# Accessibility bug reports — www.medicaid.gov, week 2026-W35

31 issue type(s) from 6990 pages scanned. Generated 2026-08-30 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-5d86144b`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc  
**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:** 642 instances; 298 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 298 of 6990 scanned pages (642 instances).

### Steps to reproduce
1. Open https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc.
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://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=2&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8856&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=0&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=27&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=8&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=27&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=7&q=
- https://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=8786&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=9&q=
- https://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=8846&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=27&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=30&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=796&page=11&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=8&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=0&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=2271&limit=10&page=5&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=891&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=10&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=28&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=736&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=1001&q=

…and more — 298 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://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=2&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8856&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=0&q=&sort=field_faq_date%3Adesc

---

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

**Bug ID:** `VS-dbcd53e5`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20  
**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:** 1284 instances; 1279 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 1279 of 6990 scanned pages (1284 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20.
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://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7446
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-18-015-16
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-045-45
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-46-004-4
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002155
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010119
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-2-016-18
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002018
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-055-55
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-60-002-2
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv009117
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx007266
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002023
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg013179
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7459
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7893
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-26-001-1
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7947
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-9223
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004056
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-9162
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7200
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-6-030-30

…and more — 1279 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://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7446
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-18-015-16

---

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

**Bug ID:** `VS-59ddc3c9`  
**Pattern ID:** `VS-9429bb8d`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg020239  
**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:** 1325 instances; 1325 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 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 1325 of 6990 scanned pages (1325 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg020239.
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://medicaid.gov/tmsis/dataguide/v4/data-elements/elg020239
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot002108
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/ftx-financial-transaction/individual-health-insurance-premium-payment
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt001004
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002155
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010119
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095403
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002018
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv009117
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002025
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002060
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx007266
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002023
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002147
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002021
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg013179
- https://medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/elg-eligible/elg-identifiers
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg017222
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip003243
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005169
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg005100
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004056
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002096
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx004197

…and more — 1325 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://medicaid.gov/tmsis/dataguide/v4/data-elements/elg020239
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot002108

---

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

**Bug ID:** `VS-a984f1f8`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116  
**XPath / selector:** `<div class="nav nav-tabs nav-justified" role="tablist">`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r68` ([reference](https://alfa.siteimprove.com/rules/sia-r68))  
**Severity:** Moderate  
**Frequency:** 968 instances; 921 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 921 of 6990 scanned pages (968 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116.
2. Locate the element: <div class="nav nav-tabs nav-justified" role="tablist">
3. Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=2&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002155
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010119
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=27&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=8&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002018
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=0&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv009117
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx007266
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002023
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=27&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg013179
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=2&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004056
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=7&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002096
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/tpl006075
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg002025
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003192
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=9&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv008112
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip003265
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=27&q=

…and more — 921 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://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=2&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002155

---

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

**Bug ID:** `VS-aa6e529b`  
**Pattern ID:** `VS-4408605e`  
**URL:** https://medicaid.gov/medicaid/outreach-tools/helping-connect-enrollees-care  
**XPath / selector:** `<th>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r46` ([reference](https://alfa.siteimprove.com/rules/sia-r46))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (7 weeks)

### Description
Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 1 of 6990 scanned pages (1 instances).

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

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

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

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

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

---

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

**Bug ID:** `VS-78b65cf5`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** https://medicaid.gov/medicaid/quality-of-care/quality-improvement/addressing-childhood-obesity  
**XPath / selector:** `<a style="text-decoration:none;" href="#three" title="">`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** Siteimprove Alfa — `sia-r62` ([reference](https://alfa.siteimprove.com/rules/sia-r62))  
**Severity:** Moderate  
**Frequency:** 4 instances; 2 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (7 weeks)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 2 of 6990 scanned pages (4 instances).

