# Accessibility bug reports — www.medicaid.gov, week 2026-W30

39 issue type(s) from 7314 pages scanned. Generated 2026-07-26 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-5765ec0f`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&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:** 490 instances; 228 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 228 of 7314 scanned pages (490 instances).

### Steps to reproduce
1. Open http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&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
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=831&page=22&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=736&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=1&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=1001&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=22&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=25&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=5&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=736&page=16&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=0&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=916&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=15&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=8816&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=866&page=24&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=17&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=24&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=29&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=0&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=10&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=2271&limit=10&page=1&q=&sort=field_faq_date%3Adesc

…and more — 228 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
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=831&page=22&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=736&q=

---

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

**Bug ID:** `VS-6a136e43`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128  
**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:** 563 instances; 563 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 563 of 7314 scanned pages (563 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128.
2. Locate the element: <a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">
3. Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-015-15
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv004062
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2098
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-156-156
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-81-032-32
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-1-026-33
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-86-004-4
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-6-036-36
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-350
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7912
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/prv-6-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003193
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-28-002-2
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-16-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-1-084-84
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-19-002-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-35-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/prv-provider/prov-affiliated-programs
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003256
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-032-32
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003034
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-5-014-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-85-029-29

…and more — 563 pages total ([download CSV](csv/alfa__sia-r14.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-015-15
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-64562f0f`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `p:nth-child(1) > a > img`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** axe-core — `image-alt` ([reference](https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 1 instances; 1 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (5 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 7314 scanned pages (1 instances).

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

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

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

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

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

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

---

## Image has accessible name (WCAG 1.1.1)

**Bug ID:** `VS-3ceba623`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `<img src="/media/file/monitor-eval-1115-demonstrations0.png/">`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** Siteimprove Alfa — `sia-r2` ([reference](https://alfa.siteimprove.com/rules/sia-r2))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (5 weeks)

### Description
Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 1 of 7314 scanned pages (1 instances).

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

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

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

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

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

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

---

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

**Bug ID:** `VS-b6ee8b73`  
**Pattern ID:** `VS-9429bb8d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128  
**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:** 477 instances; 477 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 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 477 of 7314 scanned pages (477 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128.
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/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt004274
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv004062
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003037
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002074
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg013184
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg015201
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002088
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002116
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002057
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004108
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003193
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg001010
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003266
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr001004
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/crx-claim-pharmacy/file-header-record-rx
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/prv-provider/prov-affiliated-programs
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003256
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg004071
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002089
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003034
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095390
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg004069

…and more — 477 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/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092

---

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

**Bug ID:** `VS-fc38a703`  
**Pattern ID:** `VS-d6097011`  
**URL:** http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=  
**XPath / selector:** `<ul class="select2-selection__rendered" id="select2-edit-field-topics-container">`  
**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:** 496 instances; 462 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 462 of 7314 scanned pages (496 instances).

### Steps to reproduce
1. Open http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=.
2. Locate the element: <ul class="select2-selection__rendered" id="select2-edit-field-topics-container">
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
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv004062
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=831&page=22&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=736&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002088
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003193
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=1&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=1001&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=22&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/prv-provider/prov-affiliated-programs
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003256
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003034
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=25&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095390
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg004069
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=5&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006196
- 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/tmsis/dataguide/v3/data-elements/elg005091
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx009352
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006220

…and more — 462 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
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092

---

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

**Bug ID:** `VS-ff38b023`  
**Pattern ID:** `VS-4408605e`  
**URL:** https://www.medicaid.gov/medicaid/outreach-tools/helping-connect-enrollees-care  
**XPath / selector:** `<th>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r46` ([reference](https://alfa.siteimprove.com/rules/sia-r46))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (5 weeks)

### Description
Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 1 of 7314 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/outreach-tools/helping-connect-enrollees-care.
2. Locate the element: <th>
3. Confirm the Siteimprove Alfa finding for rule sia-r46 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.medicaid.gov/medicaid/outreach-tools/helping-connect-enrollees-care

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

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

---

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

**Bug ID:** `VS-253dc249`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** http://medicaid.gov/medicaid/quality-of-care/quality-improvement/addressing-childhood-obesity  
**XPath / selector:** `<a style="text-decoration:none;" href="#one" title="">`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** Siteimprove Alfa — `sia-r62` ([reference](https://alfa.siteimprove.com/rules/sia-r62))  
**Severity:** Moderate  
**Frequency:** 3 instances; 1 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (4 weeks)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 1 of 7314 scanned pages (3 instances).

