# Accessibility bug reports — www.medicaid.gov, week 2026-W26

35 issue type(s) from 8291 pages scanned. Generated 2026-07-13 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-b5fa69fb`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&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:** 473 instances; 226 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 226 of 8291 scanned pages (473 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&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=696&page=29&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=44&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=34&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/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=831&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=11&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=791&page=3&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=20&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=886&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=32&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=881&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=876&page=24&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=42&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=831&page=29&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=6&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=726&page=54&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=29&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=6&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=826&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=24&q=

…and more — 226 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=696&page=29&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=44&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=

---

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

**Bug ID:** `VS-142949df`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236  
**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:** 1732 instances; 1732 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 1732 of 8291 scanned pages (1732 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236.
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/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-793
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6238
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7836
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1620
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-156-156
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004124
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-81-032-32
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg013184
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-83-006-6
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-s-013-13
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8737
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-018-13
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7168
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg008133
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1658
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-341
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7627
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7945
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2498

…and more — 1732 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/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-64562f0f`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** http://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 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (2 weeks)

### 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 8291 scanned pages (1 instances).

### Steps to reproduce
1. Open http://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
- http://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-3ceba623`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** http://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 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (2 weeks)

### Description
Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 1 of 8291 scanned pages (1 instances).

### Steps to reproduce
1. Open http://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
- http://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-388c3bd1`  
**Pattern ID:** `VS-9429bb8d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236  
**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:** 1495 instances; 1495 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### 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 1495 of 8291 scanned pages (1495 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236.
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/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv007100
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003222
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg003030
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002174
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl006077
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002026
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003174
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004124
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003037
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002074
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg013184
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002106
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg014192
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002088
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003178
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl001088
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt002090

…and more — 1495 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/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv007100
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159

---

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

**Bug ID:** `VS-8faf6525`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236  
**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:** 992 instances; 971 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 971 of 8291 scanned pages (992 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236.
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/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003222
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002174
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002026
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004124
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003037
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002074
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg013184
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=44&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg008133
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002057
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003197
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=34&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002078
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr004059
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003193
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002060
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003206
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip003285
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=2&q=

…and more — 971 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/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179

---

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

**Bug ID:** `VS-2b06a2a3`  
**Pattern ID:** `VS-4408605e`  
**URL:** http://medicaid.gov/medicaid/outreach-tools/helping-connect-enrollees-care  
**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:** 1 instances; 1 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (2 weeks)

### Description
Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 1 of 8291 scanned pages (1 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/outreach-tools/helping-connect-enrollees-care.
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
- http://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

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-10f338a8`  
**Pattern ID:** `VS-e9fe47ac`  
**URL:** http://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 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### 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 8291 scanned pages (1 instances).

### Steps to reproduce
1. Open http://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
- http://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-ea121e34`  
**Pattern ID:** `VS-28ebd979`  
**URL:** http://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 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (2 weeks)

### Description
Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 8291 scanned pages (1 instances).

### Steps to reproduce
1. Open http://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
- http://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-52fcb9f0`  
**Pattern ID:** `VS-1467ea8a`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236  
**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:** 7382 instances; 1495 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### 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 1495 of 8291 scanned pages (7382 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236.
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/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv007100
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003222
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg003030
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002174
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl006077
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002026
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003174
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004124
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003037
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002074
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg013184
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002106
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg014192
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002088
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003178
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl001088
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt002090

…and more — 1495 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/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv007100
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159

---

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

**Bug ID:** `VS-3684156b`  
**Pattern ID:** `VS-fab92378`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/t-msis-coding-blog  
**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 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### 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 8291 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/t-msis-coding-blog.
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/v3/t-msis-coding-blog

### 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-9e31a7ee`  
**Pattern ID:** `VS-0841abc2`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=15&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-0b0j"] > .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:** 988 instances; 471 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### 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 471 of 8291 scanned pages (988 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=15&q=.
2. Locate the element: span[data-select2-id="select2-data-1-0b0j"] > .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%5B0%5D=896&page=15&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=786&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=44&q=
- http://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=2271&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=6&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=34&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/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=881&page=47&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=28&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=31&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=831&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=11&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=5&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%5B0%5D=8816&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=1&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=22&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=791&page=3&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=881&page=46&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=20&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1006&page=12&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=886&q=

