,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Document should have one main landmark (WCAG criterion undetermined)",
   "description": "Document should have one main landmark. Detected by axe-core rule landmark-one-main on 305 of 4664 scanned pages (305 instances).",
   "remediation_tip": "Each page should have exactly one <main> landmark.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-one-main.",
   "actual_behavior": "Document should have one main landmark. Detected by axe-core rule landmark-one-main on 305 of 4664 scanned pages (305 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html",
    "http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html",
    "http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "3e866d4c",
     "html": "<html>",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d25f622d",
   "fingerprint": "98ff321a",
   "rule_id": "heading-order",
   "rule_label": "Heading levels should only increase by one",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 277 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 277,
    "affected_pages_previous": 265
   },
   "frequency": {
    "instances": 280,
    "pages_affected": 277,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Heading levels should only increase by one (WCAG criterion undetermined)",
   "description": "Heading levels should only increase by one. Detected by axe-core rule heading-order on 277 of 4664 scanned pages (280 instances).",
   "remediation_tip": "Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule heading-order.",
   "actual_behavior": "Heading levels should only increase by one. Detected by axe-core rule heading-order on 277 of 4664 scanned pages (280 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/reports/local-coverage-proposed-lcds-alphabetical-report.aspx?proposedStatus=all",
    "http://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33411&lcdStatus=all&sortBy=title",
    "https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities"
   ],
   "html_fragments": [
    {
     "fingerprint": "2772e8cc",
     "html": "<h3 id=\"navStickyHeader\" class=\"bg-white d-inline expand-head-pad\">Report Information</h3>",
     "selectors": [
      "#navStickyHeader"
     ]
    },
    {
     "fingerprint": "dc7523a7",
     "html": "<h4><strong>Current Grant Funding Opportunities:</strong></h4>",
     "selectors": [
      "h4:nth-child(3)"
     ]
    },
    {
     "fingerprint": "4b48be92",
     "html": "<h4 id=\"dmHeader0\">I.  Proposed Decision</h4>",
     "selectors": [
      "#dmHeader0"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx",
     "count": 6
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx",
     "count": 5
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx",
     "count": 5
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-646b1e0b",
   "fingerprint": "afad441e",
   "rule_id": "sia-r66",
   "rule_label": "Text has enhanced contrast",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.6",
   "wcag_name": "Contrast (Enhanced)",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r66",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 190 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 190,
    "affected_pages_previous": 182
   },
   "frequency": {
    "instances": 1073,
    "pages_affected": 190,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Text has enhanced contrast (WCAG 1.4.6)",
   "description": "Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 190 of 4664 scanned pages (1073 instances).",
   "remediation_tip": "Increase text contrast to meet WCAG AAA (7:1).",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r66 (WCAG 1.4.6).",
   "actual_behavior": "Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 190 of 4664 scanned pages (1073 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 10
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 10
    },
    {
     "pattern": "/medicare-coverage-database/view/ncd.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [
    {
     "technology": "jsDelivr",
     "lift": 2.35,
     "pages_with_both": 19
    },
    {
     "technology": "Bootstrap",
     "lift": 2.35,
     "pages_with_both": 19
    },
    {
     "technology": "Microsoft ASP.NET",
     "lift": 2.35,
     "pages_with_both": 19
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-fbf54eba",
   "fingerprint": "773d6316",
   "rule_id": "sia-r74",
   "rule_label": "Link is distinguishable without relying on color",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r74",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 190 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 190,
    "affected_pages_previous": 181
   },
   "frequency": {
    "instances": 13131,
    "pages_affected": 190,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Link is distinguishable without relying on color (WCAG 1.4.8)",
   "description": "Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 190 of 4664 scanned pages (13131 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r74",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r74 (WCAG 1.4.8).",
   "actual_behavior": "Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 190 of 4664 scanned pages (13131 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 11
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 10
    },
    {
     "pattern": "/medicare-coverage-database/view/ncd.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [
    {
     "technology": "jsDelivr",
     "lift": 2.35,
     "pages_with_both": 19
    },
    {
     "technology": "Bootstrap",
     "lift": 2.35,
     "pages_with_both": 19
    },
    {
     "technology": "Microsoft ASP.NET",
     "lift": 2.35,
     "pages_with_both": 19
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f7dba940",
   "fingerprint": "477d8088",
   "rule_id": "sia-r14",
   "rule_label": "Accessible name of link or button matches visible label",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.3",
   "wcag_name": "Label in Name",
   "wcag_level": "A",
   "wcag_version": "2.1",
   "wcag_category": "WCAG 2.1 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r14",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 189 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 189,
    "affected_pages_previous": 182
   },
   "frequency": {
    "instances": 481,
    "pages_affected": 189,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Accessible name of link or button matches visible label (WCAG 2.5.3)",
   "description": "Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 189 of 4664 scanned pages (481 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r14 (WCAG 2.5.3).",
   "actual_behavior": "Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 189 of 4664 scanned pages (481 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 11
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 10
    },
    {
     "pattern": "/medicare-coverage-database/view/ncd.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [
    {
     "technology": "jsDelivr",
     "lift": 2.35,
     "pages_with_both": 19
    },
    {
     "technology": "Bootstrap",
     "lift": 2.35,
     "pages_with_both": 19
    },
    {
     "technology": "Microsoft ASP.NET",
     "lift": 2.35,
     "pages_with_both": 19
    }
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "WS",
      "group": "Without speech",
      "prevalence": 0.005,
      "percent": "0.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Without speech (0.5%)."