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

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

### Affected pages
- https://medicaid.gov/medicaid/quality-of-care/quality-improvement/addressing-childhood-obesity
- https://medicaid.gov/medicaid/quality-of-care/quality-improvement/oral-health-quality-improvement-resources/advancing-oral-health-prevention-in-primary-care

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

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

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

### Example pages
- https://medicaid.gov/medicaid/quality-of-care/quality-improvement/addressing-childhood-obesity
- https://medicaid.gov/medicaid/quality-of-care/quality-improvement/oral-health-quality-improvement-resources/advancing-oral-health-prevention-in-primary-care

---

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

**Bug ID:** `VS-585091b5`  
**Pattern ID:** `VS-1467ea8a`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg020239  
**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:** 6358 instances; 1325 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 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 1325 of 6990 scanned pages (6358 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg020239.
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://medicaid.gov/tmsis/dataguide/v4/data-elements/elg020239
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot002108
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/ftx-financial-transaction/individual-health-insurance-premium-payment
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt001004
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002155
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010119
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095403
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002018
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv009117
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002025
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002060
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx007266
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002023
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002147
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002021
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg013179
- https://medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/elg-eligible/elg-identifiers
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg017222
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip003243
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005169
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg005100
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004056
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002096
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx004197

…and more — 1325 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://medicaid.gov/tmsis/dataguide/v4/data-elements/elg020239
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot002108

---

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

**Bug ID:** `VS-5b8dff37`  
**Pattern ID:** `VS-fab92378`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/technical-instructions  
**XPath / selector:** `#items-per-page`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `select-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/select-name?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 2 instances; 2 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (8 weeks)

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

### Description
Select element must have an accessible name. Detected by axe-core rule select-name on 2 of 6990 scanned pages (2 instances).

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

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

### Affected pages
- https://medicaid.gov/tmsis/dataguide/v4/technical-instructions
- https://medicaid.gov/tmsis/dataguide/v3/t-msis-coding-blog

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

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

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

### Example pages
- https://medicaid.gov/tmsis/dataguide/v4/technical-instructions
- https://medicaid.gov/tmsis/dataguide/v3/t-msis-coding-blog

---

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

**Bug ID:** `VS-50bd7f4c`  
**Pattern ID:** `VS-0841abc2`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=5&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-nvw5"] > .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:** 1338 instances; 626 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 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 626 of 6990 scanned pages (1338 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=5&q=.
2. Locate the element: span[data-select2-id="select2-data-1-nvw5"] > .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://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=5&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=39&q=
- https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=846&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=866&page=3&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=2&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8856&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=0&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=881&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=27&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=3&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=8&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=976&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=27&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=0&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=7&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=4&q=
- https://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=8786&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=831&page=26&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=9&q=
- https://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=8846&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8826&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=2&q=&sort=field_faq_date%3Adesc

…and more — 626 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://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=5&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=39&q=
- https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc

---

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

**Bug ID:** `VS-dba0fa65`  
**Pattern ID:** `VS-ebb1c464`  
**URL:** https://medicaid.gov/state-overviews/state-profiles  
**XPath / selector:** `#map`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-prohibited-attr` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-prohibited-attr?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 2 instances; 2 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### HTML snippet
```html
<div aria-disabled="true" aria-label="State Map Image. Keyboard navigating users can use dropdown to select state." id="map" style="position: relative; width: 880px; height: 502.857px; overflow: hidde
```

### Description
Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 2 of 6990 scanned pages (2 instances).

### Steps to reproduce
1. Open https://medicaid.gov/state-overviews/state-profiles.
2. Locate the element: #map
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/state-overviews/state-profiles
- https://medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa

### 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/state-overviews/state-profiles
- https://medicaid.gov/medicaid/prescription-drugs/state-prescription-drug-resources/state-plan-amendments-spa

---

## Form field has accessible name (WCAG 4.1.2)

**Bug ID:** `VS-c9aa74a2`  
**Pattern ID:** `VS-a48e6078`  
**URL:** https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc  
**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:** 643 instances; 299 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 299 of 6990 scanned pages (643 instances).

