Ransomware Attacks Show that Healthcare Must Take Cybersecurity Seriously

In a previous blog, we provided a primer on HIPAA compliance and discussed the importance of complying with this complex federal law, which is geared toward protecting patients’ private health information (PHI). While healthcare providers and healthcare industry vendors cannot afford to ignore HIPAA, a new threat has emerged and is poised to become much bigger: ransomware attacks on hospitals and healthcare providers that are not seeking to breach patient information but instead render it inaccessible until the organization pays a hefty ransom.

Ransomware Attacks Show that Healthcare Must Take Cybersecurity Seriously

In just the past few weeks, the following major ransomware attacks on healthcare facilities have occurred:

  • In February 2016, hackers used a piece of ransomware called Locky to attack Hollywood Presbyterian Medical Center in Los Angeles, rendering the organization’s computers inoperable. After a week, the hospital gave in to the hackers’ demands and paid a $17,000.00 Bitcoin ransom for the key to unlock their computers.
  • In early March 2016, Methodist Hospital in Henderson, Kentucky, was also attacked using Locky ransomware. Instead of paying the ransom, the organization restored the data from backups. However, the hospital was forced to declare a “state of emergency” that lasted for approximately three days.
  • In late March, MedStar Health, which operates 10 hospitals and over 250 outpatient clinics in the Maryland/DC area, fell victim to a ransomware attack. The organization immediately shut down its network to prevent the attack from spreading and began to gradually restore data from backups. Although MedStar’s hospitals and clinics remained open, employees were unable to access email or electronic health records, and patients were unable to make appointments online; everything had to go back to paper.

Likely, this is only the beginning. A recent study by the Health Information Trust Alliance found that 52% of U.S. hospitals’ systems were infected by malicious software.

What is ransomware?

Ransomware is malware that renders a system inoperable (in essence, holding it hostage) until a ransom fee (usually demanded in Bitcoin) is paid to the hacker, who then provides a key to unlock the system. As opposed to many other forms of cyber attacks, which usually seek to access the data on a system (such as credit card information and Social Security numbers), ransomware simply locks the data down.

Hackers usually employ social engineering techniques – such as phishing emails and free software downloads – to get ransomware onto a system. Only one workstation needs to be infected for ransomware to work; once the ransomware has infected a single workstation, it traverses the targeted organization’s network, encrypting files on both mapped and unmapped network drives. Given enough time, it may even reach an organization’s backup files – making it impossible to restore the system using backups, as Methodist Hospital and MedStar did.

Once the files are encrypted, the ransomware displays a pop-up or a webpage explaining that the files have been locked and giving instructions on how to pay to unlock them (some MedStar employees reported having seen such a pop-up before the system was shut down). The ransom is nearly always demanded in the form of Bitcoin (abbreviated as BTC), an untraceable “cryptocurrency.” Once the ransom is paid, the hacker promises, a decryption key will be provided to unlock the files.

Unfortunately, because ransomware perpetrators are criminals – and thus, untrustworthy to begin with – paying the ransom is not guaranteed to work. An organization may pay hundreds, even thousands of dollars and receive no response, or receive a key that does not work, or that does not fully work. For these reasons, as well as to deter future attacks, the FBI recommends that ransomware victims not cave in and pay. However, some organizations may panic and be unable to exercise such restraint.

Because of this, ransomware attacks can be much more lucrative for hackers than actually stealing data. Once a set of data is stolen, the hacker must procure a buyer and negotiate a price, but in a ransomware attack, the hacker already has a “buyer”: the owner of the information, who is not in a position to negotiate on price.

Why is the healthcare industry being targeted in ransomware attacks?

There are several reasons why the healthcare industry has become a prime target for ransomware attacks. First is the sensitivity and importance of healthcare data. A company that sells, say, candy or pet supplies will take a financial hit if it cannot access its customer data for a few days or a week; orders may be left unfilled or delivered late. However, no customers will be harmed or die if a box of chocolates or a dog bed isn’t delivered on time. The same cannot be said for healthcare; physicians, nurses, and other medical professionals need immediate and continuous access to patient data to prevent injuries, even deaths.

