The Attack Surface of the Healthcare Industry
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Paubox SECURE @ Home 2020 Virtual Healthcare Cybersecurity & Innovation Conference October 21 - 22, 2020 https://www.paubox.com/blog/jeremiah-grossman-confirmed-to-speak-at-paubox-secure/ https://try.paubox.com/paubox-secure-2020
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The Attack Surface of the Healthcare Industry
- 1. THE ATTACK SURFACE OF THE HEALTHCARE INDUSTRY OCTOBER 21, 2020 BIT DISCOVERY
- 2. •CEO, Bit Discovery •20 years in Information Security •Founder of WhiteHat Security •Black Belt in Brazilian Jiu-Jitsu JEREMIAH GROSSMAN
- 3. Coalition serves over 25,000 small and midsize organizations across every sector of the US and Canada. Report covers not just “breaches,” but breaches resulting in material harm.
- 8. Bit Discovery 2020 FEDERAL TRADE COMMISSION, Plaintiff, v. EQUIFAX INC., Defendant.
- 9. Bit Discovery 2020 USE-CASES ASSET INVENTORY • Vulnerability & Patch Management • Third-Party Risk Management • Mergers & Acquisition • Cyber-Insurance • Policy & Compliance • Security Ratings • Incident Response • Sales & Marketing Enablement • Investments
- 11. Bit Discovery 2020 INTERNET “COPY” OF THE • Generated by Bit Discovery + 400 data sources. • WHOIS databases, domain names, ASN, ports, service banners, technology stack, website index page(s), full TLS certificate info, email addresses, password dumps, etc. • Each asset has potentially 115 unique data points. • Each data point updated daily-to-monthly. • Hundreds of snapshots collected over 5 years. Largest Data-Set Of It’s Kind *missing ~30% of the Internet* 4.5 Billion DNS Entries 200+ INTERNET SNAPSHOTS 515 DATA SOURCES 115 DATA COLUMNS 150 YEARS OF CPU TIME
- 13. Bit Discovery 2020 INSIGHTS What do you want to know? • How many websites, VPNs, mail servers, DNS servers, SSH servers, etc.? • How many of what assets are “in the cloud” or use a particular CDN? • How many assets have expired or soon-to-be expired TLS certificates? • What asset are using or NOT using PHP, Drupal, Citrix, F5, Wordpress, etc.? • In what countries are assets located? • What assets or services should probably not be externally exposed (RDP, MySQL, Dev/ Staging)? By Organization By Industry Your Inventory
- 14. Bit Discovery 2020 ASSET as·set | ˈaset | noun a domain name, subdomain, or IP addresses and/or combination thereof of a device connected to the Internet or internal network. • (an asset) may include, but not limited to, web servers, name servers, IoT devices, or network printers.
- 15. Total Assets (hospitals & health) The total number of Internet-connected assets globally. HCA Ascension Tenet Trinity Vibra Community Health Atrium CommonSpirit LifePoint Providence MEDIAN 0 30,000 60,000 90,000 120,000 1,897 1,883 183 10,594 749 10,594 356 3,506 788 1,910 104,605
- 16. Total Assets (Healthcare) The total number of Internet-connected assets globally. Cardinal Kaiser McKesson Anthem CVS Cigna Humana UnitedHealth MEDIAN 0 30,000 60,000 90,000 120,000 21,360 108,759 18,645 6,360 43,153 19,900 22,819 70,645 10,020
- 17. Domain Names The total number of registered domain names. HCA Ascension Tenet Trinity Vibra Community Health Atrium CommonSpirit LifePoint Providence MEDIAN 0 1,500 3,000 4,500 6,000 107 90 3 1,286 50 1,286 36 307 38 123 5,264 Cardinal Kaiser McKesson Anthem CVS Cigna Humana UnitedHealth MEDIAN 0 1,500 3,000 4,500 6,000 808 5,615 204 404 953 1,434 1,086 663 523 Hospitals & Health Healthcare
- 18. Cloud Assets The percentage of Internet-accessible and cloud-hosted assets. Cloud providers include Amazon Web Services, Microsoft Azure, Google App Engine, and others. HCA Ascension Tenet Trinity Vibra Community Health Atrium CommonSpirit LifePoint Providence MEDIAN 0 0 0 0 1 15.40% 16.78% 24.59% 15.40% 7.88% 15.40% 14.04% 32.94% 0.63% 5.18% 53.70% Cardinal Kaiser McKesson Anthem CVS Cigna Humana UnitedHealth MEDIAN 0 0 0 1 1 8.54% 6.26% 83.91% 15.30% 1.17% 10.82% 5.01% 2.83% 44.26% Hospitals & Health Healthcare
