{
 "schema_version": "0.1",
 "site": "www.medicaid.gov",
 "scan_week": "2026-W37",
 "generated_at": "2026-09-30T18:09:22.530Z",
 "source_files": [
  "docs/reports/www.medicaid.gov/2026-W37/",
  "data/www.medicaid.gov/findings.json",
  "data/www.medicaid.gov/2026-W37/summary.json"
 ],
 "summary": {
  "pages_known": 56276,
  "pages_scanned_this_week": 7188,
  "pages_with_known_issues": 48052,
  "findings": 31,
  "clusters": 29,
  "new_findings": 0,
  "persistent_findings": 30,
  "high_priority_findings": 22
 },
 "top_risks": [
  {
   "finding_id": "VS-9429bb8d",
   "rule_id": "aria-required-children",
   "rule_label": "Certain ARIA roles must contain particular children",
   "severity": "Critical",
   "priority": "p1",
   "trend": "worsening",
   "pages_affected": 425,
   "rationale": "Critical severity; affects 425 pages; worsening trend",
   "top_url": "https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042"
  },
  {
   "finding_id": "VS-1467ea8a",
   "rule_id": "aria-allowed-attr",
   "rule_label": "Elements must only use supported ARIA attributes",
   "severity": "Critical",
   "priority": "p1",
   "trend": "worsening",
   "pages_affected": 425,
   "rationale": "Critical severity; affects 425 pages; worsening trend",
   "top_url": "https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042"
  },
  {
   "finding_id": "VS-0841abc2",
   "rule_id": "aria-input-field-name",
   "rule_label": "ARIA input fields must have an accessible name",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 229,
   "rationale": "Serious severity; affects 229 pages; persistent across weeks",
   "top_url": "https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q="
  },
  {
   "finding_id": "VS-ebb1c464",
   "rule_id": "aria-prohibited-attr",
   "rule_label": "Elements must only use permitted ARIA attributes",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 2,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "https://medicaid.gov/"
  },
  {
   "finding_id": "VS-33841929",
   "rule_id": "label-title-only",
   "rule_label": "Form elements should have a visible label",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 2,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing"
  },
  {
   "finding_id": "VS-646b1e0b",
   "rule_id": "sia-r66",
   "rule_label": "Text has enhanced contrast",
   "severity": "Moderate",
   "priority": "p2",
   "trend": "persistent",
   "pages_affected": 3430,
   "rationale": "affects 3430 pages; persistent across weeks",
   "top_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"
  },
  {
   "finding_id": "VS-cb53cc4d",
   "rule_id": "sia-r111",
   "rule_label": "Target size is at least 44×44 CSS pixels (Enhanced)",
   "severity": "Moderate",
   "priority": "p2",
   "trend": "persistent",
   "pages_affected": 3430,
   "rationale": "affects 3430 pages; persistent across weeks",
   "top_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"
  },
  {
   "finding_id": "VS-c18be945",
   "rule_id": "sia-r57",
   "rule_label": "Scrolling content can be accessed by keyboard",
   "severity": "Moderate",
   "priority": "p2",
   "trend": "persistent",
   "pages_affected": 3428,
   "rationale": "affects 3428 pages; persistent across weeks",
   "top_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"
  },
  {
   "finding_id": "VS-2208081b",
   "rule_id": "sia-r73",
   "rule_label": "Text has minimum contrast ratio of 4.5:1",
   "severity": "Moderate",
   "priority": "p2",
   "trend": "improving",
   "pages_affected": 2552,
   "rationale": "affects 2552 pages",
   "top_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"
  },
  {
   "finding_id": "VS-d5d82446",
   "rule_id": "landmark-one-main",
   "rule_label": "Document should have one main landmark",
   "severity": "Moderate",
   "priority": "p2",
   "trend": "worsening",
   "pages_affected": 1732,
   "rationale": "affects 1732 pages; worsening trend",
   "top_url": "https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17"
  }
 ],
 "findings": [
  {
   "finding_id": "VS-9429bb8d",
   "fingerprint": "d9ef25ac",
   "rule_id": "aria-required-children",
   "rule_label": "Certain ARIA roles must contain particular children",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI",
   "severity": "Critical",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Critical severity; affects 425 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 425,
    "affected_pages_previous": 224
   },
   "frequency": {
    "instances": 425,
    "pages_affected": 425,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Certain ARIA roles must contain particular children (WCAG 1.3.1)",
   "description": "Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 425 of 7188 scanned pages (425 instances).",
   "remediation_tip": "Add the child roles this container role requires (e.g. a list needs listitem children).",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule aria-required-children (WCAG 1.3.1).",
   "actual_behavior": "Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 425 of 7188 scanned pages (425 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [
    {
     "fingerprint": "084e4684",
     "html": "<div class=\"nav nav-tabs nav-justified\" role=\"tablist\">",
     "selectors": [
      ".nav"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v3/data-elements/mcr003042",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/ftx005179",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/data-elements/mcr003037",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-1467ea8a",
   "fingerprint": "fc8886ab",
   "rule_id": "aria-allowed-attr",
   "rule_label": "Elements must only use supported ARIA attributes",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI",
   "severity": "Critical",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Critical severity; affects 425 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 425,
    "affected_pages_previous": 224
   },
   "frequency": {
    "instances": 2071,
    "pages_affected": 425,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Elements must only use supported ARIA attributes (WCAG 4.1.2)",
   "description": "Elements must only use supported ARIA attributes. Detected by axe-core rule aria-allowed-attr on 425 of 7188 scanned pages (2071 instances).",
   "remediation_tip": "Remove ARIA attributes that aren't allowed on this role/element.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule aria-allowed-attr (WCAG 4.1.2).",
   "actual_behavior": "Elements must only use supported ARIA attributes. Detected by axe-core rule aria-allowed-attr on 425 of 7188 scanned pages (2071 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [
    {
     "fingerprint": "e8b33a04",
     "html": "<a class=\"nav-item nav-link active\" href=\"#overview\" role=\"link\" aria-selected=\"true\" aria-controls=\"overview\" data-toggle=\"tab\">Overview</a>",
     "selectors": [
      "a[href$=\"#overview\"]"
     ]
    },
    {
     "fingerprint": "4b1aed0a",
     "html": "<a class=\"nav-item nav-link\" href=\"#validvalues\" role=\"link\" aria-selected=\"false\" aria-controls=\"validvalues\" data-toggle=\"tab\">Valid Values</a>",
     "selectors": [
      "a[href$=\"#validvalues\"]"
     ]
    },
    {
     "fingerprint": "0d0d83f3",
     "html": "<a class=\"nav-item nav-link\" href=\"#relatedrules\" role=\"link\" aria-selected=\"false\" aria-controls=\"relatedrules\" data-toggle=\"tab\">Related Rules</a>",
     "selectors": [
      "a[href$=\"#relatedrules\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v3/data-elements/mcr003042",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/ftx005179",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/data-elements/mcr003037",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   }
  },
  {
   "finding_id": "VS-0841abc2",
   "fingerprint": "a3512e8b",
   "rule_id": "aria-input-field-name",