### Steps to reproduce
1. Open https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc.
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://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=2&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8856&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=0&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=27&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=8&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=27&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=7&q=
- https://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=8786&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=9&q=
- https://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=8846&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=27&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=30&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=796&page=11&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=8&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=0&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=2271&limit=10&page=5&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=891&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=10&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=28&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=736&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=1001&q=

…and more — 299 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://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=2&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8856&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=0&q=&sort=field_faq_date%3Adesc

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-5fee3958`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372  
**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:** 71292 instances; 3178 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3178 of 6990 scanned pages (71292 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372.
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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8354&page=6
- https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1859
- https://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/spa-and-1915-waiver-processing-statistics
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6490
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7446
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-18-015-16
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7390
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-045-45
- https://medicaid.gov/faq?fcf=41371&page=1&sl=yes
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=2&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8856&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=0&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1901&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2001&f%5B3%5D=sub_topic_faq_library_facet%3A2086&f%5B4%5D=sub_topic_faq_library_facet%3A2396&f%5B5%5D=sub_topic_faq_library_facet%3A2526&page=82
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-8-002-2
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-46-004-4
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002155
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6399
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010119
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=27&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A691&f%5B1%5D=topics%3A706&f%5B2%5D=topics%3A3156&page=1
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1965
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-341

…and more — 3178 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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8354&page=6
- https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc

---

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

**Bug ID:** `VS-5d8a5c6b`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8354&page=6  
**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:** 1553 instances; 1059 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 1059 of 6990 scanned pages (1553 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8354&page=6.
2. Locate the element: <p class="usa-footer__contact-info margin-bottom-0">
3. Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8354&page=6
- https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/spa-and-1915-waiver-processing-statistics
- https://medicaid.gov/faq?fcf=41371&page=1&sl=yes
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=2&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8856&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=0&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1901&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2001&f%5B3%5D=sub_topic_faq_library_facet%3A2086&f%5B4%5D=sub_topic_faq_library_facet%3A2396&f%5B5%5D=sub_topic_faq_library_facet%3A2526&page=82
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=27&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A691&f%5B1%5D=topics%3A706&f%5B2%5D=topics%3A3156&page=1
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A796&f%5B1%5D=state%3A956&f%5B2%5D=state%3A991&f%5B3%5D=topics%3A741&f%5B4%5D=topics%3A856&f%5B5%5D=topics%3A2726&f%5B6%5D=topics%3A3001&f%5B7%5D=topics%3A3381&f%5B8%5D=topics%3A5196&page=2
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1901&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2101&f%5B4%5D=sub_topic_faq_library_facet%3A2386&f%5B5%5D=sub_topic_faq_library_facet%3A2531&page=2
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=8&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=0&q=
- https://medicaid.gov/state-overviews/state-profiles
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A716&f%5B1%5D=state%3A781&f%5B2%5D=state%3A846&f%5B3%5D=state%3A896&f%5B4%5D=state%3A946&f%5B5%5D=state%3A956&f%5B6%5D=state%3A981&f%5B7%5D=state%3A1041&f%5B8%5D=state%3A1051&page=7
- https://medicaid.gov/about-us/organization/todd-jones
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/81926
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=27&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A756&f%5B1%5D=state%3A766&f%5B2%5D=state%3A866&f%5B3%5D=state%3A911&f%5B4%5D=state%3A1036&page=0
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8404&page=0
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1966&f%5B1%5D=sub_topic_faq_library_facet%3A2091&f%5B2%5D=sub_topic_faq_library_facet%3A2346&f%5B3%5D=sub_topic_faq_library_facet%3A2386&f%5B4%5D=sub_topic_faq_library_facet%3A2416&f%5B5%5D=sub_topic_faq_library_facet%3A2476&page=84
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=2&q=
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&fcf=41639&page=4&sl=yes
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1926&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%3A2086&f%5B4%5D=sub_topic_faq_library_facet%3A2091&f%5B5%5D=sub_topic_faq_library_facet%3A2371&page=2

…and more — 1059 pages total ([download CSV](csv/alfa__sia-r73.csv)).

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

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

### Example pages
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8354&page=6
- https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/spa-and-1915-waiver-processing-statistics

---

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

**Bug ID:** `VS-338d0284`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://medicaid.gov/about-us/leadership  
**XPath / selector:** `<p class="MsoNormal" style="box-sizing:inherit;font-size:18px;line-height:1.5;margin-block:1em 0px;margin-bottom:0px;margin-top:0px;">`  
**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:** 25 instances; 6 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 6 of 6990 scanned pages (25 instances).

