# Accessibility bug reports — www.medicaid.gov, week 2026-W36

25 issue type(s) from 6575 pages scanned. Generated 2026-09-06 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-43a2ea5e`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=  
**XPath / selector:** `<textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">`  
**WCAG SC:** 2.5.8 — Target Size (Minimum) (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r113` ([reference](https://alfa.siteimprove.com/rules/sia-r113))  
**Severity:** Moderate  
**Frequency:** 460 instances; 219 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 219 of 6575 scanned pages (460 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=.
2. Locate the element: <textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">
3. Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

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

### Affected pages
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=44&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=36&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=8&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=826&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=49&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=3&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=2&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=0&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=24&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=16&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=19&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=7&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=8&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=901&page=8&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=3&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=1&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=2&q=

…and more — 219 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/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=44&q=

---

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

**Bug ID:** `VS-401188f6`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3  
**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:** 1085 instances; 1085 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 1085 of 6575 scanned pages (1085 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3.
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/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-7-001-1
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7809
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8653
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-1-017-21
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-453
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/prv001009
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-54-001_1-5
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-23-002-5
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7945
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7910
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003155
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-16-006-6
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/prv-2-003-3
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002180
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-16-001-1
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-79-031-31
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6493
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-26-001-1
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv005074
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-1-020-15
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002056
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-3-015-20

…and more — 1085 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/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-7-001-1

---

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

**Bug ID:** `VS-bef512a7`  
**Pattern ID:** `VS-9429bb8d`  
**URL:** https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002048  
**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:** 982 instances; 982 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 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 982 of 6575 scanned pages (982 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002048.
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/v3/data-elements/cip002048
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002161
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/tpl004055
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/prv001009
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002129
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/crx002060
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002043
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003155
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002023
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg010156
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002180
- https://medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-plan-population-enrolled
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv005074
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002056
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002207
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg003059
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/tpl005064
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095387
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002023
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002251
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip001012
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003089
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv003058
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip003243

…and more — 982 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/v3/data-elements/cip002048
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002161
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/tpl004055

---

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

**Bug ID:** `VS-962854eb`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=  
**XPath / selector:** `<ul class="select2-selection__rendered" id="select2-edit-field-topics-container">`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r68` ([reference](https://alfa.siteimprove.com/rules/sia-r68))  
**Severity:** Moderate  
**Frequency:** 748 instances; 726 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 726 of 6575 scanned pages (748 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=.
2. Locate the element: <ul class="select2-selection__rendered" id="select2-edit-field-topics-container">
3. Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/prv001009
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003155
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=44&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=36&q=
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002180
- https://medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-plan-population-enrolled
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv005074
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=8&q=
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002056
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=0&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095387
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=826&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002023
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip001012
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003089
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv003058
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=1&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx003145
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=49&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=3&q=
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/mcr001112
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=0&q=

…and more — 726 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/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=

---

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

**Bug ID:** `VS-5101458c`  
**Pattern ID:** `VS-1467ea8a`  
**URL:** https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002048  
**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:** 4781 instances; 982 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 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 982 of 6575 scanned pages (4781 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002048.
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/v3/data-elements/cip002048
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002161
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/tpl004055
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/prv001009
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002129
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/crx002060
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx002043
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003155
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002023
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg010156
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002180
- https://medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-plan-population-enrolled
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv005074
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002056
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002207
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg003059
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/tpl005064
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095387
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002023
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002251
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip001012
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003089
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv003058
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip003243

…and more — 982 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/v3/data-elements/cip002048
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002161
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/tpl004055

---

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

**Bug ID:** `VS-7d2f01ea`  
**Pattern ID:** `VS-0841abc2`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-n6jz"] > .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:** 853 instances; 410 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 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 410 of 6575 scanned pages (853 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=.
2. Locate the element: span[data-select2-id="select2-data-1-n6jz"] > .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=541&page=24&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=44&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=36&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=29&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=8&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=956&page=4&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=826&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=18&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=946&page=3&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=49&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=826&page=3&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=3&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=916&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=4&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=12&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=0&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=24&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=876&page=2&q=

…and more — 410 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=541&page=24&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=44&q=

---

## Form field has accessible name (WCAG 4.1.2)

**Bug ID:** `VS-15ee0ea6`  
**Pattern ID:** `VS-a48e6078`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=  
**XPath / selector:** `<span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false">`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** Siteimprove Alfa — `sia-r8` ([reference](https://alfa.siteimprove.com/rules/sia-r8))  
**Severity:** Moderate  
**Frequency:** 460 instances; 219 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 219 of 6575 scanned pages (460 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=.
2. Locate the element: <span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false">
3. Confirm the Siteimprove Alfa finding for rule sia-r8 against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=44&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=36&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=8&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=826&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=49&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=3&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=2&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=0&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=24&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=871&page=16&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=19&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=7&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=8&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=901&page=8&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=3&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=1&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=2&q=