   }
  },
  {
   "finding_id": "VS-f054f4a4",
   "fingerprint": "5fa3b5a6",
   "rule_id": "sia-r53",
   "rule_label": "Headings are structured hierarchically",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r53",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 164 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 164,
    "affected_pages_previous": 167
   },
   "frequency": {
    "instances": 165,
    "pages_affected": 164,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Headings are structured hierarchically (WCAG criterion undetermined)",
   "description": "Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 164 of 4664 scanned pages (165 instances).",
   "remediation_tip": "Use headings in a logical, non-skipping order.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r53",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r53.",
   "actual_behavior": "Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 164 of 4664 scanned pages (165 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2",
    "https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 12
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 7
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [
    {
     "technology": "jsDelivr",
     "lift": 2.21,
     "pages_with_both": 16
    },
    {
     "technology": "Bootstrap",
     "lift": 2.21,
     "pages_with_both": 16
    },
    {
     "technology": "Microsoft ASP.NET",
     "lift": 2.21,
     "pages_with_both": 16
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-c18be945",
   "fingerprint": "8634e2fd",
   "rule_id": "sia-r57",
   "rule_label": "Scrolling content can be accessed by keyboard",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r57",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 163 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 163,
    "affected_pages_previous": 109
   },
   "frequency": {
    "instances": 163,
    "pages_affected": 163,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Scrolling content can be accessed by keyboard (WCAG criterion undetermined)",
   "description": "Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 163 of 4664 scanned pages (163 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r57.",
   "actual_behavior": "Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 163 of 4664 scanned pages (163 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc",
    "https://cms.gov/about-cms/work-with-us/careers/positions",
    "https://www.cms.gov/medicare/regulations-guidance/transmittals/2024-transmittals/r12626otn"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals",
     "count": 3
    },
    {
     "pattern": "/about-cms/work-with-us/careers/positions",
     "count": 1
    },
    {
     "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals/r12626otn",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "Drupal",
     "lift": 2.15,
     "pages_with_both": 14
    },
    {
     "technology": "Acquia Cloud Platform",
     "lift": 2.15,
     "pages_with_both": 14
    },
    {
     "technology": "Amazon Web Services",
     "lift": 2.15,
     "pages_with_both": 14
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-2cd767ca",
   "fingerprint": "3123e4f3",
   "rule_id": "sia-r78",
   "rule_label": "Table header has scope",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r78",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 124 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 124,
    "affected_pages_previous": 101
   },
   "frequency": {
    "instances": 149,
    "pages_affected": 124,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Table header has scope (WCAG criterion undetermined)",
   "description": "Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 124 of 4664 scanned pages (149 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r78",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r78.",
   "actual_behavior": "Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 124 of 4664 scanned pages (149 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html",
    "https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 9
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx",
     "count": 2
    },
    {
     "pattern": "/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "jsDelivr",
     "lift": 1.65,
     "pages_with_both": 7
    },
    {
     "technology": "Bootstrap",
     "lift": 1.65,
     "pages_with_both": 7
    },
    {
     "technology": "Microsoft ASP.NET",
     "lift": 1.65,
     "pages_with_both": 7
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-179ad9b3",
   "fingerprint": "0e001fcc",
   "rule_id": "sia-r113",
   "rule_label": "Target size is at least 24×24 CSS pixels or has spacing (Minimum)",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.8",
   "wcag_name": "Target Size (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.2",
   "wcag_category": "WCAG 2.2 AA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r113",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 103 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 103,
    "affected_pages_previous": 79
   },
   "frequency": {
    "instances": 395,
    "pages_affected": 103,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8)",
   "description": "Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 103 of 4664 scanned pages (395 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r113",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r113 (WCAG 2.5.8).",
   "actual_behavior": "Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 103 of 4664 scanned pages (395 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 11
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 2
    },
    {
     "pattern": "/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LR",
      "group": "Limited reach",
      "prevalence": 0.02,
      "percent": "2.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-d6097011",
   "fingerprint": "b46c5395",
   "rule_id": "sia-r68",
   "rule_label": "Presentational children of an element are not focusable",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r68",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 60,
    "affected_pages_previous": 45
   },
   "frequency": {
    "instances": 216,
    "pages_affected": 60,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Presentational children of an element are not focusable (WCAG 1.3.1)",
   "description": "Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 60 of 4664 scanned pages (216 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r68",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r68 (WCAG 1.3.1).",
   "actual_behavior": "Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 60 of 4664 scanned pages (216 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html",
    "http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35172&lcdStatus=all&sortBy=title&ver=72",
    "https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0043.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 7
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx",
     "count": 4
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx",
     "count": 4
    }
   ],
   "associated_technologies": [
    {
     "technology": "jsDelivr",
     "lift": 2.02,
     "pages_with_both": 6
    },
    {
     "technology": "Bootstrap",
     "lift": 2.02,
     "pages_with_both": 6
    },
    {
     "technology": "Microsoft ASP.NET",
     "lift": 2.02,
     "pages_with_both": 6
    }
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-04a9d28c",
   "fingerprint": "02cfba82",
   "rule_id": "presentational-attr",
   "rule_label": "Presentational attribute (use CSS)",
   "engine": "deprecated-html",
   "tool": "deprecated-html",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": null,
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 57,
    "affected_pages_previous": 40
   },
   "frequency": {
    "instances": 2094,
    "pages_affected": 57,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Presentational attribute (use CSS) (WCAG criterion undetermined)",
   "description": "Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 57 of 4664 scanned pages (2094 instances).",
   "remediation_tip": null,
   "suggested_fix": "Not captured by automated scan — requires manual testing.",
   "expected_behavior": "Element passes deprecated-html rule presentational-attr.",
   "actual_behavior": "Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 57 of 4664 scanned pages (2094 instances).",
   "testing_environment": "Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html",
    "https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html",
    "http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1212.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "9c73fd4b",
     "html": "<img src=\"bakpg.png\" alt=\"Previous Page [Alt-p]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\">",
     "selectors": [
      "img"
     ]
    },
    {
     "fingerprint": "f9ef1f44",
     "html": "<img src=\"uptop.png\" alt=\"Up a level [Alt-u]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\">",
     "selectors": [
      "img"
     ]
    },
    {
     "fingerprint": "1cc6b28a",
     "html": "<img src=\"fwdpg.png\" alt=\"Next Page [Alt-n]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\">",
     "selectors": [
      "img"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 5
    },
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 3
    },
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-7a0e5645",
   "fingerprint": "15da996e",
   "rule_id": "sia-r4",
   "rule_label": "Document has a valid lang attribute",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "3.1.1",
   "wcag_name": "Language of Page",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r4",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 56,
    "affected_pages_previous": 32
   },
   "frequency": {
    "instances": 56,
    "pages_affected": 56,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Document has a valid lang attribute (WCAG 3.1.1)",
   "description": "Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 56 of 4664 scanned pages (56 instances).",
   "remediation_tip": "Add a valid lang attribute to <html>.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r4",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r4 (WCAG 3.1.1).",
   "actual_behavior": "Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 56 of 4664 scanned pages (56 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html",
    "https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html",
    "https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-a24eaa8c",
   "fingerprint": "8d462fe1",
   "rule_id": "sia-r2",
   "rule_label": "Image has accessible name",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.1.1",
   "wcag_name": "Non-text Content",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r2",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 14,
    "affected_pages_current": 55,
    "affected_pages_previous": 31
   },
   "frequency": {
    "instances": 55,
    "pages_affected": 55,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Image has accessible name (WCAG 1.1.1)",
   "description": "Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 55 of 4664 scanned pages (55 instances).",
   "remediation_tip": "Give every <img> an accessible name (alt text), or alt=\"\" if purely decorative.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r2",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r2 (WCAG 1.1.1).",
   "actual_behavior": "Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 55 of 4664 scanned pages (55 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html",
    "https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html",
    "https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-3c632d31",
   "fingerprint": "7d010b8c",
   "rule_id": "sia-r64",
   "rule_label": "Element has required owned roles",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r64",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 55,
    "affected_pages_previous": 30
   },
   "frequency": {
    "instances": 55,
    "pages_affected": 55,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Element has required owned roles (WCAG 1.3.1)",
   "description": "Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 55 of 4664 scanned pages (55 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r64",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r64 (WCAG 1.3.1).",
   "actual_behavior": "Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 55 of 4664 scanned pages (55 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html",
    "https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html",
    "https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-0066c67d",
   "fingerprint": "67db3700",
   "rule_id": "empty-heading",
   "rule_label": "Headings should not be empty",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI",
   "severity": "Minor",
   "priority": "p3",
   "confidence": "high",
   "rationale": "affects 298 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 298,
    "affected_pages_previous": 247
   },
   "frequency": {
    "instances": 298,
    "pages_affected": 298,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Headings should not be empty (WCAG criterion undetermined)",
   "description": "Headings should not be empty. Detected by axe-core rule empty-heading on 298 of 4664 scanned pages (298 instances).",
   "remediation_tip": "Remove empty headings or give them text. Don't use heading tags for spacing.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule empty-heading.",
   "actual_behavior": "Headings should not be empty. Detected by axe-core rule empty-heading on 298 of 4664 scanned pages (298 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html",
    "http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html",
    "http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "c6c37699",
     "html": "<h1></h1>",
     "selectors": [
      "h1:nth-child(2)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-0ba8ce9d",
   "fingerprint": "1b1ae391",
   "rule_id": "scope-attr-valid",
   "rule_label": "scope attribute should be used correctly",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 42,
    "affected_pages_previous": 38
   },
   "frequency": {
    "instances": 850,
    "pages_affected": 42,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "scope attribute should be used correctly (WCAG criterion undetermined)",
   "description": "scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 42 of 4664 scanned pages (850 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule scope-attr-valid.",
   "actual_behavior": "scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 42 of 4664 scanned pages (850 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=258&proposed=Y",
    "https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&ncaid=233&proposed=N&type=Closed",
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1138.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "487e118e",
     "html": "<td valign=\"top\" scope=\"row\">September  30, 2011</td>",
     "selectors": [
      "tr:nth-child(2) > td[scope=\"row\"]"
     ]
