Healthcare Cybersecurity

Threat Actors Increasingly Targeting Vulnerabilities for Initial Access

The exploitation of vulnerabilities in software and operating systems is becoming far more common for initial access to networks, with phishing declining in prevalence, according to Mandiant’s M-Trends 2024 Report. Manidant, part of Google Cloud, is a leading provider of dynamic cyber defense, threat intelligence, and incident response services. The latest report is based on data from Mandiant Consulting investigations of targeted attack activity conducted between January 1, 2023, and December 31, 2023.

Exploited software vulnerabilities were the initial access method in 38% of intrusions investigated by Manidant, up 6% from 2022, with phishing used for initial access in 17% of incidents, down from 22% in 2022. Attackers are increasingly targeting edge devices and are exploiting a wide variety of vulnerabilities. In 2023, Mandiant identified 97 unique zero-day vulnerabilities being exploited in the wild, up 56% from 2022. The exploitation of zero day vulnerabilities used to be limited to a small number of threat actors, typically nation-state cyberespionage groups. While state-sponsored threat actors continue to target zero-day flaws, especially China-nexus threat actors, ransomware and data extortion groups are increasingly acquiring and utilizing 0days, helped by the rise of commercially available turnkey exploit kits.

Threat actors are combining exploits of zero-day flaws with living-off-the-land techniques, which involve native, legitimate tools within a system to allow them to maintain persistence for longer and avoid detection. One of the reasons for the decline in phishing as an initial attack vector is the widespread adoption of multifactor authentication (MFA). While MFA is effective at preventing phishing attacks, Mandiant has identified an increase in the use of web proxies and adversary-in-the-middle phishing pages that can steal credentials and login session tokens to bypass MFA. Defenses can be improved against these attacks by adopting phishing-resistant MFA.

Mandiant has also observed an increase in malware, with 626 new malware families identified in 2023, more than any other year to date. The most common malware families were backdoors (33%), downloaders (16%), droppers (15%), credential stealers (7%) and ransomware (5%). The industries most commonly targeted by threat actors were financial services (17%), business and professional services (13%), high technology (12%), retail and hospitality (9%), and healthcare (8%), with attacks increasingly targeting cloud environments, as more organizations transition to the cloud. The most likely reason for targeting these sectors is they store a wealth of sensitive information, including proprietary business data, personally identifiable information, protected health information, and financial records.

Mandiant’s data show that organizations are getting better at identifying intrusions. Last year, attackers were present in networks for a median of 10 days before the intrusions were detected, down from a median of 16 days in 2022. “Defenders should be proud, but organizations must remain vigilant. A key theme throughout M-Trends 2024 is that attackers are taking steps to evade detection and remain on systems for longer, and one of the ways they accomplish this is through the use of zero-day vulnerabilities,” Jurgen Kutscher, Vice President, Mandiant Consulting at Google Cloud, told The HIPAA Journal. “This further highlights the importance of an effective threat hunt program, as well as the need for comprehensive investigations and remediation in the event of a breach.”

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March 2024 Healthcare Data Breach Report

March was a particularly bad month for healthcare data breaches with 93 branches of 500 or more records reported to the Department of Health and Human Services (HHS) Office for Civil Rights (OCR), a 50% increase from February and a 41% year-over-year increase from March 2023. The last time more than 90 data breaches were reported in a single month was September 2020.

The reason for the exceptionally high number of data breaches was a cyberattack on the rehabilitation and long-term acute care hospital operator Ernest Health. When a health system experiences a breach that affects multiple hospitals, the breach is usually reported as a single breach. In this case, the breach was reported individually for each of the 31 affected hospitals. Had the breach been reported to OCR as a single breach, the month’s breach total would have been 60, well below the average of 66.75 breaches a month over the past 12 months.

Healthcare data breaches in the past 12 months

 

 

healthcare data breaches in March 2020-2024

While the breach total was high, the number of individuals affected by healthcare data breaches fell for the fourth consecutive month to the lowest monthly total since January 2023. Across the 93 reported data breaches, the protected health information of 2,971, 249 individuals was exposed or impermissibly disclosed – the lowest total for March since 2020.

records compromised in healthcare data breaches in the past 12 months

healthcare records breached in march 2020-2024

Biggest Healthcare Data Breaches in March 2024

18 data breaches were reported in March that involved the protected health information of 10,000 or more individuals, all of which were hacking incidents. The largest breach of the month was reported by the Pennsylvanian dental care provider, Risa’s Dental and Braces.  While the breach was reported in March, it occurred 8 months previously in July 2023. A similarly sized breach was reported by Oklahoma’s largest emergency medical care provider, Emergency Medical Services Authority. Hackers gained access to its network in February and stole files containing names, addresses, dates of birth, and Social Security numbers.

