HIPAA Breach News

1,080 Chaplaincy Health Care Patients Potentially Impacted by Phishing Attack

Chaplaincy Health Care, a not-for-profit healthcare provider based in Richland, WA, has experienced a phishing attack that has resulted in the exposure of 1,080 patients’ protected health information.

The phishing attack occurred on November 20, 2018 and was discovered within 4 hours. Prompt action was taken to block unauthorized access and a third-party computer forensics firm was hired to assist with the breach investigation.

The investigation confirmed that a single email account was accessed by the attacker. After gaining access to the email account, the attacker attempted to access further accounts. The breach was discovered when the employee was alerted that her account had been used to send a phishing email to an email contact.

No evidence was uncovered to suggest any patient health information was viewed or copied but, out of an abundance of caution, all patients affected by the breach have been offered complimentary credit monitoring and identity theft protection services through LifeLock for 12 months. Patients were notified about the breach on January 3, 2019.

The firm investigating the breach concluded that the primary aim of the attack was to compromise as many email accounts as possible rather than to access sensitive information, although it was not possible to determine whether any emails in the compromised account had been accessed.

The compromised email account contained full names, home addresses, dates of birth, medical record numbers, prescription information, dates of service, and the last four digits of Social Security numbers.

“Chaplaincy Health Care sincerely apologizes for the inconvenience and the concern this incident has caused,” explained Gary Castillo, Executive Director of Chaplaincy Health Care. “Information security is very important to us and we will continue to do everything we can to fortify our operational protections for our patients and their families.”

In response to the breach, Chaplaincy Health Care has implemented two-factor authentication on its email accounts and employees have been provided with further training on protecting sensitive patient information.

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Ransomware Attack on Podiatric Offices of Bobby Yee Impacts 24,000 Patients

A ransomware attack on the Podiatric Offices of Bobby Yee has resulted in the encryption of files containing the protected health information (PHI) of up to 24,000 patients and other individuals.

The attack took place on October 29, 2018. Medical records were encrypted by the ransomware along with files containing information such as full name, address, contact telephone number(s), gender, birth date, Social Security number, and health insurance information.

Prompt action was taken to protect patient data and an investigation into the breach did not uncover any evidence to suggest the attacker viewed or copied any patients’ PHI.

The Podiatric Offices of Bobby Yee explained in a December 20, 2018, press release “We may need to reconfirm or reconstruct the information, including your medical information.” It is unclear whether the ransom was paid to obtain the key to decrypt patient data or whether files were recovered from backups.

Humana Insurance Applicants Affected by Bankers Life Data Breach

Humana has announced that certain insurance applicants have had some of their personal information exposed as a result of a hacking incident at the Chicago-based health insurer Bankers Life.

Bankers Life is a division of CNO Financial Group and a business associate of Humana. Bankers Life discovered on August 7, 2018, that hackers had gained access to its systems between May 30 and September 12, 2018. Access to its systems was gained using stolen employee credentials.

The breach was one of the largest healthcare data breaches of 2018 and affected around 566,2017 individuals, according to a breach report issued by CNO Financial Group in November 2018.

Humana notified the California Attorney General of the breach on January 3, 2019. According to the report, Humana was notified about the breach on October 25, 2018.

The breach affects individuals who had previously applied for a health insurance policy through Humana. Information included on those applications includes names, addresses, dates of birth, Humana health insurance application numbers and policy numbers, cost of coverage, and the last four digits of Social Security numbers.

Bankers Life has offered affected individuals free credit monitoring and identity repair services for 12 months. It is currently unclear exactly how many Humana insurance applicants have been affected.

Humana has also recently informed the Department of Health and Human Services’ Office for Civil Rights about another data breach affecting its members – The theft of paper/film records containing the PHI of 684 individuals. The breach report was submitted to OCR on December 31, 2018. No further information on the breach is available at the time of writing.

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Advertising Expenditures Increase 64% Following a Healthcare Data Breach

A recent study has explored the relationship between advertising expenditures and healthcare data breaches. The study shows hospitals significantly increase advertising spending following a data breach.

Healthcare Data Breaches Are the Costliest to Mitigate

Healthcare data breaches are the most expensive to mitigate, far higher than breaches in other industry sectors. According to the Ponemon Institute/IBM Security’s 2018 cost of a data breach study, healthcare data breaches cost, on average, $408 per lost or stolen record. The costs are double, or in some cases almost triple, those in other industry sectors.