### Steps to reproduce
1. Open https://medicaid.gov/about-us/leadership.
2. Locate the element: <p class="MsoNormal" style="box-sizing:inherit;font-size:18px;line-height:1.5;margin-block:1em 0px;margin-bottom:0px;margin-top:0px;">
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://medicaid.gov/about-us/leadership
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=4
- https://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main
- https://medicaid.gov/medicaid/outreach-tools/helping-connect-enrollees-care
- https://medicaid.gov/medicaid/enrollment-strategies/continuous-eligibility-medicaid-and-chip-coverage

### 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://medicaid.gov/about-us/leadership
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=4
- https://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing

---

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

**Bug ID:** `VS-fd412742`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372  
**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:** 43785 instances; 3178 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3178 of 6990 scanned pages (43785 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372.
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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8354&page=6
- https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1859
- https://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/spa-and-1915-waiver-processing-statistics
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6490
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7446
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-18-015-16
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7390
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-045-45
- https://medicaid.gov/faq?fcf=41371&page=1&sl=yes
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=2&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8856&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=0&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1901&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2001&f%5B3%5D=sub_topic_faq_library_facet%3A2086&f%5B4%5D=sub_topic_faq_library_facet%3A2396&f%5B5%5D=sub_topic_faq_library_facet%3A2526&page=82
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-8-002-2
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-46-004-4
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002155
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6399
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010119
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=27&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A691&f%5B1%5D=topics%3A706&f%5B2%5D=topics%3A3156&page=1
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1965
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-341

…and more — 3178 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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8354&page=6
- https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc

---

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

**Bug ID:** `VS-e83dc3b6`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7929  
**XPath / selector:** `.small`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 20106 instances; 4297 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 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 4297 of 6990 scanned pages (20106 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7929.
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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7929
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1859
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6477
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-83-025-25
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-1-007-29
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7323
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1024
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-028-28
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg020239
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6490
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7446
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-18-015-16
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7390
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6462
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-045-45
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot002108
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-48-006-6
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-828
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/ftx-financial-transaction/individual-health-insurance-premium-payment
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-54-012-12
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-8-002-2

…and more — 4297 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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7929
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18

---

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

**Bug ID:** `VS-08723a78`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7929  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-one-main` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 4277 instances; 4277 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 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 4277 of 6990 scanned pages (4277 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7929.
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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7929
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1859
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6477
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-83-025-25
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-1-007-29
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7323
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1024
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-028-28
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg020239
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6490
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7446
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-18-015-16
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7390
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6462
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-045-45
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot002108
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-48-006-6
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-828
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/ftx-financial-transaction/individual-health-insurance-premium-payment
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-54-012-12
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-8-002-2

…and more — 4277 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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7929
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18

---

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

**Bug ID:** `VS-28013290`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7929  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `page-has-heading-one` ([reference](https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 4265 instances; 4265 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 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 4265 of 6990 scanned pages (4265 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7929.
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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7929
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1859
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6477
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-83-025-25
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-1-007-29
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7323
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1024
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-028-28
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg020239
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6490
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7446
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-18-015-16
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7390
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6462
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-045-45
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot002108
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-48-006-6
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-828
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/ftx-financial-transaction/individual-health-insurance-premium-payment
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-54-012-12
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-8-002-2

…and more — 4265 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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7929
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18

---

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

**Bug ID:** `VS-b1bc273d`  
**Pattern ID:** `VS-33841929`  
**URL:** https://medicaid.gov/state-overviews/state-profiles  
**XPath / selector:** `#select-state`  
**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:** 26 instances; 5 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### HTML snippet
```html
<select id="select-state" name="state" class="usa-select margin-top-0" aria-labelledby="select-state-label" aria-describedby="select-state-instructions">
```

### Description
Form elements should have a visible label. Detected by axe-core rule label-title-only on 5 of 6990 scanned pages (26 instances).

### Steps to reproduce
1. Open https://medicaid.gov/state-overviews/state-profiles.
2. Locate the element: #select-state
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/state-overviews/state-profiles
- https://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/home-community-based-services-during-public-health-emergencies/emergency-preparedness-and-response-for-home-and-community-based-hcbs-1915c-waivers
- https://medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data
- https://medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/innovative-practices

### 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/state-overviews/state-profiles
- https://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/home-community-based-services-during-public-health-emergencies/emergency-preparedness-and-response-for-home-and-community-based-hcbs-1915c-waivers

---

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

**Bug ID:** `VS-73400c0f`  
**Pattern ID:** `VS-d25f622d`  
**URL:** https://medicaid.gov/state-overviews/stateprofile.html?state=Georgia  
**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:** 339 instances; 310 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 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 310 of 6990 scanned pages (339 instances).

