National Medical Support Notice - Part A

OMB 0970-0222

Section 401 of the Child Support Performance and Incentives Act of 1998 (CSPIA) Pub.L. 105-200 requires state child support agencies under title IV-D of the Social Security Act (the Act) to enforce the health care coverage provision in a child support order, and to use the National Medical Support Notice (NMSN) as the means of enforcement. The law requires the NMSN to be promulgated by regulations issued jointly by the Departments of Health and Human Service (HHS) and Labor (DOL). This request for a nonsubstantive change is to correct two minor typographical errors.

The latest form for National Medical Support Notice - Part A expires 2022-10-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form Part A - Revised 2 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) Form
Form Part A - Revised 2 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) Form
Form Part A - Revised 2 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) Form
Form Part A - Revised 2 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) Form
Form NMSN Matrix State Medical Support Contacts and Program Requirement Matrix (State Respondents) Form
Form NMSN Matrix State Medical Support Contacts and Program Requirement Matrix (State Respondents) Form
Form Part A - Revised 2 National Medical Support Notice-Part A (Employer Respondents) Form
Form Part A - Revised 2 National Medical Support Notice-Part A (Employer Respondents) Form
Form Part A - Revised 2 National Medical Support Notice-Part A (State Respondents) Form
Form Part A - Revised 2 National Medical Support Notice-Part A (State Respondents) Form
2023 e-NMSN record specifications-NMSN Part A_NonSub Change Request_1.2.24.docx Justification for No Material/Nonsubstantive Change
2023 e-NMSN record specifications-NMSN Part A_NonSub Change Request_1.2.24.docx Justification for No Material/Nonsubstantive Change
NMSN Part A _NonSub Change Request_nc_3-2-23.docx Justification for No Material/Nonsubstantive Change
NMSN Part A _NonSub Change Request_nc_3-2-23.docx Justification for No Material/Nonsubstantive Change
NonSub Change Request - MNSN Updates 0970-0222.docx Justification for No Material/Nonsubstantive Change
NonSub Change Request - MNSN Updates 0970-0222.docx Justification for No Material/Nonsubstantive Change
2022 10 27 Public Comments Received on the National Medical Support Notice Part A after 30 day comment period Responses Final for NC.docx Supplementary Document
2022 10 27 Public Comments Received on the National Medical Support Notice Part A after 30 day comment period Responses Final for NC.docx Supplementary Document
Attachment A - Public Comments Received on the National Medical Support Notice Part A_final.docx Supplementary Document
Attachment A - Public Comments Received on the National Medical Support Notice Part A_final.docx Supplementary Document
2022 10 27 NMSN_Part_A_Sample_Form_after 30 day comment period clean Final to NC.docx Supplementary Document
2022 10 27 NMSN_Part_A_Sample_Form_after 30 day comment period clean Final to NC.docx Supplementary Document
NMSN Part A Supporting Statement _NonSub Chg - eNMSN_1.2.24.docx Supporting Statement A
NMSN Part A Supporting Statement _NonSub Chg - eNMSN_1.2.24.docx Supporting Statement A
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) Form
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) Form
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) Form
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) Form
State Medical Support Contacts and Program Requirement Matrix (State Respondents) Form
State Medical Support Contacts and Program Requirement Matrix (State Respondents) Form
National Medical Support Notice-Part A (Employer Respondents) Form
National Medical Support Notice-Part A (Employer Respondents) Form
National Medical Support Notice-Part A (State Respondents) Form
National Medical Support Notice-Part A (State Respondents) Form

All Historical Document Collections

202401-0970-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2024-01-03
202302-0970-005 Approved without change	No material or nonsubstantive change to a currently approved collection	2023-03-03
202211-0970-008 Approved without change	No material or nonsubstantive change to a currently approved collection	2022-11-23
202209-0970-007 Approved without change	Revision of a currently approved collection	2022-09-22
201911-0970-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2019-11-04
201907-0970-003 Approved without change	Revision of a currently approved collection	2019-07-15
201606-0970-008 Approved with change	Extension without change of a currently approved collection	2016-06-28
201308-0970-003 Approved without change	No material or nonsubstantive change to a currently approved collection	2013-08-29
201306-0970-005 Approved without change	Extension without change of a currently approved collection	2013-06-25
201012-0970-001 Approved without change	Revision of a currently approved collection	2010-12-06
200712-0970-005 Approved without change	Revision of a currently approved collection	2007-12-17
200411-0970-005 Approved without change	Reinstatement with change of a previously approved collection	2004-11-30
200011-0970-001 Approved without change	New collection (Request for a new OMB Control Number)	2000-11-08

OMB Details

National Medical Support Notice-Part A (State Respondents)

Federal Enterprise Architecture: Community and Social Services - Social Services

Form Part A

National Medical Support Notice - Part A

Fillable Printable

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.