In addition to the high costs of mitigating the breaches, the same study confirmed that loss of patients to competitors is a very real threat. Data breaches cause damage to a brand and trust in an organization can be easily lost when confidential personal information is exposed or stolen.

The Ponemon Institute study revealed healthcare organizations have a high churn rate after a breach. At 6.7%, it is higher than the financial sector (6.1%), services (5.2%), energy (3.0%) and education (2.7%).

Hospitals’ Advertising Expenditure Increases 64% Following a Data Breach

In a recent study, Sung J. Choi, PhD and M. Eric Johnson, PhD., investigated how advertising expenditures at hospitals changed following a data breach.

The study, which was recently published in the American Journal of Managed Care, revealed hospitals increase advertising spending by an average of 64% in the year following a data breach. Advertising expenditures were found to be 79% higher over the two-year period following a data breach.

The researchers note that breached hospitals were most likely to be large or teaching hospitals located in urban settings. Hospitals that experienced data breaches had an average of 566 beds and were typically located in areas where there were other hospitals and, consequently, high competition for patients.

Hospitals in the control group that had not experienced a data breach spent an average of £238,000 on advertising each year, whereas hospitals that experienced data breaches spent an average of $817,205 on advertising in the year following a breach – Almost three times as much as the control group. An average of $1.75 million was spend on advertising in the two years following a breach.

The researchers suggest that the increase in spending is an attempt to minimize patient loss to competitors and to help repair hospitals’ reputations.

The researchers note that the data from the study came from 2011-2014 before ransomware attacks on hospitals became common. Given how much more these types of data breaches disrupt medical services provided by hospitals, advertising spending may be even higher following these types of breaches.

“Advertising and the efforts to fix the damages from a data breach increase healthcare costs and may divert resources and attention away from initiatives to improve care quality,” wrote the researchers. “Advertising costs subsequent to a breach are another cost to the healthcare system that could be avoided with better data security.”

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Blue Cross Blue Shield of Michigan Members Notified of Business Associate Ransomware Attack

A business associate of Blue Cross Blue Shield of Michigan has experienced a ransomware attack that has potentially resulted in the theft of plan members’ protected health information. This is the second data breach affecting Blue Cross Blue Shield of Michigan plan members to be reported in December. Some plan members’ PHI was stored on a laptop computer that was stolen from a different business associate.

The latest breach was experienced by Austin, TX-based Wolverine Solutions Group, a vendor that provides business services to Blue Cross Blue Shield of Michigan and several other healthcare clients.

On September 23, 2018, ransomware was installed on its network that resulted in the encryption of files on servers and workstations, including files containing protected health information.

A third-party computer forensics firm conducted an investigation into the breach but found no evidence of data exfiltration; however, data theft could not be entirely ruled out. The types of information that was potentially accessed and copied included demographic data, health plan contract numbers, and a limited about of health information. Some Social Security numbers may also have been compromised.

According to Databreaches.net, the data breach was not confined to Blue Cross Blue Shield of Michigan. Other healthcare clients were also affected including Molina Healthcare. 895 Molina Healthcare patients have also been notified that their PHI was potentially compromised.

Wolverine Solutions has written to all affected individuals to alert them to the breach and, out of an abundance of caution, has offered 12 months of complimentary credit monitoring services to breach victims. Due to Blue Cross Blue Shield of Michigan’s policies, its members have been offered extended protection for 24 months.

Wolverine Solutions has already taken steps to improve security and has moved to a new computer system that has added protection against these types of attacks. All employees have also received further training on the new safeguards.

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Email Account Breach Impacts Hundreds of Choice Rehabilitation Residents

Choice Rehabilitation of Creve Coeur, MO, has discovered an unauthorized individual hacked into a corporate email account of one of its employees and set up a mail forwarder to send emails to a personal email account.

The breach occurred on July 1, 2018 and the mail forwarder remained active until September 30, 2018. A detailed analysis of the email account revealed the protected health information of certain residents was included in billing documents attached to emails that had been sent to its associated skilled nursing facilities.

Highly sensitive information such as financial data, Social Security numbers, Medicare and Medicaid numbers, dates of birth and contact information remained secure at all times. The breach was limited to billing information related to physical, speech, and occupational therapy provided to patients such as names, payor information, medical record numbers, start and end dates of therapy, diagnoses, treatment information, billing codes, and the name of the facility where care was provided.