### Steps to reproduce
1. Open https://medicaid.gov/state-overviews/stateprofile.html?state=Georgia.
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/state-overviews/stateprofile.html?state=Georgia
- https://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/spa-and-1915-waiver-processing-statistics
- https://medicaid.gov/medicaid/home-community-based-services/home-and-community-based-services-hcbs-quality/testing-experience-functional-tools
- https://medicaid.gov/state-overviews/state-profiles
- https://medicaid.gov/about-us/organization/todd-jones
- https://medicaid.gov/new-notable?page=3
- https://medicaid.gov/medicaid/indian-health-medicaid/tribal-affairs-guidance-resources
- https://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/monthly-medicaid-chip-application-eligibility-determination-and-enrollment-reports-data
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/177991
- https://medicaid.gov/medicaid/long-term-services-supports/institutional-long-term-care/inpatient-psychiatric-services-individuals-under-age-21
- https://medicaid.gov/about-us/organization/jennifer-kostesich
- https://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/chip-spa-processing-tools-for-states
- https://medicaid.gov/about-us/organization/jeremy-silanskis
- https://medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly
- https://medicaid.gov/state-drug-utilization-data-sdud-faqs
- https://medicaid.gov/medicaid/benefits/reentry-services-for-incarcerated-individuals/state-planning-grants-promote-continuity-of-care-for-medicaid-chip-beneficiaries-following-incarceration
- https://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center/health-home-technical-assistance
- https://medicaid.gov/state-overviews/stateprofile.html?state=Maine
- https://medicaid.gov/medicaid/managed-care/profiles-program-features
- https://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-technical-assistance-states
- https://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/home-community-based-services-final-regulation
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106731
- https://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/file-formats-and-data-definitions/file-format/data-definition-archive
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106741
- https://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification/good-faith-effort-exemption-requests-home-health-care-services

…and more — 310 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/state-overviews/stateprofile.html?state=Georgia
- https://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/spa-and-1915-waiver-processing-statistics
- https://medicaid.gov/medicaid/home-community-based-services/home-and-community-based-services-hcbs-quality/testing-experience-functional-tools

---

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

**Bug ID:** `VS-e8ebdfe2`  
**Pattern ID:** `VS-8806389c`  
**URL:** https://medicaid.gov/medicaid/home-community-based-services/home-and-community-based-services-hcbs-quality/testing-experience-functional-tools  
**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:** 46 instances; 46 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 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 46 of 6990 scanned pages (46 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/home-community-based-services/home-and-community-based-services-hcbs-quality/testing-experience-functional-tools.
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://medicaid.gov/medicaid/home-community-based-services/home-and-community-based-services-hcbs-quality/testing-experience-functional-tools
- https://medicaid.gov/medicaid/indian-health-medicaid/tribal-affairs-guidance-resources
- https://medicaid.gov/about-us/organization/jennifer-kostesich
- https://medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly
- https://medicaid.gov/medicaid/data-systems/medicaid-and-chip-business-information-solution/macbis-financial
- https://medicaid.gov/chip
- https://medicaid.gov/resources-for-states/mac-learning-collaboratives
- https://medicaid.gov/medicaid
- https://medicaid.gov/medicaid/benefits/behavioral-health-services
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=4
- https://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/medicaid-and-chip-resources
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources
- https://medicaid.gov/medicaid/long-term-services-supports/institutional-long-term-care
- https://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/functional-areas/quality-measurement
- https://medicaid.gov/medicaid/data-systems/medicaid-and-chip-business-information-solution/medicaid-chip-research-files
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=2
- https://medicaid.gov/medicaid/managed-care
- https://medicaid.gov/medicaid/benefits/hospice-benefits
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=24
- https://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing
- https://medicaid.gov/medicaid/financial-management/state-budget-expenditure-reporting-for-medicaid-and-chip/expenditure-reports-mbes/cbes
- https://medicaid.gov/state-overviews
- https://medicaid.gov/medicaid/quality-of-care/quality-of-care-performance-measurement/adult-medicaid-quality-grants
- https://medicaid.gov/medicaid/data-systems/health-information-exchange

