Healthcare Cybersecurity

Data Shows Elevenfold Increase in Data-only Extortion Attacks

There has been a sharp increase in data-only extortion incidents, with ransomware gangs increasingly opting not to encrypt files, instead simply breaching networks, exfiltrating sensitive data, and demanding a ransom payment to prevent the data from being leaked or sold.

Ransomware started to become popular with threat actors in the early to mid-2010s. Attacks involved breaching networks and using robust encryption to prevent data access. The emergence of untraceable cryptocurrencies helped fuel an explosion in ransomware attacks. In the mid-2010s, encryption alone proved to be sufficient, with the majority of victims opting to pay to recover their data. By 2020, double extortionbecame more prevalent, where data is stolen prior to file encryption. A ransom payment is required to obtain the decryption keys and prevent the publication or sale of stolen data. Double extortion fast became the norm, with the majority of ransomware attacks involving data theft and extortion.

The rapid rise in ransomware attacks forced organizations to address their data backup policies. While attacks may involve deletion or encryption of backups, victims are now much more likely to have offline backup copies of critical data that they can use to recover from the encryption with minimal data loss. It is often the threat of sale or leaking of exfiltrated data that is the primary reason for paying a ransom, as organizations seek to limit reputational damage.

Data encryption increases the chances of detection, attacks take longer, and fewer victims are paying ransoms to recover encrypted data. Threat actors understand that the reputational harm caused by data leaks is often enough, and some groups have abandoned encryption altogether. For example, PEAR (Pure Extortion and Ransom), a newly formed threat group that emerged in 2025, has exclusively adopted data-only extortion, as has the Silent Ransom group.

The recently published Arctic Wolf 2026 Threat Report confirms that ransomware attacks continue to be lucrative for threat actors. Ransomware attacks accounted for 44% ofArctic Wolf’s incident response (IR) cases from November 2024 to November 2025, exactly the same percentage as the previous reporting period. While there have been significant law enforcement operations targeting the most prolific ransomware groups – LockBit, ALPHV/BlackCat, and BlackSuit – those actions have had little effect on reducing the volume of attacks, and have simply shifted the ransomware ecosystem. There has been a proliferation of smaller groups, and some groups have stepped up attack volume to fill the vacuum.

Arctic Wolf’s report highlights the growing trend of data extortion-only attacks, which increased elevenfold between November 2024 and November 2025.  Data extortion-only attacks increased from 2% of Arctic Wolf’s IR cases in the previous reporting period to 22% in the current reporting period. “We’re seeing a clear pivot in attacker behavior. As organizations improve their ability to recover from encryption events, some threat actors are skipping ransomware altogether and moving straight to data theft and extortion,” said Kerri Shafer-Page, VP of Incident Response, Arctic Wolf. “From an incident response perspective, this shift fundamentally changes how impact is assessed and managed.”

Arctic Wolf said the increase in data extortion-only attacks shows that threat groups are willing and able to evolve when needed, and attributes the rise in attacks to organizations being better prepared and able to recover quickly from traditional encryption events. Arctic Wolf reports that ransomware actors are maturing their affiliate ecosystems and are now operating very much like business enterprises, with structured affiliate programs, tiered revenue models, and operational support to attract and retain a broader pool of cybercriminals.

Arctic Wolf also reports a prominent trend of diversification of ransomware-as-a-service (RaaS) offerings, where, in addition to a percentage of any ransom payments, affiliates are offered data extortion and access monetization, allowing them to profit from stolen data and compromised credentials without having to encrypt files with ransomware. For the time being, at least, Arctic Wolf has not observed any significant increase in activity from groups with these offerings. What has had an immediate impact is groups absorbing affiliates from other RaaS programs, such as Qilin, which recruited affiliates from the RansomHub operation when it shut down, and rapidly accelerated attacks and became the most prolific threat group.

Aside from ransomware, Business Email Compromise (BEC) continues to be favored by hackers, accounting for 26% of Arctic Wolf’s IR cases, although the targets were primarily finance and legal firms, rather than healthcare organizations. While phishing is the leading initial access vector for BEC attacks, other hacking incidents mostly involved attacks on remote access tools, remote monitoring and management software, and VPNs. These access vectors were used in around two-thirds of non-BEC IR cases, up from 24% three years ago. The exploitation of vulnerabilities has fallen from 26% of IR cases in the previous reporting period to just 11% in the current reporting period.

The post Data Shows Elevenfold Increase in Data-only Extortion Attacks appeared first on The HIPAA Journal.

Healthcare Remains the Sector Most Targeted by Ransomware Groups as Attacks Increase 49% YOY

A new record was set for ransomware attacks last year, with disclosed ransomware attacks increasing by 49% year-over-year to a record-high of 1,174 attacks, according to Black Fog’s 2025 State of Ransomware Report. There was also a 37% year-over-year increase in undisclosed attacks, with 7,079 victims added to dark web data leak sites in 2025. The figures indicate that globally, 86% of ransomware attacks are not disclosed by victims.

Data theft almost always occurs with ransomware attacks. In 2025, 96% of attacks involved data exfiltration prior to file encryption, which results in greater organizational harm. Data exfiltration has contributed to the significant increase in breach costs, as data theft results in greater reputational harm and increased regulatory exposure. In 2025, the average cost of a data breach was $4.44 million globally, and $7.42 million for healthcare data breaches. Healthcare retained its position as the sector most targeted by ransomware groups in 2025, accounting for 22% of disclosed attacks. All sectors experienced an increase in attacks in 2025, apart from education, which saw a 13% year-over-year decrease in attacks.

The breakup of large ransomware groups has led to a fragmentation of the ransomware ecosystem, and the number of active ransomware groups continued to increase in 2025. Black Fog tracked 130 different ransomware groups in 2025, of which 52 were new groups that emerged in 2025, a 9% increase from 2024. Several groups that emerged in 2025 have disproportionately targeted the healthcare sector, including Sinobi, Insomnia, and Devman. Devman issued the largest ever ransom demand of $91 million in 2025 for its attack on China’s real estate development company Shimao Group Holdings. World Leaks, widely believed to be a rebrand of Hunters International, has also claimed several healthcare victims, as have all of the top three most prolific and dangerous ransomware groups of the year: Qilin, Akira & Play.

There was a surge in activity by the most prolific ransomware group – Qilin – in 2025, which claimed a total of 1,115 disclosed and undisclosed attacks. Qilin was behind two of the most impactful healthcare ransomware attacks of the year – ApolloMD and Covenant Health. The ransomware attack on ApolloMD was detected in May 2025, yet it took until February 2026 to confirm that the protected health information of more than 626,500 patients was compromised.

The attack on Covenant Health also occurred in May 2025. Initial access was gained on May 18, 2025, and, as was the case with the attack on ApolloMD, sensitive data was rapidly identified and exfiltrated. The Covenant Health attack was detected on May 26, 2025, when the affected systems were shut down to contain the incident. Disruption continued into June, and the attack was initially disclosed a month later, although the initial breach report suggested that the protected health information of just 7,864 individuals was compromised in the incident. As the investigation progressed, it became clear that data theft was far more extensive. In December 2025, when the investigation concluded, Covenant Health confirmed that 478,188 patients had been affected.

Akira was the second-most active group, claiming a total of 776 victims in 2025, with the third most active group – Play – accounting for 405 ransomware attacks. Black Fog identified the emergence of large-scale, AI-enabled attacks last year, when a ransomware group hijacked Anthropic’s Claude model to autonomously perform reconnaissance, exploitation, and data theft – the first time that an AI-led ransomware campaign has been identified.

“The global impact of ransomware across 2025 has been unprecedented. From high street chains to hospitals, ransomware doesn’t respect borders, the size of organization, or the sector you’re in. It’s brought vital services, established companies – and the smaller partners who depend on them – to a grinding halt,” Dr Darren Williams, Founder and CEO of BlackFog said. “The disruption they cause is only part of the story. Attackers aren’t just breaking in – they’re intent on stealing data to power extortion. By weaponizing AI they can outpace defenders at a new scale and use stealthy targeted techniques to slip past traditional security measures. Putting protections in place to close these gaps and prevent data exfiltration has to take priority as attackers focus on targeting organizations’ most sensitive information.”

The post Healthcare Remains the Sector Most Targeted by Ransomware Groups as Attacks Increase 49% YOY appeared first on The HIPAA Journal.

FBI Urges Organziations to Take 10 Actions to Improve Cyber Resilience

The Federal Bureau of Investigation (FBI) has launched a campaign to improve the resilience of industry, government, and critical infrastructure against cyber intrusions. Operation Winter SHIELD (Securing Homeland Infrastructure by Enhancing Layered Defense) is tied to the National Cyber Strategy and the FBI Cyber Strategy, which views industry, government, and critical infrastructure as partners in detecting, confronting, and dismantling cyber threats.

“Our goal is simple: to move the needle on resilience across industry by helping organizations understand where adversaries are focused and what concrete steps they can take now (and build toward in the future) to make exploitation harder.” Operation Winter Shield provides a practical roadmap for securing information technology and operational technology environments, hardening defenses, and reducing the attack surface. The campaign has kicked off with 10 recommendations developed with domestic and international partners to improve defenses against current cyber threats. The recommendations reflect current adversary behavior and common security gaps identified in recent investigations of cyberattacks.

The ten recommendations cover high-impact measures for reducing cyber risk by improving resilience and reducing the attack surface. Over the following 10 weeks, the FBI will publish further information and guidance on these cybersecurity measures:

  1. Adopt phishing-resistant authentication – Many data breaches start with credentials stolen in phishing attacks.
  2. Implement a risk-based vulnerability management program – Threat actors often exploit known, unpatched vulnerabilities in operating systems, software, and firmware for initial access.
  3. Track and retire end-of-life tech on a defined schedule – End-of-life software and devices are often targeted as they no longer receive security updates.
  4. Manage third-party risk – Security is only as good as the weakest link, which is often the least-protected vendor with network or data access.
  5. Protect and preserve security logs – Security logs are essential for detection, response, and attribution, and are often deleted by threat actors to hide their tracks.
  6. Maintain offline immutable backups and test restoration – Resilience depends on backups and tested recovery.
  7. Identify inventory and protect internet-facing systems and services – Eliminate any unnecessary exposure and reduce the attack surface.
  8. Strengthen email authentication and malicious content protections – Email is one of the most common initial access vectors and must be adequately secured.
  9. Reduce administrator privileges – Persistent administrative access enables rapid escalation when credentials are compromised.
  10. Exercise incident response plans with all stakeholders – Testing the response plan will allow organizations to respond rapidly and reduce the impact of a successful compromise.
Operation Winter Shield

Source: Federal Bureau of Investigation.

The post FBI Urges Organziations to Take 10 Actions to Improve Cyber Resilience appeared first on The HIPAA Journal.

HHS-OIG Identifies Web Application Security Weaknesses at Large U.S. Hospital

An audit of a large Southeastern hospital by the Department of Health and Human Services Office of Inspector General (HHS-OIG) identified security weaknesses in internet-facing applications, which could potentially be exploited by threat actors for initial access. Similar security weaknesses are likely to exist at many U.S. hospitals. The aim of the audit was to assess whether the hospital had implemented adequate cybersecurity controls to prevent and detect cyberattacks, if processes were in place to ensure the continuity of care in the event of a cyberattack, and whether sufficient measures had been implemented to protect Medicare enrollee data.

The audited hospital had more than 300 beds and was part of a network of providers who share patients’ protected health information for treatment, payment, and healthcare operations. The hospital had adopted the HITRUST Common Security Framework (CSF) version 9.4 as its main cybersecurity framework, used that framework for regulatory compliance and risk management, and had implemented physical, technical, and administrative safeguards as required by the HIPAA Rules.

HHS-OIG reviewed the hospital’s policies and procedures to assess its cybersecurity practices concerning data protection, data loss prevention, network management, and incident response, and interviewed appropriate staff members to gain further cybersecurity and risk mitigation insights. HHS-OIG conducted penetration tests and external vulnerability assessments on four of the hospital’s internet-facing applications.

The hospital had implemented cybersecurity controls to protect Medicare enrollee data and ensure the continuity of care in the event of a cyberattack, and the cybersecurity controls detected most of HHS-OIG’s simulated cyberattacks; however, weaknesses were found that allowed the HHS-OIG to capture login credentials and use them to access the account management web application, and a security weakness in its input validation controls allowed manipulation of the application.

HHS-OIG sent 2,171 phishing emails, but only the last 500 were blocked. A total of 108 users clicked the link in the email (6% click rate), and one user entered their login credentials in the HHS-OIG phishing website. The captured login credentials allowed HHS-OIG to access the account, although it did not appear to contain patient information. Once the web application was accessed, HHS-OIG was able to view the user’s devices associated with the account, as well as a list with options to deactivate multifactor authentication and add/remove devices from the account. If it were a real cyberattack, a threat actor could use the access for a more extensive compromise. HHS-OIG said strong user identification and authentication (UIA) controls for the account management web application had not been implemented; however, the click rate and login rate were relatively low, therefore, no recommendations were made regarding its anti-phishing controls.

Another internet-facing application was found to lack strong input validation controls, which made the application vulnerable to an injection attack. An attacker could inject malicious code into weak input fields, alter commands sent to the website, and access sensitive data or manipulate the system. While the hospital had conducted vulnerability scans and third-party penetration tests, the vulnerability failed to be identified. Further, the web application did not have a web application firewall for filtering, monitoring, and blocking malicious web traffic, such as injection attacks.

HHS-OIG made four recommendations: Implement strong user identification and authentication controls for the account management web application; periodically assess and update user identification and authentication controls across all systems; assess all web applications to determine if an automated technical solution, such as a web application firewall, is required; and utilize a wider array of testing tools for identifying vulnerabilities in applications, such as dynamic application testing tools, static application testing tools, and manual, interactive testing.

HHS-OIG did not name the audited hospital due to the risk that it could be targeted by threat actors. Further audits of this nature will be conducted on other healthcare providers to determine whether similar security issues exist and if there are any opportunities for the HHS to improve guidance and outreach to help hospitals improve their security controls.

“This report highlights the need for healthcare organizations to adapt their security programs to reflect a fundamental shift: sensitive data now resides not just in on-prem, internal apps, but also in web-based SaaS applications,” Russell Spitler, CEO of Nudge Security, told the HIPAA Journal. “Traditional network-focused security controls cannot adequately protect cloud applications where data flows across organizational boundaries. This makes identity security controls—particularly MFA and SSO—essential for protecting this dynamic attack surface.”

Spitler suggests “healthcare organizations should take a systematic approach that prioritizes comprehensive visibility and strong authentication controls across their entire application ecosystem.” Key steps recommended by Spitler include:

  • Conducting a comprehensive inventory of all SaaS and web applications to understand the full picture of the organization’s attack surface
  • Prioritizing MFA implementation for applications with privileged access or sensitive data, starting with internet-facing systems
  • Deploying SSO solutions that can enforce MFA centrally while improving user experience and reducing password-related security risks
  • Using conditional access policies that require MFA for any access from outside the corporate network or from unmanaged devices
  • Regularly testing authentication controls through penetration testing and phishing simulations, as HHS OIG did in this audit

The post HHS-OIG Identifies Web Application Security Weaknesses at Large U.S. Hospital appeared first on The HIPAA Journal.

CISA Issues Guidance for Proactively Defending Against Insider Threats

Insider threats are one of the leading causes of data breaches in healthcare, more so than in many other industry sectors. A 2018 study by Verizon found insider incidents outnumbered incidents involving external parties, with 56% of healthcare data breaches due to insiders and 43% due to external actors. A study by the cybersecurity firm Metomic found that the percentage of healthcare organizations reporting no insider incidents has declined from 34% in 2019 to 24% in 2024.

Insider incidents can stem from a lack of knowledge about HIPAA or disregard for patient privacy, such as when healthcare employees snoop on medical records. Negligent insiders can easily expose patient data by failing to follow the organization’s policies and procedures, and malicious insiders steal patient information for financial gain or revenge. Copying patient information to take to a new practice or employer is also common.

Due to the high risk of insider threats in healthcare and other critical infrastructure sectors, the U.S. Cybersecurity and Infrastructure Security Agency (CISA) is urging critical infrastructure organizations to take decisive action against insider threats, and has published a new resource specifically developed for critical infrastructure organizations and state, local, tribal, and territorial (SLTT) governments to help them assemble a multi-disciplinary insider threat management team. The guidance includes proven strategies for proactively preventing, detecting, mitigating, and responding to insider threats.

Insiders have institutional knowledge and legitimate access rights, allowing them to easily access and steal sensitive data, and detecting insider breaches can be a challenge. Insider incidents can cause significant harm to healthcare organizations, including reputational damage, revenue loss, and harm to people and key assets. “Whether driven by intent or accident, insider threats pose one of the most serious risks to organizational security and resilience- demanding proactive measures to detect, prevent, and respond,” explained CISA.

“Insider threats remain one of the most serious challenges to organizational security because they can erode trust and disrupt critical operations,” said Acting CISA Director Dr. Madhu Gottumukkala. “CISA is committed to helping organizations confront this risk head-on by delivering practical strategies, expert guidance, and actionable resources that empower leaders to act decisively — building resilient, multi-disciplinary teams, fostering accountability, and safeguarding the systems Americans rely on every day.”

Combating insider threats requires an insider threat mitigation program that includes physical security, cybersecurity, personnel awareness, and partnerships with the community, and assembling a multi-disciplinary insider threat management team is a critical part of that process. The threat management team should oversee the insider threat management program, monitor for potential threats, and act quickly to mitigate the consequences of negligent and malicious insider actions. With an effective insider threat management team in place, organizations can reduce the damage and frequency of insider threat incidents.

A threat management team will be far more effective than any one individual, with teams able to be scaled and adjusted in scope and capability as the organization matures and evolves. Having a range of insider threat subject matter experts will allow the organization to obtain varied perspectives and generate more accurate and holistic threat assessments. Team members should include threat analysts, general counsel, human resources, the CISO, CSO, as well as external parties, including investigators, law enforcement, and medical or mental health counselors.

In the guidance, CISA offers a framework consisting of four stages – Plan, Organize, Execute, and Maintain (POEM). The Plan stage allows the organization to structure and scope the role of the threat management team. The Organize phase involves the team guiding employee awareness, creating a culture of reporting, and providing the necessary support to relevant departments to identify potential insider threat activity. The Execute phase involves upholding the insider threat mitigation program, and the Maintain phase is concerned with developing the threat management team to ensure it remains effective over time.

“Insider threats can disrupt operations, compromise safety, and cause reputational damage without warning. Organizations with mature insider threat programs are more resilient to disruptions, should they occur. People are the first and best line of defense against malicious insider threats, and organizations should act now to safeguard their people and assets,” said CISA Executive Assistant Director for Infrastructure Security Steve Casapulla.

The post CISA Issues Guidance for Proactively Defending Against Insider Threats appeared first on The HIPAA Journal.

U.S. Data Compromises Hit Record High in 2025

An unwanted new record was set in 2025 for data compromises, which increased by 4% from the record-breaking total in 2024, according to the Identity Theft Resource Center (ITRC). The ITRC is a non-profit organization dedicated to helping victims of data breaches, scams, and identity theft. ITRC also offers education to help consumers protect themselves against identity theft and fraud. ITRC tracks data compromises, which include data breaches, data leaks, and accidental exposures of sensitive consumer data.

The record total of 3,332 data compromises in a year represents a 79% increase in just five years, and the third successive year when more than 3,000 data compromises have been identified. While the historic high is concerning, there is at least some good news, as the number of individuals affected by data compromises has fallen sharply to the lowest annual total since 2014. Across the 3,332 data compromises, 278.8 million individuals were affected, down from 2024’s shockingly high total of 1.36 billion. The relatively low total is due to a lack of mega data breaches, which have been a regular feature over the past few years.

An ITRC poll of 1,000 U.S. consumers revealed 80% received at least one breach notice in the past year, and two-fifths received between three and five different notices. Out of the individuals who received a notice about a data breach, 88% said they experienced one or more negative consequences, such as an account takeover, an increase in spam emails and phishing attempts, or mental health issues.

Worryingly, the frequency with which data breach notices are being received is leading to breach fatigue. Out of the people who did nothing after receiving a notice, 48.3% said they had breach fatigue from so many notices, 46.1% said they had feelings of helplessness because they felt they couldn’t do anything about it, 41.6% said they did nothing because they felt from the language of the notification that the breach was not serious to warrant any action, and 36% said they didn’t trust the notice and thought it was a scam.

Out of the 3,332 data compromises, 2,928 were data breaches, involving 232,726,796 victim notices, 24 were data exposures involving 527,894 victim notices, and there were 366 unknown compromises, involving 1,584,024 victim notices. Four of the data compromises involved previously compromised data. The largest confirmed data compromises of the year (based on victim notices) occurred at PowerSchool (71.9 million), AT&T (44 million), Aflac (22.7 million), Prosper Funding (17.6 million), and Conduent Business Services. The number of individuals affected by the Conduent data breach has yet to be confirmed, but it was a massive data breach, affecting 14.7 million individuals in Texas alone.

