There are some positive vibes this week about progress toward an omnibus deal, which would mean a bigger health care package is in play, Peter, Maya and Victoria report.

What they're saying: Senate Majority Leader Chuck Schumer on Monday touted "positive and productive conversations, enough that both sides are moving forward in good faith.”

• Schumer added the Senate should be prepared to vote on a one-week CR later this week (as we have been anticipating) "so we can give appropriators more time to finish a full funding bill before the holidays."

Yes, but: There’s still no deal on appropriations top-line numbers. But Democrats did hold off on the release of their own omnibus proposal on Monday because of progress in bipartisan talks over the weekend.

• Sen. Richard Shelby said he spoke to Speaker Nancy Pelosi on Sunday and Monday, and the sides are "trading suggestions on how to bridge the gap" that he put around $25 billion.

Here's where the potential health care riders stand:

1) Diagnostic tests. There has been some movement on the VALID Act, which is aimed at modernizing a patchwork of regulations on diagnostic tests.

• Negotiators last week floated changes aimed at exempting some tests at academic medical centers, which had raised objections about what they view as cumbersome new regulations.
• But lobbyists say that the academic medical centers are still not won over and do not view the floated exemption as going far enough. That continues to be a hurdle for the bill.
• Still, the bill is in the mix, and we previously reported it could be part of a deal to be paired with stepping up FDA oversight of cosmetics.

2) Provider cuts. Doctors and other clinicians are still pushing for Congress to stop the entire Medicare payment cut in the physician fee schedule, and the American Medical Association and American Hospital Association ramped up lobbying with in-person Hill meetings last week.

• “I felt pretty good about my visits,” AMA president Jack Resneck told Maya on Monday. “I think even though there's a long list of things to do, [lawmakers] get the critical nature of this, and that this can't wait to be fixed next year.”

3) Medicare Advantage. We’re still waiting on an updated CBO score for the Improving Seniors’ Timely Access to Care Act, which would streamline Medicare Advantage prior authorization.

• A new CMS proposed rule should slash the bill’s price tag, but it’s not clear yet if CBO will make that official. Advocates are pushing for the congressional budget wonks to weigh in, based on Maya's conversations with aides and lobbyists.

4) Puerto Rico. Members of the Puerto Rican government and health care industry met with House and Senate leadership last week to discuss Puerto Rico’s Medicaid funding cliff, a congressional aide and a Puerto Rico federal affairs staffer confirmed.

• While full details are still to be determined once there’s a top-line number, Carmen Feliciano, executive director of the Puerto Rico Federal Affairs Administration, said in a statement the FMAP level is likely to stay at the current 76% level based on discussions with Congress.

5) Telehealth. If telehealth ends up being in the omnibus, it is likely to be only a one-year extension of the PHE flexibilities that end on Dec. 31, Krista Drobac, a partner at Sirona Strategies, said.

• That’s because the CBO score would be favorable for one year and then could give more time for data and evidence to inform whether it should be extended further.

Democratic Rep. Pramila Jayapal is joining GOP Rep. Victoria Spartz’s push to reign in health care costs. The pair plans to introduce a bill later today to fight hospital consolidation, they told Maya exclusively.

Why it matters: This bill shows there’s some bipartisan enthusiasm for taking on the fight against hospital costs, which Peter predicted will be one of Congress’s next big health policy battles.

• Spartz released a slate of bills aimed at cracking down on health care costs earlier this year, but this is her first bill on the topic introduced with a Democratic cosponsor.

How it works: The bill would clarify the Federal Trade Commission's ability to take action against anti-competitive conduct by non-profit hospitals and other hospital service organizations.

• The short legislation adds a line to the Federal Trade Commission Act to cover non-profit hospitals under laws against unfair methods of competition.

What they’re saying: “We are saying enough is enough with corporate profiteering off people’s illnesses in our healthcare system,” Jayapal said in a statement ahead of the bill’s introduction.

The other side: The American Hospital Association didn’t have a comment on the bill, but the powerful lobby has an entire page of its website devoted to “The Value of Hospital Mergers.”

Rep.-elect Rich McCormick, the newest member of the GOP Doctors Caucus, says he wants to push his new Republican colleagues to put addressing health care costs at the forefront of their agenda in the next Congress in anticipation of 2024.

What he's saying: "We may have a new president in a few years, but if nothing else we should have something ready to go. Because even though health care isn't on the front burner, it should be," McCormick told Victoria in a phone interview last week.

• "Literally, you're talking about something that is the biggest cost for Americans. We should be all over this."
• McCormick discussed ideas such as making prior authorizations easier for patients to access cancer medicine so they're not paying out-of-pocket for expensive drugs, or comparing health care prices across state lines.
• But he didn't point to specific legislative policies, besides saying they should be "free-market based."

McCormick, who will represent Georgia's 6th Congressional District, is an emergency room doctor and a Marine veteran, and is now set to be the only new member of the GOP Doctors Caucus next year.

• As of our call, he said he had eight more ER shifts to work at Northside Hospital Gwinnett in Lawrenceville, Georgia, before showing up to his new job on Jan. 3.
• McCormick believes being an ER doctor makes him think differently from other Republicans on health care, since he's seen the difficulties for both patients and hospitals up close.
• "ER is an interesting specialty," he said. "We are the safety net of health care. I do have a well-rounded perspective, being an ER doc, seeing first-hand frustrated patients with surprise billing, lack of transparency."

One skeptical thing: He doesn't think the GOP's COVID investigations will lead to any big revelations — though that won't stop him from supporting them.

• "I think we all know where COVID came from, and whether it was an accident, or mismanagement or whatever it was, we know it came from China. The question is why and how," McCormick said.
• "I think it's going to be a very difficult investigation because I don't think there's going to be transparency ... I'm all for it, but I don't have high hopes that it's going to solve anything."

Two fun things: His wife, Debra, is also a doctor (an oncologist), and McCormick is a self-described history buff.