…and more — 46 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://medicaid.gov/medicaid/home-community-based-services/home-and-community-based-services-hcbs-quality/testing-experience-functional-tools
- https://medicaid.gov/medicaid/indian-health-medicaid/tribal-affairs-guidance-resources
- https://medicaid.gov/about-us/organization/jennifer-kostesich

---

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

**Bug ID:** `VS-79097597`  
**Pattern ID:** `VS-0ba8ce9d`  
**URL:** https://medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/about  
**XPath / selector:** `tr:nth-child(1) > td[scope="row"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `scope-attr-valid` ([reference](https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 9 instances; 2 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (7 weeks)

### HTML snippet
```html
<td scope="row">Fact Sheet for Child and Adult Core Sets Reporting</td>
```

### Description
scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 2 of 6990 scanned pages (9 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/about.
2. Locate the element: tr:nth-child(1) > td[scope="row"]
3. Confirm the axe-core finding for rule scope-attr-valid.

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

### Affected pages
- https://medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/about
- https://medicaid.gov/state-overviews/scorecard/about

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

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

### Example pages
- https://medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/about
- https://medicaid.gov/state-overviews/scorecard/about

---

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

**Bug ID:** `VS-8d91b164`  
**Pattern ID:** `VS-4fac2f41`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=5&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-nvw5"] > .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:** 1341 instances; 629 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 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 629 of 6990 scanned pages (1341 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=5&q=.
2. Locate the element: span[data-select2-id="select2-data-1-nvw5"] > .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://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=5&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=39&q=
- https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=846&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=866&page=3&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=2&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8856&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=0&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=881&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=27&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=3&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=8&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=976&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=27&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=0&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=981&page=7&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=916&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=736&page=4&q=
- https://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=8786&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=831&page=26&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=9&q=
- https://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=8846&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8826&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=2&q=&sort=field_faq_date%3Adesc

…and more — 629 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://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=5&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=39&q=
- https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc

---

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

**Bug ID:** `VS-9fd0776a`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372  
**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:** 100387 instances; 3177 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3177 of 6990 scanned pages (100387 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372.
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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8354&page=6
- https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1859
- https://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/spa-and-1915-waiver-processing-statistics
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6490
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7446
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-18-015-16
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7390
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-045-45
- https://medicaid.gov/faq?fcf=41371&page=1&sl=yes
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=731&page=2&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B0%5D=8856&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=8696&limit=10&page=0&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1901&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2001&f%5B3%5D=sub_topic_faq_library_facet%3A2086&f%5B4%5D=sub_topic_faq_library_facet%3A2396&f%5B5%5D=sub_topic_faq_library_facet%3A2526&page=82
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-8-002-2
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-46-004-4
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002155
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6399
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010119
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=27&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A691&f%5B1%5D=topics%3A706&f%5B2%5D=topics%3A3156&page=1
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1965
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-341

…and more — 3177 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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8354&page=6
- https://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=8796&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc

---

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

**Bug ID:** `VS-03e11d2c`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372  
**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:** 2120 instances; 2120 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 2120 of 6990 scanned pages (2120 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372.
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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1859
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6490
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7446
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-18-015-16
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7390
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-045-45
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-8-002-2
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-46-004-4
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002155
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6399
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010119
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1965
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-341
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1016
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-45-004-4
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-2-016-18
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8407
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002018
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1077
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-055-55
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-60-002-2
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv009117

…and more — 2120 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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1859
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20

---

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

**Bug ID:** `VS-6204a9df`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372  
**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:** 2104 instances; 2104 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 2104 of 6990 scanned pages (2104 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372.
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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1859
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6490
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7446
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-18-015-16
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/rule-7390
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-045-45
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-8-002-2
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-46-004-4
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002155
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6399
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010119
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1965
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-341
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1016
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-45-004-4
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-2-016-18
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8407
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002018
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1077
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-055-55
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-60-002-2
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv009117

…and more — 2104 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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6372
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1859
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-23-020-20

