# Accessibility bug reports — www.medicaid.gov, week 2026-W37

31 issue type(s) from 7188 pages scanned. Generated 2026-09-13 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-7dcc9ed6`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&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:** 261 instances; 125 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 125 of 7188 scanned pages (261 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&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=716&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=2&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=1&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=1&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=871&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=6&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=541&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=25&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=24&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=31&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=30&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=2271&limit=10&page=5&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=826&page=27&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=0&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=10&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=77&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=25&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=866&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=25&q=

…and more — 125 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=716&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=2&q=

---

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

**Bug ID:** `VS-86f59ad2`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614  
**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:** 471 instances; 471 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 471 of 7188 scanned pages (471 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614.
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/rule-2614
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2402
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-s-014-19
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-27-022-22
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-79-031-31
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-341
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095377
- https://medicaid.gov/
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt002119
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003089
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002096
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-25-009-9
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt001001
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-022-13
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002163
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/all-31-001-1
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-9-002-2
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8798
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002029
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002239
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002099
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot002140

…and more — 471 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/rule-2614
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179

---

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

**Bug ID:** `VS-6730a1cb`  
**Pattern ID:** `VS-9429bb8d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042  
**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:** 425 instances; 425 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 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 425 of 7188 scanned pages (425 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042.
2. Locate the element: .nav
3. Confirm the axe-core finding for rule aria-required-children against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003037
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002162
- https://medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/cot-claim-other/claim-line-record-ot
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005169
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002175
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095377
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt002119
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003089
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002096
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg001011
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt001001
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr001004
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg009144
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002034
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt002051
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip001006
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002163
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004122
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002108
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip001007
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002029
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002239
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095357

…and more — 425 pages total ([download CSV](csv/axe-core__aria-required-children.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003037

---

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

**Bug ID:** `VS-d9475295`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&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:** 352 instances; 341 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 341 of 7188 scanned pages (352 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&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=716&page=6&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=2&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=8&q=
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095377
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt002119
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=1&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=1&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003089
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002096
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=871&q=
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt001001
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=6&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002163
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=541&q=
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002108
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002029
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002239
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=25&q=
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002099
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=24&q=

…and more — 341 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=716&page=6&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179

---

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

**Bug ID:** `VS-2bc88e63`  
**Pattern ID:** `VS-4408605e`  
**URL:** https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra  
**XPath / selector:** `<th>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r46` ([reference](https://alfa.siteimprove.com/rules/sia-r46))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (8 weeks)

### Description
Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 1 of 7188 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra.
2. Locate the element: <th>
3. Confirm the Siteimprove Alfa finding for rule sia-r46 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra

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

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

---

## Table cell has header (WCAG 1.3.1)

**Bug ID:** `VS-fe2e536a`  
**Pattern ID:** `VS-3f067795`  
**URL:** https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra  
**XPath / selector:** `<td>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r77` ([reference](https://alfa.siteimprove.com/rules/sia-r77))  
**Severity:** Moderate  
**Frequency:** 2 instances; 1 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (4 weeks)

### Description
Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 1 of 7188 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra.
2. Locate the element: <td>
3. Confirm the Siteimprove Alfa finding for rule sia-r77 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra

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

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

---

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

**Bug ID:** `VS-f8c0b898`  
**Pattern ID:** `VS-1467ea8a`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042  
**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:** 2071 instances; 425 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 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 425 of 7188 scanned pages (2071 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042.
2. Locate the element: a[href$="#overview"]
3. Confirm the axe-core finding for rule aria-allowed-attr against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003037
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002162
- https://medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/cot-claim-other/claim-line-record-ot
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005169
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002175
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095377
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt002119
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003089
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002096
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/elg001011
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt001001
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr001004
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/elg009144
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002034
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt002051
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip001006
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002163
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx004122
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002108
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip001007
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002029
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002239
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095357

…and more — 425 pages total ([download CSV](csv/axe-core__aria-allowed-attr.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003037

---

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

**Bug ID:** `VS-ede6cc86`  
**Pattern ID:** `VS-0841abc2`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-em6g"] > .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:** 476 instances; 229 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 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 229 of 7188 scanned pages (476 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=.
2. Locate the element: span[data-select2-id="select2-data-1-em6g"] > .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=716&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=2&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=1&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=79&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=3&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=8&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=1&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=1&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=871&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=5&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=6&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=541&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=49&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=25&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=24&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=31&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=30&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=891&page=22&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=29&q=

…and more — 229 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=716&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=6&q=

---

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

**Bug ID:** `VS-8ab22672`  
**Pattern ID:** `VS-ebb1c464`  
**URL:** https://medicaid.gov/  
**XPath / selector:** `time[datetime="2026-09-11"]`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-prohibited-attr` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-prohibited-attr?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 7 instances; 2 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (13 weeks)

### HTML snippet
```html
<time class="nn-card__date flex-shrink-0 text-center margin-right-2 border" datetime="2026-09-11" aria-label="Sep 11">
```

### Description
Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 2 of 7188 scanned pages (7 instances).

### Steps to reproduce
1. Open https://medicaid.gov/.
2. Locate the element: time[datetime="2026-09-11"]
3. Confirm the axe-core finding for rule aria-prohibited-attr against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- https://medicaid.gov/
- https://medicaid.gov/eligibility

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

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

### Example pages
- https://medicaid.gov/
- https://medicaid.gov/eligibility

---

## Form field has accessible name (WCAG 4.1.2)

**Bug ID:** `VS-9df48fd9`  
**Pattern ID:** `VS-a48e6078`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&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:** 261 instances; 125 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 125 of 7188 scanned pages (261 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&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=716&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=2&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=8&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=1&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=1&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=871&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=6&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=541&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=25&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=24&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=31&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=30&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=2271&limit=10&page=5&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=826&page=27&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=0&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=10&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=77&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=25&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=866&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=25&q=

…and more — 125 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=716&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=2&q=

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-82b63c70`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107  
**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:** 132252 instances; 3430 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3430 of 7188 scanned pages (132252 instances).

