# Accessibility bug reports — www.medicaid.gov, week 2026-W40

24 issue type(s) from 2696 pages scanned. Generated 2026-09-30 by [vital-scans](https://github.com/mgifford/vital-core), following [accessibility bug-reporting best practices](https://mgifford.github.io/ACCESSIBILITY.md/examples/ACCESSIBILITY_BUG_REPORTING_BEST_PRACTICES.html).

> Automated checks find roughly a third of accessibility barriers. Fields marked "requires manual testing" cannot be observed by an automated scan and need a human with assistive technology.

---
## Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8)

**Bug ID:** `VS-00350601`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=41&q=  
**XPath / selector:** `<textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">`  
**WCAG SC:** 2.5.8 — Target Size (Minimum) (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r113` ([reference](https://alfa.siteimprove.com/rules/sia-r113))  
**Severity:** Moderate  
**Frequency:** 64 instances; 30 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 30 of 2696 scanned pages (64 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=41&q=.
2. Locate the element: <textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">
3. Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

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

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=41&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=15&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=6&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=2&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=26&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=0&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=42&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=13&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=40&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=696&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=891&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=28&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=826&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=43&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=726&page=0&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=2271&limit=10&page=3&q=&sort=field_faq_date%3Adesc
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=886&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=3&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=39&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=881&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=876&page=4&q=

…and more — 30 pages total ([download CSV](csv/alfa__sia-r113.csv)).

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

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

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=41&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=15&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=

---

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

**Bug ID:** `VS-033ea34d`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16  
**XPath / selector:** `<a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">`  
**WCAG SC:** 2.5.3 — Label in Name (Level A)  
**Rule:** Siteimprove Alfa — `sia-r14` ([reference](https://alfa.siteimprove.com/rules/sia-r14))  
**Severity:** Moderate  
**Frequency:** 120 instances; 120 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 120 of 2696 scanned pages (120 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16.
2. Locate the element: <a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">
3. Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7183
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6363
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7860
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-891
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-26-011-11
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-15-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002084
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg016212
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004060
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-096-92
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt001227
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/crx-claim-pharmacy/file-header-record-rx
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6642
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7319
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002053
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002050
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-50-001-4
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-79-047-47
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8756
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-4-010-10
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-83-036-36
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002141
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-8731

…and more — 120 pages total ([download CSV](csv/alfa__sia-r14.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7183

---

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

**Bug ID:** `VS-6fbb414e`  
**Pattern ID:** `VS-9429bb8d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095  
**XPath / selector:** `.nav`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `aria-required-children` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 93 instances; 93 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<div class="nav nav-tabs nav-justified" role="tablist">
```

### Description
Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 93 of 2696 scanned pages (93 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095.
2. Locate the element: .nav
3. Confirm the axe-core finding for rule aria-required-children against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002024
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003255
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002190
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002099
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/tpl003050
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002198
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004058
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002084
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg016212
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004060
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt001227
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003254
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/crx-claim-pharmacy/file-header-record-rx
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/mcr005070
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx004207
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002053
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002050
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg002028
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002104
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002141
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002097
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003116
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/tpl006077

…and more — 93 pages total ([download CSV](csv/axe-core__aria-required-children.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002024
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008

---

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

**Bug ID:** `VS-46db8702`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008  
**XPath / selector:** `<div class="nav nav-tabs nav-justified" role="tablist">`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r68` ([reference](https://alfa.siteimprove.com/rules/sia-r68))  
**Severity:** Moderate  
**Frequency:** 79 instances; 75 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 75 of 2696 scanned pages (79 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008.
2. Locate the element: <div class="nav nav-tabs nav-justified" role="tablist">
3. Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=41&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=15&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=6&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=2&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002084
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg016212
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004060
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt001227
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/crx-claim-pharmacy/file-header-record-rx
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=1&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002053
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002050
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=26&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=0&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002141
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003116
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=0&q=
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl004059
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr002030
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002138
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003095
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=42&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=13&q=

…and more — 75 pages total ([download CSV](csv/alfa__sia-r68.csv)).

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r68

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=41&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=15&q=

---

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

**Bug ID:** `VS-1bd49362`  
**Pattern ID:** `VS-1467ea8a`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095  
**XPath / selector:** `a[href$="#overview"]`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-allowed-attr` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 453 instances; 93 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<a class="nav-item nav-link active" href="#overview" role="link" aria-selected="true" aria-controls="overview" data-toggle="tab">Overview</a>
```

