{
 "schema_version": "0.1",
 "site": "www.medicaid.gov",
 "scan_week": "2026-W31",
 "generated_at": "2026-09-30T18:09:21.762Z",
 "source_files": [
  "docs/reports/www.medicaid.gov/2026-W31/",
  "data/www.medicaid.gov/findings.json",
  "data/www.medicaid.gov/2026-W31/summary.json"
 ],
 "summary": {
  "pages_known": 56276,
  "pages_scanned_this_week": 7478,
  "pages_with_known_issues": 48052,
  "findings": 31,
  "clusters": 30,
  "new_findings": 0,
  "persistent_findings": 30,
  "high_priority_findings": 22
 },
 "top_risks": [
  {
   "finding_id": "VS-9429bb8d",
   "rule_id": "aria-required-children",
   "rule_label": "Certain ARIA roles must contain particular children",
   "severity": "Critical",
   "priority": "p1",
   "trend": "worsening",
   "pages_affected": 465,
   "rationale": "Critical severity; affects 465 pages; worsening trend",
   "top_url": "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095"
  },
  {
   "finding_id": "VS-1467ea8a",
   "rule_id": "aria-allowed-attr",
   "rule_label": "Elements must only use supported ARIA attributes",
   "severity": "Critical",
   "priority": "p1",
   "trend": "worsening",
   "pages_affected": 465,
   "rationale": "Critical severity; affects 465 pages; worsening trend",
   "top_url": "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095"
  },
  {
   "finding_id": "VS-0841abc2",
   "rule_id": "aria-input-field-name",
   "rule_label": "ARIA input fields must have an accessible name",
   "severity": "Serious",
   "priority": "p1",
   "trend": "worsening",
   "pages_affected": 308,
   "rationale": "Serious severity; affects 308 pages; worsening trend",
   "top_url": "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=8&q="
  },
  {
   "finding_id": "VS-ebb1c464",
   "rule_id": "aria-prohibited-attr",
   "rule_label": "Elements must only use permitted ARIA attributes",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 3,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "http://medicaid.gov/eligibility"
  },
  {
   "finding_id": "VS-33841929",
   "rule_id": "label-title-only",
   "rule_label": "Form elements should have a visible label",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 3,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "http://medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/innovative-practices"
  },
  {
   "finding_id": "VS-646b1e0b",
   "rule_id": "sia-r66",
   "rule_label": "Text has enhanced contrast",
   "severity": "Moderate",
   "priority": "p2",
   "trend": "persistent",
   "pages_affected": 3319,
   "rationale": "affects 3319 pages; persistent across weeks",
   "top_url": "http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0"
  },
  {
   "finding_id": "VS-cb53cc4d",
   "rule_id": "sia-r111",
   "rule_label": "Target size is at least 44×44 CSS pixels (Enhanced)",
   "severity": "Moderate",
   "priority": "p2",
   "trend": "persistent",
   "pages_affected": 3319,
   "rationale": "affects 3319 pages; persistent across weeks",
   "top_url": "http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0"
  },
  {
   "finding_id": "VS-c18be945",
   "rule_id": "sia-r57",
   "rule_label": "Scrolling content can be accessed by keyboard",
   "severity": "Moderate",
   "priority": "p2",
   "trend": "persistent",
   "pages_affected": 3317,
   "rationale": "affects 3317 pages; persistent across weeks",
   "top_url": "http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0"
  },
  {
   "finding_id": "VS-f18df681",
   "rule_id": "region",
   "rule_label": "All page content should be contained by landmarks",
   "severity": "Moderate",
   "priority": "p2",
   "trend": "worsening",
   "pages_affected": 2279,
   "rationale": "affects 2279 pages; worsening trend",
   "top_url": "https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953"
  },
  {
   "finding_id": "VS-fa44f293",
   "rule_id": "page-has-heading-one",
   "rule_label": "Page should contain a level-one heading",
   "severity": "Moderate",
   "priority": "p2",
   "trend": "worsening",
   "pages_affected": 2278,
   "rationale": "affects 2278 pages; worsening trend",
   "top_url": "https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953"
  }
 ],
 "findings": [
  {
   "finding_id": "VS-9429bb8d",
   "fingerprint": "d9ef25ac",
   "rule_id": "aria-required-children",
   "rule_label": "Certain ARIA roles must contain particular children",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI",
   "severity": "Critical",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Critical severity; affects 465 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 465,
    "affected_pages_previous": 224
   },
   "frequency": {
    "instances": 465,
    "pages_affected": 465,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Certain ARIA roles must contain particular children (WCAG 1.3.1)",
   "description": "Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 465 of 7478 scanned pages (465 instances).",
   "remediation_tip": "Add the child roles this container role requires (e.g. a list needs listitem children).",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule aria-required-children (WCAG 1.3.1).",
   "actual_behavior": "Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 465 of 7478 scanned pages (465 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008"
   ],
   "html_fragments": [
    {
     "fingerprint": "084e4684",
     "html": "<div class=\"nav nav-tabs nav-justified\" role=\"tablist\">",
     "selectors": [
      ".nav"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/cot002095",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/ftx003068",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/prv001008",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-1467ea8a",
   "fingerprint": "fc8886ab",
   "rule_id": "aria-allowed-attr",
   "rule_label": "Elements must only use supported ARIA attributes",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI",
   "severity": "Critical",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Critical severity; affects 465 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 465,
    "affected_pages_previous": 224
   },
   "frequency": {
    "instances": 2247,
    "pages_affected": 465,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Elements must only use supported ARIA attributes (WCAG 4.1.2)",
   "description": "Elements must only use supported ARIA attributes. Detected by axe-core rule aria-allowed-attr on 465 of 7478 scanned pages (2247 instances).",
   "remediation_tip": "Remove ARIA attributes that aren't allowed on this role/element.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule aria-allowed-attr (WCAG 4.1.2).",
   "actual_behavior": "Elements must only use supported ARIA attributes. Detected by axe-core rule aria-allowed-attr on 465 of 7478 scanned pages (2247 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003068",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008"
   ],
   "html_fragments": [
    {
     "fingerprint": "e8b33a04",
     "html": "<a class=\"nav-item nav-link active\" href=\"#overview\" role=\"link\" aria-selected=\"true\" aria-controls=\"overview\" data-toggle=\"tab\">Overview</a>",
     "selectors": [
      "a[href$=\"#overview\"]"
     ]
    },
    {
     "fingerprint": "4b1aed0a",
     "html": "<a class=\"nav-item nav-link\" href=\"#validvalues\" role=\"link\" aria-selected=\"false\" aria-controls=\"validvalues\" data-toggle=\"tab\">Valid Values</a>",
     "selectors": [
      "a[href$=\"#validvalues\"]"
     ]
    },
    {
     "fingerprint": "0d0d83f3",
     "html": "<a class=\"nav-item nav-link\" href=\"#relatedrules\" role=\"link\" aria-selected=\"false\" aria-controls=\"relatedrules\" data-toggle=\"tab\">Related Rules</a>",
     "selectors": [
      "a[href$=\"#relatedrules\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/cot002095",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/ftx003068",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/prv001008",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   }
  },
  {
   "finding_id": "VS-0841abc2",
   "fingerprint": "a3512e8b",
   "rule_id": "aria-input-field-name",
   "rule_label": "ARIA input fields must have an accessible name",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-input-field-name?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity; affects 308 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 308,
    "affected_pages_previous": 145
   },
   "frequency": {
    "instances": 648,
    "pages_affected": 308,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "ARIA input fields must have an accessible name (WCAG 4.1.2)",
   "description": "ARIA input fields must have an accessible name. Detected by axe-core rule aria-input-field-name on 308 of 7478 scanned pages (648 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-input-field-name?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule aria-input-field-name (WCAG 4.1.2).",
