# Accessibility bug reports — www.medicaid.gov, week 2026-W34

34 issue type(s) from 6585 pages scanned. Generated 2026-08-23 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-44383968`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&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:** 233 instances; 113 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 113 of 6585 scanned pages (233 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=.
2. Locate the element: <textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">
3. Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

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

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=6&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=43&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=18&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&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%5B%5D=8816&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=796&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=791&page=64&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=17&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=22&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=3&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=946&page=2&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=1&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=876&page=27&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=13&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=41&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=726&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=19&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=3&q=

…and more — 113 pages total ([download CSV](csv/alfa__sia-r113.csv)).

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

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

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=6&q=

---

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

**Bug ID:** `VS-6198cb9d`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42  
**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:** 341 instances; 341 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 341 of 6585 scanned pages (341 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42.
2. Locate the element: <a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">
3. Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-22-006-6
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7594
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-22r-009-9
- https://medicaid.gov/
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip003285
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-28-002-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7905
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-1-017-21
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-9-021-21
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg016210
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7759
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002146
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-022-13
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip001006
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002024
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7569
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-14-009-9
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003034
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003074
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2051
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8660

…and more — 341 pages total ([download CSV](csv/alfa__sia-r14.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-22-006-6
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-d46cad3a`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** https://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 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (7 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 6585 scanned pages (1 instances).

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

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

### Affected pages
- https://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

---

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

**Bug ID:** `VS-842fa827`  
**Pattern ID:** `VS-9429bb8d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg001003  
**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:** 297 instances; 297 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 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 297 of 6585 scanned pages (297 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg001003.
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/elg001003
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002035
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg008133
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002152
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip003285
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003142
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002108
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003315
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg016210
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002146
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002054
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006205
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002030
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip001006
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002031
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002024
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/cot-claim-other/file-header-record-ot
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003034
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006194
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/tpl001011
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004141
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg016215
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001010

…and more — 297 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/elg001003
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002035

---

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

**Bug ID:** `VS-ed3cdbbe`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=  
**XPath / selector:** `<ul class="select2-selection__rendered" id="select2-edit-field-topics-container">`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r68` ([reference](https://alfa.siteimprove.com/rules/sia-r68))  
**Severity:** Moderate  
**Frequency:** 262 instances; 255 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 255 of 6585 scanned pages (262 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=.
2. Locate the element: <ul class="select2-selection__rendered" id="select2-edit-field-topics-container">
3. Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=6&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=43&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip003285
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003142
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg016210
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002146
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=0&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip001006
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=5&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002024
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003034
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003074
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=18&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=796&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx001010
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt003188
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004131
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003135
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg018229

…and more — 255 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/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165

---

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

**Bug ID:** `VS-3246a980`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** https://medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality  
**XPath / selector:** `<a style="text-decoration:none;" href="#four" title="">`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** Siteimprove Alfa — `sia-r62` ([reference](https://alfa.siteimprove.com/rules/sia-r62))  
**Severity:** Moderate  
**Frequency:** 4 instances; 1 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (6 weeks)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 1 of 6585 scanned pages (4 instances).

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

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

### Affected pages
- https://medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality

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

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

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

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-52afd08d`  
**Pattern ID:** `VS-e9fe47ac`  
**URL:** https://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 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (8 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 6585 scanned pages (1 instances).

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

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

### Affected pages
- https://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

---

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

**Bug ID:** `VS-33b50399`  
**Pattern ID:** `VS-1467ea8a`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg001003  
**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:** 1449 instances; 297 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 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 297 of 6585 scanned pages (1449 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg001003.
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/elg001003
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002035
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg008133
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002152
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip003285
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003142
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002108
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip003315
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg016210
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002146
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002054
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006205
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002030
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip001006
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002031
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002024
- https://www.medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/cot-claim-other/file-header-record-ot
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003034
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006194
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/tpl001011
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004141
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg016215
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001010

…and more — 297 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/elg001003
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002035

---

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

**Bug ID:** `VS-a2fa0baf`  
**Pattern ID:** `VS-0841abc2`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=15&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-9itn"] > .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:** 494 instances; 236 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 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 236 of 6585 scanned pages (494 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=15&q=.
2. Locate the element: span[data-select2-id="select2-data-1-9itn"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]
3. Confirm the axe-core finding for rule aria-input-field-name against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=15&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=45&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=6&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=43&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=4&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=14&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=18&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=4&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8816&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=796&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=866&page=24&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=846&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=3&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=806&q=

…and more — 236 pages total ([download CSV](csv/axe-core__aria-input-field-name.csv)).

