# Accessibility bug reports — www.medicaid.gov, week 2026-W24

38 issue type(s) from 2828 pages scanned. Generated 2026-07-06 by [vital-scans](https://github.com/mgifford/vital-core), following [accessibility bug-reporting best practices](https://mgifford.github.io/ACCESSIBILITY.md/examples/ACCESSIBILITY_BUG_REPORTING_BEST_PRACTICES.html).

> Automated checks find roughly a third of accessibility barriers. Fields marked "requires manual testing" cannot be observed by an automated scan and need a human with assistive technology.

---
## Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8)

**Bug ID:** `VS-60c1f6f9`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=  
**XPath / selector:** `<textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">`  
**WCAG SC:** 2.5.8 — Target Size (Minimum) (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r113` ([reference](https://alfa.siteimprove.com/rules/sia-r113))  
**Severity:** Moderate  
**Frequency:** 82 instances; 39 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 39 of 2828 scanned pages (82 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=.
2. Locate the element: <textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">
3. Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

### Impact
Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%).
- **Limited manipulation/strength** (13.0% of population)
- **Limited reach** (2.0% of population)
- **Limited vision** (2.4% of population)

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=4&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=50&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=1&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8806&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=991&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=811&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1026&limit=10&page=0&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=7971&limit=10&page=2&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1041&limit=10&page=7&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=2&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=861&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8761&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1036&limit=10&page=1&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=846&page=3&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=711&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=996&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=19&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=981&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8766&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=7971&limit=10&page=0&q=&sort=field_approval_date%3Adesc

…and more — 39 pages total ([download CSV](csv/alfa__sia-r113.csv)).

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

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

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=4&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=

---

## Accessible name of link or button matches visible label (WCAG 2.5.3)

**Bug ID:** `VS-0750bf19`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276  
**XPath / selector:** `<a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">`  
**WCAG SC:** 2.5.3 — Label in Name (Level A)  
**Rule:** Siteimprove Alfa — `sia-r14` ([reference](https://alfa.siteimprove.com/rules/sia-r14))  
**Severity:** Moderate  
**Frequency:** 123 instances; 123 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 123 of 2828 scanned pages (123 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276.
2. Locate the element: <a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">
3. Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name.

### Impact
Affects Without vision (1.0%), Without speech (0.5%).
- **Without vision** (1.0% of population)
- **Without speech** (0.5% of population)

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-006-6
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002076
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg011161
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002017
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/clt-claim-long-term-care/claim-line-record-lt
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-31-008-8
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006196
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-037-37
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv002140
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008290
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-798
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-18-007-7
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7255
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002039
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003251
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095373
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002244
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7816
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-14-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002025
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-043-43
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8669

…and more — 123 pages total ([download CSV](csv/alfa__sia-r14.csv)).

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-006-6

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-38918f70`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `p:nth-child(1) > a > img`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** axe-core — `image-alt` ([reference](https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 1 instances; 1 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<img src="/media/file/monitor-eval-1115-demonstrations0.png/">
```

### Description
Images must have alternative text. Detected by axe-core rule image-alt on 1 of 2828 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation.
2. Locate the element: p:nth-child(1) > a > img
3. Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation

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

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

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

---

## Image has accessible name (WCAG 1.1.1)

**Bug ID:** `VS-29ab8ed7`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `<img src="/media/file/monitor-eval-1115-demonstrations0.png/">`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** Siteimprove Alfa — `sia-r2` ([reference](https://alfa.siteimprove.com/rules/sia-r2))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 1 of 2828 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation.
2. Locate the element: <img src="/media/file/monitor-eval-1115-demonstrations0.png/">
3. Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation

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

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

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

---

## Certain ARIA roles must contain particular children (WCAG 1.3.1)

**Bug ID:** `VS-6e7c847d`  
**Pattern ID:** `VS-9429bb8d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276  
**XPath / selector:** `.nav`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `aria-required-children` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 311 instances; 311 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<div class="nav nav-tabs nav-justified" role="tablist">
```

### Description
Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 311 of 2828 scanned pages (311 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276.
2. Locate the element: .nav
3. Confirm the axe-core finding for rule aria-required-children against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002041
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008285
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002116
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002076
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003193
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx001012
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002077
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002082
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004122
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg011161
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008304
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002017
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006194
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/clt-claim-long-term-care/claim-line-record-lt
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095390
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg016215
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006196
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003264
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/tpl006086
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg005088
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg005092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002178
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv008113

…and more — 311 pages total ([download CSV](csv/axe-core__aria-required-children.csv)).

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

### Suggested fix
**How to fix:** Add the child roles this container role requires (e.g. a list needs listitem children).