   "rule_label": "ARIA input fields must have an accessible name",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-input-field-name?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity; affects 229 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 229,
    "affected_pages_previous": 145
   },
   "frequency": {
    "instances": 476,
    "pages_affected": 229,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "ARIA input fields must have an accessible name (WCAG 4.1.2)",
   "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).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-input-field-name?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule aria-input-field-name (WCAG 4.1.2).",
   "actual_behavior": "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).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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="
   ],
   "html_fragments": [
    {
     "fingerprint": "b83690ed",
     "html": "<span class=\"select2-selection select2-selection--multiple\" role=\"combobox\" aria-haspopup=\"true\" aria-expanded=\"false\" tabindex=\"-1\" aria-disabled=\"false\">",
     "selectors": [
      "span[data-select2-id=\"select2-data-1-em6g\"] > .selection > .select2-selection.select2-selection--multiple[role=\"combobox\"]",
      "span[data-select2-id=\"select2-data-4-dm8w\"] > .selection > .select2-selection.select2-selection--multiple[role=\"combobox\"]",
      "span[data-select2-id=\"select2-data-1-rtj8\"] > .selection > .select2-selection.select2-selection--multiple[role=\"combobox\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 22
    },
    {
     "pattern": "/medicaid/section-1115-demo/demonstration-and-waiver-list",
     "count": 3
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   }
  },
  {
   "finding_id": "VS-ebb1c464",
   "fingerprint": "62f3ac21",
   "rule_id": "aria-prohibited-attr",
   "rule_label": "Elements must only use permitted ARIA attributes",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-prohibited-attr?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "low",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 13,
    "affected_pages_current": 2,
    "affected_pages_previous": 4
   },
   "frequency": {
    "instances": 7,
    "pages_affected": 2,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Elements must only use permitted ARIA attributes (WCAG 4.1.2)",
   "description": "Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 2 of 7188 scanned pages (7 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-prohibited-attr?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule aria-prohibited-attr (WCAG 4.1.2).",
   "actual_behavior": "Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 2 of 7188 scanned pages (7 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://medicaid.gov/",
    "https://medicaid.gov/eligibility"
   ],
   "html_fragments": [
    {
     "fingerprint": "3a0d3cef",
     "html": "<time class=\"nn-card__date flex-shrink-0 text-center margin-right-2 border\" datetime=\"2026-09-11\" aria-label=\"Sep 11\">",
     "selectors": [
      "time[datetime=\"2026-09-11\"]"
     ]
    },
    {
     "fingerprint": "91c9e166",
     "html": "<time class=\"nn-card__date flex-shrink-0 text-center margin-right-2 border\" datetime=\"2026-08-28\" aria-label=\"Aug 28\">",
     "selectors": [
      "time[datetime=\"2026-08-28\"]"
     ]
    },
    {
     "fingerprint": "c30a337c",
     "html": "<time class=\"nn-card__date flex-shrink-0 text-center margin-right-2 border\" datetime=\"2026-08-11\" aria-label=\"Aug 11\">",
     "selectors": [
      "time[datetime=\"2026-08-11\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/",
     "count": 1
    },
    {
     "pattern": "/eligibility",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   }
  },
  {
   "finding_id": "VS-33841929",
   "fingerprint": "e18c0475",
   "rule_id": "label-title-only",
   "rule_label": "Form elements should have a visible label",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "low",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 13,
    "affected_pages_current": 2,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 38,
    "pages_affected": 2,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Form elements should have a visible label (WCAG criterion undetermined)",
   "description": "Form elements should have a visible label. Detected by axe-core rule label-title-only on 2 of 7188 scanned pages (38 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule label-title-only.",
   "actual_behavior": "Form elements should have a visible label. Detected by axe-core rule label-title-only on 2 of 7188 scanned pages (38 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing",
    "https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing"
   ],
   "html_fragments": [
    {
     "fingerprint": "e9dcf231",
     "html": "<select aria-labelledby=\"filter-th-87386-0\" class=\"usa-select height-1\" data-col-index=\"0\" title=\"Filter by Type\">\n          <option value=\"\">All</option>\n        <option value=\"Federal Upper Limit\">F",
     "selectors": [
      "select[aria-labelledby=\"filter-th-87386-0\"]"
     ]
    },
    {
     "fingerprint": "50034708",
     "html": "<select aria-labelledby=\"filter-th-87386-1\" class=\"usa-select height-1\" data-col-index=\"1\" title=\"Filter by Year\">",
     "selectors": [
      "select[aria-labelledby=\"filter-th-87386-1\"]"
     ]
    },
    {
     "fingerprint": "27f31403",
     "html": "<select aria-labelledby=\"filter-th-87386-2\" class=\"usa-select height-1\" data-col-index=\"2\" title=\"Filter by Month\">",
     "selectors": [
      "select[aria-labelledby=\"filter-th-87386-2\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicaid/prescription-drugs/pharmacy-pricing",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-646b1e0b",
   "fingerprint": "afad441e",
   "rule_id": "sia-r66",
   "rule_label": "Text has enhanced contrast",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.6",
   "wcag_name": "Contrast (Enhanced)",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r66",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 3430 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 3430,
    "affected_pages_previous": 3426
   },
   "frequency": {
    "instances": 132252,
    "pages_affected": 3430,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Text has enhanced contrast (WCAG 1.4.6)",
   "description": "Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3430 of 7188 scanned pages (132252 instances).",
   "remediation_tip": "Increase text contrast to meet WCAG AAA (7:1).",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r66 (WCAG 1.4.6).",
   "actual_behavior": "Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3430 of 7188 scanned pages (132252 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/federal-policy-guidance",
     "count": 8
    },
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 7
    },
    {
     "pattern": "/faq",
     "count": 5
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-cb53cc4d",
   "fingerprint": "1738fa81",
   "rule_id": "sia-r111",
   "rule_label": "Target size is at least 44×44 CSS pixels (Enhanced)",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.5",
   "wcag_name": "Target Size (Enhanced)",
   "wcag_level": "AAA",
   "wcag_version": "2.1",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r111",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 3430 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 3430,
    "affected_pages_previous": 3426
   },
   "frequency": {
    "instances": 79347,
    "pages_affected": 3430,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5)",
   "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).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r111 (WCAG 2.5.5).",
   "actual_behavior": "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).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/federal-policy-guidance",