U.S. News & World Report points to another culprit: the fact that healthcare, unlike many other industries, went digital practically overnight instead of gradually and over time. Additionally, many healthcare organizations see their IT departments as a cost to be minimized, and therefore do not allocate enough money or human resources to this function:

According to the statistics by Office of National Coordinator for Health Information Technology, while only 9.4 percent of hospitals used a basic electronic record system in 2008, 96.9 percent of them were using certified electronic record systems in 2014.

This explosive growth rate is alarming and indicates that health care entities could not have the organizational readiness for adopting information technologies over such short period of time. Many of the small- or medium-sized health care organizations do not view IT as an integral part of medical care but rather consider it as a mandate that was forced on them by larger hospitals or the federal government. Precisely due to this reason, health care organizations do not prioritize IT and security technologies in their investments and thus do not allocate required resources to ensure the security of their IT systems which makes them especially vulnerable to privacy breaches.

What can the healthcare industry do about ransomware?

First, the healthcare industry needs a major shift in mindset: Providers must stop seeing information systems and information security as overhead costs to be minimized, realize that IT is a critical part of 21st century healthcare, and allocate the appropriate monetary and human resources to running and securing their information systems.

The good news is, since ransomware almost always enters a system through simple social engineering techniques such as phishing emails, it is fully possible to prevent ransomware attacks by taking such measures as:

  • Instituting a comprehensive organizational cyber security policy
  • Implementing continuous employee training on security awareness
  • Regular penetration tests to identify vulnerabilities

Continuum GRC feels that it is much better to prevent a ransomware attack than to attempt to deal with one after it has occurred, especially in a healthcare environment, where lives are at stake should patient data become inaccessible. Continuum GRC offers full-service and in-house risk assessment and risk management subscriptions helping companies all around the world sustain a proactive cyber security program. Continuum GRC is proactive cyber security®. Call 1-888-896-6207 to discuss your organization’s cyber security needs and find out how we can help you prevent your facility from becoming the next victim of a ransomware attack.

What is PCI DSS Compliance?

Confused about PCI DSS compliance? This article will explain PCI DSS and the importance of complying with this important information security standard.

What is PCI DSS?

PCI DSS stands for the Payment Card Industry (PCI) Data Security Standard (DSS). The PCI DSS is a proprietary information security standard that was established in 2004 by the major credit card brands. The standards apply to organizations that handle major branded credit cards, including Visa, MasterCard, American Express, Discover, and JCB. The PCI DSS does not cover private label cards, such as department store credit cards, that are not associated with a major card brand.

PCI DSS compliance and credit card security.

The PCI DSS consists of common sense steps that coincide with widely accepted data security best practices. The goals of the PCI DSS standards are to help merchants securely process credit card transactions and prevent fraud.

Who must be PCI DSS compliant? Is PCI DSS compliance required by law?

While PCI DSS is not mandated by U.S. federal law, some states have laws that refer to PCI DSS explicitly or contain equivalent mandated standards. Additionally, the major credit card brands require that all organizations, worldwide, that accept or process their cards be compliant with PCI DSS. If your organization processes, stores, or transmits cardholder data, you are required to be compliant with PCI DSS.

What does PCI DSS compliance entail?

The PCI DSS outlines 12 requirements, each falling under one of six categories, or “goals.” The following is a brief overview of these goals and their corresponding requirements:

Goal No. 1: Build & Maintain a Secure Network

  1. Organizations must install and maintain a secure network to conduct transactions, including utilizing firewalls that are effective but do not result in undue inconvenience to cardholders or vendors.
  2. Organizations must not use vendor-supplied defaults for system passwords and other security parameters, as these defaults are widely known by hackers. They should be changed before a system is installed on the network.

