WASHINGTON - House Speaker Dennis Hastert intervened forcefully Thursday in negotiations on a long-stalled patients' rights bill, joining in marathon talks aimed at uniting congressional Republicans on the issue.
''We're making some progress,'' the Illinois Republican said as negotiators took a brief break shortly before midnight. ''This is hard work,'' he added of efforts to forge agreement on a bill to strengthen the hand of patients in dealing with their HMOs.
Bargainers met late into the night in the Capitol office of Senate Republican Whip Don Nickles, who has played the lead role in talks - now suspended - aimed at reaching agreement with Democrats on the bill. They were joined for the first time by Rep. Charles Norwood of Georgia, a rebel on the issue who has consistently advocated a broader series of protections favored by the White House and many Democrats but opposed by most Republicans.
The late-night talks marked the latest turn in a complicated series of events surrounding the politically sensitive issue, in which the House and Senate passed widely different versions of the same bill.
The House-passed bill, which cleared over the objection of Hastert and most members of the leadership, would empower patients with a range of protections, including the right to sue their HMOs for denial of care.
The Senate-passed measure, by comparison, applies to far fewer individuals, and contains no new right to sue.
Both bills provide guarantees on other items, including access to emergency care.
Efforts at forging a bipartisan compromise appeared to produce progress at first, but then ground to a halt.
Senate Democrats brought the issue back to the Senate floor earlier this month, attempting to win approval for the House-passed measure. They failed, 51-48, and Senate Republicans made it clear they would turn their attention to trying to find common ground with House Republicans.
Sen. Phil Gramm, R-Texas, charged at the time that Democrats were committing a ''cynical political act'' in forcing the vote. But Sen. Edward M. Kennedy, D-Mass., said the private talks thus far had been ''an endless road to nowhere.''
Hastert's personal involvement reflects his own long-standing interest in the issue as well as a belief, often stated in private, that President Clinton's signature on a compromise measure is vital for Republicans this election year.
And even agreement among Republicans doesn't guarantee passage in the House and Senate, much less approval by Clinton.
Republican sources, speaking on condition of anonymity, say Hastert has discussed the issue privately with Clinton in the past. His participation in the negotiations in Nickles' office came after a series of private meetings, including one with the Senate GOP whip, one with Norwood, and another with the members of the rank and file who had been involved in the formal negotiations with the Senate.