     "count": 8
    },
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 7
    },
    {
     "pattern": "/faq",
     "count": 5
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-c18be945",
   "fingerprint": "8634e2fd",
   "rule_id": "sia-r57",
   "rule_label": "Scrolling content can be accessed by keyboard",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r57",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 3428 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 3428,
    "affected_pages_previous": 3425
   },
   "frequency": {
    "instances": 40917,
    "pages_affected": 3428,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Scrolling content can be accessed by keyboard (WCAG criterion undetermined)",
   "description": "Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3428 of 7188 scanned pages (40917 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r57.",
   "actual_behavior": "Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3428 of 7188 scanned pages (40917 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/federal-policy-guidance",
     "count": 8
    },
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 7
    },
    {
     "pattern": "/faq",
     "count": 5
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-2208081b",
   "fingerprint": "40bbca09",
   "rule_id": "sia-r73",
   "rule_label": "Text has minimum contrast ratio of 4.5:1",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r73",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 2552 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 2552,
    "affected_pages_previous": 2885
   },
   "frequency": {
    "instances": 3694,
    "pages_affected": 2552,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8)",
   "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).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r73 (WCAG 1.4.8).",
   "actual_behavior": "Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 2552 of 7188 scanned pages (3694 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/federal-policy-guidance",
     "count": 9
    },
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 9
    },
    {
     "pattern": "/faq",
     "count": 6
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d5d82446",
   "fingerprint": "3627341e",
   "rule_id": "landmark-one-main",
   "rule_label": "Document should have one main landmark",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 1732 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 1732,
    "affected_pages_previous": 1041
   },
   "frequency": {
    "instances": 1732,
    "pages_affected": 1732,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Document should have one main landmark (WCAG criterion undetermined)",
   "description": "Document should have one main landmark. Detected by axe-core rule landmark-one-main on 1732 of 7188 scanned pages (1732 instances).",
   "remediation_tip": "Each page should have exactly one <main> landmark.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-one-main.",
   "actual_behavior": "Document should have one main landmark. Detected by axe-core rule landmark-one-main on 1732 of 7188 scanned pages (1732 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [
    {
     "fingerprint": "c30e96bb",
     "html": "<html class=\"no-js\" lang=\"en\">",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/rule-2614",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/validation-rules/rule-1767",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f18df681",
   "fingerprint": "09987718",
   "rule_id": "region",
   "rule_label": "All page content should be contained by landmarks",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 1732 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 1732,
    "affected_pages_previous": 1046
   },
   "frequency": {
    "instances": 7825,
    "pages_affected": 1732,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "All page content should be contained by landmarks (WCAG criterion undetermined)",
   "description": "All page content should be contained by landmarks. Detected by axe-core rule region on 1732 of 7188 scanned pages (7825 instances).",
   "remediation_tip": "Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule region.",
   "actual_behavior": "All page content should be contained by landmarks. Detected by axe-core rule region on 1732 of 7188 scanned pages (7825 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [
    {
     "fingerprint": "b8db5cfb",
     "html": "<div class=\"small p-1\">",
     "selectors": [
      ".small"
     ]
    },
    {
     "fingerprint": "658adb3f",
     "html": "<div class=\"d-flex justify-content-between m-2 mb-2\">",
     "selectors": [
      ".justify-content-between"
     ]
    },
    {
     "fingerprint": "ffcbeb49",
     "html": "<p class=\"font-weight-bold m-0 mr-1\">Version:</p>",
     "selectors": [
      ".font-weight-bold"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/rule-2614",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/validation-rules/rule-1767",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-fa44f293",
   "fingerprint": "a01b2a6c",
   "rule_id": "page-has-heading-one",
   "rule_label": "Page should contain a level-one heading",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 1731 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 1731,
    "affected_pages_previous": 1041
   },
   "frequency": {
    "instances": 1731,
    "pages_affected": 1731,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Page should contain a level-one heading (WCAG criterion undetermined)",
   "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).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule page-has-heading-one.",
   "actual_behavior": "Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 1731 of 7188 scanned pages (1731 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [
    {
     "fingerprint": "c30e96bb",
     "html": "<html class=\"no-js\" lang=\"en\">",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/rule-2614",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/validation-rules/rule-1767",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-aa242c2d",
   "fingerprint": "9bf7674d",
   "rule_id": "sia-r87",
   "rule_label": "First focusable element is link to main content",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r87",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 882 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 882,
    "affected_pages_previous": 543
   },
   "frequency": {
    "instances": 882,
    "pages_affected": 882,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "First focusable element is link to main content (WCAG criterion undetermined)",
   "description": "First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 882 of 7188 scanned pages (882 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r87",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r87.",
   "actual_behavior": "First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 882 of 7188 scanned pages (882 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/rule-2614",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/data-elements/mcr003042",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/ftx005179",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "Popper",
     "lift": 3.63,
     "pages_with_both": 102
    },
    {
     "technology": "Bootstrap",
     "lift": 3.63,
     "pages_with_both": 102
    },
    {
     "technology": "DataTables",
     "lift": 3.61,
     "pages_with_both": 102
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-7118fead",
   "fingerprint": "0d932ac9",
   "rule_id": "sia-r61",
   "rule_label": "Form field label is visible",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r61",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 878 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 878,