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002041

---

## Presentational children of an element are not focusable (WCAG 1.3.1)

**Bug ID:** `VS-8e1bc774`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276  
**XPath / selector:** `<div class="nav nav-tabs nav-justified" role="tablist">`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r68` ([reference](https://alfa.siteimprove.com/rules/sia-r68))  
**Severity:** Moderate  
**Frequency:** 121 instances; 117 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 117 of 2828 scanned pages (121 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276.
2. Locate the element: <div class="nav nav-tabs nav-justified" role="tablist">
3. Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002076
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg011161
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002017
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/clt-claim-long-term-care/claim-line-record-lt
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006196
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=4&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv002140
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008290
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002039
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003251
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=50&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095373
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=1&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002244
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=991&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=811&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002025
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1026&limit=10&page=0&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=2&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx007250
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/tpl002019

…and more — 117 pages total ([download CSV](csv/alfa__sia-r68.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002076

---

## Element has required aria-owns (WCAG 1.3.1)

**Bug ID:** `VS-15bc5e81`  
**Pattern ID:** `VS-4408605e`  
**URL:** https://www.medicaid.gov/state-overviews/puerto-rico.html  
**XPath / selector:** `<th>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r46` ([reference](https://alfa.siteimprove.com/rules/sia-r46))  
**Severity:** Moderate  
**Frequency:** 6 instances; 4 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 4 of 2828 scanned pages (6 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/state-overviews/puerto-rico.html.
2. Locate the element: <th>
3. Confirm the Siteimprove Alfa finding for rule sia-r46 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.medicaid.gov/state-overviews/puerto-rico.html
- https://www.medicaid.gov/state-overviews/usvi.html
- https://www.medicaid.gov/state-overviews/guam.html
- https://www.medicaid.gov/medicaid/outreach-tools/helping-connect-enrollees-care

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r46

### Example pages
- https://www.medicaid.gov/state-overviews/puerto-rico.html
- https://www.medicaid.gov/state-overviews/usvi.html
- https://www.medicaid.gov/state-overviews/guam.html

---

## Table cell has header (WCAG 1.3.1)

**Bug ID:** `VS-a31e003b`  
**Pattern ID:** `VS-3f067795`  
**URL:** https://www.medicaid.gov/state-overviews/puerto-rico.html  
**XPath / selector:** `<td>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r77` ([reference](https://alfa.siteimprove.com/rules/sia-r77))  
**Severity:** Moderate  
**Frequency:** 25 instances; 3 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 3 of 2828 scanned pages (25 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/state-overviews/puerto-rico.html.
2. Locate the element: <td>
3. Confirm the Siteimprove Alfa finding for rule sia-r77 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.medicaid.gov/state-overviews/puerto-rico.html
- https://www.medicaid.gov/state-overviews/usvi.html
- https://www.medicaid.gov/state-overviews/guam.html

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r77

### Example pages
- https://www.medicaid.gov/state-overviews/puerto-rico.html
- https://www.medicaid.gov/state-overviews/usvi.html
- https://www.medicaid.gov/state-overviews/guam.html

---

## Link in text block is visually distinguishable without color (WCAG 1.4.1)

**Bug ID:** `VS-4989edbf`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality  
**XPath / selector:** `<a style="text-decoration:none;" href="#one" title="">`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** Siteimprove Alfa — `sia-r62` ([reference](https://alfa.siteimprove.com/rules/sia-r62))  
**Severity:** Moderate  
**Frequency:** 12 instances; 4 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 4 of 2828 scanned pages (12 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality.
2. Locate the element: <a style="text-decoration:none;" href="#one" title="">
3. Confirm the Siteimprove Alfa finding for rule sia-r62 against WCAG 1.4.1 Use of Color.

### Impact
Affects Without color perception (4.5%), Limited vision (2.4%).
- **Without color perception** (4.5% of population)
- **Limited vision** (2.4% of population)

### Affected pages
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/addressing-childhood-obesity
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/maternal-infant-health-care-quality
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/oral-health-quality-improvement-resources/advancing-oral-health-prevention-in-primary-care

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

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

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

### Example pages
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/addressing-childhood-obesity
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/maternal-infant-health-care-quality

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-f1a54936`  
**Pattern ID:** `VS-e9fe47ac`  
**URL:** https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `p:nth-child(1) > a`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** axe-core — `link-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1 instances; 1 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<a href="/medicaid/section-1115-demonstrations/downloads/monitor-eval-1115-demonstrations-infographic.pdf"><img src="/media/file/monitor-eval-1115-demonstrations0.png/"></a>
```

### Description
Links must have discernible text. Detected by axe-core rule link-name on 1 of 2828 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation.
2. Locate the element: p:nth-child(1) > a
3. Confirm the axe-core finding for rule link-name against WCAG 2.4.4 Link Purpose (In Context).

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation

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

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

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

---

## Link has accessible name (WCAG 2.4.4)

**Bug ID:** `VS-bf3ec45d`  
**Pattern ID:** `VS-28ebd979`  
**URL:** https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `<a href="/medicaid/section-1115-demonstrations/downloads/monitor-eval-1115-demonstrations-infographic.pdf">`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** Siteimprove Alfa — `sia-r11` ([reference](https://alfa.siteimprove.com/rules/sia-r11))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 2828 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation.
2. Locate the element: <a href="/medicaid/section-1115-demonstrations/downloads/monitor-eval-1115-demonstrations-infographic.pdf">
3. Confirm the Siteimprove Alfa finding for rule sia-r11 against WCAG 2.4.4 Link Purpose (In Context).

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation

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

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

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

---

## Elements must only use supported ARIA attributes (WCAG 4.1.2)

**Bug ID:** `VS-500b7c76`  
**Pattern ID:** `VS-1467ea8a`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276  
**XPath / selector:** `a[href$="#overview"]`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-allowed-attr` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 1513 instances; 311 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<a class="nav-item nav-link active" href="#overview" role="link" aria-selected="true" aria-controls="overview" data-toggle="tab">Overview</a>
```