Financial services remained the most targeted sector, with 739 confirmed data compromises, and the healthcare sector took second spot, with 534 confirmed compromises, down slightly from 2024’s 537 compromises. Professional services was the third most targeted sector with 478 compromises, followed by manufacturing (299) and education (188).

ITRC draws attention to a five-year trend of threat actors increasingly targeting static identifiers, which facilitate long-term fraud. Social Security numbers were involved in two-thirds of data breach reports in 2025, with one-third involving either bank accounts or driver’s license numbers. Between 2021 and 2025, the number of compromises involving Social Security numbers almost doubled, driver’s license data breaches increased by 139% over the same period, and bank account information breaches increased by 168%.

ITRC warns of the increasing risk from supply chain data breaches, which in the space of a year almost doubled from 660 affected entities in 2024 to 1,251 affected entities in 2025, despite the number of attacks only increasing by one year-over-year. From 2021 to 2025, supply chain breaches doubled and now account for 30% of all breaches involving at least one third party.

For several years, ITRC has highlighted the growing trend of breached entities failing to provide consumers with adequate information about a data breach, preventing them from making an informed decision about the amount of risk they face from their data being exposed. For instance, a healthcare provider states in a breach notice that there has been a data incident involving protected health information, which was potentially subject to unauthorized access, when the reality is that a ransomware group has not only exfiltrated their data, but also posted the data on the dark web, where it can be downloaded free of charge by anyone.

ITRC said that in 2020, almost 100% of data breach notifications provided the root cause of the data breach in their notices, whereas in 2025, only 30% did. In the space of a year, the percentage of notices withholding the attack vector details increased from 65% in 2024 to 70% in 2025. “Businesses should prioritize transparency over liability mitigation,” urged James Lee, ITRC president.

The post U.S. Data Compromises Hit Record High in 2025 appeared first on The HIPAA Journal.

HHS-OIG Report Highlights Key HHS Cybersecurity Challenges

The U.S. Department of Health and Human Services Office of Inspector General has published its annual report on the Top Management and Performance Challenges Facing HHS to help the department improve the effectiveness and efficiency of its programs. The report highlights some of the cybersecurity challenges faced by HHS, including a lack of standardized governance and controls, which complicates HHS’s preparedness efforts to prevent and respond to cybersecurity threats.

The HHS is a large department with disparate organizational approaches to cybersecurity across its various divisions and programs. While the department has taken steps to consolidate cybersecurity functions and improve cybersecurity, HHS-OIG says overall progress is often still dependent on each division and program. In addition, the HHS has an army of contractors, grantees, and other external entities that number in the thousands. Cybersecurity solutions must be implemented within the HHS, but also by each contractor, grantee, and external entity. That makes cybersecurity improvements especially challenging, and the ability of the HHS to mitigate cybersecurity threats is often dependent on those entities implementing cybersecurity solutions specific to their operations. “Protecting technology and data requires broader efforts beyond implementing technical fixes, such as establishing clear expectations; modernizing program rules; and conducting effective oversight of the Department’s contractors, grantees, and other external entities,” HHS-OIG said.

The healthcare sector remains a key target for cyber actors. Ransomware attacks continue in volume, as financially motivated threat actors encrypt and steal data to use as leverage to obtain ransom payments. Cyberattacks are growing in sophistication and are continually evolving, and the HHS must be able to respond quickly, alert the sector about vulnerabilities under exploitation, and help prepare the sector for evolving threats.

The HHS plays a key role in improving cybersecurity across the sector and responding to threats, yet the diffuse nature of HHS cybersecurity authorities and responsibilities is complicating HHS’s response efforts. The HHS has limited resources for improving cybersecurity across the healthcare and public health sector, such as the sector’s reliance on legacy technology and workforce challenges. Further, privacy and security are governed by HIPAA, which is more than two decades old. HHS-OIG warned that the HIPAA Privacy Rule and the HIPAA Security Rule may not be sufficient to address contemporary privacy concerns and the increasing cybersecurity risks to electronic protected health information. As such, HHS-OIG said the HHS must adapt as privacy and security needs evolve.