…and more — 471 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%5B0%5D=896&page=15&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=786&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&q=

---

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

**Bug ID:** `VS-39efa13b`  
**Pattern ID:** `VS-ebb1c464`  
**URL:** http://medicaid.gov/medicaid/data-systems/it-procurement-opportunities  
**XPath / selector:** `#map-svg-map-default-1744055166`  
**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:** 3 instances; 3 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### HTML snippet
```html
<div id="map-svg-map-default-1744055166" class="map-container" aria-disabled="true" aria-label="State Map Image. Keyboard navigating users can use dropdown to select state." style="position: relative;
```

### Description
Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 3 of 8291 scanned pages (3 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/data-systems/it-procurement-opportunities.
2. Locate the element: #map-svg-map-default-1744055166
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
- http://medicaid.gov/medicaid/data-systems/it-procurement-opportunities
- http://medicaid.gov/about-us/where-can-people-get-help-medicaid-chip
- 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
- http://medicaid.gov/medicaid/data-systems/it-procurement-opportunities
- http://medicaid.gov/about-us/where-can-people-get-help-medicaid-chip
- https://www.medicaid.gov/medicaid/data-systems/it-procurement-opportunities

---

## Form field has accessible name (WCAG 4.1.2)

**Bug ID:** `VS-fac38788`  
**Pattern ID:** `VS-a48e6078`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&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:** 474 instances; 227 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 227 of 8291 scanned pages (474 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&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=696&page=29&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=44&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=34&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/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=831&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=11&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=791&page=3&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=20&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=886&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=32&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=881&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=876&page=24&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=42&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=831&page=29&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=6&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=726&page=54&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=29&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=6&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=826&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=24&q=

…and more — 227 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=696&page=29&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=44&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-1fd14477`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0  
**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:** 66849 instances; 4074 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 4074 of 8291 scanned pages (66849 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0.
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
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A1511&f%5B2%5D=fpg_topics_facet%3A8411&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_type_facet%3A1481&page=111
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7138
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6932
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7333
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/faq?fcf=&fd=09%2F13%2F2017&page=2&sb=-published&sl=yes&stid=22%2C23&td=09%2F13%2F2017&tid=6
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003222
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-793
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/survey-and-certification-guidance
- https://www.medicaid.gov/faq?entry=48745&page=0
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/well-child-care
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002174
- https://www.medicaid.gov/faq?fd=09%2F30%2F2013&page=84&sl=yes&td=09%2F30%2F2013&tid=2
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8898
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-902
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1491&f%5B1%5D=fpg_topics_facet%3A8601&page=108

…and more — 4074 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
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A1511&f%5B2%5D=fpg_topics_facet%3A8411&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_type_facet%3A1481&page=111

---

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

**Bug ID:** `VS-7e56ae53`  
**Pattern ID:** `VS-2208081b`  
**URL:** http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0  
**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:** 7243 instances; 909 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 909 of 8291 scanned pages (7243 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0.
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
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A1511&f%5B2%5D=fpg_topics_facet%3A8411&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_type_facet%3A1481&page=111
- https://www.medicaid.gov/faq?fcf=&fd=09%2F13%2F2017&page=2&sb=-published&sl=yes&stid=22%2C23&td=09%2F13%2F2017&tid=6
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/survey-and-certification-guidance
- https://www.medicaid.gov/faq?entry=48745&page=0
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/well-child-care
- https://www.medicaid.gov/faq?fd=09%2F30%2F2013&page=84&sl=yes&td=09%2F30%2F2013&tid=2
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1491&f%5B1%5D=fpg_topics_facet%3A8601&page=108
- http://medicaid.gov/medicaid/prescription-drugs/program-releases?page=2
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=state_waiver_status_facet%3A1591&f%5B1%5D=state_waiver_status_facet%3A1611&items_per_page=10&page=69&search_api_fulltext=2024
- http://medicaid.gov/resources-for-states/working-families-tax-cut-legislation
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%22%5D
- https://www.medicaid.gov/resources-for-states/medicaid-and-chip-program-portal/macpro-training-help/medicaid-chip-pdf-repository
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?70905_xml=&page=0
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%22%5D
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1016&f%5B1%5D=fpg_topics_facet%3A8601&page=111
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1856&f%5B1%5D=sub_topic_faq_library_facet%3A1866&f%5B10%5D=sub_topic_faq_library_facet%3A2376&f%5B11%5D=sub_topic_faq_library_facet%3A2496&f%5B12%5D=sub_topic_faq_library_facet%3A2501&f%5B13%5D=sub_topic_faq_library_facet%3A2516&f%5B2%5D=sub_topic_faq_library_facet%3A1876&f%5B3%5D=sub_topic_faq_library_facet%3A1936&f%5B4%5D=sub_topic_faq_library_facet%3A2031&f%5B5%5D=sub_topic_faq_library_facet%3A2036&f%5B6%5D=sub_topic_faq_library_facet%3A2041&f%5B7%5D=sub_topic_faq_library_facet%3A2106&f%5B8%5D=sub_topic_faq_library_facet%3A2351&f%5B9%5D=sub_topic_faq_library_facet%3A2366&page=80
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A891&f%5B2%5D=state%3A1026&page=1656
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A771&f%5B1%5D=fpg_topics_facet%3A1011&f%5B2%5D=fpg_topics_facet%3A1531&f%5B3%5D=fpg_topics_facet%3A3046&f%5B4%5D=fpg_topics_facet%3A8381&f%5B5%5D=fpg_topics_facet%3A8901&page=107
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/section-1135-waiver-flexibilities
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=44&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/140831
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83481
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A7321&page=1655

