A Barts Health malware attack forced the shutdown of hospital IT systems on Friday last week as the UK NHS Trust attempted to limit the damage caused and contain the infection.
Barts Health is the largest NHS Trust in the United Kingdom, operating six hospitals in the capital: Mile End Hospital, Newham University Hospital, St Bartholomew’s Hospital, The London Chest Hospital, The Royal London Hospital, and Whipps Cross University Hospital.
The Barts Health malware attack occurred on Friday 13, 2016. Given the number of ransomware attacks on healthcare organizations in recent months, rumors started to quickly circulate that this was another healthcare ransomware attack.
A statement was released on Friday claiming the Trust had experienced an ‘IT attack,’ and that as a precaution, a number of drives were taken offline to prevent the spread of the infection. The type of malware that had been installed was not known, although the NHS trust did say in its statement that it did not believe ransomware was involved.
Multiple drives were shut down following the discovery of the malware including those used by the pathology department, although patient data were unaffected and the NHS Trust’s Cerner Millennium patient administration system remained operational, as did the systems used by the radiology department.
Today, Barts Health reports that all of its systems are back online and the infection has been removed. Medical services for patients were not affected, although Barts Health said due to the need for requests to be processed manually, it may take a few days for the pathology department to deal with the backlog.
Barts Health also reiterated that at no point were patient medical records compromised. No mention has been made about how the malware was installed and the type of malware involved was not announced. However, the Barts Health malware attack involved a form of malware that had not previously been seen and was a ‘Trojan Malware.’
The Trust said “whilst it had the potential to do significant damage to computer network files, our measures to contain the virus were successful”.
Ransomware Attacks on UK Hospitals
In November last year, the Northern Lincolnshire and Goole NHS Trust was attacked with ransomware which resulted in IT systems at three hospitals being crippled. As a result of that attack, the NHS Trust was forced to cancel 2,800 operations and appointments while the infection was removed and systems restored. The majority of IT systems had to be taken offline, hence the major disruption to medical services.
While Locky and Samas have been used extensively in attacks on U.S. hospitals, the Northern Lincolnshire and Goole NHS Trust ransomware attack involved a ransomware variant known as Globe2 – A relativity new variant that was first identified in August 2016.
Globe ransomware has been spread primarily via spam email and malicious file attachments. Opening the file attachment triggers the downloading of the ransomware. As with other ransomware variants, the attachments appear to be files such as invoices or medical test results.
Malicious links are also used to spread ransomware infections. Clicking a link directs users to malicious websites where ransomware is automatically downloaded. Fortunately for organizations attacked with Globe ransomware, a decryptor has been developed by Emisoft, which is available for free download.
However, relatively few ransomware variants have been cracked. Recovery can also take time resulting in considerable disruption to business processes. Ensuring backups of all critical data are regularly made will ensure that files can be recovered without giving in to attackers’ demands.
Preventing malware and ransomware attacks requires multi-layered defenses. Since many infections occur as a result of infected email attachments and links, organizations should employ an advanced spam filtering solution such as SpamTitan. SpamTitan has been independently tested and shown to block 99.97% of spam email. SpamTitan will also block 100% of known malware.
A Los Angeles Valley College ransomware attack has resulted in file systems being taken out of action for seven days and considerable costs being incurred to resolve the infection.
Attackers succeeded in taking control of one of the college’s servers on December 30, 2016. When staff returned after the Christmas break they discovered the computer system to be out of action and essential files locked with powerful encryption.
The attackers had succeeded in locking a wide range of file types on network drives and computers. Unfortunately, the college was unable to recover the files from a backup. Administrators therefore faced a tough decision. To try to recover from the attack without paying the ransom and risk file loss or to give in to the attacker’s demands and pay for the keys to unlock the encryption.
Los Angeles Valley College Ransomware Attack Nets Criminal Gang $28,000
Due to the extent of the infection and the number of devices affected, the ransom payment was considerable. The attackers set the price at $28,000 for the decryption keys. The ransom demand was high but the college had little in the way of options.
The ransom note that was loaded onto the college’s X-drive said if the ransom was not paid within 7 days, the unique keys to unlock the encryption would be permanently deleted. That would likely have resulted in all of the locked files being permanently lost.
The college enlisted help from cybersecurity experts to determine the likelihood of files being recovered without paying the ransom. However, college administrators were advised to dig deep and pay the attackers for the key. While there is no guarantee that paying the ransom would result in viable keys being supplied, the college’s cybersecurity experts said there was a high probability of data recovery if the ransom was paid and a very low probability of data being recovered if the ransom demand was ignored. The likely cost of resolving the infection without paying the ransom was also estimated to be higher than attempting to remove the infection. The decision was therefore made to pay the attackers in Bitcoin as requested.
The attackers made good on their promise and supplied the keys to unlock the data. Now IT staff must apply those keys and remove the encryption on the server, network drives, and the many infected computers. Fortunately for the college, a cyber insurance policy will pay out and cover the cost of the ransom and resetting systems. However, there will be other costs that need to be covered, which will must be paid by the district.
Recovery from the Los Angeles Valley College ransomware attack will not be a quick and simple process, even though the decryption keys have been supplied by the attackers. The district’s Chief Information Officer Jorge Mata said “There are often a lot of steps where there’s no coming back, and if you pick the wrong path, there’s no return.” The recovery process therefore requires care and precision and cannot be rushed. The process could well take a number of weeks. The main priority is to recover the email system. Other systems and devices will then be methodically restored.