    "affected_pages_previous": 539
   },
   "frequency": {
    "instances": 878,
    "pages_affected": 878,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Form field label is visible (WCAG criterion undetermined)",
   "description": "Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 878 of 7188 scanned pages (878 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r61.",
   "actual_behavior": "Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 878 of 7188 scanned pages (878 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/rule-2614",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/data-elements/mcr003042",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/ftx005179",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "Popper",
     "lift": 3.63,
     "pages_with_both": 101
    },
    {
     "technology": "Bootstrap",
     "lift": 3.63,
     "pages_with_both": 101
    },
    {
     "technology": "DataTables",
     "lift": 3.61,
     "pages_with_both": 101
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f7dba940",
   "fingerprint": "477d8088",
   "rule_id": "sia-r14",
   "rule_label": "Accessible name of link or button matches visible label",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.3",
   "wcag_name": "Label in Name",
   "wcag_level": "A",
   "wcag_version": "2.1",
   "wcag_category": "WCAG 2.1 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r14",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 471 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 471,
    "affected_pages_previous": 284
   },
   "frequency": {
    "instances": 471,
    "pages_affected": 471,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Accessible name of link or button matches visible label (WCAG 2.5.3)",
   "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).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r14 (WCAG 2.5.3).",
   "actual_behavior": "Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 471 of 7188 scanned pages (471 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v4/data-quality-measures/rule-2614",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/data-elements/mcr003042",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/ftx005179",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "Popper",
     "lift": 3.63,
     "pages_with_both": 54
    },
    {
     "technology": "Bootstrap",
     "lift": 3.63,
     "pages_with_both": 54
    },
    {
     "technology": "DataTables",
     "lift": 3.61,
     "pages_with_both": 54
    }
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "WS",
      "group": "Without speech",
      "prevalence": 0.005,
      "percent": "0.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Without speech (0.5%)."
   }
  },
  {
   "finding_id": "VS-d6097011",
   "fingerprint": "b46c5395",
   "rule_id": "sia-r68",
   "rule_label": "Presentational children of an element are not focusable",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r68",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 341 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 341,
    "affected_pages_previous": 183
   },
   "frequency": {
    "instances": 352,
    "pages_affected": 341,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Presentational children of an element are not focusable (WCAG 1.3.1)",
   "description": "Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 341 of 7188 scanned pages (352 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r68",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r68 (WCAG 1.3.1).",
   "actual_behavior": "Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 341 of 7188 scanned pages (352 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 11
    },
    {
     "pattern": "/medicaid/section-1115-demo/demonstration-and-waiver-list",
     "count": 2
    },
    {
     "pattern": "/tmsis/dataguide/v3/data-elements/mcr003042",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "Popper",
     "lift": 2.29,
     "pages_with_both": 24
    },
    {
     "technology": "Bootstrap",
     "lift": 2.29,
     "pages_with_both": 24
    },
    {
     "technology": "DataTables",
     "lift": 2.28,
     "pages_with_both": 24
    }
   ],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-e05344b9",
   "fingerprint": "9d7a222a",
   "rule_id": "sia-r18",
   "rule_label": "aria attribute is permitted for element role",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r18",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 219 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 219,
    "affected_pages_previous": 117
   },
   "frequency": {
    "instances": 1073,
    "pages_affected": 219,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "aria attribute is permitted for element role (WCAG criterion undetermined)",
   "description": "aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 219 of 7188 scanned pages (1073 instances).",
   "remediation_tip": "Only use ARIA states/properties that are allowed on this element/role.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r18",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r18.",
   "actual_behavior": "aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 219 of 7188 scanned pages (1073 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v3/data-elements/mcr003042",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/ftx005179",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/data-elements/ftx095377",
     "count": 1
    }
   ],
   "associated_technologies": [
    {
     "technology": "Popper",
     "lift": 3.62,
     "pages_with_both": 24
    },
    {
     "technology": "Bootstrap",
     "lift": 3.62,
     "pages_with_both": 24
    },
    {
     "technology": "DataTables",
     "lift": 3.61,
     "pages_with_both": 24
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d25f622d",
   "fingerprint": "98ff321a",
   "rule_id": "heading-order",
   "rule_label": "Heading levels should only increase by one",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 170 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 170,
    "affected_pages_previous": 116
   },
   "frequency": {
    "instances": 175,
    "pages_affected": 170,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Heading levels should only increase by one (WCAG criterion undetermined)",
   "description": "Heading levels should only increase by one. Detected by axe-core rule heading-order on 170 of 7188 scanned pages (175 instances).",
   "remediation_tip": "Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule heading-order.",
   "actual_behavior": "Heading levels should only increase by one. Detected by axe-core rule heading-order on 170 of 7188 scanned pages (175 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://medicaid.gov/",
    "http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing",
    "https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/177991"
   ],
   "html_fragments": [
    {
     "fingerprint": "4a71427f",
     "html": "<h4 id=\"nn-title-192301\" class=\"margin-top-0 margin-bottom-2 nn-card__title\">",
     "selectors": [
      "#nn-title-192301"
     ]
    },
    {
     "fingerprint": "07a7ab9b",
     "html": "<h4 class=\"usa-footer__primary-link\">Related Sites</h4>",
     "selectors": [
      ".region-footer-first > .usa-footer__primary-content.usa-footer__primary-content--collapsible > h4"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/{id}",
     "count": 7
    },
    {
     "pattern": "/state-resource-center/disaster-response-toolkit/federal-disaster-resources/{id}",
     "count": 3
    },
    {
     "pattern": "/",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-179ad9b3",
   "fingerprint": "0e001fcc",
   "rule_id": "sia-r113",
   "rule_label": "Target size is at least 24×24 CSS pixels or has spacing (Minimum)",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.8",
