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Dentons & McKenna Long to Merge, Giving Clients a Competitive Edge

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Dentons & McKenna partners approve merger. Learn more about how clients inside the US will gain unrivaled access to markets around the world and international clients will enjoy increased strength and reach across the US.

Press Release

http://www.dentons-mckenna-combination.com/

Dentons & McKenna Long to Merge, Giving Clients a Competitive Edge

Health Insurance Exchanges: State of the States

This week, CMS reported that 36,000 persons have currently taken advantage of the tax season Special Enrollment Period to sign up for coverage and the New Mexico Health Insurance Exchange board voted to stop building its individual marketplace technology, and instead continue to use HealthCare.gov to enroll individuals and families.

Read the full Health Insurance Exchanges: State of the States post on our Exchanging Views blog.

Health Insurance Exchanges: State of the States

Health Care Weekly Wrap-Up

Federal Update

Supreme Court Rules that Providers Cannot Sue States over Medicaid Reimbursement Rates

This week, the Supreme Court ruled 5-4 in Armstrong v. Exceptional Child Centerthat the Constitution’s Supremacy Clause does not allow providers a private right to sue states over Medicaid reimbursement rates. The Court rejected the providers’ argument that there was a Supremacy Clause conflict. Instead, the Majority found that Medicaid was created by Congress under the Spending Clause authority and gave the secretary of the Department of Health and Human Services the power to apply appropriate remedies for noncompliance by withholding federal funding. The case was filed in 2009 by a group of private health care providers serving disabled adults and children in Idaho against the state’s Health and Welfare Department. The plaintiffs alleged that Idaho violated federal law by keeping Medicaid reimbursement rates at 2006 levels, despite a study showing costs of providing services had increased, thus hindering Medicaid beneficiaries’ ability to adequately access care.

Few Sign-ups for HealthCare.gov Special Enrollment Period

The federal exchange, which facilitates enrollment in Affordable Care Act (ACA) exchange plans for 37 states, implemented a special tax season enrollment period this spring for individuals who discover while filing their 2014 taxes that they owe the ACA’s individual mandate penalty for lacking health coverage in 2014. The special enrollment period allows these individuals to purchase coverage to avoid the penalty in 2015. The Department of Health and Human Services (HHS) reported this week that as of March 29, only 36,000 have signed up for coverage during the special enrollment period that began on March 15, 2015, and which runs until April 30, 2015.

Most state-based exchanges have also allowed a similar special enrollment period, but those sign-up figures are not included in CMS’ numbers and, in most cases, have not been released.

GAO Report Compares ACA’s Qualified Health Plans to CHIP Coverage

A report by the Government Accountability Office (GAO) analyzes coverage in the Children’s Health Insurance Program (CHIP) and qualified health plans (QHP) sold on the ACA’s exchanges. The report looks at one plan each in five states: Colorado, Illinois, Kansas, New York, and Utah. The CHIP comparison plan was selected based on high enrollment, and the QHPs were selected based on the lowest cost silver plan premium.

The report found that CHIP and QHPs largely cover the same services. However, CHIP plans were more generous to beneficiaries in terms of cost. For instance, out-of-pocket costs were always lower in CHIP plans compared to QHPs, even when the ACA’s cost-sharing reduction and premium subsidies were incorporated. The report shows that an office visit to a specialist in Colorado would cost CHIP enrollees a copayment ranging from $2 to $10, but the lowest available copayment in the Colorado QHP was $25. In addition, CHIP premiums were always lower than those of QHPs. As the report states, “For example, the 2014 annual premium for the selected Illinois CHIP plan for an individual at 150 percent of the federal poverty level (FPL) was $0. By comparison, the 2014 annual premium for the selected Illinois QHP was $1,254, which was reduced to $944 for an individual at 150 percent of the FPL, after considering federal subsidies to offset the cost of coverage.” With lower cost-sharing, the actuarial value of a CHIP plan is thus greater than QHPs.

National Roundup

Maryland. The Department of Health and Human Services Office of the Inspector General has released its audit of Maryland’s allocation of shared costs between the Maryland Health Benefit Exchange and Maryland’s Medicaid program. The report finds that the state misallocated $28.4 million in establishment grant funding for SFYs 2013 and 2014 because it used outdated estimated enrollment data and a cost allocation methodology with a material defect to apportion costs.

New Mexico. As reported by Politico, the New Mexico Health Insurance Exchange (NMHIX) board has voted to stop building its own technology for a State-based Marketplace and will enter into a lease with the federal government to continue as a Supported State-based Marketplace using the HealthCare.gov enrollment platform for its individual marketplace. During the presentation, staff noted that even if the NMHIX built its own online Marketplace, the system would not be ready until Plan Year 2017.

Ohio. The Cleveland Clinic has announced that its charity care expenses were cut from $171 million in 2013 to $101 million in 2014—a 40 percent reduction. The Clinic directly credits the ACA’s expansion of Medicaid eligibility in Ohio.

Tennessee. Republican Governor Bill Haslam’s proposal to adopt the ACA’s Medicaid expansion has been voted down for a second time in the state legislature. After passing through the Senate Health Committee last week, the Senate’s Commerce and Labor Committee voted 6-2 against the latest version of the governor’s Insure Tennessee proposal.

From the States…

A complete roundup of this week’s exchange action in the states is available through our State of The States: Health Insurance Exchanges publication here.

New York

With passage of the state budget Tuesday night, the news on the health care front was more about what was not included in the budget, rather than what was passed. The most closely watched health care provision of the budget—the new assessment, or tax, on all health insurers in the individual, small group and large group insurance market—was removed from the budget. Also removed was a provision that would have established a private equity pilot program allowing non-publicly traded businesses to make private capital investments to assist in restructuring health care delivery systems. One of the few provisions that did survive budget negotiations allows the state to negotiate supplemental rebates directly with pharmaceutical manufacturers on covered outpatient drugs with a pre-existing rebate agreement with the federal government. However, the final agreement limited this provision so that it only applies to antiretroviral and hepatitis drugs.

Around Town

A survey by the National Alliance for Mental Illness finds that health plans are not providing coverage of mental health and substance abuse conditions on the same terms as other medical coverage.

An analysis by Oliver Wyman estimates that CMS’s proposed rate for Medicare Advantage will reduce plan payments for beneficiaries with chronic kidney disease by 23 percent.

A report by the American Health Policy Institute attempts to provide insight into the health care “black box” to give a better understanding of the key cost drivers in employer health plans.

An Issue Brief from the Heritage Foundation explains that if the Supreme Court rules to prohibit subsidies in states with a federal exchange in King v. Burwell, enrollees will qualify for a Special Enrollment Period to purchase new coverage.

Health Care Weekly Wrap-Up

Health Insurance Exchanges: State of the States

This week, the Kaiser Family Foundation released an analysis that estimated that 50 percent of households receiving financial assistance to purchase private health insurance on the Marketplaces will have to return a portion of that subsidy when they file their tax returns as part of the tax credit reconciliation process and Access Health CT released information showing that users that interacted with the Marketplace’s online avatar were nine times more likely to enroll in coverage.

Read the full Health Care Exchanges: State of the States post on our Exchanging Views blog.

Health Insurance Exchanges: State of the States

Health Care Weekly Wrap-Up

Federal Health Care Update

House Passes Bipartisan Bill to Replace Physician Payment Formula in Medicare and Extend CHIP Funding

This week, the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015 (H.R. 2), was passed by the House with a wide bipartisan majority. The bill would permanently repeal and replace the sustainable growth rate (SGR), the formula that determines Medicare’s annual updates to the physician fee schedule. The formula has been temporarily overridden by Congress 17 times since 2003, with legislation known as the “doc fix.”

The bill is estimated by the Congressional Budget Office to add $141 billion to the deficit from 2016-2025. Because of disagreements about funding offsets that have stopped permanent replacement of the SGR in the past, the House bill is not fully paid for. However, to offset a portion of the bill’s increased spending, minor changes to Medicare are incorporated, including an increase to the share of costs that upper-income seniors have to pay for Parts B and D coverage, and limiting first-dollar coverage in Medigap plans beginning in 2020.

In addition, the bill reauthorizes funding for the Children’s Health Insurance Program (CHIP), for an additional two years with the use of the enhanced federal match rate provided under the Affordable Care Act (ACA). The extra federal match rate will result in savings to states as no state will get less than an 88 percent match rate and 12 states will receive a 100 percent match rate over this period. About 6 million children will continue to be covered by CHIP. It also continues the ACA’s increased funding of community health centers.

