On April 30, 2025, the Michigan State Medical Society (MSMS) delivered powerful testimony before the House Health Policy Committee in opposition to House Bill 4399—legislation that would permit nurse practitioners (NPs) to practice independently without physician oversight. MSMS is grateful for the strong and articulate voices of physicians and others who are advocating for patient safety and high standards of care.
MSMS Past President Rose Ramirez, MD; MSMS Legal Counsel Kathleen Westfall, JD, of Kerr Russell; and Beena Nagappala, MD, Board Chair of the Michigan Academy of Family Physicians, represented Michigan’s physicians with clarity and conviction. Their testimony underscored the critical need to maintain physician-led care teams and exposed the significant risks posed by this bill.
HB 4399 would also allow nurse practitioners to prescribe controlled substances, order, receive, and dispense complimentary starter doses of controlled substances without delegation by a physician, and supervise any person engaged in a health occupation.
TAKE ACTION NOW
1. Contact your lawmakers today and urge them to OPPOSE HB 4399 and any legislation that compromises the standards of medical care.
2. Contact the House Health Policy Committee with your opposition by sending the message below to the Committee Clerk at hcrawley@house.mi.gov:
“My name is (insert name). I would like to submit a card of opposition for HB 4399. Thank you.”
While the bill sponsor, Rep. David Prestin (R-Cedar River), claims this measure would help address workforce shortages in rural areas, physician advocates cautioned that it oversimplifies a complex problem.
Ms. Westfall made it clear that the bill fails to address the root causes of health professional shortages—issues such as administrative burden, staffing challenges, and inadequate reimbursement for Medicaid and Medicare patients. She also raised valid legal concerns, including a lack of clarity on when NPs would cross into the unlicensed practice of medicine and the absence of safeguards for title transparency.
“While it is nice to think about the idea of the people whom this bill may help, we must give consideration as to who this bill might hurt,” Westfall emphasized. “Michiganders deserve access to care, but they also deserve access to quality care by professionals who have the necessary education, training and experience to render it.”
Doctor Ramirez echoed these concerns, noting that granting independent practice to NPs is not a solution to the structural issues plaguing our healthcare system. “Burdensome regulations, administrative tasks, reimbursement challenges, and persistent staffing shortages do not merely go away by giving independent practice to nurse practitioners,” she testified. “These are systemic issues that need to be addressed in a sustainable, effective manner.”
As discussion on HB 4399 continues, MSMS urges physicians to take action. Your voice is critical in protecting patients and preserving the integrity of team-based, physician-led care.
More testimony is expected in the coming weeks. MSMS remains committed to advocating for patient-centered, physician-led care and will continue to keep you informed as developments unfold.