Cybersecurity Saturday

Cybersecurity Saturday

From the cybersecurity policy and law enforcement front,

  • Cyberscoop tells us,
    • “Members of Congress are pressing federal agencies and telecommunications companies for more information about a reported Chinese government-backed hacking campaign that breached the networks of at least three major U.S. telecoms.
    • “Earlier this month, the Wall Street Journal reported that a hacking group tied to Beijing successfully broke into the networks of Verizon, AT&T and Lumen Technologies. The hackers reportedly went undetected for months, possibly gaining access to systems and infrastructure used to process court-authorized wiretaps.
    • ‘On Thursday, Republican and Democratic leaders on the House Energy and Commerce Committee wrote to the three telecommunication firms asking for more information on their response, calling the incident “extremely alarming for both economic and national security reasons.” * * *
    • “The members requested a briefing with the telecoms to learn more about when they became aware of the compromise, findings from any internal investigations and subsequent engagement with law enforcement, their plans to notify affected customers and what if any corrective steps have been taken to harden cybersecurity in the wake of the incident.
    • “The House Homeland Security Committee has also requested a briefing on the hack from the Cybersecurity and Infrastructure Security Agency, according to a committee aide.”
  • Federal News Network lets us know,
    • “The Defense Department released the final rule for the long-awaited Cybersecurity Maturity Model Certification program today [October 11], further paving the way for CMMC requirements to show up in contracts starting next year.
    • “The final CMMC program rule was released for public inspection today. It’s expected to officially publish in the Federal Register on Tuesday, Oct. 15.
    • “The rule establishes the mechanisms for the CMMC program. The goal of CMMC is to verify whether defense contractors are following cybersecurity requirements for protecting critical defense information. Many contractors will be required to receive a third-party audit under the program, a significant departure from the current regime of relying on self-attestation.”
  • Per an October 3, 2024, HHS press release,
    • “Today, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced a $240,000 civil monetary penalty against Providence Medical Institute in Southern California, concerning potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule, following a ransomware attack breach report investigation by OCR. Ransomware and hacking are the primary cyber-threats in health care. There has been a 264% increase in large breaches reported to OCR involving ransomware attacks since 2018.
    • “Failures to fully implement all of the HIPAA Security Rule requirements leaves HIPAA covered entities and business associates vulnerable to cyberattacks at the expense of the privacy and security of patients’ health information,” said OCR Director Melanie Fontes Rainer. “The health care sector needs to get serious about cybersecurity and complying with HIPAA. OCR will continue to stand up for patient privacy and work to ensure the security of health information of every person. On behalf of OCR, I urge all health care entities to always stay alert and take every precaution and steps to keep their systems safe from cyberattacks.” * * *
    • “The Notice of Final Determination may be found at: https://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/agreements/pmi-nfd/index.html
  • Fedscoop notes,
    • “The Department of Health and Human Services is working on a new strategic plan for the use of artificial intelligence across the entire breadth of its mission, the department’s top AI official said Tuesday.
    • “Micky Tripathi — HHS’s acting chief AI officer and its assistant secretary for technology policy — said at the NVIDIA AI Summit in Washington, D.C., that the AI strategic plan should arrive sometime in January and that it will span “the entire, you know, sort of breadth of what the department covers.”
    • “During a panel discussion, Tripathi detailed the complex web of mission sets spanning “the value chain of life sciences and health care” that HHS oversees that the new strategic plan will attempt to wrap its arms around. Those include medical research and discovery, preclinical work, measuring the safety and effectiveness of medical products, health care delivery, health technology standards setting, human services, public health and more, he said.”

From the cybersecurity vulnerabilities and breaches front,

  • Beckers Health IT informs us,
    • “In the past 12 months, 92% of healthcare organizations reported experiencing at least one cyberattack, up from 88% in 2023, an Oct. 8 survey from Proofpoint and Ponemon Institute found.
    • “Of those cyberattacks, 69% reported disruptions to patient care as a direct consequence.”
  • The American Hospital Association News reports,
    • “The FBI, along with the National Security Agency, Cyber National Mission Force and United Kingdom’s National Cyber Security Centre, today released a joint agency advisory on cyber operations by the Russian Federation’s Foreign Intelligence Service (SVR), also known as APT29, Midnight Blizzard, Cozy Bear, and the Dukes, targeting U.S. and global entities. The agencies recommend prioritizing rapid patch deployment and keeping software up to date to protect against cyberattacks.
    • “This alert highlights the SVR’s aggressive targeting of U.S. critical infrastructure for espionage and possible future offensive cyber operations,’ said John Riggi, AHA national advisor for cybersecurity and risk. “Although health care is not cited as being intentionally targeted by this SVR campaign, it is noted that any entity could become a target of opportunity if it has internet-facing vulnerabilities. The SVR takes advantage of opportunistic tactics to host malicious infrastructure, conduct follow-on operations from compromised accounts, or attempt to pivot to other networks on unprotected victim infrastructure. To mitigate this threat and other types of cyberattacks, such as ransomware attacks, it is imperative that health care entities prioritize patching internet-facing vulnerabilities, employ multi-factor authentication and follow the voluntary cybersecurity performance goals.”
  • HHS’s Health Section Cybersecurity Coordination Center issued its September report on vulnerabilities of interest to the health sector.
  • Cyberscoop points out,
    • “The number of malicious packages found in the open-source ecosystem has dramatically grown in the past year, according to a new report from Sonatype.
    • “The cybersecurity firm found that the number of malicious packages intentionally uploaded into open-source repositories has jumped by more than 150% compared to last year. Open-source software, a transparent development process where almost anyone can contribute to the code and components, is the bedrock of the digital age that can be found in most modern digital technologies.
    • “Sonatype, a firm that specializes in the open-source supply chain, looked at more than 7 million open-source projects and found that more than 500,000 contained a malicious package.
    • “Vulnerabilities in open-source packages and the developers who maintain them have become a hot topic following a spree of high-profile bugs and cyberattacks in recent years. Earlier this year, the maintainer of the data-compression tool XZ Utils was the focus of a yearslong campaign by hackers with the aim of inserting a vulnerability that would have been found in Linux servers throughout the world.”
  • The Cybersecurity and Infrastructure Security Agency (CISA) alerted us on October 10,
    • CISA has observed cyber threat actors leveraging unencrypted persistent cookies managed by the F5 BIG-IP Local Traffic Manager (LTM) module to enumerate other non-internet facing devices on the network. F5 BIG-IP is a suite of hardware and software solutions designed to manage and secure network traffic. A malicious cyber actor could leverage the information gathered from unencrypted persistence cookies to infer or identify additional network resources and potentially exploit vulnerabilities found in other devices present on the network.
    • CISA urges organizations to encrypt persistent cookies employed in F5 BIG-IP devices and review the following article for details on how to configure the BIG-IP LTM system to encrypt HTTP cookies. Additionally, F5 has developed an iHealth heuristic to detect and alert customers when cookie persistence profiles do not have encryption enabled. BIG-IP iHealth is a diagnostic tool that “evaluates the logs, command output, and configuration of a BIG-IP system against a database of known issues, common mistakes, and published F5 best practices” to help users verify the optimal operation of their BIG-IP systems.
  • CISA added six more known exploited vulnerabilities to its catalog this week.
  • Cybersecurity Dive adds,
    • “Ivanti released updates for three actively exploited zero-day vulnerabilities in Ivanti Cloud Service Appliance, which hackers are chaining together with a previously disclosed path traversal vulnerability, the company said in a Tuesday blog post
    • “Successful exploitation of the flaws can allow an attacker to gain administrative privileges to bypass restrictions, obtain remote code execution or run arbitrary SQL statements. The vulnerabilities are listed as CVE-2024-9379CVE-2024-9380CVE-2024-9381
    • “Ivanti previously disclosed and issued a patch that would address the prior critical vulnerability, listed as CVE-2024-8963, on Sept. 10. The company said it discovered the path traversal vulnerability when it was investigating exploitation of an OS command injection vulnerability, listed as CVE-2024-8190.”

From the ransomware front,

  • Tech Radar reports,
    • “The number of active ransomware groups over the last 12 months is on the rise as criminals look for more ways to target businesses, new research has claimed.
    • “The 2024 State of Threat Report from Secureworks has revealed a rise in the number of active ransomware groups over the last 12 months – identifying a 30% rise in the number of active groups.
    • “The figures represents a diversification of the landscape rather than a particularly drastic increase in criminals. Since the notorious Lockbit disruption, in which the most prolific group was briefly shut down, the ransomware ecosystem has evolved, with 31 new groups being established.” * * *
    • “One of the key findings from the report is that unpatched vulnerabilities remain the top Initial Access Vector (IAV) in ransomware attacks, making up almost 50% of all IAVs. This outlines more than ever the importance of staying on top of cybersecurity and software updates.”
  • Per Security Affairs,
    • “Sophos researchers warn that ransomware operators are exploiting the critical vulnerability CVE-2024-40711 in Veeam Backup & Replication to create rogue accounts and deploy malware.
    • “In early September 2024, Veeam released security updates to address multiple vulnerabilities impacting its products, the company fixed 18 high and critical severity flaws in Veeam Backup & Replication, Service Provider Console, and One.
    • “The most severe flaw included in the September 2024 security bulletin is a critical, remote code execution (RCE) vulnerability tracked as CVE-2024-40711 (CVSS v3.1 score: 9.8) impacting Veeam Backup & Replication (VBR).”
  • Palo Alto Networks Unit 24 tells us,
    • “In July 2024, researchers from Palo Alto Networks discovered a successor to INC ransomware named Lynx. Since its emergence, the group behind this ransomware has actively targeted organizations in various sectors such as retail, real estate, architecture, and financial and environmental services in the U.S. and UK.
    • “Lynx ransomware shares a significant portion of its source code with INC ransomware. INC ransomware initially surfaced in August 2023 and had variants compatible with both Windows and Linux. While we haven’t confirmed any Linux samples yet for Lynx ransomware, we have noted Windows samples. This ransomware operates using a ransomware-as-a-service (RaaS) model.”

From the cybersecurity defenses front,

  • American Hospital Association cybersecurity expert John Riggi offers his perspective on this year’s cybersecurity challenges in the healthcare sector.
  • “Moffitt Cancer Center was one of many health systems impacted by the Change Healthcare ransomware attack earlier this year. The organization’s VP of RCM operations [Lynn Ansley] explains [in Health Leaders] how she navigated the disaster.”
  • Here is a link to Dark Reading’s CISO Corner.
  • HHS’s 405(d) program shares an endpoints security poster with the public.

