# Accessibility bug reports — www.medicaid.gov, week 2026-W28

40 issue type(s) from 8593 pages scanned. Generated 2026-07-24 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:** 483 instances; 226 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 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 8593 scanned pages (483 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=1001&page=10&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=996&page=31&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=826&page=28&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=776&page=15&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=1&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=786&page=81&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/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=1&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=1&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/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=18&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=956&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=5&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/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8741&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=6&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=996&page=28&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=1001&page=10&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=34&q=

---

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

**Bug ID:** `VS-256d2834`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26  
**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:** 1325 instances; 1325 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 1325 of 8593 scanned pages (1325 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26.
2. Locate the element: <a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">
3. Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-15-006-6
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-60-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6238
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002143
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt003235
- 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/v3/data-elements/elg004064
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2188
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002220
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-4-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-21-009-9
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002053
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002035
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv001002
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-350

…and more — 1325 pages total ([download CSV](csv/alfa__sia-r14.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-38918f70`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `p:nth-child(1) > a > img`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** axe-core — `image-alt` ([reference](https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 1 instances; 1 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (4 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 8593 scanned pages (1 instances).

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

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

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

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

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

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

---

## Image has accessible name (WCAG 1.1.1)

**Bug ID:** `VS-29ab8ed7`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `<img src="/media/file/monitor-eval-1115-demonstrations0.png/">`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** Siteimprove Alfa — `sia-r2` ([reference](https://alfa.siteimprove.com/rules/sia-r2))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (4 weeks)

### Description
Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 1 of 8593 scanned pages (1 instances).

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

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

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

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

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

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

---

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

**Bug ID:** `VS-d2b8a747`  
**Pattern ID:** `VS-9429bb8d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111  
**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:** 1311 instances; 1311 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 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 1311 of 8593 scanned pages (1311 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111.
2. Locate the element: .nav
3. Confirm the axe-core finding for rule aria-required-children against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-accreditation-organization
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg003030
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002044
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002143
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt003235
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002035
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004124
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg004064
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002074
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002106
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002220
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg014192
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002053
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002035
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008285
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv001002

…and more — 1311 pages total ([download CSV](csv/axe-core__aria-required-children.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236

---

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

**Bug ID:** `VS-f2fff492`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111  
**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:** 890 instances; 858 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 858 of 8593 scanned pages (890 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111.
2. Locate the element: <div class="nav nav-tabs nav-justified" role="tablist">
3. Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-accreditation-organization
- 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/cip002143
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt003235
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002035
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004124
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg004064
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002106
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002220
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002053
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002035
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv001002
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002219
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=10&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg003040
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002068
- 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/v4/data-elements/mcr010117
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003206
- 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 — 858 pages total ([download CSV](csv/alfa__sia-r68.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068

---

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

**Bug ID:** `VS-6cb7fb9e`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality  
**XPath / selector:** `<a style="text-decoration:none;" href="#three" title="">`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** Siteimprove Alfa — `sia-r62` ([reference](https://alfa.siteimprove.com/rules/sia-r62))  
**Severity:** Moderate  
**Frequency:** 7 instances; 2 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (3 weeks)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 2 of 8593 scanned pages (7 instances).

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

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

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

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

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

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

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

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-f1a54936`  
**Pattern ID:** `VS-e9fe47ac`  
**URL:** https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `p:nth-child(1) > a`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** axe-core — `link-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1 instances; 1 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 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 8593 scanned pages (1 instances).

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

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

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

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

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

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

---

## Link has accessible name (WCAG 2.4.4)

**Bug ID:** `VS-bf3ec45d`  
**Pattern ID:** `VS-28ebd979`  
**URL:** https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `<a href="/medicaid/section-1115-demonstrations/downloads/monitor-eval-1115-demonstrations-infographic.pdf">`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** Siteimprove Alfa — `sia-r11` ([reference](https://alfa.siteimprove.com/rules/sia-r11))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (4 weeks)

### Description
Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 8593 scanned pages (1 instances).

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

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

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

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

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

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

---

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

**Bug ID:** `VS-f236911d`  
**Pattern ID:** `VS-1467ea8a`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111  
**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:** 6390 instances; 1311 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 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 1311 of 8593 scanned pages (6390 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111.
2. Locate the element: a[href$="#overview"]
3. Confirm the axe-core finding for rule aria-allowed-attr against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-accreditation-organization
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg003030
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002044
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002143
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt003235
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002035
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004124
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg004064
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002074
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002106
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002220
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg014192
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002053
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002035
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008285
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv001002