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

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

### Affected pages
- 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

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-10f338a8`  
**Pattern ID:** `VS-e9fe47ac`  
**URL:** http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `p:nth-child(1) > a`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** axe-core — `link-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1 instances; 1 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (6 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 7314 scanned pages (1 instances).

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

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

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

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

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

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

---

## Link has accessible name (WCAG 2.4.4)

**Bug ID:** `VS-ea121e34`  
**Pattern ID:** `VS-28ebd979`  
**URL:** http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `<a href="/medicaid/section-1115-demonstrations/downloads/monitor-eval-1115-demonstrations-infographic.pdf">`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** Siteimprove Alfa — `sia-r11` ([reference](https://alfa.siteimprove.com/rules/sia-r11))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (5 weeks)

### Description
Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 7314 scanned pages (1 instances).

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

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

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

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

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

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

---

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

**Bug ID:** `VS-9e01bc62`  
**Pattern ID:** `VS-1467ea8a`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128  
**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:** 2322 instances; 477 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 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 477 of 7314 scanned pages (2322 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128.
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/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt004274
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv004062
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003037
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002074
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg013184
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg015201
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002088
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002116
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002057
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004108
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003193
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg001010
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003266
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr001004
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/crx-claim-pharmacy/file-header-record-rx
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/prv-provider/prov-affiliated-programs
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003256
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg004071
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002089
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003034
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095390
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg004069

…and more — 477 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/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092

---

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

**Bug ID:** `VS-a4f15ed1`  
**Pattern ID:** `VS-fab92378`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/technical-instructions  
**XPath / selector:** `#items-per-page`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `select-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/select-name?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 1 instances; 1 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (6 weeks)

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

### Description
Select element must have an accessible name. Detected by axe-core rule select-name on 1 of 7314 scanned pages (1 instances).

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

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

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

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

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

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

---

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

**Bug ID:** `VS-e1532264`  
**Pattern ID:** `VS-0841abc2`  
**URL:** http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-eet5"] > .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:** 1038 instances; 484 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 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 484 of 7314 scanned pages (1038 instances).

### Steps to reproduce
1. Open http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=.
2. Locate the element: span[data-select2-id="select2-data-1-eet5"] > .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
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=891&page=5&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=831&page=22&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=33&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=736&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=931&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=996&page=31&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=0&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=1001&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=716&page=22&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=22&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=756&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=5&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=26&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=22&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=25&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=36&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=81&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=3&q=

…and more — 484 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
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=891&page=5&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=1&q=

---

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

**Bug ID:** `VS-eec3e56a`  
**Pattern ID:** `VS-ebb1c464`  
**URL:** http://medicaid.gov/chip/state-program-information  
**XPath / selector:** `#map-svg-map-default-1745254648`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-prohibited-attr` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-prohibited-attr?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 8 instances; 2 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### HTML snippet
```html
<div id="map-svg-map-default-1745254648" class="map-container" aria-disabled="true" aria-label="State Map Image. Keyboard navigating users can use dropdown to select state." style="position: relative;
```

### Description
Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 2 of 7314 scanned pages (8 instances).

### Steps to reproduce
1. Open http://medicaid.gov/chip/state-program-information.
2. Locate the element: #map-svg-map-default-1745254648
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/chip/state-program-information
- https://www.medicaid.gov/index.html

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

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

### Example pages
- http://medicaid.gov/chip/state-program-information
- https://www.medicaid.gov/index.html

---

## Form field has accessible name (WCAG 4.1.2)

**Bug ID:** `VS-5e4cd476`  
**Pattern ID:** `VS-a48e6078`  
**URL:** http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&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:** 491 instances; 229 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 229 of 7314 scanned pages (491 instances).