### Steps to reproduce
1. Open https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107.
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/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A811&f%5B1%5D=state%3A901&f%5B2%5D=state%3A971&f%5B3%5D=state%3A1006&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2346&f%5B1%5D=sub_topic_faq_library_facet%3A2376&page=84
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A731&f%5B1%5D=state%3A796&f%5B2%5D=state%3A861&f%5B3%5D=state%3A991&page=0
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A751&f%5B2%5D=fpg_topics_facet%3A906&f%5B3%5D=fpg_topics_facet%3A2826&f%5B4%5D=fpg_topics_facet%3A6486&f%5B5%5D=fpg_topics_facet%3A8591&page=109
- http://medicaid.gov/faq?entry=47167&page=0
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A906&f%5B1%5D=fpg_topics_facet%3A6171&f%5B2%5D=fpg_topics_facet%3A8701&f%5B3%5D=fpg_topics_facet%3A8901&page=108
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1526&f%5B3%5D=fpg_topics_facet%3A8901&page=6
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2026&f%5B1%5D=sub_topic_faq_library_facet%3A2091&f%5B2%5D=topic_faq_library_facet%3A2181&f%5B3%5D=topic_faq_library_facet%3A2236&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?page=1672&task=content-based-image-retrieval
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1496&f%5B3%5D=fpg_topics_facet%3A8861&page=4
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A1011&f%5B10%5D=fpg_topics_facet%3A3261&f%5B11%5D=fpg_topics_facet%3A6481&f%5B12%5D=fpg_topics_facet%3A6486&f%5B13%5D=fpg_topics_facet%3A8406&f%5B14%5D=fpg_topics_facet%3A8611&f%5B15%5D=fpg_topics_facet%3A8711&f%5B2%5D=fpg_topics_facet%3A1021&f%5B3%5D=fpg_topics_facet%3A1491&f%5B4%5D=fpg_topics_facet%3A1496&f%5B5%5D=fpg_topics_facet%3A1501&f%5B6%5D=fpg_topics_facet%3A1511&f%5B7%5D=fpg_topics_facet%3A1521&f%5B8%5D=fpg_topics_facet%3A1531&f%5B9%5D=fpg_topics_facet%3A2696&page=2
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2402
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1501&f%5B1%5D=fpg_topics_facet%3A2826&page=110
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A876&f%5B2%5D=state%3A891&f%5B3%5D=state%3A986&f%5B4%5D=topics%3A2826&page=2
- https://www.medicaid.gov/faq?fcf=41307&page=84&sl=yes
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A2696&f%5B2%5D=fpg_topics_facet%3A6171&f%5B3%5D=fpg_topics_facet%3A8891&page=111
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A1891&page=84&sl=yes
- https://www.medicaid.gov/medicaid/managed-care/guidance/state-directed-payments/approved-state-directed-payment-preprints?page=115
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=2&q=

…and more — 3430 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/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A811&f%5B1%5D=state%3A901&f%5B2%5D=state%3A971&f%5B3%5D=state%3A1006&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2346&f%5B1%5D=sub_topic_faq_library_facet%3A2376&page=84

---

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

**Bug ID:** `VS-42fe57fb`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107  
**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:** 3694 instances; 2552 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 2552 of 7188 scanned pages (3694 instances).