### Description
Elements must only use supported ARIA attributes. Detected by axe-core rule aria-allowed-attr on 311 of 2828 scanned pages (1513 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276.
2. Locate the element: a[href$="#overview"]
3. Confirm the axe-core finding for rule aria-allowed-attr against WCAG 4.1.2 Name, Role, Value.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited manipulation/strength** (13.0% of population)

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002041
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008285
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002116
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002076
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003193
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx001012
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002077
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002082
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004122
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg011161
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008304
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002017
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006194
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/clt-claim-long-term-care/claim-line-record-lt
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095390
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg016215
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006196
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003264
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/tpl006086
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg005088
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg005092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002178
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv008113

…and more — 311 pages total ([download CSV](csv/axe-core__aria-allowed-attr.csv)).

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

### Suggested fix
**How to fix:** Remove ARIA attributes that aren't allowed on this role/element.

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002041

---

## Select element must have an accessible name (WCAG 4.1.2)

**Bug ID:** `VS-a4f15ed1`  
**Pattern ID:** `VS-fab92378`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/technical-instructions  
**XPath / selector:** `#items-per-page`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `select-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/select-name?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 1 instances; 1 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<select id="items-per-page" class="form-select">
                                <option value="10">10</option>
                                <option value="25">25</option>
                         
```

### Description
Select element must have an accessible name. Detected by axe-core rule select-name on 1 of 2828 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/technical-instructions.
2. Locate the element: #items-per-page
3. Confirm the axe-core finding for rule select-name against WCAG 4.1.2 Name, Role, Value.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited manipulation/strength** (13.0% of population)

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/technical-instructions

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

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

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

---

## ARIA input fields must have an accessible name (WCAG 4.1.2)

**Bug ID:** `VS-ffd9963e`  
**Pattern ID:** `VS-0841abc2`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=981&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-ocgy"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-input-field-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-input-field-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 245 instances; 116 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false" tabindex="-1" aria-disabled="false">
```

### Description
ARIA input fields must have an accessible name. Detected by axe-core rule aria-input-field-name on 116 of 2828 scanned pages (245 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=981&q=.
2. Locate the element: span[data-select2-id="select2-data-1-ocgy"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]
3. Confirm the axe-core finding for rule aria-input-field-name against WCAG 4.1.2 Name, Role, Value.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited manipulation/strength** (13.0% of population)

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=981&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=2&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=791&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=826&page=28&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=4&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=2&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=4&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=726&page=0&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=861&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=846&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=7971&limit=10&page=1&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1041&limit=10&page=1&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=50&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=1&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8806&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=991&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1041&limit=10&page=0&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=1&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=811&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=3&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1026&limit=10&page=0&q=&sort=field_approval_date%3Adesc

…and more — 116 pages total ([download CSV](csv/axe-core__aria-input-field-name.csv)).

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

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-input-field-name?application=axeAPI

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=981&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=2&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=791&q=