…and more — 909 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
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A1511&f%5B2%5D=fpg_topics_facet%3A8411&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_type_facet%3A1481&page=111
- https://www.medicaid.gov/faq?fcf=&fd=09%2F13%2F2017&page=2&sb=-published&sl=yes&stid=22%2C23&td=09%2F13%2F2017&tid=6

---

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

**Bug ID:** `VS-b2e8e41d`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%22%5D  
**XPath / selector:** `<p class="welcome-text core-set ng-star-inserted">`  
**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:** 102 instances; 20 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 20 of 8291 scanned pages (102 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%22%5D.
2. Locate the element: <p class="welcome-text core-set ng-star-inserted">
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/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%22%5D
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=1
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22CO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22DE%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MA%22%5D
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=6
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22DC%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22LA%22%5D
- https://www.medicaid.gov/medicaid/enrollment-strategies/continuous-eligibility-medicaid-and-chip-coverage
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=0
- https://www.medicaid.gov/dq-atlas/landing/resources/downloads
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=3
- http://medicaid.gov/medicaid/benefits/assurance-of-transportation
- http://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-change-request
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SC%22%5D
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=20
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=2
- http://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-r74

### Example pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%22%5D
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources

---

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

**Bug ID:** `VS-2de7b1f8`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0  
**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:** 42481 instances; 4074 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 4074 of 8291 scanned pages (42481 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0.
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
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A1511&f%5B2%5D=fpg_topics_facet%3A8411&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_type_facet%3A1481&page=111
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7138
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6932
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7333
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/faq?fcf=&fd=09%2F13%2F2017&page=2&sb=-published&sl=yes&stid=22%2C23&td=09%2F13%2F2017&tid=6
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003222
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-793
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/survey-and-certification-guidance
- https://www.medicaid.gov/faq?entry=48745&page=0
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/well-child-care
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002174
- https://www.medicaid.gov/faq?fd=09%2F30%2F2013&page=84&sl=yes&td=09%2F30%2F2013&tid=2
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8898
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-902
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1491&f%5B1%5D=fpg_topics_facet%3A8601&page=108

…and more — 4074 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
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A1511&f%5B2%5D=fpg_topics_facet%3A8411&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_type_facet%3A1481&page=111

---

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

**Bug ID:** `VS-02a6a6df`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117  
**XPath / selector:** `.small`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 28627 instances; 6382 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

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

### Description
All page content should be contained by landmarks. Detected by axe-core rule region on 6382 of 8291 scanned pages (28627 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117.
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/v3/validation-rules/rule-6117
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6794
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7138
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv007100
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2611
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6932
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2003
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-5-012-12
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7333
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3137
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-630
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6129
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1789
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6155
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7634
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003222

…and more — 6382 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/v3/validation-rules/rule-6117
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229

