A nurse practitioner’s scope of practice in Michigan runs through a physician. Under current Michigan law, an NP performs clinical acts, tasks, and functions that a physician delegates, and prescriptive authority for controlled substances flows from that same delegation. A 2023 proposal to let experienced NPs practice without a delegation agreement did not become law, so the delegation model remains the operative framework.
What NPs Can and Cannot Do on Their Own
Michigan law defines a nurse practitioner as a registered professional nurse who holds a specialty certification from the Board of Nursing in a recognized field such as nurse practitioner, nurse midwifery, or clinical nurse specialist.1Michigan Legislature. Michigan Compiled Laws MCL 333.17201 The specialty certification does not, by itself, authorize autonomous practice. An NP may perform the clinical work a physician delegates to them, and the written delegation agreement is what sets the ceiling on what they are allowed to do day to day.
Within that structure, NPs assess patients, diagnose conditions, order and interpret diagnostic tests, develop treatment plans, and manage ongoing care. How far any individual NP’s practice extends depends on what the delegating physician has authorized in writing.
For Medicaid billing, Michigan requires a documented collaborative practice agreement between the NP and the physician. It must describe the kinds of services the NP will provide, the criteria for referral and consultation, and evidence of periodic evaluation meetings.2State of Michigan. Nurse Practitioner / Physician Agreement DCH-1575 Both professionals must develop the agreement together, and it has to be kept available for state review.
Prescribing Controlled Substances
Prescriptive authority for controlled substances does not sit on the NP’s license. A physician may delegate the prescribing of Schedule II through V controlled substances to an NP, but only through a written authorization that includes the names and license numbers of both the physician and the NP, any limitations on the delegation, and the effective date.3Cornell Law Institute. Michigan Administrative Code R 338.119 – Delegation of Prescribing Controlled Substances The delegating physician has to review and update this authorization annually and keep a copy at their primary place of practice. When the delegation is in place, the NP may issue prescriptions for up to a 90-day supply of a Schedule II controlled substance.
The practical consequence is worth understanding before you rely on it. If an NP loses their delegating physician relationship, the ability to prescribe controlled substances ends until a new delegation is in place. In parts of the state where physicians are scarce, one collapsed relationship can leave patients without necessary medications for weeks or months.
Federal MATE Act Training
A federal training requirement sits on top of the state prescribing rules. Since June 27, 2023, any DEA-registered practitioner authorized to prescribe Schedule II through V substances must complete a one-time attestation about training on substance use disorders.4Drug Enforcement Administration. Opioid Use Disorder – MATE Act Q and A NPs who graduated from an accredited advanced practice nursing program within the past five years may satisfy this requirement if their curriculum included at least eight hours of training on treating opioid and other substance use disorders. Everyone else must complete at least eight hours of qualifying training. The DEA does not require proof at the time of application, but keeping the certificates on file is the safer approach.
Licensing and Certification
Practicing as an NP in Michigan requires a current registered nurse license plus a specialty certification granted by the Michigan Board of Nursing. The specialty certification has three requirements: a current Michigan RN license, completion of an accredited advanced practice nursing program, and national board certification from a recognized organization.5Cornell Law Institute. Michigan Administrative Code R 338.10404b Accepted certifying bodies include the American Nurses Credentialing Center, the Pediatric Nursing Certification Board, the National Certification Corporation, the American Academy of Nurse Practitioners, the Oncology Nursing Certification Corporation, and the American Association of Critical Care Nurses Certification Corporation.
Applications go through Michigan’s LARA online licensing portal. The initial specialty application fee runs roughly $41 to $57 depending on the certification period. Renewal is every two years and costs about $161 for a registered nurse with specialty certification.6State of Michigan. Michigan Nursing Licensing Guide Those are state fees only; national certification exam fees are separate and run several hundred dollars depending on the certifying body.
Continuing Education and One-Time Trainings
Michigan NPs complete 25 hours of continuing education during each two-year renewal cycle. At least two of those hours must cover pain and symptom management, and no more than 12 credit hours can be earned within a single 24-hour period.7State of Michigan. Michigan Nursing FAQs NPs who hold specialty licenses may have additional CE requirements on top of that baseline.
Two other trainings apply to all Michigan nursing licensees. Since 2019, licensees must complete training in identifying victims of human trafficking before renewal. For renewals completed after June 1, 2021, NPs must also complete one hour of implicit bias training for each year of licensure since that date.6State of Michigan. Michigan Nursing Licensing Guide After the catch-up period, one hour of implicit bias training per year of the renewal cycle continues going forward. Both requirements are verified by attestation at renewal.
The 2023 Independent-Practice Bill
Senate Bill 279 would have changed the picture significantly. According to the Senate Fiscal Agency’s analysis, the bill would have amended the Public Health Code to remove the requirement that NPs perform acts, tasks, or functions delegated by a physician, provided the NP met specific conditions: at least 4,000 hours of practice as a nurse practitioner, national certification in the NP’s role and population focus, and a maintained collaborative agreement with a physician or physician assistant.8Michigan Legislature. Senate Bill 279 Bill Analysis The proposal drew a line between eliminating the delegation agreement and preserving a collaborative agreement: NPs would have made independent clinical decisions while keeping a formal relationship with a physician for consultation.
SB 279 did not pass during the 2023–2024 session. The Michigan Council of Nurse Practitioners has continued to push similar legislation under new bill numbers, but as of this writing Michigan has not enacted full practice authority. Anything you read describing independent NP practice as current Michigan law is inaccurate.
Malpractice Insurance in Practice
Michigan does not require NPs by statute to carry individual malpractice insurance. In practice, hospitals, staffing firms, and physician delegation agreements routinely require it as a condition of privileges or employment. The common coverage expectation is $1,000,000 per claim with a $3,000,000 aggregate, though facilities set higher or lower limits depending on the clinical setting and procedures involved. Annual premiums for Michigan NPs vary widely by specialty, from a few hundred dollars for a new graduate to over $2,500 for specialties involving obstetric or surgical procedures. NPs who would move to independent practice if legislation eventually passes would need to plan for this cost on their own, since employer-provided coverage would no longer be in the background.