Revised Part A National Medical Support Notice (NMSN) and Instructions


Publication Date: October 30, 2019



DATE: October 30, 2019

TO: State IV-D Agencies

SUBJECT:  Revised Part A National Medical Support Notice (NMSN) and Instructions

ATTACHMENT:  National Medical Support Notice Form and Instructions, OMB 0970-0222 [No longer available]

The Office of Management and Budget (OMB) has approved the revised NMSN Part A with a new expiration date of October 31, 2022. State child support agencies, under title IV-D of the Social Security Act, must enforce the health care coverage provision in a child support order and use the NMSN to aid enforcement. Tribal IV-D agencies do not have to use these forms.

On March 19, 2019, a notice for public comment for Part A was published in the Federal Register, page 10096, Volume 84, Number 53 (PDF) Visit disclaimer page . The revised OMB-approved form includes an option for state child support agencies to use the NMSN Part A to notify an employer that a medical support order has terminated.

Significant Changes to the NMSN Part A Form and Instructions

  1. A checkbox was added to distinguish between the National Medical Support Order/Notice and a Termination Order/Notice.
  2. The Employer Responsibilities section indicates that employers are required to terminate medical insurance when they receive an NMSN with the Termination Order/Notice checkbox checked on page one unless the parent wishes to continue the insurance voluntarily.

The Department of Labor is the agency that will update the NMSN Part B form.  OCSE will publish the revised NMSN Part B on its website once the updated form is available.  Meanwhile, continue using the current NMSN Part B form. 


EFFECTIVE DATE:  November 1, 2019

INQUIRIES:  ACF/OCSE Regional Program Managers

Scott M. Lekan
Office of Child Support Enforcement


Current as of: