#OpSafePharma 3.0: Italian Hacktivists Attack the Healthcare Sector

The #OpSafePharma is a hacktivist campaign targeting the Italian healthcare and pharma industries, protesting their treatment of ADHD. Hacktivists affiliated with Anonymous Italia perform DDoS attacks and leak information stolen from databases of websites related to the abovementioned sectors. The campaign, which started in March 2016, was relaunched at the beginning of June following a decrease in the number of attacks against Italian targets in the past month.

On August 21, 2016, Anonymous Italia and its affiliated hacktivist collective AntiSec-Italia, relaunched the campaign, this time dubbed #OperationSafePharma, targeting four different healthcare-related Italian institutions with website defacement attacks and substantial data leakages. The outcomes of the operation, namely the screenshots of the defaced websites and the addresses of the downloadable data leakages, uploaded on dedicated file sharing platforms, were announced on the social media outlets of AntiSec-Italia, specifically on their Facebook page and Twitter account.

AntiSec-Italia published the outcomes of the operation on its Facebook page
AntiSec-Italia published the outcomes of the operation on its Facebook page

 

 

 

 

 

 

 

 

 

 

 

 

The Data Leakage

The hacktivists leaked approximately 2.5 GB of data, stolen from the databases of two prominent Italian healthcare institutions, and provided links to file-sharing platforms where they uploaded the dumps.

We acquired the leaked databases and, upon verification, we assess that they mostly contain internal communications, as well as a great volume of personal data relating to the in-house personnel of the two healthcare institutions, mainly CVs of the physicians and administrative executives working in the facilities. We did not find any indications that medical records of patients treated in these healthcare facilities were disclosed or compromised during the data leakage. Notably, the most recent documents we detected within the stolen files are dated August 5, 2016.

A partial list of the folders included in one of the leaked databases.
A partial list of the folders included in one of the leaked databases.
Sample of leaked data, notably personal documents of a patient who applied to be treated by a different physician
Sample of leaked data, notably personal documents of a patient who applied to be treated by a different physician

Website Defacements

The group defaced four distinct websites, explaining in a public statement – recycled from previous operations – the rationale underpinning the protest.

Screenshots of the defacements related to two of the affected Italian medical facilities
Screenshots of the defacements related to two of the affected Italian medical facilities

Assessment

Our assessment is that this latest iteration of #OperationSafePharma originates more from a one-time opportunity window that the hacktivist group AntiSec-Italia spotted in vulnerable websites associated with Italian medical centers and hospitals, than a concerted effort by multiple Anonymous-affiliated collectives to launch a massive hacktivist campaign against the Italian healthcare sector as a whole. We base this assumption on the analysis conducted using our automated SMA (Social Media Analytics) toolset, which indicated a spike in the activity of the attackers.

Nonetheless, the achievements of the operation, in particular the exfiltration of sensitive databases belonging to prominent Italian healthcare institutions, display noteworthy technical capabilities by the initiators of the offensive.

As yet, we have not identified any preparations for future hacktivist campaigns against the Italian healthcare or financial sector, nonetheless we continue to monitor Italian hacktivist threat actors on a daily basis.

The Healthcare Sector is Targeted by Cybercriminals More than Ever

The healthcare sector has recently become a desirable target for cyber crooks. According to Symantec ISTR report statistics, healthcare was the most breached sub-sector in 2015, comprising almost 40% of all the attacks. Hospital security systems are generally less secure than those of financial organizations, as monetary theft has always been perceived as the greatest threat for organizations, and dangers to other sectors were usually underestimated. Moreover, awareness of cyber-attacks against hospitals and medical centers is much lower than it is to financial cybercrime, and as a result, the employees are less well-trained on how to avoid falling victim to a cyber-attack.

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Top 10 Sub-Sectors Breached by Number of Incidents According to Symantec ISTR report

Only lately, this concept has started to be challenged, revealing the potential damage that can be caused by the theft and leakage of patient data. However, the ‘bad guys’ remain one step ahead and during the last few months, we have witnessed a spate of attacks targeting the healthcare industry: ransomware attacks encrypting essential data and demanding payment of a ransom, numerous data leakages revealing confidential patient data, unauthorized access to medical networks and even the hacking of medical devices, such as pumps and X-ray equipment.

Moreover, the healthcare sector is being targeted by hackers not only directly, but also via third-party companies in the supply chain, such as equipment and drug suppliers. These companies usually store some confidential data that originates in the hospitals’ databases and may even have access to the hospital IT systems, but they are far less secure than the hospitals themselves. Thus, they serve as a preferable infiltration point for malicious actors pursuing the theft of medical data and attempting to infiltrate the hospitals’ networks.