   "wcag_name": "Target Size (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.2",
   "wcag_category": "WCAG 2.2 AA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r113",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 125 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 125,
    "affected_pages_previous": 69
   },
   "frequency": {
    "instances": 261,
    "pages_affected": 125,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8)",
   "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).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r113",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r113 (WCAG 2.5.8).",
   "actual_behavior": "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).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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="
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 19
    },
    {
     "pattern": "/medicaid/section-1115-demo/demonstration-and-waiver-list",
     "count": 3
    },
    {
     "pattern": "/chip/state-program-information/chip-spa",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LR",
      "group": "Limited reach",
      "prevalence": 0.02,
      "percent": "2.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-a48e6078",
   "fingerprint": "2ccef0fa",
   "rule_id": "sia-r8",
   "rule_label": "Form field has accessible name",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r8",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 125 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 125,
    "affected_pages_previous": 69
   },
   "frequency": {
    "instances": 261,
    "pages_affected": 125,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Form field has accessible name (WCAG 4.1.2)",
   "description": "Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 125 of 7188 scanned pages (261 instances).",
   "remediation_tip": "Associate the form field with a label.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r8",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r8 (WCAG 4.1.2).",
   "actual_behavior": "Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 125 of 7188 scanned pages (261 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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="
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 19
    },
    {
     "pattern": "/medicaid/section-1115-demo/demonstration-and-waiver-list",
     "count": 3
    },
    {
     "pattern": "/chip/state-program-information/chip-spa",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   }
  },
  {
   "finding_id": "VS-04a9d28c",
   "fingerprint": "02cfba82",
   "rule_id": "presentational-attr",
   "rule_label": "Presentational attribute (use CSS)",
   "engine": "deprecated-html",
   "tool": "deprecated-html",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": null,
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 114 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 114,
    "affected_pages_previous": 65
   },
   "frequency": {
    "instances": 134,
    "pages_affected": 114,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Presentational attribute (use CSS) (WCAG criterion undetermined)",
   "description": "Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 114 of 7188 scanned pages (134 instances).",
   "remediation_tip": null,
   "suggested_fix": "Not captured by automated scan — requires manual testing.",
   "expected_behavior": "Element passes deprecated-html rule presentational-attr.",
   "actual_behavior": "Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 114 of 7188 scanned pages (134 instances).",
   "testing_environment": "Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [
    {
     "fingerprint": "8febe8a4",
     "html": "<td valign=\"top\" colspan=\"7\" class=\"dataTables_empty\">No data available in table</td>",
     "selectors": [
      "td"
     ]
    },
    {
     "fingerprint": "95a33b85",
     "html": "<td valign=\"top\" colspan=\"6\" class=\"dataTables_empty\">No data available in table</td>",
     "selectors": [
      "td"
     ]
    },
    {
     "fingerprint": "fd2c7be6",
     "html": "<td valign=\"top\" colspan=\"2\" class=\"dataTables_empty\">No data available in table</td>",
     "selectors": [
      "td"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/tmsis/dataguide/v3/validation-rules/rule-2766",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v4/validation-rules/rule-2646",
     "count": 1
    },
    {
     "pattern": "/tmsis/dataguide/v3/data-elements/cot003225",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f054f4a4",
   "fingerprint": "5fa3b5a6",
   "rule_id": "sia-r53",
   "rule_label": "Headings are structured hierarchically",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r53",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 85,
    "affected_pages_previous": 58
   },
   "frequency": {
    "instances": 88,
    "pages_affected": 85,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Headings are structured hierarchically (WCAG criterion undetermined)",
   "description": "Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 85 of 7188 scanned pages (88 instances).",
   "remediation_tip": "Use headings in a logical, non-skipping order.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r53",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r53.",
   "actual_behavior": "Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 85 of 7188 scanned pages (88 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/{id}",
     "count": 6
    },
    {
     "pattern": "/state-resource-center/disaster-response-toolkit/federal-disaster-resources/{id}",
     "count": 5
    },
    {
     "pattern": "/",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-4fac2f41",
   "fingerprint": "550210da",
   "rule_id": "aria-allowed-role",
   "rule_label": "ARIA role should be appropriate for the element",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI",
   "severity": "Minor",
   "priority": "p3",
   "confidence": "high",
   "rationale": "affects 231 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 231,
    "affected_pages_previous": 145
   },
   "frequency": {
    "instances": 479,
    "pages_affected": 231,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "ARIA role should be appropriate for the element (WCAG criterion undetermined)",
   "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).",
   "remediation_tip": "Remove or change the ARIA role — it isn't allowed on this element type.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule aria-allowed-role.",
   "actual_behavior": "ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 231 of 7188 scanned pages (479 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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="
   ],
   "html_fragments": [
    {
     "fingerprint": "e5333dd9",
     "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",
     "selectors": [
      "span[data-select2-id=\"select2-data-1-em6g\"] > .selection > .select2-selection.select2-selection--multiple[role=\"combobox\"] > .select2-search.select2-search--inline > textarea",
      "span[data-select2-id=\"select2-data-4-dm8w\"] > .selection > .select2-selection.select2-selection--multiple[role=\"combobox\"] > .select2-search.select2-search--inline > textarea",
      "span[data-select2-id=\"select2-data-1-rtj8\"] > .selection > .select2-selection.select2-selection--multiple[role=\"combobox\"] > .select2-search.select2-search--inline > textarea"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicaid/medicaid-state-plan-amendments",
     "count": 21
    },
    {
     "pattern": "/medicaid/section-1115-demo/demonstration-and-waiver-list",
     "count": 3
    },
    {
     "pattern": "/",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-8806389c",
   "fingerprint": "ffb2ae06",
   "rule_id": "landmark-unique",