Los Angeles Valley College Ransomware Attack One of Many Such Attacks on Educational Institutions
The Los Angeles Valley College ransomware attack has hit the headlines due to the extent of the infection and high ransom demand, but it is one of many such attacks to have occurred over the past 12 months. Educational institutions have been heavily targeted by attackers due to the value of college and school data. Educational establishments cannot risk data loss and are therefore likely to pay the ransom to regain access to files.
In the past few months, other educational institutions in the United States that have been attacked with ransomware include M.I.T, University of California-Berkeley, and Harvard University as well as many K-12 schools throughout the country. Figures from Malwarebytes suggest that 9% of ransomware attacks targeted educational establishments.
How Can Educational Institutions Protect Against Ransomware Attacks?
There are a number of steps that educational institutions can take to reduce the risk of ransomware attacks and ensure that recovery is possible without having to resort to paying a ransom. The most important step to take is to ensure that all data is backed up regularly, including the email system. Backups should be stored on air-gapped devices, not on network drives. A separate backup should be stored in the cloud.
However, backups can fail and files can be corrupted. It is therefore important that protections are implemented to prevent ransomware from being delivered via the two most common attack vectors: Email and the Internet.
Email is commonly used to deliver ransomware or malicious code that downloads the file-encrypting software. Preventing these malicious emails from being delivered to staff and students’ inboxes is therefore essential. An advanced spam filter such as SpamTitan should therefore be installed. SpamTitan blocks 99.97% of spam emails and 100% of known malware.
To protect against web-borne attacks and prevent exploit kit activity and drive-by downloads, schools and colleges should use a web filter such as WebTitan. WebTitan uses a variety of methods to block access to malicious webpages where malware and ransomware is downloaded. WebTitan can also be configured to prevent malicious third-party adverts from being displayed. These adverts – called malvertising – are commonly used to infect end users by redirecting their browsers to websites containing exploit kits.
For further information on SpamTitan and WebTitan, to find out more about how both anti-ransomware solutions can prevent infection, and to register for a free 30-day trial of both products, contact TitanHQ today.
2016 was a particularly bad year for data breaches. A large number of huge data breaches from years gone by were also discovered in 2016.
The largest breach of 2016 – by some distance – affected Yahoo. The credentials of more than 1 billion users were obtained by the gang behind the attack. A massive cyberattack on MySpace was discovered, with the attackers reportedly obtaining 427 million passwords. 171 million vk.com account details were stolen, including usernames, email addresses, and plaintext passwords. 2016 also saw the discovery of a massive cyberattack on the professional networking platform LinkedIn. The credentials of more than 117 million users were stolen in the attack. Then there was the 51-million iMesh account hack, and 43 million Last.fm accounts were stolen….to name but a few.
The data stolen in these attacks are now being sold on darknet marketplaces to cybercriminals and are being used to commit a multitude of fraud.
One of the biggest threats for businesses comes from business email compromise (BEC) scams. BEC scams involve an attacker impersonating a company executive or vendor and requesting payment of a missed invoice. The attacker sends an email to a member of the accounts team and requests payment of an invoice by wire transfer, usually for several thousand dollars. All too often, even larger transfers are made. Some companies have lost tens of millions of dollars to BEC fraudsters.
Since the email appears to have been sent from a trusted email account, transfer requests are often not questioned. Cybercriminals also spend a considerable amount of time researching their targets. If access to corporate email accounts is gained, the attackers are able to look at previous emails sent by the targets and copy their writing style.
They learn about how transfer requests are usually emailed, the terms used by each company and executive, how emails are addressed, and the amounts of the transfers that have been made. With this information an attacker can craft convincing emails that are unlikely to arouse suspicion.
The scale of the problem was highlighted earlier this year when the FBI released figures as part of a public awareness campaign in June. The FBI reported that $3.1 billion had been lost as a result of BEC scams. Just four months earlier, the losses were $2.3 billion, clearly showing that the threat was becoming more severe.
This year also saw a huge increase in W-2 scams in the United States. W-2 data is requested from HR departments in a similar manner to the BEC scams. Rather than trying to fool email recipients into making fraudulent transfers, the attackers request W-2 data on employees in order to allow them to file fraudulent tax returns in their names. The IRS issued a warning earlier this following a huge increase in W2 attacks on organizations in the United States.
Companies large and small were targeted, with major attacks conducted on Seagate, Snapchat, Central Concrete Supply Co. Inc, and Mainline Health. Between January and March 2016, 55 major – and successful – W-2 scams were reported to the IRS.
Attackers do not even need email account passwords to conduct these attacks. Email addresses of CEOs and executives can easily be spoofed to make them appear that they have been sent internally. The sheer number of stolen email addresses – and in many cases also passwords – makes the threat of BEC and W-2 attacks even greater. Security experts predict next year will be even tougher for businesses with even more cyberattacks than in 2016.
Improve Your Defenses Against Email-Borne Threats in 2017
Reducing the risk of these attacks requires multi-layered defenses. It is essential that all employees authorized to make corporate bank transfers receive training on email security and are alerted to the risk of BEC scams. Policies should be introduced that require bank transfer requests to be authorized by a supervisor and/or authenticated by phone prior to the transfer being made.
All employees should be instructed to use strong passwords and never to share work passwords anywhere else online. Many employees still use the same password for work as for personal accounts. However, if one online platform is breached, it can give the attackers access to all other platforms where the same password has been used – including corporate email accounts.