   "actual_behavior": "ARIA input fields must have an accessible name. Detected by axe-core rule aria-input-field-name on 308 of 7478 scanned pages (648 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=8&q=",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=786&q=",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=10&q="
   ],
   "html_fragments": [
    {
     "fingerprint": "b83690ed",
     "html": "<span class=\"select2-selection select2-selection--multiple\" role=\"combobox\" aria-haspopup=\"true\" aria-expanded=\"false\" tabindex=\"-1\" aria-disabled=\"false\">",
     "selectors": [
      "span[data-select2-id=\"select2-data-1-zx1c\"] > .selection > .select2-selection.select2-selection--multiple[role=\"combobox\"]",
      "span[data-select2-id=\"select2-data-4-rii3\"] > .selection > .select2-selection.select2-selection--multiple[role=\"combobox\"]",
      "span[data-select2-id=\"select2-data-1-tm9u\"] > .selection > .select2-selection.select2-selection--multiple[role=\"combobox\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 22
    },
    {
     "pattern": "/medicaid/section-1115-demo/demonstration-and-waiver-list",
     "count": 2
    },
    {
     "pattern": "/chip/state-program-information/chip-spa",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   }
  },
  {
   "finding_id": "VS-ebb1c464",
   "fingerprint": "62f3ac21",
   "rule_id": "aria-prohibited-attr",
   "rule_label": "Elements must only use permitted ARIA attributes",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-prohibited-attr?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "medium",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 3,
    "affected_pages_previous": 4
   },
   "frequency": {
    "instances": 13,
    "pages_affected": 3,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Elements must only use permitted ARIA attributes (WCAG 4.1.2)",
   "description": "Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 3 of 7478 scanned pages (13 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-prohibited-attr?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule aria-prohibited-attr (WCAG 4.1.2).",
   "actual_behavior": "Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 3 of 7478 scanned pages (13 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://medicaid.gov/eligibility",
    "https://www.medicaid.gov/",
    "https://www.medicaid.gov/homepage"
   ],
   "html_fragments": [
    {
     "fingerprint": "a596f33f",
     "html": "<div id=\"map-svg-map-1749492555669\" class=\"map-container\" aria-disabled=\"true\" aria-label=\"State Map Image. Keyboard navigating users can use dropdown to select state.\" style=\"position: relative; widt",
     "selectors": [
      "#map-svg-map-1749492555669"
     ]
    },
    {
     "fingerprint": "201c0931",
     "html": "<time class=\"nn-card__date flex-shrink-0 text-center margin-right-2 border\" datetime=\"2026-07-31\" aria-label=\"Jul 31\">",
     "selectors": [
      "div[aria-labelledby=\"nn-title-194316\"] > .flex-align-start.flex-1.display-flex > time[datetime=\"2026-07-31\"][aria-label=\"Jul 31\"]",
      "div[aria-labelledby=\"nn-title-194311\"] > .flex-align-start.flex-1.display-flex > time[datetime=\"2026-07-31\"][aria-label=\"Jul 31\"]"
     ]
    },
    {
     "fingerprint": "26e30683",
     "html": "<time class=\"nn-card__date flex-shrink-0 text-center margin-right-2 border\" datetime=\"2026-07-27\" aria-label=\"Jul 27\">",
     "selectors": [
      "time[datetime=\"2026-07-27\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/eligibility",
     "count": 1
    },
    {
     "pattern": "/",
     "count": 1
    },
    {
     "pattern": "/homepage",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   }
  },
  {
   "finding_id": "VS-33841929",
   "fingerprint": "e18c0475",
   "rule_id": "label-title-only",
   "rule_label": "Form elements should have a visible label",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "medium",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 3,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 10,
    "pages_affected": 3,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Form elements should have a visible label (WCAG criterion undetermined)",
   "description": "Form elements should have a visible label. Detected by axe-core rule label-title-only on 3 of 7478 scanned pages (10 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule label-title-only.",
   "actual_behavior": "Form elements should have a visible label. Detected by axe-core rule label-title-only on 3 of 7478 scanned pages (10 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/innovative-practices",
    "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"
   ],
   "html_fragments": [
    {
     "fingerprint": "50034708",
     "html": "<select aria-labelledby=\"filter-th-87376-0\" class=\"usa-select height-1\" data-col-index=\"0\" title=\"Filter by Year\">",
     "selectors": [
      "select[aria-labelledby=\"filter-th-87376-0\"]",
      "select[aria-labelledby=\"filter-th-152991-1\"]",
      "select[aria-labelledby=\"filter-th-87381-0\"]"
     ]
    },
    {
     "fingerprint": "1926a37c",
     "html": "<select aria-labelledby=\"filter-th-87376-1\" class=\"usa-select height-1\" data-col-index=\"1\" title=\"Filter by State Full Name\">",
     "selectors": [
      "select[aria-labelledby=\"filter-th-87376-1\"]"
     ]
    },
    {
     "fingerprint": "6aa0b2ba",
     "html": "<select aria-labelledby=\"filter-th-152991-2\" class=\"usa-select height-1\" data-col-index=\"2\" title=\"Filter by Date\">",
     "selectors": [
      "select[aria-labelledby=\"filter-th-152991-2\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicaid/prescription-drugs/drug-utilization-review/innovative-practices",
     "count": 1
    },
    {
     "pattern": "/prior-annual-medicaid-hospice-rate-letters",
     "count": 1
    },
    {
     "pattern": "/medicaid/prescription-drugs/drug-utilization-review/drug-utilization-review-annual-report",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-646b1e0b",
   "fingerprint": "afad441e",
   "rule_id": "sia-r66",
   "rule_label": "Text has enhanced contrast",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.6",
   "wcag_name": "Contrast (Enhanced)",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r66",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 3319 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 3319,
    "affected_pages_previous": 3426
   },
   "frequency": {
    "instances": 114340,
    "pages_affected": 3319,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Text has enhanced contrast (WCAG 1.4.6)",
   "description": "Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3319 of 7478 scanned pages (114340 instances).",
   "remediation_tip": "Increase text contrast to meet WCAG AAA (7:1).",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r66 (WCAG 1.4.6).",
   "actual_behavior": "Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3319 of 7478 scanned pages (114340 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A936&f%5B1%5D=topics%3A3001&f%5B2%5D=topics%3A4676&page=1659",
    "https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A751&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_topics_facet%3A8861&f%5B5%5D=fpg_topics_facet%3A8901&page=6"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 5
    },
    {
     "pattern": "/federal-policy-guidance",
     "count": 5
    },
    {
     "pattern": "/faq",
     "count": 5
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-cb53cc4d",
   "fingerprint": "1738fa81",
   "rule_id": "sia-r111",
   "rule_label": "Target size is at least 44×44 CSS pixels (Enhanced)",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.5",
   "wcag_name": "Target Size (Enhanced)",
   "wcag_level": "AAA",
   "wcag_version": "2.1",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r111",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 3319 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 3319,
    "affected_pages_previous": 3426
   },
   "frequency": {
    "instances": 67902,
    "pages_affected": 3319,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5)",
   "description": "Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3319 of 7478 scanned pages (67902 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r111 (WCAG 2.5.5).",
   "actual_behavior": "Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3319 of 7478 scanned pages (67902 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A936&f%5B1%5D=topics%3A3001&f%5B2%5D=topics%3A4676&page=1659",
    "https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A751&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_topics_facet%3A8861&f%5B5%5D=fpg_topics_facet%3A8901&page=6"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 5
    },
    {
     "pattern": "/federal-policy-guidance",
     "count": 5
    },
    {
     "pattern": "/faq",
     "count": 5
