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 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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Human Hacking, Not Automated Attacks, Top Cyber Threat

Human hacking, also known as social engineering, has surpassed hardware and software vulnerabilities and is now the top cybersecurity threat, Computer Weekly reports:

Human hacking, also known as social engineering, has surpassed hardware and software vulnerabilities and is now the top cybersecurity threat.

[A]ttackers shifted away from automated exploits in 2015. Instead, attackers engaged people through email, social media and mobile apps to do the dirty work of infecting systems, stealing credentials and transferring funds.

 Researchers found that machine exploits were replaced by human exploitation, with attackers opting for attachment-based social engineering campaigns rather than purchasing expensive technical exploit kits.

 Across attacks of all sizes, threat actors used social engineering to trick people into doing things that once depended on malicious code.

What is Human Hacking?

Human hacking is a type of con during which, instead of trying to hack into a system, the hacker engages in old-fashioned espionage techniques that involve human interaction and prey on weaknesses in human psychology, such as helpfulness, curiosity—even greed. A human hacker may approach an access-controlled door carrying a number of packages and pretend to fumble for their key or access card; an unsuspecting employee, thinking they are being helpful to a co-worker, opens the door for the hacker. This technique is known in the industry as tailgaiting. Or, using the pretexting technique, the hacker may phone an employee, pose as a help desk worker, and attempt to get the employee to provide their system access credentials.

These simple techniques are surprisingly effective. TechTarget reports that a human hacker recently used pretexting to compromise the U.S. Department of Justice. The hacker phoned the DOJ, pretending to be a new employee who was having difficulty accessing the department’s web portal. The hacker was quickly provided with a token that granted him full access to the DOJ intranet. As a result, information on 20,000 FBI agents and 9,000 Department of Homeland Security employees was publicly leaked.

Other common human hacking techniques include:

  • Baiting takes advantage of human curiosity—or, in some cases, greed. The attacker puts a legitimate-looking and interesting label (such as “Employee Salary Report Q4”) on a malware-infected device, such as a USB drive, then leaves it in a place where someone will find it, such as a bathroom, a hallway, or an elevator. Then, the hacker simply waits for someone to pick up the device and insert it into their computer.
  • Phishing is a technique most Internet users have seen in action. The hacker (or phisher) sends an email that appears to be from a legitimate source, usually a bank or another business. The email requests that the receiver “verify” information by clicking on a link and warns of dire consequences, such as their account being deactivated, if the receiver does not do so. The link leads to a legitimate-looking but fraudulent website that requests personal information, such as online banking access credentials or even a debit card PIN.
  • Spear phishing is a more targeted form of phishing where a particular individual or organization is phished, as opposed to random mass attacks.
  • A Scareware scheme combines malware and human psychology. The con involves tricking victims into believing they have downloaded illegal content or that their computers have been infected with malware. The human hacker then offers the victim a “fix” in the form of a download – which is actually malware.

How Can Your Organization Prevent Human Hacking?

As with all cyber security issues, the best defense is a good offense. Continuum GRC recommends that organizations take a proactive approach to preventing human hacking, beginning with establishing a comprehensive cyber security policy and employee training program. If employees are aware of the types of cons human hackers run, they can learn to identify and report them before any damage is done. Continuum GRC offers the fastest ticket to policy and governance readiness in the business.

Additionally, organizations that conduct ongoing risk assessments and fix the gaps identified are on average a whopping 96% less likely to suffer a breach by hackers. Continuum GRC recommends organizations of any size implement a risk management program sooner than later when it may be too late.

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 human hacking.