Upon discovery of the breach, access to the compromised email account was blocked, the mail forwarder was deactivated, and the personal email account used by the attacker has been deactivated. Choice Rehabilitation alerted other corporate users about the breach and reminded them of security safeguards to prevent unauthorized account access. Security awareness training will continue to be regularly provided to employees. Additional safeguards have also been implemented to improve email and network security and monitoring of corporate emails accounts has been stepped up.

Choice Rehabilitation has not received any information to suggest the forwarded emails were opened by the attacker. Due to the nature of the PHI that was potentially accessed, Choice Rehabilitation believes the risk of PHI misuse is low.

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Vendor of Dental Center of Northwest Ohio Suffers Ransomware Attack

Current and former patients of the Dental Center of Northwest Ohio in Toledo, OH, are being notified that some of their protected health information has potentially been compromised as a result of a ransomware attack on one of its vendors.

Arakyta, a managed IT service provider, notified the dental center on September 1, 2018, of a security breach on a server hosting certain dental center systems. Assisted by third-party computer experts, the dental center determined on November 7, 2018, that an unknown, unauthorized individual had gained access to the server and had potentially viewed or copied patient data.

No evidence of data theft was detected and no reports have been received from patients to suggest any protected health information was stolen and misused. However, since it was not possible to rule out data theft with a high degree of certainty, the decision was taken to issue notifications to patients and to provide them with complimentary credit monitoring and identity theft restoration services.

The types of data potentially viewed/copied by the attacker included full names, home addresses, dates of birth, Social Security numbers, driver’s license numbers, state identification numbers, medical histories, diagnoses, treatment information, clinical data, medical records, patient ID numbers, health insurance information, benefit information, and financial data.

Both the dental center and Arakyta had security measures in place to prevent unauthorized data access, but those controls were bypassed by the attacker. The dental center has since reviewed its policies related to the privacy and security of patient data and has implemented additional safeguards to prevent further breaches of protected health information.

The breach has been reported to the Department of Health and Human Services’ Office for Civil Rights (OCR) and other appropriate authorities. The breach summary has yet to be added to the OCR breach portal, so it is currently unclear how many patients have been affected.

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Orlando Family Physicians Group Phishing Attack Impacts 8,400 Patients

8,400 patients of the Humana-owned Family Physicians Group in Orlando are being notified that some of their protected health information has potentially been compromised as a result of a phishing attack.

Family Physicians Group is one of the largest providers of healthcare for Medicare and Medicaid beneficiaries in Central Florida and operates 22 clinics in the region.

An investigation into the breach confirmed that an employee’s email account was accessed by an unauthorized individual on August 7, 2018. Unauthorized account access remained possible until August 21, 2018, when the breach was discovered and login credentials were changed. The login credentials were obtained by the attacker when the employee responded to a phishing email.

Affected patients were notified about the incident on December 28, 2018. It is unclear why it took more than 4 months to issue notifications to patients.

An analysis of the emails in the compromised account confirmed certain messages contained the protected health information of patients. No financial data or Social Security numbers were recorded in emails. The breach was limited to names, dates of birth, physicians’ names, and health insurance information.

Family Physicians Group has not received any information to suggest that patient data were stolen and misused.

Family Physicians Group reset all email passwords as a precaution and has upgraded its email application and implemented further security measures to improve protection from phishing attacks.

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15,000 Customers Notified About Blue Cross Blue Shield of Michigan Data Breach

Approximately 15,000 customers of Blue Cross Blue Shield of Michigan have been notified that some of their private information was stored on a laptop computer that was stolen from an employee of a business associate of one of its subsidiaries.

The laptop computer was stolen on October 26, 2018, and Blue Cross Blue Shield of Michigan was alerted to the exposure of plan members’ protected health information (PHI) on November 12, 2018. The breach affects members of Blue Cross’ Medicare Advantage health insurance plans. Notifications are now being mailed to all plan members affected by the breach.

The laptop computer was protected with a password and plan members’ data stored on the device had been encrypted; however, the employee’s credentials may also have been stolen. Consequently, there is a risk that PHI could have been accessed.

The data stored on the stolen laptop was limited to names, addresses, members’ identification numbers, dates of birth, genders, provider information, diagnoses, and medications. The laptop did not contain Social Security numbers or financial data.

An investigation into the incident has been launched and the employee’s login credentials have now been changed. The risk of identity theft and fraud is believed to be low; however, out of an abundance of caution, all individuals affected by the breach have been offered 24 months of complimentary identity theft protection services. There is no indication that any information stored on the stolen laptop has been accessed by unauthorized individuals.

