Guyana National Day

Antony J. Blinken, Secretary of State

On behalf of the Government of the United States, I congratulate the people of Guyana on your 55th anniversary of independence.

The partnership between the United States and Guyana is rooted in our shared principles.  We value our continued collaboration to strengthen Guyana’s democratic institutions and processes.  Guyana’s hosting of the annual Tradewinds joint exercises next month is a testament to our strong security partnership.  Our joint efforts to combat narcotics and illegal, unreported, and unregulated fishing will continue to contribute to regional stability and cooperation.  We value our shared commitment to addressing climate change, and hope that we can work together to increase investments in renewable energy.

As you celebrate this joyous occasion with family and friends, we join you in recognizing this Independence Day celebration.

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  • United States Reaches Proposed Settlement with Ranch Owner to Restore Creek and Wetlands and Pay Damages for Trespass
    In Crime News
    The U.S. Department of Justice, U.S. Environmental Protection Agency (EPA) and Bureau of Land Management (BLM) announced that they have reached a proposed settlement with John Raftopoulos, Diamond Peak Cattle Company LLC and Rancho Greco Limited LLC (collectively, the defendants) to resolve violations of the Clean Water Act (CWA) and the Federal Land Policy and Management Act (FLPMA) involving unauthorized discharges of dredged or fill material into waters of the United States and trespass on federal public lands in northwest Moffat County, Colorado.
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  • Florida Doctor Charged in Massive $681 Million Substance Abuse Treatment Fraud Scheme
    In Crime News
    A Palm Beach County, Florida doctor was arrested and charged with conspiring to commit health care fraud and wire fraud for his alleged participation in a massive years-long health care fraud scheme throughout Palm Beach County, billing for fraudulent tests and treatments for vulnerable patients seeking treatment for drug and/or alcohol addiction.
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  • Private Health Coverage: Results of Covert Testing for Selected Offerings
    In U.S GAO News
    GAO performed 31 covert tests to selected sales representatives and stated that we had pre-existing conditions, such as diabetes or heart disease, and we requested coverage for these conditions to see if the sales representative directed GAO's undercover agents to a comprehensive Patient Protection and Affordable Care Act (PPACA)-compliant plan, or a PPACA-exempt plan that does not cover what we requested. As part of these tests, GAO gauged whether sales representatives engaged in potentially deceptive practices, such as making false or misleading statements about coverage or omitting material information about coverage. The results of the covert tests ranged from sales representatives appropriately explaining to GAO's undercover agents that a PPACA-exempt plan would not cover the pre-existing condition the undercover agents stated that they had, to engaging in potentially deceptive marketing practices that misrepresented or omitted information about the products they were selling. Specifically, in 21 of 31 covert tests, the sales representative appropriately referred undercover agents to a PPACA-compliant plan. In two of 31 covert tests, the sales representatives did not appear to engage in deceptive marketing practices but were not always consistent or clear in their explanation of the type of coverage and plans they were selling. In the remaining eight of 31 covert tests, the sales representatives engaged in potentially deceptive marketing practices, such as claiming the pre-existing condition was covered when the health plan documents GAO received after purchase said otherwise. GAO plans to refer these eight cases of potential deceptive marketing practices to the Federal Trade Commission (FTC) and corresponding state insurance commissioners' offices for follow-up as appropriate. Millions of Americans obtain health insurance coverage in the individual market, which consists mainly of private plans sold directly to consumers without access to group coverage. While generally regulated by states, starting in 2014, PPACA established a number of new federal requirements for the individual health insurance market. For example, PPACA prohibited insurers from excluding coverage or charging higher premiums for pre-existing conditions and required that individual market plans cover a set of essential health benefits, including coverage for mental health and substance abuse disorder services, prescription drugs, and maternity and newborn care. Certain types of health coverage arrangements that can be sold directly to consumers do not have to comply with some or all of PPACA's individual market requirements and, as a result, may be less expensive, but also offer more limited benefits compared to PPACA-compliant plans. Recent changes to federal law and regulations could result in the increased use of PPACA-exempt health coverage arrangements as alternatives to PPACA-compliant plans in the individual market. For example, in 2018, federal regulations expanded the availability of short term, limited duration insurance (STLDI) plans, a type of PPACA-exempt arrangement. In addition, starting January 1, 2019, individuals who fail to maintain "minimum essential coverage," as required by PPACA, no longer face a tax penalty. Further, the devastating economic effects of the Coronavirus Disease 2019 (COVID-19) pandemic could create additional demand for affordable health coverage, including PPACA-exempt plans.  