On Friday morning, the Senate departed for a two-week recess without taking action on the bill. Senate Majority Leader Mitch McConnell (R-KY) told members that the SGR bill will be promptly addressed upon the Senate’s return to Washington, and that CMS will delay payments to providers in the interim in order to prevent reimbursement cuts.

GOP Budgets Move to the Floor

This week, the House passed Budget Committee Chairman Tom Price’s budget for fiscal year 2016 in a 228-199 vote, with 17 Republicans voting against it and no Democrats voting for it. The budget included structural Medicare reforms, cuts to Medicaid spending, and the full repeal of the ACA.

On the other side of Capitol Hill, the Senate had a “vote-a-rama” where they offered hundreds of amendments to the Republican budget proposal with the Senate ultimately voting 52-46 just after 3:00 a.m. on Friday morning to approve a budget resolution advanced by Senate Republicans. To resolve differences between the House and Senate versions, the two chambers will form a conference committee after the recess.

Administration Launches Network to Facilitate Changes in Health Care Payments

The Obama Administration has announced the start of the newly created Health Care Payment Learning and Action Network (“Network”). The Network has been launched to help advance and expand the use of the alternative payment models that were included in the Affordable Care Act (ACA). The goal is to move the entire health care system towards payments based on value and quality rather than volume. This effort coincides with the Secretary of Health and Human Services’ (HHS) previously announced goal of tying 30 percent of Medicare payments to alternative payment models by next year, and 50 percent by 2018.

According to the HHS fact sheet, “The Network will serve as a forum where payers, providers, employers, purchasers, states, consumer groups, individual consumers, and others can discuss, track, and share best practices on how to transition towards alternative payment models that emphasize value. The Network will be supported by an independent contractor that will act as a convener and facilitator.”

Thus far, over 2,800 patients, insurers, providers, states, consumer groups, employers and other partners have registered to participate in the Network, including the nation’s largest insurers.

National Health Interview Survey Released by the Centers for Disease Control and Prevention

Results from the latest National Health Interview Survey were released by the Centers for Disease Control and Prevention which provides a fresh snapshot of the health insurance status of Americans. Findings include: 53 million Americans were uninsured for at least some part of the January-September 2014 period and 27.2 million were uninsured for more than a year. In 2005, 18.9 percent of adults aged 18-64 years were uninsured at the time of the interview; from 2009 to 2013, more than 20 percent of adults lacked coverage but the percentage of uninsured dropped to 16.7 percent in the January-September 2014 period. In 2005, 11.5 percent of adults had public coverage and 70.9 percent had private health insurance coverage; in 2013, 16.7 percent had public coverage and 64.2 percent had private health insurance coverage; in the 2014 period, public coverage increased to 17.6 percent and private coverage increased to 67 percent.

National Roundup

New Hampshire. This week, the state House Finance Committee voted 6-3 to remove a provision from the state budget that would have extended the ACA’s Medicaid expansion in New Hampshire past 2016. Currently, about 34,000 people are signed up for the state’s expanded program and could lose coverage. It’s uncertain whether Democratic Governor Maggie Hassan would sign a budget that did not include Medicaid expansion. New Hampshire was recently granted federal approval to offer the ACA’s expansion population private coverage through premium assistance.

Tennessee. On Wednesday night, the state Senate Health and Welfare Committee passed Medicaid expansion legislation by a 6-2-1 vote. Republican Governor Bill Haslam’s proposal to adopt the ACA’s expansion had previously been rejected in a special session. The bill now moves ahead to the Commerce and Labor Committee, but its future remains uncertain.

From the States…

A complete roundup of this week’s exchange action in the states is available through our State of The States: Health Insurance Exchanges publication here.

New York

As previously mentioned, in late January, Governor Cuomo (D) released his fiscal 2015-16 state budget proposal which included a new $69 million annual “assessment,” or tax, to be used to fund the state’s exchange – New York State of Health. The tax is part of an effort to have the state’s exchange become self-sustaining in 2015, as required by the Governor’s original executive order which created the exchange. The Governor’s budget proposal was followed in early March by the State Senate and Assembly’s “one-house” budget proposals. The Republican-controlled Senate removed the assessment completely in their one-house budget proposal, while the Democratic-controlled Assembly chose to keep the assessment on carriers, but included language to prevent insurers from passing the assessment fee onto their consumers.