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-c18be945",
   "fingerprint": "8634e2fd",
   "rule_id": "sia-r57",
   "rule_label": "Scrolling content can be accessed by keyboard",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r57",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 3317 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 3317,
    "affected_pages_previous": 3425
   },
   "frequency": {
    "instances": 54363,
    "pages_affected": 3317,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Scrolling content can be accessed by keyboard (WCAG criterion undetermined)",
   "description": "Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3317 of 7478 scanned pages (54363 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r57.",
   "actual_behavior": "Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3317 of 7478 scanned pages (54363 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A936&f%5B1%5D=topics%3A3001&f%5B2%5D=topics%3A4676&page=1659",
    "https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A751&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_topics_facet%3A8861&f%5B5%5D=fpg_topics_facet%3A8901&page=6"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 5
    },
    {
     "pattern": "/federal-policy-guidance",
     "count": 5
    },
    {
     "pattern": "/faq",
     "count": 5
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f18df681",
   "fingerprint": "09987718",
   "rule_id": "region",
   "rule_label": "All page content should be contained by landmarks",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 2279 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 2279,
    "affected_pages_previous": 1046
   },
   "frequency": {
    "instances": 10132,
    "pages_affected": 2279,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "All page content should be contained by landmarks (WCAG criterion undetermined)",
   "description": "All page content should be contained by landmarks. Detected by axe-core rule region on 2279 of 7478 scanned pages (10132 instances).",
   "remediation_tip": "Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule region.",
   "actual_behavior": "All page content should be contained by landmarks. Detected by axe-core rule region on 2279 of 7478 scanned pages (10132 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-21-007-7",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095"
   ],
   "html_fragments": [
    {
     "fingerprint": "b8db5cfb",
     "html": "<div class=\"small p-1\">",
     "selectors": [
      ".small"
     ]
    },
    {
     "fingerprint": "658adb3f",
     "html": "<div class=\"d-flex justify-content-between m-2 mb-2\">",
     "selectors": [
      ".justify-content-between"
     ]
    },
    {
     "fingerprint": "ffcbeb49",
     "html": "<p class=\"font-weight-bold m-0 mr-1\">Version:</p>",
     "selectors": [
      ".font-weight-bold"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v3/validation-rules/rule-7953",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/all-21-007-7",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/cot002095",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-fa44f293",
   "fingerprint": "a01b2a6c",
   "rule_id": "page-has-heading-one",
   "rule_label": "Page should contain a level-one heading",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 2278 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 2278,
    "affected_pages_previous": 1041
   },
   "frequency": {
    "instances": 2278,
    "pages_affected": 2278,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Page should contain a level-one heading (WCAG criterion undetermined)",
   "description": "Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 2278 of 7478 scanned pages (2278 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule page-has-heading-one.",
   "actual_behavior": "Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 2278 of 7478 scanned pages (2278 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-21-007-7",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095"
   ],
   "html_fragments": [
    {
     "fingerprint": "c30e96bb",
     "html": "<html class=\"no-js\" lang=\"en\">",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v3/validation-rules/rule-7953",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/all-21-007-7",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/cot002095",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d5d82446",
   "fingerprint": "3627341e",
   "rule_id": "landmark-one-main",
   "rule_label": "Document should have one main landmark",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 2274 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 2274,
    "affected_pages_previous": 1041
   },
   "frequency": {
    "instances": 2274,
    "pages_affected": 2274,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Document should have one main landmark (WCAG criterion undetermined)",
   "description": "Document should have one main landmark. Detected by axe-core rule landmark-one-main on 2274 of 7478 scanned pages (2274 instances).",
   "remediation_tip": "Each page should have exactly one <main> landmark.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-one-main.",
   "actual_behavior": "Document should have one main landmark. Detected by axe-core rule landmark-one-main on 2274 of 7478 scanned pages (2274 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7953",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-21-007-7",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095"
   ],
   "html_fragments": [
    {
     "fingerprint": "c30e96bb",
     "html": "<html class=\"no-js\" lang=\"en\">",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v3/validation-rules/rule-7953",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/all-21-007-7",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/cot002095",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-2208081b",
   "fingerprint": "40bbca09",
   "rule_id": "sia-r73",
   "rule_label": "Text has minimum contrast ratio of 4.5:1",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r73",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 2182 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 2182,
    "affected_pages_previous": 2885
   },
   "frequency": {
    "instances": 6316,
    "pages_affected": 2182,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8)",
   "description": "Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 2182 of 7478 scanned pages (6316 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r73 (WCAG 1.4.8).",
   "actual_behavior": "Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 2182 of 7478 scanned pages (6316 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://medicaid.gov/medicaid/medicaid-state-plan-amendments?page=0",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A936&f%5B1%5D=topics%3A3001&f%5B2%5D=topics%3A4676&page=1659",
    "https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A751&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_topics_facet%3A8861&f%5B5%5D=fpg_topics_facet%3A8901&page=6"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 7
    },
    {
     "pattern": "/federal-policy-guidance",
     "count": 6
    },
    {
     "pattern": "/faq",
     "count": 5
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-aa242c2d",
   "fingerprint": "9bf7674d",
   "rule_id": "sia-r87",
   "rule_label": "First focusable element is link to main content",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r87",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 1142 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 1142,
    "affected_pages_previous": 543
   },
   "frequency": {
    "instances": 1142,
    "pages_affected": 1142,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "First focusable element is link to main content (WCAG criterion undetermined)",
   "description": "First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 1142 of 7478 scanned pages (1142 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r87",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r87.",
   "actual_behavior": "First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 1142 of 7478 scanned pages (1142 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-21-050-50",
    "https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1789",
    "https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-14-004-5"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/mis-21-050-50",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/validation-rules/rule-1789",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/data-quality-measures/ffs-14-004-5",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "DataTables",
     "lift": 3.04,
     "pages_with_both": 126
    },
    {
     "technology": "Popper",
     "lift": 3.04,
     "pages_with_both": 126
    },
    {
     "technology": "Bootstrap",
     "lift": 3.04,