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

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

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=15&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=

---

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

**Bug ID:** `VS-1a68226f`  
**Pattern ID:** `VS-ebb1c464`  
**URL:** https://medicaid.gov/  
**XPath / selector:** `time[datetime="2026-08-17"]`  
**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:** 20 instances; 8 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### HTML snippet
```html
<time class="nn-card__date flex-shrink-0 text-center margin-right-2 border" datetime="2026-08-17" aria-label="Aug 17">
```

### Description
Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 8 of 6585 scanned pages (20 instances).

### Steps to reproduce
1. Open https://medicaid.gov/.
2. Locate the element: time[datetime="2026-08-17"]
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
- https://medicaid.gov/
- https://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/covid-19-phe-unwinding-section-1902e14a-waiver-approvals
- https://medicaid.gov/medicaid/data-systems/it-procurement-opportunities
- https://medicaid.gov/about-us/where-can-people-get-help-medicaid-chip
- https://medicaid.gov/chip/state-program-information
- https://www.medicaid.gov/
- http://medicaid.gov/chip/state-program-information
- https://medicaid.gov/eligibility

### 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
- https://medicaid.gov/
- https://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/covid-19-phe-unwinding-section-1902e14a-waiver-approvals
- https://medicaid.gov/medicaid/data-systems/it-procurement-opportunities

---

## Form field has accessible name (WCAG 4.1.2)

**Bug ID:** `VS-5e79aa3a`  
**Pattern ID:** `VS-a48e6078`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&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:** 233 instances; 113 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 113 of 6585 scanned pages (233 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=.
2. Locate the element: <span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false">
3. Confirm the Siteimprove Alfa finding for rule sia-r8 against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=6&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=43&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=18&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&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%5B%5D=8816&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=796&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=791&page=64&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=17&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=22&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=3&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=946&page=2&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=1&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=876&page=27&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=13&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=41&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=726&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=19&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=3&q=

…and more — 113 pages total ([download CSV](csv/alfa__sia-r8.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=6&q=

---

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

**Bug ID:** `VS-7fed5c99`  
**Pattern ID:** `VS-be8d563e`  
**URL:** https://medicaid.gov/chip/reports-evaluations  
**XPath / selector:** `.helpful-box-gray-sm > p > span`  
**WCAG SC:** 1.4.3 — Contrast (Minimum) (Level AA)  
**Rule:** axe-core — `color-contrast` ([reference](https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 2 instances; 1 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (6 weeks)

