RansomwareTargeting Healthcare and Public and Private Health Sector

Coastal Connection I SmartWorks Managed Services - Network and Date Security


This joint cybersecurity advisory was coauthored by the Cybersecurity and Infrastructure Security Agency (CISA), the Federal Bureau of Investigation (FBI), and the Department of Health and Human Services (HHS).

CISA, FBI, and HHS have credible information of an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers. CISA, FBI, and HHS are sharing this information to provide warning to healthcare providers to ensure that they take timely and reasonable precautions to protect their networks from these threats.


Key Findings

  • CISA, FBI, and HHS assess malicious cyber actors are targeting the HPH Sector with TrickBot and BazarLoader malware, often leading to ransomware attacks, data theft, and the disruption of healthcare services.

  • These issues will be particularly challenging for organizations within the COVID-19 pandemic; therefore, administrators will need to balance this risk when determining their cybersecurity investments.

Threat Details

The cybercriminal enterprise behind TrickBot, which is likely also the creator of BazarLoader malware, has continued to develop new functionality and tools, increasing the ease, speed, and profitability of victimization. These threat actors increasingly use loaders—like TrickBot and BazarLoader (or BazarBackdoor)—as part of their malicious cyber campaigns. Cybercriminals disseminate TrickBot and BazarLoader via phishing campaigns that contain either links to malicious websites that host the malware or attachments with the malware. Loaders start the infection chain by distributing the payload; they deploy and execute the backdoor from the command and control (C2) server and install it on the victim’s machine.


Plans and Policies

CISA, FBI, and HHS encourage HPH Sector organizations to maintain business continuity plans—the practice of executing essential functions through emergencies (e.g., cyberattacks)—to minimize service interruptions. Without planning, provision, and implementation of continuity principles, organizations may be unable to continue operations. Evaluating continuity and capability will help identify continuity gaps. Through identifying and addressing these gaps, organizations can establish a viable continuity program that will help keep them functioning during cyberattacks or other emergencies. CISA, FBI, and HHS suggest HPH Sector organizations review or establish patching plans, security policies, user agreements, and business continuity plans to ensure they address current threats posed by malicious cyber actors.


Network Best Practices

  • Patch operating systems, software, and firmware as soon as manufacturers release updates.

  • Check configurations for every operating system version for HPH organization-owned assets to prevent issues from arising that local users are unable to fix due to having local administration disabled.

  • Regularly change passwords to network systems and accounts and avoid reusing passwords for different accounts.

  • Use multi-factor authentication where possible.

  • Disable unused remote access/Remote Desktop Protocol (RDP) ports and monitor remote access/RDP logs.

  • Implement application and remote access allow listing to only allow systems to execute programs known and permitted by the established security policy.

  • Audit user accounts with administrative privileges and configure access controls with least privilege in mind.

  • Audit logs to ensure new accounts are legitimate.

  • Scan for open or listening ports and mediate those that are not needed.

  • Identify critical assets such as patient database servers, medical records, and teleheatlh and telework infrastructure; create backups of these systems and house the backups offline from the network.

  • Implement network segmentation. Sensitive data should not reside on the same server and network segment as the email environment.

  • Set antivirus and anti-malware solutions to automatically update; conduct regular scans.

Ransomware Best Practices

CISA, FBI and HHS do not recommend paying ransoms. Payment does not guarantee files will be recovered. It may also embolden adversaries to target additional organizations, encourage other criminal actors to engage in the distribution of ransomware, and/or fund illicit activities. In addition to implementing the above network best practices, the FBI, CISA and HHS also recommend the following:

  • Regularly back up data, air gap, and password protect backup copies offline.

  • Implement a recovery plan to maintain and retain multiple copies of sensitive or proprietary data and servers in a physically separate, secure location.

User Awareness Best Practices

  • Focus on awareness and training. Because end users are targeted, make employees and stakeholders aware of the threats—such as ransomware and phishing scams—and how they are delivered. Additionally, provide users training on information security principles and techniques as well as overall emerging cybersecurity risks and vulnerabilities.

  • Ensure that employees know who to contact when they see suspicious activity or when they believe they have been a victim of a cyberattack. This will ensure that the proper established mitigation strategy can be employed quickly and efficiently.


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