Monday Roundup

Photo by Sven Read on Unsplash

From Washington, DC,

  • Federal News Network tells us,
    • “Close to 15,000 blue-collar federal employees working in trade, craft and manual labor jobs are likely to see their federal pay rates increase by as much as 12%, once a new proposed rule from the Office of Personnel Management becomes finalized.
    • “The proposed regulations, which OPM released on Monday, aim to improve overall pay parity for roughly 168,000 blue-collar federal workers who are paid hourly through the Federal Wage System (FWS). In practice, OPM’s proposal would align the map of FWS wage areas more closely with the General Schedule’s locality pay map.
    • “This would lead to greater equity across federal pay systems, with FWS workers’ pay more aligned with GS workers who work in the same geographic area,” OPM wrote in a press release Monday.
    • ‘As a result of the proposed re-mapping, around 15,000 blue-collar federal employees would begin receiving higher pay rates once OPM’s regulations become final — as long as there are no major changes to how the proposed regulations are currently written.”
  • and
    • “The Postal Service, more than three years into a 10-year reform plan, is seeking a higher borrowing limit with the Treasury Department to sustain its infrastructure upgrades.
    • ‘USPS, in an update to its “Delivering for America” plan last week, said its current $15 billion debt limit with Treasury was set in the 1970s, and has not been adjusted for inflation in decades.
    • “We continue to lack access to capital and credit markets that most in the private sector rely on in transformative situations like ours,” USPS wrote in a report last week.
    • “USPS is also calling on the Office of Personnel Management to reassess what it pays into the Civil Service Retirement System, the pension system for federal employees who began government service before 1987.”
  • Gallagher timely reminds us about ACA FAQ 63 which told us
  • The American Hospital Association News informs us,
    • “AHA President and CEO Rick Pollack Oct. 7 sent a letter to President Biden urging the Administration to take immediate actions to increase the supply of IV solutions for hospitals and other health care providers that are struggling with shortages following the closure of a Baxter manufacturing plant as a result of Hurricane Helene.  
    • “Our members are already reporting substantial shortages of these lifesaving and life-supporting products,” Pollack wrote. “Patients across America are already feeling this impact, which will only deepen in the coming days and weeks unless much more is done to alleviate the situation and minimize the impact on patient care.”  
    • “The letter includes a number of specific actions the AHA is asking the Administration to take to support hospitals’ ability to care for patients and communities. In addition, the AHA invited the White House and agency experts to join the association in a forum to communicate directly with hospitals and health systems to “inform each other in real time on the status of the situation while we work together to mitigate the impact on patients.” 
  • Fierce Healthcare offers a summary of HHS’s proposed 2026 notice of benefit and payment parameters for the ACA marketplace. The public comment deadline is November 12, 2024.

From the Food and Drug Administration front,

  • Per an FDA press release,
    • “Today [October 7], the U.S. Food and Drug Administration granted marketing authorization for the Healgen Rapid Check COVID-19/Flu A&B Antigen Test. The test, authorized for use without a prescription, is for use by individuals experiencing respiratory symptoms and uses a nasal swab sample to deliver at-home results in approximately 15 minutes for COVID-19 and influenza (flu). The test detects proteins from both SARS-CoV-2 (the virus that causes COVID-19) and influenza A and B (the viruses that causes flu).  
    • “This is the first over the counter (OTC) test that can detect influenza to be granted marketing authorization using a traditional premarket review pathway, which enables the test to be marketed in the absence of an applicable emergency use declaration. Other OTC flu/COVID tests are currently available under emergency use authorization.” 
  • Per MedTech Dive,
    • The Food and Drug Administration approved Exact Sciences’ Cologuard Plus colorectal cancer test, the company said Friday [October 4]
    • The product is an updated version of Exact Sciences’ existing stool-based cancer test. The company expects to launch the test, which has higher specificity than its predecessor, with Medicare coverage and guideline inclusion in 2025.
    • Exact Sciences recently failed to land a Medicare price premium for Cologuard Plus, but Leerink Partners and William Blair analysts expect one of the company’s subsequent attempts to succeed.

From the public health and medical research front,

  • The Wall Street Journal reports,
    • “The Nobel Prize in medicine was awarded to Victor Ambros and Gary Ruvkun for the discovery of microRNA, molecules that help control how genes are expressed.
    • “Their findings unlocked new areas of research into the roles these molecules play in human health. Researchers are exploring microRNA treatments for cancer, heart disease and dementia.”
    • “Ruvkun and Ambros were giddy with excitement on Monday after learning of their Nobel honors.”
    • Kudos to the recipients.
  • and, on a different topic,
    • “Inflammaging, a chronic low-grade inflammation, is associated with an increased risk of heart attack, cancer, Alzheimer’s and other conditions. It occurs as we age, but some people develop it more than others.
    • “Chronic inflammation can be caused by cellular senescence, where damaged aging cells secrete inflammatory proteins. 
    • “Prevention and treatment measures include lifestyle changes such as exercise, healthy diet and adequate sleep.”
  • The American Medical Association lets us know eight things that doctors wish their patient knew about the flu vaccine.
  • Consumer Reports, writing in the Washington Post, fills us in on how to choose the right multivitamin for your body’s needs.
  • Per BioPharma Dive,
    • “An experimental, muscle-preserving therapy from Scholar Rock succeeded in a Phase 3 trial in spinal muscular atrophy, positioning the biotechnology company to seek approvals in the U.S. and Europe early next year.
    • “A regimen of Scholar Rock’s drug, apitegromab, and a standard SMA therapy significantly improved motor function after one year versus treatment with a typical SMA medicine and a placebo, the company said Monday. Specifically, a prespecified, pooled analysis showed children between 2 and 12 years old who received one of two tested doses had an average difference versus placebo of about a 1.8-point change from baseline on a scale used to evaluate their physical abilities.
    • “Motor function benefits were also observed in a smaller, exploratory group of 13- to 21-year-olds, according to the company. No new safety findings were reported, and no one dropped out of the trial due to side effects. “We believe these data collectively show that apitegromab has the potential to become part of a new standard of care,” CEO Jay Backstrom said on a conference call. Shares more than quadrupled in value Monday.”

From the U.S. healthcare business front,

  • Per Fierce Healthcare,
    • “The healthcare industry is making the push toward greater adoption of value-based care, yet it’s not a secret that progress has been slow-moving.
    • “With that backdrop, UnitedHealth Group has released its latest “A Path Forward” report, which is a biennial look at progress in the shift to value. The paper includes dozens of policy recommendations that the team believes can accelerate that transformation.
    • “Wyatt Decker, M.D., UnitedHealth Group executive vice president and chief physician who’s leading the charge at the company on value-based care and innovation, told Fierce Healthcare in an interview that the U.S. healthcare system is extremely effective at addressing crises, complex patient conditions and end-stage needs. But it’s in prevention where “we really fall down,” he said.
    • “We don’t, by and large, have a system that focuses on keeping people healthy and well,” Decker said. “Most people wonder why their physician or their assistants don’t reach out when it’s time to get a screening and why they have so much trouble scheduling appointments, finding doctors, and, of course, figuring out how much it’s all going to cost.” 
  • and
    • “GenAI experimentation, research and potential use cases proliferate by the day. Like other industries, healthcare is hurrying to jump on the opportunity. A growing number of companies are creating genAI products to help organizations streamline their administrative workflows, simplify physician notetaking or respond to basic patient questions. But publicly available tools, like ChatGPT, are popular, easy to access and simple to use. If consumers are using them, are doctors, too?
    • “The answer, Fierce Healthcare finds, is yes. In the first in-depth look of its kind into physician use of public genAI tools, Fierce Healthcare spoke with nearly two dozen doctors, students, AI experts and regulators, and helped conduct a survey of more than 100 physicians. The reporting confirms that some doctors are turning to tools intended for non-clinical uses to make clinical decisions. With no standardized guidelines, lagging physician training and regulators racing to try to keep up with rapidly changing technology, guardrails to protect patients appear to be years behind current rates of utilization.
    • “You have an uncertain regulatory environment, you’ve got a march of technology and at the same time, you have an uptake by both consumers and healthcare professionals. And the consequences of that are very much uncertain,” Peter Bonis, M.D., chief medical officer at Wolters Kluwer, an information services company, told Fierce Healthcare.”

  • The FEHBlog learned a new use for the work “hallucination” today at the Texas Bar Association’s Health Law Conference. A generative AI mistake is a hallucination.
  • McKinsey and Company discuss “Advancing inclusive care pathways for people with disabilities. Across disease types, patients with disabilities experience inequities all along the care pathway—with consequently worse outcomes. Inclusive pathway designs and targeted interventions could help.”

Cybersecurity Saturday

From the cybersecurity policy front,

  • Healthcare Dive informs us,
    • “Lawmakers introduced a bill Thursday [September 26] that would set cybersecurity standards for healthcare organizations as the industry faces a wave of cyberattacks and data breaches. 
    • “The legislation, sponsored by Sens. Ron Wyden, D-Ore., and Mark Warner, D-Va., would direct the HHS to develop minimum cybersecurity standards for providers, health plans, claims clearinghouses and business associates. Enhanced cyber standards would apply to organizations that are deemed important to national security.” * * *
    • “The bill requires the HHS to adopt minimum and enhanced cybersecurity measures that would apply to HIPAA-covered entities and their business associates.
    • “Healthcare organizations would be required to conduct cybersecurity assessments and stress tests. The HHS would audit the data security of at least 20 companies per year to ensure compliance. 
    • “The legislation also seeks to increase civil penalties for organizations that fail to comply with security standards — including a proposed minimum fine of $250,000 for violations in willful neglect that go uncorrected. 
    • “The HHS would also be authorized to charge user fees to covered entities and business associates. Those fees would allow the agency to take on the increased oversight work, a challenge the HHS hasn’t been appropriately funded to manage, the senators wrote in a summary of the legislation.”
  • Wow. It strikes the FEHBlog that at least parts of this bill, in not the whole tamale, could be enacted in the lame duck session of Congress at the end of this year. The bill has a variety of effective dates.
  • Why? Beckers Health IT adds,
    • “The financial fallout from recent data breaches in the healthcare industry continues to raise alarms as organizations grapple with the costs of cyberattacks and ensuing lawsuits.
    • “Two incidents — the ransomware attack on St. Louis-based Ascension and a class-action lawsuit faced by Allentown, Pa.-based Lehigh Valley Health Network — highlight the impact of these breaches on health systems’ operations and bottom lines.”
  • Cybersecurity Dive points out,
    • “The U.S. has made significant progress improving its cybersecurity posture, implementing about 80% of the recommendations the Cyberspace Solarium Commission detailed in 2020, according to a report released Thursday [September 26]. But more work is still required to shore up additional efforts related to critical infrastructure and economic security. 
    • “Among the key remaining priorities is a push to identify the “minimum security burdens” of critical infrastructure entities that have a “disproportionate impact on U.S. national security,” the report said. The commission called on the next administration to detail intelligence and information-sharing benefits, alongside security burdens, to these “systemically important entities.”
    • “The U.S. needs to develop an economic continuity plan that would operate as an incident response and resilience plan in case of a catastrophic cyber event or other crisis, the commission said. Federal authorities also need to codify a joint collective plan for sharing threat information between government, private industry and international intelligence partners.”
  • Per a NIST press release,
    • “Today [September 24], U.S. Secretary of Commerce Gina Raimondo announced that the Department of Commerce’s National Institute of Standards and Technology (NIST) has awarded $6 million to Carnegie Mellon University (CMU) to establish a joint center to support cooperative research and experimentation for the test and evaluation of modern AI capabilities and tools. The center will be housed on the Carnegie Mellon campus, in Pittsburgh.
    • “Artificial intelligence is the defining technology of our generation, and at the Commerce Department we are committed to working with America’s world-class higher education institutions, like Carnegie Mellon University, to advance safe, secure and trustworthy development of AI,” Raimondo said. “I am excited to announce this NIST award of $6 million for Carnegie Mellon to boost research of AI systems and support a new generation of scientists and engineers that will help advance American innovation globally.”

From the CrowdStrike front

  • Cybersecurity Dive offers five takeaways from a CrowdStrike official’s apologetic testimony before Congress last Thursday.

From the cyber breaches and vulnerabilities front,

  • Cybersecurity Dive lets us know,
    • “Security researchers are warning about critical vulnerabilities in the Common Unix Printing System used on Linux, which could allow a hacker to gain control over remote command execution when the flaws are chained together and a print job is separately launched by the user.
    • “The vulnerabilities, listed as CVE-2024-47076CVE-2024-47175CVE-2024-47176 and CVE-2024-47177, can allow an attacker to replace IPP urls on a printer with a malicious version, giving them the ability to command capabilities on a system. 
    • “The vulnerabilities were initially assigned a score of 9.9, with the expectation of coordinated disclosure and later public notification by Oct. 6. However, the original research leaked on Thursday, and security researchers have since dialed back some of their initial fears, which compared the potential impact to Log4j and Heartbleed.”
  • This week, the Cybersecurity and Infrastructure Security Administration added one known exploited vulnerability to its catalog on September 24, 2024,
    • CVE-2024-7593. Ivanti Virtual Traffic Manager Authentication Bypass Vulnerability
  • Cybersecurity Dive cautions,
    • “A state-linked botnet linked to the Flax Typhoon threat group is actively targeting 66 security vulnerabilities for exploitation, researchers from VulnCheck said Monday. Last week the Five Eyes intelligence partners named the botnet in a global threat advisory
    • “However, researchers from VulnCheck warn that only 27 of the CVEs are listed in the Cybersecurity and Infrastructure Security Agency’s closely monitored catalog of known exploited vulnerabilities.  
    • “Researchers say the discrepancy between the actively targeted CVEs and the official CISA catalog highlights a longstanding backlog in identifying security threats that critical infrastructure providers, private companies and government agencies are up against.” * * *
    • NIST brought in an outside firm to help reduce the analysis backlog. A NIST spokesperson said the agency has made progress towards reducing the backlog, and an update on that progress is pending.” 