   "rule_label": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 32,
    "affected_pages_previous": 11
   },
   "frequency": {
    "instances": 32,
    "pages_affected": 32,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined)",
   "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).",
   "remediation_tip": "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.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-unique.",
   "actual_behavior": "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).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [
    {
     "fingerprint": "571f8a9c",
     "html": "<aside class=\"grid-container\" role=\"complementary\">",
     "selectors": [
      ".landing-page-blue-ribbon > aside"
     ]
    },
    {
     "fingerprint": "8adb5b03",
     "html": "<div class=\"dataTables_paginate paging_simple_numbers usa-pagination ikn-datatables-pagination\" id=\"DataTables_Table_0_paginate\" style=\"\" aria-label=\"Pagination\" role=\"navigation\">",
     "selectors": [
      "#DataTables_Table_0_paginate"
     ]
    },
    {
     "fingerprint": "9f8096be",
     "html": "<aside class=\"section\" role=\"complementary\">",
     "selectors": [
      ".section"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/resources-for-states/disaster-response-toolkit/federal-disaster-resources",
     "count": 9
    },
    {
     "pattern": "/medicaid/prescription-drugs/pharmacy-pricing",
     "count": 2
    },
    {
     "pattern": "/",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-fbf54eba",
   "fingerprint": "773d6316",
   "rule_id": "sia-r74",
   "rule_label": "Link is distinguishable without relying on color",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r74",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 14,
    "affected_pages_current": 11,
    "affected_pages_previous": 4
   },
   "frequency": {
    "instances": 75,
    "pages_affected": 11,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Link is distinguishable without relying on color (WCAG 1.4.8)",
   "description": "Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 11 of 7188 scanned pages (75 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r74",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r74 (WCAG 1.4.8).",
   "actual_behavior": "Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 11 of 7188 scanned pages (75 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/resources-for-states/disaster-response-toolkit/federal-disaster-resources",
     "count": 8
    },
    {
     "pattern": "/state-overviews/scorecard/main",
     "count": 2
    },
    {
     "pattern": "/medicaid/quality-of-care/core-set-data-dashboard",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-2cd767ca",
   "fingerprint": "3123e4f3",
   "rule_id": "sia-r78",
   "rule_label": "Table header has scope",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r78",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 13,
    "affected_pages_current": 4,
    "affected_pages_previous": 2
   },
   "frequency": {
    "instances": 4,
    "pages_affected": 4,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Table header has scope (WCAG criterion undetermined)",
   "description": "Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 4 of 7188 scanned pages (4 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r78",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r78.",
   "actual_behavior": "Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 4 of 7188 scanned pages (4 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/state-overviews/scorecard/main",
     "count": 2
    },
    {
     "pattern": "/state-overviews/scorecard/measure/State-Plan-Amendment-and-1915-Waiver-Processing",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-e5ec42f0",
   "fingerprint": "5e16fc6a",
   "rule_id": "sia-r72",
   "rule_label": "Element role is consistent with ARIA landmark",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r72",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 13,
    "affected_pages_current": 4,
    "affected_pages_previous": 1
   },
   "frequency": {
    "instances": 382,
    "pages_affected": 4,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Element role is consistent with ARIA landmark (WCAG criterion undetermined)",
   "description": "Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 4 of 7188 scanned pages (382 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r72",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r72.",
   "actual_behavior": "Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 4 of 7188 scanned pages (382 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "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"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/state-overviews/scorecard/main",
     "count": 2
    },
    {
     "pattern": "/state-overviews/scorecard/measure/State-Plan-Amendment-and-1915-Waiver-Processing",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-4408605e",
   "fingerprint": "265d5c76",
   "rule_id": "sia-r46",
   "rule_label": "Element has required aria-owns",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r46",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 8,
    "affected_pages_current": 1,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Element has required aria-owns (WCAG 1.3.1)",
   "description": "Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 1 of 7188 scanned pages (1 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r46",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r46 (WCAG 1.3.1).",
   "actual_behavior": "Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 1 of 7188 scanned pages (1 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-3f067795",
   "fingerprint": "f9bf7824",
   "rule_id": "sia-r77",
   "rule_label": "Table cell has header",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r77",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W37",
    "weeks_observed": 4,
    "affected_pages_current": 1,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 2,
    "pages_affected": 1,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Table cell has header (WCAG 1.3.1)",
   "description": "Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 1 of 7188 scanned pages (2 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r77",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r77 (WCAG 1.3.1).",
   "actual_behavior": "Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 1 of 7188 scanned pages (2 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-ff3ceb19",
   "fingerprint": "e04cf6f7",
   "rule_id": "landmark-main-is-top-level",
   "rule_label": "Main landmark should not be contained in another landmark",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-main-is-top-level?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W28",
    "last_observed": "2026-W37",
    "weeks_observed": 8,
    "affected_pages_current": 1,
    "affected_pages_previous": 1
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Main landmark should not be contained in another landmark (WCAG criterion undetermined)",
   "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).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-main-is-top-level?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-main-is-top-level.",
   "actual_behavior": "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).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/style-guide/foundation/breakpoints"
   ],
   "html_fragments": [
    {
     "fingerprint": "16092c9e",
     "html": "<main id=\"content\" class=\"grid-col-12 desktop:grid-col-9\" role=\"main\">",
     "selectors": [
      ".style-guide-page > .grid-gap-sm.grid-row > main"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/style-guide/foundation/breakpoints",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-cd69be3a",