Organizations should also implement controls to block phishing and spear phishing attacks. Blocking phishing emails reduces reliance on the effectiveness of anti-phishing training for employees.
SpamTitan is a highly effective tool for blocking malicious spam emails, including phishing and spear phishing emails. SpamTitan uses a range of techniques to identify spam and scam emails including Bayesian analyses, greylisting and blacklists. SpamTitan incorporates robust anti-malware and anti-phishing protection, as well as outbound email scanning to block spam and scams from corporate email accounts. SpamTitan is regularly tested by independent experts and is shown to block 99.97% of spam email with a low false positive rate of just 0.03%.
2016 may have been a particularly bad year for data breaches and the outlook doesn’t look good for 2017, but by taking affirmative action and implementing better defenses against email-borne attacks, you could ensure that your company is not added to the 2017 list of data breach and scam statistics.
Malicious email spam volume has increased again. According to the latest figures from Kaspersky Lab, malicious email spam volume in Q3, 2016 reached a two-year high.
In Q3 alone, Kaspersky Lab’s antivirus products identified 73,066,751 malicious email attachments which represents a 37% increase from the previous quarter. Malicious spam email volume has not been at the level seen in Q3 since the start of 2014. Kaspersky Lab’s figures show that six out of ten emails (59.19%) are spam; a rise of around 2% from Q2, 2016. September was the worst month of the year to date, with 61.25% of emails classified as unsolicited spam.
Spam includes a wide range of unsolicited emails including advertising and marketing by genuine companies, although cybercriminals extensively use email to distribute malware such as banking Trojans, keyloggers, and ransomware. The use of the latter has increased considerably throughout the year. In Q3, the majority of malicious emails contained either ransomware or downloaders that are used to install ransomware on personal computers and business networks.
Ransomware is a form of malware that locks files on a computer with powerful encryption, preventing the victim from gaining access to their data. Many ransomware variants are capable of spreading laterally and can encrypt files on other networked computers. All it takes is for one individual in a company to open an infected email attachment or click on a malicious link in an email for ransomware to be downloaded.
Spammers often use major news stories to trick people into opening the messages. The release of the iPhone 7 in Q3 saw spammers take advantage. Spam campaigns attempted to convince people that they had won an iPhone 7. Others offered the latest iPhone at rock bottom prices or offered an iPhone 7 for free in exchange for agreeing to test the device. Regardless of the scam, the purpose of the emails is the same. To infect computers with malware.
There was an increase in malicious email spam volume from India in Q3. India is now the largest source of spam, accounting for 14.02% of spam email volume. Vietnam was second with 11.01%, with the United States in third place, accounting for 8.88% of spam emails sent in the quarter.
Phishing emails also increased considerably in Q3, 2016. Kaspersky Lab identified 37,515,531 phishing emails in the quarter; a 15% increase compared to the Q2.
Business email compromise (BEC) attacks and CEO fraud are on the rise. These scams involve impersonating a CEO or executive and convincing workers in the accounts department to make fraudulent bank transfers or email sensitive data such as employee tax information. Some employees have been fooled into revealing login credentials for corporate bank accounts. Cybercriminals use a range of social engineering techniques to fool end users into opening emails and revealing sensitive information to attackers.
Security awareness training is important to ensure all individuals – from the CEO down – are aware of email-borne threats; although all it takes is for one individual to be fooled by a malicious email for a network to be infected or a fraudulent bank transfer to be made.
The rise in malicious email spam volume in Q3, 2016 shows just how important it is to install an effective spam filter such as SpamTitan.
SpamTitan has been independently tested by VB Bulletin and shown to block 99.97% of spam emails. SpamTitan has also been verified as having a low false positive rate of just 0.03%. Dual antivirus engines (Kaspersky Lab and ClamAV) make SpamTitan highly effective at identifying malicious emails and preventing them from being delivered to end users.
If your end users are still receiving spam emails you should consider switching antispam providers. To find out the difference that SpamTitan can make, contact the Sales Team today and register for a free, no obligation 30-day trial.
In response to the massive rise in ransomware attacks on healthcare organizations, the Department of Health and Human Services’ Office for Civil Rights has developed new HIPAA guidance on ransomware for covered entities.
The guidance covers best practices that can be adopted to prevent cybercriminals from installing ransomware, along with helpful advice on how to prepare for ransomware attacks and how to respond when critical files are encrypted by malicious software. Importantly, the new HHS guidance on ransomware also confirms how these security breaches are classed under the Health Insurance Portability and Accountability Act. Many healthcare security professionals feel that HIPAA guidance on ransomware has been long overdue.
HIPAA Guidance on Ransomware Clarifies Attacks ARE Reportable Data Breaches
In the new HIPAA guidance on ransomware, OCR has clarified the reporting requirements for ransomware attacks under HIPAA. Over the past few months, as ransomware attacks on healthcare organizations have soared, there has been much confusion over whether these attacks are classed as security incidents under HIPAA Rules.
It has been argued that since ransomware blindly encrypts files and does not usually involve the attackers actually gaining access to data, the incidents should not be reportable to the HHS. Also, it has been argued that there is no need to issue breach notification letters to patients whose data are temporarily encrypted.
The OCR has now confirmed that ransomware attacks are reportable and require a full breach response, including the mailing of breach notification letters to affected patients and health plan members.
A ransomware attack is considered to be a data breach unless the covered entity can demonstrate that there was only a “low probability that PHI has been compromised.” The OCR considers a breach to have occurred if “unauthorized individuals have taken possession or control of the information.”