From the ransomware front,

  • Modern Healthcare tells us,
    • The number of healthcare providers affected by ransomware attacks is steadily growing. 
    • More than two-thirds of healthcare providers reported a ransomware attack in the past year compared with 60% in 2023, according to a survey released Thursday from cybersecurity company Sophos. In 2021, only 34% of providers said they were affected by an attack.
  • Bleeping Computer warns,
    • “Microsoft warns that ransomware threat actor Storm-0501 has recently switched tactics and now targets hybrid cloud environments, expanding its strategy to compromise all victim assets.
    • “The threat actor first emerged in 2021 as a ransomware affiliate for the Sabbath ransomware operation. Later they started to deploy file-encrypting malware from Hive, BlackCat, LockBit, and Hunters International gangs. Recently, they have been observed to deploy the Embargo ransomware.
    • “Storm-0501’s recent attacks targeted hospitals, government, manufacturing, and transportation organizations, and law enforcement agencies in the United States.”
  • PC World explains how to turn on Microsoft Windows’ built in ransomware protection.

From the cybersecurity defenses front,

  • SC Media calls attention to “five ways to beef up network security and reduce data theft.”
    • “Rethink access control
    • “Raise the firewall game
    • “Take incident response seriously
    • “Tap into network visibility
    • “Segment the network
  • “These five approaches to network data security have been around for quite some time, yet they continue to mature and stay relevant because of new AI features that align with emerging challenges. Ultimately, the security team needs to choose and deploy the right combination of these tools that correlate with industry-specific risks facing the organization.”
  • A Dark Reading commentator explains why “Managing Cyber-Risk Is No Different Than Managing Any Business Risk. A sound cyber-risk management strategy analyzes all the business impacts that may stem from an attack and estimates the related costs of mitigation versus the costs of not taking action.”
  • Per a CISA press release,
    • “Today [September 26], the Australian Signals Directorate Australian Cyber Security Centre (ASD ACSC), the Cybersecurity and Infrastructure Security Agency (CISA), and other U.S. and international partners released the joint guide Detecting and Mitigating Active Directory Compromises. This guide informs organizations of recommended strategies to mitigate common techniques used by malicious actors to compromise Active Directory.
    • “Active Directory is the most widely used authentication and authorization solution in enterprise information technology (IT) networks globally. Malicious actors routinely target Active Directory as part of efforts to compromise enterprise IT networks by escalating privileges and targeting the highest confidential user objects.  
    • “Responding to and recovering from malicious activity involving Active Directory can be consuming, costly, and disruptive. CISA encourages organizations review the guidance and implement the recommended mitigations to improve Active Directory security.”

Tuesday Tidbits

Photo by Patrick Fore on Unsplash

From Washington, DC,

  • BioPharma Dive tells us,
    • Novo Nordisk’s top executive vowed to reopen price negotiations with insurers covering the company’s obesity and diabetes drugs at a congressional hearing on Tuesday in which lawmakers pressed Novo to lower the cost of the fast-selling medicines.
    • At the hearing, Novo CEO Lars Fruergaard Jørgensen said the company would consider new talks with insurers about the list prices of Wegovy and Ozempic if they follow through on a pledge to keep the medicines on their formularies. Novo has claimed that insurers have previously pulled coverage of its other medicines — such as insulins — once the company lowered list prices, because it resulted in less revenue for payers afterwards.
    • “If it works in a way where patients get access to a more affordable medicine, and we have certainty that it actually happens and not like when we lowered prices in prior rounds — that less people got access to our medicine — we will be positive towards it,” Jørgensen said.” * * *
    • [Senate HELP Committee Chair Bernie] Sanders [I VT] came to the hearing with, what he claimed, is a commitment from Cigna [Express Scripts], UnitedHealth Group [/ Optum Rx] and CVS Health [/ Caremark] to commit to covering the two drugs even if lower list prices lead to lower rebates. The initiative for doing so was the difference in list and after-rebate prices for Wegovy and Ozempic in the U.S. compared to other countries.”
  • Here is a link to the Federal Trade Commission’s public administrative complaint against Express Scripts, Caremark, and Optum Rx over insulin rebates.
  • Per Healthcare Dive,
    • “The chair of the powerful Senate Finance Committee is pressing hospitals on their compliance with federal emergency care law amid mounting reports that patients who need lifesaving abortions are being turned away.
    • “Sen. Ron Wyden, D-Ore., sent letters to eight hospitals in states with abortion restrictions on Monday, asking about policies and procedures they have in place around the Emergency Medical Treatment and Active Labor Act, or EMTALA.
    • “Wyden also asked for a list of personnel involved in deciding when terminating a pregnancy is the appropriate course of treatment, and what legal and human resource support is offered to them by the hospital.”
  • CMS has created a website for its new civil monetary penalty program applicable to Section 111 reporting that will take effect on October 5, 2024, and will hold a compliance webinar on October 15, 2024, at 1 pm ET.
  • Per HHS press releases,
    • “Today, the U.S. Department of Health and Human Services (HHS), through the Administration for Strategic Preparedness and Response (ASPR), announced actions to increase the supply of mpox vaccine, supporting the U.S. Government commitment to make over a million combined doses of mpox vaccines available to the global mpox response. This is the largest international donation of the JYNNEOS mpox vaccine to date, which just received regulatory approval from WHO last week.”
  • and
    • “Today, the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS), announced nearly $75 million to support health care services in rural America. Funding will launch new opioid treatment and recovery services in rural communities, strengthen maternal health care in the South, and help rural hospitals stay open. HRSA Administrator Carole Johnson attended an event yesterday in Wilson, North Carolina, where she discussed the impact of this investment in rural health care.” * * *
    • “For a list of the awards, visit: https://www.hrsa.gov/about/news/fy24-rural-award-announcements
  • Bloomberg reports,
    • “The Biden administration issued a final rule Tuesday designed to address suspicious billing for durable medical equipment that may have cost the Medicare program more than $2 billion.
    • “The problem involving urinary catheters has disproportionately affected accountable care organizations, the groups of doctors, clinicians, and hospitals that provide coordinated care for beneficiaries in traditional Medicare. 
    • “After detecting the spike in billing in early 2023, the Centers for Medicare & Medicaid Services stopped payment on almost all of the claims and began an investigation.
    • “They found the activity “was attributed to a small group of durable medical equipment supply companies,” and “determined that the beneficiaries did not receive catheters and were not billed directly, physicians did not order these supplies, and supplies were not needed,” said a CMS fact sheet. Since then, the top 15 billers of suspicious catheter claims have had their Medicare enrollment revoked.
    • “The CMS rule (RIN 0938-AV20) excludes payments involving certain billing codes for durable medical equipment from calculations used to assess an ACO’s financial performance in 2023.”

From the public health and medical research front,

  • BioPharma Dive tells us
    • “Obesity drug startup Metsera on Tuesday reported its first clinical data since launching in April with $290 million in venture funding. The data come from a Phase 1 trial of a drug, MET-097, that’s designed to have longer-lasting effects than injectable GLP-1 therapies like Novo Nordisk’s Wegovy. The results show that a weekly administration of the highest dose tested stimulated weight loss of 7.5% over 36 days, “matching, or potentially exceeding,” currently marketed and investigational anti-obesity medications, Metsera chief medical officer Steve Marso said in a statement. Metsera claimed the findings are supportive of once-monthly dosing and will start mid-stage trials in the fourth quarter, with results expected next year.” 
  • Per a National Institutes of Health press release,
    • “Cancer incidence trends in 2021 largely returned to what they were before the COVID-19 pandemic, according to a study by researchers at the National Institutes of Health (NIH). However, there was little evidence of a rebound in incidence that would account for the decline in diagnoses in 2020, when screening and other medical care was disrupted. One exception was breast cancer, where the researchers did see an uptick in diagnoses of advanced-stage disease in 2021. The study appears Sept. 24, 2024, in the Journal of the National Cancer Institute.
    • “A previous study showed that new cancer diagnoses fell abruptly in early 2020, as did the volume of pathology reports, suggesting that many cancers were not being diagnosed in a timely manner. To determine whether these missed diagnoses were caught in 2021, possibly as more advanced cancers, researchers from NIH’s National Cancer Institute (NCI) compared observed cancer incidence rates for 2021 with those expected from pre-pandemic trends using data from NCI’s Surveillance, Epidemiology, and End Results Program.”
    • “A full recovery in cancer incidence should appear as an increase over pre-pandemic levels (also known as a rebound) to account for the missed diagnoses. The researchers looked at cancer overall, as well as five major cancer types that vary in how they are typically detected: through screening (female breast and prostate cancer), due to symptoms (lung and bronchus and pancreatic cancer), or incidentally during other medical procedures (thyroid cancer).
    • “Cancer incidence rates overall and for most specific cancers approached pre-pandemic levels, with no significant rebound to account for the 2020 decline. However, in addition to an uptick in new diagnoses of advanced breast cancer in 2021, the data also provided some evidence of an increase in diagnoses of advanced pancreatic cancer. Also, new diagnoses of thyroid cancers in 2021 were still below pre-pandemic levels.
    • “The researchers concluded that 2021 was a transition year that was still affected by new variants and new waves of COVID-19 cases, which continued to impact medical care. They said the findings highlight the need for ongoing monitoring to understand the long-term impacts of the pandemic on cancer diagnoses and outcomes.”
  • CNN reports,
    • “The US government plans to make more at-home Covid-19 tests available for free this month as the country heads into respiratory virus season with high levels of the coronavirus already circulating.
    • “Each household will be able to order another round of four free at-home test kits starting at the end of September at COVIDTests.gov.
    • “More than 900 million test kits have been delivered directly to US residents through the COVIDTests.gov program, according to the US Department of Health and Human Services.
    • “COVID-19 testing can help you know if you have COVID-19 so you can decide what to do next, like getting treatment to reduce your risk of severe illness and taking steps to lower your chances of spreading the virus to others,” the agency said.
    • “This next set of tests – the program’s seventh round of distribution – will be able to detect currently circulating variants and can be used as people prepare for year-end holiday gatherings.”
  • The Washington Post reports that “Doctors and patients struggle with starting and stopping GLP-1 medications with little guidance.”
  • Per Fierce Pharma,
    • “The FDA is having second thoughts about the broad labels it has granted PD-1 inhibitors in newly diagnosed stomach cancer, questioning whether restrictions should be placed on products from Bristol Myers Squibb and Merck & Co. plus a stomach cancer hopeful from BeiGene.
    • “In a briefing document prepared for an Oncologic Drugs Advisory Committee meeting slated for Thursday, the FDA suggested that PD-1 inhibitors may not be suitable for certain patients with HER2-negative gastric cancer who have low PD-L1 expression, even though these immunotherapies have shown life-extension benefits in broad study populations.”

