Memo to Michigan Lawmakers: How NOT to Increase Access to Care

Michigan already faces a serious shortage of both physicians and bedside nurses. New legislative proposals could make the problem worse. HB 4399 would remove physician supervision requirements for certain nurses, allowing them to practice independently with inadequate training to diagnose and treat patients safely.

We sent two letters to lawmakers in Michigan to caution against such a move. In Michigan and everywhere it’s been tried, scope of practice expansion primarily benefits corporate and insurer interests, not patients. It allows insurers to:

• Pay lower reimbursement rates for ‘equivalent’ services;
• Collect more direct clinical data for utilization management and risk adjustment in Medicare Advantage;
• Accelerate insurer-aligned care models such as retail clinics, telehealth, and home-based programs and move away from value-based care.

These outcomes increase insurer control over care delivery while reducing patient choice and physician autonomy. In essence, scope expansion transfers the practice of medicine from licensed professionals to corporate entities. This decreases patient safety.

Read our two letters to Michigan legislators:

H.B. 4399 APRN Scope of Practice Expansion Impact on Access to Care >

H.B. 4399 APRN Scope of Practice Expansion / Impact on Free Market Trade >