The Health Sector Cybersecurity Coordination Center (HC3) has warned healthcare organizations that use Fortinet’s FortiSIEM platform to patch a critical vulnerability that is likely to be targeted by malicious actors and has issued a threat brief on Emotet malware.

FortiSIEM Command Injection Vulnerability – CVE-2023-36553

A critical vulnerability has been identified by Fortinet in its FortiSIEM platform. The vulnerability has been assigned a CVSS v3.1 severity score of 9.8 out of 10 and can be exploited remotely by malicious actors to execute arbitrary commands. The flaw is related to a bug discovered and patched by Fortinet in October 2023 – CVE-2023-34992. While there have been no known instances of the vulnerability being exploited in attacks, Fortinet vulnerabilities are actively targeted by malicious actors and exploitation of the flaw is likely.

“An improper neutralization of special elements used in an OS command vulnerability in FortiSIEM report server may allow a remote unauthenticated attacker to execute unauthorized commands via crafted API requests,” said Fortinet in a recent security advisory.

The vulnerability affects the following FortiSIEM versions: 4.7, 4.9, 4.10, 5.0, 5.1, 5.2, 5.3, and 5.4. Users should upgrade to a fixed version as soon as possible. The vulnerability has been fixed in versions: 7.1.0, 7.0.1, 6.7.6, 6.6.4, 6.5.2, 6.4.3, or later.

Emotet Malware – A Persistent Threat to the HPH Sector

Emotet malware was first identified in 2014 and started life as a banking Trojan; however, the malware has evolved over the years and is now commonly used as a first-stage malware for delivering other malware payloads such as banking Trojans, multi-purpose malware, information stealers, and ransomware, including the infamous TrickBot Trojan. Devices infected with Emotet are added to a botnet under the control of the operator of the malware, a group tracked as Mummy Spider, also known as TA542, GOLD CABIN & Mealybug, which is believed to operate out of Ukraine.

At its height, Emotet was called the world’s most dangerous malware by Europol, and Check Point data suggests one in every 5 organizations worldwide has been infected with Emotet. Emotet activity follows a rhythm of around 2-3 months of attacks followed by a period of little to no activity, which can last between 3 and 12 months. In January 2021, an international law enforcement operation took control of the botnet’s infrastructure, and an update was pushed out that uninstalled the malware from all infected devices. 10 months later, the botnet had been rebuilt.

While activity did not recover to the levels at the height of its success, the botnet continues to grow and still poses a significant threat. There were activity spikes in late spring 2022 before activity dropped off, and activity spiked again in Spring 2022. According to Check Point, the botnet now consists of around 130,000 unique devices in 179 countries and Emotet was the most prolific malware variant in February 2023. Emotet is used to gain initial access to networks, can elevate privileges, evade defenses, steal credentials, move laterally, exfiltrate data, and download other malware payloads and has been, and still is, one of the most potent weapons against the health sector. Recent activity includes the delivery of ransomware variants such as Quantum and BlackCat.

Emotet malware is most commonly delivered via phishing emails containing malicious URLs that link to a document containing a malicious macro that downloads the Emotet payload. The malware achieves persistence through Windows registry keys which ensure the malware executes on each reboot. The malware may also achieve persistence via the Windows Startup folder or via scheduled tasks and can also run as a Windows service that is executed automatically. HC3’s Emotet Threat Brief includes recommendations for healthcare and public health sector organizations on defense and mitigations.

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The U.S. Cybersecurity and Infrastructure Security Agency (CISA) has published a new mitigation guide for Healthcare and Public Health (HPH) Sector for combating pervasive cyber threats affecting the sector. The guidance is a supplemental companion to the HPH Cyber Risk Summary, published by CISA on July 19, 2023, and maps CISA’s Cross-Sector Cybersecurity Performance Goals (CPGs) to the 405(d) Health Industry Cybersecurity Practices (HCIP): Managing Threats and Protecting Patients guidance that was jointly published by the Department of Health and Human Services (HHS) and the Health Sector Coordinating Council (HSCC).