   "fingerprint": "dd1abed5",
   "rule_id": "landmark-no-duplicate-main",
   "rule_label": "Document should not have more than one main landmark",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-no-duplicate-main?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W28",
    "last_observed": "2026-W37",
    "weeks_observed": 8,
    "affected_pages_current": 1,
    "affected_pages_previous": 1
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 7188
   },
   "on_key_page": false,
   "summary": "Document should not have more than one main landmark (WCAG criterion undetermined)",
   "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).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-no-duplicate-main?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-no-duplicate-main.",
   "actual_behavior": "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).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.medicaid.gov/style-guide/foundation/breakpoints"
   ],
   "html_fragments": [
    {
     "fingerprint": "468d6694",
     "html": "<main id=\"content\" class=\"main-content grid-col-12\" role=\"main\">",
     "selectors": [
      ".main-content"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/style-guide/foundation/breakpoints",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  }
 ],
 "clusters": {
  "by_wcag_criterion": [
   {
    "cluster_id": "71f257a8",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.6",
    "wcag_name": "Contrast (Enhanced)",
    "wcag_level": "AAA",
    "findings": [
     "VS-646b1e0b"
    ],
    "total_pages_affected": 3430,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "b393058c",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.5",
    "wcag_name": "Target Size (Enhanced)",
    "wcag_level": "AAA",
    "findings": [
     "VS-cb53cc4d"
    ],
    "total_pages_affected": 3430,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "36ac08de",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-c18be945"
    ],
    "total_pages_affected": 3428,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "140fec0b",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.8",
    "wcag_name": "Visual Presentation",
    "wcag_level": "AAA",
    "findings": [
     "VS-2208081b",
     "VS-fbf54eba"
    ],
    "total_pages_affected": 2563,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "91fd3b4c",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-d5d82446"
    ],
    "total_pages_affected": 1732,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "0649d9b9",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-f18df681"
    ],
    "total_pages_affected": 1732,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "b8f97020",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-fa44f293"
    ],
    "total_pages_affected": 1731,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "0ba1e7fd",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-aa242c2d"
    ],
    "total_pages_affected": 882,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "75cf28e4",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-7118fead"
    ],
    "total_pages_affected": 878,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "a849192e",
    "type": "wcag_criterion",
    "wcag_sc": "4.1.2",
    "wcag_name": "Name, Role, Value",
    "wcag_level": "A",
    "findings": [
     "VS-1467ea8a",
     "VS-0841abc2",
     "VS-ebb1c464",
     "VS-a48e6078"
    ],
    "total_pages_affected": 781,
    "max_severity": "Critical"
   },
   {
    "cluster_id": "423bd52e",
    "type": "wcag_criterion",
    "wcag_sc": "1.3.1",
    "wcag_name": "Info and Relationships",
    "wcag_level": "A",
    "findings": [
     "VS-9429bb8d",
     "VS-d6097011",
     "VS-4408605e",
     "VS-3f067795"
    ],
    "total_pages_affected": 768,
    "max_severity": "Critical"
   },
   {
    "cluster_id": "fd9ed1c5",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.3",
    "wcag_name": "Label in Name",
    "wcag_level": "A",
    "findings": [
     "VS-f7dba940"
    ],
    "total_pages_affected": 471,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "97a17643",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-4fac2f41"
    ],
    "total_pages_affected": 231,
    "max_severity": "Minor"
   },
   {
    "cluster_id": "0c75ddb8",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-e05344b9"
    ],
    "total_pages_affected": 219,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "e08c8d69",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-d25f622d"
    ],
    "total_pages_affected": 170,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "24c4a455",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.8",
    "wcag_name": "Target Size (Minimum)",
    "wcag_level": "AA",
    "findings": [
     "VS-179ad9b3"
    ],
    "total_pages_affected": 125,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "66669a92",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-04a9d28c"
    ],
    "total_pages_affected": 114,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "b05da4e9",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-f054f4a4"
    ],
    "total_pages_affected": 85,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "c7d2a838",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-8806389c"
    ],
    "total_pages_affected": 32,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "4b43ba23",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-2cd767ca"
    ],
    "total_pages_affected": 4,
    "max_severity": "Moderate"
   }
  ],
  "by_url_pattern": [
   {
    "cluster_id": "e8945b61",
    "type": "url_pattern",
    "pattern": "/resources-for-states/disaster-response-toolkit/federal-disaster-resources",
    "findings": [
     "VS-8806389c",
     "VS-fbf54eba"
    ],
    "total_pages": 17
   },
   {
    "cluster_id": "926c5f58",
    "type": "url_pattern",
    "pattern": "/state-overviews/scorecard/main",
    "findings": [
     "VS-2cd767ca",
     "VS-e5ec42f0"
    ],
    "total_pages": 4
   },
   {
    "cluster_id": "23512ba8",
    "type": "url_pattern",
    "pattern": "/state-overviews/scorecard/measure/State-Plan-Amendment-and-1915-Waiver-Processing",
    "findings": [
     "VS-2cd767ca",
     "VS-e5ec42f0"
    ],
    "total_pages": 4
   },
   {
    "cluster_id": "1b6140dc",
    "type": "url_pattern",
    "pattern": "/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra",
    "findings": [
     "VS-4408605e",
     "VS-3f067795"
    ],
    "total_pages": 2
   },
   {
    "cluster_id": "ed6e0123",
    "type": "url_pattern",
    "pattern": "/style-guide/foundation/breakpoints",
    "findings": [
     "VS-ff3ceb19",
     "VS-cd69be3a"
    ],
    "total_pages": 2
   }
  ]
 },
 "technology_findings": [
  {
   "technology": "Popper",
   "finding": "axe:landmark-one-main",
   "lift": 3.63,
   "pages_with_both": 200,
   "technology_pages": 200,
   "interpretation": "Pages using Popper are 3.63× more likely to have finding axe:landmark-one-main."
  },
  {
   "technology": "Popper",
   "finding": "axe:region",
   "lift": 3.63,
   "pages_with_both": 200,
   "technology_pages": 200,
   "interpretation": "Pages using Popper are 3.63× more likely to have finding axe:region."
  },
  {
   "technology": "Bootstrap",
   "finding": "axe:landmark-one-main",
   "lift": 3.63,
   "pages_with_both": 200,
   "technology_pages": 200,
   "interpretation": "Pages using Bootstrap are 3.63× more likely to have finding axe:landmark-one-main."
  },
  {
   "technology": "Bootstrap",
   "finding": "axe:region",
   "lift": 3.63,
   "pages_with_both": 200,
   "technology_pages": 200,
   "interpretation": "Pages using Bootstrap are 3.63× more likely to have finding axe:region."
  },
  {
   "technology": "Popper",
   "finding": "axe:page-has-heading-one",
   "lift": 3.63,
   "pages_with_both": 198,
   "technology_pages": 200,
   "interpretation": "Pages using Popper are 3.63× more likely to have finding axe:page-has-heading-one."
