[{"_1":2,"_112":-5,"_113":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6252802,"mediaKeyId","3185874-a128b8883645fe8e03682ea131c4c8f1","parentId",3185874,"title","Heated testimony on HB 4399: nurse practitioners seek full practice authority while medical groups warn of safety risks","audioSeconds",2805,"startMs",2435000,"endMs",5240000,"viewUrl","/Search/View?dp=1&key=3185874-a128b8883645fe8e03682ea131c4c8f1&start=2435&end=5240","thumbnailUrl","https://assets.pipeline.soar.com/3185874-a128b8883645fe8e03682ea131c4c8f1/thumbnail_2435000.jpg","articleUrl","/articles/6252802/Michigan/Heated-testimony-on-HB-4399-nurse-practitioners-seek-full-practice-authority-while-medical-groups-warn-of-safety-risks","mediaUrl","https://secure.pipeline.soar.com/6252802-9ced490bd09a7d19ac73e5ea21a3c7ac/orig.mp4?Expires=1770892039&Signature=XaZvlR2xgLzukzZCsFlpKgd7udAvkHP8p2gr7nzqq3kE8B3CqA985Yoa7G20xgT1-I1LLKAfDpcMJ6ArKEM6cxQs3SmAKsMqi7Yq6Db9zPY8phnmYEGEGacv~LgTs2pdIVLt27DIwYv1ZDm3OFKsHNAq8XhZXMphUt3XlztLxZsNLmMXHVqupt-BGMqbBNKz2GUReQTveWTx0sPtyD3eQXKLdCXN4MTMA8Xr0tVZF5ZXvT-9ma9aqtcpcwGzDBjXuIexydW5sy1MoXByIHWs2hWXjz7ZpOgMobn8z7D4YiiCeRQBXKv8CWNHlOcuitwH5hW93~SqwxynYlwv12t-xQ__&Key-Pair-Id=KUT5TJCACFTXG","author","Health Policy","date","2025-04-30T00:00:00Z","article","Representative Natalie Preston introduced House Bill 4399 to the Michigan House Health Policy Committee, saying the bill “does not increase the scope of practice for nurse practitioners. It simply codifies the existing regulations around what a nurse practitioner is currently providing to their patients.” Preston said the measure would remove the statutory requirement that a physician contract delegate practice authority to nurse practitioners and instead allow the Michigan Board of Nursing to grant nurse practitioner specialty certification consistent with national accreditation and board requirements.

Supporters testified that the bill would increase access and build workforce capacity. Nyla Russell of the Michigan Council of Nurse Practitioners said Michigan has over 14,000 nurse practitioners and argued the bill would ease credentialing barriers that now require a physician contract before obtaining DEA and controlled‑substance registrations and Medicaid participation. “Patients have access to safe, high quality care without unnecessary regulatory burden,” Russell said, and she described full practice authority as “a healthcare access bill, a workforce development and retention” measure.

Ramona Menkert, dean of the Wayne State University College of Nursing, told the committee nursing schools prepare graduate nurse practitioners with advanced pharmacology, pathophysiology and supervised clinical training; she said programs must meet accrediting and certification standards and that decades of data support NP quality and safety.

Opponents warned the bill lacks minimum supervision and training requirements. Kathleen Westfall, a health‑care attorney representing the Michigan State Medical Society, told the committee HB 4399 “will not achieve” the stated workforce goals and lacks any requirement for minimum supervised patient‑contact hours before independent practice or prescriptive authority. Westfall said the bill “provides no clear guidance to the Department of Licensing and Regulatory Affairs as to when a nurse practitioner is engaging in the practice of a nurse practitioner and when they are engaging in the unlicensed practice of medicine.”

Dr. Rose Ramirez, a family physician and former president of the Michigan State Medical Society, testified that evidence does not show full practice authority improves access in underserved regions and cautioned about variation in NP educational programs, including online and accelerated formats. “Please, do not approve house bill 43 99 because it holds a grand promise that it ultimately cannot fulfill,” she said.

Dr. Mohan Nagapala, speaking for the Michigan Academy of Family Physicians, warned differences in clinical training between physicians and NPs are significant and said the bill would weaken professional standards and risk costly additional testing and hospitalizations. Several committee members pressed supporters on rural access and reimbursement effects; witnesses said the bill does not change payer reimbursement rates but may reduce practice overhead by removing contractual physician fees, which supporters said could increase hiring and access.