From the U.S. healthcare business front,

  • The American Hospital Association News reports,
    • “An EY report prepared for the AHA shows that tax-exempt hospitals and health systems delivered $10 in benefits to their communities for every dollar’s worth of federal tax exemption in 2020, the most recent year for which comprehensive data is available. It represents an increase from $9 in benefits from the prior year despite efforts in battling the COVID-19 pandemic.”  
  • Per Business Insurance,
    • “Prudential Financial is re-entering the U.S. stop-loss insurance market, targeting employers with at least 100 employees, offering coverage for medical, prescription drug, dental, vision, and short-term disability claims, BenefitsPro reports. Prudential aims to leverage its experience under the leadership of Jessica Gillespie, who is head of Prudential’s group insurance products. The stop-loss market has seen significant price hikes, with some competitors dissatisfied with their financial outcomes.”
  • and
    • “Health insurance companies are increasingly covering prescriptions written by pharmacists as states expand pharmacists’ prescribing authority through “test to treat” legislation, Forbes reports. This shift aims to improve access to medications amid a shortage of primary care physicians. Major insurers like Cigna and Blue Cross and Blue Shield of Illinois are adapting their coverage policies accordingly.”
  • The New York Times reports
    • “Every day, patients send hundreds of thousands of messages to their doctors through MyChart, a communications platform that is nearly ubiquitous in U.S. hospitals.
    • “They describe their pain and divulge their symptoms — the texture of their rashes, the color of their stool — trusting the doctor on the other end to advise them. 
    • “But increasingly, the responses to those messages are not written by the doctor — at least, not entirely. About 15,000 doctors and assistants at more than 150 health systems are using a new artificial intelligence feature in MyChart to draft replies to such messages.
    • “Many patients receiving those replies have no idea that they were written with the help of artificial intelligence. In interviews, officials at several health systems using MyChart’s tool acknowledged that they do not disclose that the messages contain A.I.-generated content.
    • “The trend troubles some experts who worry that doctors may not be vigilant enough to catch potentially dangerous errors in medically significant messages drafted by A.I.”

Cybersecurity Saturday

From the cybersecurity policy and law enforcement front,

  • Federal News Network tells us
    • “A record number of federal agencies and their chief information officers are getting top marks on how they manage IT and cybersecurity.
    • “A total of 13 agencies [including the U.S. Office of Personnel Management] received an overall A letter grades on a semiannual Federal IT Acquisition Reform Act (FITARA) scorecard.
    • “Another 10 agencies got a B grade for their overall IT and cybersecurity management. Only one agency, the Energy Department, received a C grade. No agencies received a D or an F.
    • “Agencies generally saw lower scores in the previous FITARA scorecard released in February.”
  • KFF Health News gives low marks to the federal agencies responsible for protecting healthcare organizations against cyberattacks.
  • Per a CISA press release,
    • “The Cybersecurity and Infrastructure Security Agency (CISA) published the Federal Civilian Executive Branch (FCEB) Operational Cybersecurity Alignment (FOCAL) Plan today. As the operational lead for federal cybersecurity, CISA uses this plan to guide coordinated support and services to agencies, drive progress on a targeted set of priorities, and align collective operational defense capabilities. The end result is reducing the risk to more than 100 FCEB agencies.
    • “Each FCEB agency has a unique mission, and thus have independent networks and system architectures to advance their critical work. This independence means that agencies have different cyber risk tolerance and strategies. However, a collective approach to cybersecurity reduces risk across the interagency generally and at each agency specifically, and the FOCAL Plan outlines this will occur. CISA developed this plan in collaboration with FCEB agencies to provide standard, essential components of enterprise operational cybersecurity and align collective operational defense capabilities across the federal enterprise.” * * *
    • “The FOCAL Plan was developed for FCEB agencies, but public and private sector organizations should find it useful as a roadmap to establish their own plan to bolster coordination of their enterprise security capabilities. 
    • “The Plan is not intended to provide a comprehensive or exhaustive list that an agency or CISA must accomplish. Rather, it is designed to focus resources on actions that substantively advance operational cybersecurity improvements and alignment goals.”
  • Dark Reading reports,
    • “The Justice Department today [September 19] announced a court-authorized operation to disrupt a botnet affecting 200,000 devices in the United States and abroad.
    • “According to unsealed documents, the botnet, known as Raptor Train, is operated by People’s Republic of China (PRC) state-sponsored hackers working for a company based in Beijing. Known publicly as Integrity Technology Group, it is also known as the advanced persistent threat (APT) group Flax Typhoon in the private sector.
    • A variety of connected and Internet of things (IoT) devices have been affected by the botnet malware, including small-office/home-office (SOHO) routers, Internet protocol cameras, digital video recorders, and network-attached storage (NAS) devices.”

From the cyber vulnerabilities and breaches front,

  • Cybersecurity Dive lets us know,
    • “Ivanti warned Thursday of a critical path traversal vulnerability in Cloud Service Appliance, which is currently facing exploitation attempts by hackers. The vulnerability, listed as CVE-2024-8963, has a CVSS score of 9.4 and allows an unauthenticated hacker to gain access to restricted functionality.
    • “Ivanti previously issued a patch for CSA on Sept. 10., but the company said the path traversal vulnerability was discovered while investigating exploitation linked to an OS command injection vulnerability, listed as CVE-2024-8190
    • “The company warned that when the two vulnerabilities are used in conjunction with each other, a hacker can bypass admin authentication and execute arbitrary commands.” 
  • Dark Reading tells us “Security Firm’s North Korean Hacker Hire was not an Isolated Incident; What happened to KnowBe4 also has happened to many other organizations, and it’s still a risk for companies of all sizes due to a sophisticated network of government-sponsored fake employees.” Check out the article.

From the ransomware front,

  • Dark Reading informs us,
    • “Inc ransomware is on the rise, with one well-known threat actor recently using it to target American healthcare organizations.
    • “Vice Society, which Microsoft tracks as Vanilla Tempest, has been active since July 2022. In that time, the Russian-speaking group has made use of various families of ransomware to aid its double extortion attacks, including BlackCat, Hello Kitty, Quantum Locker, Rhysida, Zeppelin — including its own variant — and its own, eponymous program.
    • “In a series of posts on X, Microsoft Threat Intelligence Center (MSTIC) flagged the group’s latest weapon: Inc ransomware.”
  • Per Cybersecurity Dive,
    • “A special legislative committee in Suffolk County, New York, found officials ignored repeated warnings and failed to prepare ahead of a September 2022 ransomware attack that disrupted essential government services for months, in a report released last week.
    • “Officials blamed the ransomware attack on a failure of leadership, including the lack of an incident response plan and a failure to respond to FBI warnings of potential infiltration. 
    • “Suffolk County operated using a variety of IT teams and had no CISO, resulting in a lack of coordination on how to prepare for potential cyber threats. The attack has so far cost the county more than $25 million in remediation costs and other expenses.”
  • Cyberscoop reports on a debate of experts at the 2024 mWISE conference about what more could be done to stop ransomware attacks in the wake of police action and tens of millions in ransom payments over the past year. 

From the cyber defenses front,

  • Cyberscoop points out,
    • “UnitedHealth Group is still in the recovery process months after a ransomware attack on its Change Healthcare subsidiary, with its chief information security officer saying the company has essentially “started over” with regard to its computer systems. 
    • “When I say start over, I really, truly mean start over,” Steven Martin said Thursday at the Mandiant Worldwide Information Security Exchange (mWISE). “The only thing that we kept from the old environment into the new environment was the cables. New routers, new switches, new compute infrastructure, deployed everything from a safe environment, truly started over. I felt like that was the only way that we could really ensure that we ended up with something that we could stand behind for the health care space, because it’s what it deserved.” 
  • Cybersecurity Dive adds,
    • “CEOs and company boards often ask Kevin Mandia, founder and former CEO of Mandiant, how to determine the strength of their CISOs. Above all else, Mandia advises executives to assess their CISO’s disposition.
    • “Do you have a CISO with a security mindset?” “If they don’t have that, you’re probably not going to have a great security program,” Mandia said Wednesday during his opening keynote at the Mandiant Worldwide Information Security Exchange conference in Denver.” * * *
    • “Over the past couple decades Mandia’s crafted a series of five questions designed to help executives and board members test their confidence in a CISO’s ability to excel in their job.
    • “The questions on Mandia’s CISO confidence test include:
      • How would you break into us? What is our weak spot?
      • What is our worst-case scenario?
      • What would you do if the worst-case scenario occurred?
      • How resilient are we? How long would it take to recover our systems and applications?
      • What do you need?
    • “Mandia, who now serves in a strategic security advisor role at Google Cloud, said CEOs should focus on their CISO’s response to these questions as a measure of their demeanor.
    • “I tell CEOs, you don’t even care what the answer is to these questions as long as your CISO actually has one, because at least that means you have the mindset,” Mandia said.”
  • Health Tech offers five steps to follow after a breach.
  • Per Bleeping Computer,
    • “Microsoft announced today that Hotpatching is now available in public preview for Windows Server 2025, allowing installation of security updates without restarting.
    • “Hotpatching deploys Windows security updates without requiring a reboot by patching the in-memory code of running processes without restarting them after each installation.
    • “Among the benefits of Windows Hotpatching, Redmond highlights faster installs and reduced resource usage, lower workload impact because of fewer reboots over time, and improved security protection because it reduces the time exposed to security risks.
    • “Instead of 12 mandatory reboots a year on ‘Patch Tuesday,’ you’ll now only have quarterly scheduled reboots (with the rare possibility of reboots being required in a nominal Hotpatch month),” said Windows Server Director of Product Hari Pulapaka on Friday [September 20].”

Weekend Update

From Washington, DC,

  • The Hill reports,
    • “Rep. Andy Harris (R-Md.) predicted on Friday [September 13] that a government shutdown will be avoided as one looms.
    • “Do you believe that Republicans will be able to avoid a government shutdown?” NewsNation’s Blake Burman asked Harris on “The Hill.” “And do you think shutdowns are useful tools, or not?”
    • “There will not be a government shutdown, you know, one month before an election, that I can tell you,” Harris responded. 
    • “Lawmakers are racing to avoid a shutdown before the end-of-the-month deadline.”
  • Sen. Tim Kaine (D VA) has signed onto a bill as a co-sponsor to mandate FEHB coverage of IVF procedures. The Senate Majority Leader reportedly plans to bring up an IVF mandate bill this coming week.  
  • The American Medical Association’s public website explains various Medicare payment reform laws for its members.