With these changes, and because of their lower relative costs, PPACA-exempt health coverage arrangements may be attractive to consumers, particularly those who find it difficult to afford PPACA-compliant plans. However, such arrangements generally do not need to follow PPACA's requirement that plans in the individual market be presented to consumers in defined categories outlining the extent to which they are expected to cover medical care. As a result, depending on how they are marketed and sold, PPACA-exempt arrangements could present risks for consumers, if, for example, they buy them mistakenly believing that coverage is as comprehensive as for PPACA-compliant plans. GAO was asked to obtain insights on the marketing and sales practices of insurance sales representatives who sell PPACA-exempt plans. In this report, GAO describes the results of covert tests we conducted involving selected sales representatives, when contacted by individuals stating that they had pre-existing conditions. In this regard, GAO agents performed a number of covert tests (i.e., undercover phone calls) from November 2019 through January 2020 posing as individuals needing to purchase health insurance to cover pre-existing conditions. GAO also discussed the marketing and oversight of PPACA-exempt arrangements with senior officials from federal agencies, including the FTC, and Centers of Medicare and Medicaid Services (CMS) within the Department of Health and Human Services (HHS), as well as the National Association of Insurance Commissioners (NAIC)5. GAO provided a draft of this product to FTC, HHS, and NAIC for review and comment. FTC, HHS, and NAIC provided technical comments, which GAO incorporated as appropriate. HHS provided additional written comments on a draft of this report. For more information, contact Seto Bagdoyan at (202)-6722 or bagdoyans@gao.gov.
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  • VA Disability Benefits: VA Should Continue to Improve Access to Quality Disability Medical Exams for Veterans Living Abroad
    In U.S GAO News
    The number of disability claims for veterans living abroad—in foreign countries or U.S. territories—increased 14 percent from fiscal years 2014 to 2019. During this time period, claims processing time frames improved. In fiscal year 2019, the Veterans Benefits Administration (VBA) of the Department of Veterans Affairs (VA) approved comparable percentages of disability claims for veterans living abroad and domestically—63 percent and 64 percent respectively. However, for a subset of these claims—those where veterans likely received a disability medical exam scheduled by Department of State (State) embassy staff—approval rates were often lower. Veterans' access to disability medical exams abroad improved as VBA has increasingly relied on contracted examiners, rather than embassy-referred examiners, to conduct these exams. According to VBA, this shift expanded the pool of trained examiners abroad and increased the frequency and depth of VBA's quality reviews for contract exams. These quality reviews help VBA and its contractor identify and address common errors, according to VBA and contractor officials. However, several factors continue to limit some veterans' ability to access quality disability medical exams (see figure). Factors That Impair the Access of Veterans Living Abroad to Quality Disability Medical Exams Unknown quality of certain exams: A subset of veterans living abroad receive disability medical exams from an embassy-referred provider. VBA does not systematically assess the quality of these exams. Without doing so, VBA cannot determine if such exams affect the approval rates of veterans who receive them or contribute to longer processing times and are unable to make informed decisions about their use. Travel reimbursement: Under current VA regulations, VA is not authorized to reimburse veterans for travel expenses for certain services incurred in foreign countries as it is for those incurred within the United States, including U.S. territories. Consequently, some veterans living in foreign countries may be unable to afford to travel to exams. Examiner reimbursement: The Veterans Health Administration's (VHA) Foreign Medical Program reimburses examiners referred by embassy staff via paper checks in U.S. currency. These checks may be slow to arrive and not accepted by foreign banks, according to State and other officials and staff we interviewed. Such payment issues can deter examiners from being willing to conduct disability medical exams and thus limit veterans' access to these exams in foreign countries. Of the roughly 1 million disability claims VBA processed in fiscal year 2019, 18,287 were for veterans living abroad. Veterans living abroad are entitled to the same disability benefits as those living domestically, but GAO previously reported that veterans living abroad