The consequences of attacks on the healthcare industry may be extensive, including the impairment of the medical center functioning, which may result in danger to human lives in the worst case scenario. In other cases, personal data will be stolen and sold on underground markets. Cybercriminals will take advantages of these personal details for identity theft or for future cyber-attacks combining social engineering based on the stolen details.

While monitoring closed Deep-Web and Darknet sources, SenseCy analysts recently noticed a growing interest toward the healthcare sector among cyber criminals. Databases of medical institutions are traded on illicit marketplaces and closed forums, along with access to their servers. In the last few months alone, we came across several occurrences indicating extensive trade of medical records and access to servers where this data is stored.

The first case, in May 2016, was the sale of RDP access for a large clinic group with several branches in the central U.S., which was offered for sale on a Darknet closed forum. For a payment of $50,000 Bitcoins, the buyer would receive access to the compromised workstation, with access to 3 GB of data stored on four hard disks. Additionally, the workstation allows access to an aggregate electronical system (EHR) for managing medical records, where data regarding patients, suppliers, payments and more can be exploited.

Although the seller did not mention the origin of the credentials he was selling, he claimed that local administrator privileges could be received on the compromised system. He also specified that 45 users from the medical personnel were logged into the system from the workstation he hacked.

The relatively high price for this offer indicates the high demand for medical information. With RDP access, the potential attackers can perform any action on the compromised workstation: install malware, encrypt the files or erase them, infect other machines in the network and access any data stored in the network. The consequences can be tremendous.

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An excerpt of the sale thread posted on a Darknet forum

 

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Screenshot allegedly taken on the hacked workstation

Just a few weeks later, in June 2016, our analysts detected another cyber-accident related to healthcare. This time, three databases allegedly stolen via an RDP access to a medical organization were offered for sale for more than $500,000 on a dedicated Darknet marketplace. In one of his posts, the seller claimed that one of the databases belongs to a large American health insurer.

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One of the sales posts on a Darknet marketplace
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Screenshot posted by the seller as a proof of hacking into a medical organization

Before long, we again discovered evidence of hacking into a medical-related organization, this time by Russian-speaking hackers. On one of the forums we monitor, a member tried to sell an SSH access to the server of an American company supplying equipment to 130 medical center in the U.S. He uploaded screenshots proving that he accessed the server where personal data of patients is stored.

The conclusions following these findings are concerning. An extensive trade in medical information and compromised workstations and servers is a common sight on underground illegal markets. This business generates hundreds of thousands, if not millions of dollars annually, ensuring its continuation as long as there are such high profits to those involved. Since the ramifications can be grave, the healthcare sector must take all necessary measures to protect their systems and data:

  1. Implement a strong password policy, because many hacks are a result of brute-force attack. Strong passwords and two-factor authentications to log into organizational systems should be the number one rule for medical organizations.
  2. Deploy suitable security systems.
  3. Instruct the employees to follow cyber security rules – choosing strong and unique passwords, spotting phishing email messages, avoiding clicking on links and downloading files from unknown sources, etc. Consider periodic training for employees on these issues to maintain high awareness and compliance with the rules.
  4. Use Cyber Threat Intelligence (CTI) – to keep up with the times regarding the current most prominent threats to your organization and industry.
  5. Keep all software updated.

Cyber Threats to the Insurance Industry

Written by Gal Landesman

In recent years, insurance companies have been finding themselves affected by the rising number of major incidents of cyberattacks. On the one hand, this trend presents a business opportunity for selling cyber insurance to organizations concerned about protecting their sensitive assets. On the other hand, insurance companies are not excluded from the cyber battlefield, as they hold large amounts of sensitive information regarding their clientele and are therefore targeted by cyber criminals. Moreover, data breaches that occur in the insurance industry are more difficult to detect than credit card information theft because clients check their bank accounts more frequently.

(Please note –  this blog post is an excerpt from our report: “Cyber Threats to the Insurance Industry”. If you are interested in receiving the full report please write to: info@sensecy.com).

Cyber Insurance

Cyber insurance is a service much sought-after by many companies today. Most fear the bad PR in the wake of a cyberattack, the cost of dealing with the Data Protection Commissioner and handling affected clients. The financial burden and threat of reputation damage caused by downtime and data leakage are becoming more noticeable. Companies in industries such as healthcare, financial services, telecommunications and online retails now realize that cyber insurance is essential to minimize potential financial impact.