From the public health and medical research front,

  • The AMA points out the top preventive health tips that your internist wants you to know.
  • The New York Times identifies “Three Medical Practices That Older Patients Should Question. Some treatments and procedures become routine despite lacking strong evidence to show that they’re beneficial. Recent studies have called a few into question.”
  • The Washington Post reports,
    • “More than 5 percent of women who get their tubes tied later become pregnant, a new analysis suggests — and researchers say the failure of tubal sterilization procedures, which are widely considered permanent, “may be considerably more common than many expect.”
    • “The study, published in NEJM Evidence, used data from the National Survey of Family Growth, which looks at contraception use, pregnancy and birth outcomes among a representative sample of U.S. women aged 15 to 44. The data was assembled during four waves of data collection from about 4,000 women who had tubal ligations between 2002 and 2015. * * *
    • “When choosing what birth control will work best for them, people consider many different things, including safety, convenience, and how fast they can start to use the method,” says Eleanor Bimla Schwarz, chief of the UCSF Division of General Internal Medicine at Zuckerberg San Francisco General and the study’s first author, in a news release.
    • “This study shows that tubal surgery cannot be considered the best way to prevent pregnancy. People using a contraceptive arm implant, or an IUD are less likely to become pregnant than those who have their tubes tied.”
    • “The researchers call for more inquiry into the “real-world effectiveness” of different forms of contraception.”
  • STAT News informs us from a Barcelona, Spain, oncology conference held this weekend,
    • “An AstraZeneca immunotherapy, given both before and after surgery, improved survival rates in patients with bladder cancer, results that could reshape how muscle-invasive bladder tumors are treated. 
    • “The regimen using Imfinzi, the company’s anti-PD-L1 checkpoint inhibitor, cut the risk of death by 25% compared to treating patients before surgery with chemotherapy alone, researchers reported Sunday. It also lowered the risk of disease recurrence by about a third. 
    • “It really is offering a curative-intent regimen and improving the cure rate in the disease,” Susan Galbraith, AstraZeneca’s head of oncology R&D, told STAT at the European Society for Medical Oncology meeting in Barcelona, using the word “transformative” several times. The results of the Phase 3 NIAGARA trial were presented in a presidential session at the conference and simultaneously published in the New England Journal of Medicine.
    • “Galbraith said the company would talk with regulators about the data, but experts will be watching to see if an ongoing debate about clinical trial design could pose a problem in this case.”
  • and
    • “Patients with advanced cancers often develop a secondary condition that causes them to shed weight, making it even harder to tolerate their cancer treatments. Called cachexia, it’s an under-recognized syndrome that researchers are still trying to tease out, and one that’s attracting more interest from drugmakers.
    • “On Saturday, Pfizer reported that an experimental antibody not only helped cancer patients with cachexia regain some weight versus placebo, but that it also seemed to increase their muscle mass and activity levels, signaling that the added weight translated into meaningful benefits.”
  • and
    • “A targeted immunotherapy being developed by the biotech iTeos Therapeutics and GSK delivered promising response rates in patients with a type of lung cancer, propelling the treatment into a pivotal Phase 3 trial and adding fuel to a broader debate about the validity of the target.
    • “The companies reported on Saturday that their combination of a TIGIT-targeting antibody and GSK’s Jemperli increased the percentage of patients who saw their tumors shrink versus those who received Jemperli alone, meeting the goals of the Phase 2 trial and the expectations that analysts had set for the study to be considered a success.”

From the U.S. healthcare business front,

  • Healthcare Dive tells us,
    • “Health systems are a large market for artificial intelligence startups, but companies selling to insurers or life sciences firms create value more quickly, according to an analysis by venture capital firm Flare Capital Partners.
    • “Most AI startups selling their products to health systems haven’t progressed past early-stage investment rounds. Just over 5% of those companies have reached a Series C raise or later, compared with nearly 10% of startups in life sciences and about 16% of companies selling to health plans. 
    • “The gap suggests AI startups in the life sciences and health plan markets have been able to create more value for their customers, according to Flare. But those sectors also have higher operating margins and can likely devote more resources — and time — to scale AI products.”\ 

Cybersecurity Saturday

From the cybersecurity policy front,

  • Federal News Network tells us,
    • “White House officials are contemplating a new cybersecurity executive order that would focus on the use of artificial intelligence.
    • “Federal cybersecurity leaders, convening at the Billington Cybersecurity Conference in Washington this past week, described AI as both a major risk and a significant opportunity for cyber defenders.
    • ‘White House Deputy National Security Advisor Anne Neuberger called AI a “classic dual use technology.” But Neuberger is bullish on how it could improve cyber defenses, including analyzing logs for cyber threats, generating more secure software code, and patching existing vulnerabilities.
    • “We see a lot of promise in the AI space,” Neuberger said. “You saw it in the president’s first executive order. As we work on the Biden administration’s potentially second executive order on cybersecurity, we’re looking to incorporate some particular work in AI, so that we’re leaders in the federal government in breaking through in each of these three areas and making the tech real and proving out what’s possible.”
  • Per a Labor Department Employee Benefit Security Administration press release,
    • “In its continuing effort to protect U.S. workers’ retirement and health benefits, the U.S. Department of Labor today updated current cybersecurity guidance confirming that it applies to all types of plans governed by the Employee Retirement Income Security Act, including health and welfare plans, and all employee retirement benefit plans.
      • “The new Compliance Assistance Release issued by the department’s Employee Benefits Security Administration provides best practices in cybersecurity for plan sponsors, plan fiduciaries, recordkeepers and plan participants. The release updates EBSA’s 2021 guidance and includes the following:
      • Tips for Hiring a Service Provider: Helps plan sponsors and fiduciaries prudently select a service provider with strong cybersecurity practices and monitor their activities, as ERISA requires.
      • Cybersecurity Program Best Practices: Assists plan fiduciaries and recordkeepers in mitigating risks. 
      • Online Security Tips: Offers plan participants who check their online retirement accounts with rules for reducing the risk of fraud and loss.”
  • Cybersecurity Dive lets us know,
    • “The White House Office of the National Cyber Director launched a program Wednesday to help fill the gap of about 500,000 available cybersecurity jobs across the country. 
    • “Service for America, a program developed alongside the Office of Management and Budget and the Office of Personnel Management, is a recruitment and hiring push that will help connect Americans with available jobs in cybersecurity, technology and artificial intelligence. 
    • “The program’s major emphasis is to reach job candidates without traditional qualifications, such as computer science or engineering backgrounds. 
    • “Many Americans do not realize that a cyber career is available to them,” National Cyber Director Harry Coker Jr. said in a blog post released Wednesday. “There is a perception that you need a computer science degree and a deeply technical background to get a job in cyber.”
    • “In reality, Coker said people of all backgrounds can find well-paying jobs in cybersecurity, and the White House has been promoting efforts to connect a new generation of prospective candidates into those positions.”
  • and
    • “Marsh McLennan and Zurich Insurance Group on Thursday [September 5] issued a call for government intervention to help resolve the growing risk of catastrophic cyber events and a multibillion dollar gap in terms of what the current insurance market can absorb. 
    • “The cyber insurance market has seen significant growth in recent years, and is expected to exceed $28 billion in gross written premiums in 2027, more than double the amount written in 2023, according to a whitepaper released by the firms Thursday.  
    • “However, the companies warn a risk protection gap of about $900 billion exists between insured losses and economic losses due to cyberattacks. Many small- to medium-sized businesses are either underinsured or carry no coverage to protect against such losses.” 

From the cyber vulnerabilities and breaches front,

  • Per a Centers for Medicare Services press release,
    • “The Centers for Medicare & Medicaid Services (CMS) and Wisconsin Physicians Service Insurance Corporation (WPS) are notifying people whose protected health information or other personally identifiable information (PII) may have been compromised in connection with Medicare administrative services provided by WPS. WPS is a CMS contractor that handles Medicare Part A/B claims and related services for CMS.  
    • “The notification comes following discovery of a security vulnerability in the MOVEit software, a third-party application developed by Progress Software and used by WPS for the transfer of files in providing services to CMS. WPS is among many organizations in the United States that have been impacted by the MOVEit vulnerability. The security incident may have impacted PII of Medicare beneficiaries that was collected in managing Medicare claims as well as PII collected to support CMS audits of healthcare providers that some individuals who are not Medicare beneficiaries have visited to receive health care services.
    • “CMS and WPS are mailing written notifications to 946,801 current people with Medicare whose PII may have been exposed, informing them of the breach and explaining actions being taken in response.”
  • Cybersecurity Dive reports,
    • “Federal authorities in the U.S. and nine other countries warn that threat groups affiliated with Russia’s military intelligence service are targeting global critical infrastructure and key resource sectors, according to a joint cybersecurity advisory released Thursday. 
    • “Threat groups affiliated with a specialist unit of the Russian General Staff Main Intelligence Directorate have targeted government services, financial services, transportation systems, energy, and healthcare sectors of NATO members and countries in Europe, Central America and Asia, officials said in the advisory.
    • “To date, the FBI has observed more than 14,000 instances of domain scanning across at least 26 NATO members and several additional EU countries,” authorities said in the advisory. The attackers have defaced victim websites, scanned infrastructure, and exfiltrated and leaked stolen data.”
  • The Cybersecurity and Infrastructure Security Agency added three known exploited vulnerabilities to its catalog:
  • Dark Reading adds,
    • “This week the US Cybersecurity and Infrastructure Security Agency (CISA) warned about two new industrial control systems (ICS) vulnerabilities in products widely used in healthcare and critical manufacturing — sectors prone to attract cybercrime.
    • “The vulnerabilities affect Baxter’s Connex Health Portal and Mitsubishi Electric’s MELSEC line of programmable controllers. Both vendors have issued updates for the vulnerabilities and recommended mitigations that customers of the respective technologies can take to further mitigate risk.”
  • Per Cybersecurity Dive,
    • “Just over half of businesses in the U.S. and U.K. have been targets of a financial scam powered by “deepfake” technology, with 43% falling victim to such attacks, according to a survey by finance software provider Medius.
    • “Of the 1,533 U.S. and U.K. finance professionals polled by Medius, 85% viewed such scams as an “existential” threat to their organization’s financial security, according to a report on the findings published last month. Deepfakes are artificial intelligence-manipulated images, videos, or audio recordings that are bogus yet convincing.
    • “More and more criminals are seeing deepfake scams as an effective way to get money from businesses,” Ahmed Fessi, chief transformation and information officer at Medius, said in an interview. These scams “combine phishing techniques with social engineering, plus the power of AI.”

From the ransomware front,

  • Tech Radar points out,
    • “Research from Searchlight Cyber has shown the number of ransomware groups that operated in the first half of 2024 rose to 73, up from 46 in the same period of 2023. The findings suggest law enforcement’s efforts to curb cyber criminal groups have seen some success, especially in disrupting the operations of notorious group BlackCat, which has since dissolved.
    • “Groups were targeted by law enforcement in ‘Operation Cronos’, which facilitated the arrests of two people, took down 28 servers, obtained 1,000 decryption keys, and froze 200 crypto accounts – all linked to the infamous LockBit organization.
    • “Although the number of groups has risen, the number of victims has fallen, which indicates a potential diversification rather than growth of ransomware groups. Other Ransomware as a Service (RaaS) groups such as RansomHub and BlackBasta have become more active, complicating the landscape for cyber security.
  • Tripwire fills us in about Cicada ransomware.
  • ‘Per Cybersecurity Dive,
    • “A previously disclosed cyberattack at Halliburton disrupted parts of its operations and information was stolen in connection with the incident, the company said in a filing with the Securities and Exchange Commission Tuesday. 
    • “Halliburton discovered the attack in late August and immediately shut off certain services as a proactive measure. It continues to offer its products and services across the globe, the company said.
    • “The Houston company has incurred and will continue to incur certain expenses related to the attack. However, it does not expect the attack to have a material impact on its financial condition or results of operations.”

From the cybersecurity defenses front,

  • The Wall Street Journal reports,
    • “Cybersecurity professionals are reporting modest budget increases amid the need to defend against new hacking threats and secure emerging technologies such as artificial intelligence.
    • “Spending on cybersecurity is rising 8% this year, compared with 6% in 2023, according to a survey of chief information security officers published Thursday by cybersecurity consulting firm IANS and recruiting company Artico Search. The survey polled 755 CISOs from April into August, with 681 completing its budget section.
    • “Despite the small improvement, security spending is growing at a lower rate than the 17% increase in 2022. Still, the shift indicates a gradual recovery after companies slowed cyber spending and in some cases froze hiring after the pandemic, said Steve Martano, an Artico partner and IANS faculty member. 
    • “People are feeling more optimistic than they were six months ago,” Martano said, adding that more cybersecurity leaders are seeing small budget increases and there are signs the security job market will improve.”
  • Dark Reading offers a commentary on “How CISOs Can Effectively Communicate Cyber-Risk. A proximity resilience graph offers a more accurate representation of risk than heat maps and risk registers,and allows CISOs to tell a complex story in a single visualization.”
  • ISACA offers a commentary on “The Never-ending Quest: Why Continuous Monitoring is Crucial for Cybersecurity.”
  • If you work for or represent a small or medium sized HIPAA covered entity or business associate, you may want to “register for an introductory webinar [to held on September 10 at noon ET and September 11 at 3 pm] on the free Security Risk Assessment Tool (SRA Tool) hosted by Altarum with the U.S. Department of Health and Human Services Office for Civil Rights (OCR) and the Assistant Secretary for Technology Policy (ASTP). The webinar will also feature changes in SRA Tool version 3.5, available in September 2024.”
  • Security Week shares a discussion between CSOs Jaya Baloo from Rapid7 and Jonathan Trull from Qualys about the route, role, and requirements in becoming and being a successful CISO.