may not be able to access disability medical exams as readily as their domestic counterparts. VBA uses medical exam reports to help determine if a veteran should receive disability benefits. GAO was asked to review the disability claims and exam processes for veterans living abroad. Among other things, this report examines disability claims trends for veterans living abroad and these veterans' ability to access quality disability medical exams. GAO analyzed VBA claims data for fiscal years 2014 to 2019; assessed data reliability; reviewed relevant federal laws, regulations, policies, and contract documents; and interviewed employees of VBA, State, and other stakeholders. GAO is making five recommendations, including that VBA assess the quality of embassy-referred exams, VBA and VHA assess whether to reimburse beneficiaries for travel to disability medical exams in foreign countries, and that VBA and VHA pay examiners located by embassy staff electronically. The Department of Veterans Affairs concurred with GAO's recommendations. For more information, contact Elizabeth Curda at (202) 512-7215 or curdae@gao.gov.
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  • National Bio and Agro-defense Facility: DHS and USDA Are Working to Transfer Ownership and Prepare for Operations, but Critical Steps Remain
    In U.S GAO News
    The Department of Homeland Security (DHS) and U.S. Department of Agriculture (USDA) have taken steps to plan for and implement the successful transfer of the National Bio and Agro-Defense Facility (NBAF) from DHS to USDA for ownership and operation. (See figure.) The facility is to house state-of-the-art laboratories for research on foreign animal diseases—diseases not known to be present in the United States—that could infect U.S livestock and, in some cases, people. The departments' steps are consistent with selected key practices for implementation of government reforms. In addition, USDA has taken steps to prepare for NBAF's operation by identifying and addressing staffing needs; these steps are consistent with other selected key practices GAO examined for strategically managing the federal workforce during a government reorganization. However, critical steps remain to implement the transfer of ownershp of NBAF to USDA and prepare for the facility's operation, and some efforts have been delayed. Critical steps include obtaining approvals to work with high-consequence pathogens such as foot-and-mouth disease, and physically transferring pathogens to the facility. DHS estimates that construction of NBAF has been delayed by at least 2.5 months because of the effects of the COVID-19 pandemic. USDA officials stated that, until the full effects of delays to construction are known, USDA cannot fully assess the effects on its efforts to prepare for the facility's operation. In addition, USDA's planning efforts were delayed before the pandemic for the Biologics Development Module—a laboratory at NBAF intended to enhance and expedite the transition of vaccines and other countermeasures from research to commercial viability. A November 2018 schedule called for USDA to develop the business model and operating plan for the module in 2019. Officials stated in May 2020 that USDA intends to develop the business model and operating plan by fiscal year 2020's end. Construction Site of the National Bio and Agro-Defense Facility (NBAF) as of November 2019 and an Artist's Rendering of NBAF When Complete USDA's efforts to date to collaborate with DHS and other key federal or industry stakeholders on NBAF have included meeting regularly with DHS officials to define mission and research priorities, developing written agreements with DHS about DHS's roles and responsibilities before and after the transfer, and collaborating with the intelligence community, as well as with relevant international research groups and global alliances, on an ongoing basis. These efforts are consistent with selected key practices for interagency collaboration, such as including relevant participants and clarifying roles. Foreign animal diseases—some of which infect people—can pose threats to the United States. USDA and DHS have been developing NBAF to conduct research on and develop countermeasures (e.g., vaccines) for such diseases, as part of a national policy to defend U.S. agriculture against terrorist attacks and other emergencies. DHS is constructing NBAF in Manhattan, Kansas. DHS originally assumed responsibility for owning and operating NBAF. However, USDA will carry out this responsibility instead, following an executive order from 2017 to improve efficiency of government programs. Construction is expected to cost about $1.25 billion. GAO was asked to review issues related to development of NBAF and USDA's plans for operating it. This report examines (1) efforts to transfer ownership of NBAF from DHS to USDA and to prepare for the facility's operation and (2) USDA's efforts to collaborate with stakeholders. GAO reviewed DHS and USDA documents and interviewed key department officials and various stakeholders. GAO also compared the departments' efforts on NBAF with selected key practices for government reforms and collaboration. For more information, contact Steve D. Morris at (202) 512-3841 or morriss@gao.gov.
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