### Description
Elements must only use supported ARIA attributes. Detected by axe-core rule aria-allowed-attr on 93 of 2696 scanned pages (453 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095.
2. Locate the element: a[href$="#overview"]
3. Confirm the axe-core finding for rule aria-allowed-attr against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002024
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003255
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002190
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002099
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/tpl003050
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cip002198
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004058
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002084
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg016212
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004060
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt001227
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003254
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/crx-claim-pharmacy/file-header-record-rx
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/mcr005070
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx004207
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002053
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002050
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg002028
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002104
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002141
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002097
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003116
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/tpl006077

…and more — 93 pages total ([download CSV](csv/axe-core__aria-allowed-attr.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002024
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008

---

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

**Bug ID:** `VS-49a24127`  
**Pattern ID:** `VS-0841abc2`  
**URL:** http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=0&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-qmha"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-input-field-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-input-field-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 129 instances; 60 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false" tabindex="-1" aria-disabled="false">
```

### Description
ARIA input fields must have an accessible name. Detected by axe-core rule aria-input-field-name on 60 of 2696 scanned pages (129 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=0&q=.
2. Locate the element: span[data-select2-id="select2-data-1-qmha"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]
3. Confirm the axe-core finding for rule aria-input-field-name against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=0&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=22&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=41&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=15&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=6&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=2&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=881&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=861&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=26&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=36&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=876&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=2271&limit=10&page=4&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8786&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=1&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=0&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=926&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=42&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=726&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=13&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=956&page=15&q=

…and more — 60 pages total ([download CSV](csv/axe-core__aria-input-field-name.csv)).

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

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

### Example pages
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=0&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=22&q=

---

## Form field has accessible name (WCAG 4.1.2)

**Bug ID:** `VS-d55b93cc`  
**Pattern ID:** `VS-a48e6078`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=41&q=  
**XPath / selector:** `<span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false">`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** Siteimprove Alfa — `sia-r8` ([reference](https://alfa.siteimprove.com/rules/sia-r8))  
**Severity:** Moderate  
**Frequency:** 64 instances; 30 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 30 of 2696 scanned pages (64 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=41&q=.
2. Locate the element: <span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false">
3. Confirm the Siteimprove Alfa finding for rule sia-r8 against WCAG 4.1.2 Name, Role, Value.

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

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=41&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=15&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=6&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=2&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=26&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=0&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=0&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=42&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=13&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=941&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=40&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=696&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=891&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=28&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=826&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=43&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=726&page=0&q=
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=2271&limit=10&page=3&q=&sort=field_faq_date%3Adesc
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=886&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=811&page=3&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=39&q=
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=881&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=876&page=4&q=

…and more — 30 pages total ([download CSV](csv/alfa__sia-r8.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=41&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=15&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-c691c18c`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656  