…and more — 219 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/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=44&q=

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-390bb787`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3  
**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:** 73020 instances; 3128 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3128 of 6575 scanned pages (73020 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3.
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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2059
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1911&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2406&page=84
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-937
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-7-001-1
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7809
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8653
- 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=0
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1941&f%5B1%5D=sub_topic_faq_library_facet%3A1981&f%5B2%5D=sub_topic_faq_library_facet%3A2431&f%5B3%5D=sub_topic_faq_library_facet%3A2531&page=3
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A916&f%5B1%5D=state%3A966&f%5B2%5D=state%3A991&f%5B3%5D=topics%3A741&f%5B4%5D=topics%3A3156&page=1670
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?objectId=3231280&page=66
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-1-017-21
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8304
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7753
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6271
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-453
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-7-016-4
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/prv001009
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-54-001_1-5
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?n=1&page=1670&searchtype=1

…and more — 3128 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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176

---

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

**Bug ID:** `VS-01cb7654`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1911&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2406&page=84  
**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:** 1137 instances; 1137 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 1137 of 6575 scanned pages (1137 instances).

### Steps to reproduce
1. Open https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1911&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2406&page=84.
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/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1911&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2406&page=84
- 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=0
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1941&f%5B1%5D=sub_topic_faq_library_facet%3A1981&f%5B2%5D=sub_topic_faq_library_facet%3A2431&f%5B3%5D=sub_topic_faq_library_facet%3A2531&page=3
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A916&f%5B1%5D=state%3A966&f%5B2%5D=state%3A991&f%5B3%5D=topics%3A741&f%5B4%5D=topics%3A3156&page=1670
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?objectId=3231280&page=66
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?n=1&page=1670&searchtype=1
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A741&f%5B1%5D=topics%3A921&f%5B2%5D=topics%3A5196&page=1667
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?page=3&sl=yes&usid=AR
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A841&f%5B1%5D=state%3A846&f%5B2%5D=state%3A966&f%5B3%5D=topics%3A701&f%5B4%5D=topics%3A3186&f%5B5%5D=topics%3A3541&f%5B6%5D=topics%3A6481&f%5B7%5D=topics%3A7301&page=1668&task=face-presentation-attack-detection
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A681&f%5B1%5D=state%3A966&f%5B2%5D=state%3A986&f%5B3%5D=state%3A1026&f%5B4%5D=topics%3A701&f%5B5%5D=topics%3A1031&page=1665
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A906&f%5B10%5D=fpg_type_facet%3A1481&f%5B11%5D=fpg_type_facet%3A1506&f%5B12%5D=fpg_type_facet%3A8596&f%5B2%5D=fpg_topics_facet%3A936&f%5B3%5D=fpg_topics_facet%3A1011&f%5B4%5D=fpg_topics_facet%3A1016&f%5B5%5D=fpg_topics_facet%3A2696&f%5B6%5D=fpg_topics_facet%3A3046&f%5B7%5D=fpg_topics_facet%3A6481&f%5B8%5D=fpg_topics_facet%3A6486&f%5B9%5D=fpg_topics_facet%3A8411&page=5
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8379&page=2
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=44&q=
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1511&f%5B1%5D=fpg_topics_facet%3A3261&f%5B2%5D=fpg_type_facet%3A1486&page=107
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A766&f%5B1%5D=topics%3A3166&f%5B2%5D=topics%3A3186&f%5B3%5D=topics%3A8646&page=1666
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=36&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B10%5D=topics%3A721&f%5B11%5D=topics%3A741&f%5B12%5D=topics%3A1031&f%5B13%5D=topics%3A2726&f%5B14%5D=topics%3A8301&f%5B9%5D=topics%3A691&page=1666
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A846&f%5B1%5D=state%3A876&f%5B2%5D=state%3A991&f%5B3%5D=state%3A1001&f%5B4%5D=state%3A1026&page=1663
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=38522&f%5B0%5D=state_waiver_status_facet%3A1561&f%5B1%5D=waiver_state_facet%3A711&f%5B2%5D=waiver_state_facet%3A736&f%5B3%5D=waiver_state_facet%3A881&f%5B4%5D=waiver_state_facet%3A926&f%5B5%5D=waiver_state_facet%3A981&page=68
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=8&q=
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A771&f%5B2%5D=fpg_topics_facet%3A1021&f%5B3%5D=fpg_topics_facet%3A1491&f%5B4%5D=fpg_topics_facet%3A1531&page=111
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=20579&f%5B0%5D=waiver_authority_facet%3A1596&f%5B1%5D=waiver_state_facet%3A726&page=4
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A856&f%5B2%5D=fpg_topics_facet%3A1531&f%5B3%5D=fpg_topics_facet%3A8601&f%5B4%5D=fpg_topics_facet%3A8611&f%5B5%5D=fpg_topics_facet%3A8891&page=107