     "pages_with_both": 126
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-7118fead",
   "fingerprint": "0d932ac9",
   "rule_id": "sia-r61",
   "rule_label": "Form field label is visible",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r61",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 1136 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 1136,
    "affected_pages_previous": 539
   },
   "frequency": {
    "instances": 1136,
    "pages_affected": 1136,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Form field label is visible (WCAG criterion undetermined)",
   "description": "Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 1136 of 7478 scanned pages (1136 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r61.",
   "actual_behavior": "Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 1136 of 7478 scanned pages (1136 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-21-050-50",
    "https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1789",
    "https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-14-004-5"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/mis-21-050-50",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/validation-rules/rule-1789",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/data-quality-measures/ffs-14-004-5",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "DataTables",
     "lift": 3.01,
     "pages_with_both": 125
    },
    {
     "technology": "Popper",
     "lift": 3.01,
     "pages_with_both": 125
    },
    {
     "technology": "Bootstrap",
     "lift": 3.01,
     "pages_with_both": 125
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f7dba940",
   "fingerprint": "477d8088",
   "rule_id": "sia-r14",
   "rule_label": "Accessible name of link or button matches visible label",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.3",
   "wcag_name": "Label in Name",
   "wcag_level": "A",
   "wcag_version": "2.1",
   "wcag_category": "WCAG 2.1 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r14",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 589 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 589,
    "affected_pages_previous": 284
   },
   "frequency": {
    "instances": 594,
    "pages_affected": 589,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Accessible name of link or button matches visible label (WCAG 2.5.3)",
   "description": "Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 589 of 7478 scanned pages (594 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r14 (WCAG 2.5.3).",
   "actual_behavior": "Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 589 of 7478 scanned pages (594 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-21-050-50",
    "https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1789",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-156-156"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/mis-21-050-50",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/validation-rules/rule-1789",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/mcr-12-156-156",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "DataTables",
     "lift": 3.04,
     "pages_with_both": 64
    },
    {
     "technology": "Popper",
     "lift": 3.04,
     "pages_with_both": 64
    },
    {
     "technology": "Bootstrap",
     "lift": 3.04,
     "pages_with_both": 64
    }
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "WS",
      "group": "Without speech",
      "prevalence": 0.005,
      "percent": "0.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Without speech (0.5%)."
   }
  },
  {
   "finding_id": "VS-d6097011",
   "fingerprint": "b46c5395",
   "rule_id": "sia-r68",
   "rule_label": "Presentational children of an element are not focusable",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r68",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 383 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 383,
    "affected_pages_previous": 183
   },
   "frequency": {
    "instances": 400,
    "pages_affected": 383,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Presentational children of an element are not focusable (WCAG 1.3.1)",
   "description": "Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 383 of 7478 scanned pages (400 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r68",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r68 (WCAG 1.3.1).",
   "actual_behavior": "Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 383 of 7478 scanned pages (400 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=8&q=",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=786&q=",
    "https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002035"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 9
    },
    {
     "pattern": "/tmsis/dataguide/v3/data-elements/crx002035",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/ftx009326",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "DataTables",
     "lift": 1.91,
     "pages_with_both": 22
    },
    {
     "technology": "Popper",
     "lift": 1.91,
     "pages_with_both": 22
    },
    {
     "technology": "Bootstrap",
     "lift": 1.91,
     "pages_with_both": 22
    }
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-e05344b9",
   "fingerprint": "9d7a222a",
   "rule_id": "sia-r18",
   "rule_label": "aria attribute is permitted for element role",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r18",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 241 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 241,
    "affected_pages_previous": 117
   },
   "frequency": {
    "instances": 1163,
    "pages_affected": 241,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "aria attribute is permitted for element role (WCAG criterion undetermined)",
   "description": "aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 241 of 7478 scanned pages (1163 instances).",
   "remediation_tip": "Only use ARIA states/properties that are allowed on this element/role.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r18",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r18.",
   "actual_behavior": "aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 241 of 7478 scanned pages (1163 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002035",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx009326",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv002023"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v3/data-elements/crx002035",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/ftx009326",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/prv002023",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "DataTables",
     "lift": 3.04,
     "pages_with_both": 22
    },
    {
     "technology": "Popper",
     "lift": 3.04,
     "pages_with_both": 22
    },
    {
     "technology": "Bootstrap",
     "lift": 3.04,
     "pages_with_both": 22
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d25f622d",
   "fingerprint": "98ff321a",
   "rule_id": "heading-order",
   "rule_label": "Heading levels should only increase by one",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 191 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 191,
    "affected_pages_previous": 116
   },
   "frequency": {
    "instances": 211,
    "pages_affected": 191,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Heading levels should only increase by one (WCAG criterion undetermined)",
   "description": "Heading levels should only increase by one. Detected by axe-core rule heading-order on 191 of 7478 scanned pages (211 instances).",
   "remediation_tip": "Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule heading-order.",
   "actual_behavior": "Heading levels should only increase by one. Detected by axe-core rule heading-order on 191 of 7478 scanned pages (211 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/managed-care/guidance/state-directed-payments",
    "http://medicaid.gov/medicaid/data-systems/health-information-exchange/federal-financial-participation-for-hit-and-hie",
    "https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22GU%22%5D"
   ],
   "html_fragments": [
    {
     "fingerprint": "07a7ab9b",
     "html": "<h4 class=\"usa-footer__primary-link\">Related Sites</h4>",
     "selectors": [
      ".region-footer-first > .usa-footer__primary-content.usa-footer__primary-content--collapsible > h4"
     ]
    },
    {
     "fingerprint": "c24ea3e3",
     "html": "<h3>Related Resources</h3>",
     "selectors": [
      ".field--name-field-resources-list > h3"
     ]
    },
    {
     "fingerprint": "8089ae67",
     "html": "<h4 _ngcontent-ng-c1107956043=\"\" class=\"title\">Selected characteristics</h4>",
     "selectors": [
      "h4"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/state-resource-center/disaster-response-toolkit/federal-disaster-resources/{id}",
     "count": 2
    },
    {
     "pattern": "/new-notable",
