The medical device manufacturer Livanova, the Massachusetts community behavioral health center Aspire Health Alliance, and Santa Rosa Behavioral Healthcare Hospital in California have experienced ransomware attacks that exposed patient data.

Livanova, London, UK

Livanova, a UK-headquartered medical device manufacturer specializing in cardiac surgery and neuromodulation devices, has suffered a ransomware attack that disrupted portions of its IT systems. The ransomware attack was discovered on November 19, 2023, and the forensic investigation confirmed that hackers gained access to its network on October 26, 2023. The LockBit ransomware group claimed responsibility for the attack.

Livanova announced in a SEC filing in November that it was dealing with a cyberattack; however, it was initially unclear to what extent patient data was involved. On April 10, 2024, Livanova confirmed that the personal and protected health information of U.S. patients had been exfiltrated from its systems in the attack. In an April 25, 2024, announcement, Livanova said the investigation is ongoing however it has been determined that information such as names, contact information, dates of birth, Social Security numbers, health insurance information, and medical information such as diagnoses, conditions, treatment information, prescription information, medical record number, device serial numbers, and physician names were involved.

The affected individuals have been advised to monitor their credit reports and account statements and to be alert to unsolicited communications involving personal information. Livnova has arranged for complimentary identity protection and credit monitoring services to be provided to the affected U.S. patients. It is currently unclear how many individuals have been affected. In a February 2024 earnings call, the company confirmed that the company had incurred costs of around $2.6 million in Q4, 2023, as a result of the attack.

Aspire Health Alliance, Massachusetts

Aspire Health Alliance, a state-designated community behavioral health center with facilities in Quincy, Braintree, and Marshfield in Massachusetts, has notified 17,490 individuals about a cyberattack that was detected on September 13, 2023. Suspicious activity was identified within its computer network and a third-party forensic investigation confirmed that its systems had been accessed by an unauthorized third party that acquired certain files and data stored on its network.

A comprehensive review was conducted to determine the types of data involved, and that process was completed on February 26, 2024, when it was confirmed that personal and protected health information was involved. The types of data varied from individual to individual and may have included names, other personal identifiers, and Social Security numbers. While data was exposed or acquired, no reports have been received to indicate any patient data has been misused. Complimentary credit monitoring and identity protection services have been offered to individuals whose Social Security numbers were impacted, and additional security measures have been implemented to reduce the risk of a similar incident occurring in the future.

Santa Rosa Behavioral Healthcare Hospital, California

Santa Rosa Behavioral Healthcare Hospital, part of the Northern California Behavioral Health System (NCBHS), has fallen victim to a cyberattack that disrupted some of its IT systems. The attack was detected on January 28, 2024, and a third-party forensic investigation confirmed that an unauthorized third party accessed its network between January 27, 2024, and January 28, 2024. During that time, files containing patient data were accessed or acquired.

The file review confirmed that the following types of information had been exposed or stolen: names, dates of birth, medical record numbers, services received, dates of services, treating physician, and for some patients, Social Security numbers and/or driver’s license numbers. Affected patients have been advised to monitor the statements they receive from their healthcare providers and health insurers and report any services they haven’t received. Individuals whose Social Security or driver’s license numbers were involved have been offered complimentary identity theft protection services. The incident has been reported to regulators but is not yet shown on the Office for Civil Rights breach portal, so it is currently unclear how many individuals have been affected.

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A Portland, ME-based accounting and consulting firm has recently reported a data breach to the Maine Attorney General that involved the personal information of 1,107,354 individuals. Berry, Dunn, McNeil & Parker, LLC (BerryDunn) provides health data analytics services to healthcare providers, health insurers, and government regulatory and healthcare policy agencies and its clients provide BerryDunn with personal and health data to allow the firm to perform its contracted services.

BerryDunn’s Health Analytics Practice Group (HAPG) contracted with a managed service provider (MSP) called Reliable Networks of Maine, LLC (RMN), which manages systems on behalf of HAPG. On September 14, 2023, RMN notified HAPG that it had identified suspicious activity on its network, including in the systems it manages for HAPG. BerryDunn immediately initiated its incident response protocols and brought in third-party cybersecurity experts to investigate to determine the extent to which client data was involved.