Committee chair VanderWaal said testimony would continue in a subsequent meeting; no committee vote on HB 4399 was recorded during this session.","mediaType","Video","parentTitle","Health Policy | Wednesday, April 30, 2025","oneSentenceSummary","Representative Preston and nurse practitioner advocates told the House Health Policy Committee HB 4399 would remove the statutory physician‑contract requirement and ease credentialing barriers; physician groups and medical‑society witnesses warned the bill lacks minimum supervision and patient‑safety safeguards.","taxTitle","Health Policy, House of Representative, Committees\t\t\t\t\t, Legislative, Michigan","taxId",27466,"location","Michigan","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6252807,"Hospitals and nurse advocates support Michigan joining nurse‑licensure compact, citing staffing and telehealth benefits",265,1437000,1702000,"/Search/View?dp=1&key=3185874-a128b8883645fe8e03682ea131c4c8f1&start=1437&end=1702","https://assets.pipeline.soar.com/3185874-a128b8883645fe8e03682ea131c4c8f1/thumbnail_1437000.jpg","/articles/6252807/Michigan/Hospitals-and-nurse-advocates-support-Michigan-joining-nurselicensure-compact-citing-staffing-and-telehealth-benefits","https://secure.pipeline.soar.com/6252807-9b29c0ad37e7fe3afe7b7cb06062ed22/orig.mp4?Expires=1770892039&Signature=k3UihdWaQNqKaBgZf~yPy-54udmiIiCfz3WtfnVGOQGXlxq3piddWAIa5JFRqqi9nMHYF5VvlrfH8~nyn2tIRh2TWxzZRPiF6Pud6snrdiaQUq6TziLhPVficI9D-ypA3mG-KevKYDhEop3QfRHm1TLRUO9wVupcJWEF1o0ip1vIVg3HOYYKT~IhOr8GBbgw0OxY20LGAO6-dPlw0ATy3cd9oZnKtmY49xZx1qUJpi~3unlr46SY8WxbEIAI3HEQ-cR4O2foBVvjC7-nLw3gp4hRZGFbubKzHPlqfgTkUmsHaqMMo07f7jg6RZGWNLX7V3yE-7Rsj4oEzQLIUs1cCA__&Key-Pair-Id=KUT5TJCACFTXG","Doctor Doug DeCenzo, regional chief nursing officer for Trinity Health Michigan, testified in support of House Bill 4246, which would permit Michigan to join the Nurse Licensure Compact. DeCenzo said the state faces workforce pressure: a Michigan Health and Hospital Association survey found “almost 5,000 nurse vacancies in hospitals statewide,” and Trinity Health’s virtual‑care model currently must recruit virtual nurses solely from Michigan, “further exhausting the state's nursing talent pool.”

DeCenzo told the committee that 41 states and two U.S. territories have entered compacts and argued there is no evidence the compact reduces patient‑care quality. “A nurse licensure compact in Michigan would allow nurses to practice more easily, conveniently, and cost effectively across state lines,” he said, adding it would help with emergency redeployment and telehealth.

Sherry Martin, a nurse with decades of clinical experience, also spoke in support and recounted her career path and belief that the compact would grant nurses greater professional flexibility. Martin said she has advocated for the compact for years and urged lawmakers to “move into the future,” noting many other states already participate.

Witness cards were read into the record for professional organizations that registered support (some indicated they did not wish to speak) and other stakeholders were listed as having filed cards either supporting or opposing the bill. Committee members thanked witnesses and noted the committee would continue consideration of related bills.

No formal committee action on HB 4246 was recorded during this segment; testimony continued elsewhere on the agenda.","Representatives from Trinity Health Michigan and nurse advocates told the House Health Policy Committee that joining the Nurse Licensure Compact would improve staffing flexibility, telehealth access and emergency redeployment of nurses; witnesses noted other states’ experience and debated continuing‑education concerns.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6252811,"House Health Policy committee adopts substitute for HB 4101 and reports HB 4380 to the floor",142,1270000,1412000,"/Search/View?dp=1&key=3185874-a128b8883645fe8e03682ea131c4c8f1&start=1270&end=1412","https://assets.pipeline.soar.com/3185874-a128b8883645fe8e03682ea131c4c8f1/thumbnail_1270000.jpg","/articles/6252811/Michigan/House-Health-Policy-committee-adopts-substitute-for-HB-4101-and-reports-HB-4380-to-the-floor","https://secure.pipeline.soar.com/6252811-d7af21ece0d9dcd3d671e8060d1d97e0/orig.mp4?Expires=1770892039&Signature=lW3sC85DP91ZNgsnlQ4xm5BfyOgsCA3BDYSZ0B7dyp107A-VCYfTs9a0H21rdqHIVdjed9iOkdEUaRFszxK0YkU-oo4F-mSUxQvweS53sdqULuvVm8YeKNqgh-BW2ip~Q-aH4NV8S5ctrGzPPaPYWplfsCpsefWnM-ofxzyqu~L4zyru6WDfjP~AApBbSdDUXBHzI8djti4SADxWBNQBWB8z17pS5d9NiHFYhHKaEuuKfankk2-D~ZMTlm3PKyjRbRG98-JC2a09-O65830EkP0TkFmv7FKPEV3HGwsHGaLwjCwN0b~ZpLGYmRr~I~LvaCTaDZAbnCSuKnKLzLSA~w__&Key-Pair-Id=KUT5TJCACFTXG","The Michigan House Health Policy Committee adopted the H‑1 substitute for House Bill 4101 and then voted to refer the bill to the Committee on Rules. Representative Meerman moved to adopt the H‑1 substitute for HB 4101; the clerk recorded 17 yeas, 0 nays, and the substitute was adopted. Representative Bierlein then moved to report HB 4101 (as the H‑1 substitute) to the committee on rules; the motion carried on a recorded vote of 17 yeas, 0 nays.