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

### Description
Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 1 of 6585 scanned pages (2 instances).

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

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

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

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

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

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

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-83237072`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7  
**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:** 125833 instances; 3139 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3139 of 6585 scanned pages (125833 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7.
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/mis-86-007-7
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A2386&f%5B2%5D=sub_topic_faq_library_facet%3A2531&page=3
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1516&f%5B1%5D=fpg_topics_facet%3A8601&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A826&f%5B1%5D=state%3A846&f%5B2%5D=state%3A956&f%5B3%5D=topics%3A936&f%5B4%5D=topics%3A7431&page=1667
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3156&f%5B1%5D=topics%3A3791&f%5B2%5D=topics%3A3896&f%5B3%5D=topics%3A5811&f%5B4%5D=topics%3A6486&f%5B5%5D=topics%3A7411&page=1662&task=face-presentation-attack-detection
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- 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%3A1976&f%5B1%5D=sub_topic_faq_library_facet%3A1986&f%5B2%5D=sub_topic_faq_library_facet%3A2091&f%5B3%5D=sub_topic_faq_library_facet%3A2431&f%5B4%5D=sub_topic_faq_library_facet%3A2531&page=0
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=39258.&page=4
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A1986&f%5B2%5D=sub_topic_faq_library_facet%3A2081&f%5B3%5D=sub_topic_faq_library_facet%3A2091&f%5B4%5D=sub_topic_faq_library_facet%3A2496&f%5B5%5D=sub_topic_faq_library_facet%3A2516&page=84
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-22-006-6
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1866&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2081&f%5B3%5D=sub_topic_faq_library_facet%3A2336&f%5B4%5D=sub_topic_faq_library_facet%3A2406&f%5B5%5D=sub_topic_faq_library_facet%3A2496&page=81
- https://www.medicaid.gov/faq?fcf=40859&page=3&sl=yes
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?70905_xml=&f%5B0%5D=state%3A846&f%5B1%5D=state%3A1051&page=0
- http://medicaid.gov/faq?fcf=40769&page=83&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A721&f%5B1%5D=topics%3A4486&page=4
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A681&items_per_page=10&page=0&search_api_fulltext=2026
- 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=11
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A891&f%5B2%5D=state%3A1026&page=1656

…and more — 3139 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/mis-86-007-7
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A2386&f%5B2%5D=sub_topic_faq_library_facet%3A2531&page=3
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1516&f%5B1%5D=fpg_topics_facet%3A8601&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=4

---

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

**Bug ID:** `VS-7d4e515f`  
**Pattern ID:** `VS-2208081b`  
**URL:** http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A2386&f%5B2%5D=sub_topic_faq_library_facet%3A2531&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:** 4255 instances; 2441 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 2441 of 6585 scanned pages (4255 instances).

### Steps to reproduce
1. Open http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A2386&f%5B2%5D=sub_topic_faq_library_facet%3A2531&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%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A2386&f%5B2%5D=sub_topic_faq_library_facet%3A2531&page=3
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1516&f%5B1%5D=fpg_topics_facet%3A8601&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A826&f%5B1%5D=state%3A846&f%5B2%5D=state%3A956&f%5B3%5D=topics%3A936&f%5B4%5D=topics%3A7431&page=1667
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3156&f%5B1%5D=topics%3A3791&f%5B2%5D=topics%3A3896&f%5B3%5D=topics%3A5811&f%5B4%5D=topics%3A6486&f%5B5%5D=topics%3A7411&page=1662&task=face-presentation-attack-detection
- https://www.medicaid.gov/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%3A1976&f%5B1%5D=sub_topic_faq_library_facet%3A1986&f%5B2%5D=sub_topic_faq_library_facet%3A2091&f%5B3%5D=sub_topic_faq_library_facet%3A2431&f%5B4%5D=sub_topic_faq_library_facet%3A2531&page=0
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=39258.&page=4
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A1986&f%5B2%5D=sub_topic_faq_library_facet%3A2081&f%5B3%5D=sub_topic_faq_library_facet%3A2091&f%5B4%5D=sub_topic_faq_library_facet%3A2496&f%5B5%5D=sub_topic_faq_library_facet%3A2516&page=84
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1866&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2081&f%5B3%5D=sub_topic_faq_library_facet%3A2336&f%5B4%5D=sub_topic_faq_library_facet%3A2406&f%5B5%5D=sub_topic_faq_library_facet%3A2496&page=81
- https://www.medicaid.gov/faq?fcf=40859&page=3&sl=yes
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?70905_xml=&f%5B0%5D=state%3A846&f%5B1%5D=state%3A1051&page=0
- http://medicaid.gov/faq?fcf=40769&page=83&sl=yes
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A721&f%5B1%5D=topics%3A4486&page=4
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A681&items_per_page=10&page=0&search_api_fulltext=2026
- 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=11
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A891&f%5B2%5D=state%3A1026&page=1656
- https://medicaid.gov/medicaid/section-1115-demonstrations/reentry-section-1115-demonstrations
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=state_waiver_status_facet%3A1586&f%5B1%5D=state_waiver_status_facet%3A1606&items_per_page=10&objectId=1899363&page=4
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1986&f%5B1%5D=sub_topic_faq_library_facet%3A2061&fcf=41245&page=6&sl=yes
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1946&f%5B1%5D=sub_topic_faq_library_facet%3A1961&f%5B2%5D=sub_topic_faq_library_facet%3A1971&f%5B3%5D=sub_topic_faq_library_facet%3A2431&page=84
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A701&f%5B1%5D=topics%3A6476&f%5B2%5D=topics%3A6486&f%5B3%5D=topics%3A7391&page=4&task=gaussian-processes
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A916&page=1661&task=event-based-vision