### Steps to reproduce
1. Open http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&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
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=831&page=22&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=736&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=1&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=1001&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=22&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=25&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=5&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=736&page=16&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=0&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=916&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=15&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=8816&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=866&page=24&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=17&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=24&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=29&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=0&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=896&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=10&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=2271&limit=10&page=1&q=&sort=field_faq_date%3Adesc

…and more — 229 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
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=831&page=22&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=736&q=

---

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

**Bug ID:** `VS-f844b397`  
**Pattern ID:** `VS-be8d563e`  
**URL:** https://www.medicaid.gov/chip/reports-evaluations  
**XPath / selector:** `.helpful-box-gray-sm > p > span`  
**WCAG SC:** 1.4.3 — Contrast (Minimum) (Level AA)  
**Rule:** axe-core — `color-contrast` ([reference](https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 2 instances; 1 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (5 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 7314 scanned pages (2 instances).

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

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

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

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

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

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

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-1cd336c2`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317  
**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:** 124686 instances; 3490 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3490 of 7314 scanned pages (124686 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317.
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/validation-rules/rule-7317
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2341&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2371&f%5B3%5D=sub_topic_faq_library_facet%3A2421&f%5B4%5D=sub_topic_faq_library_facet%3A2521&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1911&f%5B1%5D=sub_topic_faq_library_facet%3A1956&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=0
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A891&f%5B1%5D=topics%3A5896&page=1660
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A851&f%5B1%5D=state%3A971&f%5B2%5D=state%3A1026&page=1651
- http://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%3A2091&f%5B3%5D=sub_topic_faq_library_facet%3A2501&page=4
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128
- http://medicaid.gov/medicaid/prescription-drugs/program-releases?page=30
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-79-013-13
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3156&f%5B1%5D=topics%3A3791&f%5B2%5D=topics%3A3896&f%5B3%5D=topics%3A5811&f%5B4%5D=topics%3A6486&f%5B5%5D=topics%3A7411&page=1662&task=face-presentation-attack-detection
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1531&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=110
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A806&f%5B1%5D=state%3A926&f%5B2%5D=state%3A996&page=1662
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1921&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2341&f%5B4%5D=sub_topic_faq_library_facet%3A2476&page=80
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-015-15
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- http://medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-final-rules
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A876&f%5B1%5D=state%3A896&f%5B2%5D=topics%3A741&page=3
- 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/validation-rules/rule-2635
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A736&f%5B1%5D=waiver_state_facet%3A786&f%5B2%5D=waiver_state_facet%3A976&items_per_page=50&page=69
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1531&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=109
- http://medicaid.gov/faq?fcf=41078&page=83&sl=yes

…and more — 3490 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/validation-rules/rule-7317
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2341&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2371&f%5B3%5D=sub_topic_faq_library_facet%3A2421&f%5B4%5D=sub_topic_faq_library_facet%3A2521&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1911&f%5B1%5D=sub_topic_faq_library_facet%3A1956&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=0