### Steps to reproduce
1. Open https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107.
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/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A811&f%5B1%5D=state%3A901&f%5B2%5D=state%3A971&f%5B3%5D=state%3A1006&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2346&f%5B1%5D=sub_topic_faq_library_facet%3A2376&page=84
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A731&f%5B1%5D=state%3A796&f%5B2%5D=state%3A861&f%5B3%5D=state%3A991&page=0
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A751&f%5B2%5D=fpg_topics_facet%3A906&f%5B3%5D=fpg_topics_facet%3A2826&f%5B4%5D=fpg_topics_facet%3A6486&f%5B5%5D=fpg_topics_facet%3A8591&page=109
- http://medicaid.gov/faq?entry=47167&page=0
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A906&f%5B1%5D=fpg_topics_facet%3A6171&f%5B2%5D=fpg_topics_facet%3A8701&f%5B3%5D=fpg_topics_facet%3A8901&page=108
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1526&f%5B3%5D=fpg_topics_facet%3A8901&page=6
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2026&f%5B1%5D=sub_topic_faq_library_facet%3A2091&f%5B2%5D=topic_faq_library_facet%3A2181&f%5B3%5D=topic_faq_library_facet%3A2236&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?page=1672&task=content-based-image-retrieval
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1496&f%5B3%5D=fpg_topics_facet%3A8861&page=4
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A1011&f%5B10%5D=fpg_topics_facet%3A3261&f%5B11%5D=fpg_topics_facet%3A6481&f%5B12%5D=fpg_topics_facet%3A6486&f%5B13%5D=fpg_topics_facet%3A8406&f%5B14%5D=fpg_topics_facet%3A8611&f%5B15%5D=fpg_topics_facet%3A8711&f%5B2%5D=fpg_topics_facet%3A1021&f%5B3%5D=fpg_topics_facet%3A1491&f%5B4%5D=fpg_topics_facet%3A1496&f%5B5%5D=fpg_topics_facet%3A1501&f%5B6%5D=fpg_topics_facet%3A1511&f%5B7%5D=fpg_topics_facet%3A1521&f%5B8%5D=fpg_topics_facet%3A1531&f%5B9%5D=fpg_topics_facet%3A2696&page=2
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1501&f%5B1%5D=fpg_topics_facet%3A2826&page=110
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A876&f%5B2%5D=state%3A891&f%5B3%5D=state%3A986&f%5B4%5D=topics%3A2826&page=2
- https://www.medicaid.gov/faq?fcf=41307&page=84&sl=yes
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A2696&f%5B2%5D=fpg_topics_facet%3A6171&f%5B3%5D=fpg_topics_facet%3A8891&page=111
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A1891&page=84&sl=yes
- https://www.medicaid.gov/medicaid/managed-care/guidance/state-directed-payments/approved-state-directed-payment-preprints?page=115
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=2&q=
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1906&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2446&f%5B3%5D=sub_topic_faq_library_facet%3A2456&page=5
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A701&f%5B1%5D=topics%3A921&f%5B2%5D=topics%3A3631&f%5B3%5D=topics%3A5446&f%5B4%5D=topics%3A7401&f%5B5%5D=topics%3A8461&f%5B6%5D=topics%3A8516&f%5B7%5D=topics%3A8706&page=6&task=content-based-image-retrieval
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A716&f%5B1%5D=state%3A781&f%5B10%5D=topics%3A936&f%5B11%5D=topics%3A1011&f%5B12%5D=topics%3A2826&f%5B13%5D=topics%3A3046&f%5B14%5D=topics%3A3271&f%5B15%5D=topics%3A6476&f%5B16%5D=topics%3A7296&f%5B17%5D=topics%3A7311&f%5B18%5D=topics%3A8491&f%5B19%5D=topics%3A8496&f%5B2%5D=state%3A841&f%5B3%5D=state%3A881&f%5B4%5D=state%3A891&f%5B5%5D=state%3A931&f%5B6%5D=state%3A941&f%5B7%5D=state%3A1006&f%5B8%5D=state%3A8296&f%5B9%5D=topics%3A701&page=1672
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1496&f%5B2%5D=fpg_topics_facet%3A1501&page=110

…and more — 2552 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/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A811&f%5B1%5D=state%3A901&f%5B2%5D=state%3A971&f%5B3%5D=state%3A1006&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2346&f%5B1%5D=sub_topic_faq_library_facet%3A2376&page=84

---

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

**Bug ID:** `VS-60854c80`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://www.medicaid.gov/state-overviews/scorecard/main  
**XPath / selector:** `<p class="welcome-text ng-star-inserted">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r74` ([reference](https://alfa.siteimprove.com/rules/sia-r74))  
**Severity:** Moderate  
**Frequency:** 75 instances; 11 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 11 of 7188 scanned pages (75 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/state-overviews/scorecard/main.
2. Locate the element: <p class="welcome-text ng-star-inserted">
3. Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- https://www.medicaid.gov/state-overviews/scorecard/main
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=25
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=20
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=23
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=21
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=21
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=4
- http://medicaid.gov/state-overviews/scorecard/main
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=1
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=18

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

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

### Example pages
- https://www.medicaid.gov/state-overviews/scorecard/main
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=25
- https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard

---

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

**Bug ID:** `VS-b83a5dfe`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107  
**XPath / selector:** `<button class="usa-button" type="submit">`  
**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:** 79347 instances; 3430 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3430 of 7188 scanned pages (79347 instances).

### Steps to reproduce
1. Open https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107.
2. Locate the element: <button class="usa-button" type="submit">
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/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A811&f%5B1%5D=state%3A901&f%5B2%5D=state%3A971&f%5B3%5D=state%3A1006&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2346&f%5B1%5D=sub_topic_faq_library_facet%3A2376&page=84
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A731&f%5B1%5D=state%3A796&f%5B2%5D=state%3A861&f%5B3%5D=state%3A991&page=0
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A751&f%5B2%5D=fpg_topics_facet%3A906&f%5B3%5D=fpg_topics_facet%3A2826&f%5B4%5D=fpg_topics_facet%3A6486&f%5B5%5D=fpg_topics_facet%3A8591&page=109
- http://medicaid.gov/faq?entry=47167&page=0
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A906&f%5B1%5D=fpg_topics_facet%3A6171&f%5B2%5D=fpg_topics_facet%3A8701&f%5B3%5D=fpg_topics_facet%3A8901&page=108
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1526&f%5B3%5D=fpg_topics_facet%3A8901&page=6
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2026&f%5B1%5D=sub_topic_faq_library_facet%3A2091&f%5B2%5D=topic_faq_library_facet%3A2181&f%5B3%5D=topic_faq_library_facet%3A2236&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?page=1672&task=content-based-image-retrieval
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1496&f%5B3%5D=fpg_topics_facet%3A8861&page=4
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A1011&f%5B10%5D=fpg_topics_facet%3A3261&f%5B11%5D=fpg_topics_facet%3A6481&f%5B12%5D=fpg_topics_facet%3A6486&f%5B13%5D=fpg_topics_facet%3A8406&f%5B14%5D=fpg_topics_facet%3A8611&f%5B15%5D=fpg_topics_facet%3A8711&f%5B2%5D=fpg_topics_facet%3A1021&f%5B3%5D=fpg_topics_facet%3A1491&f%5B4%5D=fpg_topics_facet%3A1496&f%5B5%5D=fpg_topics_facet%3A1501&f%5B6%5D=fpg_topics_facet%3A1511&f%5B7%5D=fpg_topics_facet%3A1521&f%5B8%5D=fpg_topics_facet%3A1531&f%5B9%5D=fpg_topics_facet%3A2696&page=2
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2402
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1501&f%5B1%5D=fpg_topics_facet%3A2826&page=110
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A876&f%5B2%5D=state%3A891&f%5B3%5D=state%3A986&f%5B4%5D=topics%3A2826&page=2
- https://www.medicaid.gov/faq?fcf=41307&page=84&sl=yes
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A2696&f%5B2%5D=fpg_topics_facet%3A6171&f%5B3%5D=fpg_topics_facet%3A8891&page=111
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A1891&page=84&sl=yes
- https://www.medicaid.gov/medicaid/managed-care/guidance/state-directed-payments/approved-state-directed-payment-preprints?page=115
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=2&q=