     "count": 2
    },
    {
     "pattern": "/medicaid/managed-care/guidance/state-directed-payments",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-179ad9b3",
   "fingerprint": "0e001fcc",
   "rule_id": "sia-r113",
   "rule_label": "Target size is at least 24×24 CSS pixels or has spacing (Minimum)",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.8",
   "wcag_name": "Target Size (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.2",
   "wcag_category": "WCAG 2.2 AA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r113",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 149 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 149,
    "affected_pages_previous": 69
   },
   "frequency": {
    "instances": 315,
    "pages_affected": 149,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8)",
   "description": "Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 149 of 7478 scanned pages (315 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r113",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r113 (WCAG 2.5.8).",
   "actual_behavior": "Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 149 of 7478 scanned pages (315 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=8&q=",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=786&q=",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=34&q="
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 22
    },
    {
     "pattern": "/medicaid/section-1115-demo/demonstration-and-waiver-list",
     "count": 2
    },
    {
     "pattern": "/chip/state-program-information/chip-spa",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "jQuery UI",
     "lift": 1.62,
     "pages_with_both": 13
    }
   ],
   "impact": {
    "groups": [
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LR",
      "group": "Limited reach",
      "prevalence": 0.02,
      "percent": "2.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-a48e6078",
   "fingerprint": "2ccef0fa",
   "rule_id": "sia-r8",
   "rule_label": "Form field has accessible name",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r8",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 149 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 149,
    "affected_pages_previous": 69
   },
   "frequency": {
    "instances": 315,
    "pages_affected": 149,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Form field has accessible name (WCAG 4.1.2)",
   "description": "Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 149 of 7478 scanned pages (315 instances).",
   "remediation_tip": "Associate the form field with a label.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r8",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r8 (WCAG 4.1.2).",
   "actual_behavior": "Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 149 of 7478 scanned pages (315 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=8&q=",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=786&q=",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=34&q="
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 22
    },
    {
     "pattern": "/medicaid/section-1115-demo/demonstration-and-waiver-list",
     "count": 2
    },
    {
     "pattern": "/chip/state-program-information/chip-spa",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "jQuery UI",
     "lift": 1.62,
     "pages_with_both": 13
    }
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   }
  },
  {
   "finding_id": "VS-04a9d28c",
   "fingerprint": "02cfba82",
   "rule_id": "presentational-attr",
   "rule_label": "Presentational attribute (use CSS)",
   "engine": "deprecated-html",
   "tool": "deprecated-html",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": null,
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 132 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 132,
    "affected_pages_previous": 65
   },
   "frequency": {
    "instances": 163,
    "pages_affected": 132,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Presentational attribute (use CSS) (WCAG criterion undetermined)",
   "description": "Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 132 of 7478 scanned pages (163 instances).",
   "remediation_tip": null,
   "suggested_fix": "Not captured by automated scan — requires manual testing.",
   "expected_behavior": "Element passes deprecated-html rule presentational-attr.",
   "actual_behavior": "Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 132 of 7478 scanned pages (163 instances).",
   "testing_environment": "Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv002023",
    "https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-014-14",
    "https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6379"
   ],
   "html_fragments": [
    {
     "fingerprint": "95a33b85",
     "html": "<td valign=\"top\" colspan=\"6\" class=\"dataTables_empty\">No data available in table</td>",
     "selectors": [
      "td"
     ]
    },
    {
     "fingerprint": "adc5e776",
     "html": "<td valign=\"top\" colspan=\"5\" class=\"dataTables_empty\">No data available in table</td>",
     "selectors": [
      "td"
     ]
    },
    {
     "fingerprint": "8febe8a4",
     "html": "<td valign=\"top\" colspan=\"7\" class=\"dataTables_empty\">No data available in table</td>",
     "selectors": [
      "td"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/prv002023",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/data-quality-measures/mis-21-014-14",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/validation-rules/rule-6379",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f054f4a4",
   "fingerprint": "5fa3b5a6",
   "rule_id": "sia-r53",
   "rule_label": "Headings are structured hierarchically",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r53",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 108 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 108,
    "affected_pages_previous": 58
   },
   "frequency": {
    "instances": 119,
    "pages_affected": 108,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Headings are structured hierarchically (WCAG criterion undetermined)",
   "description": "Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 108 of 7478 scanned pages (119 instances).",
   "remediation_tip": "Use headings in a logical, non-skipping order.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r53",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r53.",
   "actual_behavior": "Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 108 of 7478 scanned pages (119 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/managed-care/guidance/state-directed-payments",
    "https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations",
    "http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106876"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/state-resource-center/disaster-response-toolkit/federal-disaster-resources/{id}",
     "count": 3
    },
    {
     "pattern": "/medicaid/managed-care/guidance/state-directed-payments",
     "count": 1
    },
    {
     "pattern": "/medicaid/section-1115-demonstrations/about-section-1115-demonstrations",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-4fac2f41",
   "fingerprint": "550210da",
   "rule_id": "aria-allowed-role",
   "rule_label": "ARIA role should be appropriate for the element",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI",
   "severity": "Minor",
   "priority": "p3",
   "confidence": "high",
   "rationale": "affects 311 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 311,
    "affected_pages_previous": 145
   },
   "frequency": {
    "instances": 653,
    "pages_affected": 311,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "ARIA role should be appropriate for the element (WCAG criterion undetermined)",
   "description": "ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 311 of 7478 scanned pages (653 instances).",
   "remediation_tip": "Remove or change the ARIA role — it isn't allowed on this element type.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule aria-allowed-role.",
   "actual_behavior": "ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 311 of 7478 scanned pages (653 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=8&q=",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=786&q=",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=10&q="
   ],
   "html_fragments": [
    {
     "fingerprint": "e5333dd9",
     "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",
     "selectors": [
      "span[data-select2-id=\"select2-data-1-zx1c\"] > .selection > .select2-selection.select2-selection--multiple[role=\"combobox\"] > .select2-search.select2-search--inline > textarea",
      "span[data-select2-id=\"select2-data-4-rii3\"] > .selection > .select2-selection.select2-selection--multiple[role=\"combobox\"] > .select2-search.select2-search--inline > textarea",
