# Accessibility bug reports — www.medicaid.gov, week 2026-W33

37 issue type(s) from 6890 pages scanned. Generated 2026-08-16 by [vital-scans](https://github.com/mgifford/vital-core), following [accessibility bug-reporting best practices](https://mgifford.github.io/ACCESSIBILITY.md/examples/ACCESSIBILITY_BUG_REPORTING_BEST_PRACTICES.html).

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

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

**Bug ID:** `VS-a5e9f626`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=  
**XPath / selector:** `<textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">`  
**WCAG SC:** 2.5.8 — Target Size (Minimum) (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r113` ([reference](https://alfa.siteimprove.com/rules/sia-r113))  
**Severity:** Moderate  
**Frequency:** 242 instances; 116 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 116 of 6890 scanned pages (242 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=.
2. Locate the element: <textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">
3. Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

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

### Affected pages
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=26&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=9&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=23&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=28&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=7&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=916&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=6&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=10&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=776&page=7&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=3&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=991&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=541&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=811&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=891&page=22&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=2326&limit=10&page=4&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1026&limit=10&page=0&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=29&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=0&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8826&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=0&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=2&q=

…and more — 116 pages total ([download CSV](csv/alfa__sia-r113.csv)).

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

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

### Example pages
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=26&q=

---

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

**Bug ID:** `VS-6341594d`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95  
**XPath / selector:** `<a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">`  
**WCAG SC:** 2.5.3 — Label in Name (Level A)  
**Rule:** Siteimprove Alfa — `sia-r14` ([reference](https://alfa.siteimprove.com/rules/sia-r14))  
**Severity:** Moderate  
**Frequency:** 375 instances; 375 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 375 of 6890 scanned pages (375 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95.
2. Locate the element: <a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">
3. Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2188
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-10-024-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-6-011-11
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9062
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg009144
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-003-3
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002068
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-26-013-13
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-51-003-3
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-51-007-7
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095390
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx001004
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-81-031-31
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7799
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx009352
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1409
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/prv-6-004-4
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1438
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-9-018-20
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg003043
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg016209
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6623

…and more — 375 pages total ([download CSV](csv/alfa__sia-r14.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2188

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-64562f0f`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `p:nth-child(1) > a > img`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** axe-core — `image-alt` ([reference](https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 1 instances; 1 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (6 weeks)

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

### Description
Images must have alternative text. Detected by axe-core rule image-alt on 1 of 6890 scanned pages (1 instances).

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

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

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

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

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

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

---

## Image has accessible name (WCAG 1.1.1)

**Bug ID:** `VS-3ceba623`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `<img src="/media/file/monitor-eval-1115-demonstrations0.png/">`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** Siteimprove Alfa — `sia-r2` ([reference](https://alfa.siteimprove.com/rules/sia-r2))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (6 weeks)

### Description
Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 1 of 6890 scanned pages (1 instances).

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

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

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

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

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

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

---

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

**Bug ID:** `VS-61d24bb7`  
**Pattern ID:** `VS-9429bb8d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209  
**XPath / selector:** `.nav`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `aria-required-children` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 316 instances; 316 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Description
Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 316 of 6890 scanned pages (316 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209.
2. Locate the element: .nav
3. Confirm the axe-core finding for rule aria-required-children against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003178
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg008133
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002068
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt003193
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg009144
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002068
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt003204
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002089
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt001004
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002098
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095390
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx001004
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx009352
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/elg-eligible/primary-demographics-eligibility
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002104
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg003043
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg016209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004280
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg005092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004142
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008308
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg011166
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg010147

…and more — 316 pages total ([download CSV](csv/axe-core__aria-required-children.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003178

---

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

**Bug ID:** `VS-b31e2965`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209  
**XPath / selector:** `<div class="nav nav-tabs nav-justified" role="tablist">`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r68` ([reference](https://alfa.siteimprove.com/rules/sia-r68))  
**Severity:** Moderate  
**Frequency:** 275 instances; 265 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 265 of 6890 scanned pages (275 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209.
2. Locate the element: <div class="nav nav-tabs nav-justified" role="tablist">
3. Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=26&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=9&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg009144
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=23&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002068
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=28&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095390
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx001004
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx009352
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg003043
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg016209
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=7&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=916&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=6&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008308
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip004334
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=10&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002030
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=776&page=7&q=

…and more — 265 pages total ([download CSV](csv/alfa__sia-r68.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240

---

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

**Bug ID:** `VS-15bc5e81`  
**Pattern ID:** `VS-4408605e`  
**URL:** https://www.medicaid.gov/state-overviews/puerto-rico.html  
**XPath / selector:** `<th>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r46` ([reference](https://alfa.siteimprove.com/rules/sia-r46))  
**Severity:** Moderate  
**Frequency:** 2 instances; 2 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (6 weeks)

### Description
Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 2 of 6890 scanned pages (2 instances).

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

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

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

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

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

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

---

## Table cell has header (WCAG 1.3.1)

**Bug ID:** `VS-a31e003b`  
**Pattern ID:** `VS-3f067795`  
**URL:** https://www.medicaid.gov/state-overviews/puerto-rico.html  
**XPath / selector:** `<td>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r77` ([reference](https://alfa.siteimprove.com/rules/sia-r77))  
**Severity:** Moderate  
**Frequency:** 8 instances; 1 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (3 weeks)

### Description
Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 1 of 6890 scanned pages (8 instances).

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

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

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

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

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

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-10f338a8`  
**Pattern ID:** `VS-e9fe47ac`  
**URL:** http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `p:nth-child(1) > a`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** axe-core — `link-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1 instances; 1 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (7 weeks)

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

### Description
Links must have discernible text. Detected by axe-core rule link-name on 1 of 6890 scanned pages (1 instances).