---

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

**Bug ID:** `VS-028590ad`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2341&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2371&f%5B3%5D=sub_topic_faq_library_facet%3A2421&f%5B4%5D=sub_topic_faq_library_facet%3A2521&page=0  
**XPath / selector:** `<p class="usa-footer__contact-info margin-bottom-0">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r73` ([reference](https://alfa.siteimprove.com/rules/sia-r73))  
**Severity:** Moderate  
**Frequency:** 5735 instances; 2380 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 2380 of 7314 scanned pages (5735 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2341&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2371&f%5B3%5D=sub_topic_faq_library_facet%3A2421&f%5B4%5D=sub_topic_faq_library_facet%3A2521&page=0.
2. Locate the element: <p class="usa-footer__contact-info margin-bottom-0">
3. Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2341&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2371&f%5B3%5D=sub_topic_faq_library_facet%3A2421&f%5B4%5D=sub_topic_faq_library_facet%3A2521&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1911&f%5B1%5D=sub_topic_faq_library_facet%3A1956&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=0
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A891&f%5B1%5D=topics%3A5896&page=1660
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A851&f%5B1%5D=state%3A971&f%5B2%5D=state%3A1026&page=1651
- http://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%3A2091&f%5B3%5D=sub_topic_faq_library_facet%3A2501&page=4
- http://medicaid.gov/medicaid/prescription-drugs/program-releases?page=30
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3156&f%5B1%5D=topics%3A3791&f%5B2%5D=topics%3A3896&f%5B3%5D=topics%3A5811&f%5B4%5D=topics%3A6486&f%5B5%5D=topics%3A7411&page=1662&task=face-presentation-attack-detection
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1531&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=110
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A806&f%5B1%5D=state%3A926&f%5B2%5D=state%3A996&page=1662
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1921&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2341&f%5B4%5D=sub_topic_faq_library_facet%3A2476&page=80
- http://medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-final-rules
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A876&f%5B1%5D=state%3A896&f%5B2%5D=topics%3A741&page=3
- 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=waiver_state_facet%3A736&f%5B1%5D=waiver_state_facet%3A786&f%5B2%5D=waiver_state_facet%3A976&items_per_page=50&page=69
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1531&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=109
- http://medicaid.gov/faq?fcf=41078&page=83&sl=yes
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A2696&f%5B1%5D=fpg_topics_facet%3A3261&f%5B2%5D=fpg_topics_facet%3A8406&page=105
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A541&f%5B1%5D=state%3A971&f%5B2%5D=state%3A996&f%5B3%5D=state%3A7971&page=0
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A1501&f%5B2%5D=fpg_topics_facet%3A1521&page=0
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=831&page=22&q=
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1491&f%5B3%5D=fpg_topics_facet%3A1496&f%5B4%5D=fpg_topics_facet%3A1526&f%5B5%5D=fpg_type_facet%3A1476&page=4
- https://www.medicaid.gov/medicaid/managed-care/guidance/state-directed-payments/approved-state-directed-payment-preprints?items_per_page=50&page=110
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A926&f%5B1%5D=state%3A1036&f%5B2%5D=topics%3A936&page=1661

…and more — 2380 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/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2341&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2371&f%5B3%5D=sub_topic_faq_library_facet%3A2421&f%5B4%5D=sub_topic_faq_library_facet%3A2521&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1911&f%5B1%5D=sub_topic_faq_library_facet%3A1956&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=0
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A891&f%5B1%5D=topics%3A5896&page=1660

---

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

**Bug ID:** `VS-c0b2803a`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WI%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:** 21 instances; 8 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 8 of 7314 scanned pages (21 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WI%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%22WI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22IA%22%5D
- http://medicaid.gov/medicaid/eligibility-policy/medicaid-eligibility-quality-control-program
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=3
- https://www.medicaid.gov/medicaid/outreach-tools/helping-connect-enrollees-care
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WV%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%22WI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D

---

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

**Bug ID:** `VS-8aa6ad74`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317  
**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:** 74437 instances; 3490 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3490 of 7314 scanned pages (74437 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317.
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/validation-rules/rule-7317
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2341&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2371&f%5B3%5D=sub_topic_faq_library_facet%3A2421&f%5B4%5D=sub_topic_faq_library_facet%3A2521&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1911&f%5B1%5D=sub_topic_faq_library_facet%3A1956&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=0
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A891&f%5B1%5D=topics%3A5896&page=1660
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A851&f%5B1%5D=state%3A971&f%5B2%5D=state%3A1026&page=1651
- http://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%3A2091&f%5B3%5D=sub_topic_faq_library_facet%3A2501&page=4
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128
- http://medicaid.gov/medicaid/prescription-drugs/program-releases?page=30
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-79-013-13
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3156&f%5B1%5D=topics%3A3791&f%5B2%5D=topics%3A3896&f%5B3%5D=topics%3A5811&f%5B4%5D=topics%3A6486&f%5B5%5D=topics%3A7411&page=1662&task=face-presentation-attack-detection
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1531&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=110
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A806&f%5B1%5D=state%3A926&f%5B2%5D=state%3A996&page=1662
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1921&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2341&f%5B4%5D=sub_topic_faq_library_facet%3A2476&page=80
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-015-15
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- http://medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-final-rules
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A876&f%5B1%5D=state%3A896&f%5B2%5D=topics%3A741&page=3
- 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/validation-rules/rule-2635
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A736&f%5B1%5D=waiver_state_facet%3A786&f%5B2%5D=waiver_state_facet%3A976&items_per_page=50&page=69
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1531&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=109
- http://medicaid.gov/faq?fcf=41078&page=83&sl=yes