      "span[data-select2-id=\"select2-data-1-tm9u\"] > .selection > .select2-selection.select2-selection--multiple[role=\"combobox\"] > .select2-search.select2-search--inline > textarea"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 22
    },
    {
     "pattern": "/medicaid/section-1115-demo/demonstration-and-waiver-list",
     "count": 2
    },
    {
     "pattern": "/chip/state-program-information/chip-spa",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-8806389c",
   "fingerprint": "ffb2ae06",
   "rule_id": "landmark-unique",
   "rule_label": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 39,
    "affected_pages_previous": 11
   },
   "frequency": {
    "instances": 39,
    "pages_affected": 39,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined)",
   "description": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 39 of 7478 scanned pages (39 instances).",
   "remediation_tip": "When a landmark role/type repeats (e.g. two <nav>s), give each a distinct accessible name with aria-label or aria-labelledby (e.g. \"Primary\" and \"Footer\" navigation) so screen-reader users can tell them apart.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-unique.",
   "actual_behavior": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 39 of 7478 scanned pages (39 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/managed-care/guidance/state-directed-payments",
    "http://medicaid.gov/medicaid/financial-management/medicaid-administrative-claiming",
    "https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality"
   ],
   "html_fragments": [
    {
     "fingerprint": "9f8096be",
     "html": "<aside class=\"section\" role=\"complementary\">",
     "selectors": [
      ".section"
     ]
    },
    {
     "fingerprint": "571f8a9c",
     "html": "<aside class=\"grid-container\" role=\"complementary\">",
     "selectors": [
      ".landing-page-blue-ribbon > aside"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/resources-for-states/innovation-accelerator-program/functional-areas",
     "count": 2
    },
    {
     "pattern": "/medicaid/benefits/prevention",
     "count": 2
    },
    {
     "pattern": "/resources-for-states/disaster-response-toolkit/federal-disaster-resources",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-fbf54eba",
   "fingerprint": "773d6316",
   "rule_id": "sia-r74",
   "rule_label": "Link is distinguishable without relying on color",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r74",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 9,
    "affected_pages_previous": 4
   },
   "frequency": {
    "instances": 30,
    "pages_affected": 9,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Link is distinguishable without relying on color (WCAG 1.4.8)",
   "description": "Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 9 of 7478 scanned pages (30 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r74",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r74 (WCAG 1.4.8).",
   "actual_behavior": "Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 9 of 7478 scanned pages (30 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/section-1115-demonstrations/budget-neutrality",
    "http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=3",
    "https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22KS%22%5D"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/quality-of-care/core-set-data-dashboard/main",
     "count": 5
    },
    {
     "pattern": "/resources-for-states/disaster-response-toolkit/federal-disaster-resources",
     "count": 2
    },
    {
     "pattern": "/medicaid/section-1115-demonstrations/budget-neutrality",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-2cd767ca",
   "fingerprint": "3123e4f3",
   "rule_id": "sia-r78",
   "rule_label": "Table header has scope",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r78",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 5,
    "affected_pages_previous": 2
   },
   "frequency": {
    "instances": 5,
    "pages_affected": 5,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Table header has scope (WCAG criterion undetermined)",
   "description": "Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 5 of 7478 scanned pages (5 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r78",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r78.",
   "actual_behavior": "Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 5 of 7478 scanned pages (5 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22KS%22%5D",
    "https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22PA%22%5D",
    "https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/quality-of-care/core-set-data-dashboard/main",
     "count": 5
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-e5ec42f0",
   "fingerprint": "5e16fc6a",
   "rule_id": "sia-r72",
   "rule_label": "Element role is consistent with ARIA landmark",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r72",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 5,
    "affected_pages_previous": 1
   },
   "frequency": {
    "instances": 900,
    "pages_affected": 5,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Element role is consistent with ARIA landmark (WCAG criterion undetermined)",
   "description": "Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 5 of 7478 scanned pages (900 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r72",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r72.",
   "actual_behavior": "Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 5 of 7478 scanned pages (900 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22KS%22%5D",
    "https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22PA%22%5D",
    "https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/quality-of-care/core-set-data-dashboard/main",
     "count": 5
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-4c341c77",
   "fingerprint": "aada626a",
   "rule_id": "sia-r85",
   "rule_label": "Keyboard trap does not exist",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r85",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 8,
    "affected_pages_current": 4,
    "affected_pages_previous": 1
   },
   "frequency": {
    "instances": 247,
    "pages_affected": 4,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Keyboard trap does not exist (WCAG criterion undetermined)",
   "description": "Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 4 of 7478 scanned pages (247 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r85",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r85.",
   "actual_behavior": "Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 4 of 7478 scanned pages (247 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22KS%22%5D",
    "https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22PA%22%5D",
    "https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NY%22%5D"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/quality-of-care/core-set-data-dashboard/main",
     "count": 4
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-efd91fdd",
   "fingerprint": "12434796",
   "rule_id": "sia-r62",
   "rule_label": "Link in text block is visually distinguishable without color",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.1",
   "wcag_name": "Use of Color",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r62",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W31",
    "weeks_observed": 5,
    "affected_pages_current": 3,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 8,
    "pages_affected": 3,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Link in text block is visually distinguishable without color (WCAG 1.4.1)",
   "description": "Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 3 of 7478 scanned pages (8 instances).",
   "remediation_tip": "Make links visually distinguishable from surrounding text (not by color alone).",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r62",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r62 (WCAG 1.4.1).",
   "actual_behavior": "Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 3 of 7478 scanned pages (8 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality",
    "http://medicaid.gov/medicaid/quality-of-care/quality-improvement/oral-health-quality-improvement-resources/advancing-oral-health-prevention-in-primary-care",
    "https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/addressing-childhood-obesity"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality",
     "count": 1
    },
    {
     "pattern": "/medicaid/quality-of-care/quality-improvement/oral-health-quality-improvement-resources/advancing-oral-health-prevention-in-primary-care",
     "count": 1
    },
    {
     "pattern": "/medicaid/quality-of-care/quality-improvement/addressing-childhood-obesity",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without color perception (4.5%), Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-ff3ceb19",
