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One year ago today the US government (unspecified) weighed in on the UK's moves to send the "Lockerbie bomber" back home, either under a Prisoner Transfer Agreement or on compassion grounds. The 9 August letter was passed to US ambassador in London, Richard LeBaron, who passed it on three days later in a letter recently declassified. 
Addressed to the Scottish Justice ministry, it first mentions Megrahi's potential "transfer," and then acknowledges Scotland's rules on compassionate release, noting "as a matter of practice such release is not granted unless the prisoner has a life expectancy of less than three months." It's not clear if the writer was aware just such a prognosis had come in six days earlier (see 3 August). While acknowledging the decision was Scotland's to make, the letter passed on these concerns:
"The United States is not prepared to support Megrahi's release on compassionate release or bail. [...] it would be most appropriate for Megrahi to remain imprisoned for the entirety of his sentence. This was the understanding and expectation at the time arrangements were made for his trial in Scottish Court in the Netherlands, were he or his confederate to be convicted and their appeals upheld."
The part that got the Obama administration in trouble with conservatives was entertaining the "if" of a release despite these pleas:
"Nevertheless, if Scottish authorities come to the conclusion that Megrahi must be released from Scottish custody, the U.S. position is that conditional release on compassionate grounds would be a far preferable alternative to prisoner transfer, which we strongly oppose."
This was quickly portrayed and repeated as American "double-talk" - they decried the "compassionate" release, yet had said they approved it, thus in some minds allowing the decision that followed. It's clearly a ludicrous line to take, and has since faded to the background.
The letter then listed two conditions which "would be very important to the United States and would partially mitigate the concerns of the American victims' families." One was a clear medical consensus that three months really means that or less, with exam results "made available to the United States and the families of the victims of Pan Am 103." And secondly, he was not to leave Scotland. "We believe that the welcoming reception that Megrahi might receive if he is permitted to travel abroad would be extremely inappropriate..."
So in short, the US government poisition was that Megrahi should not leave jail if at all possible, and any "freedom" should be for no longer than the last three months. He should leave Scotland under no circumstances, aside from burial. Any return to Libya, as a swapped prisoner or as a free man, would be a black eye for Washington.
Megrahi's own hope had always been to return home in a third and unstated way - a free man declared innocent, after a fair hearing of his second appeal. That would be less a black eye than a broken arm to the United States' reputation, but the choice for that officially was in the hands of one man - Megrahi himself. He could surrender the appeal he was granted, as required for the PTA, or keep it open to be carried on after his death. And he was given no clear sign whether either of these ways home would be permitted.