Further regulation could help in this regard; however, the HHS has been slow to enact updates to the HIPAA Rules. A Privacy Rule update was proposed by HHS under the previous Trump administration in late 2020, yet a final rule has still not been published more than five years after the update was first proposed. The update is still on the HHS’s agenda, but there has been no indication when a final rule will be published. An extensive update to modernize the HIPAA Security Rule to strengthen cybersecurity across the sector was proposed in the final days of the Biden administration. While there is an urgent need to improve cybersecurity across the sector, it is currently unclear if the HHS, under the Trump administration, plans on implementing the proposed rule.

HHS-OIG said the HHS has taken action to address the challenges it highlights in the report, but there are considerable opportunities for further progress, and until the HIPAA Rules are updated, HHS must continue to work within the statutory authorities established by HIPAA in 1996, the HIPAA Privacy Rule in 2000, and the HIPAA Security Rule in 2003.

The post HHS-OIG Report Highlights Key HHS Cybersecurity Challenges appeared first on The HIPAA Journal.

OCR Advises HIPAA-Regulated Entities to Take Steps to Harden System Security

In the first of its 2026 quarterly cybersecurity newsletters, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) urged HIPAA-regulated entities to take steps to harden system security and make it more difficult for hackers to gain access to their networks and sensitive patient and health plan member data.

The HIPAA Security Rule requires HIPAA-regulated entities to ensure the confidentiality, integrity, and availability of electronic protected health information that the regulated entity creates, receives, maintains, or transmits, which must include identifying risks and vulnerabilities to ePHI and taking timely action to reduce those risks and vulnerabilities to a low and acceptable level. OCR Director Paula Stannard has already stated this year that OCR will be looking closely at HIPAA Security Rule compliance. OCR will continue with its risk analysis enforcement initiative, which will evolve to include risk management to ensure that regulated entities are taking prompt action to reduce risks and vulnerabilities to ePHI identified by their risk analyses.

OCR explained in the newsletter that risks can be reduced by creating a set of standardized security controls and settings for different types of electronic information systems, addressing security weaknesses and vulnerabilities, and customizing electronic information systems to reduce the attack surface.

OCR reminded medical device manufacturers that they have an obligation to ensure that their devices include accurate labelling to allow users to take steps to ensure the security of the devices throughout the product lifecycle, and the importance of following Food and Drug Administration (FDA) guidance on security risk management, security architecture, and security testing. Healthcare providers need to read the labelling on their devices carefully and ensure they understand how the devices should be configured to remain safe and effective through the entire product lifecycle.

OCR highlighted three key areas for hardening system security, all of which are vital for HIPAA Security Rule compliance. Threat actors search for known vulnerabilities that can be exploited to gain a foothold in a network, including vulnerabilities in operating systems, software, and device firmware. Whether the device is brand new or has been in use for some time, patches must be applied to fix known vulnerabilities. It may not be possible to patch vulnerabilities as soon as they are discovered; however, other remedial actions should be taken, as recommended by vendors, to reduce the risk of exploitation until patches are released and can be applied. A comprehensive and accurate IT asset inventory should be maintained, and policies and procedures developed and implemented to ensure a good patching cadence for all operating systems, software, and devices.

All organizations should take steps to reduce the attack surface by removing unnecessary software and devices, including software and devices that are no longer used, software features included in operating systems that serve no purpose for the regulated entity, and generic and service accounts created during the installation process. Accounts created during installation may have default passwords, which must be changed. OCR explained that in many of its investigations, accounts have been found for well-known databases, networking software, and anti-malware solutions that still have default passwords that provide privileged access.

Many cyberattacks occur as a result of misconfigurations. HIPAA-regulated entities must ensure security measures are installed, enabled, and properly configured. “Security measures often found in operating systems, as well as some other software, intersect with some of the technical safeguard standards and implementation specifications of the HIPAA Security Rule, such as, for example, access controls, encryption, audit controls, and authentication,” explained OCR. “A regulated entity’s risk analysis and risk management plan can inform its decisions regarding the implementation of these and other security measures.”

As OCR will be scrutinizing risk management and has advised regulated entities of their responsibilities to harden system security, all regulated entities should ensure they take the advice on board. “Defining, creating, and applying system hardening techniques is not a one-and-done exercise,” explained OCR. “Evaluating the ongoing effectiveness of implemented security measures is important to ensure such measures remain effective over time,” and is essential for HIPAA Security Rule compliance.

The post OCR Advises HIPAA-Regulated Entities to Take Steps to Harden System Security appeared first on The HIPAA Journal.