Blue Cross Blue Shield of Michigan is working closely with its subsidiary company and is assessing policies and procedures and will update them accordingly. Additional safeguards will also be implemented to prevent further security breaches.

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Largest Healthcare Data Breaches of 2018

This post summarizes the largest healthcare data breaches of 2018: Healthcare data breaches that have resulted in the loss, theft, unauthorized accessing, impermissible disclosure, or improper disposal of 100,000 or more healthcare records.

2018 has seen 18 data breaches that have exposed 100,000 or more healthcare records. 8 of those breaches saw more than half a million healthcare records exposed, and three of those breaches exposed more than 1 million healthcare records.

A Bad Year for Healthcare Data Breaches

As of December 27, 2018, the Department of Health and Human Services’ Office for Civil Rights (OCR) has received notifications of 351 data breaches of 500 or more healthcare records. Those breaches have resulted in the exposure of 13,020,821 healthcare records.

It is likely that the year will finish on a par with 2017 in terms of the number of reported healthcare data breaches; however, more than twice as many healthcare records have been exposed in 2018 than in 2017.

In 2017, there were 359 data breaches of 500 or more records reported to OCR. Those breaches resulted in the exposure of 5,138,179 healthcare records.

The Largest Healthcare Data Breaches of 2018

Listed below is a summary of the largest healthcare data breaches of 2018. A brief description of those breaches has been listed below.

At the time of writing, OCR is still investigating all but one of the breaches listed below. Only the LifeBridge Health breach investigation has been closed.

Rank

 

Name of Covered Entity Covered Entity Type Individuals Affected Type of Breach
1 AccuDoc Solutions, Inc. Business Associate 2,652,537 Hacking/IT Incident
2 UnityPoint Health Business Associate 1,421,107 Hacking/IT Incident
3 Employees Retirement System of Texas Health Plan 1,248,263 Unauthorized Access/Disclosure
4 CA Department of Developmental Services Health Plan 582,174 Theft
5 MSK Group Healthcare Provider 566,236 Hacking/IT Incident
6 CNO Financial Group, Inc. Health Plan 566,217 Unauthorized Access/Disclosure
7 LifeBridge Health, Inc Healthcare Provider 538,127 Hacking/IT Incident
8 Health Management Concepts, Inc. Business Associate 502,416 Hacking/IT Incident
9 AU Medical Center, INC Healthcare Provider 417,000 Hacking/IT Incident
10 SSM Health St. Mary’s Hospital – Jefferson City Healthcare Provider 301,000 Improper Disposal
11 Oklahoma State University Center for Health Sciences Healthcare Provider 279,865 Hacking/IT Incident
12 Med Associates, Inc. Business Associate 276,057 Hacking/IT Incident
13 Adams County Healthcare Provider 258,120 Unauthorized Access/Disclosure
14 MedEvolve Business Associate 205,434 Unauthorized Access/Disclosure
15 HealthEquity, Inc. Business Associate 165,800 Hacking/IT Incident
16 St. Peter’s Surgery & Endoscopy Center Healthcare Provider 134,512 Hacking/IT Incident
17 New York Oncology Hematology, P.C. Healthcare Provider 128,400 Hacking/IT Incident
18 Boys Town National Research Hospital Healthcare Provider 105,309 Hacking/IT Incident

 

Causes of the Largest Healthcare Data Breaches of 2018

Further information on the causes of the largest healthcare breaches of 2018.

AccuDoc Solutions, Inc.

Morrisville, NC-based AccuDoc Solutions, a billing company that operates the online payment system used by Atrium Health’s network of 44 hospitals in North Carolina, South Carolina and Georgia, discovered that some of its databases had been compromised between September 22 and September 29, 2018. The databases contained the records of 2,652,537 patients. While data could have been viewed, AccuDoc reports that the databases could not be downloaded. Not only was this the largest healthcare data breach of 2018, it was the largest healthcare data breach to be reported since September 2016.

UnityPoint Health

A UnityPoint Health phishing attack was detected on May 31, 2018. The forensic investigation revealed multiple email accounts had been compromised between March 14 and April 3, 2018 as a result of employees being fooled in a business email compromise attack. A trusted executive’s email account was spoofed, and several employees responded to the messages and disclosed their email credentials. The compromised email accounts contained the PHI of 1,421,107 individuals.

Employees Retirement System of Texas

The Employees Retirement System of Texas discovered a flaw in its ERS OnLine portal that allowed certain individuals to view the protected health information of other members after logging into the portal. The breach was attributed to a coding error. Up to 1,248,263 individuals’ PHI was potentially viewed by other health plan members.

CA Department of Developmental Services

The California Department of Developmental Services experienced a break in at its offices. During the time the thieves were in the offices they potentially accessed the sensitive information of approximately 15,000 employees, contractors, job applicants, and parents of minors who receive DDS services, in addition to the PHI of 582,174 patients.

MSK Group

Tennessee-based MSK Group, P.C, a network of orthopedic medical practices, discovered in May 2018 that hackers had gained access to its network. Certain parts of the network had been accessed by the hackers over a period of several months. The records of 566,236 patients, which included personal, health and insurance information, may have been viewed or copied by the hackers.

CNO Financial Group, Inc.

Chicago-based health insurer Bankers Life, a division of CNO Financial Group Inc., discovered hackers gained access to its systems between May 30 and September 13, 2018 and potentially stole the personal information of 566,217 individuals.

LifeBridge Health, Inc

The Baltimore-based healthcare provider LifeBridge Health discovered malware had been installed on a server that hosted the electronic medical record system used by LifeBridge Potomac Professionals and LifeBridge Health’s patient registration and billing systems. Those systems contained the PHI of 538,127 patients.

Health Management Concepts, Inc.

Health Management Concepts discovered hackers gained access to a server used for sharing files and installed ransomware. The ransom demand was paid to unlock the encrypted files; however, HMC reported that the hackers were ‘inadvertently provided’ with a file that contained the PHI of 502,416 individuals. It is suspected that the file was unwittingly sent to the attackers to prove they could decrypt files.

AU Medical Center, INC

An Augusta University Medical Center phishing attack resulted in an unauthorized individual gaining access to the email accounts of two employees. The compromised email accounts contained the PHI of 417,000 patients.

SSM Health St. Mary’s Hospital – Jefferson City

St. Mary’s Hospital moved to new premises and all patients’ medical records were transferred to the new facility; however, on June 1, 2018, the hospital discovered administrative documents containing the protected health information of 301,000 patients had been left behind. In the most part, the breach was limited to names and medical record numbers.

Oklahoma State University Center for Health Sciences

Oklahoma State University Center for Health Sciences discovered an unauthorized individual gained access to parts of its computer network and potentially accessed files containing billing information of Medicaid patients. The breach affected 279,865 patients, although only a limited amount of PHI was accessible.

Med Associates, Inc.

The Latham, NY-based health billing company Med Associates, which provides claims services to more than 70 healthcare providers, discovered an employee’s computer has been accessed by an unauthorized individual. It is possible that the attacker gained access to the PHI of up to 276,057 patients.

Adams County

Adams County, WI, discovered hackers gained access to its network and potentially accessed the PHI and PII of 258,102 individuals. The compromised systems were used by the departments of Health and Human Services, Child Support, Veteran Service Office, Extension Office, Adams County Employees, Solid Waste, and the Sheriff’s Office.

MedEvolve

MedEvolve, a provider of electronic billing and record services to healthcare providers, discovered an FTP server had been left unsecured between March 29, 2018 and May 4, 2018. A file on the FTP server contained the PHI of 205,434 patients of Premier Immediate Medical Care.

HealthEquity, Inc.

HealthEquity, a Utah-based company that provides services to help individuals gain tax advantages to offset the cost of healthcare, experienced a phishing attack that resulted in hackers gaining access to the email accounts of two employees. Those accounts contained the PHI of 165,800 individuals.

St. Peter’s Surgery & Endoscopy Center

St. Peter’s Surgery & Endoscopy Center in New York discovered malware had been installed on one of its servers which potentially allowed hackers to view the PHI of 134,512 patients. The malware was discovered the same day it was installed. The fast detection potentially prevented patients’ data from being viewed or copied.

New York Oncology Hematology, P.C.

A phishing attack on New York Oncology Hematology in Albany, NY, resulted in hackers gaining access to the email accounts of 15 employees. Those accounts contained the PHI of 128,400 current and former patients and employees.

Boys Town National Research Hospital

Boys Town National Research Hospital, an Omaha, NE hospital specializing in pediatric deafness, visual and communication disorders, experienced a phishing attack that allowed hackers to gain access to a single email account. The email account contained the PHI of 105,309 patients.

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