…and more — 3490 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/validation-rules/rule-7317
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2341&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2371&f%5B3%5D=sub_topic_faq_library_facet%3A2421&f%5B4%5D=sub_topic_faq_library_facet%3A2521&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1911&f%5B1%5D=sub_topic_faq_library_facet%3A1956&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=0

---

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

**Bug ID:** `VS-8086e32c`  
**Pattern ID:** `VS-33841929`  
**URL:** https://www.medicaid.gov/prior-annual-medicaid-hospice-rate-letters  
**XPath / selector:** `select[aria-labelledby="filter-th-152991-1"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `label-title-only` ([reference](https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 34 instances; 5 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### HTML snippet
```html
<select aria-labelledby="filter-th-152991-1" class="usa-select height-1" data-col-index="1" title="Filter by Year">
```

### Description
Form elements should have a visible label. Detected by axe-core rule label-title-only on 5 of 7314 scanned pages (34 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/prior-annual-medicaid-hospice-rate-letters.
2. Locate the element: select[aria-labelledby="filter-th-152991-1"]
3. Confirm the axe-core finding for rule label-title-only.

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

### Affected pages
- https://www.medicaid.gov/prior-annual-medicaid-hospice-rate-letters
- https://www.medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/drug-utilization-review-annual-report
- https://www.medicaid.gov/chip/reports-evaluations
- https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- http://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-data

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

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

### Example pages
- https://www.medicaid.gov/prior-annual-medicaid-hospice-rate-letters
- https://www.medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/drug-utilization-review-annual-report
- https://www.medicaid.gov/chip/reports-evaluations

---

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

**Bug ID:** `VS-0ff4cfe9`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386  
**XPath / selector:** `.small`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 10051 instances; 2256 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 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 2256 of 7314 scanned pages (10051 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386.
2. Locate the element: .small
3. Confirm the axe-core finding for rule region.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-79-013-13
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7634
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7394
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-015-15
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-60-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1226
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2635
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7836
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt004274
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv004062
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-49-005-5
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-1-014-5
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2098
- https://www.medicaid.gov/tmsis/dataguide/v3/appendices
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-3-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-156-156
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-81-032-32

…and more — 2256 pages total ([download CSV](csv/axe-core__region.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663

---

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

**Bug ID:** `VS-fa8a6dd3`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386  
**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:** Moderate  
**Frequency:** 2252 instances; 2252 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 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 2252 of 7314 scanned pages (2252 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386.
2. Locate the element: html
3. Confirm the axe-core finding for rule page-has-heading-one.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-79-013-13
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7634
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7394
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-015-15
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-60-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1226
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2635
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7836
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt004274
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv004062
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-49-005-5
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-1-014-5
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2098
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-3-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-156-156
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-81-032-32
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003037

…and more — 2252 pages total ([download CSV](csv/axe-core__page-has-heading-one.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663

---

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

**Bug ID:** `VS-b9ab29b0`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-one-main` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 2246 instances; 2246 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 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 2246 of 7314 scanned pages (2246 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386.
2. Locate the element: html
3. Confirm the axe-core finding for rule landmark-one-main.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-79-013-13
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7634
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002247
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7394
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-015-15
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-60-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1226
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2635
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7836
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt004274
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv004062
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-49-005-5
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-1-014-5
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2098
- https://www.medicaid.gov/tmsis/dataguide/v3/appendices
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-3-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-156-156
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-81-032-32

…and more — 2246 pages total ([download CSV](csv/axe-core__landmark-one-main.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1386
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663

---

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

**Bug ID:** `VS-12e4d570`  
**Pattern ID:** `VS-d25f622d`  
**URL:** https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j  
**XPath / selector:** `.field--name-field-resources-list > h3`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 268 instances; 245 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

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

### Description
Heading levels should only increase by one. Detected by axe-core rule heading-order on 245 of 7314 scanned pages (268 instances).