On a separate motion, Representative Thompson moved to report House Bill 4380 to the floor “with recommendation that the bill then pass.” The clerk recorded 17 yeas, 0 nays and the motion prevailed; HB 4380 was reported to the floor with the committee’s recommendation that it pass.

Committee chair VanderWaal read witness cards submitted in support of the pair of PT compact bills from professional organizations including the American Physical Therapy Association of Michigan and Michigan Occupational Therapy (witnesses indicated they did not wish to speak).","The committee adopted the H‑1 substitute for House Bill 4101 and referred the bill to the committee on rules; it also reported House Bill 4380 to the floor with recommendation that it pass. Roll calls recorded unanimous votes.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6252815,"Michigan maternal-child council urges sustaining Medicaid, highlights record-low infant mortality",730,282000,1012000,"/Search/View?dp=1&key=3185874-a128b8883645fe8e03682ea131c4c8f1&start=282&end=1012","https://assets.pipeline.soar.com/3185874-a128b8883645fe8e03682ea131c4c8f1/thumbnail_282000.jpg","/articles/6252815/Michigan/Michigan-maternal-child-council-urges-sustaining-Medicaid-highlights-record-low-infant-mortality","https://secure.pipeline.soar.com/6252815-0883fc5921528b73d7baf8bbe1855da0/orig.mp4?Expires=1770892039&Signature=FC-hhdRpXgOJFeqPD01zR-f5c736MsFKqxVAXfaGwPiZjVOEAjo0~Cqlz04QtEayFfSQHRzNyrnIhd~Ao8Glwwynf-cdrPALP~dE1E1NV7jKGTAQ20aSw5xRqLe3T77Cyi0YGfIC8zx5vFtsIr-ux1LSYuXy9RcCHxGiujtriWNPTBLljw2Zml0Ml3IuIsKFaP~6e5M7UIkMZWeo20pbo~vQ4SJnMOdf9OK~3uJmP-X6M38DBNOIcJ6nFt4oNxT2P9kODOVS~ufuXlHpZamfi49mq7xcYHeVEMN0zbF2bsCtMhXvBlBwWiXKobBBsa2AN3FmULKz8ixGI8rqGAoEGw__&Key-Pair-Id=KUT5TJCACFTXG","Amy Zegman, executive director of the Michigan Council of Maternal and Child Health, told the Michigan House Health Policy Committee that sustained investment is essential to preserve recent gains in maternal and infant health. Zegman said Michigan’s infant mortality rate is “at the lowest on record, 6.1,” and urged lawmakers to continue support for programs that reduce downstream costs and improve outcomes.

Zegman said the council, a nonprofit that brings together clinicians and public‑health professionals, has focused in recent years on behavioral health, maternal health and perinatal quality collaboratives. “We have 9 regional perinatal quality collaboratives,” she said, describing them as local networks that meet regularly to review regional data and coordinate clinical and community responses.

The council highlighted several program areas: expansion of behavioral‑health supports for children and adolescents, improved access to school‑based mental‑health services, immunization outreach during a multi‑state measles outbreak, and supports for families enrolled in Children’s Special Health Care Services. Zegman told the committee the program covers about 2,700 medical diagnoses and “about 55,000 enrollees,” and that roughly 70 percent of those children are dually enrolled in Medicaid.

Zegman also warned the committee about the consequences of federal Medicaid changes. “Medicaid covers over a million children in Michigan. Over 40 percent of our births in Michigan are covered by Medicaid,” she said, adding that recent additions to Medicaid—doulas and centering‑pregnancy programs—would be at risk if eligibility or funding is reduced. The council expects to publish a phase‑two birth equity education project in the fall and offered to work with legislators on policy, statute and appropriation options.

Representative Thompson asked about cesarean and induction practices and their downstream effects on breastfeeding and outcomes; Zegman declined to give clinical advice but agreed hypertension control and supports that reduce avoidable interventions are important. Zegman also said the council works with WIC and the Michigan Breastfeeding Network to expand breastfeeding support, including hospital‑grade pumps and peer counseling at the local level.

The council left contact information and offered to coordinate further briefings for legislators and staff.","Amy Zegman of the Michigan Council of Maternal and Child Health told the House Health Policy Committee the state should sustain recent maternal‑health investments, citing a record-low infant mortality rate of 6.1 per 1,000 live births and warning about risks from potential federal Medicaid changes.","actionData","errors"]

Article not found

Heated testimony on HB 4399: nurse practitioners seek full practice authority while medical groups warn of safety risks

Hospitals and nurse advocates support Michigan joining nurse‑licensure compact, citing staffing and telehealth benefits

House Health Policy committee adopts substitute for HB 4101 and reports HB 4380 to the floor

Michigan maternal-child council urges sustaining Medicaid, highlights record-low infant mortality