…and more — 1311 pages total ([download CSV](csv/axe-core__aria-allowed-attr.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236

---

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

**Bug ID:** `VS-bfdec3d2`  
**Pattern ID:** `VS-fab92378`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/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:** 2 instances; 2 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 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 2 of 8593 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/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/t-msis-coding-blog
- https://www.medicaid.gov/tmsis/dataguide/v4/technical-instructions

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/t-msis-coding-blog
- https://www.medicaid.gov/tmsis/dataguide/v4/technical-instructions

---

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

**Bug ID:** `VS-b77e2914`  
**Pattern ID:** `VS-0841abc2`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-2krc"] > .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:** 999 instances; 467 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 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 467 of 8593 scanned pages (999 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=.
2. Locate the element: span[data-select2-id="select2-data-1-2krc"] > .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=1001&page=5&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=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=10&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=756&page=4&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=996&page=31&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=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=826&page=28&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=27&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=13&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=756&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=776&page=15&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=36&q=

…and more — 467 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=1001&page=5&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-5f86aa07`  
**Pattern ID:** `VS-ebb1c464`  
**URL:** http://medicaid.gov/about-us/where-can-people-get-help-medicaid-chip  
**XPath / selector:** `#map-svg-map-1741285150489`  
**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:** 2 instances; 2 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### HTML snippet
```html
<div id="map-svg-map-1741285150489" class="map-container" aria-disabled="true" aria-label="State Map Image. Keyboard navigating users can use dropdown to select state." style="position: relative; widt
```

### Description
Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 2 of 8593 scanned pages (2 instances).

### Steps to reproduce
1. Open http://medicaid.gov/about-us/where-can-people-get-help-medicaid-chip.
2. Locate the element: #map-svg-map-1741285150489
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/about-us/where-can-people-get-help-medicaid-chip
- https://www.medicaid.gov/state-overviews/state-profiles

### 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/about-us/where-can-people-get-help-medicaid-chip
- https://www.medicaid.gov/state-overviews/state-profiles

---

## 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:** 482 instances; 225 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 225 of 8593 scanned pages (482 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=1001&page=10&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=996&page=31&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=826&page=28&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=776&page=15&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=1&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=786&page=81&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/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=1&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=1&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/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=18&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=956&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=5&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/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8741&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=6&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=996&page=28&q=

…and more — 225 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=1001&page=10&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=34&q=

---

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

**Bug ID:** `VS-a9773a65`  
**Pattern ID:** `VS-be8d563e`  
**URL:** http://medicaid.gov/chip/reports-evaluations  
**XPath / selector:** `.helpful-box-gray-sm > p > span`  
**WCAG SC:** 1.4.3 — Contrast (Minimum) (Level AA)  
**Rule:** axe-core — `color-contrast` ([reference](https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 2 instances; 1 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (4 weeks)

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

### Description
Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 1 of 8593 scanned pages (2 instances).

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

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

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

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

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

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

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-9db52072`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26  
**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:** 94539 instances; 4198 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 4198 of 8593 scanned pages (94539 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26.
2. Locate the element: text: "Here's how you know "
3. Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced).

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A2696&f%5B4%5D=fpg_topics_facet%3A8601&page=110
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?category12Id=1401&category3Id=140103&f%5B0%5D=topics%3A7381&page=1657
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A856&f%5B2%5D=fpg_topics_facet%3A1501&f%5B3%5D=fpg_topics_facet%3A6486&page=4
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-accreditation-organization
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1496&f%5B1%5D=fpg_topics_facet%3A1531&f%5B2%5D=fpg_topics_facet%3A3046&f%5B3%5D=fpg_topics_facet%3A8381&f%5B4%5D=fpg_topics_facet%3A8611&f%5B5%5D=fpg_topics_facet%3A8616&f%5B6%5D=fpg_topics_facet%3A8711&f%5B7%5D=fpg_topics_facet%3A8891&f%5B8%5D=fpg_topics_facet%3A8896&page=3
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A751&f%5B1%5D=topics%3A936&f%5B2%5D=topics%3A5811&page=1658
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-15-006-6
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2451&fcf=40870&page=4&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- http://medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-final-rules
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1491&f%5B1%5D=fpg_topics_facet%3A8601&page=108
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-60-001-1
- 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
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/improving-care-for-sickle-cell-disease

