Prior to 1965, hospitals in the U.S. were largely segregated. Medicare, Title VI of the 1964 Civil Rights Act, required the desegregation of hospitals in America. Non-compliance with the law would disqualify hospitals from receiving federal funding.
During the administration of Lyndon B. Johnson, the Department of Health Education and Welfare was charged with certifying non-discriminatory practices in hospitals. Federal inspectors and civil rights activists were sent to hospitals nationwide to inspect their compliance with the law and the hospitals’ eligibility to receive Medicare funds. David Barton Smith, professor emeritus of healthcare management at Temple University, authored the book, The Power to Heal: Civil Rights, Medicare, and the Struggle to Transform America's Health Care System. In an article in U.S. News and World Report, Smith summarized, “With the passage of Medicare, hospitals quickly integrated—a thousand in less than four months.”