CISA has identified vulnerabilities and insecure configurations across the HPH sector that present opportunities for mitigating risks before they can be exploited by threat actors. The top vulnerabilities in the HPH sector are web application vulnerabilities, encryption weaknesses, unsupported software and Windows operating systems, known exploited vulnerabilities, and vulnerable services. These vulnerabilities are commonly exploited in phishing, ransomware, and denial of service attacks, and often lead to data breaches. The 25-page guidance document outlines three mitigation strategies for improving defenses against the most common attack vectors and includes recommendations and cybersecurity best practices for asset management and security, identity management and device security, and vulnerability, patch, and configuration management.

Knowing what assets are on the organization’s network is fundamental to cybersecurity. All assets must be known, as well as their relationships and interdependencies, the functions of each asset, what each exposes, and the software/firmware that each is running.  Organizations that have not implemented and maintained a complete inventory of all assets risk exposing vulnerabilities and services that can be exploited by threat actors. Once the asset inventory has been created, healthcare organizations can focus on securing all assets, segmenting networks to limit the potential for lateral movement, and using demilitarized zones (DMZs) and firewalls to shield assets from unauthorized access. The guidance includes recommendations for network segmentation, securing vulnerable and exploitable services, and asset security mitigations.

As the HPH sector continues to transition from on-premises to online systems, is vital that devices and digital accounts are properly secured through effective identity management and device security controls. The guidance suggests several focus areas, including email security and phishing prevention, access management, password policies, data protection and data loss prevention strategies, and logging and monitoring for unauthorized access.

Vulnerabilities and weak configurations are commonly exploited by cyber actors to gain initial access to internal systems and data. CISA stresses the importance of proactively scanning devices and systems for vulnerabilities or technology flaws that threat actors could exploit, and engaging in a continuous process of identifying vulnerabilities, assessing and prioritizing threats, mitigating vulnerabilities, verifying vulnerabilities have been addressed, and improving defenses. In addition to vulnerability management, HPH entities should implement security configuration management (SecCM) to identify and address misconfigurations in default system settings.

In addition to the recommendations for healthcare organizations, CISA has urged technology manufacturers to employ secure by design principles and ensure their products have the necessary security measures built in for the entire product lifecycle and to ensure that their default configurations are secure.

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The U.S. Food and Drug Administration (FDA) has published a report it commissioned that makes recommendations on how to manage the cybersecurity risks of legacy medical devices. Legacy medical devices are classed as devices that can no longer be reasonably protected against current cybersecurity threats, even though they may still adequately perform their primary function and have a useful life beyond the declared end-of-support or end-of-life date.

When medical devices reach end-of-life, patches stop being released to fix vulnerabilities, and unpatched vulnerabilities can be exploited to gain access to the devices and networks to which they are connected. In many cases, the vendors of the devices cannot continue to issue software patches due to outdated technology and compatibility issues and healthcare delivery organizations (HDOs) may not be able to replace them due to the high cost of doing so. If the devices were to be removed from use, it could have serious implications for patient safety and clinical operations.

Medical devices are regulated by the FDA, which was tasked by Congress in 2022 to ensure the cybersecurity of medical devices. The FDA has already issued final guidance on premarket submissions for medical devices, which must now meet minimum standards for cybersecurity in order to be approved for use in the United States by the FDA. While the final guidance addresses cybersecurity risks associated with new medical devices that come onto the market, it does nothing to address the cybersecurity of the millions of devices that are already in use at hospitals across the United States.

In November 2023, the FDA contracted with MITRE to produce a report on legacy medical devices, which were legally sold and had cybersecurity controls that were effective at the point of purchase but can no longer be reasonably protected. In an ideal world, these devices should be replaced; however, the issue is complex, and it must be managed in a way that minimizes negative impacts on patient care and safety.

To produce the report, Next Steps Toward Managing Legacy Medical Device Cybersecurity Risks, MITRE interviewed medical device manufacturers, healthcare providers, and cybersecurity experts to identify potential solutions for reducing the cybersecurity risks associated with legacy devices, and the report includes recommendations for reducing cyber risks for hospitals that do not have the resources and budgets to replace the devices. The recommendations address the challenges of shared responsibility over the medical device lifecycle, vulnerability management, workforce development, and mutual aid for less well-resourced healthcare delivery organizations (HDOs).