    },
    {
     "fingerprint": "0573f722",
     "html": "<td valign=\"top\" scope=\"row\">October 30, 2011</td>",
     "selectors": [
      "tr:nth-child(3) > td[scope=\"row\"]"
     ]
    },
    {
     "fingerprint": "248ae7fb",
     "html": "<td valign=\"top\" scope=\"row\">March xx, 2011</td>",
     "selectors": [
      "tr:nth-child(4) > td[scope=\"row\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 19
    },
    {
     "pattern": "/medicare-coverage-database/details/nca-proposed-decision-memo.aspx",
     "count": 2
    },
    {
     "pattern": "/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1138.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-4408605e",
   "fingerprint": "265d5c76",
   "rule_id": "sia-r46",
   "rule_label": "Element has required aria-owns",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r46",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W38",
    "weeks_observed": 14,
    "affected_pages_current": 18,
    "affected_pages_previous": 20
   },
   "frequency": {
    "instances": 30,
    "pages_affected": 18,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Element has required aria-owns (WCAG 1.3.1)",
   "description": "Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 18 of 4664 scanned pages (30 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r46",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r46 (WCAG 1.3.1).",
   "actual_behavior": "Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 18 of 4664 scanned pages (30 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53026&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=62",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57891&articleStatus=all&bc=3&sortBy=title&ver=32"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 16
    },
    {
     "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals",
     "count": 1
    },
    {
     "pattern": "/medicare/quality/value-based-programs/value-based-purchasing-snf-vbp-program/spotlights-announcements",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-fa44f293",
   "fingerprint": "a01b2a6c",
   "rule_id": "page-has-heading-one",
   "rule_label": "Page should contain a level-one heading",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 18,
    "affected_pages_previous": 17
   },
   "frequency": {
    "instances": 18,
    "pages_affected": 18,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Page should contain a level-one heading (WCAG criterion undetermined)",
   "description": "Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 18 of 4664 scanned pages (18 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule page-has-heading-one.",
   "actual_behavior": "Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 18 of 4664 scanned pages (18 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1462.html",
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0113.html",
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0384.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "3e866d4c",
     "html": "<html>",
     "selectors": [
      "html"
     ]
    },
    {
     "fingerprint": "88cfebb1",
     "html": "<html lang=\"en\" dir=\"ltr\" prefix=\"og: https://ogp.me/ns#\" class=\" js\" style=\"--vw: 12.8px; --vh: 8px;\">",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P1462.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P0113.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P0384.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-388b5438",
   "fingerprint": "e21585c3",
   "rule_id": "sia-r80",
   "rule_label": "Scrollable element is keyboard accessible",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r80",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W38",
    "weeks_observed": 14,
    "affected_pages_current": 16,
    "affected_pages_previous": 8
   },
   "frequency": {
    "instances": 456,
    "pages_affected": 16,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Scrollable element is keyboard accessible (WCAG 1.4.8)",
   "description": "Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 16 of 4664 scanned pages (456 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r80",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r80 (WCAG 1.4.8).",
   "actual_behavior": "Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 16 of 4664 scanned pages (456 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39434&ver=7",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58183&articleStatus=all&bc=3&sortBy=title&ver=14",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59695&articleStatus=all&bc=3&sortBy=title&ver=5"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 10
    },
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 6
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-efd91fdd",
   "fingerprint": "12434796",
   "rule_id": "sia-r62",
   "rule_label": "Link in text block is visually distinguishable without color",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.1",
   "wcag_name": "Use of Color",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r62",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 14,
    "affected_pages_current": 6,
    "affected_pages_previous": 6
   },
   "frequency": {
    "instances": 12,
    "pages_affected": 6,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Link in text block is visually distinguishable without color (WCAG 1.4.1)",
   "description": "Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 6 of 4664 scanned pages (12 instances).",
   "remediation_tip": "Make links visually distinguishable from surrounding text (not by color alone).",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r62",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r62 (WCAG 1.4.1).",
   "actual_behavior": "Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 6 of 4664 scanned pages (12 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33394&lcdStatus=all&sortBy=title&ver=50",
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39242&sortBy=relevance&ver=5",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59649&ver=19"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 4
    },
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without color perception (4.5%), Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-48291402",
   "fingerprint": "50880f5a",
   "rule_id": "sia-r71",
   "rule_label": "iframe element is not empty",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r71",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W38",
    "weeks_observed": 14,
    "affected_pages_current": 6,
    "affected_pages_previous": 8
   },
   "frequency": {
    "instances": 59,
    "pages_affected": 6,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "iframe element is not empty (WCAG 1.4.8)",
   "description": "iframe element is not empty. Detected by Siteimprove Alfa rule sia-r71 on 6 of 4664 scanned pages (59 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r71",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r71 (WCAG 1.4.8).",
   "actual_behavior": "iframe element is not empty. Detected by Siteimprove Alfa rule sia-r71 on 6 of 4664 scanned pages (59 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58183&articleStatus=all&bc=3&sortBy=title&ver=14",
    "http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38051&lcdStatus=all&sortBy=title&stateRegion=all&ver=17",
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38773&lcdStatus=all&sortBy=title&ver=27"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 4
    },
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-3f067795",
   "fingerprint": "f9bf7824",
   "rule_id": "sia-r77",