…and more — 4198 pages total ([download CSV](csv/alfa__sia-r66.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229

---

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

**Bug ID:** `VS-1f7646d5`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A2696&f%5B4%5D=fpg_topics_facet%3A8601&page=110  
**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:** 10964 instances; 1590 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 1590 of 8593 scanned pages (10964 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A2696&f%5B4%5D=fpg_topics_facet%3A8601&page=110.
2. Locate the element: <p class="usa-footer__contact-info margin-bottom-0">
3. Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A2696&f%5B4%5D=fpg_topics_facet%3A8601&page=110
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?category12Id=1401&category3Id=140103&f%5B0%5D=topics%3A7381&page=1657
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A856&f%5B2%5D=fpg_topics_facet%3A1501&f%5B3%5D=fpg_topics_facet%3A6486&page=4
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1496&f%5B1%5D=fpg_topics_facet%3A1531&f%5B2%5D=fpg_topics_facet%3A3046&f%5B3%5D=fpg_topics_facet%3A8381&f%5B4%5D=fpg_topics_facet%3A8611&f%5B5%5D=fpg_topics_facet%3A8616&f%5B6%5D=fpg_topics_facet%3A8711&f%5B7%5D=fpg_topics_facet%3A8891&f%5B8%5D=fpg_topics_facet%3A8896&page=3
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A751&f%5B1%5D=topics%3A936&f%5B2%5D=topics%3A5811&page=1658
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2451&fcf=40870&page=4&sl=yes
- http://medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-final-rules
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1491&f%5B1%5D=fpg_topics_facet%3A8601&page=108
- 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
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/improving-care-for-sickle-cell-disease
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83666
- 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?f%5B0%5D=state%3A541&f%5B1%5D=state%3A846&f%5B2%5D=state%3A941&f%5B3%5D=state%3A7971&page=1657
- 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
- http://medicaid.gov/medicaid/data-systems/health-information-technology/health-disparities
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=state_waiver_status_facet%3A1561&f%5B1%5D=state_waiver_status_facet%3A1601&f%5B10%5D=waiver_state_facet%3A806&f%5B11%5D=waiver_state_facet%3A816&f%5B12%5D=waiver_state_facet%3A826&f%5B13%5D=waiver_state_facet%3A831&f%5B14%5D=waiver_state_facet%3A851&f%5B15%5D=waiver_state_facet%3A861&f%5B16%5D=waiver_state_facet%3A876&f%5B17%5D=waiver_state_facet%3A886&f%5B18%5D=waiver_state_facet%3A916&f%5B19%5D=waiver_state_facet%3A941&f%5B2%5D=waiver_state_facet%3A681&f%5B20%5D=waiver_state_facet%3A956&f%5B21%5D=waiver_state_facet%3A961&f%5B22%5D=waiver_state_facet%3A971&f%5B23%5D=waiver_state_facet%3A976&f%5B24%5D=waiver_state_facet%3A991&f%5B25%5D=waiver_state_facet%3A1051&f%5B26%5D=waiver_state_facet%3A8296&f%5B3%5D=waiver_state_facet%3A711&f%5B4%5D=waiver_state_facet%3A716&f%5B5%5D=waiver_state_facet%3A726&f%5B6%5D=waiver_state_facet%3A746&f%5B7%5D=waiver_state_facet%3A781&f%5B8%5D=waiver_state_facet%3A791&f%5B9%5D=waiver_state_facet%3A796&items_per_page=50&page=0&search_api_fulltext=
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1936&f%5B1%5D=sub_topic_faq_library_facet%3A2106&fcf=41163&page=0&sl=yes
- https://www.medicaid.gov/about-us/organization/adrienne-delozier
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/100706
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A806&f%5B1%5D=waiver_state_facet%3A881&f%5B2%5D=waiver_state_facet%3A8296&items_per_page=50&page=2
- https://www.medicaid.gov/faq?fcf=41557&page=1&sl=yes
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1856&f%5B1%5D=sub_topic_faq_library_facet%3A2056&f%5B2%5D=sub_topic_faq_library_facet%3A2441&f%5B3%5D=sub_topic_faq_library_facet%3A2526&page=84&sl=yes
- https://www.medicaid.gov/faq?fcf=40867&page=84&sl=yes
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=10&q=

…and more — 1590 pages total ([download CSV](csv/alfa__sia-r73.csv)).