Goal No. 2: Protect Cardholder Data

  1. Cardholder data should not be stored – whether in electronic or paper form – unless absolutely necessary. Magnetic strip and chip data should never be stored. When it is necessary to store cardholder data, it must be stored securely. Primary account numbers (PAN) must be rendered unreadable.
  2. Cardholder data that is transmitted across open, public networks must be encrypted.

Goal No. 3: Maintain a Vulnerability Management Program

  1. Anti-virus software must be used and regularly updated.
  2. All systems and applications must be secure and free of bugs or vulnerabilities that could allow data breaches. Software and operating systems should be kept up-to-date; vendor-supplied patches should be installed right away.

Goal No. 4: Implement Strong Access Control Measures

  1. Cardholder data should be accessible by employees on a “need to know” basis; employees should have access to only those systems and data that they absolutely need to perform their job.
  2. Every user should have a unique ID to access the system, and users should be authenticated using a strong password or passphrase, biometrics, or a token device or smart card.
  3. Data must be protected physically as well as electronically. This involves measures such as restricting physical access to different parts of the building, maintaining a visitor log, physically securing media, mandating the use of document shredders, and putting locks on dumpsters.

Goal No. 5: Regularly Monitor and Test Networks

  1. All access to network resources and cardholder data must be tracked, monitored, and regularly tested. Audit trails should be secured, and audit trail history should be retained for at least one year, with at least three months of history always available for analysis.
  2. Security systems and processes should be regularly tested, especially after new software deployments or system changes.

Goal No. 6: Maintain an Information Security Policy

  1. The organization must have a comprehensive security policy that addresses all PCI DSS requirements. All personnel should be trained on the sensitivity of cardholder data and their specific responsibilities regarding data security. These responsibilities must be clearly defined and adhered to at all times.

What happens if I’m not PCI DSS compliant, and a data breach occurs?

Although there are no federal laws regarding PCI DSS, your business may be found in violation of your state’s laws regarding data privacy, some of which mirror PCI DSS standards or refer to them directly. Additionally, the credit card companies that mandate PCI DSS could impose fines on your organization amounting to tens or even hundreds of thousands of dollars; if you are unable to pay the fines, you will no longer be able to accept their cards.

Despite the fact that the federal government does not mandate PCI DSS, federal law enforcement may still get involved to ensure that the credit card data stolen from your organization is not being used to finance terrorist activities. And, of course, your customers’ data will have been breached, which could result in massive, possibly irreparable damage to your organization’s reputation and/or civil lawsuits.

What can I do to ensure that my organization is PCI DSS compliant?

The PCI DSS focuses heavily on proactive steps that organizations can take to secure cardholder data and prevent breaches. Continuum GRC agrees with this approach; we feel that it is much better to be secure and prevent a breach than to have to react to one and face steep fines, legal ramifications, and damage to your organization’s good name.

The specifics of PCI DSS compliance requirements are quite complex. Thankfully, the PCI DSS compliance experts at Continuum GRC are here to help. Continuum GRC’s modules were designed by leading PCI DSS Qualified Security Assessors (QSA) approved by the PCI Security Standards Council (SSC). We provide our clients with scalable, efficient solutions for meeting the rigorous demands of PCI DSS compliance.

Continuum GRC offers full-service and in-house risk assessment and risk management subscriptions helping companies all around the world sustain a proactive cyber security program. Continuum GRC is proactive cyber security®. Call 1-888-896-6207 to discuss your organization’s cyber security needs and find out how we can help you with PCI DSS compliance.

What is HIPAA Compliance?

Confused about HIPAA and HIPAA compliance? This article will explain HIPAA and the importance of complying with this complex federal law.

What is HIPAA?

HIPAA is the Health Insurance Portability and Accountability Act of 1996, which was signed into law by President Bill Clinton. The HITECH Act, which was signed by President Obama in 2009, updated HIPAA by outlining rules and penalties regarding breaches of private health information (PHI).