Philips Respironics, a provider of respiratory care products, initially reported a hacking-related breach to OCR involving the PHI of 457,152 individuals. Hackers gained access to the network of the Queens, NY-based billing service provider M&D Capital Premier Billing in July 2023, and stole files containing the PHI of 284,326 individuals, an August 2023 hacking incident was reported by Yakima Valley Radiology in Washington that involved the PHI of 235,249 individuals, and the California debt collection firm Designed Receivable Solutions, experienced a breach of the PHI of 129,584 individuals. The details of the breach are not known as there has been no public announcement other than the breach report to OCR.

 Name of Covered Entity State Covered Entity Type Individuals Affected Breach Cause
Risas Dental & Braces PA Healthcare Provider 618,189 Hacking Incident
Emergency Medical Services Authority OK Healthcare Provider 611,743 Hacking Incident
Philips Respironics PA Business Associate 457,152 Exploited software vulnerability (MoveIT Transfer)
M&D Capital Premier Billing LLC NY Business Associate 284,326 Hacking Incident
Yakima Valley Radiology, PC WA Healthcare Provider 235,249 Hacked email account
Designed Receivable Solutions, Inc. CA Business Associate 129,584 Hacking Incident
University of Wisconsin Hospitals and Clinics Authority WI Healthcare Provider 85,902 Compromised email account
Aveanna Healthcare GA Healthcare Provider 65,482 Compromised email account
Ezras Choilim Health Center, Inc. NY Healthcare Provider 59,861 Hacking Incident (data theft confirmed)
Valley Oaks Health IN Healthcare Provider 50,034 Hacking Incident
Family Health Center MI Healthcare Provider 33,240 Ransomware attack
CCM Health MN Healthcare Provider 28,760 Hacking Incident
Weirton Medical Center WV Healthcare Provider 26,793 Hacking Incident
Pembina County Memorial Hospital ND Healthcare Provider 23,811 Hacking Incident (data theft confirmed)
R1 RCM Inc. IL Business Associate 16,121 Hacking Incident (data theft confirmed)
Ethos, also known as Southwest Boston Senior Services MA Business Associate 14,503 Hacking Incident
Pomona Valley Hospital Medical Center CA Healthcare Provider 13,345 Ransomware attack on subcontractor of a vendor
Rancho Family Medical Group, Inc. CA Healthcare Provider 10,480 Cyberattack on business associate (KMJ Health Solutions)

 

Data Breach Causes and Location of Compromised PHI

As has been the case for many months, hacking incidents dominated the breach reports. 76 of the month’s breaches were classed as hacking/IT incidents, which involved the records of 2,918,585 individuals, which is 98.2% of all records compromised in March. The average breach size was 38,402 records and the median breach size was 3,144 records. The nature of the hacking incidents is getting harder to determine as little information about the incidents is typically disclosed in breach notifications, such as whether ransomware or malware was used. The lack of information makes it hard for the individuals affected by the breach to assess the level of risk they face. Many of these breaches were explained as “cyberattacks that caused network disruption” in breach notices, which suggests they were ransomware attacks.

Causes of March 2024 healthcare data breaches

There were 11 unauthorized access/disclosure incidents reported involving a total of 36,533 records. The average breach size was 3,321 records and the median breach size was 1,956 records. There were 4 theft incidents and 1 loss incident, involving a total of 15,631 records (average: 3,126 records; median 3,716 records), and one improper disposal incident involving an estimated 500 records. The most common location for breached PHI was network servers, which is to be expected based on the number of hacking incidents, followed by compromised email accounts.

Location of breached PHI in March 2024 healthcare data breaches

Where Did the Data Breaches Occur?

The OCR data breach portal shows there were 77 data breaches at healthcare providers (2,030,568 records), 10 breaches at business associates (920,522 records), and 6 data breaches at health plans (20,159 records). As OCR recently confirmed in its Q&A for healthcare providers affected by the Change Healthcare ransomware attack, it is the responsibility of the covered entity to report breaches of protected health information when the breach occurs at a business associate; however, the responsibility for issuing notifications can be delegated to the business associate. In some cases, data breaches at business associates are reported by the business associate for some of the affected covered entity clients, with some covered entities deciding to issue notifications themselves. That means that data breaches at business associates are often not abundantly clear on the breach portal. The HIPAA Journal has determined the location of the breaches, with the pie charts below show where the breaches occurred, rather than the entity that reported the breach.

Data breaches at HIPAA-regulated entities in March 2024

Records breached at HIPAA-regulated entities in March 2024

Geographical Distribution of Healthcare Data Breaches

In March, data breaches were reported by HIPAA-regulated entities in 33 U.S. states. Texas was the worst affected state with 16 breaches reported, although 8 of those breaches were reported by Ernest Health hospitals that had data compromised in the same incident. California experienced 10 breaches, including 3 at Ernest Health hospitals, with New York also badly affected with 7 reported breaches.

State Breaches
Texas 16
California 10
New York 7
Pennsylvania 6
Indiana 5
Colorado & Florida 4
Illinois, Ohio & South Carolina 3
Arizona, Idaho, Massachusetts, Michigan, Minnesota, New Mexico, North Carolina, Oklahoma & Utah 2
Alabama, Georgia, Kansas, Kentucky, Nevada, New Jersey, North Dakota, Oregon, Tennessee, Virginia, Washington, West Virginia, Wisconsin & Wyoming 1

HIPAA Enforcement Activity in March 2024

OCR announced one settlement with a HIPAA-regulated entity in March to resolve alleged violations of the HIPAA Rules. The Oklahoma-based nursing care company Phoenix Healthcare was determined to have failed to provide a daughter with a copy of her mother’s records when the daughter was the personal representative of her mother. It took 323 days for the records to be provided, which OCR determined was a clear violation of the HIPAA Right of Access and proposed a financial penalty of $250,000.

Phoenix Healthcare requested a hearing before an Administrative Law Judge, who upheld the violations but reduced the penalty to $75,000. Phoenix Healthcare appealed the penalty and the Departmental Appeals Board affirmed the ALJ’s decision; however, OCR offered Phoenix Healthcare the opportunity to settle the alleged violations for $35,000, provided that Phoenix Healthcare agreed not to challenge the Departmental Appeals Board’s decision.

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Only 28% of Ransomware Victims Choose to Pay Ransom

According to the Q1, 2024 ransomware report from the ransomware remediation firm Coveware, ransom payments have fallen to a record low with only 28% of victims opting to pay the ransom to recover files and/or prevent the exposure of stolen data. In Q1, 2019, more than 80% of victims of ransomware attacks paid the ransom, but the percentage has been steadily falling, with only 29% of victims paying up in Q4, 2023, and just 28% in Q1, 2024.

Coveware suggests several reasons for the decline in payments, including better preparation and more advanced protective measures that allow victims to recover files without having to pay the ransom, legal pressure on victims not to give in to demands, and growing distrust of ransom groups. There have been an increasing number of attacks where payment has been made only for the attackers to continue to leak data or trade stolen data with other groups. For instance, the recent Blackcat ransomware attack on Change Healthcare saw the operators pocket the $22 million ransom payment and not pay the affiliate, who switched to the RansomHub group, which started leaking the data to pressure Change Healthcare into paying another ransom payment.

Coveware also reports that the confidence of ransomware affiliates has been shaken by recent law enforcement operations against LockBit and BlackCat. While groups were able to recover from the takedowns, the operations demonstrated that ransomware groups are not beyond the reach of Western law enforcement agencies. Further, the actions of the groups following the attacks have not helped to restore affiliates’ confidence. Both groups have had public disputes with affiliates and refused to pay them their cut of the ransoms, and coupled with the risk of having their identities discovered by law enforcement, many have chosen to quit conducting attacks for those groups and potentially quit ransomware altogether.

Based on the attacks where Coveware has been engaged to assist with recovery, Akira is now the dominant group with a market share of 21%, followed by Blackbasta and Lockbit which each have a 9% share, medusa, Phobos, and BlackCat with 6%, and Rhysida, BlackSuit and Inc Ransom with a 4% market share. BlackBasta has returned to the list of top ransomware groups, which suggests that affiliates have been leaving BlackCat and Lockbit, while the increase in Phobos attacks suggests that some affiliates are choosing to set up their own operations.

There has been a trend for increasing ransom payments since 2019 and a sharp increase in payments in Q1, 2023; however, by Q3, 2024, ransom payments started to fall. That fall has continued, with Q1, 2024 seeing an average payment of $381,980, down 32% from the previous quarter. Median payments have been increasing slowly and jumped by 25% to $250,000 in Q1, 2024. This is due to ransomware groups demanding more reasonable payments to increase the likelihood of being paid.

The threat of publication of stolen data is often enough to get victims to pay up. 23% of victims who were only faced with the threat of publication of their data chose to pay the ransom in Q1; however, there is no guarantee that the stolen data will be deleted. The law enforcement disruption of LockBit confirmed that the group still held a lot of data from attacks where the victims had paid to have their data deleted. There have been several cases where payment has been made to one group, only for the data to be provided to another ransomware group for re-extortion.

Coveware tracks the ransomware vectors used to gain initial access to networks; although that is becoming increasingly difficult, with the initial access vector unclear in more than 40% of Q1, 2024 attacks. Remote access compromise is the most common of the confirmed attack vectors, with software vulnerabilities and phishing both in decline. It is also common for multiple attack vectors to be used to achieve an extortion-level impact. While few sectors have escaped ransomware attacks, in Q1, 2024, healthcare was the worst affected industry, accounting for 18.7% of attacks, followed by professional services (17.8%), the public sector (11.2%), and consumer services (10.3%).

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CISA & Partners Share New Threat Intelligence on Akira Ransomware

The Cybersecurity & Infrastructure Security Agency (CISA), Federal Bureau of Investigation (FBI), Europol’s European Cybercrime Centre (EC3), and the Netherlands’ National Cyber Security Centre (NCSC-NL) have issued a joint cybersecurity advisory about the Akira ransomware operation, which has conducted more than 250 attacks and has been paid around $42 million in ransom payments. The group’s operators are highly skilled and are associated with the infamous Conti ransomware operation.

Akira is a relatively new ransomware group that emerged in April 2023 that mostly targets small- to medium-sized businesses and demands ransom payments from around $200,000 to millions of dollars. The group has attacked many verticals including finance, real estate, manufacturing, and healthcare. Attacks on healthcare targets prompted the Health Sector Cybersecurity Coordination Center to issue a Sector Alert about Akira ransomware in September 2023. The latest cybersecurity advisory from CISA and Partners shares information on the latest tactics, techniques, and procedures (TTPs) used by the group, updated indicators of compromise (IoCs), and recommended mitigations for network defenders.

Akira has been observed gaining initial access to victims’ networks through a Virtual Private Network (VPN) service without multifactor authentication, primarily through the exploitation of the Cisco vulnerabilities CVE-20203259 and CVE-2023-20269. The group also targets external facing services including Remote Desktop Protocol (RDP), abuses valid credentials, and conducts spear phishing attacks.

When a corporate network has been breached, the group moves laterally and attempts to obtain Windows domain credentials, then deploys ransomware to encrypt files. The group engages in double extortion tactics, stealing sensitive data from victims and demanding payment to prevent stolen data from being leaked and for the keys to decrypt files. Initially, the group only attacked Windows systems but has developed a Linux encryptor and now also targets VMware ESXi virtual machines. The group uses Kerberoasting techniques and Mimikatz to obtain credentials, LaZagne to help with privilege escalation, PowerTool to exploit the Zemana AntiMalware driver and terminate antivirus-related processes, and FileZilla, WinRAR, WinSCP, and RClone for data exfiltration.

The cybersecurity advisory includes several recommended mitigations to prevent and reduce the impact of Akira ransomware attacks, some of the most important of which are ensuring that patches are applied to fix known exploited vulnerabilities – especially CVE-20203259 and CVE-2023-20269, enforcing phishing-resistant multifactor authentication across the organizations in particular for VPNs, webmail, and accounts linked to critical systems, and ensuring that software is kept up to date.

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Palo Alto Networks Updates Mitigations as Exploitation of 0Day Firewall Vulnerability Grows

Exploitation of a recently disclosed zero-day vulnerability affecting Palo Alto Networks firewalls has grown since proof-of-concept exploits were released, and a previously recommended mitigation is ineffective at preventing exploitation of the flaw.

The vulnerability, tracked as CVE-2024-3400, is a command injection flaw in versions 10.2, 11.0, and 11.1 of the PAN-OS operating system that powers its firewalls. The vulnerability is thought to have been exploited since March 26, 2024, initially by a nation-state-affiliated group tracked as Operation MidnightEclipse; however, Palo Alto Networks has detected an additional 20 IP addresses attempting to exploit the flaw.

The vulnerability affects the GlobalProtect gateway or portal VPN feature on certain PAN-OS devices, and can be exploited by an unauthenticated attacker to execute arbitrary code with root privileges. The vulnerability has a maximum CVSS v3 severity score of 10. According to security researchers at Rapid7, the vulnerability is being exploited as part of an exploit chain, along with a second vulnerability that has yet to have a CVE assigned. The second vulnerability is a file creation vulnerability in the GlobalProtect web server.

Initially, Palo Alto Networks said PAN-OS firewalls are vulnerable to attack if GlobalProtect gateway and device telemetry are both enabled. Palo Alto Networks released an initial security advisory about the flaw on Friday, along with recommended mitigations. A secondary mitigation action suggested by Palo Alto Networks was disabling device telemetry; however, Palo Alto has now confirmed that the mitigation is no longer effective, as vulnerable firewalls do not need device telemetry to be enabled to be exposed to attacks.

According to SharowServer, around 156,000 vulnerable Palo Alto Networks devices are exposed to the Internet, although it is unclear how many of those devices have been patched. To remediate the vulnerability, customers should ensure a hotfix is applied. Rapid7 has confirmed that the hotfixes released by Palo Alto networks are effective at preventing the exploitation of CVE-2024-3400.

The hotfixes are PAN-OS 10.2.9-h1, PAN-OS 11.0.4-h1, PAN-OS 11.1.2-h3, and all later versions. On Thursday and Friday, Palo Alto Networks released hotfixes for other commonly deployed maintenance releases, as detailed in an updated HC3 Sector Alert from the Health Sector Cybersecurity Coordination Center (HC3).

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Ransomware Attacks Up 20% YoY with 55% Increase in Active Ransomware Groups

An analysis of ransomware activity by GuidePoint Security’s Research and Intelligence Team (GRIT) shows a 55% year-over-year increase in active ransomware groups and an almost 20% increase in ransomware victims (1,024) compared to Q1, 2023.

According to Guidepoint Security’s Q1 2024 Ransomware Report, the industries most impacted by ransomware attacks were manufacturing, retail and wholesale, and healthcare. While there was a 7.4% increase in posted victims from February to March, there was a decline in attacks on healthcare organizations, which fell from 32 new additions to data leak sites in February to just 20 in March. There was a similar reduction in attacks on law firms, which decreased from 20 in February to 10 in March. In Q1, 2024, more than half of all victims (537 attacks) were based in the United States – The first time since Q2, 2023, that more than 50% of attacks were conducted in the US. The United Kingdom was the second most targeted country (60 attacks).

In Q1, 2023, GRIT identified 29 distinct, active ransomware groups whereas 45 groups were detected in Q1, 2024. The most active ransomware group in Q1, 2024 was LockBit. Even with the law enforcement disruption of the LockBit ransomware group in February 2024, LockBit retained the top spot claiming 219 victims in the quarter, although this was below the typical number of attacks the group conducts. Prior to the law enforcement operation that disrupted its operation on February 20, 2024, LockBit was averaging 3 attacks a day. From February 24 through the end of March, the group dropped to an average of 2 attacks a day. The group now appears to be back up to full speed, claiming 97 victims in March alone. The next most active group was Blackbasta which conducted 73 attacks in Q1, 2024, up 151% from the previous quarter, followed by Play with 71 attacks, down 37% from Q4, 2023. While the Qilin ransomware-as-a-service group conducted relatively few attacks (44) in 2023, it has increased activity considerably in 2024 claiming 34 victims in the quarter.

There has been significant law enforcement activity against ransomware groups in recent months. LockBit survived the attempted takedown by the Operation Cronos Task Force, which only caused a few days of severe disruption but ransomware attacks have been conducted at a lower volume in the weeks since. In late December, law enforcement disrupted the ALPHV/Blackcat ransomware group, which was the second most prolific ransomware group in 2023. The group responded by removing virtually all restrictions for affiliates and actively encouraged attacks on healthcare organizations until the attack on Change Healthcare, after which the group appeared to pocket the full ransom payment as part of an exit scam and shut down its operation.

Even with the disruption of LockBit and the ALPHV shutdown, there was still a 19.2% increase in reported victims in the quarter with a minimum of 50 victims added to data leak sites each week and a high of 125 victims posted one week in March. GRIT identified attempts by several groups to attract new affiliates in Q1, including the Medusa, Cloak, and RansomHub groups, which were advertising their RaaS operations on deep and dark web forums in January and February 2024, with RansomHub activity appearing to have increased in the weeks since. Three new ransomware groups emerged in Q1 – Killsec, Donex, and Redransomware. While these groups only conducted a small number of attacks (22) in March, activity is likely to increase. Attacks fell from 1,117 in Q4, 2023 to 1,024 in Q1, 2024, and with the shutdown of the ALPHV operation, Q2 may see attacks continue to decline; however, the affiliates who worked for ALPHV are likely to switch ransomware operations, with other groups likely to increase activity to fill the gap.

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Cyberattacks Have Increased but Ransomware Attacks Have Declined in 2024

IT professionals and security executives believe cyberattacks have increased since 2023 according to a recent survey by Keeper Security.  The cybersecurity firm surveyed 800 IT leaders globally, and 92% said they thought cyberattacks have increased in the past year with 95% saying that cyberattacks have become so sophisticated that they feel unprepared to deal with emerging threat vectors such as AI-based attacks (35%), deepfakes (30%), leveraged 5G networks (29%), unauthorized cloud control (25%), and fileless attacks (23%). It is not only external threat actors that are conducting attacks, as 40% of respondents said they have experienced a cyberattack caused by an insider. The main types of attacks that have increased in frequency are phishing (51%), malware (49%), ransomware (44%), and password attacks (31%). A majority of IT professionals said phishing and smishing attacks have become much harder to detect, which many attribute to the use of generative AI by cybercriminals.

There was a surge in ransomware attacks in 2023; however, attacks have fallen in 2024 according to the Israeli cybersecurity firm Cyberint. In 2023, there was a 55.5% increase in victims of ransomware attacks, with 5,070 organizations reporting attacks in 2023 and 1,309 reported attacks in Q4 alone. However, in Q1, 2024, only 1,048 have been reported, down 22% from Q4, 2023.

Cyberint offers several possible explanations for the decline. There has been increased law enforcement activity, including two operations targeting two of the most active groups, LockBit and ALPHV, that disrupted their operations. In the case of LockBit, the disruption was particularly short, with the group claiming to have rebuilt its infrastructure within a week of the takedown. In Q1, 2024, 210 attacks were attributed to LockBit showing that the disruption was only temporary. In December 2023, a law enforcement operation seized some of the infrastructure of the ALPHV group, and while the group remained active, only 51 attacks were confirmed in Q1, 2024, down from 109 attacks in Q4, 2024. The group also recovered quickly and, in response, removed restrictions for affiliates, and actively encouraged attacks on healthcare targets. The ALPHV group has now shut down following the attack on Change Healthcare, although ALPHV is expected to rebrand and return.

Cyberint also suggests that the decreasing number of victims paying ransoms has made ransomware attacks less profitable, leading some affiliates to pursue other sources of income. Data from the ransomware remediation firm Coveware shows ransom payments fell to a record low in Q4, 2023, with only 29% of victims choosing to pay the ransom. Ransom payments have also fallen to an average payment in Q4, 2023 of $568,705, a 33% decrease from the previous quarter.

While some groups appear to have shut down their operations, several new groups have emerged. In Q1, 2024, Cyberint tracked the emergence of 10 new ransomware groups. While these groups have not been conducting attacks on the scale of ALPHV, there is the potential for them to scale up their operations. One of those groups, RansomHub, is attempting to extort Change Healthcare, and claims it has the data stolen in its ALPHV ransomware attack.

While the reduction in ransomware attacks is good news, it is too early to tell whether the decline will continue or if it is just a blip. What is more certain is that, in the short term at least, ransomware is likely to continue to be one of the biggest cyber threats faced by organizations.

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Companies with Strong Cybersecurity Programs Deliver Higher Returns for Shareholders

Investing in cybersecurity can help organizations prevent data breaches and avoid regulatory fines, but there are other benefits. A recently released report from Diligent Institute and Bitsight shows organizations that have a strong cybersecurity program tend to have better financial performance and deliver higher returns for their shareholders.

For the report, Diligent Institute and Bitsight analyzed data from 4,149 mid to large-sized organizations in multiple sectors across Australia, Canada, France, Germany, Japan, the United Kingdom, and the United States. Cybersecurity oversight at the committee level was assessed to determine the impact on cybersecurity risk ratings and each company’s cyber oversight structure was correlated with their security performance data, with each company given a security performance classification of basic, intermediate, or advanced.