…and more — 1137 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/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1911&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2406&page=84
- 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=0
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1941&f%5B1%5D=sub_topic_faq_library_facet%3A1981&f%5B2%5D=sub_topic_faq_library_facet%3A2431&f%5B3%5D=sub_topic_faq_library_facet%3A2531&page=3

---

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

**Bug ID:** `VS-7cb7b057`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://medicaid.gov/medicaid/eligibility-policy/seniors-medicare-and-medicaid-enrollees  
**XPath / selector:** `<p>`  
**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:** 12 instances; 2 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 2 of 6575 scanned pages (12 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/eligibility-policy/seniors-medicare-and-medicaid-enrollees.
2. Locate the element: <p>
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/medicaid/eligibility-policy/seniors-medicare-and-medicaid-enrollees
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=23

### 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/medicaid/eligibility-policy/seniors-medicare-and-medicaid-enrollees
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=23

---

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

**Bug ID:** `VS-f1ff850d`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3  
**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:** 45716 instances; 3128 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3128 of 6575 scanned pages (45716 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3.
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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2059
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1911&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2406&page=84
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-937
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-7-001-1
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7809
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8653
- 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=0
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1941&f%5B1%5D=sub_topic_faq_library_facet%3A1981&f%5B2%5D=sub_topic_faq_library_facet%3A2431&f%5B3%5D=sub_topic_faq_library_facet%3A2531&page=3
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A916&f%5B1%5D=state%3A966&f%5B2%5D=state%3A991&f%5B3%5D=topics%3A741&f%5B4%5D=topics%3A3156&page=1670
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?objectId=3231280&page=66
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-1-017-21
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8304
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7753
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6271
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-453
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-7-016-4
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/prv001009
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-54-001_1-5
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?n=1&page=1670&searchtype=1

…and more — 3128 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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176

---

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

**Bug ID:** `VS-e48684cb`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3  
**XPath / selector:** `.small`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 18114 instances; 4003 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 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 4003 of 6575 scanned pages (18114 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3.
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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002048
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7802
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002161
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2059
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1964
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-879
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-937
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-335
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-7-001-1
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7809
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/tpl004055
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8653
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-5-001-1
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7897
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7202
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9207
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1603
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1056
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-011-11
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-1-017-21
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1818

…and more — 4003 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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002048
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7802

---

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

**Bug ID:** `VS-9a2288d6`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3  
**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:** 3991 instances; 3991 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 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 3991 of 6575 scanned pages (3991 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3.
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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002048
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7802
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002161
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2059
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1964
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-879
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-937
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-335
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-7-001-1
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7809
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/tpl004055
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8653
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-5-001-1
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7897
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7202
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9207
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1603
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1056
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-011-11
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-1-017-21
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1818

…and more — 3991 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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002048
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7802

---

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

**Bug ID:** `VS-5b8e2220`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3  
**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:** 3982 instances; 3982 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 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 3982 of 6575 scanned pages (3982 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3.
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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002048
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7802
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002161
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2059
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1964
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-879
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-937
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-335
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-7-001-1
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7809
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/tpl004055
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8653
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-5-001-1
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7897
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7202
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9207
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1603
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1056
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-2-011-11
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-1-017-21
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1818

…and more — 3982 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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002048
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7802

---

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

**Bug ID:** `VS-73fb0bc5`  
**Pattern ID:** `VS-d25f622d`  
**URL:** https://medicaid.gov/chip/chip-eligibility-enrollment/substitution-strategies  
**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:** 85 instances; 81 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 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 81 of 6575 scanned pages (85 instances).