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

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

### Affected pages
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- 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/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106341
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance
- https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-dispute-resolution
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/99166
- https://www.medicaid.gov/new-notable?page=91
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/quality-of-care-patient-safety
- http://medicaid.gov/chip/chip-eligibility-enrollment/enrollment-strategies
- https://www.medicaid.gov/medicaid/home-community-based-services/home-and-community-based-services-hcbs-quality
- http://medicaid.gov/medicaid/long-term-services-supports/self-directed-services
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/97856
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/monthly-medicaid-chip-application-eligibility-determination-and-enrollment-reports-data
- https://www.medicaid.gov/new-notable?page=92
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106611
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/eligibility-verification-policies
- https://www.medicaid.gov/medicaid/data-systems/medicaid-and-chip-business-information-solution/macbis-financial/medicaid-budget-and-expenditure-system-mbes/cms-37-medicaid-program-budget-report
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/improving-asthma-control
- https://www.medicaid.gov/federal-policy-guidance-sidebar-content
- https://www.medicaid.gov/medicaid/access-care
- http://medicaid.gov/state-overviews/stateprofile.html?state=North-Carolina
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/52304
- https://www.medicaid.gov/state-overviews/stateprofile.html?state=Indiana
- https://www.medicaid.gov/state-drug-utilization-data-sdud-faqs

…and more — 245 pages total ([download CSV](csv/axe-core__heading-order.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j
- 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

---

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

**Bug ID:** `VS-ce81907e`  
**Pattern ID:** `VS-8806389c`  
**URL:** https://www.medicaid.gov/resources-for-states/medicaid-and-chip-program-portal/macpro-training-help  
**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:** 45 instances; 45 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 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 45 of 7314 scanned pages (45 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/resources-for-states/medicaid-and-chip-program-portal/macpro-training-help.
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/resources-for-states/medicaid-and-chip-program-portal/macpro-training-help
- http://medicaid.gov/chip
- https://www.medicaid.gov/medicaid/data-systems/medicaid-and-chip-business-information-solution/macbis-financial
- http://medicaid.gov/medicaid/long-term-services-supports/real-choice-systems-change/state-profile-tool-grant-program
- https://www.medicaid.gov/medicaid/financial-management/state-budget-expenditure-reporting-for-medicaid-and-chip/expenditure-reports-mbes/cbes
- http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
- https://www.medicaid.gov/nondiscrimination-policy-update
- https://www.medicaid.gov/about-us/messages/arkansas-fast-tracks-medicaid-enrollment
- https://www.medicaid.gov/style-guide
- https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance
- https://www.medicaid.gov/medicaid/indian-health-medicaid
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=0
- https://www.medicaid.gov/medicaid/managed-care
- https://www.medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-reporting
- https://www.medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/drug-utilization-review-annual-report
- https://www.medicaid.gov/medicaid/long-term-services-supports/real-choice-systems-change/state-profile-tool-grant-program
- https://www.medicaid.gov/medicaid/managed-care/guidance
- https://www.medicaid.gov/style-guide/patterns
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19
- https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=18
- https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-mdrp-file-formats-data-definitions-and-medicaid-drug-programs-mdp-email-communications/index.html
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/archived-unwinding-and-returning-regular-operations-after-covid-19
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=50&page=3
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=4

…and more — 45 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/resources-for-states/medicaid-and-chip-program-portal/macpro-training-help
- http://medicaid.gov/chip
- https://www.medicaid.gov/medicaid/data-systems/medicaid-and-chip-business-information-solution/macbis-financial

---

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

**Bug ID:** `VS-4e0fbdac`  
**Pattern ID:** `VS-ff3ceb19`  
**URL:** https://www.medicaid.gov/style-guide  
**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:** 4 instances; 4 of 7314 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W30 (3 weeks)

### 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 4 of 7314 scanned pages (4 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/style-guide.
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
- https://www.medicaid.gov/style-guide/patterns
- https://www.medicaid.gov/style-guide/foundation/logo
- https://www.medicaid.gov/style-guide/components/back-to-top

### 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
- https://www.medicaid.gov/style-guide/patterns
- https://www.medicaid.gov/style-guide/foundation/logo

---

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

**Bug ID:** `VS-767202b2`  
**Pattern ID:** `VS-cd69be3a`  
**URL:** https://www.medicaid.gov/style-guide  
**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:** 4 instances; 4 of 7314 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W30 (3 weeks)

### 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 4 of 7314 scanned pages (4 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/style-guide.
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
- https://www.medicaid.gov/style-guide/patterns
- https://www.medicaid.gov/style-guide/foundation/logo
- https://www.medicaid.gov/style-guide/components/back-to-top

