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||11,000,000|
|CareFirst Blue Shield||1,100,000|
|Saint Agnes HealthCare||25,000|
|St. Vincent Medical Group||760|
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.