The investigation confirmed that a threat actor gained access to the RMN network and used the vendor’s privileged access to steal data from the HAPG systems the MSP managed. A vendor was engaged to conduct a review of the affected files, and that process was completed on April 2, 2024. The information exposed or stolen in the incident included names, addresses, dates of birth, Social Security numbers, health insurance policy numbers, Medicare or Medicaid numbers, state or governmental ID numbers, passport numbers, and medical information. Notification letters were mailed to the affected individuals on April 25, 2024, and complimentary credit monitoring and identity theft protection services have been offered to the affected individuals. Those services include a $1 million identity theft reimbursement policy.

It is unclear how many of BerryDunn clients have been affected. BerryDunn has confirmed that it has decommissioned all systems under the control of RMN, migrated all HAPG data to secure internal BerryDunn servers, and said those servers are continuously monitored for unauthorized access under its cybersecurity program.

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A bipartisan coalition of 22 state attorneys general sent a letter to UnitedHealth Group CEO Andrew Witty to express their concern about the response to the February 21, 2024, ransomware attack on Change Healthcare and the continuing problems faced by providers, pharmacies, and patients.

Providers and pharmacies in their various jurisdictions have reported catastrophic disruptions due to the extended outage and limited restoration of Change Healthcare’s services, and wholly inadequate responses from Change Healthcare and its payor partners. Many providers and pharmacies have said they are in jeopardy of collapse, with patients experiencing disruption to care due to delays in receiving vital prescription medications. In some cases, patients have been denied access to medications due to providers’ inability to conduct eligibility checks.

In the weeks following the attack, the Attorneys General have received increasingly dire messages from healthcare facilities, care providers, and patients due to the prolonged disruption to Change Healthcare’s services. The outage has caused problems with prescription drug access, there are catastrophic billing and payment backlogs, and other problems stemming from the continued lack of access to Change Healthcare’s services.

“Facilities that use Change Healthcare as their backbone to track services and claims have been unable to timely complete prior authorizations, confirm benefits, document and submit claims, and in some instances have even lost access to basic care IT infrastructure,” wrote the Attorneys General. “You must do more than you are currently to avoid imposing further harm to our states’ health care infrastructure and the patients who rely upon it.”

In addition to the lack of access to Change Healthcare’s systems, it has now been confirmed that there was a considerable data breach. UnitedHealth Group issued a statement confirming that personally identifiable and protected health information was compromised and that the data breach could affect “a substantial proportion of the U.S. population.” Further, “Given the ongoing nature and complexity of the data review, it is likely to take several months of continued analysis before enough information will be available to identify and notify impacted customers and individuals.”

The Attorneys General have been contacted by care providers and non-HG facilities who said they are unable to reach Change Healthcare staff who can provide timely information about the data that has been breached, how they can get financial support that does not impose unreasonable conditions such as waiver of liability, and how they can document and submit claims during the outage. While financial assistance has been provided, for many providers that have experienced financial difficulties due to the attack, the support offered has been “paltry”. Some independent providers have been quoted relief of as little as $10 per week.

In the letter, the Attorneys General outlined some of the specific actions that they believe need to be taken to help alleviate the harm caused by the outage. Those measures include the enhancement and expansion of financial assistance to all affected providers, ensuring providers and practices owned by UHG or its subsidiaries are not being offered more advantageous financial assistance than others, providing a dedicated helpline to allow providers to resolve unanswered questions, ensuring that the claims backlog is expeditiously resolved, to issuing timely notifications to the practices and patients whose data has been compromised. The Attorneys General also asked to be provided with an independent analysis confirming that UHG’s and Change Healthcare’s systems have been secured and the vulnerabilities that contributed to the cyberattack have been addressed.

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Kaiser Permanente Health Plan Inc. is notifying 13.4 million individuals that some of their personal data has been disclosed to third parties such as Microsoft (Bing), Google, and X (Twitter) via tracking technologies on its websites and apps. This is the largest healthcare data breach to be reported so far in 2024 and the largest confirmed healthcare data breach to date involving website tracking technologies.

Kaiser Permanente said the tracking technologies were identified during a voluntary internal investigation and they have now been removed from its websites and mobile applications. Additional measures have been implemented to prevent similar occurrences in the future. Notifications are being sent to all individuals who have potentially been affected “out of an abundance of caution,” including current and former health plan members in all markets that Kaiser Permanente operates, and individuals who used its websites and mobile apps. Notifications are expected to be issued in May 2024.