**XPath / selector:** `text: "Here’s how you know"`  
**WCAG SC:** 1.4.6 — Contrast (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r66` ([reference](https://alfa.siteimprove.com/rules/sia-r66))  
**Severity:** Moderate  
**Frequency:** 52687 instances; 1273 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 1273 of 2696 scanned pages (52687 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656.
2. Locate the element: text: "Here’s how you know"
3. Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced).

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

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1956&f%5B1%5D=sub_topic_faq_library_facet%3A1981&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2086&page=4
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A751&f%5B1%5D=topics%3A856&f%5B2%5D=topics%3A7411&page=7
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2386&f%5B1%5D=sub_topic_faq_library_facet%3A2436&f%5B2%5D=sub_topic_faq_library_facet%3A2451&page=4
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A906&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A1491&f%5B4%5D=fpg_topics_facet%3A3046&f%5B5%5D=fpg_type_facet%3A1476&f%5B6%5D=fpg_type_facet%3A1536&page=0
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1891&f%5B1%5D=sub_topic_faq_library_facet%3A2096&page=81&sl=yes
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1931&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2076&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=7
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1926&f%5B1%5D=sub_topic_faq_library_facet%3A2021&f%5B2%5D=sub_topic_faq_library_facet%3A2036&f%5B3%5D=sub_topic_faq_library_facet%3A2081&f%5B4%5D=sub_topic_faq_library_facet%3A2446&page=84
- https://www.medicaid.gov/faq?fcf=41254&page=3&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-17-005-14
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A996&objectId=3242896&page=65
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8361&f%5B0%5D=waiver_state_facet%3A731&f%5B1%5D=waiver_state_facet%3A931&page=1
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A846&f%5B1%5D=waiver_state_facet%3A881&page=63
- https://www.medicaid.gov/faq?entry=48729&page=84
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A761&f%5B1%5D=topics%3A1496&page=1661
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2031&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2511&page=2
- https://www.medicaid.gov/faq?fcf=41089&page=0&sl=yes
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A716&f%5B1%5D=state%3A781&f%5B10%5D=topics%3A2726&f%5B11%5D=topics%3A3141&f%5B12%5D=topics%3A3261&f%5B13%5D=topics%3A3381&f%5B14%5D=topics%3A3791&f%5B15%5D=topics%3A7296&f%5B16%5D=topics%3A7386&f%5B17%5D=topics%3A7391&f%5B18%5D=topics%3A8496&f%5B2%5D=state%3A841&f%5B3%5D=state%3A881&f%5B4%5D=state%3A891&f%5B5%5D=state%3A941&f%5B6%5D=state%3A1006&f%5B7%5D=state%3A8296&f%5B8%5D=topics%3A761&f%5B9%5D=topics%3A936&page=0
- https://www.medicaid.gov/federal-policy-guidance?fcf=1190&page=111&sl=yes
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8311&page=2

…and more — 1273 pages total ([download CSV](csv/alfa__sia-r66.csv)).

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

### Suggested fix
**How to fix:** Increase text contrast to meet WCAG AAA (7:1).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18

---

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

**Bug ID:** `VS-9f176a22`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656  
**XPath / selector:** `<p class="usa-footer__contact-info margin-bottom-0">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r73` ([reference](https://alfa.siteimprove.com/rules/sia-r73))  
**Severity:** Moderate  
**Frequency:** 1049 instances; 1049 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 1049 of 2696 scanned pages (1049 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656.
2. Locate the element: <p class="usa-footer__contact-info margin-bottom-0">
3. Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1956&f%5B1%5D=sub_topic_faq_library_facet%3A1981&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2086&page=4
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A751&f%5B1%5D=topics%3A856&f%5B2%5D=topics%3A7411&page=7
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2386&f%5B1%5D=sub_topic_faq_library_facet%3A2436&f%5B2%5D=sub_topic_faq_library_facet%3A2451&page=4
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A906&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A1491&f%5B4%5D=fpg_topics_facet%3A3046&f%5B5%5D=fpg_type_facet%3A1476&f%5B6%5D=fpg_type_facet%3A1536&page=0
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1891&f%5B1%5D=sub_topic_faq_library_facet%3A2096&page=81&sl=yes
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1931&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2076&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=7
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1926&f%5B1%5D=sub_topic_faq_library_facet%3A2021&f%5B2%5D=sub_topic_faq_library_facet%3A2036&f%5B3%5D=sub_topic_faq_library_facet%3A2081&f%5B4%5D=sub_topic_faq_library_facet%3A2446&page=84
- https://www.medicaid.gov/faq?fcf=41254&page=3&sl=yes
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A996&objectId=3242896&page=65
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8361&f%5B0%5D=waiver_state_facet%3A731&f%5B1%5D=waiver_state_facet%3A931&page=1
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A846&f%5B1%5D=waiver_state_facet%3A881&page=63
- https://www.medicaid.gov/faq?entry=48729&page=84
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A761&f%5B1%5D=topics%3A1496&page=1661
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2031&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2511&page=2
- https://www.medicaid.gov/faq?fcf=41089&page=0&sl=yes
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A716&f%5B1%5D=state%3A781&f%5B10%5D=topics%3A2726&f%5B11%5D=topics%3A3141&f%5B12%5D=topics%3A3261&f%5B13%5D=topics%3A3381&f%5B14%5D=topics%3A3791&f%5B15%5D=topics%3A7296&f%5B16%5D=topics%3A7386&f%5B17%5D=topics%3A7391&f%5B18%5D=topics%3A8496&f%5B2%5D=state%3A841&f%5B3%5D=state%3A881&f%5B4%5D=state%3A891&f%5B5%5D=state%3A941&f%5B6%5D=state%3A1006&f%5B7%5D=state%3A8296&f%5B8%5D=topics%3A761&f%5B9%5D=topics%3A936&page=0
- https://www.medicaid.gov/federal-policy-guidance?fcf=1190&page=111&sl=yes
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8311&page=2
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A761&f%5B1%5D=fpg_topics_facet%3A1516&f%5B2%5D=fpg_topics_facet%3A2826&f%5B3%5D=fpg_topics_facet%3A6171&f%5B4%5D=fpg_topics_facet%3A8591&f%5B5%5D=fpg_topics_facet%3A8711&page=111