How HIPAA Covered Entities Must Respond to Ransomware Attacks
Any HIPAA covered entity that experiences a ransomware attack must orchestrate a full breach response and proceed as they would for a malware attack or if a hacker gained access to PHI.
An accurate and thorough risk assessment must be conducted to determine whether there is any risk to the confidentiality, integrity, or availability of electronic protected health information (ePHI). HIPAA requires the infection to be contained and data must be restored to allow normal operations to continue. Security measures must be implemented to mitigate risks and prevent future attacks.
The Office for Civil Rights must be notified of the breach within 60 days of the discovery of the attack if the breach impacts 500 or more patients, or at the end of the year in the case of a smaller breach of patient records. Breach notification letters must also be mailed to patients within 60 days, in accordance with the HIPAA Breach Notification Rule. A breach notice must also be submitted to the media if the breach impacts 500 or more individuals.
Preparing for a Ransomware Attack
The new HIPAA guidance on ransomware explains that organizations must be prepared to deal with ransomware attacks.
Healthcare organizations should implement cybersecurity protection measures to prevent ransomware attacks, such as installing a robust spam filtering solution such as SpamTitan. Spam filters can prevent the majority of malicious emails from being delivered to end users. Staff members should also be trained on the risk of ransomware and advised how to identify phishing emails and malicious websites.
A risk analysis should be conducted to identify potential cybersecurity vulnerabilities that could be exploited by hackers to install ransomware. Any vulnerabilities that could increase the risk of a ransomware attack being successful should be addressed in a timely fashion.
An emergency operation plan must also be developed that can be immediately put in place upon discovery of a ransomware attack. The new HIPAA guidance on ransomware also states that emergency response plans should be regularly tested to ensure that they are effective.
Ransomware Attacks on Healthcare Organizations Soar
This year has seen an extraordinary number of ransomware attacks on healthcare organizations. In February, ransomware was installed on computers at Hollywood Presbyterian Medical Center in California and a ransom demand of $17,000 was issued. Hollywood Presbyterian Medical Center felt the best course of action to minimize damage was to pay the ransom and obtain the decryption keys to unlock data. On receipt of the funds, the attackers made good on their promise and supplied the keys to unlock the encryption.
However, some organizations have discovered that simply paying a ransom demand does not spell the end of the problem. There have been cases – notably Kansas Heart Hospital – where a ransom has been paid, only for a second ransom demand to be issued. Other companies have paid and not been supplied with working keys. Paying a ransom is no guarantee that data can be decrypted.
The FBI advises against paying ransom demands. Not only is there no guarantee that the attackers will supply working keys, but payment of ransoms only encourages the attackers to continue with their ransomware campaigns. Only by preparing for ransomware attacks can organizations ensure that in the event of ransomware being installed, they will be able to recover their files quickly without giving in to attackers’ demands.
The Ransomware Threat Should Not Be Ignored
The threat to healthcare organizations is severe. Research conducted by anti-phishing company PhishMe showed that in Q1, 2016, 93% of phishing emails contained ransomware. Figures from Symantec Security Response show that on average, 4,000 ransomware attacks have occurred every day since January 1, 2016. A report from security firm Solutionary, shows that in 2016, 88% of ransomware detections were by healthcare organizations.
So far this year, in addition to the attack on Hollywood Presbyterian Medical Center, ransomware attacks have been reported by MedStar Health and DeKalb Health, while Prime Healthcare reported that three of its hospitals – Desert Valley Hospital, Chino Valley Medical Center and Alvarado Hospital Medical Center – were attacked with ransomware. Methodist Hospital in Kentucky, Massachusetts General Hospital, and Yuba Sutter Medical Clinic in California have also reported ransomware attacks this year, to name but a few.
It may not be possible to prevent ransomware attacks, but if healthcare organizations invest in better security protections, the majority of attacks can be prevented. Provided that adequate preparations are made for ransomware attacks, in the event that the malicious software is installed, damage can be limited.
The HIPAA guidance on ransomware can be downloaded from the HHS website.
Locky Ransomware Replaces Dridex as the Top Email Security Threat
Locky was first identified in February 2016 and is believed to have been released by the criminal gang behind the Dridex banking malware. In fact, Locky is distributed using the infamous Necurs botnet, one of the largest botnets currently in operation. Necurs was also used to deliver Dridex malware, which was the top email security threat in Q1. Figures from Proofpoint suggest Locky has been used in 69% of email attacks involving malicious documents in Quarter 2, 2016.
Not only is Locky now the top email security threat, malicious message volume also increased significantly in quarter 2. Proofpoint charted the rise in malicious email volume and the Quarterly Threat Summary shows volume has increased by 230% since Q1, 2016.
Bear in mind that the huge rise in malicious emails occurred even though the Necurs botnet went silent in early June and Locky emails essentially stopped being delivered. However, the botnet did not remain inactive for long. By the end of June it was back with a vengeance, with huge volumes of Locky emails delivered as part of a massive new campaign.
Exploit Kits Are Mostly Delivering CryptXXX Crypto-Ransomware
While Locky may be the top email security threat, exploit kits still pose a major risk to businesses and personal computer users. The Angler exploit kit may have died a death in early June, but Neutrino has now taken over as the EK of choice. Neutrino is targeting numerous vulnerabilities and CryptXXX crypto-ransomware is the main threat. The ransomware variant only appeared in Q2, but it has fast become a major problem and the most common EK threat.
