Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Nurse Practitioner Practice Authority topic
No spam. Unsubscribe anytime.
Debate broadens over nurse practitioner full practice authority as committee hears both sides of HB 4399
Summary
Representative Preston and supporters told the House Health Policy Committee that House Bill 4399 would remove the statutory physician‑contract requirement for nurse practitioners while opponents warned the bill lacks required safeguards and could harm patient safety if enacted as written.
Representative Preston introduced House Bill 4399 to remove the statutory requirement that nurse practitioners enter contracts with physicians to provide care under their own license. The committee heard extensive testimony both supporting and opposing the proposal.
Supporters said the bill would not expand clinical scope but would remove an administrative barrier that restricts nurse practitioners’ ability to practice, particularly in underserved and rural areas. Representative Preston said 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.” Nyla Russell of the Michigan Council of Nurse Practitioners and dozens of nurse practitioners in the audience said full practice authority would improve access to primary care, reduce emergency‑department crowding and retain graduates who otherwise might practice in full‑practice states.
Educators also testified. Dr. Ramona Benkert, dean of Wayne State University’s College of Nursing, told the committee that graduate nursing programs train nurse practitioners with advanced coursework and clinical hours, and she said decades of research support nurse practitioners’ quality and safety in practice.
Opponents — including the Michigan State Medical Society, independent physicians and the Michigan Academy of Family Physicians — urged caution. Kathleen Westfall, counsel for the Michigan State Medical Society, said HB 4399 “goes too far” as written because it lacks minimum supervised clinical hours before independent practice, does not set board rules for referral or consultation, and could take effect before administrative safeguards are in place. Physician witnesses warned that differences in training and clinical experience between physicians and nurse practitioners can matter in complex cases, and they cited studies and state comparisons that, in their view, do not show improved access in underserved areas solely from removing delegation requirements.
Stakeholders and lawmakers asked about controlled substances and Medicaid credentialing. Witnesses for proponents said the bill would not change prescriptive authority that is already regulated by state and federal safeguards and that Medicaid participation and credentialing requirements would remain governed by payers and statute.
Why it matters: HB 4399 would change statutory supervision requirements for nurse practitioners in Michigan and is part of a broader national debate about scope of practice, workforce capacity and patient safety. If enacted, the bill could alter how primary care services are delivered in rural and urban communities.
Committee process: The committee scheduled additional testimony for a future meeting and read multiple supporting and opposing witness cards into the record. No final committee vote on HB 4399 was recorded during this session.
Quote: “This bill does not increase the scope of practice for nurse practitioners. It simply codifies the existing regulations,” Representative Preston told the committee.
