House Policy Committee Passes HB 4399 —  Continued Advocacy Needed

Since its introduction this spring, MAFP along with the Michigan State Medical Society, Michigan Osteopathic Association, Michigan Chapter-American Academy of Pediatrics, Michigan College of Emergency Physicians, Michigan Society of Hematology and Oncology, the Michigan Radiological Association, and the Michigan Chapter of the American College of Cardiology, have voiced strong opposition to House Bill 4399, which would allow nurse practitioners to practice medicine without physician supervision.

This morning, the House Health Policy Committee passed HB 4399 with a 9 yes, 1 no and 1 pass vote. A H-1 substitute was adopted that would require 1,000 hours of experience practicing as a nurse practitioner in Michigan or another state and complete at least 15 hours of continuing education per renewal cycle in pharmacology, therapeutics, or prescribing. The bill sponsor, Rep. David Prestin (R-Cedar River), mentioned that this bill would grant the state additional “points” to obtain Rural Health Transformation Project funding from the federal government. In reality, having full practice authority for NPs would not drastically change the state’s total score, contrary to what was shared by the bill sponsor in committee.

MAFP President Bashar Yalldo, MD, FAAFP said that while HB 4399 is presented as a solution to access challenges, it ignores the underlying issues of inadequate reimbursement, physician burnout, and persistent workforce shortages. Dr. Yalldo reaffirmed that team-based, physician-led care remains the best model, especially for underserved populations.

“Allowing independent practice without physician involvement has not improved access, quality, or cost in other states," Dr. Yalldo said. "We value nurse practitioners and the role they play on the care team, but the strongest model, especially for complex and underserved populations, remains team-based, physician-led care. This bill risks creating two standards of care in Michigan, and underserved communities deserve better, not less. MAFP will continue to push for real solutions, including improved reimbursement, loan repayment and retention programs, and support for true team-based care.”  

HB 4399 has now been referred to the House Rules Committee. Please see this infographic outlining the bill’s legislative path. We are currently on step four.