…and more — 2441 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%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A2386&f%5B2%5D=sub_topic_faq_library_facet%3A2531&page=3
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1516&f%5B1%5D=fpg_topics_facet%3A8601&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A826&f%5B1%5D=state%3A846&f%5B2%5D=state%3A956&f%5B3%5D=topics%3A936&f%5B4%5D=topics%3A7431&page=1667

---

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

**Bug ID:** `VS-a9872641`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23  
**XPath / selector:** `<p class="field-content">`  
**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:** 142 instances; 11 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 11 of 6585 scanned pages (142 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23.
2. Locate the element: <p class="field-content">
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/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=50&page=2
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=19
- https://medicaid.gov/state-overviews/scorecard
- http://medicaid.gov/about-us/leadership
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NE%22%5D
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=50&page=4
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22TN%22%5D
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=24
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=4
- https://medicaid.gov/medicaid/section-1115-demonstrations/budget-neutrality

### 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/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=50&page=2
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=19

---

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

**Bug ID:** `VS-b7cc9048`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7  
**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:** 74219 instances; 3139 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3139 of 6585 scanned pages (74219 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7.
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/mis-86-007-7
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A2386&f%5B2%5D=sub_topic_faq_library_facet%3A2531&page=3
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1516&f%5B1%5D=fpg_topics_facet%3A8601&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A826&f%5B1%5D=state%3A846&f%5B2%5D=state%3A956&f%5B3%5D=topics%3A936&f%5B4%5D=topics%3A7431&page=1667
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3156&f%5B1%5D=topics%3A3791&f%5B2%5D=topics%3A3896&f%5B3%5D=topics%3A5811&f%5B4%5D=topics%3A6486&f%5B5%5D=topics%3A7411&page=1662&task=face-presentation-attack-detection
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- 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%3A1976&f%5B1%5D=sub_topic_faq_library_facet%3A1986&f%5B2%5D=sub_topic_faq_library_facet%3A2091&f%5B3%5D=sub_topic_faq_library_facet%3A2431&f%5B4%5D=sub_topic_faq_library_facet%3A2531&page=0
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=39258.&page=4
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A1986&f%5B2%5D=sub_topic_faq_library_facet%3A2081&f%5B3%5D=sub_topic_faq_library_facet%3A2091&f%5B4%5D=sub_topic_faq_library_facet%3A2496&f%5B5%5D=sub_topic_faq_library_facet%3A2516&page=84
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-22-006-6
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1866&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2081&f%5B3%5D=sub_topic_faq_library_facet%3A2336&f%5B4%5D=sub_topic_faq_library_facet%3A2406&f%5B5%5D=sub_topic_faq_library_facet%3A2496&page=81
- https://www.medicaid.gov/faq?fcf=40859&page=3&sl=yes
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?70905_xml=&f%5B0%5D=state%3A846&f%5B1%5D=state%3A1051&page=0
- http://medicaid.gov/faq?fcf=40769&page=83&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A721&f%5B1%5D=topics%3A4486&page=4
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A681&items_per_page=10&page=0&search_api_fulltext=2026
- 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=11
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A891&f%5B2%5D=state%3A1026&page=1656