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

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

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

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

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

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

---

## Link has accessible name (WCAG 2.4.4)

**Bug ID:** `VS-ea121e34`  
**Pattern ID:** `VS-28ebd979`  
**URL:** http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation  
**XPath / selector:** `<a href="/medicaid/section-1115-demonstrations/downloads/monitor-eval-1115-demonstrations-infographic.pdf">`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** Siteimprove Alfa — `sia-r11` ([reference](https://alfa.siteimprove.com/rules/sia-r11))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (6 weeks)

### Description
Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 6890 scanned pages (1 instances).

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

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

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

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

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

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

---

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

**Bug ID:** `VS-9e9fd8cd`  
**Pattern ID:** `VS-1467ea8a`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209  
**XPath / selector:** `a[href$="#overview"]`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-allowed-attr` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 1535 instances; 316 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Description
Elements must only use supported ARIA attributes. Detected by axe-core rule aria-allowed-attr on 316 of 6890 scanned pages (1535 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209.
2. Locate the element: a[href$="#overview"]
3. Confirm the axe-core finding for rule aria-allowed-attr against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003178
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg008133
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002068
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt003193
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg009144
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002068
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt003204
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002089
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt001004
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002098
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095390
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx001004
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx009352
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/elg-eligible/primary-demographics-eligibility
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002104
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg003043
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg016209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot004280
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg005092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004142
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008308
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg011166
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg010147

…and more — 316 pages total ([download CSV](csv/axe-core__aria-allowed-attr.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003178

---

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

**Bug ID:** `VS-3684156b`  
**Pattern ID:** `VS-fab92378`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/t-msis-coding-blog  
**XPath / selector:** `#items-per-page`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `select-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/select-name?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 1 instances; 1 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (7 weeks)

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

### Description
Select element must have an accessible name. Detected by axe-core rule select-name on 1 of 6890 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/t-msis-coding-blog.
2. Locate the element: #items-per-page
3. Confirm the axe-core finding for rule select-name against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/t-msis-coding-blog

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

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

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

---

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

**Bug ID:** `VS-bd70e1a9`  
**Pattern ID:** `VS-0841abc2`  
**URL:** http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=16&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-61ts"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-input-field-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-input-field-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 524 instances; 249 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Description
ARIA input fields must have an accessible name. Detected by axe-core rule aria-input-field-name on 249 of 6890 scanned pages (524 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=16&q=.
2. Locate the element: span[data-select2-id="select2-data-1-61ts"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]
3. Confirm the axe-core finding for rule aria-input-field-name against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=16&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=26&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=9&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=23&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=28&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=32&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=901&page=8&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=15&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=7&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=1&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=916&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=6&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=901&page=29&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=15&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8741&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=53&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=33&q=

…and more — 249 pages total ([download CSV](csv/axe-core__aria-input-field-name.csv)).

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

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

### Example pages
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=16&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=8&q=