---

## Elements must only use permitted ARIA attributes (WCAG 4.1.2)

**Bug ID:** `VS-9a2228bf`  
**Pattern ID:** `VS-ebb1c464`  
**URL:** https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa  
**XPath / selector:** `#map-svg-map-1733145095414`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-prohibited-attr` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-prohibited-attr?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 8 instances; 7 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<div id="map-svg-map-1733145095414" class="map-container" aria-disabled="true" aria-label="State Map Image. Keyboard navigating users can use dropdown to select state." style="position: relative; widt
```

### Description
Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 7 of 2828 scanned pages (8 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa.
2. Locate the element: #map-svg-map-1733145095414
3. Confirm the axe-core finding for rule aria-prohibited-attr against WCAG 4.1.2 Name, Role, Value.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited manipulation/strength** (13.0% of population)

### Affected pages
- https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa
- https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/covid-19-phe-unwinding-section-1902e14a-waiver-approvals
- https://www.medicaid.gov/state-overviews/state-profiles/index.html
- https://www.medicaid.gov/about-us/where-can-people-get-help-medicaid-chip
- https://www.medicaid.gov/chip/state-program-information
- https://www.medicaid.gov/eligibility
- https://www.medicaid.gov/medicaid/data-systems/it-procurement-opportunities

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

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-prohibited-attr?application=axeAPI

### Example pages
- https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa
- https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/covid-19-phe-unwinding-section-1902e14a-waiver-approvals
- https://www.medicaid.gov/state-overviews/state-profiles/index.html

---

## Form field has accessible name (WCAG 4.1.2)

**Bug ID:** `VS-b1263685`  
**Pattern ID:** `VS-a48e6078`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=  
**XPath / selector:** `<span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false">`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** Siteimprove Alfa — `sia-r8` ([reference](https://alfa.siteimprove.com/rules/sia-r8))  
**Severity:** Moderate  
**Frequency:** 82 instances; 39 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 39 of 2828 scanned pages (82 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=.
2. Locate the element: <span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false">
3. Confirm the Siteimprove Alfa finding for rule sia-r8 against WCAG 4.1.2 Name, Role, Value.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited manipulation/strength** (13.0% of population)

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=4&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=50&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=1&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8806&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=991&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=811&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1026&limit=10&page=0&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=7971&limit=10&page=2&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1041&limit=10&page=7&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=2&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=861&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8761&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1036&limit=10&page=1&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=846&page=3&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=711&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=996&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=19&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=981&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8766&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=7971&limit=10&page=0&q=&sort=field_approval_date%3Adesc

…and more — 39 pages total ([download CSV](csv/alfa__sia-r8.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=4&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=

---

## Elements must meet minimum color contrast ratio thresholds (WCAG 1.4.3)

**Bug ID:** `VS-f844b397`  
**Pattern ID:** `VS-be8d563e`  
**URL:** https://www.medicaid.gov/chip/reports-evaluations  
**XPath / selector:** `.helpful-box-gray-sm > p > span`  
**WCAG SC:** 1.4.3 — Contrast (Minimum) (Level AA)  
**Rule:** axe-core — `color-contrast` ([reference](https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 2 instances; 1 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<span id="nav-icon">🛈</span>
```

### Description
Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 1 of 2828 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/chip/reports-evaluations.
2. Locate the element: .helpful-box-gray-sm > p > span
3. Confirm the axe-core finding for rule color-contrast against WCAG 1.4.3 Contrast (Minimum).

### Impact
Affects Limited vision (2.4%), Without color perception (4.5%).
- **Limited vision** (2.4% of population)
- **Without color perception** (4.5% of population)

### Affected pages
- https://www.medicaid.gov/chip/reports-evaluations

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

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

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

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-e38815a9`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person  
**XPath / selector:** `text: "Here’s how you know"`  
**WCAG SC:** 1.4.6 — Contrast (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r66` ([reference](https://alfa.siteimprove.com/rules/sia-r66))  
**Severity:** Moderate  
**Frequency:** 32739 instances; 1200 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 1200 of 2828 scanned pages (32739 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person.
2. Locate the element: text: "Here’s how you know"
3. Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced).

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54067
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2009
- https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/improving-care-for-sickle-cell-disease
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations
- https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7441
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/81446
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8417
- https://www.medicaid.gov/state-overviews
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106341
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality/contraception-medicaid-improving-maternal-and-infant-health
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54036
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83526
- https://www.medicaid.gov/about-us/organization/adrienne-delozier
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/100706
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7354
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6738
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8142
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-006-6

…and more — 1200 pages total ([download CSV](csv/alfa__sia-r66.csv)).

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

### Suggested fix
**How to fix:** Increase text contrast to meet WCAG AAA (7:1).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66

### Example pages
- https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54067

---

## Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8)

**Bug ID:** `VS-6bc9ab0c`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person  
**XPath / selector:** `<p class="usa-footer__contact-info margin-bottom-0">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r73` ([reference](https://alfa.siteimprove.com/rules/sia-r73))  
**Severity:** Moderate  
**Frequency:** 3197 instances; 814 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 814 of 2828 scanned pages (3197 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person.
2. Locate the element: <p class="usa-footer__contact-info margin-bottom-0">
3. Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54067
- https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/improving-care-for-sickle-cell-disease
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations
- https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/81446
- https://www.medicaid.gov/state-overviews
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106341
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality/contraception-medicaid-improving-maternal-and-infant-health
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54036
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83526
- https://www.medicaid.gov/about-us/organization/adrienne-delozier
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/100706
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance
- https://www.medicaid.gov/resources-for-states/medicaid-state-technical-assistance/medicaid-school-based-services/us-department-of-education-school-based-services-resources
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106731
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/102166
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83201
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/81031
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/99166
- https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/covid-19-phe-unwinding-section-1902e14a-waiver-approvals
- https://www.medicaid.gov/medicaid/enrollment-strategies/medicaid-and-chip-coverage-of-lawfully-residing-children-pregnant-women
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=30488&page=3

…and more — 814 pages total ([download CSV](csv/alfa__sia-r73.csv)).