The 8 recommendations made in the report are:

• Collection of quantitative and qualitative data to allow HDOs and medical device manufacturers (MDMs) to make informed decisions about the risks and costs of replacement versus the continued use of legacy devices.
• Development of information sharing agreement templates to increase transparency and ensure appropriate expectations are included for managing legacy medical device security risks.
• Establishment of a security architecture working group including a broad range of stakeholders to identify and prioritize security controls that may be implemented within an HDO’s infrastructure to improve cyber risk management.
• Development of a research program in modular design for medical devices. If medical devices were designed to be modular, HDOs could have the option of replacing legacy software or hardware components rather than having to totally replace devices.
• Conduction of a study on vulnerability management coordination to explore approaches to streamline and improve vulnerability management processes, which are often costly and resource-intensive.
• Development of competency models for roles related to legacy cyber risk management to help less well-resourced HDOs and support workforce training.
• Participation in mutual aid partnerships, including ad-hoc relationships, private sector partnerships, and state/local government partnerships.

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A joint cybersecurity advisory has been issued by the U.S. Cybersecurity and Infrastructure Security Agency (CISA), Federal Bureau of Investigation (FBI), and the Multi-State Information Sharing and Analysis Center (MS-ISAC) about Rhysida ransomware.

Rhysida ransomware is a ransomware-as-a-service (RaaS) operation that first emerged in May 2023. The group engages in double extortion tactics, involving data theft and encryption, with ransom payment required to obtain the keys to decrypt files and prevent the public release of stolen data. Researchers at Check Point identified significant similarities between Rhysida ransomware and Vice Society, one of the most prolific ransomware groups since 2021 that aggressively targeted the education and healthcare sectors.

In August 2023, the HHS’ Health Sector Cybersecurity Coordination Center (HC3) issued its own advisory about Rhysida ransomware following several attacks on the healthcare sector, including the attack on Prospect Medical Holdings, which affected 17 hospitals and 166 clinics across the United States. The latest cybersecurity advisory includes an update on the tactics, techniques, and procedures (TTPs) and Indicators of Compromise (IoCs) from malware analyses and recent incident response investigations to help network defenders and incident response teams detect and block attacks in progress.

Rhysida ransomware actors have been observed using a variety of techniques for gaining initial access to victims’ networks, including leveraging external-facing remote services such as virtual private networks (VPNs), commonly through the use of compromised credentials. These attacks have proven successful against organizations that have failed to implement multi-factor authentication for VPN connections. Rhysida ransomware actors have also exploited unpatched vulnerabilities, such as the Zerologon (CVE-2020-1472) vulnerability in Microsoft’s Netlogon Remote Protocol, and commonly use phishing emails. Once initial access has been achieved, the group often creates Remote Desktop Protocol (RDP) connections for lateral movement, establishes VPN access, and uses PowerShell and native network administration tools to perform operations, which helps them to evade detection by hiding their activity within normal Windows systems and network activities.

The FBI, CISA, and the MS-ISAC suggest several mitigations for hardening security, including steps that can be taken to block the main attack vectors, restrict lateral movement, and detect attacks in progress. These include enabling phishing-resistant multifactor authentication, especially for webmail, VPNs, and accounts that access critical systems; disabling command-line and scripting activities and permissions; restricting the use of PowerShell; enhancing PowerShell logging and logging within processes; restricting the use of RDP; and securing remote access through application controls.

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The U.S. Cybersecurity and Infrastructure Security Agency (CISA) and the Federal Bureau of Investigation (FBI) have issued an updated cybersecurity advisory about Royal ransomware, which is thought to be about to shut down and rebrand.