Cybersecurity Saturday

From the cybersecurity policy front,

  • Cybersecurity Dive reports,
    • “The Cybersecurity and Infrastructure Security Agency introduced an online portal Thursday [August 29] for organizations to voluntarily report malicious cyberattacks, vulnerabilities and data breaches. 
    • “The CISA services portal is a secure platform that provides enhanced functionality and collaboration features, including the ability to save and update incident reports, share submitted reports with colleagues or clients and search for reports. Users can also have informal discussions with CISA through the portal.
    • “An organization experiencing a cyberattack or incident should report it — for its own benefit, and to help the broader community,” Jeff Greene, executive assistant director for cybersecurity at CISA, said in a statement. “CISA and our government partners have unique resources and tools to aid with response and recovery, but we can’t help if we don’t know about an incident.”
  • Per FedScoop,
    • “Federal agencies are counting down the days until September 30 to meet a combination of zero-trust cybersecurity requirements. The requirements are part of a multi-year strategy by the Office of Management and Budget (OMB) to apply various cybersecurity techniques to safeguard federal agency users, networks, devices and data.
    • “One of the more vexing requirements, according to a new report, includes provisions to inventory and monitor the increasingly complex IT landscape involving not just traditional IT but also an ever-expanding array of operating technologies (OT) and the Internet of Things (IoT). The convergence of data and applications linked to IT, OT and IoT devices has introduced a new era of security risks that OMB has tasked agencies to address.
    • “The widespread adoption of OT devices not only expands the number and diversity of assets agencies must manage but also the range of vulnerabilities they need to address,” explains a new report commissioned for FedScoop and underwritten by Asc3nd Technologies Group. “More to the point: Linking OT data and devices to IT systems creates new pathways for cyberattacks that adversaries are exploiting with increasing frequency.”
    • “To address those and related risks, OMB directive M-24-04 requires agencies, among other things, to put tools and measures in place that provide a comprehensive understanding of all devices connected to their networks. They must also be prepared to provide detailed asset reports to the Cybersecurity and Infrastructure Agency (CISA) within 72 hours.”
  • The Wall Street Journal adds,
    • As cyberattacks plague companies across all industries and cause headaches for consumers, regulators are demanding that victims report hacks in short time periods—and the rules are rarely consistent, creating a compliance nightmare.
    • In addition to widely publicized rules such as those brought into force by the U.S. Securities and Exchange Commission in December 2023, many companies must also comply with other federal demands, rules from state regulators and industry-specific requirements. * * *
    • “Health insurer Blue Cross Blue Shield Association, for instance, said in its response [to CISA proposed Cyber Incident Reporting for Critical Infrastructure Act (CIRCIA) rule] that healthcare companies may need to report incidents under the Health Insurance Portability and Accountability Act, the Federal Trade Commission’s rules on data privacy, the SEC’s rules and CIRCIA, once that rule is final.  
    • “Four separate standards with similar but slightly different compliance expectations would impose an unreasonable burden with marginal benefit towards improving cybersecurity as compared to having a single, harmonized standard,” said Kris Haltmeyer, the association’s vice president of policy analysis.”

From the cyber vulnerabilities and breaches front,

  • Dark Reading points out,
    • “Multiple exploit campaigns linked to a Russian-backed threat actor (variously known as APT29, Cozy Bear, and Midnight Blizzard) were discovered delivering n-day mobile exploits that commercial spyware vendors have used before.
    • “According to Google’s Threat Analysis Group (TAG), the exploit campaigns were delivered “from a watering hole attack on Mongolian government websites,” and each one is identical to exploits previously used by commercial surveillance vendors (CSVs) Intellexa and NSO Group. That suggests, as the researchers at Google TAG note, that the authors and/or providers are the same. * * *
    • “The researchers go on to add that though there are still outstanding questions as to how the exploits were acquired, this does highlight how exploits developed first by the commercial surveillance industry become even more of a threat as threat actors come across them.” 
  • Cyberscoop adds,
    • “Online scam cycles have gotten significantly shorter and more effective over the past four years, as cybercriminals increasingly favor smaller, simpler, faster and more targeted campaigns that can yield higher revenues over the long term.
    • “The findings, from a mid-year cybercrime report released Thursday by Chainalysis, show that scammers are refreshing their online and blockchain-based infrastructure faster than ever before.
    • “For instance, a huge chunk of all scam revenues being tracked by Chainalysis on the blockchain (43%) were sent to wallets that only became active over the past year — something the company said suggests a surge of newly created scamming campaigns.
    • “That’s significantly larger than any other observed year — the previous high was 29.9% in 2022 — and it has coincided with what Chainalysis described as a concerted effort by criminals to dramatically shrink the time they spend on one spam campaign before moving onto another.”

From the CrowdStrike outage front,

  • Cybersecurity Dive informs us,
    • “The financial impact from last month’s ill-fated CrowdStrike Falcon sensor update that caused a global IT network outage will continue through the first half of 2025, company executives said Wednesday during an earnings call.
    • “Executives warned investors of temporary delays in its sales pipeline generation, longer sales cycles due to increased scrutiny from new and existing customers and muted upsell potential.
    • “CrowdStrike expects an impact of about $60 million in net new annual recurring revenue and subscription revenue due to what it dubbed its “customer commitment packages,” discounts it’s offering some customers through the second half of this year, CFO Burt Podbere said during the Wednesday earnings call for the company’s fiscal 2025 second quarter, which ended July 31. “When we get to the back half of next year, we’ll start to see an acceleration in the business.”

From the ransomware front,

  • The American Hospital Association News reports,
    • “The FBI, Cybersecurity and Infrastructure Agency and the Department of Defense Cyber Crime Center Aug. 29 issued a joint advisory to warn of Iranian-based cyber actors leveraging unauthorized network access to U.S. organizations, including health care organizations, to facilitate, execute and profit from future ransomware attacks by apparently Russian-affiliated ransomware gangs. The Iranian group, which is associated with the Government of Iran, has conducted a high volume of cyberattack attempts on U.S. organizations since 2017 and as recently as August 2024. Based on an FBI assessment, the cyber actors obtain network access for espionage reasons then collaborate with ransomware groups, including the notorious Russian-linked ransomware groups RansomHub and APLHV aka BlackCat, to execute ransomware attacks against the espionage target. BlackCat was responsible for the 2024 Change Healthcare ransomware attack, the largest and most consequential cyberattack in U.S. history. The advisory does not indicate if the Iranian actors had any role in the Change Healthcare attack but does state that the Iranian group’s ransomware activities are not likely sanctioned by the Government of Iran.
    • “The joint advisory provides tactics, techniques, procedures, and indicators of compromise obtained from FBI investigations and third-party reporting. The federal agencies urge organizations to apply the recommendations in the mitigations section of the advisory to reduce the likelihood of compromise from these Iranian-based cyber actors and other ransomware attacks.
    • “This alert demonstrates the close ‘international cooperation’ between hackers to exploit cyber espionage campaigns for criminal profit,” said John Riggi, AHA national advisor for cybersecurity and risk. “This alert also demonstrates the nation-state level sophistication and expertise of the ransomware groups that target U.S. health care. No health care organization, regardless of their cybersecurity preparedness, can be expected to fully defend against a group of nation-state-trained hackers collaborating with sophisticated ransomware gangs. Clearly, the initial access leading to a subsequent ransomware attack, sanctioned or not, is state-sponsored. We strongly encourage the U.S. government to treat these attacks as national security threats, by policy and action, and impose significant risk and consequences on our cyber adversaries. Offense is the best defense.”
    • “Although there is no specific threat information at this time, the field is reminded to remain especially vigilant over the holiday weekend, as we have historically seen increased targeting of health care around the holidays.”
  • Bleeping Computer adds,
    • “The RansomHub ransomware gang is behind the recent cyberattack on oil and gas services giant Halliburton, which disrupted the company’s IT systems and business operations.
    • “The attack caused widespread disruption, and Bleeping Computer was told that customers couldn’t generate invoices or purchase orders because the required systems were down.
    • “Halliburton disclosed the attack last Friday in an SEC filing, stating they suffered a cyberattack on August 21, 2024, by an unauthorized party.
  • Cybersecurity Dive reports,
    • “Volt Typhoon, a prolific state-linked threat actor, is exploiting a zero-day vulnerability in Versa Director servers in a campaign targeting internet service providers, managed service providers and other technology firms, researchers from Black Lotus Labs warned in a blog post Tuesday.
    • “The vulnerability, listed as CVE-2024-39717, allows users to upload files that are potentially malicious and gives them advanced privileges. 
    • “Black Lotus Labs researchers identified a custom webshell, which they call VersaMem, that is designed to intercept and harvest credentials and allow an attacker to gain access to a downstream computer network as an authenticated user. 

From the cybersecurity defenses front,

  • Per a NIST press release,
    • “[On August 29], the U.S. Artificial Intelligence Safety Institute at the U.S. Department of Commerce’s National Institute of Standards and Technology (NIST) announced agreements that enable formal collaboration on AI safety research, testing and evaluation with both Anthropic and OpenAI.
    • “Each company’s Memorandum of Understanding establishes the framework for the U.S. AI Safety Institute to receive access to major new models from each company prior to and following their public release. The agreements will enable collaborative research on how to evaluate capabilities and safety risks, as well as methods to mitigate those risks. 
    • “Safety is essential to fueling breakthrough technological innovation. With these agreements in place, we look forward to beginning our technical collaborations with Anthropic and OpenAI to advance the science of AI safety,” said Elizabeth Kelly, director of the U.S. AI Safety Institute. “These agreements are just the start, but they are an important milestone as we work to help responsibly steward the future of AI.”
    • “Additionally, the U.S. AI Safety Institute plans to provide feedback to Anthropic and OpenAI on potential safety improvements to their models, in close collaboration with its partners at the U.K. AI Safety Institute.” 
  • Per Dark Reading, “Ransomware attacks and email-based fraud account for 80% to 90% of all claims processed by cyber insurers, but a handful of cybersecurity technologies can help prevent big damages.” Check it out.