CryptXXX may now be the most prevalent EK ransomware variant in use; however, there has been an explosion in the number of ransomware variants in 2016. Since the final quarter of 2015, the number of ransomware variants has increased by a factor of between 5 and 6 according to Proofpoint. The majority of ransomware is delivered via exploit kits, although many users are directed to malicious websites via links delivered by spam email.
Fortunately, EK activity has fallen considerably since April. Angler EK activity started to decline in late April and by the start of June EK activity had dropped by around 96%. Since the end of June, EK activity has started to increase with Neutrino the main EK now in use. Fortunately, EK activity has not returned to pre April levels. So far at least.
After a period of quiet, the Necurs botnet is back in action. A number of security companies have reported a massive surge in botnet activity which started on June 21, 2016.
The Necurs botnet has previously been used to send out huge volumes of Dridex malware and Locky; a sophisticated ransomware variant that was first discovered in February 2016. It is too early to tell whether this is just a temporary spike in activity or whether the botnet will be sending emails at the levels seen before the recent lull.
Necurs botnet activity dropped off on May 31. The volume of malicious emails being sent using the botnet fell to as few as 3 million emails per day. However, the number of emails being sent surged on June 21, shooting up to around 80 million emails. 24 hours later the volume of malicious emails had doubled to 160 million. The surge in activity comes is linked to a massive spam email campaign that is delivering emails containing malicious attachments which install Locky ransomware.
It is unclear why there was a period of quiet. Security experts having been pondering this since the dramtic fall in activity on May 31.
The Necurs botnet is massive and is believed to contain approximately 1.7 million computers, spread over 7 separate botnets. It is clear that the botnet had not been taken down, although activity across all seven of the botnets stopped. In April and May of this year, spam email volume was regularly exceeding 150 million emails a day. Now the Necurs botnet appears to be back up to speed.
Around the same time as the pause in activity, Russia’s FSB security service conducted raids resulting in the arrests of approximately 50 hackers. The gang was using the Lurk Trojan to defraud banks and other targets in Russia. It is unclear whether some of those arrests resulted in a disruption to the botnet, or whether the pause was for some other reason. Numerous theories have been suggested for the three-week pause, including the sale or the botnet and issues the operators may have had with the C&C infrastructure. If the botnet has changed hands, a single organization would likely be in control as activity across all seven botnets resumed at the same time.
The resurrection of the Necurs botnet is bad news. According to Proofpoint, the resurrection of the botnet has been accompanied by a new Locky variant which has new capabilities. The latest form of Locky is better at evading detection and determining whether it is running in a sandbox. The new capabilities were detected by Proofpoint shortly before the Necurs botnet went dark.
The past two months have seen a number of healthcare organizations attacked by cybercriminals; however, the MedStar Health ransomware attack discovered on Monday this week must rank as one of the most severe.
The MedStar Health ransomware attack is the latest in a string of attacks on U.S. healthcare organizations, as hackers up the ante and go for much bigger targets where the potential rewards are greater. It would appear that the 10-hospital health system will not need to pay a ransom to regain access to its data, but for three days MedStar Health has been forced to work without access to some of its computer systems after they were shut down to prevent the spread of the infection.
MedStar Health Ransomware Attack Affects 10 Hospitals and More than 250 Outpatient Facilities
MedStar Health is a large U.S health system operating more than 250 outpatient facilities and ten hospitals in the Washington D.C., area. On Monday morning, a virus was discovered to have been installed. The infection triggered emergency IT procedures and rapid action taken to limit the spread of the virus. Three clinical information systems were shut down, including email and the electronic health record system used to record and view patient data.
Without access to email and patient data, services at the hospital were slowed although business continued as close to normal as possible. No facilities closed their door to patients. However, in the 48 hours since the virus was discovered, IT security teams have been working around the clock to bring systems back online. Yesterday, MedStar Health reported that systems were being brought back online with enhanced functionality added bit by bit.
MedStar Health has kept the media and patients notified of progress via social media. The health system reported that “The malicious malware attack has created many inconveniences and operational challenges for our patients and associates.”
While no information was initially released on the exact nature of the computer virus that was discovered to have infiltrated its systems, a number of sources indicate the malicious software was ransomware. It has since emerged that the MedStar Health ransomware attack involved a ransomware from the Samsam family. The ransomware is also known as MSIL and Samas. The attack occurred at the Union Memorial Hospital in Baltimore.
Some computer users were presented with a message demanding a ransom to unlock files. The Baltimore Sun reported that the MedStar Health ransomware attack saw attackers demand a ransom of 45 Bitcoin (approximately $18,500) to unlock all 18 computers that were infected, with an offer to unlock one machine for 3 Bitcoin (approximately $1233).
FBI Issued Warning About Samsam Ransomware on March 25
The FBI reached out to businesses for assistance dealing with the latest ransomware threat from Samsam. While many ransomware infections use email as the vector, Samsam is installed via a tool called JexBoss. JexBoss is used to discover a vulnerability that exists in JBOSS systems. This attack is not conducted using phishing or website exploit kits, instead it works by compromising servers and spreading the infection laterally.
The vulnerability exploited is in the default configuration of the Boss Management Console (JMX) which is used to control JBoss application servers. In its default state, JMX allows unsecured access from external parties and this is used to gain shell access to install the ransomware.