---

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

**Bug ID:** `VS-4adf7012`  
**Pattern ID:** `VS-ebb1c464`  
**URL:** http://medicaid.gov/  
**XPath / selector:** `time[datetime="2026-08-04"]`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-prohibited-attr` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-prohibited-attr?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 9 instances; 3 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<time class="nn-card__date flex-shrink-0 text-center margin-right-2 border" datetime="2026-08-04" aria-label="Aug 04">
```

### Description
Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 3 of 6890 scanned pages (9 instances).

### Steps to reproduce
1. Open http://medicaid.gov/.
2. Locate the element: time[datetime="2026-08-04"]
3. Confirm the axe-core finding for rule aria-prohibited-attr against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- http://medicaid.gov/
- http://medicaid.gov/medicaid/data-systems/it-procurement-opportunities
- https://www.medicaid.gov/chip/state-program-information

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

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

### Example pages
- http://medicaid.gov/
- http://medicaid.gov/medicaid/data-systems/it-procurement-opportunities
- https://www.medicaid.gov/chip/state-program-information

---

## Form field has accessible name (WCAG 4.1.2)

**Bug ID:** `VS-d23cdc6e`  
**Pattern ID:** `VS-a48e6078`  
**URL:** http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=  
**XPath / selector:** `<span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false">`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** Siteimprove Alfa — `sia-r8` ([reference](https://alfa.siteimprove.com/rules/sia-r8))  
**Severity:** Moderate  
**Frequency:** 243 instances; 117 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 117 of 6890 scanned pages (243 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=.
2. Locate the element: <span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false">
3. Confirm the Siteimprove Alfa finding for rule sia-r8 against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=26&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=9&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=23&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=28&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=7&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=916&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=6&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=10&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=776&page=7&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=3&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=991&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=541&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=811&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=891&page=22&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=2326&limit=10&page=4&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_approval_date%5D%5Bgte%5D=&filter%5Bfield_approval_date%5D%5Blte%5D=&filter%5Bfield_effective_date%5D%5Bgte%5D=&filter%5Bfield_effective_date%5D%5Blte%5D=&filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1026&limit=10&page=0&q=&sort=field_approval_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=29&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=0&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8826&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=0&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=2&q=

…and more — 117 pages total ([download CSV](csv/alfa__sia-r8.csv)).

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

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

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

### Example pages
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=26&q=

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-bf4f2ffc`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22  
**XPath / selector:** `text: "Here's how you know "`  
**WCAG SC:** 1.4.6 — Contrast (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r66` ([reference](https://alfa.siteimprove.com/rules/sia-r66))  
**Severity:** Moderate  
**Frequency:** 127718 instances; 3236 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3236 of 6890 scanned pages (127718 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
2. Locate the element: text: "Here's how you know "
3. Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced).

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1971&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2376&f%5B4%5D=sub_topic_faq_library_facet%3A2516&page=3
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1861&f%5B1%5D=sub_topic_faq_library_facet%3A2016&f%5B2%5D=sub_topic_faq_library_facet%3A2021&f%5B3%5D=sub_topic_faq_library_facet%3A2396&page=82
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A681&f%5B1%5D=state%3A716&f%5B10%5D=topics%3A936&f%5B11%5D=topics%3A1471&f%5B12%5D=topics%3A1511&f%5B13%5D=topics%3A3046&f%5B14%5D=topics%3A3141&f%5B15%5D=topics%3A3356&f%5B16%5D=topics%3A4486&f%5B17%5D=topics%3A5811&f%5B18%5D=topics%3A5866&f%5B19%5D=topics%3A5896&f%5B2%5D=state%3A781&f%5B20%5D=topics%3A8476&f%5B21%5D=topics%3A8496&f%5B3%5D=state%3A841&f%5B4%5D=state%3A881&f%5B5%5D=state%3A891&f%5B6%5D=state%3A931&f%5B7%5D=state%3A941&f%5B8%5D=state%3A1006&f%5B9%5D=state%3A8296&page=1666
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1856&f%5B1%5D=sub_topic_faq_library_facet%3A2091&f%5B2%5D=sub_topic_faq_library_facet%3A2096&f%5B3%5D=sub_topic_faq_library_facet%3A2371&f%5B4%5D=sub_topic_faq_library_facet%3A2436&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2081&f%5B1%5D=sub_topic_faq_library_facet%3A2336&f%5B2%5D=sub_topic_faq_library_facet%3A2351&f%5B3%5D=sub_topic_faq_library_facet%3A2381&f%5B4%5D=sub_topic_faq_library_facet%3A2436&f%5B5%5D=sub_topic_faq_library_facet%3A2471&f%5B6%5D=sub_topic_faq_library_facet%3A2511&f%5B7%5D=sub_topic_faq_library_facet%3A2521&f%5B8%5D=topic_faq_library_facet%3A2271&page=10
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1921&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2341&f%5B4%5D=sub_topic_faq_library_facet%3A2476&page=80
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1891&f%5B1%5D=sub_topic_faq_library_facet%3A2096&page=81&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=state_waiver_status_facet%3A1591&f%5B1%5D=waiver_state_facet%3A726&f%5B10%5D=waiver_state_facet%3A8296&f%5B2%5D=waiver_state_facet%3A736&f%5B3%5D=waiver_state_facet%3A781&f%5B4%5D=waiver_state_facet%3A866&f%5B5%5D=waiver_state_facet%3A901&f%5B6%5D=waiver_state_facet%3A966&f%5B7%5D=waiver_state_facet%3A971&f%5B8%5D=waiver_state_facet%3A981&f%5B9%5D=waiver_state_facet%3A1006&items_per_page=10&page=69
- http://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A856&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A1021&f%5B4%5D=fpg_topics_facet%3A1511&f%5B5%5D=fpg_topics_facet%3A1526&f%5B6%5D=fpg_topics_facet%3A1531&f%5B7%5D=fpg_type_facet%3A1536&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A966&f%5B1%5D=topics%3A771&f%5B2%5D=topics%3A1016&page=1656
- http://medicaid.gov/resources-for-states/rural-health
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A2341&f%5B2%5D=sub_topic_faq_library_facet%3A2391&f%5B3%5D=sub_topic_faq_library_facet%3A2436&f%5B4%5D=sub_topic_faq_library_facet%3A2446&f%5B5%5D=sub_topic_faq_library_facet%3A2526&page=5
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A781&f%5B1%5D=state%3A806&f%5B2%5D=state%3A926&f%5B3%5D=state%3A996&f%5B4%5D=topics%3A771&page=8
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1946&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2406&f%5B3%5D=sub_topic_faq_library_facet%3A2481&f%5B4%5D=sub_topic_faq_library_facet%3A2496&f%5B5%5D=sub_topic_faq_library_facet%3A2526&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A1001&f%5B1%5D=state%3A7971&page=2
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1931&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A1986&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=5
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2188
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A2001&f%5B2%5D=sub_topic_faq_library_facet%3A2501&f%5B3%5D=sub_topic_faq_library_facet%3A2521&page=78&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?57304_xml=&f%5B0%5D=state%3A806&page=1658

…and more — 3236 pages total ([download CSV](csv/alfa__sia-r66.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1971&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2376&f%5B4%5D=sub_topic_faq_library_facet%3A2516&page=3
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209

---

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

**Bug ID:** `VS-92377ca6`  
**Pattern ID:** `VS-2208081b`  
**URL:** http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1971&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2376&f%5B4%5D=sub_topic_faq_library_facet%3A2516&page=3  
**XPath / selector:** `<p class="usa-footer__contact-info margin-bottom-0">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r73` ([reference](https://alfa.siteimprove.com/rules/sia-r73))  
**Severity:** Moderate  
**Frequency:** 5281 instances; 2507 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 2507 of 6890 scanned pages (5281 instances).

### Steps to reproduce
1. Open http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1971&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2376&f%5B4%5D=sub_topic_faq_library_facet%3A2516&page=3.
2. Locate the element: <p class="usa-footer__contact-info margin-bottom-0">
3. Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1971&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2376&f%5B4%5D=sub_topic_faq_library_facet%3A2516&page=3
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1861&f%5B1%5D=sub_topic_faq_library_facet%3A2016&f%5B2%5D=sub_topic_faq_library_facet%3A2021&f%5B3%5D=sub_topic_faq_library_facet%3A2396&page=82
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A681&f%5B1%5D=state%3A716&f%5B10%5D=topics%3A936&f%5B11%5D=topics%3A1471&f%5B12%5D=topics%3A1511&f%5B13%5D=topics%3A3046&f%5B14%5D=topics%3A3141&f%5B15%5D=topics%3A3356&f%5B16%5D=topics%3A4486&f%5B17%5D=topics%3A5811&f%5B18%5D=topics%3A5866&f%5B19%5D=topics%3A5896&f%5B2%5D=state%3A781&f%5B20%5D=topics%3A8476&f%5B21%5D=topics%3A8496&f%5B3%5D=state%3A841&f%5B4%5D=state%3A881&f%5B5%5D=state%3A891&f%5B6%5D=state%3A931&f%5B7%5D=state%3A941&f%5B8%5D=state%3A1006&f%5B9%5D=state%3A8296&page=1666
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1856&f%5B1%5D=sub_topic_faq_library_facet%3A2091&f%5B2%5D=sub_topic_faq_library_facet%3A2096&f%5B3%5D=sub_topic_faq_library_facet%3A2371&f%5B4%5D=sub_topic_faq_library_facet%3A2436&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2081&f%5B1%5D=sub_topic_faq_library_facet%3A2336&f%5B2%5D=sub_topic_faq_library_facet%3A2351&f%5B3%5D=sub_topic_faq_library_facet%3A2381&f%5B4%5D=sub_topic_faq_library_facet%3A2436&f%5B5%5D=sub_topic_faq_library_facet%3A2471&f%5B6%5D=sub_topic_faq_library_facet%3A2511&f%5B7%5D=sub_topic_faq_library_facet%3A2521&f%5B8%5D=topic_faq_library_facet%3A2271&page=10
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1921&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2341&f%5B4%5D=sub_topic_faq_library_facet%3A2476&page=80