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

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

### Example pages
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A2696&f%5B4%5D=fpg_topics_facet%3A8601&page=110
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?category12Id=1401&category3Id=140103&f%5B0%5D=topics%3A7381&page=1657
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A856&f%5B2%5D=fpg_topics_facet%3A1501&f%5B3%5D=fpg_topics_facet%3A6486&page=4

---

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

**Bug ID:** `VS-212a1106`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%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:** 207 instances; 21 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 21 of 8593 scanned pages (207 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%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%22MO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NJ%22%5D
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=20
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=50&page=1
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NE%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MT%22%5D
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=1
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MI%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/benefits/assurance-of-transportation
- 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%22LA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WY%22%5D
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=50&page=3
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SD%22%5D
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=3
- http://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-change-request
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=3&q=
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=22
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22PR%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-r74

### Example pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NJ%22%5D
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=20

---

## Scrollable element is keyboard accessible (WCAG 1.4.8)

**Bug ID:** `VS-5660247f`  
**Pattern ID:** `VS-388b5438`  
**URL:** https://www.medicaid.gov/dq-atlas/landing/resources/subscription  
**XPath / selector:** `<p _ngcontent-ng-c1416952416="">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r80` ([reference](https://alfa.siteimprove.com/rules/sia-r80))  
**Severity:** Moderate  
**Frequency:** 2 instances; 1 of 8593 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W28 (2 weeks)

### Description
Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 1 of 8593 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/dq-atlas/landing/resources/subscription.
2. Locate the element: <p _ngcontent-ng-c1416952416="">
3. Confirm the Siteimprove Alfa finding for rule sia-r80 against WCAG 1.4.8 Visual Presentation.

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

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

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r80

---

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

**Bug ID:** `VS-5c4e71f7`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26  
**XPath / selector:** `<button class="btn btn-outline-primary dropdown-toggle py-1 px-2" type="button" id="dropdownMenuButton" data-toggle="dropdown">`  
**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:** 58021 instances; 4198 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 4198 of 8593 scanned pages (58021 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26.
2. Locate the element: <button class="btn btn-outline-primary dropdown-toggle py-1 px-2" type="button" id="dropdownMenuButton" data-toggle="dropdown">
3. Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A2696&f%5B4%5D=fpg_topics_facet%3A8601&page=110
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?category12Id=1401&category3Id=140103&f%5B0%5D=topics%3A7381&page=1657
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A856&f%5B2%5D=fpg_topics_facet%3A1501&f%5B3%5D=fpg_topics_facet%3A6486&page=4
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-accreditation-organization
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1496&f%5B1%5D=fpg_topics_facet%3A1531&f%5B2%5D=fpg_topics_facet%3A3046&f%5B3%5D=fpg_topics_facet%3A8381&f%5B4%5D=fpg_topics_facet%3A8611&f%5B5%5D=fpg_topics_facet%3A8616&f%5B6%5D=fpg_topics_facet%3A8711&f%5B7%5D=fpg_topics_facet%3A8891&f%5B8%5D=fpg_topics_facet%3A8896&page=3
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A751&f%5B1%5D=topics%3A936&f%5B2%5D=topics%3A5811&page=1658
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-15-006-6
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2451&fcf=40870&page=4&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- http://medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-final-rules
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1491&f%5B1%5D=fpg_topics_facet%3A8601&page=108
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-60-001-1
- 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
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/improving-care-for-sickle-cell-disease

…and more — 4198 pages total ([download CSV](csv/alfa__sia-r111.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229

---

## 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:** 23788 instances; 5249 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 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 5249 of 8593 scanned pages (23788 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/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-21-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386
- 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/validation-rules/rule-2611
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-747
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6155
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-accreditation-organization
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg003030
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7725
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356

…and more — 5249 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/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953

---

## 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:** 5237 instances; 5237 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 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 5237 of 8593 scanned pages (5237 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/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-21-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386
- 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/validation-rules/rule-2611
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-747
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6155
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-accreditation-organization
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg003030
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7725
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356

…and more — 5237 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/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953

---

## 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:** 5226 instances; 5226 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 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 5226 of 8593 scanned pages (5226 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/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-21-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386
- 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/validation-rules/rule-2611
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-747
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6155
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-accreditation-organization
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg003030
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7725
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356