Once a web application server has been infected, the ransomware does not communicate with a command and control server, but will spread laterally and to infect Windows machines, hence the need to shut down systems. The MedStar Health ransomware attack could have been much more severe had rapid action not been taken.
This attack highlights just how important it is to ensure that all systems are patched and default software configurations are changed. Other attacks recently reported by healthcare organizations in the United States have involved Locky ransomware, which is spread via exploit kits on compromised websites and via email spam. Healthcare organizations can protect against those attacks by using web filtering and anti-spam solutions. However, it is also essential to train staff never to open email attachments from unknown sources.
Locky ransomware may be a relatively new threat for IT security professionals to worry about, but it has not taken long for the malicious malware to make its mark. It has already claimed a number of high profile victims and is fast becoming one of the most prevalent forms of ransomware.
Early last month Hollywood Presbyterian Hospital in California experienced a ransomware attack that took some of its systems out of action for a week until a ransom demand of $17,000 was paid and the hospital’s EHR was decrypted. During that week, staff at the hospital were forced to record data on paper, were unable to check medical records, and X-Ray, CT scans and other medical imaging files were inaccessible. The hospital was not targeted, instead it was the victim of a random attack. That attack was linked to Locky ransomware.
Locky Ransomware Capable of Encrypting Files Stored on Network Drives
Locky ransomware infections occur via spam email messages and it appears that Hollywood Presbyterian hospital’s systems were infected via an email campaign. Locky ransomware is not delivered via spam email directly, instead infection occurs via a malicious Word macro.
When the macro is run, the malicious code saves a file to the disk and downloads the ransomware from a remote server. Upon download the malware searches for a range of file types located on the device on which it is saved, as well as searching portable drives, virtual devices, and network drives to which the computer is connected. Volume Snapshot Service (VSS) files are also removed, removing the option of restoring via Windows backup files.
Staff training on malicious file detection often covers common file types used to mask malicious software such as screensaver files (SCR), executables (EXE), and batch files (BAT). In the case of Locky ransomware, users are more likely to be fooled as infections occur as a result of Word document (DOC) macros. Any user who receives and opens an infected Word document will automatically download Locky to their computer if they have macros set to run automatically. Since users are instructed to enable macros upon opening the infected document, many may do so in order to read the contents of the file.
According to Trustwave SpiderLabs, 18% of the spam emails it had collected over the course of the past week were ransomware, and Locky is believed to comprise a large percentage of those emails. The ransomware is being delivered by the same botnet that was used to send out Dridex malware last year. While the mastermind behind the Dridex banking malware, Moldovan Andrey Ghinkul, has now been apprehended and extradited to the U.S, the botnet infrastructure is being used for this much simpler attack.
The attacks may be simpler but they are providing to be effective. According to Fortinet, over three million hits have been recorded from the Command and Control server used to communicate with Locky.
The infections are unlikely to end until the botnet is taken down. In the meantime, it is essential to exercise caution. While the ransomware does not attack Russian systems, all other users are at risk. Businesses in particular should take action to reduce risk, such as advising staff of the threat of infection via Word files and Zip files. Using a spam filtering solution such as SpamTitan to block malicious attachments is also strongly advisable to prevent malicious emails from being delivered to staff inboxes.
Over the past 12 months, cybercriminals have used ransomware with increasing frequency to extort money out of businesses, leading some security experts to predict that healthcare ransomware infections would become a major problem in 2016.
Would cybercriminals stoop so low and attack the providers of critical medical care? The answer is yes. This week a U.S. hospital has taken the decision to pay a ransom to obtain the security keys necessary to unlock data that had been encrypted by ransomware. The attack does not appear to have been targeted, but the ransom still needed to be paid to unlock the hospital’s electronic medical record system.
Last year, Cryptowall infections were regularly reported that required individuals to pay a ransom of around $500 to get the security key to recover files. However, when businesses accidentally install ransomware the ransom demand is usually far higher. Cybercriminals can name their price and it is usually well in excess of $500.
Healthcare Ransomware Infection Results in Hospital Paying $16,664 to Unlock EHR
While businesses have been targeted by cybercriminal gangs and have had their critical data locked by ransomware, it is rare for healthcare providers to be attacked. The latest healthcare ransomware infection does not appear to have been targeted, instead a member of staff inadvertently installed malware which locked the hospital’s enterprise-wide electronic health record system (EHR): The system that houses patient health records and critical medical files.
The EHR of Southern California’s Hollywood Presbyterian Medical Center was locked on February 5, 2016., with physicians and other members of the hospital staff unable to access the EHR to view and log patient health information. An investigation into the IT issue was immediately launched and it soon became apparent that the database had been locked by ransomware.
No one wants to have to pay cybercriminals for security keys, and the hospital took steps to try to recover without having to give in to ransom demands. The Police and FBI were contacted and started an investigation. Computer experts were also brought in to help restore the computer system but all to no avail.
The news of the healthcare ransomware attack broke late last week, with early reports suggesting the hospital had received a ransom demand of 9,000 Bitcoin, or around $3.4 million. The EHR was taken out of action for more than a week while the hospital attempted to recover and unlock its files.
Eventually, the decision had to be taken to pay the ransom. While it may have been possible for patient health data to be restored from backups, the time it would take, the resources required to do that, and the disruption it would likely cause was not deemed to be worth it. Allen Stefanek, CEO of Hollywood Presbyterian Medical Center, took the decision to pay the ransom to obtain the security key to unlock the data.