Some lawmakers are questioning the necessity of the tax in light of the fact that the state already collects, on an annual basis, more than $5 billion in health care related taxes. Lawmakers have pointed out that quarterly reports about how this money is collected and disbursed, which are required under state law, have not been delivered for several years. They are now questioning whether the $69 million could be found in the $5 billion in tax revenue. The Governor, Senate Majority Leader Dean Skelos (R), Independent Democratic Conference Leader Jeff Klein (D), and Assembly Speaker Carl Heastie (D) will be continuing to hash out the final budget details over the weekend as the April 1 budget deadline approaches.

Around Town

An analysis by the Kaiser Family Foundation estimates that half of all those eligible for the ACA’s premium tax credits in 2014 will owe a repayment when they reconcile the amount of credit they received with their income.

A report by Avalere Health shows that enrollment in exchange coverage decreases as enrollees’ income increases.

A report by athenahealth and the Robert Wood Johnson Foundation finds that the ACA has not increased the demand for primary care services, as the proportion of new-patient visits to primary-care providers only increased slightly from 2013 to 2014, from 22.6 percent to 22.9 percent.

A survey by the Society for Human Resource Management examines the impact of the ACA on employers and finds that 14% of employers have already reduced employees’ hours as a result of the employer mandate, and another 6 percent plan to do so in the future.

An article in Health Affairs Blog takes a closer look at The Patient CARE Act, proposed by Senators Richard Burr and Orrin Hatch, and Representative Fred Upton as a comprehensive ACA replacement in anticipation of the King v. Burwellruling.

Health Care Weekly Wrap-Up

Lisa Ellman’s South by Southwest Drone Fever Talk Featured in Texas Bar Blog

Lisa Ellman from Dentons Aviation and Aerospace recently delivered a “Privacy in the Age of Drone Fever” talk at the 25th Annual South by Southwest Interactive Festival in Austin, Texas. Texas Bar Blog featured Lisa’s talk in their recent blog post “SXSW panel on drones fever: benefits vs. privacy“.

Ellman thinks that all of these valid points must be weighed with the potential for drones to do good in the world. And here’s where policy comes in to enable the machines to perform such beneficial functions while also addressing the privacy concerns. Noting that commercial use of drones will likely be legal in a few years as Congress is working to integrate drones into federal airspace, Ellman said that there is also “no shortage of legislation from all levels of government aimed at limiting use of drones in the name of privacy.” Some policy is smart and some isn’t, she said, referring to a proposed Oklahoma law that would allow private citizens to shoot down drones that come onto their property.

When crafting legislation, Ellman said it’s important that policymakers embrace the glories of drone technology while also avoiding the duplication of laws that are already protecting the public. “It’s likely that complete bans on drone use are overbroad because they ignore the benefits,” she said. “We must ask ourselves, ‘Are drones uniquely troublesome in certain ways?’ But we must also ask, ‘What laws and policies are already in place that protect us?'” Ellman thinks that legislation on drone use without warrants is duplicative because of 4th Amendment protections already in place and that drone-focused private property laws are duplicative because trespassing laws already exist. “We should take a close look at those and see where there are gaps, but don’t duplicate,” she said.

To read the full article, please click here.

Lisa Ellman’s South by Southwest Drone Fever Talk Featured in Texas Bar Blog

Stefan Passantino Interviewed on LexBlog Network TV

Stefan Passantino from Political Law, Ethics and Disclosure practice team was featured on LexBlog Network TV this week discussing Oregon’s decision to automatically register voters using information collected at the Department of Motor Vehicles.

The full interview may be watched via the video clip below.

Stefan Passantino Interviewed on LexBlog Network TV

Health Insurance Exchanges: State of the States

This week, HealthCare.gov’s Special Enrollment Period opened on Sunday and Governor Peter Shumlin (D) said that Vermont was considering a switch to using HealthCare.gov’s online enrollment system if improvements to Vermont Health Connect were not completed in time for this fall’s Open Enrollment.

Read the full Health Insurance Exchanges: State of the States post on our Exchanging Views blog.