Royal ransomware first emerged in September 2022 and is thought to have split from the Conti ransomware operation, with a brief spell operating as Quantum in between. Royal ransomware has been a prolific ransomware operation, having conducted more than 350 attacks since September 2022 and has issued ransom demands in excess of $275 million, according to the FBI. Royal ransomware is a private ransomware group that has targeted organizations in healthcare and public health (HPH), education, manufacturing, and communications. The number of attacks on HPH sector organizations prompted an earlier cybersecurity advisory from CISA, the FBI, and the HHS, which shared the latest tactics, techniques, and procedures (TTPs) used by the group and Indicators of Compromise (IoCs). They have been updated in the latest advisory.

In May 2023, a new ransomware variant was detected that had several coding similarities to Royal ransomware, and similar intrusion techniques were used. Researchers at Trend Micro found the two ransomware variants were almost identical, with 98% similar functions, 98.5% similarities in blocks, and 98.9% similarities in jumps based on BinDiff. The two groups have been observed using similar software and open source tools in their attacks such as Chisel and Cloudflared for network tunneling, Secure Shell (SSH) Client, OpenSSH, and MobaXterm for SSH connections, Mimikatz and Nirsoft for credential harvesting, and the attacks involved similar remote access tools.

Along with those similarities was the timing of the emergence of the new ransomware variant – Blacksuit – which led security researchers to believe that Royal was about to rebrand. Royal has just conducted a major attack on the city of Dallas which attracted considerable attention from law enforcement and, as is common after major attacks, ransomware groups often rebrand. Royal did not rebrand immediately, and it has been suggested that all did not go well with the new ransomware variant, and the rebrand was delayed. Alternatively, Blacksuit could be a spinoff variant of Royal. CISA and the FBI are convinced that the two ransomware variants are linked.

LockBit 3.0 Exploiting Citrix Bleed Vulnerability

The LockBit 3.0 group has been exploiting the critical Citrix Bleed vulnerability that affects Citrix NetScaler ADC and Gateway to gain access to the systems of its victims. The vulnerability, tracked as CVE-2023-4966, was patched by Citrix in October 2023; however, many organizations have been slow to patch and are running vulnerable appliances.

According to Security researcher Kevin Beaumont, who has been tracking the group’s attacks, several of the group’s recent victims had exposed Citrix servers that were vulnerable to the Citrix Bleed flaw, and that appears to have been exploited using a publicly available exploit.

Currently, there are more than 3,000 Citrix servers in the United States that are exposed to the Internet and vulnerable to the Citrix Bleed flaw which can be exploited remotely with no user interaction. Immediate patching is strongly recommended to prevent exploitation of the flaw.

Hunters International Ransomware Group Takes over from Hive

Hive, one of the most notorious ransomware groups in recent years, was shut down in January this year following an international law enforcement operation. The group had obtained more than $100 million in ransom payments and conducted more than 1,500 attacks worldwide, including many attacks on healthcare organizations.

Following law enforcement takedowns, ransomware groups often go quiet and then reemerge months later with a new ransomware variant. A new threat group, Hunters International, has since emerged and several similarities have been found with Hive, including coding overlaps and a 60% match between the group’s code, according to security researcher BushidoToken.

According to a recent report from Martin Zugec, technical solutions director at Bitdefender, a member of the Hunter’s International group issued a statement confirming that Hive and Hunter’s International are two separate groups and Hive’s source code and infrastructure were acquired. The Hive spokesperson said Hive sold their source code, website, and old Goland and C versions, and Hunter’s purchased them. The spokesperson for Hunter’s said encryption isn’t its primary goal, which is why the group didn’t develop everything from scratch. Bitdefender’s research uncovered evidence to suggest the adoption of Hive’s code rather than a rebrand, thus corroborating the Hunter’s International statement. Bitdefender’s analysis, recommendations, and IoCs can be found here.

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A zero-day vulnerability in the SysAid IT service management solution is being exploited by the Lace Tempest (aka FIN11, DEV-0950, TA505) threat group to gain access to SysAid servers, steal data, and deploy Clop ransomware.

The threat group is well known for exploiting zero-day vulnerabilities. Before the latest campaign, the group exploited a zero-day vulnerability in Progress Software’s MOVEit Transfer solution, stole data, and attempted to extort more than 2,000 victims. Earlier this year, a zero-day vulnerability was exploited in another file transfer solution, Fortra’s GoAnywhere MFT, and before that in 2021, the group exploited a zero-day vulnerability in the Accellion FTA.