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1891&f%5B1%5D=sub_topic_faq_library_facet%3A2096&page=81&sl=yes
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=state_waiver_status_facet%3A1591&f%5B1%5D=waiver_state_facet%3A726&f%5B10%5D=waiver_state_facet%3A8296&f%5B2%5D=waiver_state_facet%3A736&f%5B3%5D=waiver_state_facet%3A781&f%5B4%5D=waiver_state_facet%3A866&f%5B5%5D=waiver_state_facet%3A901&f%5B6%5D=waiver_state_facet%3A966&f%5B7%5D=waiver_state_facet%3A971&f%5B8%5D=waiver_state_facet%3A981&f%5B9%5D=waiver_state_facet%3A1006&items_per_page=10&page=69
- http://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A856&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A1021&f%5B4%5D=fpg_topics_facet%3A1511&f%5B5%5D=fpg_topics_facet%3A1526&f%5B6%5D=fpg_topics_facet%3A1531&f%5B7%5D=fpg_type_facet%3A1536&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A966&f%5B1%5D=topics%3A771&f%5B2%5D=topics%3A1016&page=1656
- http://medicaid.gov/resources-for-states/rural-health
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A2341&f%5B2%5D=sub_topic_faq_library_facet%3A2391&f%5B3%5D=sub_topic_faq_library_facet%3A2436&f%5B4%5D=sub_topic_faq_library_facet%3A2446&f%5B5%5D=sub_topic_faq_library_facet%3A2526&page=5
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A781&f%5B1%5D=state%3A806&f%5B2%5D=state%3A926&f%5B3%5D=state%3A996&f%5B4%5D=topics%3A771&page=8
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1946&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2406&f%5B3%5D=sub_topic_faq_library_facet%3A2481&f%5B4%5D=sub_topic_faq_library_facet%3A2496&f%5B5%5D=sub_topic_faq_library_facet%3A2526&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A1001&f%5B1%5D=state%3A7971&page=2
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1931&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A1986&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=5
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A2001&f%5B2%5D=sub_topic_faq_library_facet%3A2501&f%5B3%5D=sub_topic_faq_library_facet%3A2521&page=78&sl=yes
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?57304_xml=&f%5B0%5D=state%3A806&page=1658
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A8481&page=1654
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=26&q=
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A761&f%5B10%5D=fpg_topics_facet%3A6486&f%5B11%5D=fpg_topics_facet%3A8406&f%5B12%5D=fpg_type_facet%3A1476&f%5B13%5D=fpg_type_facet%3A1481&f%5B2%5D=fpg_topics_facet%3A856&f%5B3%5D=fpg_topics_facet%3A906&f%5B4%5D=fpg_topics_facet%3A936&f%5B5%5D=fpg_topics_facet%3A1011&f%5B6%5D=fpg_topics_facet%3A1021&f%5B7%5D=fpg_topics_facet%3A1511&f%5B8%5D=fpg_topics_facet%3A3046&f%5B9%5D=fpg_topics_facet%3A3261&page=108
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1946&f%5B1%5D=sub_topic_faq_library_facet%3A2341&f%5B2%5D=sub_topic_faq_library_facet%3A2421&f%5B3%5D=sub_topic_faq_library_facet%3A2451&f%5B4%5D=sub_topic_faq_library_facet%3A2521&f%5B5%5D=sub_topic_faq_library_facet%3A2531&page=8
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1891&f%5B1%5D=sub_topic_faq_library_facet%3A2006&f%5B2%5D=sub_topic_faq_library_facet%3A2521&f%5B3%5D=topic_faq_library_facet%3A2206&page=78

…and more — 2507 pages total ([download CSV](csv/alfa__sia-r73.csv)).

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

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

### Example pages
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1971&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2376&f%5B4%5D=sub_topic_faq_library_facet%3A2516&page=3
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1861&f%5B1%5D=sub_topic_faq_library_facet%3A2016&f%5B2%5D=sub_topic_faq_library_facet%3A2021&f%5B3%5D=sub_topic_faq_library_facet%3A2396&page=82
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A681&f%5B1%5D=state%3A716&f%5B10%5D=topics%3A936&f%5B11%5D=topics%3A1471&f%5B12%5D=topics%3A1511&f%5B13%5D=topics%3A3046&f%5B14%5D=topics%3A3141&f%5B15%5D=topics%3A3356&f%5B16%5D=topics%3A4486&f%5B17%5D=topics%3A5811&f%5B18%5D=topics%3A5866&f%5B19%5D=topics%3A5896&f%5B2%5D=state%3A781&f%5B20%5D=topics%3A8476&f%5B21%5D=topics%3A8496&f%5B3%5D=state%3A841&f%5B4%5D=state%3A881&f%5B5%5D=state%3A891&f%5B6%5D=state%3A931&f%5B7%5D=state%3A941&f%5B8%5D=state%3A1006&f%5B9%5D=state%3A8296&page=1666

---

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

**Bug ID:** `VS-3f4d4d7c`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D  
**XPath / selector:** `<p class="welcome-text core-set ng-star-inserted">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r74` ([reference](https://alfa.siteimprove.com/rules/sia-r74))  
**Severity:** Moderate  
**Frequency:** 22 instances; 8 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 8 of 6890 scanned pages (22 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D.
2. Locate the element: <p class="welcome-text core-set ng-star-inserted">
3. Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22CT%22%5D
- http://medicaid.gov/medicaid/enrollment-strategies/continuous-eligibility-medicaid-and-chip-coverage
- http://medicaid.gov/state-overviews/scorecard/welcome
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22OH%22%5D
- https://www.medicaid.gov/medicaid/outreach-tools/helping-connect-enrollees-care
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SC%22%5D

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

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

### Example pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22CT%22%5D
- http://medicaid.gov/medicaid/enrollment-strategies/continuous-eligibility-medicaid-and-chip-coverage

---

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

**Bug ID:** `VS-9f35c1c0`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22  
**XPath / selector:** `<button class="btn btn-outline-primary dropdown-toggle py-1 px-2" type="button" id="dropdownMenuButton" data-toggle="dropdown">`  
**WCAG SC:** 2.5.5 — Target Size (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r111` ([reference](https://alfa.siteimprove.com/rules/sia-r111))  
**Severity:** Moderate  
**Frequency:** 75511 instances; 3236 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3236 of 6890 scanned pages (75511 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
2. Locate the element: <button class="btn btn-outline-primary dropdown-toggle py-1 px-2" type="button" id="dropdownMenuButton" data-toggle="dropdown">
3. Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1971&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2376&f%5B4%5D=sub_topic_faq_library_facet%3A2516&page=3
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1861&f%5B1%5D=sub_topic_faq_library_facet%3A2016&f%5B2%5D=sub_topic_faq_library_facet%3A2021&f%5B3%5D=sub_topic_faq_library_facet%3A2396&page=82
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A681&f%5B1%5D=state%3A716&f%5B10%5D=topics%3A936&f%5B11%5D=topics%3A1471&f%5B12%5D=topics%3A1511&f%5B13%5D=topics%3A3046&f%5B14%5D=topics%3A3141&f%5B15%5D=topics%3A3356&f%5B16%5D=topics%3A4486&f%5B17%5D=topics%3A5811&f%5B18%5D=topics%3A5866&f%5B19%5D=topics%3A5896&f%5B2%5D=state%3A781&f%5B20%5D=topics%3A8476&f%5B21%5D=topics%3A8496&f%5B3%5D=state%3A841&f%5B4%5D=state%3A881&f%5B5%5D=state%3A891&f%5B6%5D=state%3A931&f%5B7%5D=state%3A941&f%5B8%5D=state%3A1006&f%5B9%5D=state%3A8296&page=1666
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1856&f%5B1%5D=sub_topic_faq_library_facet%3A2091&f%5B2%5D=sub_topic_faq_library_facet%3A2096&f%5B3%5D=sub_topic_faq_library_facet%3A2371&f%5B4%5D=sub_topic_faq_library_facet%3A2436&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2081&f%5B1%5D=sub_topic_faq_library_facet%3A2336&f%5B2%5D=sub_topic_faq_library_facet%3A2351&f%5B3%5D=sub_topic_faq_library_facet%3A2381&f%5B4%5D=sub_topic_faq_library_facet%3A2436&f%5B5%5D=sub_topic_faq_library_facet%3A2471&f%5B6%5D=sub_topic_faq_library_facet%3A2511&f%5B7%5D=sub_topic_faq_library_facet%3A2521&f%5B8%5D=topic_faq_library_facet%3A2271&page=10
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1921&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2341&f%5B4%5D=sub_topic_faq_library_facet%3A2476&page=80
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1891&f%5B1%5D=sub_topic_faq_library_facet%3A2096&page=81&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=state_waiver_status_facet%3A1591&f%5B1%5D=waiver_state_facet%3A726&f%5B10%5D=waiver_state_facet%3A8296&f%5B2%5D=waiver_state_facet%3A736&f%5B3%5D=waiver_state_facet%3A781&f%5B4%5D=waiver_state_facet%3A866&f%5B5%5D=waiver_state_facet%3A901&f%5B6%5D=waiver_state_facet%3A966&f%5B7%5D=waiver_state_facet%3A971&f%5B8%5D=waiver_state_facet%3A981&f%5B9%5D=waiver_state_facet%3A1006&items_per_page=10&page=69
- http://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A856&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A1021&f%5B4%5D=fpg_topics_facet%3A1511&f%5B5%5D=fpg_topics_facet%3A1526&f%5B6%5D=fpg_topics_facet%3A1531&f%5B7%5D=fpg_type_facet%3A1536&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A966&f%5B1%5D=topics%3A771&f%5B2%5D=topics%3A1016&page=1656
- http://medicaid.gov/resources-for-states/rural-health
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A2341&f%5B2%5D=sub_topic_faq_library_facet%3A2391&f%5B3%5D=sub_topic_faq_library_facet%3A2436&f%5B4%5D=sub_topic_faq_library_facet%3A2446&f%5B5%5D=sub_topic_faq_library_facet%3A2526&page=5
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A781&f%5B1%5D=state%3A806&f%5B2%5D=state%3A926&f%5B3%5D=state%3A996&f%5B4%5D=topics%3A771&page=8
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1946&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2406&f%5B3%5D=sub_topic_faq_library_facet%3A2481&f%5B4%5D=sub_topic_faq_library_facet%3A2496&f%5B5%5D=sub_topic_faq_library_facet%3A2526&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A1001&f%5B1%5D=state%3A7971&page=2
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1931&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A1986&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=5
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2188
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A2001&f%5B2%5D=sub_topic_faq_library_facet%3A2501&f%5B3%5D=sub_topic_faq_library_facet%3A2521&page=78&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?57304_xml=&f%5B0%5D=state%3A806&page=1658

…and more — 3236 pages total ([download CSV](csv/alfa__sia-r111.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1971&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2376&f%5B4%5D=sub_topic_faq_library_facet%3A2516&page=3
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209

---

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

**Bug ID:** `VS-4a3849dc`  
**Pattern ID:** `VS-33841929`  
**URL:** https://www.medicaid.gov/style-guide/components/date-picker  
**XPath / selector:** `#from-date`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `label-title-only` ([reference](https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 8 instances; 2 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<input placeholder="From" class="usa-input usa-date-picker__external-input" id="from-date" name="from-date" aria-labelledby="appointment-date-label" aria-describedby="appointment-date-hint" type="text
```