…and more — 3139 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/mis-86-007-7
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A2386&f%5B2%5D=sub_topic_faq_library_facet%3A2531&page=3
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1516&f%5B1%5D=fpg_topics_facet%3A8601&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=4

---

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

**Bug ID:** `VS-62f3a5c0`  
**Pattern ID:** `VS-33841929`  
**URL:** https://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-data  
**XPath / selector:** `select[aria-labelledby="filter-th-170741-0"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `label-title-only` ([reference](https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 14 instances; 4 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### HTML snippet
```html
<select aria-labelledby="filter-th-170741-0" class="usa-select height-1" data-col-index="0" title="Filter by Type">
```

### Description
Form elements should have a visible label. Detected by axe-core rule label-title-only on 4 of 6585 scanned pages (14 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-data.
2. Locate the element: select[aria-labelledby="filter-th-170741-0"]
3. Confirm the axe-core finding for rule label-title-only.

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

### Affected pages
- https://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-data
- https://medicaid.gov/chip/reports-evaluations
- https://medicaid.gov/medicaid/financial-management/medicaid-disproportionate-share-hospital-dsh-payments
- https://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://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-data
- https://medicaid.gov/chip/reports-evaluations
- https://medicaid.gov/medicaid/financial-management/medicaid-disproportionate-share-hospital-dsh-payments

---

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

**Bug ID:** `VS-35040fb1`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7  
**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:** 1423 instances; 1423 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 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 1423 of 6585 scanned pages (1423 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7.
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/mis-86-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-11-019-19
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-54-012-12
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-48-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-22-006-6
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-60-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg001003
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-49-005-5
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1481
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-27-029-29
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-3-002-3
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002035
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6321
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6160
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7594
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2952
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-22r-009-9
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/prv-6-001-1

…and more — 1423 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/mis-86-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638

---

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

**Bug ID:** `VS-18b2a1ca`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7  
**XPath / selector:** `.small`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 6315 instances; 1420 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 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 1420 of 6585 scanned pages (6315 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7.
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/mis-86-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-11-019-19
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-54-012-12
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-48-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-22-006-6
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-60-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg001003
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-49-005-5
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1481
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-27-029-29
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-3-002-3
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002035
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6321
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6160
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7594
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2952
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-22r-009-9
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/prv-6-001-1

…and more — 1420 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/mis-86-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638

---

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

**Bug ID:** `VS-88a880a0`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7  
**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:** 1414 instances; 1414 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 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 1414 of 6585 scanned pages (1414 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7.
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/mis-86-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-11-019-19
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-54-012-12
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-48-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-22-006-6
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-60-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg001003
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-49-005-5
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1481
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-27-029-29
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-3-002-3
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002035
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6321
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6160
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7594
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2952
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-22r-009-9
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/prv-6-001-1

…and more — 1414 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/mis-86-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638

---

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

**Bug ID:** `VS-0b890e8d`  
**Pattern ID:** `VS-d25f622d`  
**URL:** https://medicaid.gov/medicaid/section-1115-demonstrations/reentry-section-1115-demonstrations  
**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:** 377 instances; 341 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 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 341 of 6585 scanned pages (377 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/section-1115-demonstrations/reentry-section-1115-demonstrations.
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
- https://medicaid.gov/medicaid/section-1115-demonstrations/reentry-section-1115-demonstrations
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/section-1135-waiver-flexibilities
- https://medicaid.gov/resources-for-states/medicaid-and-chip-program-portal/macpro-training-help/chip-state-plan-amendments
- https://medicaid.gov/resources-for-states/eligibility-enrollment-and-renewal-tools-and-resources/renewal-strategies-and-tools
- https://medicaid.gov/medicaid/quality-of-care/medicaid-managed-care-quality/quality-of-care-external-quality-review
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-enrollment-data-collected-through-mbes
- https://medicaid.gov/
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/quality-of-care-patient-safety
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=50&page=2
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/functional-areas/performance-improvement
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106701
- https://medicaid.gov/medicaid/cost-sharing
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/functional-areas/quality-measurement/physical-and-mental-health-integration-quality-measures
- https://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-programs-mdp-system-access
- http://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-dispute-resolution
- http://medicaid.gov/resources-for-states/managed-care-review-mc-review/managed-care-review-faqs
- http://medicaid.gov/medicaid/long-term-services-supports/institutional-long-term-care/inpatient-psychiatric-services-individuals-under-age-21
- https://medicaid.gov/medicaid/data-systems/medicaid-information-technology-architecture
- https://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/archived-unwinding-and-returning-regular-operations-after-covid-19/data-reporting
- https://medicaid.gov/medicaid/quality-of-care/quality-improvement/oral-health-quality-improvement-resources
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54031
- http://medicaid.gov/state-overviews/stateprofile.html?state=Pennsylvania
- https://www.medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/combatting-opioid-misuse-and-abuse
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NJ%22%5D