- 19. CDN Assets The percentage of Internet-accessible assets being served by a well-known Content Delivery Network. CDNs include Akamai, Cloudflare, Fastly, and others. HCA Ascension Tenet Trinity Vibra Community Health Atrium CommonSpirit LifePoint Providence MEDIAN 0 0 0 0 0 1.05% 0.74% 0.00% 8.14% 0.27% 8.14% 0.00% 1.23% 4.06% 1.36% 0.19% Cardinal Kaiser McKesson Anthem CVS Cigna Humana UnitedHealth MEDIAN 0 0 0 0 0 1.59% 3.38% 0.19% 1.45% 0.33% 0.02% 10.54% 0.59% 2.94% Hospitals & Health Healthcare
- 20. Certificate Authorities The number of unique Certificate Authorities seen across the Internet-accessible assets. HCA Ascension Tenet Trinity Vibra Community Health Atrium CommonSpirit LifePoint Providence MEDIAN 0 13 25 38 50 22 19 4 27 7 27 5 25 9 27 46 Cardinal Kaiser McKesson Anthem CVS Cigna Humana UnitedHealth MEDIAN 0 28 55 83 110 47 106 24 37 42 45 60 48 50 Hospitals & Health Healthcare
- 21. Expired TLS Certs The number of expired TLS Certificates seen across the Internet-accessible assets. HCA Ascension Tenet Trinity Vibra Community Health Atrium CommonSpirit LifePoint Providence MEDIAN 0 30 60 90 120 59 55 5 103 10 103 1 81 17 63 97 Cardinal Kaiser McKesson Anthem CVS Cigna Humana UnitedHealth MEDIAN 0 175 350 525 700 243 433 14 556 107 88 614 221 264 Hospitals & Health Healthcare
- 22. Countries Hosting The number of countries hosting Internet-accessible assets. HCA Ascension Tenet Trinity Vibra Community Health Atrium CommonSpirit LifePoint Providence MEDIAN 0 4 8 12 16 6 3 4 9 2 9 3 8 4 8 16 Cardinal Kaiser McKesson Anthem CVS Cigna Humana UnitedHealth MEDIAN 0 6 12 18 24 16 20 10 23 15 13 17 11 18 Hospitals & Health Healthcare
- 23. Private IP-Space The number of Internet-connected assets where the hostname resolves to non-route-able RFC-1918 internal IP-addresses. HCA Ascension Tenet Trinity Vibra Community Health Atrium CommonSpirit LifePoint Providence MEDIAN 0 8 15 23 30 4 3 0 5 2 5 0 1 25 8 30 Cardinal Kaiser McKesson Anthem CVS Cigna Humana UnitedHealth MEDIAN 0 175 350 525 700 42 408 3 9 98 8 691 15 68 Hospitals & Health Healthcare
- 24. Wordpress (Healthcare) Extremely popular free and open-source content management system. Wordpress assets scanned with WPScan, which includes vulnerabilities in WordPress plug-ins. Total (Median) WordPress Websites Total (Median) WordPress Vulnerabilities Total (Median) WordPress Websites with at least 1 vulnerability Median # of Vulnerabilities per Wordpress website Hospitals & Health 17 0 0 0 Healthcare 70 106 5 16
- 25. GUIDANCE
- 26. Every security program must begin with an asset inventory. Jeremiah Grossman CEO, Bit Discovery • Asset Inventory (Attack Surface Map) • Multi-factor Authentication • Email Security • Routine Backups • Wire Transfer Verification • Password Management
- 27. BIT DISCOVERY
- 28. Bit Discovery 2020 CAVEATS Data Collection: • Our Internet scanners sometimes use ANY type lookups and not all service providers support ANY type DNS lookups (i.e. Cloudflare) • Round Robin DNS sometimes finds a lot of assets, sometimes a little, and changes frequently. • DNS servers and resolvers sometimes experience outages. • DNS responses may exceed TTL. • DNS servers may selectively block requests. Issues with Organization Asset Inventory: • Assets with subdomains within the ownership of a third- party domain (e.g. <company>.wpengine.com, <company>.salesforce.com, etc.) may cause issues. • Assets not listed on certificate transparency and/or doesn’t have a public DNS entry (e.g. they'll use internal DNS and a self-signed cert). • DNS errors falling outside the RFC standard, "example_site.com" (~1%) • Wildcard (*) DNS entries. • DNS providers respond with erroneous information due to breach. • WHOIS redaction due to GDPR.