Some insurance companies selling cyber insurance have reported up to 30% increase in sales over the last year. This type of insurances typically covers such things as exposure to regulatory fines, damages and litigation expenses associated with defending claims from third parties, diagnostic of the source of the breach, recovering losses and reconfiguring networks.

The cyber insurance market is fast-growing with a value of EUR one billion annually in the U.S. and EUR 160 million annually in the E.U., where it has been adopted at a slower rate.

Cyber Insurance

Insurance Company Data Breaches

Insurance companies are now selling cyber insurance to organizations – ironically making them more vulnerable to attack as they withhold valuable information about organizations and people.

Lately, regulators have been focusing their efforts on insurance companies that can sometimes hold very sensitive information on their customers, such as PII (Personally Identifiable Information) and PHI (Protected Health Information). The New York State Department of Financial Services sent out a survey in 2013 to insurance companies asking them about their cyber security policy. Insurance companies hold not only information on regular people, but they also hold sensitive and valuable information on their corporate customers. Insurers hold sensitive information on companies across a variety of industries.

The risks are evident in the following examples of reported data breaches of insurance companies:

  • Aviva Insurance company suffered a data leak disclosing information and car details to third party companies, by two of their workers.
  • The Puerto Rican insurance company Triple-S Salud (TSS) suffered a data breach and its management was fined $6.8 million by the Puerto Rico Health Insurance Administration.
  • In October 2012, Nationwide insurance provider was hacked, compromising the personal information of 1.1 million customers.

Commercial Espionage

Not only is the insurance sector suffering from the aforementioned threats, but insurance companies are apparently also facing threats from their competitors in the industry, who are going after their data in commercial espionage, employing hacking techniques. According to a report released by The Independent, SOCA – the British Serious Organized Crime Agency – suppressed reports revealing that law firms, telecom giants and insurance companies routinely hire hackers to steal information from rivals. According to the report, a key hacker admitted that 80% of his clientele were law firms, wealthy individuals and insurance companies.

Selling Insurance Information on the Underground Black Market

PPI (Personally Identifiable Information) and PHI (Protected Health Information) sales on the underground continue to rise.

Several underground marketplaces include the selling of information packages containing “verified” health insurance credentials, bank account numbers/logins, SSN and other PPI. According to Dell SecureWorks, these packages are called “fullz” – an underground term for the electronic dossier on individuals used for identity theft and fraud, and they sell for about $500 each.

Such underground marketplaces can be used as a one-stop shop for identity theft and fraud. Health insurance credentials are sold for about $20 each and their value continues to rise as the cost of health insurance and medical services rise.

Where Does All the Data Go?

Written by Gal Landesman

We have recently learned of numerous data breaches targeting the healthcare industry that have exposed electronic personal healthcare information (ePHI). Just this month, a Chicago doctor’s email account, holding information on 1,200 patients, was accessed; a stolen laptop and flash drive jeopardized 2,500 patients’ data in Michigan; the investigation of the California Sutherland Healthcare Services data breach revealed that data pertaining to 338,700 individuals has been compromised; and La Palma Inter-community Hospital announced an old case of data breach involving one of their employees who accessed personal information without permission.

We are hearing about such incidents on an almost daily basis. Symantec even named 2013 the year of “Mega Breach”, with more than 552 million identities exposed this year. According to Symantec, the healthcare sector suffered the largest number of disclosed data breaches in 2013. They blame it on the large amount of personal information that healthcare organizations store and the high regulation standards requiring them to disclose data breaches. Still, the healthcare industry is one of the most impacted by data breaches this year.

Targeted data includes health insurance information, personal details and social security numbers. What could really happen if a patient’s personal data falls into the wrong hands?

Such breaches can cost their victims dearly – putting their health coverage at risk, causing legal problems or leading to inaccurate medical records. Attackers could make fraudulent insurance claims, obtain free medical treatment or addictive prescription drugs for personal use or resale.

Cyber criminals are definitely eyeing medical records. These records can fetch about $60 apiece on the black market, according to Norse-Sans that published a detailed report on the issue this February, claiming that such records are even more valuable than credit card information because they present criminals with greater opportunities for exploitation, such as insurance and prescription fraud. Norse-Sans identified a large volume of malicious traffic in their analysis of healthcare organization traffic.

Another example of interest was published by the Wall Street Journal, days before the Norse-Sans report, featuring valuable network information of healthcare facilities that was dumped on 4shared.com (a file-sharing site), including firewall brand, networking switch, Internet addresses of wireless access points, blueprints of the facilities, locations of PCs and printers and encryption keys, usernames and passwords that could be used for network access.