### 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
- https://www.medicaid.gov/style-guide/patterns
- https://www.medicaid.gov/style-guide/foundation/logo

---

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

**Bug ID:** `VS-9dcf7117`  
**Pattern ID:** `VS-0ba8ce9d`  
**URL:** https://www.medicaid.gov/state-overviews/scorecard/about  
**XPath / selector:** `.table-container:nth-child(5) > table > tbody > tr > 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:** 57 instances; 2 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (6 weeks)

### HTML snippet
```html
<td scope="row">Prenatal and Postpartum Care</td>
```

### Description
scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 2 of 7314 scanned pages (57 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/state-overviews/scorecard/about.
2. Locate the element: .table-container:nth-child(5) > table > tbody > tr > 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/state-overviews/scorecard/about
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels

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

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

### Example pages
- https://www.medicaid.gov/state-overviews/scorecard/about
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels

---

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

**Bug ID:** `VS-21679787`  
**Pattern ID:** `VS-4fac2f41`  
**URL:** http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-eet5"] > .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:** 1042 instances; 487 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 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 487 of 7314 scanned pages (1042 instances).

### Steps to reproduce
1. Open http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=.
2. Locate the element: span[data-select2-id="select2-data-1-eet5"] > .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
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=891&page=5&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=831&page=22&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=33&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=736&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=931&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=996&page=31&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=0&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=1001&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=716&page=22&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=22&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=756&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=5&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=26&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=22&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=25&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=36&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=81&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=3&q=

…and more — 487 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
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=891&page=5&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=1&q=

---

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

**Bug ID:** `VS-dd6d8a2c`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317  
**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:** 50955 instances; 3486 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3486 of 7314 scanned pages (50955 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317.
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/validation-rules/rule-7317
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2341&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2371&f%5B3%5D=sub_topic_faq_library_facet%3A2421&f%5B4%5D=sub_topic_faq_library_facet%3A2521&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1911&f%5B1%5D=sub_topic_faq_library_facet%3A1956&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=0
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A891&f%5B1%5D=topics%3A5896&page=1660
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A851&f%5B1%5D=state%3A971&f%5B2%5D=state%3A1026&page=1651
- http://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%3A2091&f%5B3%5D=sub_topic_faq_library_facet%3A2501&page=4
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128
- http://medicaid.gov/medicaid/prescription-drugs/program-releases?page=30
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-79-013-13
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3156&f%5B1%5D=topics%3A3791&f%5B2%5D=topics%3A3896&f%5B3%5D=topics%3A5811&f%5B4%5D=topics%3A6486&f%5B5%5D=topics%3A7411&page=1662&task=face-presentation-attack-detection
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1531&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=110
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A806&f%5B1%5D=state%3A926&f%5B2%5D=state%3A996&page=1662
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1921&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2341&f%5B4%5D=sub_topic_faq_library_facet%3A2476&page=80
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-015-15
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- http://medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-final-rules
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A876&f%5B1%5D=state%3A896&f%5B2%5D=topics%3A741&page=3
- 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/validation-rules/rule-2635
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A736&f%5B1%5D=waiver_state_facet%3A786&f%5B2%5D=waiver_state_facet%3A976&items_per_page=50&page=69
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1531&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=109
- http://medicaid.gov/faq?fcf=41078&page=83&sl=yes

…and more — 3486 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/validation-rules/rule-7317
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2341&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2371&f%5B3%5D=sub_topic_faq_library_facet%3A2421&f%5B4%5D=sub_topic_faq_library_facet%3A2521&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1911&f%5B1%5D=sub_topic_faq_library_facet%3A1956&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=0

---

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

**Bug ID:** `VS-b60346b5`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317  
**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:** 1116 instances; 1116 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 1116 of 7314 scanned pages (1116 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317.
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/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-79-013-13
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-015-15
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2635
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv004062
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-49-005-5
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2098
- https://www.medicaid.gov/tmsis/dataguide/v3/appendices
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-3-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-156-156
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-81-032-32
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-937
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-27-029-29
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-1-026-33
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6539
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-1-018-19
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-86-004-4
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-6-036-36
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002088
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-350
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-6-030-30

…and more — 1116 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/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128