…and more — 3430 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/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A811&f%5B1%5D=state%3A901&f%5B2%5D=state%3A971&f%5B3%5D=state%3A1006&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2346&f%5B1%5D=sub_topic_faq_library_facet%3A2376&page=84

---

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

**Bug ID:** `VS-4f56b347`  
**Pattern ID:** `VS-33841929`  
**URL:** http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing  
**XPath / selector:** `select[aria-labelledby="filter-th-87386-0"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `label-title-only` ([reference](https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 38 instances; 2 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (13 weeks)

### HTML snippet
```html
<select aria-labelledby="filter-th-87386-0" class="usa-select height-1" data-col-index="0" title="Filter by Type">
          <option value="">All</option>
        <option value="Federal Upper Limit">F
```

### Description
Form elements should have a visible label. Detected by axe-core rule label-title-only on 2 of 7188 scanned pages (38 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing.
2. Locate the element: select[aria-labelledby="filter-th-87386-0"]
3. Confirm the axe-core finding for rule label-title-only.

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

### Affected pages
- http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing

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

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

### Example pages
- http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing

---

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

**Bug ID:** `VS-2b779ee1`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-one-main` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1732 instances; 1732 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 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 1732 of 7188 scanned pages (1732 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17.
2. Locate the element: html
3. Confirm the axe-core finding for rule landmark-one-main.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1767
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003037
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-2-002-5
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7626
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2402
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7897
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002162
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2635
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9021
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-s-014-19
- https://www.medicaid.gov/tmsis/dataguide/v3/appendices
- https://medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/cot-claim-other/claim-line-record-ot
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6875
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6552
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7549
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7529
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6122
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-27-022-22
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1077
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-2-004-4

…and more — 1732 pages total ([download CSV](csv/axe-core__landmark-one-main.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1767

---

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

**Bug ID:** `VS-fd372289`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17  
**XPath / selector:** `.small`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 7825 instances; 1732 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 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 1732 of 7188 scanned pages (7825 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17.
2. Locate the element: .small
3. Confirm the axe-core finding for rule region.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1767
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003037
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-2-002-5
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7626
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2402
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7897
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002162
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2635
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9021
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-s-014-19
- https://www.medicaid.gov/tmsis/dataguide/v3/appendices
- https://medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/cot-claim-other/claim-line-record-ot
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6875
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6552
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7549
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7529
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6122
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-27-022-22
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1077
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-2-004-4

…and more — 1732 pages total ([download CSV](csv/axe-core__region.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1767

---

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

**Bug ID:** `VS-60f983d5`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `page-has-heading-one` ([reference](https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1731 instances; 1731 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 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 1731 of 7188 scanned pages (1731 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17.
2. Locate the element: html
3. Confirm the axe-core finding for rule page-has-heading-one.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1767
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003037
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/tpl-2-002-5
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7626
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2402
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7897
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002162
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2635
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-9021
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-s-014-19
- https://medicaid.gov/tmsis/dataguide/v3/file-segment-layouts/cot-claim-other/claim-line-record-ot
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6875
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6552
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7549
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7529
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6122
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-27-022-22
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1077
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-2-004-4
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8128

…and more — 1731 pages total ([download CSV](csv/axe-core__page-has-heading-one.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1767