Health Insurance Exchanges: State of the States

Health Care Weekly Wrap-Up

Federal Health Care Update

House and Senate Republicans Release Budget Resolutions for FY 2016

This week, Republicans in both the House and Senate released their budget resolutions for fiscal year (FY) 2016. Under both proposals, the Affordable Care Act (ACA) would be fully repealed. This would include all insurance coverage provisions in the law and its taxes, saving an estimated $2 trillion from 2016-2025. However, the budgets assume that the revenue lost from the repeal of the ACA’s taxes would be replaced through tax reform. In addition, both proposals would keep the ACA’s provider payment reductions in Medicare but would guarantee that the savings were retained within the Medicare program, not spent on separate programs. Furthermore, both budgets provide the committees with reconciliation instructions to potentially repeal the ACA.

Where the House and Senate budgets significantly diverge are reforms and spending levels for Medicare and Medicaid. While the House provided greater specifics on Medicare, the Senate was more specific on Medicaid. The Senate Medicaid proposal appears to track the Hatch Burr Upton reform model. The House budget includes specific long-term and immediate reforms for Medicare, eventually transitioning the program to a premium support model that uses defined contributions to competing private plans or a reformed version of traditional Medicare to provide the Medicare benefit to seniors. The House’s budget would save an estimated $148 billion in Medicare over the next decade. In contrast, the Senate’s budget simply proposes to adopt President Obama’s savings target of about $430 billion from 2026-2025 without endorsing specific policies to achieve the savings.

For Medicaid, the House budget would unify Medicaid and the Children’s Health Insurance Program (CHIP) into a single program and block grant funding to the states, allowing them greater flexibility. The House budget estimates $913 billion in Medicaid savings over ten years compared to current law.

The Senate budget would make reforms to Medicaid modeled after CHIP, providing states with greater flexibility in designing benefits and administering the program for able-bodied kids and adults. Funding for services for the low-income elderly and disabled would remain unchanged. The Senate budget estimates Medicaid savings at about $400 billion from 2016-2025.

Both budgets would extend funding for CHIP which is currently set to expire on October 1, 2015. The budgets will now go through mark-up with an enactment deadline of April 15.

Bipartisan Bill to Replace Physician Payment Formula in Medicare

This week, a bill to repeal and replace the sustainable growth rate (SGR), the formula that determines Medicare’s annual updates to the physician fee schedule, was introduced. Under current law, if actual Medicare spending exceeds spending targets over time, automatic reductions are triggered to bring physician payments back into line. The formula has been temporarily overridden by Congress 17 times in response to the drastic payment cuts to Medicare physicians that would result from a lapse. The current temporary “doc fix” expires March 31 and Congress is trying to pass a permanent repeal and replacement of the formula.

The bipartisan bill introduced Thursday is very similar to the one that passed through the key health committees in the House and Senate last year. There is broad-based support for permanent repeal of the SGR, but there is great debate over how to pay for the added costs. The bill is estimated to cost about $200 billion over the next ten years. Because finding consensus on spending offsets has thwarted permanent repeal in the past, the House is now rumored to be offering a bill that is not fully paid for; however, funding details have not been released yet. The House is expected to vote on the bill next week. It is unclear how the House bill will be received in the Senate.

GAO Report on Improper Government Payments

The Government Accountability Office (GAO) has issued a report on government-wide improper payments in fiscal year 2014, which totaled $125 billion. The 2014 total was more than a $19 billion increase in improper payments since 2013. Improper payments represent both overpayments and underpayments to impacted individuals and service providers. According to the report, three major programs were responsible for a majority of the improper payments: Medicare, Medicaid, and the Earned Income Tax Credit program. Medicare Parts A and B made more than $45 billion in improper payments, Medicare Part D made almost $2 billion, and the Medicaid program made more than $17 billion in improper payments last year.

HHS Report: 16.4 Million Uninsured have Gained Coverage Under the ACA

A report from the Department of Health and Human Services (HHS) announced that since the ACA was enacted, 16.4 million uninsured people have gained health coverage. This represents a drop in the uninsured rate by 35 percent, from 20.3 percent to 13.2 percent over the time period. According to the report, 14.1 million adults have gained coverage since the law’s coverage expansion provisions, exchange subsidies and Medicaid expansion began in January 2014. In addition, 2.3 million young adults aged 19-25 gained insurance between 2010 and the start of open enrollment in October 2013, from the ACA provision that allows young adults up to age 26 to remain on a parent’s policy. States that expanded their Medicaid programs had a larger drop in their uninsured rates.