   "rule_label": "Table cell has header",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r77",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 3,
    "affected_pages_previous": 5
   },
   "frequency": {
    "instances": 4,
    "pages_affected": 3,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Table cell has header (WCAG 1.3.1)",
   "description": "Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 3 of 4664 scanned pages (4 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r77",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r77 (WCAG 1.3.1).",
   "actual_behavior": "Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 3 of 4664 scanned pages (4 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&NCAId=279&proposed=Y&type=Closed",
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1686.html",
    "https://www.cms.gov/medicare/quality/value-based-programs/value-based-purchasing-snf-vbp-program/spotlights-announcements"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 1
    },
    {
     "pattern": "/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1686.html",
     "count": 1
    },
    {
     "pattern": "/medicare/quality/value-based-programs/value-based-purchasing-snf-vbp-program/spotlights-announcements",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-8806389c",
   "fingerprint": "ffb2ae06",
   "rule_id": "landmark-unique",
   "rule_label": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W38",
    "weeks_observed": 14,
    "affected_pages_current": 3,
    "affected_pages_previous": 2
   },
   "frequency": {
    "instances": 3,
    "pages_affected": 3,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined)",
   "description": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 3 of 4664 scanned pages (3 instances).",
   "remediation_tip": "When a landmark role/type repeats (e.g. two <nav>s), give each a distinct accessible name with aria-label or aria-labelledby (e.g. \"Primary\" and \"Footer\" navigation) so screen-reader users can tell them apart.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-unique.",
   "actual_behavior": "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 4664 scanned pages (3 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-07-08.html",
    "https://www.cms.gov/about-cms/contact/newsroom",
    "http://www.cms.gov/apps/media?page=2"
   ],
   "html_fragments": [
    {
     "fingerprint": "e366fea7",
     "html": "<span class=\"views-field views-field-field-topic\" role=\"region\" aria-label=\"Related search topics\">\n<a href=\"/newsroom/search?about[]=33506&amp;keys= \" data-once=\"linkMatch\">Administration</a>\n</span>",
     "selectors": [
      ".views-field-field-topic[aria-label=\"Related search topics\"][role=\"region\"]:nth-child(1)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/Newsroom/MediaReleaseDatabase/Fact-sheets/{id}-Fact-sheets-items/{id}-07-08.html",
     "count": 1
    },
    {
     "pattern": "/about-cms/contact/newsroom",
     "count": 1
    },
    {
     "pattern": "/apps/media",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f2542d87",
   "fingerprint": "9cf75a1e",
   "rule_id": "sia-r79",
   "rule_label": "Duplicate role landmark is labeled",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r79",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 3,
    "affected_pages_previous": 5
   },
   "frequency": {
    "instances": 3,
    "pages_affected": 3,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Duplicate role landmark is labeled (WCAG criterion undetermined)",
   "description": "Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 3 of 4664 scanned pages (3 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r79",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r79.",
   "actual_behavior": "Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 3 of 4664 scanned pages (3 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&NCAId=279&proposed=Y&type=Closed",
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=239&proposed=N&sortBy=status&status=all",
    "http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?calid=173&proposed=N"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 3
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-91d2294a",
   "fingerprint": "648c7ef8",
   "rule_id": "font-element",
   "rule_label": "Obsolete <font> element (use CSS)",
   "engine": "deprecated-html",
   "tool": "deprecated-html",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": null,
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 13,
    "affected_pages_current": 3,
    "affected_pages_previous": 2
   },
   "frequency": {
    "instances": 27,
    "pages_affected": 3,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Obsolete <font> element (use CSS) (WCAG criterion undetermined)",
   "description": "Obsolete <font> element (use CSS). Detected by deprecated-html rule font-element on 3 of 4664 scanned pages (27 instances).",
   "remediation_tip": null,
   "suggested_fix": "Not captured by automated scan — requires manual testing.",
   "expected_behavior": "Element passes deprecated-html rule font-element.",
   "actual_behavior": "Obsolete <font> element (use CSS). Detected by deprecated-html rule font-element on 3 of 4664 scanned pages (27 instances).",
   "testing_environment": "Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=304&proposed=N",
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=268&proposed=Y&sortBy=status&status=all",
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=309&proposed=N&sortBy=status&status=all"
   ],
   "html_fragments": [
    {
     "fingerprint": "47fcc1b8",
     "html": "<font color=\"FF0000\">(Rev.)</font>",
     "selectors": [
      "font"
     ]
    },
    {
     "fingerprint": "4470df01",
     "html": "<font color=\"FF0000\"><em> for over 130,000 deaths in 2021 (more than the total number of estimated deaths from colon, breast and prostate cancer combined)</em></font>",
     "selectors": [
      "font"
     ]
    },
    {
     "fingerprint": "bd618dd4",
     "html": "<font color=\"FF0000\"><em>50</em></font>",
     "selectors": [
      "font"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 3
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f7e99f4b",
   "fingerprint": "863d1000",
   "rule_id": "sia-r69",
   "rule_label": "Text has sufficient color contrast (Enhanced)",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.3",
   "wcag_name": "Contrast (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r69",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 2,
    "affected_pages_previous": 5
   },
   "frequency": {
    "instances": 2,
    "pages_affected": 2,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Text has sufficient color contrast (Enhanced) (WCAG 1.4.3)",
   "description": "Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 2 of 4664 scanned pages (2 instances).",
   "remediation_tip": "Increase text contrast to meet WCAG AA (4.5:1, or 3:1 for large text).",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r69",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r69 (WCAG 1.4.3).",
   "actual_behavior": "Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 2 of 4664 scanned pages (2 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medical-bill-rights/help/submit-a-complaint/get-started",
    "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33624&lcdStatus=all&sortBy=title&ver=34"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medical-bill-rights/help/submit-a-complaint/get-started",
     "count": 1
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited vision (2.4%), Without color perception (4.5%)."