---

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

**Bug ID:** `VS-438614cb`  
**Pattern ID:** `VS-d25f622d`  
**URL:** https://medicaid.gov/  
**XPath / selector:** `#nn-title-192301`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 175 instances; 170 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<h4 id="nn-title-192301" class="margin-top-0 margin-bottom-2 nn-card__title">
```

### Description
Heading levels should only increase by one. Detected by axe-core rule heading-order on 170 of 7188 scanned pages (175 instances).

### Steps to reproduce
1. Open https://medicaid.gov/.
2. Locate the element: #nn-title-192301
3. Confirm the axe-core finding for rule heading-order.

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

### Affected pages
- https://medicaid.gov/
- http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/177991
- https://www.medicaid.gov/medicaid/program-integrity/affordable-care-act-program-integrity-provisions
- https://medicaid.gov/medicaid/benefits/reentry-services-for-incarcerated-individuals/state-planning-grants-promote-continuity-of-care-for-medicaid-chip-beneficiaries-following-incarceration
- https://medicaid.gov/medicaid/managed-care/profiles-program-features
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54038
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/medicaid-and-chip-resources/other-resources
- https://www.medicaid.gov/state-overviews/puerto-rico.html
- https://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification/good-faith-effort-exemption-requests-home-health-care-services
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/50072
- http://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/monthly-medicaid-chip-application-eligibility-determination-and-enrollment-reports-data
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/98321
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/53995
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality/resources
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/97716
- https://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54052
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/state-option-to-delay-procedural-disenrollments
- https://medicaid.gov/state-overviews/stateprofile.html?state=Florida
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/49452
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54065
- https://medicaid.gov/medicaid/eligibility-policy/spousal-impoverishment
- https://medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/methodology-about-medicaid-chip-enrollment-report
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/53858

…and more — 170 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/
- http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/177991

---

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

**Bug ID:** `VS-f7da2489`  
**Pattern ID:** `VS-8806389c`  
**URL:** https://medicaid.gov/  
**XPath / selector:** `.landing-page-blue-ribbon > aside`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-unique` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 32 instances; 32 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<aside class="grid-container" 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 32 of 7188 scanned pages (32 instances).

### Steps to reproduce
1. Open https://medicaid.gov/.
2. Locate the element: .landing-page-blue-ribbon > aside
3. Confirm the axe-core finding for rule landmark-unique.

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

### Affected pages
- https://medicaid.gov/
- http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- http://medicaid.gov/medicaid/data-systems/medicaid-and-chip-business-information-solution/transformed-medicaid-statistical-information-system-t-msis/t-msis-analytic-files
- https://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center
- https://www.medicaid.gov/style-guide/foundation/breakpoints
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/reducing-substance-use-disorders
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=25
- https://www.medicaid.gov/about-us/messages/arkansas-fast-tracks-medicaid-enrollment
- https://medicaid.gov/medicaid/managed-care/technical-assistance
- https://www.medicaid.gov/medicaid/managed-care
- https://medicaid.gov/medicaid/financial-management/payment-limit-demonstrations
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/functional-areas
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=20
- https://medicaid.gov/medicaid/quality-of-care/quality-of-care-performance-measurement
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=22
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=23
- https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=21
- https://medicaid.gov/medicaid/financial-management/state-budget-expenditure-reporting-for-medicaid-and-chip/expenditure-reports-mbes/cbes
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=16
- https://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-authorities
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=21
- https://medicaid.gov/medicaid/managed-care/guidance
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=4
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=1

…and more — 32 pages total ([download CSV](csv/axe-core__landmark-unique.csv)).

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

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

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

### Example pages
- https://medicaid.gov/
- http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
- http://medicaid.gov/medicaid/data-systems/medicaid-and-chip-business-information-solution/transformed-medicaid-statistical-information-system-t-msis/t-msis-analytic-files

---

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

**Bug ID:** `VS-dc02d5c2`  
**Pattern ID:** `VS-ff3ceb19`  
**URL:** https://www.medicaid.gov/style-guide/foundation/breakpoints  
**XPath / selector:** `.style-guide-page > .grid-gap-sm.grid-row > main`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-main-is-top-level` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-main-is-top-level?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 7188 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W37 (8 weeks)

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

### Description
Main landmark should not be contained in another landmark. Detected by axe-core rule landmark-main-is-top-level on 1 of 7188 scanned pages (1 instances).

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

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

### Affected pages
- https://www.medicaid.gov/style-guide/foundation/breakpoints

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

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

---

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

**Bug ID:** `VS-e828b1a0`  
**Pattern ID:** `VS-cd69be3a`  
**URL:** https://www.medicaid.gov/style-guide/foundation/breakpoints  
**XPath / selector:** `.main-content`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-no-duplicate-main` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-no-duplicate-main?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 7188 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W37 (8 weeks)

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

### Description
Document should not have more than one main landmark. Detected by axe-core rule landmark-no-duplicate-main on 1 of 7188 scanned pages (1 instances).

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

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

### Affected pages
- https://www.medicaid.gov/style-guide/foundation/breakpoints

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

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

---

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

