According to the USAF they already accepted it for approval.
Any thoughts on wear?-My guess is (based on the Air Force order of precedence for awards) that it will go before all other NATO Medals...and be allowed to become a separate NATO medal by itself since all current NATO service medals are annotated with the first award only and then ALL subsequent awards are by bronze service star...
The NATO Meritorious Service Medal (MSM) was approved by the North Atlantic Council, and is awarded to military and civilian personnel who have been commended for providing exceptional or remarkable service to NATO. The Secretary of Defense has approved the acceptance and wear of the NATO MSM for US Military and US Civilian personnel.
Eligible personnel are individuals serving permanently or temporarily within NATO's operational chain of command or in those forces under NATO command or control, or in a NATO Body, who are commended personally by a Commander or a Head of a NATO Body for:
-- Performing acts of courage in difficult or dangerous circumstances; or -- Showing exceptional leadership or personal example; or -- Making an outstanding individual contribution in any activity or program; or -- Enduring particular hardship or deprivation in the interest of NATO
The ribbon and medal fabric is NATO Blue with white edges, with silver and gold threads centered on the white. The medal disc is of silver color.
Since it is a decoration, not a general service medal, I would think if/when it is accepted - and I don't see why it wouldn't be - it would be treated like any other foreign decoration.