…and more — 341 pages total ([download CSV](csv/axe-core__heading-order.csv)).

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

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

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

### Example pages
- https://medicaid.gov/medicaid/section-1115-demonstrations/reentry-section-1115-demonstrations
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/section-1135-waiver-flexibilities

---

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

**Bug ID:** `VS-77920aeb`  
**Pattern ID:** `VS-8806389c`  
**URL:** https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23  
**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:** 101 instances; 101 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 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 101 of 6585 scanned pages (101 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23.
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/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23
- https://medicaid.gov/
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=50&page=2
- https://medicaid.gov/medicaid/data-systems/medicaid-information-technology-architecture
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/home-community-based-services-during-public-health-emergencies
- https://medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality
- https://medicaid.gov/medicaid/quality-of-care/quality-of-care-performance-measurement/chip-quality-of-care-performance-measurement
- https://medicaid.gov/medicaid/benefits/prevention
- https://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center
- https://medicaid.gov/medicaid/quality-of-care/medicaid-chip-data-products
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=19
- https://medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-reporting
- http://medicaid.gov/medicaid/quality-of-care/releases-announcements
- https://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance
- https://medicaid.gov/medicaid/quality-of-care/performance-measurement/adult-and-child-health-care-quality-measures
- https://medicaid.gov/medicaid/home-community-based-services
- https://medicaid.gov/medicaid/long-term-services-supports/money-follows-person
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/reducing-substance-use-disorders
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities
- https://medicaid.gov/medicaid/long-term-services-supports/direct-care-workforce
- https://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/unit-rebate-amount-calculation
- https://medicaid.gov/medicaid/long-term-services-supports/medicaid-employment-initiatives
- https://medicaid.gov/resources-for-states/innovation-accelerator-program
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=50&page=1
- https://medicaid.gov/medicaid/national-medicaid-chip-program-information

…and more — 101 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/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23
- https://medicaid.gov/
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=50&page=2

---

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

**Bug ID:** `VS-1d5e995e`  
**Pattern ID:** `VS-ff3ceb19`  
**URL:** https://www.medicaid.gov/style-guide/components/back-to-top  
**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:** 2 instances; 2 of 6585 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W34 (7 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 2 of 6585 scanned pages (2 instances).

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

### 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/back-to-top
- https://www.medicaid.gov/style-guide/components

---

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

**Bug ID:** `VS-a8f9d612`  
**Pattern ID:** `VS-cd69be3a`  
**URL:** https://www.medicaid.gov/style-guide/components/back-to-top  
**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:** 2 instances; 2 of 6585 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W34 (7 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 2 of 6585 scanned pages (2 instances).

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

### 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/back-to-top
- https://www.medicaid.gov/style-guide/components

---

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

**Bug ID:** `VS-4550f1c1`  
**Pattern ID:** `VS-4fac2f41`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=15&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-9itn"] > .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:** 500 instances; 239 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 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 239 of 6585 scanned pages (500 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=15&q=.
2. Locate the element: span[data-select2-id="select2-data-1-9itn"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea
3. Confirm the axe-core finding for rule aria-allowed-role.