---

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

**Bug ID:** `VS-9605e6ed`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117  
**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:** 6356 instances; 6356 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### 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 6356 of 8291 scanned pages (6356 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117.
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/v3/validation-rules/rule-6117
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6794
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7138
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv007100
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2611
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6932
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2003
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-5-012-12
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7333
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3137
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-630
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6129
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1789
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6155
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7634
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003222

…and more — 6356 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/v3/validation-rules/rule-6117
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229

---

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

**Bug ID:** `VS-37bb2542`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117  
**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:** Serious  
**Frequency:** 6351 instances; 6351 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### 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 6351 of 8291 scanned pages (6351 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117.
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/v3/validation-rules/rule-6117
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6794
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7138
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv007100
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2611
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6932
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2003
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-5-012-12
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7333
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3137
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-630
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6129
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1789
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6155
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7634
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003222

…and more — 6351 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/v3/validation-rules/rule-6117
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229

---

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

**Bug ID:** `VS-f8ff7b4b`  
**Pattern ID:** `VS-33841929`  
**URL:** http://medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data  
**XPath / selector:** `select[aria-labelledby="filter-th-87371-1"]`  
**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:** 3 instances; 2 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### HTML snippet
```html
<select aria-labelledby="filter-th-87371-1" class="usa-select height-1" data-col-index="1" title="Filter by Year">
```

### Description
Form elements should have a visible label. Detected by axe-core rule label-title-only on 2 of 8291 scanned pages (3 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data.
2. Locate the element: select[aria-labelledby="filter-th-87371-1"]
3. Confirm the axe-core finding for rule label-title-only.

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

### Affected pages
- http://medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data
- http://medicaid.gov/medicaid/financial-management/medicaid-disproportionate-share-hospital-dsh-payments

### 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
- http://medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data
- http://medicaid.gov/medicaid/financial-management/medicaid-disproportionate-share-hospital-dsh-payments

---

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

**Bug ID:** `VS-3fe2c472`  
**Pattern ID:** `VS-d25f622d`  
**URL:** http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot  
**XPath / selector:** `.region-footer-first > .usa-footer__primary-content.usa-footer__primary-content--collapsible > h4`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 331 instances; 300 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### HTML snippet
```html
<h4 class="usa-footer__primary-link">Related Sites</h4>
```

### Description
Heading levels should only increase by one. Detected by axe-core rule heading-order on 300 of 8291 scanned pages (331 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot.
2. Locate the element: .region-footer-first > .usa-footer__primary-content.usa-footer__primary-content--collapsible > h4
3. Confirm the axe-core finding for rule heading-order.

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

### Affected pages
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/survey-and-certification-guidance
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/well-child-care
- https://www.medicaid.gov/state-overviews/stateprofile.html?state=Mississippi
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%22%5D
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/section-1135-waiver-flexibilities
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/99166
- https://www.medicaid.gov/new-notable?page=91
- http://medicaid.gov/chip/chip-eligibility-enrollment/enrollment-strategies
- http://medicaid.gov/medicaid/financial-management/medicaid-administrative-claiming
- http://medicaid.gov/medicaid/financial-management/state-budget-expenditure-reporting-for-medicaid-and-chip
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/medicare-and-other-coverage-guidance
- http://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-dispute-resolution
- http://medicaid.gov/medicaid/prescription-drugs/federal-upper-limit
- http://medicaid.gov/medicaid/long-term-services-supports/self-directed-services
- https://www.medicaid.gov/state-overviews/puerto-rico.html
- http://medicaid.gov/medicaid/financial-management/actuarial-report-financial-outlook-medicaid
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54031
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=2
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources
- https://www.medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/medicaid-spa-processing-tools-for-states
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=1

…and more — 300 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
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/survey-and-certification-guidance

