According to the Macau Daily Times, MGM Paradise have completed the designs for their Cotai property.
This property, along with the potential future development from Wynn Resorts await government approval.
As noted by David McKee, it's not clear that American developers would be so patient if their grand plans were being so slowly mulled by Clark County personnel.
As long as Macau prints money, expect no criticism from the 'so blessed' American participants. Remember: China good / Obama bad.