- http://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1471&f%5B2%5D=fpg_topics_facet%3A1501&f%5B3%5D=fpg_topics_facet%3A2696&f%5B4%5D=fpg_topics_facet%3A3046&f%5B5%5D=fpg_topics_facet%3A8601&f%5B6%5D=fpg_topics_facet%3A8606&page=106
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=state_waiver_status_facet%3A1606&f%5B1%5D=waiver_state_facet%3A881&page=1
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1941&f%5B1%5D=sub_topic_faq_library_facet%3A2441&page=6
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1941&f%5B1%5D=sub_topic_faq_library_facet%3A2106&f%5B2%5D=sub_topic_faq_library_facet%3A2431&f%5B3%5D=topic_faq_library_facet%3A2536&page=6

…and more — 1049 pages total ([download CSV](csv/alfa__sia-r73.csv)).

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

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

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1956&f%5B1%5D=sub_topic_faq_library_facet%3A1981&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2086&page=4
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A751&f%5B1%5D=topics%3A856&f%5B2%5D=topics%3A7411&page=7

---

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

**Bug ID:** `VS-4a870020`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=24  
**XPath / selector:** `<p class="field-content">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r74` ([reference](https://alfa.siteimprove.com/rules/sia-r74))  
**Severity:** Moderate  
**Frequency:** 20 instances; 2 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 2 of 2696 scanned pages (20 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=24.
2. Locate the element: <p class="field-content">
3. Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=24
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=20

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

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

### Example pages
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=24
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=20

---

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

**Bug ID:** `VS-899f8753`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656  
**XPath / selector:** `<button class="usa-button" type="submit">`  
**WCAG SC:** 2.5.5 — Target Size (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r111` ([reference](https://alfa.siteimprove.com/rules/sia-r111))  
**Severity:** Moderate  
**Frequency:** 31073 instances; 1273 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 1273 of 2696 scanned pages (31073 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656.
2. Locate the element: <button class="usa-button" type="submit">
3. Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

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

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1956&f%5B1%5D=sub_topic_faq_library_facet%3A1981&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2086&page=4
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A751&f%5B1%5D=topics%3A856&f%5B2%5D=topics%3A7411&page=7
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2386&f%5B1%5D=sub_topic_faq_library_facet%3A2436&f%5B2%5D=sub_topic_faq_library_facet%3A2451&page=4
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A906&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A1491&f%5B4%5D=fpg_topics_facet%3A3046&f%5B5%5D=fpg_type_facet%3A1476&f%5B6%5D=fpg_type_facet%3A1536&page=0
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1891&f%5B1%5D=sub_topic_faq_library_facet%3A2096&page=81&sl=yes
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1931&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2076&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=7
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1926&f%5B1%5D=sub_topic_faq_library_facet%3A2021&f%5B2%5D=sub_topic_faq_library_facet%3A2036&f%5B3%5D=sub_topic_faq_library_facet%3A2081&f%5B4%5D=sub_topic_faq_library_facet%3A2446&page=84
- https://www.medicaid.gov/faq?fcf=41254&page=3&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-17-005-14
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A996&objectId=3242896&page=65
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8361&f%5B0%5D=waiver_state_facet%3A731&f%5B1%5D=waiver_state_facet%3A931&page=1
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A846&f%5B1%5D=waiver_state_facet%3A881&page=63
- https://www.medicaid.gov/faq?entry=48729&page=84
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A761&f%5B1%5D=topics%3A1496&page=1661
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2031&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2511&page=2
- https://www.medicaid.gov/faq?fcf=41089&page=0&sl=yes
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A716&f%5B1%5D=state%3A781&f%5B10%5D=topics%3A2726&f%5B11%5D=topics%3A3141&f%5B12%5D=topics%3A3261&f%5B13%5D=topics%3A3381&f%5B14%5D=topics%3A3791&f%5B15%5D=topics%3A7296&f%5B16%5D=topics%3A7386&f%5B17%5D=topics%3A7391&f%5B18%5D=topics%3A8496&f%5B2%5D=state%3A841&f%5B3%5D=state%3A881&f%5B4%5D=state%3A891&f%5B5%5D=state%3A941&f%5B6%5D=state%3A1006&f%5B7%5D=state%3A8296&f%5B8%5D=topics%3A761&f%5B9%5D=topics%3A936&page=0
- https://www.medicaid.gov/federal-policy-guidance?fcf=1190&page=111&sl=yes
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8311&page=2

…and more — 1273 pages total ([download CSV](csv/alfa__sia-r111.csv)).

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18

---

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

**Bug ID:** `VS-eacc0e48`  
**Pattern ID:** `VS-33841929`  
**URL:** https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data  
**XPath / selector:** `select[aria-labelledby="filter-th-87371-1"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `label-title-only` ([reference](https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 2 instances; 1 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (15 weeks)

### HTML snippet
```html
<select aria-labelledby="filter-th-87371-1" class="usa-select height-1" data-col-index="1" title="Filter by Year">
```

### Description
Form elements should have a visible label. Detected by axe-core rule label-title-only on 1 of 2696 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data.
2. Locate the element: select[aria-labelledby="filter-th-87371-1"]
3. Confirm the axe-core finding for rule label-title-only.

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

### Affected pages
- https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data

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

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

---

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

**Bug ID:** `VS-25bf460e`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095  
**XPath / selector:** `.small`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1964 instances; 442 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<div class="small p-1">
```