**Bug ID:** `VS-70cbbd9e`  
**Pattern ID:** `VS-4fac2f41`  
**URL:** https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-em6g"] > .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:** 479 instances; 231 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 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 231 of 7188 scanned pages (479 instances).

### Steps to reproduce
1. Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=.
2. Locate the element: span[data-select2-id="select2-data-1-em6g"] > .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=716&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=2&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=1&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=541&page=20&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=786&page=79&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=3&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=991&page=8&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=8&q=
- https://medicaid.gov/
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=1&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=911&page=1&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=871&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=5&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=976&page=6&q=
- https://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=541&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=961&page=49&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=25&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=851&page=24&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=931&page=31&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=30&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=891&page=22&q=

…and more — 231 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=716&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=6&q=

---

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

**Bug ID:** `VS-9ef3c4f0`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107  
**XPath / selector:** `text: "  Feedback  "`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 40917 instances; 3428 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3428 of 7188 scanned pages (40917 instances).

### Steps to reproduce
1. Open https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107.
2. Locate the element: text: "  Feedback  "
3. Confirm the Siteimprove Alfa finding for rule sia-r57.

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

### Affected pages
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A811&f%5B1%5D=state%3A901&f%5B2%5D=state%3A971&f%5B3%5D=state%3A1006&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2346&f%5B1%5D=sub_topic_faq_library_facet%3A2376&page=84
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A731&f%5B1%5D=state%3A796&f%5B2%5D=state%3A861&f%5B3%5D=state%3A991&page=0
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A751&f%5B2%5D=fpg_topics_facet%3A906&f%5B3%5D=fpg_topics_facet%3A2826&f%5B4%5D=fpg_topics_facet%3A6486&f%5B5%5D=fpg_topics_facet%3A8591&page=109
- http://medicaid.gov/faq?entry=47167&page=0
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A906&f%5B1%5D=fpg_topics_facet%3A6171&f%5B2%5D=fpg_topics_facet%3A8701&f%5B3%5D=fpg_topics_facet%3A8901&page=108
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1526&f%5B3%5D=fpg_topics_facet%3A8901&page=6
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2026&f%5B1%5D=sub_topic_faq_library_facet%3A2091&f%5B2%5D=topic_faq_library_facet%3A2181&f%5B3%5D=topic_faq_library_facet%3A2236&page=4
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?page=1672&task=content-based-image-retrieval
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1496&f%5B3%5D=fpg_topics_facet%3A8861&page=4
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A751&f%5B1%5D=fpg_topics_facet%3A1011&f%5B10%5D=fpg_topics_facet%3A3261&f%5B11%5D=fpg_topics_facet%3A6481&f%5B12%5D=fpg_topics_facet%3A6486&f%5B13%5D=fpg_topics_facet%3A8406&f%5B14%5D=fpg_topics_facet%3A8611&f%5B15%5D=fpg_topics_facet%3A8711&f%5B2%5D=fpg_topics_facet%3A1021&f%5B3%5D=fpg_topics_facet%3A1491&f%5B4%5D=fpg_topics_facet%3A1496&f%5B5%5D=fpg_topics_facet%3A1501&f%5B6%5D=fpg_topics_facet%3A1511&f%5B7%5D=fpg_topics_facet%3A1521&f%5B8%5D=fpg_topics_facet%3A1531&f%5B9%5D=fpg_topics_facet%3A2696&page=2
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2402
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A1501&f%5B1%5D=fpg_topics_facet%3A2826&page=110
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=9&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A876&f%5B2%5D=state%3A891&f%5B3%5D=state%3A986&f%5B4%5D=topics%3A2826&page=2
- https://www.medicaid.gov/faq?fcf=41307&page=84&sl=yes
- https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A2696&f%5B2%5D=fpg_topics_facet%3A6171&f%5B3%5D=fpg_topics_facet%3A8891&page=111
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A1891&page=84&sl=yes
- https://www.medicaid.gov/medicaid/managed-care/guidance/state-directed-payments/approved-state-directed-payment-preprints?page=115
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=2&q=

…and more — 3428 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/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A811&f%5B1%5D=state%3A901&f%5B2%5D=state%3A971&f%5B3%5D=state%3A1006&page=0
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2346&f%5B1%5D=sub_topic_faq_library_facet%3A2376&page=84

---

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

**Bug ID:** `VS-f9ec9fe9`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614  
**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:** 882 instances; 882 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 882 of 7188 scanned pages (882 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614.
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/rule-2614
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2402
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-s-014-19
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6875
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6552
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-27-022-22
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6221
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-79-031-31
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-341
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095377
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt002119
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003089
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002096
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-25-009-9
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6825
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8404
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt001001
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-022-13
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7442
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2363
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002163
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1466

…and more — 882 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/rule-2614
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179

---

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

**Bug ID:** `VS-7d76ae68`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614  
**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:** 878 instances; 878 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 878 of 7188 scanned pages (878 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614.
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/rule-2614
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2402
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7224
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-s-014-19
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6875
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6552
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-27-022-22