### Description
Form elements should have a visible label. Detected by axe-core rule label-title-only on 2 of 6890 scanned pages (8 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/style-guide/components/date-picker.
2. Locate the element: #from-date
3. Confirm the axe-core finding for rule label-title-only.

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

### Affected pages
- https://www.medicaid.gov/style-guide/components/date-picker
- http://medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/drug-utilization-review-annual-report

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

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

### Example pages
- https://www.medicaid.gov/style-guide/components/date-picker
- http://medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/drug-utilization-review-annual-report

---

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

**Bug ID:** `VS-7c673280`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `page-has-heading-one` ([reference](https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1487 instances; 1487 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Description
Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 1487 of 6890 scanned pages (1487 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
2. Locate the element: html
3. Confirm the axe-core finding for rule page-has-heading-one.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8320
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-14-004-5
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6737
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-083-126
- http://medicaid.gov/resources-for-states/rural-health
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2188
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-1-012-12
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7354
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-3-017-22
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003178
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7606
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7023
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg008133
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7943
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-10-024-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002068
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7640

…and more — 1487 pages total ([download CSV](csv/axe-core__page-has-heading-one.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209

---

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

**Bug ID:** `VS-53b2eb07`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22  
**XPath / selector:** `.small`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 6616 instances; 1485 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Description
All page content should be contained by landmarks. Detected by axe-core rule region on 1485 of 6890 scanned pages (6616 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
2. Locate the element: .small
3. Confirm the axe-core finding for rule region.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8320
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-14-004-5
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6737
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-083-126
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2188
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-1-012-12
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7354
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-3-017-22
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003178
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7606
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7023
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg008133
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7943
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-10-024-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002068
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7640
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-6-011-11