### Description
All page content should be contained by landmarks. Detected by axe-core rule region on 442 of 2696 scanned pages (1964 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095.
2. Locate the element: .small
3. Confirm the axe-core finding for rule region.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-83-025-25
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002024
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6431
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-17-005-14
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7183
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-16-001-1
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003255
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-6-030-30
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6363
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7860
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8618
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-23-001-2
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2083
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6447
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-886
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002190
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3164
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002099
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-084-136
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1135

…and more — 442 pages total ([download CSV](csv/axe-core__region.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18

---

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

**Bug ID:** `VS-51b851fa`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-one-main` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 441 instances; 441 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<html class="no-js" lang="en">
```

### Description
Document should have one main landmark. Detected by axe-core rule landmark-one-main on 441 of 2696 scanned pages (441 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095.
2. Locate the element: html
3. Confirm the axe-core finding for rule landmark-one-main.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-83-025-25
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002024
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6431
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-17-005-14
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7183
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-16-001-1
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003255
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-6-030-30
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6363
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7860
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8618
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-23-001-2
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2083
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6447
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-886
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002190
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3164
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002099
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-084-136
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1135

…and more — 441 pages total ([download CSV](csv/axe-core__landmark-one-main.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18

---

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

**Bug ID:** `VS-22b482cc`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `page-has-heading-one` ([reference](https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 441 instances; 441 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<html class="no-js" lang="en">
```

### Description
Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 441 of 2696 scanned pages (441 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095.
2. Locate the element: html
3. Confirm the axe-core finding for rule page-has-heading-one.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-83-025-25
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002024
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6431
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-17-005-14
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7183
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-16-001-1
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot003255
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-6-030-30
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6363
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7860
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8618
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-23-001-2
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2083
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6447
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-886
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002190
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-3164
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/cip002099
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-084-136
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1135

…and more — 441 pages total ([download CSV](csv/axe-core__page-has-heading-one.csv)).

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002095
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18