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6221
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-79-031-31
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-341
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095377
- https://medicaid.gov/
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt002119
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003089
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002096
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-25-009-9
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6825
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8404
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt001001
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-022-13
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7442
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2363
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002163

…and more — 878 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/rule-2614
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179

---

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

**Bug ID:** `VS-b0294917`  
**Pattern ID:** `VS-e05344b9`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042  
**XPath / selector:** `@aria-selected="true"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 1073 instances; 219 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 219 of 7188 scanned pages (1073 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042.
2. Locate the element: @aria-selected="true"
3. Confirm the Siteimprove Alfa finding for rule sia-r18.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095377
- https://medicaid.gov/
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt002119
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003089
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002096
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt001001
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002163
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002108
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002029
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002239
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002099
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot002140
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg005099
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot002135
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt002109
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003225
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg022263
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cot003188
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002303
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/elg016209
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt002155
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt002031
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx008281

…and more — 219 pages total ([download CSV](csv/alfa__sia-r18.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx005179
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095377

---

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

**Bug ID:** `VS-c865324e`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2766  
**XPath / selector:** `td`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 134 instances; 114 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 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 114 of 7188 scanned pages (134 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2766.
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-2766
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2646
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003225
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt002155
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8326
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-925
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7042
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-44-001-1
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8270
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8421
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-545
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7084
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg022266
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/ffs-9-024-1
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6488
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2043
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8446
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt001004
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1374
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2995
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6712
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-12-083-126
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6500
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6658
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7081

…and more — 114 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-2766
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2646
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot003225

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-c9c0311b`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://medicaid.gov/  
**XPath / selector:** `<h4 id="nn-title-192301" class="margin-top-0 margin-bottom-2 nn-card__title">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 88 instances; 85 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 85 of 7188 scanned pages (88 instances).

### Steps to reproduce
1. Open https://medicaid.gov/.
2. Locate the element: <h4 id="nn-title-192301" class="margin-top-0 margin-bottom-2 nn-card__title">
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

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

### Affected pages
- https://medicaid.gov/
- https://www.medicaid.gov/medicaid/program-integrity/affordable-care-act-program-integrity-provisions
- https://medicaid.gov/medicaid/managed-care/profiles-program-features
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54038
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/98321
- https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality/resources
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/97716
- https://medicaid.gov/resources-for-states/medicaid-state-technical-assistance/health-home-information-resource-center
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54052
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/49452
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/53858
- https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation/1115-demonstration-federal-evaluation-meta-analysis
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54073
- https://www.medicaid.gov/style-guide/foundation/breakpoints
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/reducing-substance-use-disorders
- https://medicaid.gov/resources-for-states/disaster-response-toolkit/section-1135-waiver-flexibilities
- https://www.medicaid.gov/medicaid/prescription-drugs/drug-utilization-review/antipsychotic-medication-use-children
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54091
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/98236
- https://medicaid.gov/medicaid/quality-of-care/medicaid-and-chip-managed-care-quality/medicaid-and-chip-quality-rating-system/website-design-resources
- http://medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=25
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/98341
- https://medicaid.gov/about-us/organization/john-giles
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/98246
- http://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/archived-unwinding-and-returning-regular-operations-after-covid-19/data-reporting

…and more — 85 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/
