June 21, 2017

Here Come the Cyber RACs: DHS Cybersecurity Task Force Releases Report — Says Current Guidelines Inadequate

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Last week, the U.S. House of Representatives Committee on Energy and Commerce held a hearing on cybersecurity in healthcare. The U.S. Department of Homeland Security (DHS) Cybersecurity Task Force also just released a report suggesting that current guidelines are not adequate to meet the current situation.

The hearing was prompted by the recent wave of ransomware infecting healthcare providers worldwide, one of the most significant such attacks in history.

A recent survey on Monitor Monday, revealed that 80 percent of respondents considered cybersecurity to be either a “red hot” or “hot” topic in healthcare. Hospitals are under attack, at risk of losing their electronic medical records (EMRs). Malware infects hospitals’ information systems, then encrypts their data. In order to get the electronic “key” to unlock the data, a ransom must be paid. 

Here is a typical message:

“Your important files are encrypted. Many of your documents, photos, videos, databases, and other files are no longer accessible because they have been encrypted. Maybe you are busy looking for a way to recover your files, but do not waste your time. Nobody can recover your files without our decryption service. We guarantee that you can recover all your files safely and easily. You have only three days to submit the payment. After that, the price will be doubled. Also, if you don’t pay in seven days, you won’t be able to recover your files forever.”

Not only healthcare establishments are vulnerable. This week the University College London (UCL) was hit with the infamous WannaCry malware. The National Security Agency (NSA) has tied this malware to North Korea, a regime long known for nefarious activities. Ransomware from that country is said to have infected more than 300,000 systems in 150 countries. Entire web hosting companies have been infected, resulting in the complete collapse of hundreds of websites and all associated cloud services supplying enterprise software.

The heartland is vulnerable. The most recent reported attack on a hospital in the United States took place late last week at the Waverly Health Center, a hospital in Cedar Falls, Iowa. A few weeks ago, ransomware hit a senior living community in Dallas, Texas. It is impossible to keep track of this deluge of malware attacks against hospitals and other healthcare facilities.

Cybersecurity Framework for Healthcare Providers

Consideration is being given to modifying Section 405(d) of the Medicare law with a view toward developing a “cybersecurity framework.” Federal agencies would be asked to harmonize “existing and future laws and regulations” across the healthcare industry. Work would begin on identifying best practices that are “scalable” from the smallest to largest healthcare organizations.

The Cyber Security Task Force report calls for the U.S. Department of Health and Human Services (HHS) to create a “cybersecurity leader role” to help align efforts across the nation’s healthcare sector. It is not entirely clear what “align” means. This leadership nexus would serve as a “single point of entry for health care industry partners” needing to share information on cyber threats.

The Stark Law and the Anti-Kickback Statute also may be modified to make it possible for cybersecurity organizations to share information and recommend software to physicians.

Medical devices are a particular area of concern. A task force is being put together to study the cybersecurity of all forms of medical devices, including implants. This promises to be a complex and difficult job, but it is viewed as being imperative.

As it creates new products, the government may start to require medical device manufacturers to adopt a secure systems development lifecycle (SDLC). Eventually, we may see approval of medical devices becoming contingent upon certification that they have been developed according to these more rigorous standards.

The backbone information systems that run healthcare are of great concern as well. It is generally recognized that many of these older systems are not as up-to-date on cybersecurity as they should be. More effort will be put into study of how these legacy information systems can be made less vulnerable to malware and other forms of hacking.

In order to better coordinate a national response to cyberattacks, the government will create MedCERT: The Medical Computer Emergency Readiness Team.

There are many recommendations and observations in the just-released report. It should be mandatory reading for every employee of ICT in every single healthcare organization across the United States.

We can be reasonably sure that eventually, healthcare organizations will be audited to make sure that they are in compliance with government-approved and certified cybersecurity practices. This was attempted in the past, but this new wave of malware has revived the notion. Thus, an entire new industry of auditors could be created: The Cyber RACs (Recovery Audit Contractors).

RACmonitor will continue to keep an eye on these developments. 

Edward Roche, PhD, JD

Edward Roche is the director of scientific intelligence for Barraclough NY, LLC. Mr. Roche is also a member of the California Bar. Prior to his career in health law, he served as the chief research officer of the Gartner Group, a leading ICT advisory firm. He was chief scientist of the Concours Group, both leading IT consulting and research organizations. Mr. Roche is a member of the RACmonitor editorial board as an investigative reporter and is a popular panelist on Monitor Mondays.

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