In a statement posted on the company’s website he confirmed that the reports of a ransom demand of 9,000 Bitcoin were untrue. The attackers were asking for 40 Bitcoin, or $16,664, to release the security key to unlock the hospital’s data.
Stefanek said, “The quickest and most efficient way to restore our systems and administrative functions was to pay the ransom and obtain the decryption key. In the best interest of restoring normal operations, we did this.”
Fortunately, healthcare ransomware attacks are relatively rare, as many healthcare providers in the United States already have controls in place to reduce the likelihood of an attack being successful. Staff are trained to be vigilant and not to install software on healthcare devices or open suspicious email attachments. Many use a spam filter to quarantine suspect emails. The latter being an essential protection against healthcare ransomware attacks.
The Importance of a Robust Spam Filter to Prevent Healthcare Ransomware Attacks
A healthcare ransomware attack does not just have a financial impact; it has potential to cause actual harm to patients. The delivery of healthcare services is slowed as a result of the inability to access and share healthcare data, and not being able to view patient health records could delay the delivery of critical patient care or result in incorrect medications being prescribed. That could be a life or death matter. Preventing healthcare ransomware attacks is therefore essential. A technological solution should be employed for maximum protection.
TitanHQ’s SpamTitan software has been developed to keep businesses protected from malware and ransomware attacks. SpamTitan uses two anti-malware engines to maximize the probability of spam emails and malicious attachments being caught and prevented from being delivered to end user inboxes. SpamTitan catches 99.9% of Spam email and quarantines emails with suspicious attachments to prevent them from being delivered.
If you want to reduce the risk of a suffering a ransomware attack and having to pay cybercriminals to unlock critical data, using a robust, powerful anti-spam solution such as SpamTitan is the best way to protect computers and networks from attack. Along with staff training to improve understanding of healthcare ransomware and other malware, it is possible to prevent attacks from being successful.
For further information on SpamTitan anti-spam solutions, contact the TitanHQ team today:
US Sales +1 813 304 2544
UK/EU Sales +44 203 808 5467
IRL +353 91 54 55 00
Or email firstname.lastname@example.org
Each January, the PwC Annual Global CEO Survey is published detailing the major perceived threats to corporate growth. This year the results of the survey show that CEOs are more worried about the cost of dealing with cyberthreats, and believe that they can actually have a major negative impact on corporate growth.
Cost of dealing with cyberthreats a major impediment to 2016 growth
The global survey probed 1,409 CEOs about their concerns about impediments to growth, with cyberthreats ranking as one of the top ten major problems. 61% of respondents said they were worried about cyberthreats and the effect they will have on growth this year.
Over-regulation and geopolitical uncertainty were considered to be more pressing concerns, being cited by 79% and 74% or respondents, while the availability of key skills was mentioned as a major threat to growth by 72% of CEOs. The cost of dealing with cyberthreats was ranked as the eighth biggest impediment to growth in 2016.
While 60% of CEOs believe there are more opportunities for growth than 3 years ago, 66% said there were now more threats to growth. 26% said they only saw more opportunities, while 32% saying they only saw more threats.
The cost of dealing with cyberthreats is considerable, although nowhere near as high of the cost of failing to deal with them. Last year the Ponemon Institute calculated the cost of cyberthreats and determined the cost to businesses is soaring, with the IBM sponsored study determining the average cost of dealing with security breaches had risen to $3.8 million.
Some of the large organizations included in the study suffered cybercrime losses as high as $65 million, with the cost of cyberthreats having risen by 23% over the course of the past two years.
The IBM Cost of Data Breach Study determined the cost per stolen record to be between $145 and $154. When cybercriminals manage to steal millions of customer records, the cost to business can therefore be considerable.
Major cyberthreats of 2016
- Cloud computing
- Mobile devices
- State sponsored hacking
- Phishing attacks
- Medical devices
Cyberthreats may be an impediment to growth, but it doesn’t mean that those threats cannot be mitigated. Given the increasing risk it is imperative that adequate security defenses are put in place to repel attacks. Malware and ransomware are becoming more sophisticated and much more difficult to identify, as are the phishing campaigns that are used to deliver the malicious software. Anti-phishing strategies must therefore be implemented to block malicious emails and staff members must be trained how to identify phishing attacks when they do occur.
Implement SpamTitan to block emails from being delivered to employee’s inboxes, conduct regular staff training exercises to better educate employees, and perform phishing email tests to ensure that members of staff get practice at identifying dummy phishing emails.
It is also essential to develop policies and controls to limit the types of websites that employees are able to visit when using their work computers as well as for BYOD. Drive-by malware downloads are an increasing threat. Exploit kits are much more commonly used to probe for security vulnerabilities, such as out of date plugins. These can be exploited and used to download malware to devices without any interaction from the user.
To mitigate the risk, patch management policies must be developed. It is more essential than ever to ensure that all software is updated as soon as patches are released.
In the United States, healthcare industry phishing campaigns have been responsible for exposing the protected health records of well over 90 million Americans over the course of the past 12 months. That’s over 28% of the population of the United States.
This week, another case of healthcare industry phishing has come to light with the announcement of Connecticut’s Middlesex Hospital data breach. The hospital discovered four of its employees responded to a phishing email, resulting in their email account logins being sent to a hacker’s command and control center. In this case the damage caused by the phishing attack was limited, and only 946 patients had their data exposed. Other healthcare organizations have not been nearly so lucky.