- https://www.medicaid.gov/medicaid/program-integrity/affordable-care-act-program-integrity-provisions
- https://medicaid.gov/medicaid/managed-care/profiles-program-features

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-0d7eae0e`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://www.medicaid.gov/state-overviews/scorecard/main  
**XPath / selector:** `<h3 _ngcontent-ng-c1329502141="" class="view-measures-related-to-header ng-star-inserted">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r78` ([reference](https://alfa.siteimprove.com/rules/sia-r78))  
**Severity:** Moderate  
**Frequency:** 4 instances; 4 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (13 weeks)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 4 of 7188 scanned pages (4 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/state-overviews/scorecard/main.
2. Locate the element: <h3 _ngcontent-ng-c1329502141="" class="view-measures-related-to-header ng-star-inserted">
3. Confirm the Siteimprove Alfa finding for rule sia-r78.

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

### Affected pages
- https://www.medicaid.gov/state-overviews/scorecard/main
- http://medicaid.gov/state-overviews/scorecard/measure/State-Plan-Amendment-and-1915-Waiver-Processing?chart=line&chartEntities=%5B%22SPA+%28non-disaster+related%29%22%2C%22SPA+%28disaster+related%29%22%2C%221915%28b%29+Waiver+Requests%2C+Amendments%2C+and+Renewals%22%2C%221915%28c%29+Waiver+Amendments+%28non-disaster+related%29%22%2C%221915%28c%29+Waiver+Amendments+%28disaster+related%29%22%2C%221915%28c%29+Waiver+New%2FRenewals%22%5D&chartGroups=%5B%22Percentage+Approved+Within+the+First+90-Day+Review+Period%22%2C%22Median+Number+of+Days+Between+Submission+and+Approval%22%2C%22Median+Number+of+Days+Pending+State+Response+to+a+Request+for+Additional+Information+%28RAI%29%22%2C%22Median+Number+of+Days+Under+CMS+Review%22%5D&chartGroupsCategory=Metric&dataView=acrossTime&keywords=%5B%224%22%5D&measure=FS.1&measureView=national&timePeriods=%5B%222016%22%2C%222023%22%5D
- http://medicaid.gov/state-overviews/scorecard/main
- https://medicaid.gov/state-overviews/scorecard/measure/State-Plan-Amendment-and-1915-Waiver-Processing?chart=line&chartEntities=%5B%22SPA+%28non-disaster+related%29%22%2C%22SPA+%28disaster+related%29%22%2C%221915%28b%29+Waiver+Requests%2C+Amendments%2C+and+Renewals%22%2C%221915%28c%29+Waiver+Amendments+%28non-disaster+related%29%22%2C%221915%28c%29+Waiver+Amendments+%28disaster+related%29%22%2C%221915%28c%29+Waiver+New%2FRenewals%22%5D&chartGroups=%5B%22Percentage+Approved+Within+the+First+90-Day+Review+Period%22%2C%22Median+Number+of+Days+Between+Submission+and+Approval%22%2C%22Median+Number+of+Days+Pending+State+Response+to+a+Request+for+Additional+Information+%28RAI%29%22%2C%22Median+Number+of+Days+Under+CMS+Review%22%5D&chartGroupsCategory=Metric&dataView=acrossTime&keywords=%5B%224%22%5D&measure=FS.1&measureView=national&timePeriods=%5B%222016%22%2C%222023%22%5D

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

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

### Example pages
- https://www.medicaid.gov/state-overviews/scorecard/main
- http://medicaid.gov/state-overviews/scorecard/measure/State-Plan-Amendment-and-1915-Waiver-Processing?chart=line&chartEntities=%5B%22SPA+%28non-disaster+related%29%22%2C%22SPA+%28disaster+related%29%22%2C%221915%28b%29+Waiver+Requests%2C+Amendments%2C+and+Renewals%22%2C%221915%28c%29+Waiver+Amendments+%28non-disaster+related%29%22%2C%221915%28c%29+Waiver+Amendments+%28disaster+related%29%22%2C%221915%28c%29+Waiver+New%2FRenewals%22%5D&chartGroups=%5B%22Percentage+Approved+Within+the+First+90-Day+Review+Period%22%2C%22Median+Number+of+Days+Between+Submission+and+Approval%22%2C%22Median+Number+of+Days+Pending+State+Response+to+a+Request+for+Additional+Information+%28RAI%29%22%2C%22Median+Number+of+Days+Under+CMS+Review%22%5D&chartGroupsCategory=Metric&dataView=acrossTime&keywords=%5B%224%22%5D&measure=FS.1&measureView=national&timePeriods=%5B%222016%22%2C%222023%22%5D
- http://medicaid.gov/state-overviews/scorecard/main

---

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

**Bug ID:** `VS-6536cc0b`  
**Pattern ID:** `VS-e5ec42f0`  
**URL:** https://www.medicaid.gov/state-overviews/scorecard/main  
**XPath / selector:** `<p _ngcontent-ng-c2822395467="" class="title scorecard">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r72` ([reference](https://alfa.siteimprove.com/rules/sia-r72))  
**Severity:** Moderate  
**Frequency:** 382 instances; 4 of 7188 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (13 weeks)

### Description
Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 4 of 7188 scanned pages (382 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/state-overviews/scorecard/main.
2. Locate the element: <p _ngcontent-ng-c2822395467="" class="title scorecard">
3. Confirm the Siteimprove Alfa finding for rule sia-r72.

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

### Affected pages
- https://www.medicaid.gov/state-overviews/scorecard/main
- http://medicaid.gov/state-overviews/scorecard/measure/State-Plan-Amendment-and-1915-Waiver-Processing?chart=line&chartEntities=%5B%22SPA+%28non-disaster+related%29%22%2C%22SPA+%28disaster+related%29%22%2C%221915%28b%29+Waiver+Requests%2C+Amendments%2C+and+Renewals%22%2C%221915%28c%29+Waiver+Amendments+%28non-disaster+related%29%22%2C%221915%28c%29+Waiver+Amendments+%28disaster+related%29%22%2C%221915%28c%29+Waiver+New%2FRenewals%22%5D&chartGroups=%5B%22Percentage+Approved+Within+the+First+90-Day+Review+Period%22%2C%22Median+Number+of+Days+Between+Submission+and+Approval%22%2C%22Median+Number+of+Days+Pending+State+Response+to+a+Request+for+Additional+Information+%28RAI%29%22%2C%22Median+Number+of+Days+Under+CMS+Review%22%5D&chartGroupsCategory=Metric&dataView=acrossTime&keywords=%5B%224%22%5D&measure=FS.1&measureView=national&timePeriods=%5B%222016%22%2C%222023%22%5D
- http://medicaid.gov/state-overviews/scorecard/main
- https://medicaid.gov/state-overviews/scorecard/measure/State-Plan-Amendment-and-1915-Waiver-Processing?chart=line&chartEntities=%5B%22SPA+%28non-disaster+related%29%22%2C%22SPA+%28disaster+related%29%22%2C%221915%28b%29+Waiver+Requests%2C+Amendments%2C+and+Renewals%22%2C%221915%28c%29+Waiver+Amendments+%28non-disaster+related%29%22%2C%221915%28c%29+Waiver+Amendments+%28disaster+related%29%22%2C%221915%28c%29+Waiver+New%2FRenewals%22%5D&chartGroups=%5B%22Percentage+Approved+Within+the+First+90-Day+Review+Period%22%2C%22Median+Number+of+Days+Between+Submission+and+Approval%22%2C%22Median+Number+of+Days+Pending+State+Response+to+a+Request+for+Additional+Information+%28RAI%29%22%2C%22Median+Number+of+Days+Under+CMS+Review%22%5D&chartGroupsCategory=Metric&dataView=acrossTime&keywords=%5B%224%22%5D&measure=FS.1&measureView=national&timePeriods=%5B%222016%22%2C%222023%22%5D

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

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

### Example pages
- https://www.medicaid.gov/state-overviews/scorecard/main
- http://medicaid.gov/state-overviews/scorecard/measure/State-Plan-Amendment-and-1915-Waiver-Processing?chart=line&chartEntities=%5B%22SPA+%28non-disaster+related%29%22%2C%22SPA+%28disaster+related%29%22%2C%221915%28b%29+Waiver+Requests%2C+Amendments%2C+and+Renewals%22%2C%221915%28c%29+Waiver+Amendments+%28non-disaster+related%29%22%2C%221915%28c%29+Waiver+Amendments+%28disaster+related%29%22%2C%221915%28c%29+Waiver+New%2FRenewals%22%5D&chartGroups=%5B%22Percentage+Approved+Within+the+First+90-Day+Review+Period%22%2C%22Median+Number+of+Days+Between+Submission+and+Approval%22%2C%22Median+Number+of+Days+Pending+State+Response+to+a+Request+for+Additional+Information+%28RAI%29%22%2C%22Median+Number+of+Days+Under+CMS+Review%22%5D&chartGroupsCategory=Metric&dataView=acrossTime&keywords=%5B%224%22%5D&measure=FS.1&measureView=national&timePeriods=%5B%222016%22%2C%222023%22%5D
- http://medicaid.gov/state-overviews/scorecard/main