---

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

**Bug ID:** `VS-eed0d6cd`  
**Pattern ID:** `VS-d25f622d`  
**URL:** http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification  
**XPath / selector:** `.field--name-field-resources-list > h3`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 49 instances; 43 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<h3>Related Links</h3>
```

### Description
Heading levels should only increase by one. Detected by axe-core rule heading-order on 43 of 2696 scanned pages (49 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification.
2. Locate the element: .field--name-field-resources-list > h3
3. Confirm the axe-core finding for rule heading-order.

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

### Affected pages
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/medicaid/data-systems/health-information-technology/health-disparities
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54038
- http://medicaid.gov/state-overviews/stateprofile.html?state=Pennsylvania
- http://medicaid.gov/medicaid/benefits/reentry-services-for-incarcerated-individuals/additional-resources
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification/good-faith-effort-exemption-requests-home-health-care-services
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54030
- http://medicaid.gov/about-us/contact-us
- https://www.medicaid.gov/medicaid/benefits/telehealth/telehealth-terms
- https://www.medicaid.gov/medicaid/data-systems/health-information-exchange/section-1115-demonstration-hie-policy
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/49452
- https://medicaid.gov/medicaid/data-systems/health-information-exchange/fee-for-service-hie-policy
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106396
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/functional-areas/quality-measurement/promoting-community-integration-through-long-term-services-and-supports-quality-measures
- https://medicaid.gov/chip/chip-managed-care
- https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106781
- https://www.medicaid.gov/medicaid/data-systems
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=24
- https://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19
- https://www.medicaid.gov/medicaid/data-systems/health-information-exchange/managed-care-organization-hie-policy
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification/evv-compliance-status-for-personal-care-services-state-or-territory
- https://medicaid.gov/about-us/organization/brent-weaver
- https://medicaid.gov/medicaid/data-systems/health-information-exchange
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106876
- http://medicaid.gov/medicaid/benefits/reentry-services-for-incarcerated-individuals/reentry-section-1115-demonstration-opportunity

…and more — 43 pages total ([download CSV](csv/axe-core__heading-order.csv)).

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

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

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

### Example pages
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/medicaid/data-systems/health-information-technology/health-disparities
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54038

---

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

**Bug ID:** `VS-eea592cb`  
**Pattern ID:** `VS-8806389c`  
**URL:** http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification  
**XPath / selector:** `.section`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-unique` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 12 instances; 12 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<aside class="section" role="complementary">
```

### Description
Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 12 of 2696 scanned pages (12 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification.
2. Locate the element: .section
3. Confirm the axe-core finding for rule landmark-unique.

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

### Affected pages
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/about-us/contact-us
- https://www.medicaid.gov/medicaid/data-systems
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=24
- https://medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19
- https://medicaid.gov/medicaid/data-systems/health-information-exchange
- http://medicaid.gov/medicaid/data-systems/health-information-technology
- https://www.medicaid.gov/medicaid/benefits/hospice-benefits
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=20
- https://www.medicaid.gov/medicaid/quality-of-care/quality-of-care-performance-measurement/adult-medicaid-quality-grants
- https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data

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

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

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

### Example pages
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/about-us/contact-us
- https://www.medicaid.gov/medicaid/data-systems