Tuesday’s Tidbits

Photo by Patrick Fore on Unsplash

From Washington, DC,

  • Fedweek lets us know,
    • “Another report to Congress has estimated an annual $1 billion cost to the FEHB program from ineligible persons being covered as family members, a cost that is passed on to both enrollees and the government in the form of higher premiums.
    • “The Congressional Budget Office estimate—agreeing with one last year from the GAO—was done in an analysis of S-4035, which is pending a vote in the full Senate after Congress reconvenes September 9. A counterpart bill, HR-7868, has cleared the House committee level, as well.
    • “The bills would require agencies to verify the eligibility of dependents enrolled in the FEHB when the employee or annuitant starts or changes a dependent’s enrollment; require OPM to audit dependents’ enrollment in the program; and expand fraud risk assessments of the program to include information on ineligible enrollees. * * *
    • “CBO expects that implementing the bill would cause enrollment to decline by about 100,000 people, on average, in each year over the 2025-2034 period. Verifications of eligibility during open season would cause a decline of about 10,000 people, on average, in each year over the same period,” it says.
    • However, that estimate “is subject to significant uncertainty because no similar verification audit of the FEHB program has been undertaken,” it added.
  • FEHBlog sermonette — About ten years ago, OPM added a provision to the FEHB standards contracts providing that the carriers would foot the bill for any family member eligibility audits. OPM never has performed a verification audit due to the FEHB program’s size. However, audits are based on sampling, and surely a sample-based audit of various geographic regions where federal and postal employees live (e.g., Washington, DC and nearby counties, Texas, Florida, etc.) would have told OPM whether or not it has a family member eligibility problem.
  • OPM does have a more glaring enrollment problem because OPM separately reports enrollment and premiums to carriers. Consequently, carriers, which carry the insurance risk, do not have the opportunity to confirm that enrollees in their records (based on OPM’s data) are paying the proper premiums for selected self only or other than self only coverage. What is the sense of nailing down family member coverage when no one knows whether the enrollee is paying the proper or any premium?
  • For close to twenty years, CMS, which implements HIPAA’s electronic standards, has made available an electronic enrollment roster transaction known as the HIPAA 820, which would allow FEHB carriers to reconcile enrollment and premiums at the individual level using computer systems. That’s a massive gap in internal controls that needs to be corrected without further delay, in the FEHBlog’s humble opinion. All that OPM has to do is tell the payroll offices to use the HIPAA 820. End of sermonette.
  • Per a company press release,
    • Maximus has been awarded a $20 million contract from the Office of Personnel Management (OPM) to serve as the Contact Center Services Provider for the agency’s new Postal Service Health Benefits Program. This program will provide health insurance to eligible Postal Service employees, annuitants, and their eligible family members starting in 2025.
    • Maximus will be leading the customer support effort to answer calls and emails for OPM’s new, enhanced customer service platform dedicated to assisting eligible individuals access health insurance benefits. Maximus will leverage offerings from its Total Experience Management (TXM) solution, including state-of-the-art telephony, customer relationship management, and call quality reporting tools to provide best-in-class customer service.
    • “The Postal Service Health Benefits Program is an invaluable benefit for the U.S. Postal Service workforce, and Maximus is uniquely positioned to develop this new contact center and Customer Experience (CX) approach based on more than 30 years of experience working with OPM,” said Larry Reagan, Senior Managing Director, Federal Civilian Market, Maximus. “Our senior team has vast experience standing up new customer service programs at scale for federal agencies to deliver a range of services, including disaster recovery, education, and health benefit services.”
  • Healthcare Dive tells us,
    • “An expensive drug for weight loss could become one of Medicare’s costliest medications, even if the majority of patients are ineligible for coverage, according to a study published on Monday in the Annals of Internal Medicine.
    • “The analysis found 3.6 million people are highly likely to be eligible for semaglutide like Wegovy, a GLP-1 that’s effective at treating obesity. More liberal definitions of eligibility could increase that number to 15.2 million patients.
    • “If all newly eligible patients received semaglutide, spending in Medicare’s Part D prescription drug benefit could increase by $34 billion to $145 billion each year, according to the study. Even if the government narrowly defined eligibility, federal spending on the medicine could still exceed $10 billion annually.”
  • Medscape adds,
    • “Now that the U.S. government has negotiated prices for some Medicare program drugs effective in 2026, Wall Street analysts are betting on a 2027 list that will include Novo Nordisk’s blockbuster Ozempic for diabetes and have a limited impact on Big Pharma. [FEHBlog note — Wegovy is the weight loss version of Ozempic. Medicare by statute does not cover weight loss drugs.]
    • “Other possible 2027 candidates include Pfizer’s cancer drugs Ibrance and Xtandi, GSK’s asthma and chronic obstructive pulmonary disease (COPD) treatment Trelegy Ellipta, Teva’s Huntington’s disease treatment Austedo and Abbvie’s irritable bowel syndrome drug Linzess, according to five analysts as well as researchers and company executives.”
  • Per an HHS press release,
    • “Today, the U.S. Department of Health and Human Services (HHS) announced more than $558 million in funding to improve maternal health, building on the Biden-Harris Administration’s commitment to reducing the nation’s high maternal mortality rate through the White House Blueprint for Addressing the Maternal Health Crisis. The Health Resources and Services Administration (HRSA), an agency of HHS, is awarding more than $440 million in funding to expand voluntary, evidence-based maternal, infant, and early childhood home visiting services for eligible families across the country. In addition, the Centers for Disease Control and Prevention (CDC) announced a new investment of $118.5 million, over five years, to 46 states, six territories, and freely associated states to continue building the public health infrastructure to better identify and prevent pregnancy-related deaths.” * * *
    • “For a complete list of Maternal, Infant, and Early Childhood Home Visiting Program awardees, visit https://mchb.hrsa.gov/programs-impact/programs/home-visiting/maternal-infant-early-childhood-home-visiting-miechv-program/fy24-awards.”
  • A Federal News Network Data Dive tells us, “USPS improves on-time delivery in delay ‘hotspots’, but faces year-end challenges. Postal experts say USPS improvements to on-time delivery are needed, and must continue, for Congress to allow these plans to keep moving forward.”

From the public health and medical research front,

  • Beckers Hospital Review reports on an August 23, 2024, press conference that leaders of the CDC, HHS and FDA held to discuss the upcoming respiratory virus season.
  • The American Medical Association informs us about what doctors wish their patients knew about lung cancer screening.
    • “Lung cancer causes about 160,000 U.S. deaths a year, which is greater than the toll of the next three most common cancers—colon, breast and prostate—combined. Yet only about 30% of lung cancer cases are diagnosed early. Most patients are diagnosed at a far less treatable, later stage of the disease. And with about 20% of lung cancer deaths preventable, evidence-based screening recommendations for high-risk patients offers the best hope to catch the disease early and provide the best chance for effective treatment.”
  • Medscape looks into how old is too old to undergo a screening colonoscopy.
  • The National Institutes of Health (NIH) issued a medical research report this afternoon.
  • Per an NIH press release,
    • “So-called low-intensity blood stem cell transplants, which use milder conditioning agents than standard stem cell transplants, do not appear to damage the lungs and may help improve lung function in some patients with sickle cell disease (SCD), according to a three-year study of adults who underwent the procedure at the National Institutes of Health (NIH).
    • “Damage to lung tissue and worsened lung function is a major complication and leading cause of death in people with sickle cell disease, a debilitating blood disorder. The new study, published today in the Annals of the American Thoracic Society, helps answer whether less intensive types of transplants, which tend to be better tolerated by many adults, by themselves either cause or promote further harm to the lungs.
    • “By using a low-intensity blood stem cell transplant for sickle cell disease, we may be able to stop the cycle of lung injury and prevent continued damage,” said study lead Parker Ruhl, M.D., an associate research physician and pulmonologist at NIH. “Without the ongoing injury, it’s possible that healing of lung tissue might occur, and this finding should help reassure adults living with sickle cell disease who are considering whether to have a low-intensity stem cell transplant procedure that their lung health will not be compromised by the transplant.”
  • Per Fierce Healthcare,
    • “UnitedHealth Group’s philanthropic arm has released a new deep dive into maternal and infant health, underscoring socioeconomic disparities in women’s health.
    • “The study found that American Indian/Alaska Native, Black and Hawaiian/Pacific Islander women had maternal mortality rates that were between 2.5 and 4.5 times higher than other ethnic groups. Severe maternal morbidity was, in 2020, two times higher among Black mothers than white mothers, and 1.5 times higher among Black mothers compared to Hispanic mothers.
    • “There were also racial disparities identified in low-birth weight, according to the study. Low birth weight rates were 2.1 times higher among babies born to Black mothers compared to infants born to white mothers.
    • “There were some bright spots in the data, however. Between 2008 and 2011 and 2018 to 2021, there were improvements to infant mortality rates among some racial groups. The study found improvements of 15% among infants born to white mothers, 12% among babies born to Black mothers and 9% for babies born to Hispanic mothers.
    • “Lisa Saul, M.D., national medical director of maternal child health at UnitedHealthcare, said in a press release that analyses like this are critical to developing targeted solutions to key challenges.”
  • Beckers Hospital Review informs us,
    • “After about 18 months since the FDA greenlit preventive COVID-19 medication Pemgarda for emergency use, the agency has tweaked its decision. 
    • “The agency has narrowed the medicine’s emergency use authorization. It is now OK to use when “the combined national frequencies of variants with substantially reduced susceptibility to Pemgarda is less than or equal to 90%,” the FDA said in an Aug. 26 letter to the drug’s maker, Invivyd. 
    • “Pemgarda (pemivibart) is authorized for the pre-exposure prophylaxis of COVID-19 in some adults and children older than 12. Eligible patients are those who have a moderate-to-severe immune compromise and are unlikely to have an adequate response to a COVID-19 vaccine.
    • “Early data indicate that COVID-19 variant KP.3.1.1 may have substantially reduced susceptibility to Pemgarda. As of Aug. 17, the variant accounted for 36.8% of COVID-19 infections, according to CDC data. If this percentage surpasses 90%, Pemgarda’s emergency use authorization could be revoked.”
  • Per MedTech Dive,
    • “Insulet received U.S. clearance Monday for its Omnipod 5 system for Type 2 diabetes management — a first for the industry — making automated insulin delivery to control blood sugar available to millions of additional people living with diabetes.
    • “The system’s tubeless pump automatically adjusts insulin levels based on data from a continuous glucose monitor (CGM), replacing manual dosing. Since its approval for Type 1 patients in 2022, Omnipod 5 has become the most prescribed insulin pump in the U.S. and has more than 250,000 users globally, Insulet Chief Medical Officer Trang Ly said in an interview with MedTech Dive.
    • “Ly discussed the product’s launch for Type 2 diabetes patients, partnerships with other device makers and how the company is working to win over doctors reluctant to prescribe insulin pump therapy.”
    • Check out the interview.