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

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=15&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=45&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=6&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=43&q=
- https://medicaid.gov/
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=4&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=14&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=18&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=18&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=4&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8816&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=796&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=866&page=24&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=846&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=3&q=

…and more — 239 pages total ([download CSV](csv/axe-core__aria-allowed-role.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=15&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=

---

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

**Bug ID:** `VS-195084ea`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7  
**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:** 32907 instances; 3136 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3136 of 6585 scanned pages (32907 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7.
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/mis-86-007-7
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A2386&f%5B2%5D=sub_topic_faq_library_facet%3A2531&page=3
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1516&f%5B1%5D=fpg_topics_facet%3A8601&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A826&f%5B1%5D=state%3A846&f%5B2%5D=state%3A956&f%5B3%5D=topics%3A936&f%5B4%5D=topics%3A7431&page=1667
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3156&f%5B1%5D=topics%3A3791&f%5B2%5D=topics%3A3896&f%5B3%5D=topics%3A5811&f%5B4%5D=topics%3A6486&f%5B5%5D=topics%3A7411&page=1662&task=face-presentation-attack-detection
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- 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%3A1976&f%5B1%5D=sub_topic_faq_library_facet%3A1986&f%5B2%5D=sub_topic_faq_library_facet%3A2091&f%5B3%5D=sub_topic_faq_library_facet%3A2431&f%5B4%5D=sub_topic_faq_library_facet%3A2531&page=0
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=42&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=39258.&page=4
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A1986&f%5B2%5D=sub_topic_faq_library_facet%3A2081&f%5B3%5D=sub_topic_faq_library_facet%3A2091&f%5B4%5D=sub_topic_faq_library_facet%3A2496&f%5B5%5D=sub_topic_faq_library_facet%3A2516&page=84
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-22-006-6
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1866&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2081&f%5B3%5D=sub_topic_faq_library_facet%3A2336&f%5B4%5D=sub_topic_faq_library_facet%3A2406&f%5B5%5D=sub_topic_faq_library_facet%3A2496&page=81
- https://www.medicaid.gov/faq?fcf=40859&page=3&sl=yes
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?70905_xml=&f%5B0%5D=state%3A846&f%5B1%5D=state%3A1051&page=0
- http://medicaid.gov/faq?fcf=40769&page=83&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A721&f%5B1%5D=topics%3A4486&page=4
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A681&items_per_page=10&page=0&search_api_fulltext=2026
- 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=11
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A891&f%5B2%5D=state%3A1026&page=1656

…and more — 3136 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/mis-86-007-7
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1921&f%5B1%5D=sub_topic_faq_library_facet%3A2386&f%5B2%5D=sub_topic_faq_library_facet%3A2531&page=3
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1516&f%5B1%5D=fpg_topics_facet%3A8601&f%5B2%5D=fpg_topics_facet%3A8716&f%5B3%5D=fpg_topics_facet%3A8861&page=4

---

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

**Bug ID:** `VS-0e8f5345`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7  
**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:** 701 instances; 701 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 701 of 6585 scanned pages (701 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7.
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/mis-86-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-22-006-6
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-27-029-29
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6321
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7594
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2952
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-22r-009-9
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8545
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-739
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-461
- https://medicaid.gov/
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip003285
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-28-002-2
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003142
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7302
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-2-004_2-61
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7905
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-1-017-21

…and more — 701 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/mis-86-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638

---

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

**Bug ID:** `VS-4677ba29`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7  
**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:** 700 instances; 700 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 700 of 6585 scanned pages (700 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-86-007-7.
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/mis-86-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-042-42
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-013-13
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-22-006-6
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-27-029-29
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6321
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7594
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2952
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-22r-009-9
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8545
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-739
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-461
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip003285
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-28-002-2
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003142
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7302
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-2-004_2-61
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7905
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-1-017-21
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-14-003-6

…and more — 700 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/mis-86-007-7
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-33-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-638

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-8499d1ab`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://medicaid.gov/medicaid/section-1115-demonstrations/reentry-section-1115-demonstrations  
**XPath / selector:** `<h4 class="usa-footer__primary-link">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 183 instances; 167 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 167 of 6585 scanned pages (183 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/section-1115-demonstrations/reentry-section-1115-demonstrations.
2. Locate the element: <h4 class="usa-footer__primary-link">
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