Among other provisions, HIPAA mandates that security measures be taken to protect PHI. HIPAA is split into five sections, or titles. HIPAA Title II, which is known as the Administrative Simplification provisions, is what most information technology (IT) professionals are referring to when they speak of “HIPAA compliance.”

HIPAA Compliance? If your organization is not HIPAA compliant, and a breach of PHI occurs, the penalties can be severe, as can be the public relations fallout for your organization.

Who must be HIPAA compliant? Does this only apply to doctors’ offices and hospitals?

HIPAA rules apply to two groups of organizations, known as “covered entities” and “business associates.”

A “covered entity” is one of the following:

  • A healthcare provider, such as a doctor’s office, pharmacy, nursing home, hospital or clinic that transmits “information in an electronic form in connection with a transaction for which HHS has adopted a standard.”
  • A health plan, such as a private-sector health insurer, a government health program such as Medicaid, Medicare, or Tricare, a company health plan, or an HMO.
  • A “healthcare clearinghouse,” which is an entity that processes health information received from another entity, such as a billing service or a community health information system.

A “business associate” is a person or an organization that performs tasks that involve the use or disclosure of PHI, such as:

  • Laboratory facilities
  • CPAs, attorneys, and other professionals with clients in the healthcare industry
  • Medical billing and coding services
  • IT providers, such as cloud hosting services and data centers, that are doing business in the healthcare industry
  • Subcontractors and the business associates of business associates must also comply with HIPAA rules.

What does HIPAA compliance entail?

The Administrative Simplification provisions in HIPAA Title II are split into five rules, including the HIPAA Privacy Rule and the HIPAA Security Rule.

The HIPAA Privacy Rule establishes national standards to protect PHI. It applies to all forms of records – electronic, oral, and written – and requires employers to implement PHI security procedures and ensure that all employees are trained on them. The HIPAA Security Rule applies to electronic protected health information (ePHI). It establishes national standards to protect ePHI and requires entities to implement administrative, physical, and technical safeguards of ePHI.

What happens if I’m not HIPAA compliant and a data breach occurs?

If your organization is not HIPAA compliant, and a breach of PHI occurs, the penalties can be severe, as can be the public relations fallout for your organization. You will be required to notify all affected patients of the breach, and this publicity could do irreparable damage to your organization’s reputation. Your organization could also face fines in excess of $1 million – and, in some cases, even criminal penalties.

Not sure where to start with HIPPA Compliance?  We created a free HIPAA Awareness & Compliance Survey that helps to determine your office’s degree of HIPAA compliance and awareness.

What can I do to ensure that my organization is HIPAA compliant?

Continuum GRC believes that the best defense against a PHI breach is a good offense – and HIPAA requires that covered entities and business associates take a proactive approach to protecting patient data. In light of the financial penalties and potential PR nightmare associated with breaches of sensitive personal medical information, HIPAA compliance is serious business.

HIPAA is a voluminous, complex law, and many organizations are baffled regarding where to begin with their HIPAA compliance. Thankfully, the HIPAA compliance experts at Continuum GRC are here to help. We offer comprehensive HIPPA compliance software that includes HIPAA Audit, HITECH, NIST 800-66 and Meaningful Use Audit services to help you evaluate your existing HIPAA protocols and establish new ones. Continuum GRC’s proprietary IT Audit Machine (ITAM IT audit software), which is fully HIPAA compliant; it helps eliminate 96% of cybercrime and nearly 100% of the headaches associated with compliance audits.

Continuum GRC offers full-service and in-house risk assessment and risk management subscriptions helping companies all around the world sustain a proactive cyber security program. Continuum GRC is proactive cyber security®. Call 1-888-896-6207 to discuss your organization’s cyber security needs and find out how we can help you with HIPAA Compliance.

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