---

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

**Bug ID:** `VS-b8ae1414`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317  
**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:** 1108 instances; 1108 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 1108 of 7314 scanned pages (1108 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317.
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/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-79-013-13
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-015-15
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2635
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv004062
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-49-005-5
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2098
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-3-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-156-156
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-81-032-32
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-937
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-27-029-29
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-1-026-33
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6539
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-1-018-19
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-86-004-4
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-6-036-36
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002088
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-350
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-6-030-30
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7912

…and more — 1108 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/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7663
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128

---

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

**Bug ID:** `VS-582dca8a`  
**Pattern ID:** `VS-e05344b9`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128  
**XPath / selector:** `@aria-selected="true"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 1228 instances; 246 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 246 of 7314 scanned pages (1228 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004128.
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/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv004062
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002088
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003193
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/prv-provider/prov-affiliated-programs
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003256
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003034
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095390
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg004069
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006196
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg005091
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx009352
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006220
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002208
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/tpl-third-party-liability/tpl-entity-contact-information
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002031
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002167
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002091
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg018229
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt001001
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg002019
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002152
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002075

…and more — 246 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/ftx004128
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv004062

---

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

**Bug ID:** `VS-e445ca90`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13  
**XPath / selector:** `td`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 180 instances; 144 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 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 144 of 7314 scanned pages (180 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13.
2. Locate the element: td
3. Confirm the deprecated-html finding for rule presentational-attr.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt004274
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003037
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr001004
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-61-002-2
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7344
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003256
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6816
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1781
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1865
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-728
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1357
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-84-022-22
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002208
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6486
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-8-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2010
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2391
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-11-001-85
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-11-020-97
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8239
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2146
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6702
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002059
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-530

…and more — 144 pages total ([download CSV](csv/deprecated-html__presentational-attr.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt004274
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003037

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-1c30e0d2`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot  
**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:** 128 instances; 115 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 115 of 7314 scanned pages (128 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot.
2. Locate the element: <h4 class="usa-footer__primary-link">
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

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

### Affected pages
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/99166
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/quality-of-care-patient-safety
- http://medicaid.gov/chip/chip-eligibility-enrollment/enrollment-strategies
- https://www.medicaid.gov/medicaid/home-community-based-services/home-and-community-based-services-hcbs-quality
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/97856
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106611
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/eligibility-verification-policies
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/improving-asthma-control
- https://www.medicaid.gov/federal-policy-guidance-sidebar-content
- https://www.medicaid.gov/medicaid/access-care
- http://medicaid.gov/state-overviews/stateprofile.html?state=North-Carolina
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WI%22%5D
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106601
- https://www.medicaid.gov/chip/financing
- https://www.medicaid.gov/medicaid/data-systems/medicaid-and-chip-business-information-solution/macbis-financial
- https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/cms-guidance
- http://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center/request-health-home-planning-funds
- https://www.medicaid.gov/medicaid/benefits/alternative-benefit-plan-coverage/designing-alternative-benefit-plan
- http://medicaid.gov/about-us/organization/karen-llanos
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- http://medicaid.gov/medicaid/indian-health-medicaid/indian-health-care-improvement-act
- https://www.medicaid.gov/about-us/organization/jessica-stephens
- http://medicaid.gov/medicaid/long-term-services-supports/real-choice-systems-change/state-profile-tool-grant-program

…and more — 115 pages total ([download CSV](csv/alfa__sia-r53.csv)).

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

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

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

### Example pages
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/99166

---

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

**Bug ID:** `VS-d7bf39ba`  
**Pattern ID:** `VS-4c341c77`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WI%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:** 228 instances; 5 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 5 of 7314 scanned pages (228 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WI%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%22WI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22IA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WV%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%22WI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-5803c4ab`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WI%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:** 5 instances; 5 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 5 of 7314 scanned pages (5 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WI%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%22WI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22IA%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WV%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%22WI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D

---

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

**Bug ID:** `VS-9de2de1c`  
**Pattern ID:** `VS-e5ec42f0`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WI%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:** 655 instances; 5 of 7314 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W30 (7 weeks)

### Description
Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 5 of 7314 scanned pages (655 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WI%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%22WI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22IA%22%5D
- https://www.medicaid.gov/state-overviews/scorecard/about
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22WV%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%22WI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NH%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22IA%22%5D