Ransomware Attacks Increased by 58% in 2025

The threat from ransomware is greater than ever, according to a new report from GuidePoint Security. The cybersecurity firm recorded a 58% year-over-year increase in victims, making 2025 the most active year ever reported by GuidePoint Security. In 2025, GuidePoint Security tracked 2,287 unique victims in Q4, 2025 alone – the largest number of victims in any quarter tracked by the GuidePoint Research and Intelligence Team (GRIT). December was the most active month in terms of claimed victims, which increased 42% year-over-year to 814 attacks. On average, 145 new victims were added to dark web data leak sites every week in 2025, with the year ending with 7,515 claimed victims.

Law enforcement operations have targeted the most active groups, and there have been notable successes; however, they have had little effect on the number of victims, which continues to increase. Rather than the ransomware-as-a-service (RaaS) landscape being dominated by one or two major actors, law enforcement operations have helped create a highly fragmented ecosystem, with smaller groups conducting attacks in high volume, using repeatable operations. In 2025, GRIT tracked 124 distinct named ransomware groups – a 46% increase from 2024 and the highest number of groups ever recorded in a single year.

While ransomware attacks are conducted globally, as in previous years, ransomware actors are primarily focused on the United States, where 55% of attacks were conducted last year, followed by Canada, which accounted for 4.5% of attacks. The manufacturing sector was the most heavily targeted, accounting for 14% of attacks, followed by the technology sector (9%), and retail/wholesale (7%). Healthcare ranked in fourth spot, with more than 500 victims in 2025.

Qilin, the most prolific RaaS group in 2025, disproportionately targets the healthcare sector. The group, which emerged in June 2024, is based in Eastern Europe and is thought to be a rebrand of the Agenda ransomware group. In 2024, the group added 154 victims to its dark web data leak site, increasing that tally by 578% to 1,044 victims in 2025, most likely by increasing its number of affiliates, many of whom are thought to have previously worked with the RansomHub group that shut down operations in April 2025. The large number of affiliates, each with their own specialties, means the group uses diverse tactics in its attacks. To put the volume of attacks into perspective, in 2025, Qilin conducted more attacks than LockBit did at its peak.

Qilin has claimed more healthcare victims than any other ransomware group, one of the most notable of which was UK pathology lab Synnovis. That single attack has reportedly caused more than $40 million in losses. The group is expected to continue as the most dominant group in 2026, although expanding operations to such an extent will make it a target for law enforcement. INC Ransom was the second biggest threat to healthcare organizations in 2025, followed by SafePay. While SafePay has been observed targeting small to mid-sized organizations, the group claimed responsibility for the ransomware attack on Conduent Business Services, which recently confirmed that 14.7 million individuals in Texas alone had their data compromised in the attack.

A relatively new ransomware group called Sinobi has conducted several attacks on healthcare organizations since it emerged in mid-2025. The group picked up the pace in Q4, adding 149 victims to its data leak site. GRIT notes that such a significant increase in tempo just a few months after forming is indicative of an established rather than an emerging or developing RaaS group, indicating the group may be a rebrand or at least has some highly experienced affiliates. In 2026, Sinobi is expected to pose a significant threat to the healthcare sector. LockBit has also returned since the law enforcement disruption in 2024, adding 106 new victims to its data leak site in December. LockBit similarly has no qualms about attacking the healthcare sector and is likely to be a significant threat in 2026.

There is growing evidence that ransomware groups are incorporating AI into their operations, most commonly for social engineering to overcome language barriers, personalize social engineering, and craft contextually appropriate lures that bypass traditional detection methods. They are also thought to have adopted AI to analyze the vast amounts of data they exfiltrate in their attacks to identify high-value data and determine appropriate ransom demands. While there are fears of AI-powered attacks, that has yet to be observed, with threat actors using AI to augment existing capabilities, rather than create fully autonomous and AI-coded malware, although both could become accessible enough for broader adoption in 2026.

“The year 2026 will likely see continued convergence of criminal innovation and AI capabilities, demanding that defenders adopt equally sophisticated technologies and intelligence-led approaches,” concluded GRIT. “The organizations best positioned to withstand this evolution will be those that prioritize rapid detection and response, implement comprehensive identity and access controls, and integrate AI-powered defenses as essential components of their security architecture rather than experimental additions.”

The post Ransomware Attacks Increased by 58% in 2025 appeared first on The HIPAA Journal.