…and more — 5226 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/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953

---

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

**Bug ID:** `VS-4f56b347`  
**Pattern ID:** `VS-33841929`  
**URL:** http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing  
**XPath / selector:** `select[aria-labelledby="filter-th-87386-0"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `label-title-only` ([reference](https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 46 instances; 11 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### HTML snippet
```html
<select aria-labelledby="filter-th-87386-0" class="usa-select height-1" data-col-index="0" title="Filter by Type">
          <option value="">All</option>
        <option value="Federal Upper Limit">F
```

### Description
Form elements should have a visible label. Detected by axe-core rule label-title-only on 11 of 8593 scanned pages (46 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing.
2. Locate the element: select[aria-labelledby="filter-th-87386-0"]
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/pharmacy-pricing
- http://medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data
- https://www.medicaid.gov/prior-annual-medicaid-hospice-rate-letters
- https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-data
- http://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-data
- https://www.medicaid.gov/style-guide/components/date-picker
- http://medicaid.gov/medicaid/financial-management/medicaid-disproportionate-share-hospital-dsh-payments
- http://medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/drug-utilization-review-annual-report
- https://www.medicaid.gov/state-overviews/state-profiles
- http://medicaid.gov/chip/reports-evaluations
- https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data

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

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

### Example pages
- http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- http://medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data
- https://www.medicaid.gov/prior-annual-medicaid-hospice-rate-letters

---

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

**Bug ID:** `VS-a50125ce`  
**Pattern ID:** `VS-d25f622d`  
**URL:** http://medicaid.gov/medicaid/data-systems/health-information-exchange/federal-financial-participation-for-hit-and-hie  
**XPath / selector:** `.field--name-field-resources-list > h3`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 679 instances; 615 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

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

### Description
Heading levels should only increase by one. Detected by axe-core rule heading-order on 615 of 8593 scanned pages (679 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/data-systems/health-information-exchange/federal-financial-participation-for-hit-and-hie.
2. Locate the element: .field--name-field-resources-list > h3
3. Confirm the axe-core finding for rule heading-order.

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

### Affected pages
- http://medicaid.gov/medicaid/data-systems/health-information-exchange/federal-financial-participation-for-hit-and-hie
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot
- 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/section-1115-demonstrations/about-section-1115-demonstrations
- http://medicaid.gov/medicaid/data-systems/health-information-technology/health-disparities
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54036
- https://www.medicaid.gov/about-us/organization/adrienne-delozier
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/100706
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/102166
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-enrollment-data-collected-through-mbes
- http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/192776
- https://www.medicaid.gov/medicaid/program-integrity/affordable-care-act-program-integrity-provisions
- http://medicaid.gov/chip/chip-eligibility-enrollment/enrollment-strategies
- https://www.medicaid.gov/resources-for-states/eligibility-enrollment-and-renewal-tools-and-resources/application-and-fair-hearings-resources
- https://www.medicaid.gov/medicaid/home-community-based-services/home-and-community-based-services-hcbs-quality
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/104786
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/154506
- https://www.medicaid.gov/resources-for-states/innovation-accelerator-program
- https://www.medicaid.gov/state-overviews/stateprofile.html?state=Oregon
- http://medicaid.gov/resources-for-states/managed-care-review-mc-review/managed-care-review-faqs
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/medicaid-and-chip-resources/other-resources

…and more — 615 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/data-systems/health-information-exchange/federal-financial-participation-for-hit-and-hie
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot

---

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

**Bug ID:** `VS-e745a5bc`  
**Pattern ID:** `VS-8806389c`  
**URL:** https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person  
**XPath / selector:** `.section`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-unique` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 136 instances; 135 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 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 135 of 8593 scanned pages (136 instances).