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

### Affected pages
- https://medicaid.gov/medicaid/section-1115-demonstrations/reentry-section-1115-demonstrations
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-enrollment-data-collected-through-mbes
- https://medicaid.gov/
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/quality-of-care-patient-safety
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=50&page=2
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/functional-areas/quality-measurement/physical-and-mental-health-integration-quality-measures
- https://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-programs-mdp-system-access
- http://medicaid.gov/resources-for-states/managed-care-review-mc-review/managed-care-review-faqs
- https://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/archived-unwinding-and-returning-regular-operations-after-covid-19/data-reporting
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54031
- http://medicaid.gov/state-overviews/stateprofile.html?state=Pennsylvania
- https://www.medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/combatting-opioid-misuse-and-abuse
- https://www.medicaid.gov/medicaid/enrollment-strategies
- https://medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality
- https://medicaid.gov/medicaid/benefits/prevention
- https://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=10&page=19
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/101031
- https://www.medicaid.gov/medicaid/access-care/documentation-of-access-care-and-service-payment-rates
- https://medicaid.gov/medicaid/managed-care/guidance/medicaid-and-chip-managed-care-reporting
- https://medicaid.gov/medicaid/benefits/telehealth/telehealth-terms
- https://medicaid.gov/medicaid/prescription-drugs/retail-price-survey
- https://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/methodology-about-medicaid-chip-enrollment-report
- https://medicaid.gov/medicaid/benefits/prevention/webinar-archive

…and more — 167 pages total ([download CSV](csv/alfa__sia-r53.csv)).

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

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

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

### Example pages
- https://medicaid.gov/medicaid/section-1115-demonstrations/reentry-section-1115-demonstrations
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?eId=ed2c8935-b8d6-404a-97d1-cf9d7eada13d&eType=EmailBlastContent&page=23
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-enrollment-data-collected-through-mbes

---

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

**Bug ID:** `VS-9aaf2084`  
**Pattern ID:** `VS-e05344b9`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165  
**XPath / selector:** `@aria-selected="true"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 723 instances; 150 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 150 of 6585 scanned pages (723 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165.
2. Locate the element: @aria-selected="true"
3. Confirm the Siteimprove Alfa finding for rule sia-r18.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://medicaid.gov/
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip003285
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003142
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg016210
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002146
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip001006
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002024
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl003034
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003074
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx001010
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt003188
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004131
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003135
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg018229
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002084
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002030
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx003116
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002037
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt003228
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg021255
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg021251
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg009270
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg005098

…and more — 150 pages total ([download CSV](csv/alfa__sia-r18.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002024
- https://medicaid.gov/

---

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

**Bug ID:** `VS-841011e5`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165  
**XPath / selector:** `td`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 119 instances; 97 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

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

### Description
Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 97 of 6585 scanned pages (119 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/crx002165.
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/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6160
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-16-003-6
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8043
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6701
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-23-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/tpl001011
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2006
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-892
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1933
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg014198
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8337
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt003263
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9036
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8350
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7592
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6891
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt002240
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7214
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6178
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/tpl-1-005-5
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-969
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002081
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8960
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2049

…and more — 97 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/v4/data-elements/crx002165
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6160
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-16-003-6

---

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

**Bug ID:** `VS-ce402993`  
**Pattern ID:** `VS-4c341c77`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NE%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:** 123 instances; 2 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 2 of 6585 scanned pages (123 instances).

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

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-9c800051`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NE%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:** 2 instances; 2 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 2 of 6585 scanned pages (2 instances).

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

---

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

**Bug ID:** `VS-ff32ce82`  
**Pattern ID:** `VS-e5ec42f0`  
**URL:** https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22NE%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:** 357 instances; 2 of 6585 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W34 (11 weeks)

### Description
Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 2 of 6585 scanned pages (357 instances).

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