Largest ever healthcare industry phishing attack suffered in 2015
In February, Anthem Inc., the second largest health insurance company in the United States, discovered it had suffered the mother of all healthcare data breaches. Approximately 78.8 million health insurance subscriber records were obtained by criminals in the attack. The breach did not occur in February, but months previously, with the hackers being allowed plenty of time to exfiltrate data.
Another U.S. health insurance company discovered it too had been hacked just a couple of weeks later. Premera Blue Cross similarly found out that hackers had gained access to its systems many months previously and had potentially obtained the records of over 11 million insurance subscribers.
Both security breaches were highly sophisticated in nature, but were discovered to have their roots in healthcare industry phishing campaigns. Employees had responded to phishing emails which ultimately allowed hackers to gain access to huge volumes of highly confidential healthcare data.
In 2014, Community Health Systems suffered a data breach that exposed the PHI of 4.5 million individuals in what was then the second largest healthcare data breach reported. That data breach had its roots in a phishing campaign sent to its employees.
Healthcare industry phishing attacks occurring with alarming frequency
In just 12 months, many healthcare providers and health plans have suffered at the hands of phishers. Some of the healthcare industry phishing attacks have been summarized in the table below:
Successful U.S. Healthcare Industry Phishing Attacks in 2015
|Premera Blue Cross
|CareFirst Blue Shield
|Saint Agnes HealthCare
|St. Vincent Medical Group
Cybercriminals attracted by easy targets and big rewards
In the United States, healthcare organizations and their business associates are covered by legislation which requires robust protections to be put in place to keep computer networks secure and patient health data safeguarded from attack. The Health Insurance Portability and Accountability Act (HIPAA) requires administrative, technical, and physical controls to be used to keep the Protected Health Information (PHI) of patients secure at all times.
Even though the industry is heavily regulated, the industry lags behind others when it comes to data security. Hackers often see healthcare organizations as an easy target. Their networks are complex and difficult to protect, and IT security budgets are insufficient to ensure that all of the appropriate protections are put in place to keep data secure.
On top of that, healthcare providers and health insurers store an extraordinary volume of highly sensitive data on patients and subscribers. Those data are much more valuable to thieves than credit card numbers. Health data, Social Security numbers, and personal information can be used to commit identity theft, medical fraud, insurance fraud, credit card fraud, and tax fraud. One set of patient data can allow criminals to fraudulently obtain tens of thousands of dollars, and the data can typically be used for much longer than credit card numbers before fraud is detected.
It is therefore no surprise that healthcare providers are such a big target. There are potentially big rewards to be gained and little effort is required. Healthcare industry phishing is therefore rife, and spear phishing campaigns are now increasingly being used to get busy healthcare employees to reveal their login credentials. Many of those campaigns are proving to be successful.
Industry reports suggest that the healthcare industry in the United States does not have sufficient controls in place to prevent against phishing attacks. A KMPG study conducted earlier this year showed that 81% of U.S. healthcare organizations had suffered cyberattacks, botnet, and malware infections. Other research conducted by Raytheon/Websense suggested that the healthcare industry in the United States suffered 340% more data breaches than other industries.
Healthcare industry phishing emails are not always easy to identify
Just a few years ago, a phishing email could be identified from a mile away. They contained numerous spelling mistakes and grammatical errors. Nigerian 419 scams were commonly seen and easily spotted. Malicious email attachments were sent, yet they could be easily identified as they were rarely masked. It is easy to train staff never to open an executable file sent via email.
Today, it’s a different story. Healthcare industry phishing emails are not always easy to identify. Malicious emails are crafted with a high level of skill, spell checks are used, subjects are researched, as are the targets. Links are sent to phishing websites that cybercriminals have spent a lot of time, money, and resources developing. Even a trained eye can have trouble identifying a fake site from a real one. The threat landscape has changed considerably in just a few years.
Sometimes healthcare industry phishing emails are so convincing that many members of staff are fooled into responding. Franciscan Health System is a good example. In 2014, a phishing campaign was sent to the healthcare provider via email. The scam was straightforward. Workers were sent an email containing a link and a good reason to click it. They clicked through to a website which required them to enter their login credentials. 19 workers reportedly fell for the campaign and revealed their email account login names and passwords. Contained in their email accounts were patient data. As many as 12,000 patients were affected.
What can be done to reduce the risk of phishing attacks?
There are a number of controls and safeguards that can be implemented to reduce the risk of healthcare industry phishing campaigns being successful, and multi-layered defenses are key to reducing risk.
Conduct Regular Staff Training
All members of staff should be trained on email and internet security, and told how to identify phishing emails and phishing websites. They must be issued with a list of best practices, and their knowledge should be tested. The sending of dummy phishing emails is a good way to check to see if they have taken onboard the information provided in training sessions.
Use Powerful Anti-Virus and Anti-Malware Software
Separate anti-virus and anti-malware solutions should be used and virus/malware definitions updated automatically. Regular scans of the network and individual devices should be scheduled at times of low network activity.
Employ Spam Filtering Software
Spam filtering solutions are essential. One of the best ways of preventing end users from falling for phishing emails is to make sure they never receive them. Powerful anti-spam solutions will block and quarantine malicious email attachments and prevent phishing emails from being delivered to end users.
Implement Web Filtering Solutions
Not all phishing campaigns come via email. Social media websites are often used as an attack vector and malicious website adverts can direct users to phishing websites. Implementing a web filter to limit the types of websites that users are permitted to visit can significantly reduce the risk of users falling for a phishing campaign. Web filtering solutions will also block access to known phishing websites.