### Steps to reproduce
1. Open https://medicaid.gov/chip/chip-eligibility-enrollment/substitution-strategies.
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/chip/chip-eligibility-enrollment/substitution-strategies
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/53995
- https://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center/health-homes-guidance
- https://medicaid.gov/medicaid/data-systems/medicaid-information-technology-architecture/medicaid-information-technology-architecture-framework
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/functional-areas/value-based-payment/childrens-oral-health-initiative-value-based-payment
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54032
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/improving-care-for-medicaid-beneficiaries-complex-care-needs-and-high-costs
- https://medicaid.gov/medicaid/benefits/hospice-benefits/hospice-payments/optional-percentage-point-reduction-for-lack-of-quality-reporting
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/192756
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54029
- https://medicaid.gov/state-overviews/stateprofile.html?state=Florida
- https://medicaid.gov/state-overviews/stateprofile.html?state=Pennsylvania
- https://medicaid.gov/medicaid/data-systems/health-information-exchange/section-1115-demonstration-hie-policy
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/52464
- https://medicaid.gov/medicaid/data-systems/health-information-exchange/fee-for-service-hie-policy
- https://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center/request-health-homes-technical-assistance
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/52303
- https://medicaid.gov/new-notable?page=2
- https://medicaid.gov/state-overviews/stateprofile.html?state=Nevada
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54039
- https://medicaid.gov/medicaid/long-term-services-supports/program-of-all-inclusive-care-for-elderly/programs-of-all-inclusive-care-for-elderly-benefits
- https://medicaid.gov/medicaid/benefits/alternative-benefit-plan-coverage/designing-alternative-benefit-plan
- https://medicaid.gov/medicaid/long-term-services-supports/institutional-long-term-care/nursing-facilities
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/50072
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/52305

…and more — 81 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/chip/chip-eligibility-enrollment/substitution-strategies
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/53995
- https://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center/health-homes-guidance

---

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

**Bug ID:** `VS-7c39545e`  
**Pattern ID:** `VS-8806389c`  
**URL:** https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=22  
**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:** 4 instances; 4 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 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 4 of 6575 scanned pages (4 instances).

### Steps to reproduce
1. Open https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=22.
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/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=22
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=23
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=25
- https://medicaid.gov/medicaid/data-systems/medicaid-and-chip-business-information-solution/macbis-financial/medicaid-budget-and-expenditure-system-mbes/cms-21-annual-chip-expenditures-reports

### 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/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=22
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=23
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=25

---

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

**Bug ID:** `VS-4cb1456d`  
**Pattern ID:** `VS-0ba8ce9d`  
**URL:** https://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels  
**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:** 51 instances; 1 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (8 weeks)

### HTML snippet
```html
<td scope="row">Alabama</td>
```

### Description
scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 1 of 6575 scanned pages (51 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels.
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/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels

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

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

---

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

**Bug ID:** `VS-440792ad`  
**Pattern ID:** `VS-4fac2f41`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-n6jz"] > .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:** 853 instances; 410 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 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 410 of 6575 scanned pages (853 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=.
2. Locate the element: span[data-select2-id="select2-data-1-n6jz"] > .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=541&page=24&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=44&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=766&page=36&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=29&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=8&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=956&page=4&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=966&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=826&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=18&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=946&page=3&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=49&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=826&page=3&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=3&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=916&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=0&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=4&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=2&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=896&page=12&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=0&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=24&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=876&page=2&q=

…and more — 410 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=541&page=24&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=44&q=

---

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

**Bug ID:** `VS-73594e13`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3  
**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:** 88026 instances; 3128 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3128 of 6575 scanned pages (88026 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3.
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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2059
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A1911&f%5B2%5D=sub_topic_faq_library_facet%3A2006&f%5B3%5D=sub_topic_faq_library_facet%3A2406&page=84
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-937
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-7-001-1
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7809
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8653
- 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=0
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1941&f%5B1%5D=sub_topic_faq_library_facet%3A1981&f%5B2%5D=sub_topic_faq_library_facet%3A2431&f%5B3%5D=sub_topic_faq_library_facet%3A2531&page=3
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=24&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A916&f%5B1%5D=state%3A966&f%5B2%5D=state%3A991&f%5B3%5D=topics%3A741&f%5B4%5D=topics%3A3156&page=1670
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?objectId=3231280&page=66
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-1-017-21
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8304
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=1&q=
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7753
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6271
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-453
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-7-016-4
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/prv001009
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-54-001_1-5
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?n=1&page=1670&searchtype=1

…and more — 3128 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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176

---

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

**Bug ID:** `VS-90fc489f`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3  
**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:** 1991 instances; 1991 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 1991 of 6575 scanned pages (1991 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3.
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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2059
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-937
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-7-001-1
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7809
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8653
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-1-017-21
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8304
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7753
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6271
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-453
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-7-016-4
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/prv001009
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-54-001_1-5
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-23-002-5
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1505
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8417
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7945
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7910
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003155
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-16-006-6
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6497