---

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

**Bug ID:** `VS-af061246`  
**Pattern ID:** `VS-4fac2f41`  
**URL:** http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=0&q=  
**XPath / selector:** `span[data-select2-id="select2-data-1-qmha"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `aria-allowed-role` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 129 instances; 60 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off" autocapitalize="none" spellcheck="false" role="searchbox" aria-autocomplete="list" autocomplete="off" aria-label="S
```

### Description
ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 60 of 2696 scanned pages (129 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=0&q=.
2. Locate the element: span[data-select2-id="select2-data-1-qmha"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea
3. Confirm the axe-core finding for rule aria-allowed-role.

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

### Affected pages
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=0&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=22&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=41&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=15&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=886&page=1&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=6&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=816&page=2&q=
- https://www.medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B%5D=881&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=861&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=746&page=1&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=6&q=
- https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=971&page=26&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=806&page=36&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B%5D=876&q=
- https://medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_topic%5D%5Bin%5D%5B0%5D=2271&limit=10&page=4&q=&sort=field_faq_date%3Adesc
- https://www.medicaid.gov/faq?filter%5Bfield_faq_date%5D%5Bgte%5D=&filter%5Bfield_faq_date%5D%5Blte%5D=&filter%5Bfield_faq_sub_topic%5D%5Bin%5D%5B%5D=8786&filter%5Bfield_faq_topic%5D%5Bin%5D%5B%5D=8696&limit=10&q=&sort=field_faq_date%3Adesc
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=711&page=1&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=926&page=0&q=
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?filter%5Bfield_state%5D%5Bin%5D%5B%5D=926&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=681&page=42&q=
- http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=726&page=0&q=
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=13&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=956&page=15&q=

…and more — 60 pages total ([download CSV](csv/axe-core__aria-allowed-role.csv)).

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

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

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

### Example pages
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=781&page=0&q=
- https://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=861&page=2&q=
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=22&q=

---

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

**Bug ID:** `VS-e61eb469`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656  
**XPath / selector:** `text: "  Feedback  "`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 10728 instances; 1273 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 1273 of 2696 scanned pages (10728 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656.
2. Locate the element: text: "  Feedback  "
3. Confirm the Siteimprove Alfa finding for rule sia-r57.

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

### Affected pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1956&f%5B1%5D=sub_topic_faq_library_facet%3A1981&f%5B2%5D=sub_topic_faq_library_facet%3A2031&f%5B3%5D=sub_topic_faq_library_facet%3A2086&page=4
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A751&f%5B1%5D=topics%3A856&f%5B2%5D=topics%3A7411&page=7
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2386&f%5B1%5D=sub_topic_faq_library_facet%3A2436&f%5B2%5D=sub_topic_faq_library_facet%3A2451&page=4
- https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A906&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A1491&f%5B4%5D=fpg_topics_facet%3A3046&f%5B5%5D=fpg_type_facet%3A1476&f%5B6%5D=fpg_type_facet%3A1536&page=0
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1891&f%5B1%5D=sub_topic_faq_library_facet%3A2096&page=81&sl=yes
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1931&f%5B1%5D=sub_topic_faq_library_facet%3A1946&f%5B2%5D=sub_topic_faq_library_facet%3A2076&f%5B3%5D=sub_topic_faq_library_facet%3A2511&page=7
- https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1926&f%5B1%5D=sub_topic_faq_library_facet%3A2021&f%5B2%5D=sub_topic_faq_library_facet%3A2036&f%5B3%5D=sub_topic_faq_library_facet%3A2081&f%5B4%5D=sub_topic_faq_library_facet%3A2446&page=84
- https://www.medicaid.gov/faq?fcf=41254&page=3&sl=yes
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-17-005-14
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A996&objectId=3242896&page=65
- http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8361&f%5B0%5D=waiver_state_facet%3A731&f%5B1%5D=waiver_state_facet%3A931&page=1
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?f%5B0%5D=waiver_state_facet%3A846&f%5B1%5D=waiver_state_facet%3A881&page=63
- https://www.medicaid.gov/faq?entry=48729&page=84
- http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A761&f%5B1%5D=topics%3A1496&page=1661
- http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A2031&f%5B1%5D=sub_topic_faq_library_facet%3A2356&f%5B2%5D=sub_topic_faq_library_facet%3A2511&page=2
- https://www.medicaid.gov/faq?fcf=41089&page=0&sl=yes
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A716&f%5B1%5D=state%3A781&f%5B10%5D=topics%3A2726&f%5B11%5D=topics%3A3141&f%5B12%5D=topics%3A3261&f%5B13%5D=topics%3A3381&f%5B14%5D=topics%3A3791&f%5B15%5D=topics%3A7296&f%5B16%5D=topics%3A7386&f%5B17%5D=topics%3A7391&f%5B18%5D=topics%3A8496&f%5B2%5D=state%3A841&f%5B3%5D=state%3A881&f%5B4%5D=state%3A891&f%5B5%5D=state%3A941&f%5B6%5D=state%3A1006&f%5B7%5D=state%3A8296&f%5B8%5D=topics%3A761&f%5B9%5D=topics%3A936&page=0
- https://www.medicaid.gov/federal-policy-guidance?fcf=1190&page=111&sl=yes
- https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8311&page=2

…and more — 1273 pages total ([download CSV](csv/alfa__sia-r57.csv)).

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57

### Example pages
- https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=topics%3A3046&f%5B1%5D=topics%3A7426&page=1656
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18

---

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

**Bug ID:** `VS-7233315f`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r87` ([reference](https://alfa.siteimprove.com/rules/sia-r87))  
**Severity:** Moderate  
**Frequency:** 224 instances; 224 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 224 of 2696 scanned pages (224 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r87.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-17-005-14
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7183
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6363
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7860
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8618
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2083
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-886
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-891
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-26-011-11
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-15-001-1
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-1-017-18
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2805
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2888
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002084
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6909
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg016212
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2815
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004060
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-805
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-096-92
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt001227

…and more — 224 pages total ([download CSV](csv/alfa__sia-r87.csv)).

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r87

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16

---

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

**Bug ID:** `VS-ead0f39f`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r61` ([reference](https://alfa.siteimprove.com/rules/sia-r61))  
**Severity:** Moderate  
**Frequency:** 222 instances; 222 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 222 of 2696 scanned pages (222 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r61.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-17-005-14
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7183
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6363
- https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-7860
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8618