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

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

### Example pages
- https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54067

---

## Link is distinguishable without relying on color (WCAG 1.4.8)

**Bug ID:** `VS-25bcedb1`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://www.medicaid.gov/about-us/leadership  
**XPath / selector:** `<p class="MsoNormal" style="box-sizing:inherit;font-size:18px;line-height:1.5;margin-block:1em 0px;margin-bottom:0px;margin-top:0px;">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r74` ([reference](https://alfa.siteimprove.com/rules/sia-r74))  
**Severity:** Moderate  
**Frequency:** 27 instances; 11 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 11 of 2828 scanned pages (27 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/about-us/leadership.
2. Locate the element: <p class="MsoNormal" style="box-sizing:inherit;font-size:18px;line-height:1.5;margin-block:1em 0px;margin-bottom:0px;margin-top:0px;">
3. Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/about-us/leadership
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/budget-neutrality
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/medicaid/eligibility-policy/medicaid-eligibility-quality-control-program
- https://www.medicaid.gov/medicaid/enrollment-strategies/continuous-eligibility-medicaid-and-chip-coverage
- https://www.medicaid.gov/medicaid/long-term-services-supports/self-directed-services
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22AK%22%5D
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/177991
- https://www.medicaid.gov/medicaid/outreach-tools/helping-connect-enrollees-care
- https://www.medicaid.gov/medicaid/eligibility-policy/seniors-medicare-and-medicaid-enrollees

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r74

### Example pages
- https://www.medicaid.gov/about-us/leadership
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/budget-neutrality

---

## Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5)

**Bug ID:** `VS-cf41d814`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person  
**XPath / selector:** `<button class="usa-button" type="submit">`  
**WCAG SC:** 2.5.5 — Target Size (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r111` ([reference](https://alfa.siteimprove.com/rules/sia-r111))  
**Severity:** Moderate  
**Frequency:** 20156 instances; 1200 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 1200 of 2828 scanned pages (20156 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person.
2. Locate the element: <button class="usa-button" type="submit">
3. Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54067
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2009
- https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/improving-care-for-sickle-cell-disease
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations
- https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7441
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/81446
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8417
- https://www.medicaid.gov/state-overviews
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106341
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality/contraception-medicaid-improving-maternal-and-infant-health
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54036
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83526
- https://www.medicaid.gov/about-us/organization/adrienne-delozier
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/100706
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7354
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6738
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8142
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-006-6

…and more — 1200 pages total ([download CSV](csv/alfa__sia-r111.csv)).

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

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

### Example pages
- https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54067

---

## Page should contain a level-one heading (WCAG criterion undetermined)

**Bug ID:** `VS-13c6c6e4`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `page-has-heading-one` ([reference](https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1427 instances; 1427 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<html class="no-js" lang="en">
```

### Description
Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 1427 of 2828 scanned pages (1427 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317.
2. Locate the element: html
3. Confirm the axe-core finding for rule page-has-heading-one.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-1-004-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2009
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002041
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9005
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7441
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8417
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1481
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-444
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2180
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7354
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6738
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8142
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008285
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-006-6
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3096
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/OR
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8137
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7200
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002116
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8431
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002076

…and more — 1427 pages total ([download CSV](csv/axe-core__page-has-heading-one.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-1-004-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276

---

## Form elements should have a visible label (WCAG criterion undetermined)

**Bug ID:** `VS-4d3feba0`  
**Pattern ID:** `VS-33841929`  
**URL:** https://www.medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/innovative-practices  
**XPath / selector:** `select[aria-labelledby="filter-th-87376-0"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `label-title-only` ([reference](https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 41 instances; 10 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<select aria-labelledby="filter-th-87376-0" class="usa-select height-1" data-col-index="0" title="Filter by Year">
```

### Description
Form elements should have a visible label. Detected by axe-core rule label-title-only on 10 of 2828 scanned pages (41 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/innovative-practices.
2. Locate the element: select[aria-labelledby="filter-th-87376-0"]
3. Confirm the axe-core finding for rule label-title-only.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/innovative-practices
- https://www.medicaid.gov/state-overviews/state-profiles/index.html
- https://www.medicaid.gov/prior-annual-medicaid-hospice-rate-letters
- https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-data
- https://www.medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/drug-utilization-review-annual-report
- https://www.medicaid.gov/chip/reports-evaluations
- https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/home-community-based-services-during-public-health-emergencies/emergency-preparedness-and-response-for-home-and-community-based-hcbs-1915c-waivers
- https://www.medicaid.gov/medicaid/financial-management/medicaid-disproportionate-share-hospital-dsh-payments
- https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data

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

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI

### Example pages
- https://www.medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/innovative-practices
- https://www.medicaid.gov/state-overviews/state-profiles/index.html
- https://www.medicaid.gov/prior-annual-medicaid-hospice-rate-letters