  },
  {
   "technology": "Bootstrap",
   "finding": "axe:page-has-heading-one",
   "lift": 3.63,
   "pages_with_both": 198,
   "technology_pages": 200,
   "interpretation": "Pages using Bootstrap are 3.63× more likely to have finding axe:page-has-heading-one."
  },
  {
   "technology": "Popper",
   "finding": "alfa:sia-r87",
   "lift": 3.63,
   "pages_with_both": 102,
   "technology_pages": 200,
   "interpretation": "Pages using Popper are 3.63× more likely to have finding alfa:sia-r87."
  },
  {
   "technology": "Bootstrap",
   "finding": "alfa:sia-r87",
   "lift": 3.63,
   "pages_with_both": 102,
   "technology_pages": 200,
   "interpretation": "Pages using Bootstrap are 3.63× more likely to have finding alfa:sia-r87."
  },
  {
   "technology": "Popper",
   "finding": "alfa:sia-r61",
   "lift": 3.63,
   "pages_with_both": 101,
   "technology_pages": 200,
   "interpretation": "Pages using Popper are 3.63× more likely to have finding alfa:sia-r61."
  },
  {
   "technology": "Bootstrap",
   "finding": "alfa:sia-r61",
   "lift": 3.63,
   "pages_with_both": 101,
   "technology_pages": 200,
   "interpretation": "Pages using Bootstrap are 3.63× more likely to have finding alfa:sia-r61."
  },
  {
   "technology": "Popper",
   "finding": "alfa:sia-r14",
   "lift": 3.63,
   "pages_with_both": 54,
   "technology_pages": 200,
   "interpretation": "Pages using Popper are 3.63× more likely to have finding alfa:sia-r14."
  },
  {
   "technology": "Bootstrap",
   "finding": "alfa:sia-r14",
   "lift": 3.63,
   "pages_with_both": 54,
   "technology_pages": 200,
   "interpretation": "Pages using Bootstrap are 3.63× more likely to have finding alfa:sia-r14."
  },
  {
   "technology": "Popper",
   "finding": "axe:aria-allowed-attr",
   "lift": 3.62,
   "pages_with_both": 48,
   "technology_pages": 200,
   "interpretation": "Pages using Popper are 3.62× more likely to have finding axe:aria-allowed-attr."
  },
  {
   "technology": "Popper",
   "finding": "axe:aria-required-children",
   "lift": 3.62,
   "pages_with_both": 48,
   "technology_pages": 200,
   "interpretation": "Pages using Popper are 3.62× more likely to have finding axe:aria-required-children."
  },
  {
   "technology": "Bootstrap",
   "finding": "axe:aria-allowed-attr",
   "lift": 3.62,
   "pages_with_both": 48,
   "technology_pages": 200,
   "interpretation": "Pages using Bootstrap are 3.62× more likely to have finding axe:aria-allowed-attr."
  }
 ],
 "third_party_findings": [
  {
   "origin": "googletagmanager.com",
   "pages_served": 1762,
   "pages_with_findings": 1134,
   "finding_co_occurrence_rate": 0.64,
   "median_bytes": 158702,
   "example_pages": [
    "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",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A926&page=1672&sl=yes&usid=MN",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A786&f%5B1%5D=state%3A866&f%5B2%5D=state%3A991&page=1672"
   ]
  },
  {
   "origin": "akamaihd.net",
   "pages_served": 92,
   "pages_with_findings": 53,
   "finding_co_occurrence_rate": 0.58,
   "median_bytes": 4826,
   "example_pages": [
    "https://www.medicaid.gov/faq?fcf=41342&page=4&sl=yes",
    "https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A771&f%5B2%5D=fpg_topics_facet%3A856&f%5B3%5D=fpg_topics_facet%3A1521&f%5B4%5D=fpg_topics_facet%3A1526&f%5B5%5D=fpg_topics_facet%3A8591&f%5B6%5D=fpg_topics_facet%3A8861&f%5B7%5D=fpg_topics_facet%3A8896&page=108",
    "https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1941&f%5B1%5D=sub_topic_faq_library_facet%3A2031&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2106&page=84"
   ]
  },
  {
   "origin": "qualtrics.com",
   "pages_served": 1337,
   "pages_with_findings": 709,
   "finding_co_occurrence_rate": 0.53,
   "median_bytes": 856039,
   "example_pages": [
    "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",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A926&page=1672&sl=yes&usid=MN",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A786&f%5B1%5D=state%3A866&f%5B2%5D=state%3A991&page=1672"
   ]
  },
  {
   "origin": "jsdelivr.net",
   "pages_served": 1337,
   "pages_with_findings": 709,
   "finding_co_occurrence_rate": 0.53,
   "median_bytes": 53126,
   "example_pages": [
    "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",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A926&page=1672&sl=yes&usid=MN",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A786&f%5B1%5D=state%3A866&f%5B2%5D=state%3A991&page=1672"
   ]
  },
  {
   "origin": "chartbeat.com",
   "pages_served": 1337,
   "pages_with_findings": 709,
   "finding_co_occurrence_rate": 0.53,
   "median_bytes": 41750,
   "example_pages": [
    "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",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A861&f%5B1%5D=state%3A926&page=1672&sl=yes&usid=MN",
    "https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A786&f%5B1%5D=state%3A866&f%5B2%5D=state%3A991&page=1672"
   ]
  }
 ],
 "metadata": {
  "generator": "vital-core",
  "schema_version": "0.1",
  "total_pages_scanned": 7188,
  "notes": [
   "Healthy pages (no known issues) are intentionally excluded.",
   "Representative examples are used instead of complete occurrence lists.",
   "Fingerprints are stable hashes for tracking recurring patterns over time.",
   "Fragment fingerprints normalize volatile attributes (id, style, data-*) before hashing.",
   "Technology lift values indicate association, not causation.",
   "Confidence reflects sample size: high=10+ affected pages, medium=3-9, low=1-2."
  ]
 }
}