The SysAid vulnerability was identified on November 2, 2023, after it had been exploited. The vulnerability, tracked as CVE-2023-47246, was identified by Microsoft, which notified SysAid. The attacks detected by Microsoft were attributed to the Lace Tempest group.

CVE-2023-47246 is a path traversal vulnerability in SysAid’s on-premises software that can be exploited to execute unauthorized code. In one of the attacks, the threat actor exploited the flaw to upload a Web Application Resource (WAR) archive containing a webshell to the webroot of the SysAid Tomcat web service. The webshell allowed the threat actor to execute PowerShell scripts to load GraceWire malware into a legitimate process such as spoolsv.exe, msiexec.exe, or svchost.exe. The malware checks for Sophos security software, and if not present, will be used to deploy additional scripts. In one attack, a Cobalt Strike listener was deployed on compromised hosts. After exfiltrating sensitive data, Clop ransomware was deployed and executed.

Given the speed at which the group has exploited vulnerabilities in the past, immediate action is required to fix the flaw. SysAid has released a patch and all SysAid users are being strongly encouraged to update to version 23.3.36 or later as soon as possible to prevent exploitation. After upgrading to the latest version, servers should be checked for signs of compromise. SysAid has published a list of Indicators of Compromise (IoCs) in its recent report on the attacks exploiting the flaw. SysAid also recommends reviewing any credentials or other information that would have been available to someone with full access to the SysAid server an to check any relevant activity logs for suspicious behavior.

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The Cybersecurity and Infrastructure Security Agency (CISA), National Security Agency, Office of the Director of National Intelligence, and partners have released guidance on software bill of materials (SBOM) generation and consumption, as part of ongoing efforts to better secure the software supply chain.

The guidance was developed by the Software Supply Chain Working Panel, which was established by the Enduring Security Framework (ESF) and is a collaborative partnership across private industry, academia, and government. The Working Panel has developed a three-part Recommended Practices Guide series, that covers best practices to help ensure a more secure software supply chain for developers, suppliers, and customer stakeholders.

The latest guidance is aimed at software developers and suppliers, and includes industry best practices and principles, including managing open source software and SBOM to maintain and provide awareness about the security of software.

Cyber actors are increasingly targeting the software supply chain and are searching for software vulnerabilities that can be exploited to allow them to attack all users of the software, such as the 2020 cyberattack on the SaaS provider SolarWinds. The attack is believed to have been conducted by the Russian state-sponsored hacking group Cozy Bear, which compromised the SolarWinds Orion IT performance and monitoring solution and added a backdoor. When a software update was rolled out to customers, so was the backdoor, resulting in the compromising of an estimated 18,000 systems. The hackers then conducted follow on activities on selected high value targets.

Cyber actors also take advantage of vulnerabilities in open source software and third-party components, such as the Log4Shell vulnerability in the Log4j logging tool, which is used by millions of computers worldwide. When a critical vulnerability was identified and patches were released, they could only be applied if it was known that Log4j was used. Because Log4j was a component of many different software solutions, the vulnerability went unaddressed as many users were unaware that they were vulnerable.

One of the ways that the security of the software supply chain can be improved is by having a complete SBOM that includes all software components and dependencies. The SBOM can be rapidly queried to determine if a vulnerable software component is used and steps can then be taken to address the problem. The latest guidance document is part of the ESF Software Supply Chain Working Panel’s second phase of guidance, which provides further details on the SBOMs that were recommended in the Phase 1 Recommended Practices Guides.

According to CISA, the guidance can be used as a basis for describing, assessing, and measuring security practices relative to the software lifecycle and the suggested practices can be applied across the acquisition, deployment, and operational phases of a software supply chain. The guidance includes recommendations in line with industry best practices and principles which software developers and software suppliers are encouraged to reference, and includes managing open source software and SBOMs to maintain and provide awareness about the security of software.

While the guidance provides recommendations for SBOM generation and consumption processes, implementing these recommendations will be a challenge for many organizations as it will require considerable investment and resources that many organizations currently lack.

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