   "fingerprint": "e04cf6f7",
   "rule_id": "landmark-main-is-top-level",
   "rule_label": "Main landmark should not be contained in another landmark",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-main-is-top-level?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W28",
    "last_observed": "2026-W31",
    "weeks_observed": 4,
    "affected_pages_current": 3,
    "affected_pages_previous": 1
   },
   "frequency": {
    "instances": 3,
    "pages_affected": 3,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Main landmark should not be contained in another landmark (WCAG criterion undetermined)",
   "description": "Main landmark should not be contained in another landmark. Detected by axe-core rule landmark-main-is-top-level on 3 of 7478 scanned pages (3 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-main-is-top-level?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-main-is-top-level.",
   "actual_behavior": "Main landmark should not be contained in another landmark. Detected by axe-core rule landmark-main-is-top-level on 3 of 7478 scanned pages (3 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/style-guide/components/button",
    "https://www.medicaid.gov/style-guide/components/back-to-top",
    "https://www.medicaid.gov/style-guide/components"
   ],
   "html_fragments": [
    {
     "fingerprint": "16092c9e",
     "html": "<main id=\"content\" class=\"grid-col-12 desktop:grid-col-9\" role=\"main\">",
     "selectors": [
      ".style-guide-page > .grid-gap-sm.grid-row > main"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/style-guide/components/button",
     "count": 1
    },
    {
     "pattern": "/style-guide/components/back-to-top",
     "count": 1
    },
    {
     "pattern": "/style-guide/components",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-cd69be3a",
   "fingerprint": "dd1abed5",
   "rule_id": "landmark-no-duplicate-main",
   "rule_label": "Document should not have more than one main landmark",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-no-duplicate-main?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W28",
    "last_observed": "2026-W31",
    "weeks_observed": 4,
    "affected_pages_current": 3,
    "affected_pages_previous": 1
   },
   "frequency": {
    "instances": 3,
    "pages_affected": 3,
    "total_pages_scanned": 7478
   },
   "on_key_page": false,
   "summary": "Document should not have more than one main landmark (WCAG criterion undetermined)",
   "description": "Document should not have more than one main landmark. Detected by axe-core rule landmark-no-duplicate-main on 3 of 7478 scanned pages (3 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-no-duplicate-main?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-no-duplicate-main.",
   "actual_behavior": "Document should not have more than one main landmark. Detected by axe-core rule landmark-no-duplicate-main on 3 of 7478 scanned pages (3 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/style-guide/components/button",
    "https://www.medicaid.gov/style-guide/components/back-to-top",
    "https://www.medicaid.gov/style-guide/components"
   ],
   "html_fragments": [
    {
     "fingerprint": "468d6694",
     "html": "<main id=\"content\" class=\"main-content grid-col-12\" role=\"main\">",
     "selectors": [
      ".main-content"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/style-guide/components/button",
     "count": 1
    },
    {
     "pattern": "/style-guide/components/back-to-top",
     "count": 1
    },
    {
     "pattern": "/style-guide/components",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  }
 ],
 "clusters": {
  "by_wcag_criterion": [
   {
    "cluster_id": "71f257a8",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.6",
    "wcag_name": "Contrast (Enhanced)",
    "wcag_level": "AAA",
    "findings": [
     "VS-646b1e0b"
    ],
    "total_pages_affected": 3319,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "b393058c",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.5",
    "wcag_name": "Target Size (Enhanced)",
    "wcag_level": "AAA",
    "findings": [
     "VS-cb53cc4d"
    ],
    "total_pages_affected": 3319,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "36ac08de",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-c18be945"
    ],
    "total_pages_affected": 3317,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "0649d9b9",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-f18df681"
    ],
    "total_pages_affected": 2279,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "b8f97020",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-fa44f293"
    ],
    "total_pages_affected": 2278,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "91fd3b4c",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-d5d82446"
    ],
    "total_pages_affected": 2274,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "140fec0b",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.8",
    "wcag_name": "Visual Presentation",
    "wcag_level": "AAA",
    "findings": [
     "VS-2208081b",
     "VS-fbf54eba"
    ],
    "total_pages_affected": 2191,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "0ba1e7fd",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-aa242c2d"
    ],
    "total_pages_affected": 1142,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "75cf28e4",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-7118fead"
    ],
    "total_pages_affected": 1136,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "a849192e",
    "type": "wcag_criterion",
    "wcag_sc": "4.1.2",
    "wcag_name": "Name, Role, Value",
    "wcag_level": "A",
    "findings": [
     "VS-1467ea8a",
     "VS-0841abc2",
     "VS-ebb1c464",
     "VS-a48e6078"
    ],
    "total_pages_affected": 925,
    "max_severity": "Critical"
   },
   {
    "cluster_id": "423bd52e",
    "type": "wcag_criterion",
    "wcag_sc": "1.3.1",
    "wcag_name": "Info and Relationships",
    "wcag_level": "A",
    "findings": [
     "VS-9429bb8d",
     "VS-d6097011"
    ],
    "total_pages_affected": 848,
    "max_severity": "Critical"
   },
   {
    "cluster_id": "fd9ed1c5",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.3",
    "wcag_name": "Label in Name",
    "wcag_level": "A",
    "findings": [
     "VS-f7dba940"
    ],
    "total_pages_affected": 589,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "97a17643",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-4fac2f41"
    ],
    "total_pages_affected": 311,
    "max_severity": "Minor"
   },
   {
    "cluster_id": "0c75ddb8",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-e05344b9"
    ],
    "total_pages_affected": 241,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "e08c8d69",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-d25f622d"
    ],
    "total_pages_affected": 191,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "24c4a455",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.8",
    "wcag_name": "Target Size (Minimum)",
    "wcag_level": "AA",
    "findings": [
     "VS-179ad9b3"
    ],
    "total_pages_affected": 149,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "66669a92",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-04a9d28c"
    ],
    "total_pages_affected": 132,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "b05da4e9",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-f054f4a4"
    ],
    "total_pages_affected": 108,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "c7d2a838",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-8806389c"
    ],
    "total_pages_affected": 39,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "4b43ba23",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-2cd767ca"
    ],
    "total_pages_affected": 5,
    "max_severity": "Moderate"
   }
  ],
  "by_url_pattern": [
   {
    "cluster_id": "2decabbc",
    "type": "url_pattern",
    "pattern": "/medicaid/quality-of-care/core-set-data-dashboard/main",
    "findings": [
     "VS-fbf54eba",
     "VS-2cd767ca",
     "VS-e5ec42f0",
     "VS-4c341c77"
    ],
    "total_pages": 19
   },
   {
    "cluster_id": "443c9348",
    "type": "url_pattern",
    "pattern": "/style-guide/components/button",
    "findings": [
     "VS-ff3ceb19",
     "VS-cd69be3a"
    ],
    "total_pages": 2
   },
   {
    "cluster_id": "0a754d38",
    "type": "url_pattern",
    "pattern": "/style-guide/components/back-to-top",
    "findings": [
     "VS-ff3ceb19",
     "VS-cd69be3a"
    ],
    "total_pages": 2
   },
   {
    "cluster_id": "43a41886",
    "type": "url_pattern",
    "pattern": "/style-guide/components",
    "findings": [
     "VS-ff3ceb19",
     "VS-cd69be3a"
    ],
    "total_pages": 2
   }
  ]
 },
 "technology_findings": [
  {
   "technology": "DataTables",
   "finding": "axe:region",
   "lift": 3.04,
   "pages_with_both": 235,
   "technology_pages": 235,
   "interpretation": "Pages using DataTables are 3.04× more likely to have finding axe:region."