…and more — 1485 pages total ([download CSV](csv/axe-core__region.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209

---

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

**Bug ID:** `VS-8afcee82`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-one-main` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1482 instances; 1482 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Description
Document should have one main landmark. Detected by axe-core rule landmark-one-main on 1482 of 6890 scanned pages (1482 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
2. Locate the element: html
3. Confirm the axe-core finding for rule landmark-one-main.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8412
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8320
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-14-004-5
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6737
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-083-126
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2188
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-1-012-12
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7354
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-3-017-22
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot003178
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7606
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7023
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg008133
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7943
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-10-024-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002068
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7640
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-6-011-11

…and more — 1482 pages total ([download CSV](csv/axe-core__landmark-one-main.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7317
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209

---

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

**Bug ID:** `VS-6b290340`  
**Pattern ID:** `VS-d25f622d`  
**URL:** http://medicaid.gov/resources-for-states/rural-health  
**XPath / selector:** `.region-footer-first > .usa-footer__primary-content.usa-footer__primary-content--collapsible > h4`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 181 instances; 169 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Description
Heading levels should only increase by one. Detected by axe-core rule heading-order on 169 of 6890 scanned pages (181 instances).

### Steps to reproduce
1. Open http://medicaid.gov/resources-for-states/rural-health.
2. Locate the element: .region-footer-first > .usa-footer__primary-content.usa-footer__primary-content--collapsible > h4
3. Confirm the axe-core finding for rule heading-order.

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

### Affected pages
- http://medicaid.gov/resources-for-states/rural-health
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54036
- http://medicaid.gov/medicaid/prescription-drugs/federal-upper-limit
- https://www.medicaid.gov/state-overviews/puerto-rico.html
- https://www.medicaid.gov/chip/benefits
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NJ%22%5D
- https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/52149
- http://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/technical-assistance-develop-evidence-based-continuum-of-crisis-care/additional-federal-guidance-improving-access-mental-health-and-substance-use-disorder-services
- https://www.medicaid.gov/tmsis/dataguide
- https://www.medicaid.gov/medicaid/managed-care/managed-care-entities
- https://www.medicaid.gov/medicaid/data-systems/health-information-exchange/section-1115-demonstration-hie-policy
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/provider-enrollment-guidance
- https://www.medicaid.gov/state-overviews/stateprofile.html?state=South-Dakota
- https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/cms-guidance
- https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/47955
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/49453
- https://www.medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/promoting-community-integration-through-long-term-services-and-supports
- http://medicaid.gov/medicaid/managed-care/managed-long-term-services-and-supports
- http://medicaid.gov/state-overviews/stateprofile.html?state=New-York
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/49847
- https://www.medicaid.gov/about-us/organization/todd-jones
- http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
- https://www.medicaid.gov/about-us/organization/vacant
- https://www.medicaid.gov/state-overviews/stateprofile.html?state=Ohio
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106631

…and more — 169 pages total ([download CSV](csv/axe-core__heading-order.csv)).

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

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

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

### Example pages
- http://medicaid.gov/resources-for-states/rural-health
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54036
- http://medicaid.gov/medicaid/prescription-drugs/federal-upper-limit

---

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

**Bug ID:** `VS-71095b0a`  
**Pattern ID:** `VS-8806389c`  
**URL:** https://www.medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/promoting-community-integration-through-long-term-services-and-supports  
**XPath / selector:** `.section`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-unique` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 33 instances; 33 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Description
Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 33 of 6890 scanned pages (33 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/promoting-community-integration-through-long-term-services-and-supports.
2. Locate the element: .section
3. Confirm the axe-core finding for rule landmark-unique.

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

### Affected pages
- https://www.medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/promoting-community-integration-through-long-term-services-and-supports
- http://medicaid.gov/medicaid/managed-care/managed-long-term-services-and-supports
- http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
- https://www.medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly
- http://medicaid.gov/medicaid/managed-care
- http://medicaid.gov/
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=1
- http://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/measuring-and-improving-quality-home-and-community-based-services
- http://medicaid.gov/resources-for-states/medicaid-and-chip-program-portal/macpro-training-help
- https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-mdrp-file-formats-data-definitions-and-medicaid-drug-programs-mdp-email-communications
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources
- http://medicaid.gov/medicaid/benefits/prevention
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=0
- https://www.medicaid.gov/style-guide/components/date-picker
- https://www.medicaid.gov/about-us/organization/mehreen-rashid
- http://medicaid.gov/medicaid/managed-care/technical-assistance
- http://medicaid.gov/medicaid/quality-of-care/performance-measurement/adult-and-child-health-care-quality-measures
- https://www.medicaid.gov/medicaid/financial-management/payment-limit-demonstrations
- https://www.medicaid.gov/style-guide/components/banner
- https://www.medicaid.gov/medicaid/managed-care/managed-long-term-services-and-supports/index.html
- https://www.medicaid.gov/medicaid/data-systems/medicaid-information-technology-architecture
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=3
- http://medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/drug-utilization-review-annual-report
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=5

…and more — 33 pages total ([download CSV](csv/axe-core__landmark-unique.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/promoting-community-integration-through-long-term-services-and-supports
- http://medicaid.gov/medicaid/managed-care/managed-long-term-services-and-supports
- http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation

---

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

**Bug ID:** `VS-665fa450`  
**Pattern ID:** `VS-ff3ceb19`  
**URL:** https://www.medicaid.gov/style-guide/components/date-picker  
**XPath / selector:** `.style-guide-page > .grid-gap-sm.grid-row > main`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-main-is-top-level` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-main-is-top-level?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 3 instances; 3 of 6890 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W33 (6 weeks)

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

### Description
Main landmark should not be contained in another landmark. Detected by axe-core rule landmark-main-is-top-level on 3 of 6890 scanned pages (3 instances).