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2083
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-886
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-891
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-26-011-11
- https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/el-15-001-1
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/el-1-017-18
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2805
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2888
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002084
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6909
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg016212
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2815
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004060
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-805
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mcr-12-096-92
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt001227

…and more — 222 pages total ([download CSV](csv/alfa__sia-r61.csv)).

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2806
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-1-004-18
- https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16

---

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

**Bug ID:** `VS-52dc8da7`  
**Pattern ID:** `VS-e05344b9`  
**URL:** https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008  
**XPath / selector:** `@aria-selected="true"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 223 instances; 46 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 46 of 2696 scanned pages (223 instances).

### Steps to reproduce
1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008.
2. Locate the element: @aria-selected="true"
3. Confirm the Siteimprove Alfa finding for rule sia-r18.

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

### Affected pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002084
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg016212
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004060
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt001227
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/crx-claim-pharmacy/file-header-record-rx
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002053
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002050
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002141
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003116
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/tpl004059
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr002030
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002138
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx003095
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr004059
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/crx-claim-pharmacy
- https://medicaid.gov/tmsis/dataguide/v4/file-segment-layouts/mcr-managed-care-plan-information/managed-care-location-and-contact-info
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/tpl001005
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/ftx095372
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg011164
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002025
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx003134
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/ftx006231
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002164
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cot001004

…and more — 46 pages total ([download CSV](csv/alfa__sia-r18.csv)).

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

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

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

### Example pages
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/prv001008
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/crx002084
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg016212

---

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

**Bug ID:** `VS-55739e10`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://medicaid.gov/tmsis/dataguide/v4/data-elements/tpl003050  
**XPath / selector:** `td`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 36 instances; 29 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

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

### Description
Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 29 of 2696 scanned pages (36 instances).

### Steps to reproduce
1. Open https://medicaid.gov/tmsis/dataguide/v4/data-elements/tpl003050.
2. Locate the element: td
3. Confirm the deprecated-html finding for rule presentational-attr.

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

### Affected pages
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/tpl003050
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8425
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8735
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-414
- https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002104
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/exp-16-006-19
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6786
- https://medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-18-001-1
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/all-14-001-1
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/cip002165
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1861
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-2000
- https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/clt002095
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7741
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/clt002065
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/crx002177
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/mcr003035
- https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-11-020-20
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-7031
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-887
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/elg011160
- https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1067
- https://medicaid.gov/tmsis/dataguide/v3/data-elements/crx002070
- https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-1579
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6350

…and more — 29 pages total ([download CSV](csv/deprecated-html__presentational-attr.csv)).

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

### Suggested fix
Not captured by automated scan — requires manual testing.

### Example pages
- https://medicaid.gov/tmsis/dataguide/v4/data-elements/tpl003050
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8425
- https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-8735

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-63682834`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification  
**XPath / selector:** `<h3>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 22 instances; 19 of 2696 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 19 of 2696 scanned pages (22 instances).

### Steps to reproduce
1. Open http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification.
2. Locate the element: <h3>
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

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

### Affected pages
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54038
- http://medicaid.gov/state-overviews/stateprofile.html?state=Pennsylvania
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification/good-faith-effort-exemption-requests-home-health-care-services
- http://medicaid.gov/about-us/contact-us
- https://www.medicaid.gov/medicaid/data-systems/health-information-exchange/section-1115-demonstration-hie-policy
- https://medicaid.gov/resources-for-states/innovation-accelerator-program/functional-areas/quality-measurement/promoting-community-integration-through-long-term-services-and-supports-quality-measures
- https://www.medicaid.gov/medicaid/data-systems
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=24
- https://www.medicaid.gov/medicaid/data-systems/health-information-exchange/managed-care-organization-hie-policy
- https://medicaid.gov/about-us/organization/brent-weaver
- https://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/106876
- http://medicaid.gov/medicaid/data-systems/health-information-technology
- https://www.medicaid.gov/resources-for-states/medicaid-state-technical-assistance/technical-assistance-develop-evidence-based-continuum-of-crisis-care
- https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/108006
- https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?page=20
- https://www.medicaid.gov/medicaid/quality-of-care/quality-of-care-performance-measurement/adult-medicaid-quality-grants
- https://www.medicaid.gov/new-notable?page=87
- https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data

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

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

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

### Example pages
- http://medicaid.gov/medicaid/home-community-based-services/home-community-based-services-guidance-additional-resources/electronic-visit-verification
- http://medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54038
- http://medicaid.gov/state-overviews/stateprofile.html?state=Pennsylvania