  },
  {
   "technology": "Popper",
   "finding": "axe:region",
   "lift": 3.04,
   "pages_with_both": 235,
   "technology_pages": 235,
   "interpretation": "Pages using Popper are 3.04× more likely to have finding axe:region."
  },
  {
   "technology": "Bootstrap",
   "finding": "axe:region",
   "lift": 3.04,
   "pages_with_both": 235,
   "technology_pages": 235,
   "interpretation": "Pages using Bootstrap are 3.04× more likely to have finding axe:region."
  },
  {
   "technology": "DataTables",
   "finding": "axe:landmark-one-main",
   "lift": 3.04,
   "pages_with_both": 234,
   "technology_pages": 235,
   "interpretation": "Pages using DataTables are 3.04× more likely to have finding axe:landmark-one-main."
  },
  {
   "technology": "Popper",
   "finding": "axe:landmark-one-main",
   "lift": 3.04,
   "pages_with_both": 234,
   "technology_pages": 235,
   "interpretation": "Pages using Popper are 3.04× more likely to have finding axe:landmark-one-main."
  },
  {
   "technology": "Bootstrap",
   "finding": "axe:landmark-one-main",
   "lift": 3.04,
   "pages_with_both": 234,
   "technology_pages": 235,
   "interpretation": "Pages using Bootstrap are 3.04× more likely to have finding axe:landmark-one-main."
  },
  {
   "technology": "DataTables",
   "finding": "alfa:sia-r87",
   "lift": 3.04,
   "pages_with_both": 126,
   "technology_pages": 235,
   "interpretation": "Pages using DataTables are 3.04× more likely to have finding alfa:sia-r87."
  },
  {
   "technology": "Popper",
   "finding": "alfa:sia-r87",
   "lift": 3.04,
   "pages_with_both": 126,
   "technology_pages": 235,
   "interpretation": "Pages using Popper are 3.04× more likely to have finding alfa:sia-r87."
  },
  {
   "technology": "Bootstrap",
   "finding": "alfa:sia-r87",
   "lift": 3.04,
   "pages_with_both": 126,
   "technology_pages": 235,
   "interpretation": "Pages using Bootstrap are 3.04× more likely to have finding alfa:sia-r87."
  },
  {
   "technology": "DataTables",
   "finding": "alfa:sia-r14",
   "lift": 3.04,
   "pages_with_both": 64,
   "technology_pages": 235,
   "interpretation": "Pages using DataTables are 3.04× more likely to have finding alfa:sia-r14."
  },
  {
   "technology": "Popper",
   "finding": "alfa:sia-r14",
   "lift": 3.04,
   "pages_with_both": 64,
   "technology_pages": 235,
   "interpretation": "Pages using Popper are 3.04× more likely to have finding alfa:sia-r14."
  },
  {
   "technology": "Bootstrap",
   "finding": "alfa:sia-r14",
   "lift": 3.04,
   "pages_with_both": 64,
   "technology_pages": 235,
   "interpretation": "Pages using Bootstrap are 3.04× more likely to have finding alfa:sia-r14."
  },
  {
   "technology": "DataTables",
   "finding": "axe:aria-allowed-attr",
   "lift": 3.04,
   "pages_with_both": 44,
   "technology_pages": 235,
   "interpretation": "Pages using DataTables are 3.04× more likely to have finding axe:aria-allowed-attr."
  },
  {
   "technology": "DataTables",
   "finding": "axe:aria-required-children",
   "lift": 3.04,
   "pages_with_both": 44,
   "technology_pages": 235,
   "interpretation": "Pages using DataTables are 3.04× more likely to have finding axe:aria-required-children."
  },
  {
   "technology": "Popper",
   "finding": "axe:aria-allowed-attr",
   "lift": 3.04,
   "pages_with_both": 44,
   "technology_pages": 235,
   "interpretation": "Pages using Popper are 3.04× more likely to have finding axe:aria-allowed-attr."
  }
 ],
 "third_party_findings": [
  {
   "origin": "googletagmanager.com",
   "pages_served": 1665,
   "pages_with_findings": 1153,
   "finding_co_occurrence_rate": 0.69,
   "median_bytes": 156684,
   "example_pages": [
    "https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A751&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_topics_facet%3A8861&f%5B5%5D=fpg_topics_facet%3A8901&page=6",
    "https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-21-007-7",
    "https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806"
   ]
  },
  {
   "origin": "akamaihd.net",
   "pages_served": 80,
   "pages_with_findings": 50,
   "finding_co_occurrence_rate": 0.63,
   "median_bytes": 4826,
   "example_pages": [
    "https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_authority_facet%3A1566&f%5B1%5D=waiver_state_facet%3A776&page=67",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A711&f%5B1%5D=state%3A731&page=1658&task=face-presentation-attack-detection",
    "https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8531&page=68"
   ]
  },
  {
   "origin": "qualtrics.com",
   "pages_served": 1081,
   "pages_with_findings": 569,
   "finding_co_occurrence_rate": 0.53,
   "median_bytes": 849863,
   "example_pages": [
    "https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A751&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_topics_facet%3A8861&f%5B5%5D=fpg_topics_facet%3A8901&page=6",
    "https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8383&page=61",
    "https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?page=65&sl=yes&usid=OH"
   ]
  },
  {
   "origin": "chartbeat.com",
   "pages_served": 1081,
   "pages_with_findings": 569,
   "finding_co_occurrence_rate": 0.53,
   "median_bytes": 41744,
   "example_pages": [
    "https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A751&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_topics_facet%3A8861&f%5B5%5D=fpg_topics_facet%3A8901&page=6",
    "https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8383&page=61",
    "https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?page=65&sl=yes&usid=OH"
   ]
  },
  {
   "origin": "digitalgov.gov",
   "pages_served": 1081,
   "pages_with_findings": 569,
   "finding_co_occurrence_rate": 0.53,
   "median_bytes": 30230,
   "example_pages": [
    "https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A751&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A8716&f%5B4%5D=fpg_topics_facet%3A8861&f%5B5%5D=fpg_topics_facet%3A8901&page=6",
    "https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8383&page=61",
    "https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?page=65&sl=yes&usid=OH"
   ]
  }
 ],
 "metadata": {
  "generator": "vital-core",
  "schema_version": "0.1",
  "total_pages_scanned": 7478,
  "notes": [
   "Healthy pages (no known issues) are intentionally excluded.",
   "Representative examples are used instead of complete occurrence lists.",
   "Fingerprints are stable hashes for tracking recurring patterns over time.",
   "Fragment fingerprints normalize volatile attributes (id, style, data-*) before hashing.",
   "Technology lift values indicate association, not causation.",
   "Confidence reflects sample size: high=10+ affected pages, medium=3-9, low=1-2."
  ]
 }
}