The study revealed companies with advanced security ratings created almost 4 times the amount of value for their shareholders as companies with basic security ratings. Over three and five years, companies with an advanced security rating had a Total Shareholders’ Return (TSR) of 372% and 91% higher respectively, compared to companies with a basic security rating. Over three and five years, the average TSR for companies with an advanced security rating was 71% and 67%, compared to a 37% and 14% TSR for companies with a basic security rating.

The report showed that healthcare and other highly-regulated sectors appreciate the importance of cybersecurity and understand that cybersecurity is not simply an IT problem, rather it is an enterprise risk that can have an impact on the company’s short-term performance and long-term health. Healthcare outperformed other sectors in terms of cybersecurity performance and had the highest average security rating of all industries represented in the study.

In addition to the correlation between cybersecurity performance and shareholder return, the researchers found a correlation between board structure and security ratings, with companies that had specialized risk or audit committees performing better than those that did not. Companies with specialized risk or audit committees had an average security rating of 710, compared to an average rating of 650 for companies that had neither of these committees.

Integrating a cybersecurity expert into a board committee tasked with cybersecurity risk oversight makes a significant difference to an organization’s security performance; however, simply having a cybersecurity expert on the board does not mean a company will have a better security rating. Companies with cybersecurity experts on the board had an average security score of 580, compared to an average rating of 700 for companies that had cybersecurity experts on either audit committees or specialized risk committees. The researchers note that it is rare for boards to include cybersecurity experts, with only 5% of the assessed companies having cybersecurity experts on their boards. “Companies seeking to hire cybersecurity expertise for the board should first ensure that the board is appropriately organized so that expertise can be properly incorporated into the oversight mechanisms,” suggested the researchers.

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Social Engineering Campaign Targets Hospital IT Helpdesks

Warnings have been issued by the American Hospital Association (AHA) and the Health Sector Cybersecurity Coordination Center (HC3) about a social engineering campaign that targets IT helpdesk at U.S. hospitals. According to the AHA, the campaign uses the stolen identities of revenue cycle employees or employees in other sensitive financial roles. The threat actor contacts the IT helpdesk and uses stolen personally identifiable information to answer security questions posed by IT helpdesk staff. Once the threat actor has navigated the questions, they request a password reset and ask to enroll a new device, often with a local area code, to receive multi-factor authentication (MFA) codes.

Once the new device has been enrolled, the threat actor logs into the user’s account and successfully passes the MFA check, the MFA code is sent to the newly registered device. The AHA warns that these attacks can also bypass phishing-resistant MFA. The main purpose of the campaign appears to be to divert legitimate payments. Once access has been gained to an employee’s email account, payment instructions are changed with payment processors, resulting in fraudulent payments to U.S. bank accounts. Access may also be used to install malware on the network.

HC3 is aware of this social engineering campaign and said IT helpdesks are told that the user has broken their phone so they cannot receive any MFA codes. The helpdesk is provided with the last four digits of the target employee’s social security number (SSN), corporate ID number, and demographic details to pass security checks. HC3 suggests the information is likely to have been obtained from publicly available sources such as professional networking sites and/or past data breaches. The tactics in the campaign mirror those used by a threat group known as Scattered Spider (UNC3944). Scattered Spider claimed responsibility for a similar campaign targeting the hospitality and entertainment industry, which led to BlackCat ransomware being used to encrypt files on the network. Ransomware is not believed to have been used in the campaign targeting the healthcare sector and it is unclear which threat group is behind the campaign.

The AHA was first made aware of the campaign in January 2024 and issued a warning to hospitals. The warning has now been reissued due to an uptick in incidents. “The risk posed by this innovative and sophisticated scheme can be mitigated by ensuring strict IT help desk security protocols, which at a minimum require a call back to the number on record for the employee requesting password resets and enrollment of new devices,” said John Riggi, AHA’s national advisor for cybersecurity and risk. “Organizations may also want to contact the supervisor on record of the employee making such a request. In addition, a video call with the requesting employee might be initiated and a screenshot of the employee presenting a valid government-issued ID be captured and preserved.” One large health system has changed its policies and procedures following a successful attack and now requires employees to visit the IT helpdesk in person in order to change their password or register a new device.

You can view the HC3 alert and recommended mitigations here.

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