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

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

### Affected pages
- https://www.medicaid.gov/style-guide/components/date-picker
- https://www.medicaid.gov/style-guide/components/banner
- https://www.medicaid.gov/style-guide/components/accordion

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

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

### Example pages
- https://www.medicaid.gov/style-guide/components/date-picker
- https://www.medicaid.gov/style-guide/components/banner
- https://www.medicaid.gov/style-guide/components/accordion

---

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

**Bug ID:** `VS-966fad96`  
**Pattern ID:** `VS-cd69be3a`  
**URL:** https://www.medicaid.gov/style-guide/components/date-picker  
**XPath / selector:** `.main-content`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-no-duplicate-main` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-no-duplicate-main?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 3 instances; 3 of 6890 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W33 (6 weeks)

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

### Description
Document should not have more than one main landmark. Detected by axe-core rule landmark-no-duplicate-main on 3 of 6890 scanned pages (3 instances).

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

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

### Affected pages
- https://www.medicaid.gov/style-guide/components/date-picker
- https://www.medicaid.gov/style-guide/components/banner
- https://www.medicaid.gov/style-guide/components/accordion

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

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

### Example pages
- https://www.medicaid.gov/style-guide/components/date-picker
- https://www.medicaid.gov/style-guide/components/banner
- https://www.medicaid.gov/style-guide/components/accordion

---

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

**Bug ID:** `VS-afa1c2a8`  
**Pattern ID:** `VS-4fac2f41`  
**URL:** http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=16&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-61ts"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `aria-allowed-role` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 526 instances; 250 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Description
ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 250 of 6890 scanned pages (526 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=16&q=.
2. Locate the element: span[data-select2-id="select2-data-1-61ts"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea
3. Confirm the axe-core finding for rule aria-allowed-role.

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

### Affected pages
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=16&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=26&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=9&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=23&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=28&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=32&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=901&page=8&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=15&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=7&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=1&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=916&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=6&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=901&page=29&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=15&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8741&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=53&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=33&q=

…and more — 250 pages total ([download CSV](csv/axe-core__aria-allowed-role.csv)).

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

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

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

### Example pages
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=16&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=8&q=

---

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

**Bug ID:** `VS-d50e9eb5`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22  
**XPath / selector:** `text: "
                An official website of the United States government
                "`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 33888 instances; 3236 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3236 of 6890 scanned pages (33888 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
2. Locate the element: text: "
                An official website of the United States government
                "
3. Confirm the Siteimprove Alfa finding for rule sia-r57.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1971&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2376&f%5B4%5D=sub_topic_faq_library_facet%3A2516&page=3
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1861&f%5B1%5D=sub_topic_faq_library_facet%3A2016&f%5B2%5D=sub_topic_faq_library_facet%3A2021&f%5B3%5D=sub_topic_faq_library_facet%3A2396&page=82
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A681&f%5B1%5D=state%3A716&f%5B10%5D=topics%3A936&f%5B11%5D=topics%3A1471&f%5B12%5D=topics%3A1511&f%5B13%5D=topics%3A3046&f%5B14%5D=topics%3A3141&f%5B15%5D=topics%3A3356&f%5B16%5D=topics%3A4486&f%5B17%5D=topics%3A5811&f%5B18%5D=topics%3A5866&f%5B19%5D=topics%3A5896&f%5B2%5D=state%3A781&f%5B20%5D=topics%3A8476&f%5B21%5D=topics%3A8496&f%5B3%5D=state%3A841&f%5B4%5D=state%3A881&f%5B5%5D=state%3A891&f%5B6%5D=state%3A931&f%5B7%5D=state%3A941&f%5B8%5D=state%3A1006&f%5B9%5D=state%3A8296&page=1666
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1856&f%5B1%5D=sub_topic_faq_library_facet%3A2091&f%5B2%5D=sub_topic_faq_library_facet%3A2096&f%5B3%5D=sub_topic_faq_library_facet%3A2371&f%5B4%5D=sub_topic_faq_library_facet%3A2436&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2081&f%5B1%5D=sub_topic_faq_library_facet%3A2336&f%5B2%5D=sub_topic_faq_library_facet%3A2351&f%5B3%5D=sub_topic_faq_library_facet%3A2381&f%5B4%5D=sub_topic_faq_library_facet%3A2436&f%5B5%5D=sub_topic_faq_library_facet%3A2471&f%5B6%5D=sub_topic_faq_library_facet%3A2511&f%5B7%5D=sub_topic_faq_library_facet%3A2521&f%5B8%5D=topic_faq_library_facet%3A2271&page=10
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1921&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2341&f%5B4%5D=sub_topic_faq_library_facet%3A2476&page=80
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1891&f%5B1%5D=sub_topic_faq_library_facet%3A2096&page=81&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=state_waiver_status_facet%3A1591&f%5B1%5D=waiver_state_facet%3A726&f%5B10%5D=waiver_state_facet%3A8296&f%5B2%5D=waiver_state_facet%3A736&f%5B3%5D=waiver_state_facet%3A781&f%5B4%5D=waiver_state_facet%3A866&f%5B5%5D=waiver_state_facet%3A901&f%5B6%5D=waiver_state_facet%3A966&f%5B7%5D=waiver_state_facet%3A971&f%5B8%5D=waiver_state_facet%3A981&f%5B9%5D=waiver_state_facet%3A1006&items_per_page=10&page=69
- http://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A856&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A1021&f%5B4%5D=fpg_topics_facet%3A1511&f%5B5%5D=fpg_topics_facet%3A1526&f%5B6%5D=fpg_topics_facet%3A1531&f%5B7%5D=fpg_type_facet%3A1536&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A966&f%5B1%5D=topics%3A771&f%5B2%5D=topics%3A1016&page=1656
- http://medicaid.gov/resources-for-states/rural-health
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A2341&f%5B2%5D=sub_topic_faq_library_facet%3A2391&f%5B3%5D=sub_topic_faq_library_facet%3A2436&f%5B4%5D=sub_topic_faq_library_facet%3A2446&f%5B5%5D=sub_topic_faq_library_facet%3A2526&page=5
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A781&f%5B1%5D=state%3A806&f%5B2%5D=state%3A926&f%5B3%5D=state%3A996&f%5B4%5D=topics%3A771&page=8
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1946&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2406&f%5B3%5D=sub_topic_faq_library_facet%3A2481&f%5B4%5D=sub_topic_faq_library_facet%3A2496&f%5B5%5D=sub_topic_faq_library_facet%3A2526&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A1001&f%5B1%5D=state%3A7971&page=2
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1931&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A1986&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=5
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2188
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A2001&f%5B2%5D=sub_topic_faq_library_facet%3A2501&f%5B3%5D=sub_topic_faq_library_facet%3A2521&page=78&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?57304_xml=&f%5B0%5D=state%3A806&page=1658