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

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

### Affected pages
- https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
- https://www.medicaid.gov/resources-for-states/innovation-accelerator-program
- https://www.medicaid.gov/medicaid/data-systems/certification
- https://www.medicaid.gov/style-guide/foundation/typography
- https://www.medicaid.gov/medicaid/data-systems/medicaid-eligibility-enrollment-toolkit
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=20
- https://www.medicaid.gov/resources-for-states/innovation-accelerator-program/functional-areas
- https://www.medicaid.gov/claims-under-camp-lejeune-justice-act-clja
- http://medicaid.gov/resources-for-states
- http://medicaid.gov/about-us/contact-us
- http://medicaid.gov/medicaid/quality-of-care/releases-announcements
- http://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program
- https://www.medicaid.gov/style-guide/foundation
- 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/quality-of-care
- https://www.medicaid.gov/style-guide/foundation/breakpoints
- http://medicaid.gov/medicaid/long-term-services-supports/real-choice-systems-change/state-profile-tool-grant-program
- http://medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data
- http://medicaid.gov/medicaid/managed-care/guidance/state-directed-payments
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities
- https://www.medicaid.gov/style-guide/components/select
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information

…and more — 135 pages total ([download CSV](csv/axe-core__landmark-unique.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation

---

## Main landmark should not be contained in another landmark (WCAG criterion undetermined)

**Bug ID:** `VS-c5fe188d`  
**Pattern ID:** `VS-ff3ceb19`  
**URL:** https://www.medicaid.gov/style-guide/foundation/typography  
**XPath / selector:** `.style-guide-page > .grid-gap-sm.grid-row > main`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-main-is-top-level` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-main-is-top-level?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 19 instances; 19 of 8593 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W28 (1 week)

### HTML snippet
```html
<main id="content" class="grid-col-12 desktop:grid-col-9" role="main">
```

### Description
Main landmark should not be contained in another landmark. Detected by axe-core rule landmark-main-is-top-level on 19 of 8593 scanned pages (19 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/style-guide/foundation/typography.
2. Locate the element: .style-guide-page > .grid-gap-sm.grid-row > main
3. Confirm the axe-core finding for rule landmark-main-is-top-level.

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

### Affected pages
- https://www.medicaid.gov/style-guide/foundation/typography
- https://www.medicaid.gov/style-guide/foundation
- https://www.medicaid.gov/style-guide/foundation/breakpoints
- https://www.medicaid.gov/style-guide/components/select
- https://www.medicaid.gov/style-guide/foundation/color
- https://www.medicaid.gov/style-guide
- https://www.medicaid.gov/style-guide/patterns
- https://www.medicaid.gov/style-guide/components/button
- https://www.medicaid.gov/style-guide/content
- https://www.medicaid.gov/style-guide/components/breadcrumb
- https://www.medicaid.gov/style-guide/templates
- https://www.medicaid.gov/style-guide/foundation/logo
- https://www.medicaid.gov/style-guide/foundation/spacing
- https://www.medicaid.gov/style-guide/components/back-to-top
- https://www.medicaid.gov/style-guide/components/date-picker
- https://www.medicaid.gov/style-guide/components/banner
- https://www.medicaid.gov/style-guide/components
- https://www.medicaid.gov/style-guide/components/pagination
- https://www.medicaid.gov/style-guide/components/accordion

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

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

### Example pages
- https://www.medicaid.gov/style-guide/foundation/typography
- https://www.medicaid.gov/style-guide/foundation
- https://www.medicaid.gov/style-guide/foundation/breakpoints

---

## Document should not have more than one main landmark (WCAG criterion undetermined)

**Bug ID:** `VS-73d0ed37`  
**Pattern ID:** `VS-cd69be3a`  
**URL:** https://www.medicaid.gov/style-guide/foundation/typography  
**XPath / selector:** `.main-content`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-no-duplicate-main` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-no-duplicate-main?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 19 instances; 19 of 8593 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W28 (1 week)

### HTML snippet
```html
<main id="content" class="main-content grid-col-12" role="main">
```

### Description
Document should not have more than one main landmark. Detected by axe-core rule landmark-no-duplicate-main on 19 of 8593 scanned pages (19 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/style-guide/foundation/typography.
2. Locate the element: .main-content
3. Confirm the axe-core finding for rule landmark-no-duplicate-main.