From the U.S. healthcare business front,

  • BioPharma Dive tells us,
    • Eli Lilly is now distributing a single-dose vial form of its popular weight loss medicine Zepbound that it says people with a valid prescription can obtain for a cash price that’s 50% less than the current cost of other GLP-1 drugs for obesity.
    • The single-dose vials are available through Lilly’s online service LillyDirect as a self-pay option, which could appeal to people without employer insurance coverage or those who don’t qualify for the company’s savings card program, Lilly said.
    • A four-week supply of Zepbound single-dose vials at a 2.5 milligram dose will cost $399, while the 5 milligram dose will cost $549. While those prices are well below the $1,060 monthly list price of Zepbound’s injector pen formulation, they’re not far from the drug’s estimated net price after accounting for rebates and discounts to insurers, according to a client note from Evercore ISI analyst Umer Raffat.
  • Per Healthcare Dive,
    • “Pfizer on Tuesday launched a direct-to-consumer service it claims will help people schedule telehealth appointments, fill prescriptions and access savings programs for the company’s migraine, COVID-19 or influenza medicines.
    • “Dubbed PfizerForAll, the online service will provide resources for people looking to obtain treatment for migraine, COVID or the flu, or to schedule vaccinations for diseases like pneumococcal pneumonia and respiratory syncytial virus.
    • “The platform aims to “streamline the path for those seeking better health,” Aamir Malik, Pfizer’s chief U.S. commercial officer, said in a statement. The company said it is working with partners UpScriptHealth, Alto Pharmacy and Instacart.”
  • MedCity News notes,
    • “Waltz Health, a digital health company focused on prescription drugs, launched Waltz Connect on Monday. The new solution aims to reduce the cost of specialty medications.
    • “Chicago-based Waltz Health was founded in 2021 and serves payers and pharmacies. It has a product called Marketplace Search, which allows users to search for any prescription and see the range of prices available at their pharmacy. It also works with health plans to bring its marketplace solutions into their pharmacy benefit.
    • “The company’s Waltz Connect product supports payers and focuses on specialty medications. When a specialty prescription is submitted for a member, Waltz Connect redirects it to the most suitable pharmacy, regardless of the pharmacy’s network status with the payer. This routing is based on the member’s benefit design and several factors, including price, turnaround time, fulfillment accuracy, member experience and adherence rates. These factors can be customized by drug class or specific drugs. Health plans also receive information on the member’s condition, prescription onboarding, the selected pharmacy’s contact information, expected fulfillment turnaround time and the number of refills.”
  • and discusses the pros and cons of artificial intelligence for health insurers. “With so much hinging on technology that is the subject of so much hype, it is important to understand where AI actually helps at present — and where it most definitely does not.”
  • Beckers Hospital Review points out,
    • “Boston-based Mass General Brigham’s Home Hospital program has expanded to 70 beds, making it the largest home hospital in the country, according to a news release shared with Becker’s.
    • “The capacity increase was accompanied by expanded clinical care teams and the creation of dedicated roles within Home Hospital created. The system has also incorporated medical assistants into the care model and expanded the ambulance services to meet growing demand.
    • “Since its launch in January 2022, the program has had more than 4,000 patient admissions and saved more than 20,000 acute care hospital-based bed days. The average patient stays in a Home Hospital bed is 5 days.”
  • and
    • Where Steward’s 31 hospitals stand
      • From seeking Chapter 11 protection on May 6 to sharing plans to close four of its hospitals across Massachusetts and Ohio that would result in a combined 2,187 layoffs, Dallas-based Steward Health Care has experienced a great deal of turbulence over the last year.
      • As the for-profit health system continues to push back bid deadlines and sale hearings for many of its hospitals, the status of each facility remains in question, leaving community members, healthcare workers and state and local lawmakers concerned.
      • Below, Becker’s has provided a list of Steward’s 31 hospitals by state, per the health system’s website, and the most recent information regarding each facility. [FEHBlog note — Beckers plans to keep this list updated.]
  • Per Fierce Healthcare,
    • “Aetna will cover intrauterine insemination as a medical benefit for eligible plans, a move the insurer called a “landmark policy change.” 
    • “Intrauterine insemination, or IUI, is usually only covered if employers offer a separate fertility benefit plan, according to an Aug. 26 news release from Aetna. 
    • “The change will apply to fully insured Aetna commercial plans. * * *
    • “Expanding IUI coverage is yet another demonstration of Aetna’s commitment to women’s health across all communities, including LGBTQ+ and unpartnered people,” Cathy Moffitt, MD, Aetna’s chief medical officer, said in the news release. “This industry-leading policy change is a stake in the ground, reflecting Aetna’s support of all who need to use this benefit as a preliminary step in building their family.”
  • Medscape adds,
    • “In a move that acknowledges the gauntlet the US health system poses for people facing serious and fatal illnesses, Medicare will pay for a new class of workers to help patients manage treatments for conditions like cancer and heart failure.
    • “The 2024 Medicare physician fee schedule includes new billing codes, including G0023, to pay for 60 minutes a month of care coordination by certified or trained auxiliary personnel working under the direction of a clinician.
    • :A diagnosis of cancer or another serious illness takes a toll beyond the physical effects of the disease. Patients often scramble to make adjustments in family and work schedules to manage treatment, said Samyukta Mullangi, MD, MBA, medical director of oncology at Thyme Care, a Nashville, Tennessee-based firm that provides navigation and coordination services to oncology practices and insurers.”

Cybersecurity Saturday

From the CrowdStrike outage front,

  • TechTarget offers lessons learned from the CrowdStrike outage.
  • Cybersecurity Dive includes an opinion piece from Deepak Kumar, the founder and CEO of Adaptiva.
    • “Patching remains a top priority for every organization, but slow, manual, and reactive patching presents far more risk than benefit. Automated patching without the capability to pause, cancel, or roll back can be reckless and lead to disruptions or worse. 
    • “Automated patching, with the necessary controls, is undoubtedly the best path forward, offering the speed needed to thwart bad actors and the control required to prevent an errant update from causing widespread issues.”

From the cybersecurity policy front,

  • Cyberscoop informs us,
    • “Federal contractors would be required to implement vulnerability disclosure policies that align with National Institute of Standards and Technology guidelines under a bipartisan Senate bill introduced last week.
    • “The Federal Contractor Cybersecurity Vulnerability Reduction Act of 2024 from Sens. Mark Warner, D-Va., and James Lankford, R-Okla., is a companion to legislation from Rep. Nancy Mace, R-S.C., which was advanced by the House Oversight Committee in May.
    • “The bill from Warner and Lankford on vulnerability disclosure policies (VDPs) aims to create a structure for contractors to receive reports of vulnerabilities in their products and then act against them before an attack occurs.
    • “VDPs are a crucial tool used to proactively identify and address software vulnerabilities,” Warner said in a statement. “This legislation will ensure that federal contractors, along with federal agencies, are adhering to national guidelines that will better protect our critical infrastructure, and sensitive data from potential attacks.”
  • Cybersecurity Dive reports from the Black Hat cybersecurity conference held at Las Vegas in the first week of August,
    • Despite a stream of devastating cyberattacks or mistakes that halt or disrupt large swaths of the economy, Jen Easterly, director of the Cybersecurity and Infrastructure Security Agency, says the war against malicious activity is not lost.
    • It is possible to elevate organizations’ ability to repel or mitigate attacks and place a greater emphasis on vendors’ responsibilities, Easterly said Wednesday during a media briefing at Black Hat. “We got ourselves into this, we have to get ourselves out,” she said.
    • Easterly’s optimism isn’t the result of blind trust. “We have made enormous progress, even just over the past several years,” she said.” * * *
    • “We have to recognize that the cybersecurity industry exists because technology vendors for decades have been allowed to create defective, flawed, insecure software that prioritizes speed to market features over security,” Easterly said. 
    • “There is more we can do but that’s where the war will be won,” Easterly said. “If we put aside the threat actors and we put aside the victims and we talk about the vendors.”
  • and
    • It’s time to stop thinking of threat groups as supervillains, experts say
    • “These villains do not have superpowers. We should not treat them like they do,” * * *
    • “The vast majority of organizations don’t have the time or resources to keep up with the chaos of tracking cybercriminal groups, Andy Piazza, senior director of threat intel at Palo Alto Networks Unit 42, said in an interview at Black Hat.
    • “You as a defender shouldn’t care about that,” Piazza said. Defenders can better serve their organizations by developing capabilities to detect and respond to malicious tactics, techniques and procedures, Piazza said.
    • “It’s hard to ignore the drama when groups are given names like Scattered Spider, Midnight Blizzard and Fancy Bear, but mythologizing the criminals responsible for cyberattacks can diminish defenders’ ability to detect and thwart malicious activity.”
  • FedScoop lets us know,
    • “The National Institute of Standards and Technology has officially released three new encryption standards that are designed to fortify cryptographic protections against future cyberattacks by quantum computers.
    • “The finalized standards come roughly eight years after NIST began efforts to prepare for a not-so-far-off future where quantum computing capabilities can crack current methods of encryption, jeopardizing crucial and sensitive information held by organizations and governments worldwide. Those quantum technologies could appear within a decade, according to a RAND Corp. article cited by NIST in the Tuesday announcement.
    • “Quantum computing technology could become a force for solving many of society’s most intractable problems, and the new standards represent NIST’s commitment to ensuring it will not simultaneously disrupt our security,” Laurie E. Locascio, director of the Department of Commerce’s NIST and undersecretary of commerce for standards and technology, said in a statement. “These finalized standards are the capstone of NIST’s efforts to safeguard our confidential electronic information.”
    • “The new standards provide computer code and instructions for implementing algorithms for general encryption and digital signatures — algorithms that serve as authentication for an array of electronic messages, from emails to credit card transactions.”
  • Federal News Network adds,
    • “CISA Director Jen Easterly said in a keynote at The White House Office of Management and Budget will soon direct agencies to map out plans for adopting post-quantum encryption to protect their most sensitive systems and data.
    • “Federal Chief Information Office Clare Martorana said the new guidance will help agencies begin to adopt new cryptographic standards from the National Institute of Standards and Technology.
    • “We will be releasing guidance directing agencies to develop a prioritized migration plan to ensure that the most sensitive systems come first,” Martorana said during an event hosted by the White House today. “We can’t do it alone. It’s critical that we continue to foster robust collaboration and knowledge sharing between public and private sectors, which is why conversations like the one we’re having today are so incredibly critical.”

From the cybersecurity vulnerabilities and breaches front,

  • The Cybersecurity and Infrastructure Security Administration (CISA) added seven known exploited vulnerabilities (KEV) to its catalog this week. NIST initially identifies the KEVs, which explains the Senate bill discussed above, and then CISA publicizes those KEVs in its catalog
  • Cybersecurity Dive notes,
    • A vulnerability in the common log file system of Microsoft Windows can lead to the blue screen of death, impacting all versions of Windows 10 and Windows 11, researchers from Fortra said Monday.  
    • “The vulnerability, listed as CVE-2024- 6768, is caused by improper validation of specified quantities of input data, according to a report by Fortra. The vulnerability can result in an unrecoverable inconsistency and trigger a function called KeBugCheckEx, leading to the blue screen. 
    • “A malicious hacker can exploit the flaw to trigger repeated crashes, disrupting system operations and the potential loss of data, according to Fortra.”
  • TechTarget explains why “recent cyberattacks against OneBlood and McLaren Health Care shed light on the operational challenges that targeted organizations face.”

From the ransomware front,

  • A Dark Reading commentator explains that to avoid losing the ransomware battle, companies that are “institutionalizing and sustaining fundamental cybersecurity practices” also must “commit to ongoing vigilance, active management, and a comprehensive understanding of evolving threats.”
    • “The challenge of institutionalizing and sustaining fundamental cybersecurity practices is multifaceted. It requires a commitment to ongoing vigilance, active management, and a comprehensive understanding of evolving threats. However, by addressing these challenges head-on and ensuring that cybersecurity practices are implemented, measured, and maintained with rigor, organizations can better protect themselves against the ever-present threat of ransomware attacks. Focusing on the basics first — such as implementing foundational controls like 2FA, fostering maintenance skills to integrate IT and security efforts, and adopting performance management practices — can lead to significant improvements in cybersecurity, providing robust protection with less investment.”
  • Cybersecurity Dive points out,
    • “Cyber risk company Resilience said in a report unveiled Tuesday that ransomware has remained a top threat since January 2023, with 64% of related claims in its portfolio resulting in a loss during that period.
    • “Increased merger-and-acquisition activity and reliance on ubiquitous software vendors created new opportunities for threat actors to unleash widespread ransomware campaigns by exploiting a single point of failure, the report said.
    • “Now more than ever, we need to rethink how the C-suite approaches cyber risk,” Resilience CEO Vishaal Hariprasad said in a press release. “Businesses are interconnected like never before, and their resilience now depends on that of their partners and others in the industry.”
  • Per Bleeping Computers,
    • “RansomHub ransomware operators are now deploying new malware to disable Endpoint Detection and Response (EDR) security software in Bring Your Own Vulnerable Driver (BYOVD) attacks.
    • “Named EDRKillShifter by Sophos security researchers who discovered it during a May 2024 ransomware investigation, the malware deploys a legitimate, vulnerable driver on targeted devices to escalate privileges, disable security solutions, and take control of the system.
    • “This technique is very popular among various threat actors, ranging from financially motivated ransomware gangs to state-backed hacking groups.”
  • and
    • “Background check service National Public Data confirms that hackers breached its systems after threat actors leaked a stolen database with millions of social security numbers and other sensitive personal information. 
    • “The company states that the breached data may include names, email addresses, phone numbers, social security numbers (SSNs), and postal addresses.”

From the cybersecurity defenses front,

  • The American Hospital Association’s National Advisor for Cybersecurity and Risk, John Riggi, explains how healthcare entities should prepare for third party cyber risk.
  • The Wall Street Journal shares remarks from a June 2024 WSJ conference on what can be learned from the Change Healthcare cyber-attack. “Two security experts explain why the hack affected so many institutions and people—and what could be done to protect the healthcare system.”
  • For several months, the FEHBlog has not been able to access the HHS 405(d) program website. Magically this week, he regained access. Here is a link to the program’s July 2024 post which concerns the urgent need for data security in healthcare AI.