---

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

**Bug ID:** `VS-5b1d8c51`  
**Pattern ID:** `VS-e05344b9`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116  
**XPath / selector:** `@aria-selected="true"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 3125 instances; 647 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 647 of 6990 scanned pages (3125 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116.
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://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002155
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010119
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002018
- https://medicaid.gov/state-overviews/state-profiles
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv009117
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx007266
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002023
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg013179
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004056
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002096
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/tpl006075
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg002025
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003192
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv008112
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip003265
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095368
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002110
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008298
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/elg-eligible/race-information
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008279
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx003142
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003194
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002016
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot002152

…and more — 647 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://medicaid.gov/tmsis/dataguide/v4/data-elements/elg007116
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002155
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010119

---

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

**Bug ID:** `VS-dbf9def1`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7194  
**XPath / selector:** `td`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 354 instances; 277 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

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

### Description
Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 277 of 6990 scanned pages (354 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7194.
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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7194
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-2-004-4
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8669
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-9-017-14
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1151
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003092
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002047
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr010117
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008298
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008279
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6551
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-790
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/tpl002019
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6129
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt003205
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1944
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003222
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004114
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008313
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg014189
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6314
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7109
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr003037
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003271
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt003265

…and more — 277 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://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7194
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-2-004-4
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8669

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-11a35008`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/spa-and-1915-waiver-processing-statistics  
**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:** 161 instances; 149 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 149 of 6990 scanned pages (161 instances).

### Steps to reproduce
1. Open https://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/spa-and-1915-waiver-processing-statistics.
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/resources-for-states/spa-and-1915-waiver-processing/spa-and-1915-waiver-processing-statistics
- https://medicaid.gov/state-overviews/state-profiles
- https://medicaid.gov/about-us/organization/todd-jones
- https://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/monthly-medicaid-chip-application-eligibility-determination-and-enrollment-reports-data
- https://medicaid.gov/medicaid/long-term-services-supports/institutional-long-term-care/inpatient-psychiatric-services-individuals-under-age-21
- https://medicaid.gov/resources-for-states/spa-and-1915-waiver-processing/chip-spa-processing-tools-for-states
- https://medicaid.gov/about-us/organization/jeremy-silanskis
- https://medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly
- https://medicaid.gov/medicaid/benefits/reentry-services-for-incarcerated-individuals/state-planning-grants-promote-continuity-of-care-for-medicaid-chip-beneficiaries-following-incarceration
- https://medicaid.gov/state-overviews/stateprofile.html?state=Maine
- https://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-technical-assistance-states
- https://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/billing-and-coding-guidance
- https://medicaid.gov/resources-for-states/mac-learning-collaboratives
- https://medicaid.gov/medicaid
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106686
- https://medicaid.gov/medicaid/benefits/behavioral-health-services
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/170756
- https://medicaid.gov/medicaid/long-term-services-supports/balancing-long-term-services-supports/balancing-incentive-program
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=4
- https://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/other-agency-guidance/survey-and-certification-guidance
- https://medicaid.gov/medicaid/long-term-services-supports/balancing-long-term-services-supports/homelessness-initiatives
- https://medicaid.gov/state-overviews/stateprofile.html?state=Connecticut
- https://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/medicaid-and-chip-resources
- https://medicaid.gov/state-overviews/stateprofile.html?state=New-Mexico
- https://medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights

…and more — 149 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/resources-for-states/spa-and-1915-waiver-processing/spa-and-1915-waiver-processing-statistics
- https://medicaid.gov/state-overviews/state-profiles
- https://medicaid.gov/about-us/organization/todd-jones

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-3851ccd1`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main  
**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:** 3 instances; 2 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 2 of 6990 scanned pages (3 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main.
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://medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main
- https://medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly/programs-of-all-inclusive-care-for-elderly-for-states

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

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

### Example pages
- https://medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main
- https://medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly/programs-of-all-inclusive-care-for-elderly-for-states

---

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

**Bug ID:** `VS-a2af3c1b`  
**Pattern ID:** `VS-e5ec42f0`  
**URL:** https://medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main  
**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:** 183 instances; 1 of 6990 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W35 (12 weeks)

### Description
Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 1 of 6990 scanned pages (183 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main.
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://medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main

### 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