Here at SenseCy, we successfully traced the usage of breached medical information on Underground forums and the DarkNet. The following are some examples of prescription drugs for sale on the Underground:

Someone is offering Clonazepam (Klonopin), which affects chemicals in the brain, for sale:

Clonazepam

Another vendor offers different drugs, including ADDERALL-IR, a psychostimulant pharmaceutical drug, and Percocet, a narcotic pain reliever (containing opioid):

ADDERALL-IR

Information for sale:

Info_for_Sale

Info_for_Sale_2

Original prescriptions for sale:

Prescriptions

Prescriptions_2

 

 

Cyber Threats to the Healthcare Industry

Written by Gal Landesman

Introduction

The healthcare industry is advancing rapidly, linking systems and medical devices to the Internet, adopting electronic health records and implementing regulatory reforms. Tremendous technological advancements in the medical industry bring with them a greater reliance on software-controlled devices and wireless technologies. These technologies are used in any visit to the doctor and in hospital wards. Many of them connect or have the capability to connect to the Internet. Alongside the opportunities presented, the industry is also a major target for cyberattack, mostly for financial motivationIn the following post, we will present some of the cyber threats currently faced by the healthcare industry.

In today’s environment, organizations are required to take responsibility for securing their networks and computers. Alarming vulnerabilities in medical devices have caused the FDA to issue guidelines for cyber security of the medical device industry. The U.S. Health Information Technology for Economic and Clinical Health Act, for example, permits the fining of hospitals and other organizations up to $1.5 million a year for serious security incidents. Unfortunately, the industry is falling short of complying with said security standards. Last year, for example, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) performed a random audit of 20 healthcare organizations, 19 of which failed.

(Note –  this blog post is an excerpt from our report: ”Cyber Threats to the Healthcare Industry”. If you are interested in receiving the full report, please write to: info@sensecy.com).

Threats to the Healthcare Industry

According to security experts, cyber criminals are shifting their focus from the financial industry to the healthcare industry, today an easier and more profitable target. Healthcare records contain valuable information for cyber criminals, such as social security numbers and personal information. Credit card records sell for an average of $2, while medical records can fetch about $20 on the black market. According to the Experian 2014 Data Breach Industry Forecast, the healthcare industry is likely to make the most breach headlines in 2014, despite the fact that 2013 was a year of mega-breaches in the healthcare industry.

Hackers' ransom note, after breaking into a Virginia government website
Hackers’ ransom note, after breaking into a Virginia government website

Identity and Information Theft

Medical identity theft occurs when someone uses an individual’s name and personal identity to fraudulently receive medical services, prescription drugs and goods, or attempts to commit fraudulent billing. Information theft can include the theft of personal information for malicious use, such as selling it on the DarkNet. According to a Ponemon Institute 2013 survey, medical identity theft claimed more than 1.84 million U.S. victims in 2013. Medical identity theft is on the rise in the U.S., where the number of victims in 2013 increased by 19%.

Medical Device Breaching

Over the last 15 years, a growing number of medical devices have become interconnected through hospital networks, the Internet, smartphones and other devices, increasing their vulnerability. This has not escaped the attention of the FDA who recently issued new guidelines to biomedical engineers, healthcare IT and procurement staff, medical device user facilities, hospitals and medical device manufacturers.

The new FDA guidelines came in response to the 2012 findings of a governmental panel that revealed that computerized hospital equipment is increasingly vulnerable to malware infection that can potentially render these devices temporarily inoperable. Many of the devices run on Windows variants. They are interconnected through internal networks to the Internet and are also exposed to laptops in the hospitals, making them vulnerable to malware.

An example of the implications that could be caused by such systems was demonstrated by the medical-device panel from the NIST Information Security & Privacy Advisory Board, who described fetal monitors in intensive-care wards that were slowed down due to malware infection. This problem can affect a wide range of devices, such as compounders, diagnostic equipment, etc.

A report issued by the Government Accountability Office (GAO) warned mostly about vulnerabilities found in wireless implanted defibrillators and insulin pumps, but thousands of other network-connected life-saving devices are also vulnerable. Malware in medical devices is probably much more prevalent than we know, since most of it is not reported to the regulators and there are no records. The OS updating process for medical devices is an onerous regulatory process.

Cyber threats to medical devices (from the GAO report)
Cyber threats to medical devices (from the GAO report)

Conclusion

We believe that the healthcare industry is facing major threats from cyberspace. These threats encompass large areas of the industry and may become a greater burden for it, compromising patient safety, and causing financial and commercial damage to the associated bodies.

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