---

## All page content should be contained by landmarks (WCAG criterion undetermined)

**Bug ID:** `VS-c1f1f6d9`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317  
**XPath / selector:** `.small`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 6271 instances; 1402 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<div class="small p-1">
```

### Description
All page content should be contained by landmarks. Detected by axe-core rule region on 1402 of 2828 scanned pages (6271 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317.
2. Locate the element: .small
3. Confirm the axe-core finding for rule region.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-1-004-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2009
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002041
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9005
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7441
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8417
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1481
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-444
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2180
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7354
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6738
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8142
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008285
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-006-6
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3096
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8137
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7200
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002116
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8431
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002076
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7675

…and more — 1402 pages total ([download CSV](csv/axe-core__region.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-1-004-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276

---

## Document should have one main landmark (WCAG criterion undetermined)

**Bug ID:** `VS-6bfcb63c`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-one-main` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1399 instances; 1399 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<html class="no-js" lang="en">
```

### Description
Document should have one main landmark. Detected by axe-core rule landmark-one-main on 1399 of 2828 scanned pages (1399 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317.
2. Locate the element: html
3. Confirm the axe-core finding for rule landmark-one-main.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-1-004-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2009
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002041
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9005
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7441
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8417
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1481
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-444
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2180
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7354
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6738
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8142
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008285
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-006-6
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3096
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8137
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7200
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002116
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8431
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002076
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7675

…and more — 1399 pages total ([download CSV](csv/axe-core__landmark-one-main.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-1-004-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276

---

## Heading levels should only increase by one (WCAG criterion undetermined)

**Bug ID:** `VS-12e4d570`  
**Pattern ID:** `VS-d25f622d`  
**URL:** https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j  
**XPath / selector:** `.field--name-field-resources-list > h3`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 760 instances; 711 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<h3>Related Resources</h3>
```

### Description
Heading levels should only increase by one. Detected by axe-core rule heading-order on 711 of 2828 scanned pages (760 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j.
2. Locate the element: .field--name-field-resources-list > h3
3. Confirm the axe-core finding for rule heading-order.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54067
- https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations
- https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581
- https://www.medicaid.gov/state-overviews
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106341
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality/contraception-medicaid-improving-maternal-and-infant-health
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54036
- https://www.medicaid.gov/about-us/organization/adrienne-delozier
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/100706
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106731
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/102166
- https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-dispute-resolution
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/99166
- https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/covid-19-phe-unwinding-section-1902e14a-waiver-approvals
- https://www.medicaid.gov/medicaid/enrollment-strategies/medicaid-and-chip-coverage-of-lawfully-residing-children-pregnant-women
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/quality-of-care-patient-safety
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/192776
- https://www.medicaid.gov/medicaid/program-integrity/affordable-care-act-program-integrity-provisions
- https://www.medicaid.gov/state-overviews/stateprofile.html?state=Alabama
- https://www.medicaid.gov/resources-for-states/eligibility-enrollment-and-renewal-tools-and-resources/application-and-fair-hearings-resources
- https://www.medicaid.gov/medicaid/home-community-based-services/home-and-community-based-services-hcbs-quality
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation

…and more — 711 pages total ([download CSV](csv/axe-core__heading-order.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54067
- https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa

---

## Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined)

**Bug ID:** `VS-e745a5bc`  
**Pattern ID:** `VS-8806389c`  
**URL:** https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person  
**XPath / selector:** `.section`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-unique` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 85 instances; 85 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<aside class="section" role="complementary">
```

### Description
Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 85 of 2828 scanned pages (85 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person.
2. Locate the element: .section
3. Confirm the axe-core finding for rule landmark-unique.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- https://www.medicaid.gov/state-overviews
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
- https://www.medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality
- https://www.medicaid.gov/claims-under-camp-lejeune-justice-act-clja
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=2
- https://www.medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/promoting-community-integration-through-long-term-services-and-supports
- https://www.medicaid.gov/medicaid/financial-management/state-budget-expenditure-reporting-for-medicaid-and-chip/expenditure-reports-mbes/cbes
- https://www.medicaid.gov/medicaid/indian-health-medicaid/tribal-affairs-guidance-resources
- https://www.medicaid.gov/medicaid/managed-care/technical-assistance
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities
- https://www.medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly
- https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance
- https://www.medicaid.gov/medicaid/indian-health-medicaid
- https://www.medicaid.gov/medicaid/long-term-services-supports/medicaid-employment-initiatives
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=0
- https://www.medicaid.gov/medicaid/prescription-drugs
- https://www.medicaid.gov/medicaid/long-term-services-supports/direct-care-workforce
- https://www.medicaid.gov/medicaid/benefits/early-and-periodic-screening-diagnostic-and-treatment/vision-and-hearing-screening-services-children-and-adolescents
- https://www.medicaid.gov/medicaid/benefits/prevention
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/measuring-and-improving-quality-home-and-community-based-services
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/measuring-and-improving-quality-home-and-community-based-services

…and more — 85 pages total ([download CSV](csv/axe-core__landmark-unique.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- https://www.medicaid.gov/state-overviews
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation

---

## scope attribute should be used correctly (WCAG criterion undetermined)

**Bug ID:** `VS-caa1d8ec`  
**Pattern ID:** `VS-0ba8ce9d`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/about  
**XPath / selector:** `tr:nth-child(1) > td[scope="row"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `scope-attr-valid` ([reference](https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 60 instances; 3 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<td scope="row">Fact Sheet for Child and Adult Core Sets Reporting</td>
```

### Description
scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 3 of 2828 scanned pages (60 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/about.
2. Locate the element: tr:nth-child(1) > td[scope="row"]
3. Confirm the axe-core finding for rule scope-attr-valid.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/about
- https://www.medicaid.gov/state-overviews/scorecard/about
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels

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

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI

### Example pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/about
- https://www.medicaid.gov/state-overviews/scorecard/about
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels

---

## ARIA role should be appropriate for the element (WCAG criterion undetermined)

**Bug ID:** `VS-506ca282`  
**Pattern ID:** `VS-4fac2f41`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=981&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-ocgy"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `aria-allowed-role` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 254 instances; 122 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off" autocapitalize="none" spellcheck="false" role="searchbox" aria-autocomplete="list" autocomplete="off" aria-label="S
```

### Description
ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 122 of 2828 scanned pages (254 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=981&q=.
2. Locate the element: span[data-select2-id="select2-data-1-ocgy"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea
3. Confirm the axe-core finding for rule aria-allowed-role.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=981&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=2&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=791&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=826&page=28&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=4&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=2&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=4&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=726&page=0&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=861&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=846&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=7971&limit=10&page=1&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1041&limit=10&page=1&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=50&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=1&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8806&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=991&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1041&limit=10&page=0&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=1&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=811&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=3&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1026&limit=10&page=0&q=&sort=field_approval_date%3Adesc

…and more — 122 pages total ([download CSV](csv/axe-core__aria-allowed-role.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=981&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=2&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=791&q=