…and more — 3236 pages total ([download CSV](csv/alfa__sia-r57.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1971&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2376&f%5B4%5D=sub_topic_faq_library_facet%3A2516&page=3
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209

---

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

**Bug ID:** `VS-23c08e4f`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r87` ([reference](https://alfa.siteimprove.com/rules/sia-r87))  
**Severity:** Moderate  
**Frequency:** 733 instances; 733 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 733 of 6890 scanned pages (733 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r87.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2188
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7606
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-10-024-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-6-011-11
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-021-21
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9062
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8404
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg009144
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-003-3
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002068
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6616
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1889
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-2-022-22
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2095
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1354
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6629
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-26-013-13
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7371
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-51-003-3
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6816

…and more — 733 pages total ([download CSV](csv/alfa__sia-r87.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95

---

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

**Bug ID:** `VS-6091dca1`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r61` ([reference](https://alfa.siteimprove.com/rules/sia-r61))  
**Severity:** Moderate  
**Frequency:** 729 instances; 729 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 729 of 6890 scanned pages (729 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r61.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-1126
- http://medicaid.gov/resources-for-states/rural-health
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2188
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7606
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-10-024-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-6-011-11
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-021-21
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9062
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8404
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg009144
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-17-003-3
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002068
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/SC
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6616
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1889
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-2-022-22
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2095
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1354
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6629
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-26-013-13
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7371

…and more — 729 pages total ([download CSV](csv/alfa__sia-r61.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95

---

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

**Bug ID:** `VS-c0ae7748`  
**Pattern ID:** `VS-e05344b9`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209  
**XPath / selector:** `@aria-selected="true"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 739 instances; 156 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 156 of 6890 scanned pages (739 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209.
2. Locate the element: @aria-selected="true"
3. Confirm the Siteimprove Alfa finding for rule sia-r18.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg009144
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002068
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095390
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx001004
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx009352
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg003043
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg016209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008308
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip004334
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002030
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002298
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003079
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg004076
- https://www.medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/elg-eligible/1115a-demonstration-information
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002241
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt003187
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip001002
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002229
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002092
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003170
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg014191
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003045
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt004279

…and more — 156 pages total ([download CSV](csv/alfa__sia-r18.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002240
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg009144

---

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

**Bug ID:** `VS-cd3ebc0a`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-021-21  
**XPath / selector:** `td`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 111 instances; 91 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Description
Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 91 of 6890 scanned pages (111 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-021-21.
2. Locate the element: td
3. Confirm the deprecated-html finding for rule presentational-attr.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-021-21
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1908
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6657
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx009352
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg016209
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1127
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-1-005-5
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1032
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-580
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8182
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6264
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6383
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-6-027_2-39
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-11-014-14
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/prv007094
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-762
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7032
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-12-083-126
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-1-013-7
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6961
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7256
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002078
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/mcr002022
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-3-001_1-18
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg001014

…and more — 91 pages total ([download CSV](csv/deprecated-html__presentational-attr.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-021-21
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1908
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6657

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-035707b2`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** http://medicaid.gov/resources-for-states/rural-health  
**XPath / selector:** `<h4 class="usa-footer__primary-link">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 82 instances; 76 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 76 of 6890 scanned pages (82 instances).

### Steps to reproduce
1. Open http://medicaid.gov/resources-for-states/rural-health.
2. Locate the element: <h4 class="usa-footer__primary-link">
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

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

### Affected pages
- http://medicaid.gov/resources-for-states/rural-health
- https://www.medicaid.gov/state-overviews/puerto-rico.html
- https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/52149
- https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/cms-guidance
- https://www.medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/promoting-community-integration-through-long-term-services-and-supports
- https://www.medicaid.gov/about-us/organization/todd-jones
- http://medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
- https://www.medicaid.gov/about-us/organization/vacant
- https://www.medicaid.gov/state-overviews/stateprofile.html?state=Ohio
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106241
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/98996
- http://medicaid.gov/privacy/third-party-privacy-policies
- https://www.medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly
- http://medicaid.gov/medicaid/managed-care
- https://www.medicaid.gov/state-overviews/stateprofile.html?state=West-Virginia
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106691
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54094
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22CT%22%5D
- http://medicaid.gov/medicaid/enrollment-strategies/continuous-eligibility-medicaid-and-chip-coverage
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/billing-and-coding-guidance
- https://www.medicaid.gov/resources-for-states/rural-health
- http://medicaid.gov/medicaid/benefits/behavioral-health-services/substance-use-disorders
- http://medicaid.gov/state-overviews/stateprofile.html?state=Oregon
- http://medicaid.gov/medicaid/data-and-systems/macbis/tmsis/tmsis-blog/127296

…and more — 76 pages total ([download CSV](csv/alfa__sia-r53.csv)).

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

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

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

### Example pages
- http://medicaid.gov/resources-for-states/rural-health
- https://www.medicaid.gov/state-overviews/puerto-rico.html
- https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/52149

---

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

**Bug ID:** `VS-23e06856`  
**Pattern ID:** `VS-4c341c77`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D  
**XPath / selector:** `<p class="selected-states-header">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r85` ([reference](https://alfa.siteimprove.com/rules/sia-r85))  
**Severity:** Moderate  
**Frequency:** 189 instances; 4 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 4 of 6890 scanned pages (189 instances).

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

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

### Affected pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22CT%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22OH%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SC%22%5D

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

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

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

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-5ef16b38`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D  
**XPath / selector:** `<h3 _ngcontent-ng-c1329502141="" class="view-measures-related-to-header core-set ng-star-inserted">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r78` ([reference](https://alfa.siteimprove.com/rules/sia-r78))  
**Severity:** Moderate  
**Frequency:** 4 instances; 4 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 4 of 6890 scanned pages (4 instances).

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

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

### Affected pages
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22CT%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22OH%22%5D
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SC%22%5D

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

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

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

---

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

**Bug ID:** `VS-fe52ec28`  
**Pattern ID:** `VS-e5ec42f0`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22CT%22%5D  
**XPath / selector:** `<p _ngcontent-ng-c2822395467="" class="title core-set">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r72` ([reference](https://alfa.siteimprove.com/rules/sia-r72))  
**Severity:** Moderate  
**Frequency:** 543 instances; 3 of 6890 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 3 of 6890 scanned pages (543 instances).

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

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

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

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

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

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