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

### Affected pages
- https://www.medicaid.gov/style-guide/foundation/typography
- https://www.medicaid.gov/style-guide/foundation
- https://www.medicaid.gov/style-guide/foundation/breakpoints
- https://www.medicaid.gov/style-guide/components/select
- https://www.medicaid.gov/style-guide/foundation/color
- https://www.medicaid.gov/style-guide
- https://www.medicaid.gov/style-guide/patterns
- https://www.medicaid.gov/style-guide/components/button
- https://www.medicaid.gov/style-guide/content
- https://www.medicaid.gov/style-guide/components/breadcrumb
- https://www.medicaid.gov/style-guide/templates
- https://www.medicaid.gov/style-guide/foundation/logo
- https://www.medicaid.gov/style-guide/foundation/spacing
- https://www.medicaid.gov/style-guide/components/back-to-top
- https://www.medicaid.gov/style-guide/components/date-picker
- https://www.medicaid.gov/style-guide/components/banner
- https://www.medicaid.gov/style-guide/components
- https://www.medicaid.gov/style-guide/components/pagination
- https://www.medicaid.gov/style-guide/components/accordion

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

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-no-duplicate-main?application=axeAPI

### Example pages
- https://www.medicaid.gov/style-guide/foundation/typography
- https://www.medicaid.gov/style-guide/foundation
- https://www.medicaid.gov/style-guide/foundation/breakpoints

---

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

**Bug ID:** `VS-1ad781a5`  
**Pattern ID:** `VS-0ba8ce9d`  
**URL:** https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels  
**XPath / selector:** `tr:nth-child(1) > td[scope="row"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `scope-attr-valid` ([reference](https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 51 instances; 1 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (4 weeks)

### HTML snippet
```html
<td scope="row">Alabama</td>
```

### Description
scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 1 of 8593 scanned pages (51 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels.
2. Locate the element: tr:nth-child(1) > td[scope="row"]
3. Confirm the axe-core finding for rule scope-attr-valid.

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

### Affected pages
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels

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

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

---

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

**Bug ID:** `VS-c1d9ae08`  
**Pattern ID:** `VS-4fac2f41`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-2krc"] > .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:** 1003 instances; 470 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 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 470 of 8593 scanned pages (1003 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=.
2. Locate the element: span[data-select2-id="select2-data-1-2krc"] > .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=1001&page=5&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=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=10&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=756&page=4&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=996&page=31&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=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=826&page=28&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=27&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=13&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=756&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=776&page=15&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=36&q=

…and more — 470 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=1001&page=5&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-1257640a`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26  
**XPath / selector:** `text: "
                An official website of the United States government
                "`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 104738 instances; 4191 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 4191 of 8593 scanned pages (104738 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26.
2. Locate the element: text: "
                An official website of the United States government
                "
3. Confirm the Siteimprove Alfa finding for rule sia-r57.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A2696&f%5B4%5D=fpg_topics_facet%3A8601&page=110
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?category12Id=1401&category3Id=140103&f%5B0%5D=topics%3A7381&page=1657
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A856&f%5B2%5D=fpg_topics_facet%3A1501&f%5B3%5D=fpg_topics_facet%3A6486&page=4
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-accreditation-organization
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1496&f%5B1%5D=fpg_topics_facet%3A1531&f%5B2%5D=fpg_topics_facet%3A3046&f%5B3%5D=fpg_topics_facet%3A8381&f%5B4%5D=fpg_topics_facet%3A8611&f%5B5%5D=fpg_topics_facet%3A8616&f%5B6%5D=fpg_topics_facet%3A8711&f%5B7%5D=fpg_topics_facet%3A8891&f%5B8%5D=fpg_topics_facet%3A8896&page=3
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A751&f%5B1%5D=topics%3A936&f%5B2%5D=topics%3A5811&page=1658
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-15-006-6
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2451&fcf=40870&page=4&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- http://medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-final-rules
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1491&f%5B1%5D=fpg_topics_facet%3A8601&page=108
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-60-001-1
- 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
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/improving-care-for-sickle-cell-disease

…and more — 4191 pages total ([download CSV](csv/alfa__sia-r57.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229

---

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

**Bug ID:** `VS-0f599655`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26  
**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:** 2621 instances; 2621 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 2621 of 8593 scanned pages (2621 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r87.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-accreditation-organization
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-15-006-6
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-60-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6238
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002143
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt003235
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7441
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002035
- 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/validation-rules/rule-8417
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg004064
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6875

…and more — 2621 pages total ([download CSV](csv/alfa__sia-r87.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229

---

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

**Bug ID:** `VS-5b974334`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26  
**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:** 2608 instances; 2608 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 2608 of 8593 scanned pages (2608 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r61.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6637
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-384
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-accreditation-organization
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8356
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-15-006-6
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-60-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6238
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002143
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt003235
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7441
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002035
- 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/validation-rules/rule-8417
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg004064
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6875