   }
  },
  {
   "finding_id": "VS-3d033717",
   "fingerprint": "1718042b",
   "rule_id": "sia-r70",
   "rule_label": "No obsolete or deprecated elements are used",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r70",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W38",
    "weeks_observed": 13,
    "affected_pages_current": 2,
    "affected_pages_previous": 1
   },
   "frequency": {
    "instances": 2,
    "pages_affected": 2,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "No obsolete or deprecated elements are used (WCAG criterion undetermined)",
   "description": "No obsolete or deprecated elements are used. Detected by Siteimprove Alfa rule sia-r70 on 2 of 4664 scanned pages (2 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r70",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r70.",
   "actual_behavior": "No obsolete or deprecated elements are used. Detected by Siteimprove Alfa rule sia-r70 on 2 of 4664 scanned pages (2 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=282&proposed=N&sortBy=status&status=all",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52841&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 1
    },
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-9207ed51",
   "fingerprint": "6cdd8dba",
   "rule_id": "sia-r45",
   "rule_label": "aria-hidden element is not exposed to assistive technology",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r45",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W26",
    "last_observed": "2026-W38",
    "weeks_observed": 8,
    "affected_pages_current": 1,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 197,
    "pages_affected": 1,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "aria-hidden element is not exposed to assistive technology (WCAG 1.3.1)",
   "description": "aria-hidden element is not exposed to assistive technology. Detected by Siteimprove Alfa rule sia-r45 on 1 of 4664 scanned pages (197 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r45",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r45 (WCAG 1.3.1).",
   "actual_behavior": "aria-hidden element is not exposed to assistive technology. Detected by Siteimprove Alfa rule sia-r45 on 1 of 4664 scanned pages (197 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=5&sort=desc"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-28ebd979",
   "fingerprint": "032345cc",
   "rule_id": "sia-r11",
   "rule_label": "Link has accessible name",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.4.4",
   "wcag_name": "Link Purpose (In Context)",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r11",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 13,
    "affected_pages_current": 1,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Link has accessible name (WCAG 2.4.4)",
   "description": "Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 4664 scanned pages (1 instances).",
   "remediation_tip": "Give the link an accessible name via text content or aria-label.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r11",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r11 (WCAG 2.4.4).",
   "actual_behavior": "Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 4664 scanned pages (1 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/data-research/cms-data/learn-more-about-cms-data"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/data-research/cms-data/learn-more-about-cms-data",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-400f3a18",
   "fingerprint": "191f610a",
   "rule_id": "sia-r7",
   "rule_label": "Element with lang attribute has correct language",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "3.1.2",
   "wcag_name": "Language of Parts",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r7",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W26",
    "last_observed": "2026-W38",
    "weeks_observed": 7,
    "affected_pages_current": 1,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Element with lang attribute has correct language (WCAG 3.1.2)",
   "description": "Element with lang attribute has correct language. Detected by Siteimprove Alfa rule sia-r7 on 1 of 4664 scanned pages (1 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r7",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r7 (WCAG 3.1.2).",
   "actual_behavior": "Element with lang attribute has correct language. Detected by Siteimprove Alfa rule sia-r7 on 1 of 4664 scanned pages (1 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-7fbb8b20",
   "fingerprint": "79bb1ee9",
   "rule_id": "sia-r59",
   "rule_label": "Element with orientation is not locked",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r59",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W26",
    "last_observed": "2026-W38",
    "weeks_observed": 12,
    "affected_pages_current": 1,
    "affected_pages_previous": 2
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Element with orientation is not locked (WCAG criterion undetermined)",
   "description": "Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 1 of 4664 scanned pages (1 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r59",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r59.",
   "actual_behavior": "Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 1 of 4664 scanned pages (1 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0617.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P0617.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-e43903a1",
   "fingerprint": "49842005",
   "rule_id": "sia-r75",
   "rule_label": "Form field error is identified and described",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r75",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W26",
    "last_observed": "2026-W38",
    "weeks_observed": 12,
    "affected_pages_current": 1,
    "affected_pages_previous": 2
   },
   "frequency": {
    "instances": 2,
    "pages_affected": 1,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Form field error is identified and described (WCAG criterion undetermined)",
   "description": "Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 1 of 4664 scanned pages (2 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r75",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r75.",
   "actual_behavior": "Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 1 of 4664 scanned pages (2 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0617.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P0617.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d69fc059",
   "fingerprint": "c827d812",
   "rule_id": "empty-table-header",
   "rule_label": "Table header text should not be empty",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI",
   "severity": "Minor",
   "priority": "p4",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W38",
    "weeks_observed": 15,
    "affected_pages_current": 20,
    "affected_pages_previous": 28
   },
   "frequency": {
    "instances": 45,
    "pages_affected": 20,
    "total_pages_scanned": 4664
   },
   "on_key_page": false,
   "summary": "Table header text should not be empty (WCAG criterion undetermined)",
   "description": "Table header text should not be empty. Detected by axe-core rule empty-table-header on 20 of 4664 scanned pages (45 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule empty-table-header.",
   "actual_behavior": "Table header text should not be empty. Detected by axe-core rule empty-table-header on 20 of 4664 scanned pages (45 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36868&lcdStatus=all&sortBy=title&ver=20",
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1138.html",
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=282&proposed=N&sortBy=status&status=all"