The types of data potentially disclosed to tech companies included names, IP addresses, sign-in statuses, and information about users navigated through the websites and apps. Other information was potentially disclosed based on individuals’ usage of the websites and apps, including search terms when using its health encyclopedia such as symptoms, drugs, injuries, and exercises.  No highly sensitive information such as Social Security numbers, financial information, and usernames/passwords were disclosed. Kaiser Permanente said it is not aware of any misuse of the disclosed data; however, it is possible that individuals may have been served targeted ads based on their interactions on Kaiser Permanente’s websites and apps.

The privacy violation has been reported to the Department of Health and Human Services’ Office for Civil Rights (OCR) as a breach of the Health Insurance Portability and Accountability Act (HIPAA). In December 2022, OCR published guidance on HIPAA and tracking technologies and recently updated its guidance to clarify when these technologies can be used and how they can be made HIPAA-compliant. OCR and the Federal Trade Commission (FTC) have been cracking down on the use of these technologies and sent around 130 warning letters to hospitals and telehealth companies last year reminding them of their obligations under HIPAA and the FTC Act, and the FTC has settled 5 complaints – Easy Healthcare (Premom), GoodRx, BetterHelp, Monument, and Cerebral – that alleged violations of the FTC Act related to the use of these technologies without consumers’ consent. State attorneys general have also investigated privacy violations related to the use of tracking technologies, including the New York Attorney General, who settled alleged violations of HIPAA and state laws with New York Presbyterian Hospital over the use of these tools.

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Politzer and Durocher, PLC, which does business as Optometric Physicians of Middle Tennessee (OPMT), has recently reported a hacking incident to the HHS Office for Civil Rights involving the personal and protected health information of 29,000 individuals. The Lebanon, TN-based eye clinic chain said it detected unauthorized access to its network on March 25, 2024. The attackers had circumvented its security controls, and accessed one of its servers and exfiltrated files containing “a very limited amount of healthcare information.” The investigation confirmed that other identifying information may have been accessed in the attack. A forensic investigation is currently underway to determine the exact types of information involved and notification letters will be mailed to the affected individuals when that process is completed. OPMT said, “Even though it is not specifically required by HIPAA, we will offer identity theft protection services to all affected individuals; we feel that this is an important precaution to protect our patients.”

The BianLian group has claimed responsibility for the attack. Like several other cybercriminal groups, BianLian tends not to use ransomware anymore and just steals data and demands payment to prevent the exposure or sale of the data. The BianLian has added OPMT to its leak site and claims to have exfiltrated 1.5TB of data in the attack, including financial information, HR data, biometric data, contracts and confidential agreements, SQL databases, and patients’ PII and PHI.

Moffitt Cancer Center Affected by Data Breach at Advarra

Moffitt Cancer Center has recently announced that it has been affected by a security breach at one of its vendors, Advarra.  Advarra provided services to Moffitt Cancer Center related to the care and treatment of patients and a research study. On October 26, 2023, Advarra discovered suspicious activity in an employee’s user account. The forensic investigation confirmed it had been accessed by an unauthorized individual on October 25, 2023, who acquired a limited amount of data. On or around February 8, 2024, Advarra completed its file review and confirmed that the compromised data belonged to Moffitt Cancer Center.

Moffitt Cancer Center was notified about the breach by Advarra on February 21, 2024, and completed its review of the affected data on March 13, 2024. Moffitt Cancer Center has confirmed that its own systems were not accessed and that the information exposed was limited to names, dates of birth, and Social Security numbers. Advarra is notifying the affected individuals on behalf of Moffitt Cancer Center.

Advarra has recently reported the breach to the HHS’ Office for Civil Rights as affecting 596 individuals and Moffit Cancer Center has reported the breach to the Maine Attorney General as affecting 26,577 individuals. Advarra said it has implemented additional measures to further strengthen its internal files system and is offering the affected individuals complimentary identity theft monitoring through Kroll. Moffitt Cancer Center also recently announced that it was affected by a data breach at another vendor, the law firm Gunster, Yoakley, and Stewart.

Patient Data Stolen in Cyberattack on Somerset Dental Las Vegas

Somerset Dental Las Vegas in Nevada has notified 11,321 patients that some of their protected health information has been exposed. The security breach was detected on February 16, 2024, and a third-party forensic investigation confirmed that certain files were exfiltrated from its network in the attack. The stolen data varied from individual to individual and may have included names, dates of birth, addresses, telephone numbers, email addresses, Social Security numbers, driver’s license numbers, health information, and dental insurance information.  Somerset Dental Las Vegas said it is reviewing its security safeguards and will strengthen security. Complimentary identity protection and credit monitoring services have been offered to individuals whose Social Security numbers and/or driver’s license numbers were involved.

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