…and more — 2608 pages total ([download CSV](csv/alfa__sia-r61.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2229

---

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

**Bug ID:** `VS-bcf69cbe`  
**Pattern ID:** `VS-e05344b9`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111  
**XPath / selector:** `@aria-selected="true"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 3181 instances; 656 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 656 of 8593 scanned pages (3181 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111.
2. Locate the element: @aria-selected="true"
3. Confirm the Siteimprove Alfa finding for rule sia-r18.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv003041
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-accreditation-organization
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002143
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt003235
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002035
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004124
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg004064
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002106
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002220
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002053
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002035
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv001002
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002219
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg003040
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002068
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010117
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003206
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003142
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt002157
- http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg006110

…and more — 656 pages total ([download CSV](csv/alfa__sia-r18.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003157
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068

---

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

**Bug ID:** `VS-b1592912`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2611  
**XPath / selector:** `td`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 477 instances; 377 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

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

### Description
Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 377 of 8593 scanned pages (477 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2611.
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/validation-rules/rule-2611
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004124
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8417
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6656
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8142
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2030
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003142
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2100
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-3096
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7541
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-612
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1889
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip003254
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002017
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2291
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3160
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip003249
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-54-010-10
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2913
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-677
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002251
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv006092

…and more — 377 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/validation-rules/rule-2611
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003272

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-3383e981`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations  
**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:** 341 instances; 313 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 313 of 8593 scanned pages (341 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations.
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
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations
- http://medicaid.gov/medicaid/data-systems/health-information-technology/health-disparities
- https://www.medicaid.gov/about-us/organization/adrienne-delozier
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/100706
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-enrollment-data-collected-through-mbes
- http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/192776
- https://www.medicaid.gov/medicaid/program-integrity/affordable-care-act-program-integrity-provisions
- http://medicaid.gov/chip/chip-eligibility-enrollment/enrollment-strategies
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/154506
- https://www.medicaid.gov/resources-for-states/innovation-accelerator-program
- https://www.medicaid.gov/state-overviews/stateprofile.html?state=Oregon
- http://medicaid.gov/resources-for-states/managed-care-review-mc-review/managed-care-review-faqs
- https://www.medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/reducing-substance-use-disorders/collaborative-learning
- https://www.medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center/request-health-home-planning-funds
- https://www.medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-reporting/how-to-use-mcpar-public-use-files
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%22%5D
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/eligibility-verification-policies
- https://www.medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/medicaid-spa-processing-tools-for-states
- http://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center/health-homes-guidance
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/98321
- https://www.medicaid.gov/medicaid/data-systems/medicaid-eligibility-enrollment-toolkit
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality
- https://www.medicaid.gov/medicaid/benefits/behavioral-health-services/parity

…and more — 313 pages total ([download CSV](csv/alfa__sia-r53.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations
- http://medicaid.gov/medicaid/data-systems/health-information-technology/health-disparities
- https://www.medicaid.gov/about-us/organization/adrienne-delozier

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-e86fbc2b`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%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:** 13 instances; 12 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 12 of 8593 scanned pages (13 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%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%22MO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NJ%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NE%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MT%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MI%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%22LA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WY%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SD%22%5D
- http://medicaid.gov/resources-for-states/medicaid-and-chip-program-portal/macpro-training-help/chip-state-plan-amendments
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22PR%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%22MO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NJ%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NE%22%5D

---

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

**Bug ID:** `VS-d8f5041e`  
**Pattern ID:** `VS-4c341c77`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%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:** 636 instances; 11 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 11 of 8593 scanned pages (636 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%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%22MO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NJ%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NE%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MT%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MI%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%22LA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WY%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SD%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22PR%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%22MO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NJ%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NE%22%5D

---

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

**Bug ID:** `VS-a7fbd466`  
**Pattern ID:** `VS-e5ec42f0`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%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:** 1842 instances; 11 of 8593 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W28 (5 weeks)

### Description
Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 11 of 8593 scanned pages (1842 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%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%22MO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NJ%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NE%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MT%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MI%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%22LA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WY%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SD%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22PR%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%22MO%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NJ%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NE%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 8593 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W28 (2 weeks)

### Description
Input purpose can be determined. Detected by Siteimprove Alfa rule sia-r60 on 1 of 8593 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