Practice Agreement · NP
Nurse Practitioner Practice Agreement in Michigan
Michigan law does not require a Nurse Practitioner to hold a named agreement with a physician. Practices still use one to define the working relationship; here is what it covers and what the state does require.
Michigan is not a full-practice-authority state — NP specialty certification alone does not grant autonomous practice (MCL 333.17201). NPs perform clinical acts, tasks, and functions DELEGATED by a physician under a written authorization; there is no experience-based pathway out of that delegation relationship.
What a Nurse Practitioner practice agreement covers in Michigan
Governed by the Michigan Board of Nursing and the Michigan Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
The Nurse Practitioner may independently diagnose, treat, and prescribe drugs other than controlled substances without physician delegation, as provided under MCL 333.17211a. If the Nurse Practitioner prescribes a Schedule II through V controlled substance, that prescribing requires delegation from the Physician, and both the Nurse Practitioner's and the Physician's names and DEA registration numbers must appear on the prescription, as required by that same section.
Source: MCL 333.17211a
- The agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- MCL 333.17201statute
Public Health Code definitions of advanced practice registered nurse, registered professional nurse, and the practice of nursing.
- MCL 333.17211astatute
Grant of independent, non-delegated prescribing authority to an APRN for nonscheduled drugs, and the physician-delegation and dual-DEA-number requirement for Schedule 2-5 controlled substances.
- MCL 333.17047statute
Mandatory practice-agreement requirement and content for physician assistants: communication/decision-making process, alternate-physician protocol, signatures, 30-day termination notice, and delineation of duties.
- MCL 333.17048statute
Board of Medicine rulemaking authority to restrict delegation of high-risk services and to restrict which drugs a PA may prescribe; no numerical PA-per-physician ratio appears in the current text.
- MCL 333.16215statute
General statute allowing a physician to delegate acts, tasks, or functions to a qualified individual under the physician's supervision, provided the act does not require the physician's own level of skill or judgment.
- MCL 333.17744gstatute
Independent pharmacist authority, separate from any physician delegation, to prescribe and dispense self-administered hormonal contraceptives and emergency contraception, subject to Board of Pharmacy training and protocol rules.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
Available remotely (no on-site requirement)
Michigan does not impose a geographic proximity requirement — the physician must be continuously available by telecommunications for consultation but need not be physically co-located with the NP.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Annually
The delegating physician must review and update the written authorization/collaborative practice agreement on an annual basis after the original or amended date; the agreement itself must provide for 'systematic formal planning and evaluation meetings' between physician and NP, with no fixed interim cadence codified beyond that annual review.
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
A physician may delegate prescribing of Schedule II-V controlled substances to an NP (excluding nurse anesthetists) via a written authorization kept at the primary practice site, with a signed copy given to the NP and reviewed/updated at least annually (Mich. Admin. Code R 338.2411). Requires the NP's own DEA registration.
Written agreement
Required
Unconditional — a written delegation/collaborative practice agreement with a physician is required for as long as the NP practices; the delegating physician must review and update it at least annually (Mich. Admin. Code R 338.2411).
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — No Michigan statute enumerating an independent NP practice-entity ownership pathway was confirmed in this pass — treat as an open item, consistent with Michigan's general prohibition on nonphysician-owned entities practicing medicine.
This ownership question is legally distinct from the clinical delegation agreement above.
Legal sources for these rules (3)
About Michigan's rules
Michigan has no independent-practice pathway for NPs, CNMs, CNSs, or PAs — specialty certification alone never grants autonomous practice, and delegated authority is renewable/revocable rather than a one-time threshold. CRNAs may deliver anesthesia care independently within the perioperative period but must still maintain a collaborating physician/dentist/podiatrist relationship. A PA-only PLLC has been prohibited since 2010.
Other clinicians in Michigan: see the state overview.