National Roundup

Alaska. Governor Bill Walker (I), has introduced a nine-page bill that would expand Medicaid in the state. The bill also includes certain Medicaid program reforms that would promote the use of telemedicine and allow Alaska to develop a tribal “1115” waiver to ensure maximum use of federal Medicaid dollars. The bill has the potential to save the state between $80 to $150 million, however the bill would also institute a 6 percent provider tax to help offset expenses.

Ohio. Governor John Kasich’s administration is proposing that Medicaid recipients earning over 100 percent of the state poverty level pay a monthly premium of $20. If the provision goes into effect, the proposal could save Ohio $1.6 million in 2016 and $3.2 million in 2017.

North Carolina. A study by Duke University’s Center for Health Policy and Inequalities Research, funded by the N.C. Nurses Association, estimates that increasing the use of advanced practice registered nurses (APRNs) through the expansion of their practice capabilities and a reduction in regulations could save between $433 million and $4.3 billion annually in North Carolina.

From the States…

A complete roundup of this week’s exchange action in the states is available through our State of The States: Health Insurance Exchanges publication here.

New York

On Thursday, New York’s Department of Health announced the modification of the Medicaid waiver year. Instead of April through December, the first year in the Delivery System Reform Incentive Payment (DSRIP) program will now run from April through March, in order to match up with New York’s fiscal year. The change will also allow Performing Provider Systems additional time to effectuate their plans before being measured on particular goals. Performing Provider Systems are in line to potentially receive more than $6 billion for health projects across the state.

Around Town

An analysis by Avalere finds that the number of Medicare Advantage beneficiaries enrolled in plans with four or five star ratings increased from 38 percent in 2014 to 60 percent in 2015.

The annual “Compendium of Unimplemented Recommendations” from the Office of the Inspector General lists the top 25 recommendations for the Department of Health and Human Services that have not been implemented.

Research by the Commonwealth Fund determines that multimarket insurers might be effective in reducing churn between coverage sources for ACA enrollees.

A report by PWC’s Health Research Institute outlines five trends to watch in health care that have been directly or indirectly influenced by the ACA.

An analysis by the Urban Institute projects the potential impact for kids if the Supreme Court rules against the administration in King v. Burwell. They estimate 1.9 million children would become uninsured.

A study by the Urban Institute, funded by the Robert Wood Johnson Foundation, analyzes the lowest-cost silver plans on the ACA’s exchanges in every state, finding an average increase of 2.9 percent from 2014 to 2015.

Health Care Weekly Wrap-Up

Andrew Shaw Pens Article on Geopolitical and Environmental Objectives in Morning Consult

Dentons’ Andrew Shaw recently authored an article in Morning Consult entitled “How A State Department Energy Program Can Enhance U.S. Geopolitical And Environmental Objectives“.

The U.S. Energy Information Administration (EIA) estimates that there are significant shale gas resources in Eastern Europe, and that developing these resources in a responsible manner could be a significant medium- to long-term response to the continent’s reliance on Russian natural gas.  For instance, the EIA estimates that Poland and Ukraine contain 148 and 128 trillion cubic feet of technically recoverable shale gas resources, respectively.  For too long, Russia has used the region’s dependence on its natural gas resources as a political cudgel, but shale gas development in Eastern Europe can free these countries from the bullying tactics of Vladimir Putin.

In addition to geopolitical benefits, increased funding for the UGTEP can provide the U.S. with ancillary environmental benefits.  As we’ve seen in the U.S., natural gas can play an important role as a bridge fuel to help address climate change.  With electricity demand expanding significantly in countries like India, natural gas generation can serve as a lower-carbon alternative to coal while also providing a reliable, base-load source of power to these growing economies.  In addition, U.S. officials can help educate other countries on regulatory approaches to addressing casing and cementing standards, wastewater management, chemical disclosure and localized air emissions.  While there is strong opposition in some Eastern European countries to hydraulic fracturing, a coordinated effort by the State Department to help leverage U.S. knowledge and expertise can help countries develop robust regulatory regimes that provide the social license necessary for production to occur.

Click here to read the full article.

Andrew Shaw Pens Article on Geopolitical and Environmental Objectives in Morning Consult