---

## Presentational attribute (use CSS) (WCAG criterion undetermined)

**Bug ID:** `VS-8588b937`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317  
**XPath / selector:** `td`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 1387 instances; 1227 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<td valign="top" colspan="7" class="dataTables_empty">No data available in table</td>
```

### Description
Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 1227 of 2828 scanned pages (1387 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317.
2. Locate the element: td
3. Confirm the deprecated-html finding for rule presentational-attr.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2009
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002041
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9005
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7441
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8417
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1481
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-444
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2180
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7354
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6738
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8142
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3096
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8137
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002116
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8431
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002076
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7675
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6525
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6687
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7229
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8987

…and more — 1227 pages total ([download CSV](csv/deprecated-html__presentational-attr.csv)).

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

### Suggested fix
Not captured by automated scan — requires manual testing.

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356

---

## Scrolling content can be accessed by keyboard (WCAG criterion undetermined)

**Bug ID:** `VS-9559ef51`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person  
**XPath / selector:** `text: "  Feedback  "`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 14377 instances; 1198 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 1198 of 2828 scanned pages (14377 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person.
2. Locate the element: text: "  Feedback  "
3. Confirm the Siteimprove Alfa finding for rule sia-r57.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54067
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2009
- https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/improving-care-for-sickle-cell-disease
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations
- https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7441
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/81446
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8417
- https://www.medicaid.gov/state-overviews
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106341
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality/contraception-medicaid-improving-maternal-and-infant-health
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54036
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83526
- https://www.medicaid.gov/about-us/organization/adrienne-delozier
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/100706
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7354
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6738
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8142
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-006-6

…and more — 1198 pages total ([download CSV](csv/alfa__sia-r57.csv)).

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

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

### Example pages
- https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54067

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-04253ab1`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j  
**XPath / selector:** `<h3>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 645 instances; 601 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 601 of 2828 scanned pages (645 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j.
2. Locate the element: <h3>
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54067
- https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations
- https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581
- https://www.medicaid.gov/state-overviews
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106341
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality/contraception-medicaid-improving-maternal-and-infant-health
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54036
- https://www.medicaid.gov/about-us/organization/adrienne-delozier
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/100706
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106731
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/102166
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/99166
- https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/covid-19-phe-unwinding-section-1902e14a-waiver-approvals
- https://www.medicaid.gov/medicaid/enrollment-strategies/medicaid-and-chip-coverage-of-lawfully-residing-children-pregnant-women
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/quality-of-care-patient-safety
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/192776
- https://www.medicaid.gov/medicaid/program-integrity/affordable-care-act-program-integrity-provisions
- https://www.medicaid.gov/state-overviews/stateprofile.html?state=Alabama
- https://www.medicaid.gov/resources-for-states/eligibility-enrollment-and-renewal-tools-and-resources/application-and-fair-hearings-resources
- https://www.medicaid.gov/medicaid/home-community-based-services/home-and-community-based-services-hcbs-quality
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/101611

…and more — 601 pages total ([download CSV](csv/alfa__sia-r53.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54067
- https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa

---

## Form field label is visible (WCAG criterion undetermined)

**Bug ID:** `VS-863a3715`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r61` ([reference](https://alfa.siteimprove.com/rules/sia-r61))  
**Severity:** Moderate  
**Frequency:** 395 instances; 395 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 395 of 2828 scanned pages (395 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r61.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2009
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7441
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8417
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7354
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6738
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8142
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-006-6
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3096
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002076
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8404
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2126
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8933
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6499
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg011161
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002017
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-886
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7005
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7053
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/clt-claim-long-term-care/claim-line-record-lt
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1986
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-31-008-8
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9170
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6713

…and more — 395 pages total ([download CSV](csv/alfa__sia-r61.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2009
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272

---

## First focusable element is link to main content (WCAG criterion undetermined)

**Bug ID:** `VS-40a6c5b4`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r87` ([reference](https://alfa.siteimprove.com/rules/sia-r87))  
**Severity:** Moderate  
**Frequency:** 390 instances; 390 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 390 of 2828 scanned pages (390 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r87.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2009
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7441
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8417
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7354
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6738
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8142
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-006-6
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3096
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002076
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8404
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2126
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8933
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6499
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg011161
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002017
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-886
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7005
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7053
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/clt-claim-long-term-care/claim-line-record-lt
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1986
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-31-008-8
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9170
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6713

…and more — 390 pages total ([download CSV](csv/alfa__sia-r87.csv)).

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r87

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2009
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272

---

## aria attribute is permitted for element role (WCAG criterion undetermined)

**Bug ID:** `VS-6e60db44`  
**Pattern ID:** `VS-e05344b9`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276  
**XPath / selector:** `@aria-selected="true"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 441 instances; 94 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 94 of 2828 scanned pages (441 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276.
2. Locate the element: @aria-selected="true"
3. Confirm the Siteimprove Alfa finding for rule sia-r18.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002076
- https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/covid-19-phe-unwinding-section-1902e14a-waiver-approvals
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg011161
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002017
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/clt-claim-long-term-care/claim-line-record-lt
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006196
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv002140
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008290
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002039
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003251
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095373
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002244
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002025
- https://www.medicaid.gov/about-us/where-can-people-get-help-medicaid-chip
- https://www.medicaid.gov/prior-annual-medicaid-hospice-rate-letters
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx007250
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/tpl002019
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002043
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt003196
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/tpl003030

…and more — 94 pages total ([download CSV](csv/alfa__sia-r18.csv)).

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

### Suggested fix
**How to fix:** Only use ARIA states/properties that are allowed on this element/role.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r18

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004276
- https://www.medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-2cff28d4`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D  
**XPath / selector:** `<h3 _ngcontent-ng-c1329502141="" class="view-measures-related-to-header core-set ng-star-inserted">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r78` ([reference](https://alfa.siteimprove.com/rules/sia-r78))  
**Severity:** Moderate  
**Frequency:** 9 instances; 6 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 6 of 2828 scanned pages (9 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D.
2. Locate the element: <h3 _ngcontent-ng-c1329502141="" class="view-measures-related-to-header core-set ng-star-inserted">
3. Confirm the Siteimprove Alfa finding for rule sia-r78.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/resources-for-states/medicaid-and-chip-program-portal
- https://www.medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly/programs-of-all-inclusive-care-for-elderly-for-states
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22AK%22%5D
- https://www.medicaid.gov/resources-for-states/medicaid-and-chip-program-portal/macpro-training-help/chip-state-plan-amendments

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

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

### Example pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/resources-for-states/medicaid-and-chip-program-portal

---

## Element role is consistent with ARIA landmark (WCAG criterion undetermined)

**Bug ID:** `VS-79322ee9`  
**Pattern ID:** `VS-e5ec42f0`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D  
**XPath / selector:** `<p _ngcontent-ng-c2822395467="" class="title core-set">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r72` ([reference](https://alfa.siteimprove.com/rules/sia-r72))  
**Severity:** Moderate  
**Frequency:** 466 instances; 4 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 4 of 2828 scanned pages (466 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D.
2. Locate the element: <p _ngcontent-ng-c2822395467="" class="title core-set">
3. Confirm the Siteimprove Alfa finding for rule sia-r72.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/state-overviews/scorecard/about
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22AK%22%5D

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r72

### Example pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/state-overviews/scorecard/about

---

## Keyboard trap does not exist (WCAG criterion undetermined)

**Bug ID:** `VS-3f3f49bb`  
**Pattern ID:** `VS-4c341c77`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D  
**XPath / selector:** `<p class="selected-states-header">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r85` ([reference](https://alfa.siteimprove.com/rules/sia-r85))  
**Severity:** Moderate  
**Frequency:** 161 instances; 3 of 2828 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 3 of 2828 scanned pages (161 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D.
2. Locate the element: <p class="selected-states-header">
3. Confirm the Siteimprove Alfa finding for rule sia-r85.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22AK%22%5D

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r85

### Example pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22FL%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22AK%22%5D