   ],
   "html_fragments": [
    {
     "fingerprint": "bcaef498",
     "html": "<th>&nbsp;</th>",
     "selectors": [
      "tbody > tr > th",
      ".TableGrid5 > tbody > tr:nth-child(1) > th:nth-child(2)"
     ]
    },
    {
     "fingerprint": "01e71718",
     "html": "<th scope=\"col\" width=\"10\">&nbsp;</th>",
     "selectors": [
      "th[width=\"10\"]"
     ]
    },
    {
     "fingerprint": "8bb6916d",
     "html": "<th scope=\"col width=\" 10\"=\"\">&nbsp;</th>",
     "selectors": [
      "th[scope=\"col width=\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 11
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 4
    },
    {
     "pattern": "/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1138.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  }
 ],
 "clusters": {
  "by_wcag_criterion": [
   {
    "cluster_id": "140fec0b",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.8",
    "wcag_name": "Visual Presentation",
    "wcag_level": "AAA",
    "findings": [
     "VS-2208081b",
     "VS-fbf54eba",
     "VS-388b5438",
     "VS-48291402"
    ],
    "total_pages_affected": 696,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "b393058c",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.5",
    "wcag_name": "Target Size (Enhanced)",
    "wcag_level": "AAA",
    "findings": [
     "VS-cb53cc4d"
    ],
    "total_pages_affected": 491,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "75cf28e4",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-7118fead"
    ],
    "total_pages_affected": 435,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "77bde739",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.1",
    "wcag_name": "Use of Color",
    "wcag_level": "A",
    "findings": [
     "VS-8ade3360",
     "VS-efd91fdd"
    ],
    "total_pages_affected": 430,
    "max_severity": "Serious"
   },
   {
    "cluster_id": "423bd52e",
    "type": "wcag_criterion",
    "wcag_sc": "1.3.1",
    "wcag_name": "Info and Relationships",
    "wcag_level": "A",
    "findings": [
     "VS-a0bdbdf6",
     "VS-6175596b",
     "VS-07ba3b17",
     "VS-9429bb8d",
     "VS-d6097011",
     "VS-3c632d31",
     "VS-4408605e",
     "VS-3f067795",
     "VS-9207ed51"
    ],
    "total_pages_affected": 399,
    "max_severity": "Critical"
   },
   {
    "cluster_id": "8af1f05d",
    "type": "wcag_criterion",
    "wcag_sc": "3.1.1",
    "wcag_name": "Language of Page",
    "wcag_level": "A",
    "findings": [
     "VS-c126b6a6",
     "VS-7a0e5645"
    ],
    "total_pages_affected": 361,
    "max_severity": "Serious"
   },
   {
    "cluster_id": "945c7205",
    "type": "wcag_criterion",
    "wcag_sc": "1.1.1",
    "wcag_name": "Non-text Content",
    "wcag_level": "A",
    "findings": [
     "VS-9074b4dd",
     "VS-a24eaa8c"
    ],
    "total_pages_affected": 349,
    "max_severity": "Critical"
   },
   {
    "cluster_id": "0649d9b9",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-f18df681"
    ],
    "total_pages_affected": 307,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "91fd3b4c",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-d5d82446"
    ],
    "total_pages_affected": 305,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "7774d667",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-0066c67d"
    ],
    "total_pages_affected": 298,
    "max_severity": "Minor"
   },
   {
    "cluster_id": "e08c8d69",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-d25f622d"
    ],
    "total_pages_affected": 277,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "71f257a8",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.6",
    "wcag_name": "Contrast (Enhanced)",
    "wcag_level": "AAA",
    "findings": [
     "VS-646b1e0b"
    ],
    "total_pages_affected": 190,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "fd9ed1c5",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.3",
    "wcag_name": "Label in Name",
    "wcag_level": "A",
    "findings": [
     "VS-f7dba940"
    ],
    "total_pages_affected": 189,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "b05da4e9",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-f054f4a4"
    ],
    "total_pages_affected": 164,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "36ac08de",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-c18be945"
    ],
    "total_pages_affected": 163,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "4b43ba23",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-2cd767ca"
    ],
    "total_pages_affected": 124,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "24c4a455",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.8",
    "wcag_name": "Target Size (Minimum)",
    "wcag_level": "AA",
    "findings": [
     "VS-179ad9b3"
    ],
    "total_pages_affected": 103,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "05fbc261",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-bd13f00a"
    ],
    "total_pages_affected": 98,
    "max_severity": "Serious"
   },
   {
    "cluster_id": "66669a92",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-04a9d28c"
    ],
    "total_pages_affected": 57,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "aa39dafc",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-0ba8ce9d"
    ],
    "total_pages_affected": 42,
    "max_severity": "Moderate"
   }
  ],
  "by_url_pattern": [
   {
    "cluster_id": "034daebc",
    "type": "url_pattern",
    "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
    "findings": [
     "VS-6175596b",
     "VS-e9fe47ac",
     "VS-c613c153",
     "VS-0ba8ce9d",
     "VS-3f067795",
     "VS-f2542d87",
     "VS-91d2294a",
     "VS-3d033717",
     "VS-d69fc059"
    ],
    "total_pages": 44
   },
   {
    "cluster_id": "7d8c5ddc",
    "type": "url_pattern",
    "pattern": "/medicare-coverage-database/view/lcd.aspx",
    "findings": [
     "VS-be8d563e",
     "VS-6175596b",
     "VS-388b5438",
     "VS-efd91fdd",
     "VS-48291402",
     "VS-f7e99f4b",
     "VS-d69fc059"
    ],
    "total_pages": 35
   },
   {
    "cluster_id": "64453d83",
    "type": "url_pattern",
    "pattern": "/medicare-coverage-database/view/article.aspx",
    "findings": [
     "VS-4408605e",
     "VS-388b5438",
     "VS-efd91fdd",
     "VS-48291402",
     "VS-3d033717"
    ],
    "total_pages": 27
   },
   {
    "cluster_id": "1eb18466",
    "type": "url_pattern",
    "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals",
    "findings": [
     "VS-07ba3b17",
     "VS-9207ed51"
    ],
    "total_pages": 3
   },
   {
    "cluster_id": "b016f25c",
    "type": "url_pattern",
    "pattern": "/data-research/cms-data/learn-more-about-cms-data",
    "findings": [
     "VS-e9fe47ac",
     "VS-28ebd979"
    ],
    "total_pages": 2
   },
   {
    "cluster_id": "13f19d0b",
    "type": "url_pattern",
    "pattern": "/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings",
    "findings": [
     "VS-dd1c019f",
     "VS-400f3a18"
    ],
    "total_pages": 2
   },
   {
    "cluster_id": "c2a5299a",
    "type": "url_pattern",
    "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P0617.html",
    "findings": [
     "VS-7fbb8b20",
     "VS-e43903a1"
    ],
    "total_pages": 2
   }
  ]
 },
 "technology_findings": [
  {
   "technology": "jQuery UI",
   "finding": "axe:heading-order",
   "lift": 9.33,
   "pages_with_both": 12,
   "technology_pages": 12,
   "interpretation": "Pages using jQuery UI are 9.33× more likely to have finding axe:heading-order."
  },
  {
   "technology": "reCAPTCHA",
   "finding": "axe:link-in-text-block",
   "lift": 3.01,
   "pages_with_both": 46,
   "technology_pages": 91,
   "interpretation": "Pages using reCAPTCHA are 3.01× more likely to have finding axe:link-in-text-block."