---

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

**Bug ID:** `VS-eea592cb`  
**Pattern ID:** `VS-8806389c`  
**URL:** http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification  
**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:** 67 instances; 67 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### 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 67 of 8291 scanned pages (67 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification.
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
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/medicaid/financial-management/medicaid-administrative-claiming
- http://medicaid.gov/medicaid/financial-management/state-budget-expenditure-reporting-for-medicaid-and-chip
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=2
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=1
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=2
- https://www.medicaid.gov/medicaid/data-systems/medicaid-and-chip-business-information-solution/macbis-financial
- http://medicaid.gov/medicaid/prescription-drugs/drug-utilization-review
- https://www.medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/promoting-community-integration-through-long-term-services-and-supports
- http://medicaid.gov/medicaid/managed-care/managed-long-term-services-and-supports
- http://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center
- http://medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data
- http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
- https://www.medicaid.gov/nondiscrimination-policy-update
- https://www.medicaid.gov/about-us/messages/arkansas-fast-tracks-medicaid-enrollment
- https://www.medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly
- https://www.medicaid.gov/medicaid/long-term-services-supports/medicaid-employment-initiatives
- https://www.medicaid.gov/medicaid/long-term-services-supports
- http://medicaid.gov/
- http://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/measuring-and-improving-quality-home-and-community-based-services
- https://www.medicaid.gov/about-us/messages/west-virginia-fast-tracks-medicaid-enrollment
- https://www.medicaid.gov/medicaid/quality-of-care/medicaid-and-chip-managed-care-quality
- http://medicaid.gov/medicaid/quality-of-care/medicaid-chip-data-products

…and more — 67 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
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/medicaid/financial-management/medicaid-administrative-claiming
- http://medicaid.gov/medicaid/financial-management/state-budget-expenditure-reporting-for-medicaid-and-chip

---

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

**Bug ID:** `VS-ffb2f87b`  
**Pattern ID:** `VS-4fac2f41`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=15&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-0b0j"] > .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:** 992 instances; 473 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### 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 473 of 8291 scanned pages (992 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=15&q=.
2. Locate the element: span[data-select2-id="select2-data-1-0b0j"] > .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%5B0%5D=896&page=15&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=786&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=44&q=
- http://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=2271&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=6&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=34&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/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=881&page=47&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=28&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=31&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=831&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=11&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=5&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%5B0%5D=8816&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=1&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=22&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=791&page=3&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=881&page=46&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=20&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1006&page=12&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=886&q=

…and more — 473 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%5B0%5D=896&page=15&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=786&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&q=

---

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

**Bug ID:** `VS-3adb53e6`  
**Pattern ID:** `VS-c18be945`  
**URL:** http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0  
**XPath / selector:** `text: "  Feedback  "`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 111891 instances; 4072 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 4072 of 8291 scanned pages (111891 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0.
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
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A1511&f%5B2%5D=fpg_topics_facet%3A8411&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_type_facet%3A1481&page=111
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7138
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6932
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7333
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/faq?fcf=&fd=09%2F13%2F2017&page=2&sb=-published&sl=yes&stid=22%2C23&td=09%2F13%2F2017&tid=6
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003222
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-793
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/survey-and-certification-guidance
- https://www.medicaid.gov/faq?entry=48745&page=0
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/well-child-care
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002174
- https://www.medicaid.gov/faq?fd=09%2F30%2F2013&page=84&sl=yes&td=09%2F30%2F2013&tid=2
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8898
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-902
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1491&f%5B1%5D=fpg_topics_facet%3A8601&page=108

…and more — 4072 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
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A1511&f%5B2%5D=fpg_topics_facet%3A8411&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_type_facet%3A1481&page=111

---

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

**Bug ID:** `VS-5b48231c`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229  
**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:** 3176 instances; 3176 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 3176 of 8291 scanned pages (3176 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229.
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/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7138
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6932
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7333
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003222
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-793
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002174
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8898
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-902
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002026
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2635
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%22%5D
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6238
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2405
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7836
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%22%5D

…and more — 3176 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/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7138

---

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

**Bug ID:** `VS-f5a57850`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229  
**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:** 3157 instances; 3157 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 3157 of 8291 scanned pages (3157 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229.
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/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7138
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6932
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7333
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003222
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-793
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002174
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8898
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-902
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002026
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2635
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6238
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2405
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7836
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1620
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-156-156

…and more — 3157 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/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7138

---

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

**Bug ID:** `VS-ad93c9c0`  
**Pattern ID:** `VS-e05344b9`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236  
**XPath / selector:** `@aria-selected="true"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 3728 instances; 762 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 762 of 8291 scanned pages (3728 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236.
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/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003222
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002174
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002026
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%22%5D
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004124
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003037
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002074
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg013184
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg008133
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002057
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003197
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002078
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr004059
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003193
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002060
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003206
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip003285
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002108
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003315
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt002157

