National Medical Support Notice Part A and Part B


Publication Date: April 24, 2012


DATE: April 24, 2012


RE: National Medical Support Notice Part A and Part B

Dear Colleague:

The federal Office of Child Support Enforcement (OCSE) revised Part A of the National Medical Support Notice (NMSN) last year with an expiration date of March 31, 2014. The Department of Labor (DOL) revised Part B in 2009 with an expiration date of October 31, 2012. OCSE and DOL are planning minor revisions to both parts by October 2012.

In an effort to synchronize the expiration dates on the forms, DOL published a Notice in the Federal Register on November 10, 2010 (75 FR 69129) to request public comments on proposed changes to Part B of the Notice. These changes were needed in order to implement the electronic NMSN efficiently and conform to the revisions of Part A of the Notice. OCSE disseminated these proposed changes via DCL-10-23. However, during the past year states have expressed concerns about investing resources in medical support enforcement and updating their systems to comply with revisions to these forms.

OCSE anticipates improvements to children’s health care coverage options in the next few years; therefore, we are reviewing the medical child support enforcement statute and rules to identify any modifications necessary to support these efforts. As a result, we will not make immediate changes to the NMSN, including automating the form.

In response to states’ concerns, and to avoid making new investments in medical support enforcement to comply with regulatory requirements that may become obsolete, OCSE in coordination with DOL plans to revise the NMSN Parts A and B by October 2012, with minor changes. The revision will synchronize the expiration dates and make conforming changes to page 1 of the NMSN Part B to match the changes made to Part A in 2011. OCSE will disseminate these new versions of Part A and B with an expiration date of October 31, 2015 through an Action Transmittal later this fall. The current forms are available on the OCSE website. Tribal child support programs are not required to use this form.

As stated in previous policy guidance, states have flexibility in implementing medical support policy; however, state child support agencies must continue to provide medical child support enforcement services in compliance with all statutory requirements, including Sections 452(f) and 466(a)(19) of the Social Security Act. This includes using the NMSN to enforce medical support, when appropriate.


Vicki Turetsky
Office of Child Support Enforcement

cc: ACF/OCSE Regional Program Managers
Tribal IV-D Directors

Current as of: