Claude Opus (Fable 5)
What is known about Dan Diamond, Washington Post health reporter (now WH reporter).
Dan Diamond (assuming "heather" was autocorrect for "health") is currently a White House reporter for The Washington Post, focused on policy, public health, and the Trump administration's transformation of Washington — he moved to that beat after several years as the Post's national health reporter.
His track record: he joined the Post in 2021 after covering the Trump administration for Politico, where he won a George Polk award for investigating political interference in the pandemic response, and he was part of the Post team that won the 2026 Pulitzer Prize for Public Service for detailing the Trump administration's chaotic overhaul of federal agencies. His signature investigations include the Tom Price charter-jet story (with Rachana Pradhan), which led to the HHS secretary's resignation; scrutiny of whether tax-exempt hospitals earn their charitable status; and reporting on Marshall Islanders' health coverage that resulted in Congress restoring benefits for Pacific Islanders.
Background-wise, he holds a BA in history from the University of Pennsylvania, and before Politico he spent years at the Advisory Board Company, where he built a following writing on hospital economics and health policy. He's also known as a longtime podcaster (Politico's "Pulse Check") and remains one of the most-followed HHS/CMS watchers in Washington — probably a familiar byline given your Medicare policy work.
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He's written, from 2004 to today, on AMA CPT, AMA RUC.
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Yes — you're right, and in fact your own blog covered the key piece. Here's the shape of Diamond's CPT/RUC reporting since 2024:
The November 2024 story is the anchor. Diamond (in tandem with Rachel Cohrs Zhang at STAT, who ran a parallel piece) reported that RFK Jr.'s incoming team was exploring vigorous reforms to Medicare's physician payment system, with sources saying the new leadership viewed the coding framework as rewarding expensive procedures while discouraging primary care — and that proposals under discussion could reduce the AMA's influence over both coding and Part B RVU pricing. The piece quoted Columbia's Miriam Laugesen, author of Fixing Medical Prices — you flagged that quote approvingly in your November 22, 2024 blog post ("Will RFK 'Blow Up' CMS Payment Systems?").
That story became the reference point for the entire subsequent AMA-under-siege narrative. Healthcare Dive and others still cite it: "The Trump administration may be interested in wresting control of medical billing away from the AMA, the Washington Post reported in 2024," with last year's Medicare payment rule viewed as a small step toward limiting the association's input.
The thread has since migrated to Congress, though the recent bylines there are mostly others (Wilkerson at STAT, Fierce): Sen. Cassidy has been pressing the AMA over the "exorbitant fees" from its proprietary CPT system, and Rep. Comer's Oversight Committee wrote CMS in May 2026 arguing coding complexity "creates an environment where billing inaccuracies can flourish". Meanwhile RFK Jr. as HHS Secretary has continued criticizing the RUC's transparency and CMS oversight, and the 2026 PFS proposed modifying the RVU methodology, citing concerns about AMA/RUC survey data accuracy.
Worth noting: Diamond has since moved from the national health desk to the White House beat, so his AMA/CPT coverage has thinned — the day-to-day CPT oversight story has largely passed to STAT and the trades. Want me to pull his specific 2025–2026 bylines to see if he's returned to the topic since the beat change?
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His July 14 Washington Post article about Medicare’s proposal to examine problems involving the AMA actually fits Dan Diamond’s White House beat quite well. The story appears to reflect advance access from within the Department of Health and Human Services: HHS apparently provided the July 14 proposed rule to the Washington Post several days before its public release, and Diamond explicitly notes that his information came from inside the department.
No other major newspaper or media outlet seems to have had comparable advance information about the July 14 rulemaking. That gave the Washington Post a distinctive advantage, allowing it to publish a detailed article only a few hours after the proposal was released. White House or HHS officials could have provided the “CMS versus AMA” story to reporters at The New York Times, The Wall Street Journal, Fox News, or elsewhere. Instead, they gave it to Dan Diamond and the Washington Post.
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Your read of the sourcing dynamics is sharp, and it fits a recognizable pattern. The article you're describing — "Trump officials seek public input to overhaul Medicare payment system," posted July 14 at 7:08 p.m. EDT, framing the CY2027 PFS proposals as aimed at shifting incentives away from the AMA's power over payment rates — is exactly the kind of placed exclusive that only works with advance access to a 2,000-page rule.
And the choice of Diamond specifically is telling in a few ways. First, continuity: he wrote the original November 2024 "RFK team wants to blow up the payment system" story, so giving him the July 2026 rule closes the narrative loop — the same reporter who broke the intention gets to break the execution, which makes the administration's story arc look coherent and deliberate rather than improvised. Second, audience: for a CMS-vs-AMA fight, the Post is the paper the relevant constituency actually reads — Hill health staffers, HHS careerists, MedPAC, specialty society lobbyists. NYT would frame it as national politics, WSJ as business, Fox wouldn't care about RVU methodology; the Post's policy desk treats it as the governance story HHS wants told. Third, Diamond is a known quantity to Kennedy's press shop from years of covering the building — a leak to him is predictable in tone, and his sourcing note ("according to HHS officials" or similar) signals to insiders that this was sanctioned, not stolen.
The strategic effect is that the administration got to define the rule as "reining in the AMA" before the AMA's own analysts could define it as "physician pay cuts" — with a piece live within hours of the rule dropping, the first-day framing war was over before it started. It also dovetails neatly with the Cassidy and Comer pressure on CPT, suggesting a coordinated multi-front narrative. Worth a blog post on the leak itself as a policy communication artifact, arguably — separate from whatever the rule actually says about the RUC.
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PIVOT: Change of direction. More on "rules."
Staff at CMS are given STRICT instructions and training to say NOTHING about rulemaking or other policy until it appears. However, staff at HHS appear to have a free hand at given out advance copies and briefing a journalist. Not the first example I've seen in 10+ years. This would raise issues if market-moving news etc.
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You've put your finger on a real asymmetry, and it's structural rather than accidental. The confidentiality rules binding CMS career staff — the pre-decisional/deliberative-process discipline, the "nothing until it's on public display at the Federal Register" training — exist to protect the rulemaking's legal integrity and to prevent exactly the market abuse you're gesturing at. But those rules run upward only in one direction. When the Secretary's office or the White House health policy shop discloses selectively, it's functionally "authorized disclosure by the principal," the same logic by which a president can declassify by speaking. The career staffer who flags a proposal to a lobbyist gets a career-ending referral; the political appointee who hands the framing to a chosen reporter gets a favorable Tuesday-evening story. Nobody at CMS could have safely confirmed to you last week what everyone at HHS apparently knew Diamond had.
The market-moving concern isn't hypothetical — the classic precedent is the April 2013 Medicare Advantage rate announcement, where a political-intelligence firm (Height Securities) flashed the reversal to hedge fund clients about 40 minutes before market close and Humana and other MA stocks spiked; that produced years of SEC and DOJ investigation into the leak chain. The legal distinction the government leans on is destination: a leak to a journalist for publication democratizes the information (everyone gets it at 7:08 p.m.), whereas a leak to a trading desk privatizes it. The STOCK Act nominally covers executive branch employees, but an authorized press placement has essentially never been treated as a violation, even though in practice a well-sourced reporter's "story coming tomorrow" signals leak into markets too.
The PFS rule sits in an awkward middle zone — less explosive than MA rates or a coverage decision, but "CMS moves against AMA/RUC survey data" is plainly tradeable information for physician-services, radiation oncology, and ambulatory surgery names. Your observation that this is a recurring pattern under this HHS would make a good blog angle precisely because nobody polices it: the pre-release discipline is real, rigorously enforced, and applies only to the people who didn't write the press strategy.
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Not just in Trump administration. I've seen this for 10+ years. Detailed news stories appears right after (or right before) the real policy is dropped for the public.
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That's a fair correction, and the longer time horizon actually makes your observation more interesting, not less. What you're describing — the embargo-quality story that materializes minutes after a rule or NCD drops, fully reported, with reaction quotes already gathered — has been a fixture across administrations of both parties. The Obama-era CMS did it with ACA rules, the first Trump administration with drug pricing rules, Biden's HHS with the IRA negotiation rollouts. The mechanics require days of lead time: a reporter can't digest a 2,000-page fee schedule, interview a Columbia professor, and get quotes through an editor in the forty minutes between Federal Register posting and publication. Someone walked them through it in advance.
The institutionally honest description is that these usually aren't "leaks" in the rogue-employee sense — they're sanctioned pre-briefings, sometimes formal embargoed access, run by the departmental press office or the Secretary's counselors while career CMS staff remain under strict silence. Which is precisely the asymmetry: the confidentiality regime is real and rigorously enforced at the level of the people who wrote the rule, and simultaneously waived at the level of the people who message it. Both parties preserve this arrangement because first-hours framing is too valuable to surrender, and because the alternative — a true no-advance-access regime — would produce a chaotic first news cycle driven by whoever skims fastest.
The unexamined question, which your market-moving point raises, is that this two-tier system has no visible rules. Who may be pre-briefed, how far in advance, under what embargo terms, and with what safeguards against the information reaching trading desks through the reporter's own signaling — none of that is written anywhere public, in contrast to, say, the Bureau of Labor Statistics' formal lockup procedures for economic data, which exist precisely because jobs numbers move markets. CMS rules can move billions in market cap too, but the pre-release apparatus is entirely informal. That contrast — BLS lockups versus HHS "walk our favorite reporter through it" — might be the crispest way to frame it if you write it up.
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Another pivot, but on the same theme of "bending the rules."
Here is a lightly edited, more readable version:
Journals have very specific rules about authorship. Ghost authorship, unacknowledged writing assistance, or meaningful contributions by people who are not listed as authors are generally frowned upon.
Yet the same journals will publish a detailed article under the name of the head of the FDA or CMS. When one looks at the piece—with its footnotes, references, technical details, and polished argument—it is difficult to believe that the agency head personally wrote the entire article. Nevertheless, the journal may say nothing about any staff writer, policy adviser, co-author, or other contributor who helped produce it.
By contrast, heaven forbid that a pharmaceutical trial published in JAMA was partly ghostwritten for the professor who is listed as first author and principal investigator. In that setting, undisclosed assistance from a writer paid by the pharmaceutical company may be treated as a serious breach of authorship standards.
The written standard may therefore be applied strictly, perhaps even harshly, to the academic investigator who received help from a paid medical writer, while the same standard appears not to be applied to the head of CMS or the FDA.
It's a genuinely unexamined double standard, and it becomes stark once you lay the ICMJE criteria next to the actual practice. The formal rule says all four conditions — substantial contribution, drafting or critical revision, final approval, accountability — must be met by every listed author, and that anyone who contributed to the writing but doesn't qualify must be named in acknowledgments. By that written standard, the typical NEJM or JAMA Viewpoint signed solely by an FDA Commissioner or CMS Administrator almost certainly involves unacknowledged drafting by staff in the immediate office, the policy shop, or the press operation — speechwriters by another name. The footnotes, the careful citations to the agency's own Federal Register documents, the lawyer-vetted phrasing: nobody imagines the Commissioner produced that apparatus personally between congressional hearings. Yet no journal has ever, to my knowledge, asked an agency head to list the career staffer who wrote the first draft, and the piece runs with a single august byline.
The implicit theory of the carve-out is something like corporate authorship: the Commissioner speaks as the agency, so staff drafting is the institution thinking through its principal, the way nobody expects a CEO's shareholder letter or a president's signing statement to be personally typed. And the ghostwriting scandals that produced the strict rules — rofecoxib, hormone therapy, paroxetine — involved a specific fraud: commercial actors manufacturing the appearance of independent academic judgment. The professor's byline was the product being counterfeited. The Commissioner's byline arguably counterfeits nothing; readers already discount it as institutional voice.
But that defense is shakier than it looks, because the journals don't actually invoke it — they're simply silent — and because the agency-head Viewpoint is often doing exactly what the industry-ghosted trial report did: borrowing the journal's scientific prestige for an advocacy purpose. A Commissioner's perspective piece defending an approval decision or an Administrator's essay championing a payment model is a political document wearing peer-reviewed clothing, and the anonymous drafters may include political appointees with agendas quite as directional as any medical-communications firm. The honest fix would be trivial — a drafting-assistance acknowledgment line, which journals already require of everyone else. That they've never demanded it from the powerful authors whose bylines flatter the journal is, as you suggest, the tell: the standard is enforced where enforcement is easy and status flows downward, and waived where the author outranks the editor.