…and more — 762 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/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003159
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179

---

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

**Bug ID:** `VS-a6c844a9`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236  
**XPath / selector:** `td`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 503 instances; 383 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### HTML snippet
```html
<td valign="top" colspan="6" class="dataTables_empty">No data available in table</td>
```

### Description
Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 383 of 8291 scanned pages (503 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236.
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/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6932
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002074
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg003040
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002057
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-3048
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1095
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-3173
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003118
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6586
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002146
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003238
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv008108
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1889
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003256
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2115
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6816
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg003041
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003034
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1055
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1109
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3160
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1376
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1576

…and more — 383 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/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6932
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-50beed4a`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/survey-and-certification-guidance  
**XPath / selector:** `<h4 class="usa-footer__primary-link">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 159 instances; 143 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 143 of 8291 scanned pages (159 instances).

### Steps to reproduce
1. Open http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/survey-and-certification-guidance.
2. Locate the element: <h4 class="usa-footer__primary-link">
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

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

### Affected pages
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/survey-and-certification-guidance
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/well-child-care
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%22%5D
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/section-1135-waiver-flexibilities
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/99166
- https://www.medicaid.gov/new-notable?page=91
- http://medicaid.gov/chip/chip-eligibility-enrollment/enrollment-strategies
- http://medicaid.gov/medicaid/financial-management/medicaid-administrative-claiming
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=1
- http://medicaid.gov/medicaid/benefits/reentry-services-for-incarcerated-individuals/additional-resources
- http://medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly/programs-of-all-inclusive-care-for-elderly-benefits
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/192741
- http://medicaid.gov/medicaid/quality-of-care/quality-improvement/foster-care-learning-collaborative
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/provider-enrollment-guidance
- 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/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/49454
- http://medicaid.gov/state-drug-utilization-data-sdud-faqs
- http://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center
- http://medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/methodology-about-medicaid-chip-enrollment-report
- http://medicaid.gov/medicaid/long-term-services-supports/institutional-long-term-care/preadmission-screening-and-resident-review
- http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/98326

…and more — 143 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
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/survey-and-certification-guidance
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/well-child-care
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%22%5D

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-ec9a6590`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%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:** 25 instances; 11 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 11 of 8291 scanned pages (25 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%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%22GU%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%22%5D
- http://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%22CO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22DE%22%5D
- https://www.medicaid.gov/dq-atlas/landing/resources/about
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22DC%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22LA%22%5D
- http://medicaid.gov/resources-for-states/medicaid-and-chip-program-portal
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SC%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-r78

### Example pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%22%5D
- http://medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly/programs-of-all-inclusive-care-for-elderly-for-states

---

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

**Bug ID:** `VS-55ff4a50`  
**Pattern ID:** `VS-4c341c77`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%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:** 429 instances; 8 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 8 of 8291 scanned pages (429 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%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%22GU%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22CO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22DE%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22DC%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22LA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SC%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%22GU%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22CO%22%5D

---

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

**Bug ID:** `VS-58a37786`  
**Pattern ID:** `VS-e5ec42f0`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%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:** 1239 instances; 7 of 8291 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W26 (3 weeks)

### Description
Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 7 of 8291 scanned pages (1239 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MS%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%22MS%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22CO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22DE%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22DC%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22LA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SC%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%22MS%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22CO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22DE%22%5D

---

## Input purpose can be determined (WCAG criterion undetermined)

**Bug ID:** `VS-0ad31bbe`  
**Pattern ID:** `VS-3fb891c5`  
**URL:** https://www.medicaid.gov/dq-atlas/landing/states  
**XPath / selector:** `<div _ngcontent-ng-c305556689="" role="radiogroup" class="toggle-input-container">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r60` ([reference](https://alfa.siteimprove.com/rules/sia-r60))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 8291 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W26 (1 week)

### Description
Input purpose can be determined. Detected by Siteimprove Alfa rule sia-r60 on 1 of 8291 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/dq-atlas/landing/states.
2. Locate the element: <div _ngcontent-ng-c305556689="" role="radiogroup" class="toggle-input-container">
3. Confirm the Siteimprove Alfa finding for rule sia-r60.

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

### Affected pages
- https://www.medicaid.gov/dq-atlas/landing/states

### 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-r60