News & Media
Nurse Practitioner Scope Isn’t the Silver Bullet It’s Being Sold As
Written by Tom George, MD, CEO of the Michigan State Medical Society
Published in The Detroit News on 11/12/2025, read the full article here.
If only unlocking billions in federal funding were as easy as passing one bill, as recent commentary has suggested. Unfortunately, the actual facts behind that claim just don’t add up.
To be clear, the Rural Health Transformation Program (RHTP) does present an opportunity to strengthen rural health care. And yes—state laws on nurse practitioner scope of practice are a small factor in the formula that determines how much funding a state may receive.
That’s about where the truth ends.
RHTP funding isn’t determined by any single policy change—certainly not by whether a state has passed full practice authority (FPA) for nurse practitioners.
Of the $50 billion in total funding available, half is divided evenly among all approved states. The other half is awarded based on a scoring system—only a fraction of which involves scope.
Scope-related policies make up just 1.75% of the total score. And because nurse practitioner scope is only one-fourth of that category, it ends up influencing less than half a percent of a state’s overall score.
Even so, Michigan likely won’t score zero. The AMA estimates Michigan will receive points for both physician assistant and dental hygienist scope.
And beyond being misleading, the claim is moot—the application window for RHTP funding closed on the same day the op-ed was published.
More importantly, it distracts from the real work that needs to happen. Independent practice laws won’t fix rural access—we’ve already seen the evidence. Instead, we need policies that retain physicians, support care teams, and promote investment in rural residency programs—that should be the focus.
Michigan patients deserve more than an empty promise. They deserve a plan that will actually work.