…and more — 1991 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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176

---

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

**Bug ID:** `VS-0497743f`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3  
**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:** 1978 instances; 1978 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 1978 of 6575 scanned pages (1978 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-19-007-3.
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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2059
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-937
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-7-001-1
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7809
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8653
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-1-017-21
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8304
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7753
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6271
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-453
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-7-016-4
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/prv001009
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-54-001_1-5
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-23-002-5
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1505
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8417
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7945
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7910
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003155
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-16-006-6
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6497

…and more — 1978 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/data-quality-measures/mcr-19-007-3
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-3176

---

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

**Bug ID:** `VS-cb186810`  
**Pattern ID:** `VS-e05344b9`  
**URL:** https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128  
**XPath / selector:** `@aria-selected="true"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 2465 instances; 508 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 508 of 6575 scanned pages (2465 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg008128.
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/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/prv001009
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003155
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002180
- https://medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/mcr-managed-care-plan-information/managed-care-plan-population-enrolled
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv005074
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002056
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095387
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002023
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip001012
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003089
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv003058
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx003145
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/mcr001112
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002072
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg018236
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006198
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cot002027
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg001001
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg014190
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/crx001003
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cot002018
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg004077
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005183
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx003185

…and more — 508 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/v3/data-elements/elg008128
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/prv001009
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003155

---

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

**Bug ID:** `VS-e4cace34`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591  
**XPath / selector:** `td`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 348 instances; 269 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 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 269 of 6575 scanned pages (348 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6591.
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/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/tpl004055
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1272
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6734
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8318
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1931
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002251
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2889
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip003241
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2536
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2097
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt001011
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-914
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2444
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2595
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1613
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7424
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cot002018
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg004077
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1503
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/prv-1-009-8
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cot002017
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-42-001-1
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6953
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6318

…and more — 269 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/v3/validation-rules/rule-6591
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/tpl004055
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1272

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-e7004ee0`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center/health-homes-guidance  
**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:** 43 instances; 42 of 6575 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W36 (13 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 42 of 6575 scanned pages (43 instances).

### Steps to reproduce
1. Open https://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center/health-homes-guidance.
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/medicaid-state-technical-assistance/health-home-information-resource-center/health-homes-guidance
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54032
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/improving-care-for-medicaid-beneficiaries-complex-care-needs-and-high-costs
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54029
- https://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center/request-health-homes-technical-assistance
- https://medicaid.gov/state-overviews/stateprofile.html?state=Nevada
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/50072
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/52305
- https://medicaid.gov/medicaid/home-community-based-services/statewide-transition-plans
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/173631
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54047
- https://medicaid.gov/medicaid/data-systems/medicaid-and-chip-business-information-solution/macbis-financial/medicaid-budget-and-expenditure-system-mbes/cms-37-medicaid-program-budget-report
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106616
- https://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54034
- https://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/strengthening-and-investing-home-and-community-based-services-for-medicaid-beneficiaries-american-rescue-plan-act-of-2021-section-9817
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/50202
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/192761
- https://medicaid.gov/medicaid/long-term-services-supports/direct-care-workforce/dsw-core-competency-project
- https://medicaid.gov/medicaid/eligibility-policy/seniors-medicare-and-medicaid-enrollees
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54048
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/49454
- https://medicaid.gov/state-overviews/stateprofile.html?state=Nebraska
- https://medicaid.gov/medicaid/prescription-drugs/medicaid-drug-policy-laws-regulations-and-federal-register-notices
- https://medicaid.gov/state-overviews/stateprofile.html?state=Washington

…and more — 42 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/medicaid-state-technical-assistance/health-home-information-resource-center/health-homes-guidance
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54032
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/improving-care-for-medicaid-beneficiaries-complex-care-needs-and-high-costs

---

## No obsolete or deprecated elements are used (WCAG criterion undetermined)

**Bug ID:** `VS-87df96e7`  
**Pattern ID:** `VS-3d033717`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=6&q=  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r70` ([reference](https://alfa.siteimprove.com/rules/sia-r70))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 6575 pages affected
  
**History:** first seen 2026-W36, last seen 2026-W36 (1 week)

### Description
No obsolete or deprecated elements are used. Detected by Siteimprove Alfa rule sia-r70 on 1 of 6575 scanned pages (1 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=756&page=6&q=.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r70.

### 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=756&page=6&q=

### 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-r70