  },
  {
   "technology": "reCAPTCHA",
   "finding": "axe:list",
   "lift": 2.68,
   "pages_with_both": 20,
   "technology_pages": 91,
   "interpretation": "Pages using reCAPTCHA are 2.68× more likely to have finding axe:list."
  },
  {
   "technology": "jsDelivr",
   "finding": "axe:link-in-text-block",
   "lift": 2.35,
   "pages_with_both": 47,
   "technology_pages": 119,
   "interpretation": "Pages using jsDelivr are 2.35× more likely to have finding axe:link-in-text-block."
  },
  {
   "technology": "Bootstrap",
   "finding": "axe:link-in-text-block",
   "lift": 2.35,
   "pages_with_both": 47,
   "technology_pages": 119,
   "interpretation": "Pages using Bootstrap are 2.35× more likely to have finding axe:link-in-text-block."
  },
  {
   "technology": "Microsoft ASP.NET",
   "finding": "axe:link-in-text-block",
   "lift": 2.35,
   "pages_with_both": 47,
   "technology_pages": 119,
   "interpretation": "Pages using Microsoft ASP.NET are 2.35× more likely to have finding axe:link-in-text-block."
  },
  {
   "technology": "jsDelivr",
   "finding": "axe:list",
   "lift": 2.35,
   "pages_with_both": 23,
   "technology_pages": 119,
   "interpretation": "Pages using jsDelivr are 2.35× more likely to have finding axe:list."
  },
  {
   "technology": "Bootstrap",
   "finding": "axe:list",
   "lift": 2.35,
   "pages_with_both": 23,
   "technology_pages": 119,
   "interpretation": "Pages using Bootstrap are 2.35× more likely to have finding axe:list."
  },
  {
   "technology": "Microsoft ASP.NET",
   "finding": "axe:list",
   "lift": 2.35,
   "pages_with_both": 23,
   "technology_pages": 119,
   "interpretation": "Pages using Microsoft ASP.NET are 2.35× more likely to have finding axe:list."
  },
  {
   "technology": "jsDelivr",
   "finding": "alfa:sia-r66",
   "lift": 2.35,
   "pages_with_both": 19,
   "technology_pages": 119,
   "interpretation": "Pages using jsDelivr are 2.35× more likely to have finding alfa:sia-r66."
  },
  {
   "technology": "jsDelivr",
   "finding": "alfa:sia-r74",
   "lift": 2.35,
   "pages_with_both": 19,
   "technology_pages": 119,
   "interpretation": "Pages using jsDelivr are 2.35× more likely to have finding alfa:sia-r74."
  },
  {
   "technology": "jsDelivr",
   "finding": "alfa:sia-r14",
   "lift": 2.35,
   "pages_with_both": 19,
   "technology_pages": 119,
   "interpretation": "Pages using jsDelivr are 2.35× more likely to have finding alfa:sia-r14."
  },
  {
   "technology": "Bootstrap",
   "finding": "alfa:sia-r66",
   "lift": 2.35,
   "pages_with_both": 19,
   "technology_pages": 119,
   "interpretation": "Pages using Bootstrap are 2.35× more likely to have finding alfa:sia-r66."
  },
  {
   "technology": "Bootstrap",
   "finding": "alfa:sia-r74",
   "lift": 2.35,
   "pages_with_both": 19,
   "technology_pages": 119,
   "interpretation": "Pages using Bootstrap are 2.35× more likely to have finding alfa:sia-r74."
  },
  {
   "technology": "Bootstrap",
   "finding": "alfa:sia-r14",
   "lift": 2.35,
   "pages_with_both": 19,
   "technology_pages": 119,
   "interpretation": "Pages using Bootstrap are 2.35× more likely to have finding alfa:sia-r14."
  }
 ],
 "third_party_findings": [
  {
   "origin": "jsdelivr.net",
   "pages_served": 323,
   "pages_with_findings": 213,
   "finding_co_occurrence_rate": 0.66,
   "median_bytes": 8320,
   "example_pages": [
    "https://cms.gov/medicare-coverage-database/reports/local-coverage-proposed-lcds-alphabetical-report.aspx?proposedStatus=all",
    "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39770&lcdStatus=all&sortBy=title&ver=13",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56199&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=115"
   ]
  },
  {
   "origin": "gstatic.com",
   "pages_served": 251,
   "pages_with_findings": 144,
   "finding_co_occurrence_rate": 0.57,
   "median_bytes": 1559242,
   "example_pages": [
    "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39770&lcdStatus=all&sortBy=title&ver=13",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56199&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=115",
    "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37779&lcdStatus=all&sortBy=title&stateRegion=all&ver=16"
   ]
  },
  {
   "origin": "google.com",
   "pages_served": 250,
   "pages_with_findings": 143,
   "finding_co_occurrence_rate": 0.57,
   "median_bytes": 42191,
   "example_pages": [
    "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39770&lcdStatus=all&sortBy=title&ver=13",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56199&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=115",
    "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37779&lcdStatus=all&sortBy=title&stateRegion=all&ver=16"
   ]
  }
 ],
 "metadata": {
  "generator": "vital-core",
  "schema_version": "0.1",
  "total_pages_scanned": 4664,
  "notes": [
   "Healthy pages (no known issues) are intentionally excluded.",
   "Representative examples are used instead of complete occurrence lists.",
   "Fingerprints are stable hashes for tracking recurring patterns over time.",
   "Fragment fingerprints normalize volatile attributes (id, style, data-*) before hashing.",
   "Technology lift values indicate association, not causation.",
   "Confidence reflects sample size: high=10+ affected pages, medium=3-9, low=1-2."
  ]
 }
}