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For example, an order that is clear and complete when submitted should require less time to review than one that is incomplete or unclear. (d) Additional requirement.Pennsylvania law gives the courts the authority to order either parent to provide medical support if it is available at no cost or at a reasonable cost. Medical support is a form of child support that provides either cash medical support or health insurance. When the court determines which parent will be responsible for providing health care, it will enter what is called a Qualified Medical Support Order, or QMCSO. View a guide for clients on medical support obligations in Luzerne County support cases. Employers with group health plans may sometimes receive medical child support orders, requiring them to extend coverage to an employee's children. A properly completed NMSN must be treated as a QMCSO. A properly completed NMSN must be treated as a QMCSO. The National Medical Support Notice (NMSN) is a federally-mandated standardized form that all state child support enforcement agencies are required to use.