How the ransomware assault at Change Healthcare went down: A timeline

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A ransomware assault earlier this yr on UnitedHealth-owned well being tech firm Change Healthcare probably stands as one of many largest information breaches of U.S. well being and medical information in historical past.

Months after the February information breach, a “substantial proportion of people living in America” are receiving discover by mail that their private and well being info was stolen by cybercriminals through the cyberattack on Change Healthcare.

Change Healthcare processes billing and insurance coverage for tons of of 1000’s of hospitals, pharmacies and medical practices throughout the U.S. healthcare sector. As such, it collects and shops huge quantities of extremely delicate medical information on sufferers in the USA. By way of a sequence of mergers and acquisitions, Change turned one of many largest processors of U.S. well being information, dealing with between one-third and one-half of all U.S. well being transactions.

Right here’s what has occurred because the ransomware assault started.

February 21, 2024

First report of outages as safety incident emerges

It appeared like an odd Wednesday afternoon, till it wasn’t. The outage was sudden. On February 21, billing techniques at medical doctors workplaces and healthcare practices stopped working, and insurance coverage claims stopped processing. The standing web page on Change Healthcare’s web site was flooded with outage notifications affecting each a part of its enterprise, and later that day the corporate confirmed it was “experiencing a network interruption related to a cyber security issue.” Clearly one thing had gone very mistaken.

It seems that Change Healthcare invoked its safety protocols and shut down its whole community to isolate intruders it present in its techniques. That meant sudden and widespread outages throughout the healthcare sector that depends on a handful of firms — like Change Healthcare — to deal with healthcare insurance coverage and billing claims for huge swathes of the USA. It was later decided that the hackers initially broke into the corporate’s techniques over every week earlier, on or round February 12.

February 29, 2024

UnitedHealth confirms it was hit by ransomware gang

After initially (and incorrectly) attributing the intrusion to hackers working for a authorities or nation-state, UnitedHealth later mentioned on February 29 that the cyberattack was in reality the work of a ransomware gang. UnitedHealth mentioned the gang “represented itself to us as ALPHV/BlackCat,” an organization spokesperson advised TechCrunch on the time. A darkish internet leak web site related to the ALPHV/BlackCat gang additionally took credit score for the assault, claiming to have stolen hundreds of thousands of People’ delicate well being and affected person info, giving the primary indication of what number of people this incident had affected.

ALPHV (aka BlackCat) is a recognized Russian-speaking ransomware-as-a-service gang. Its associates — contractors who work for the gang — break into sufferer networks and deploy malware developed by ALPHV/BlackCat’s leaders, who take a reduce of the earnings collected from the ransoms collected from victims to get their information again. 

Realizing that the breach was attributable to a ransomware gang modified the equation of the assault from the form of hacking that governments do — generally to ship a message to a different authorities as a substitute of publishing hundreds of thousands of individuals’s personal info — to a breach attributable to financially motivated cybercriminals, who’re more likely to make use of a completely totally different playbook to get their payday. 

March 3-5, 2024

UnitedHealth pays a ransom of $22 million to hackers, who then disappear

In early March, the ALPHV ransomware gang vanished. The gang’s leak web site on the darkish internet, which weeks earlier took credit score for the cyberattack, was changed with a seizure discover claiming that U.Okay. and U.S. legislation enforcement took down the gang’s web site. However each the FBI and U.Okay. authorities denied taking down the ransomware gang as that they had tried months earlier. All indicators pointed to ALPHV working off with the ransom and pulling an “exit scam.”

In a posting, the ALPHV affiliate who carried out the hack on Change Healthcare claimed that the ALPHV management stole $22 million paid as a ransom and included a hyperlink to a single bitcoin transaction on March 3 as proof of their declare. However regardless of dropping their share of the ransom fee, the affiliate mentioned the stolen information is “still with us.” UnitedHealth had paid a ransom to hackers who left the information behind and disappeared.

A pretend legislation enforcement seizure discover posted on BlackCat’s darkish internet leak web site quickly after receiving a ransom fee of $22 million.
Picture Credit: TechCrunch (screenshot)

March 13, 2024

Widespread disruption throughout U.S. healthcare amid fears of knowledge breach

In the meantime, weeks into the cyberattack, outages have been nonetheless ongoing with many unable to get their prescriptions crammed or having to pay money out of pocket. Navy medical insurance supplier TriCare mentioned “all military pharmacies worldwide” have been affected as effectively. 

The American Medical Affiliation was saying there was little info from UnitedHealth and Change Healthcare in regards to the ongoing outages, inflicting large disruption that continued to ripple throughout the healthcare sector

By March 13, Change Healthcare had obtained a “safe” copy of the stolen information that it had simply days earlier paid $22 million for. This allowed Change to start the method of poring by the dataset to find out whose info was stolen within the cyberattack, with the intention of notifying as many affected people as doable.  

March 28, 2024

U.S. authorities ups its bounty to $10 million for info resulting in ALPHV seize

By late March, the U.S. authorities mentioned it was upping its bounty for info on key management of ALPHV/BlackCat and its associates. 

By providing $10 million to anybody who can establish or find the people behind the gang, the U.S. authorities appeared to hope that one of many gang’s insiders would activate their former leaders. It additionally may very well be seen because the U.S. realizing the specter of having a major variety of People’ well being info probably revealed on-line. 

April 15, 2024

Contractor kinds new ransom gang and publishes some stolen well being information

After which there have been two — ransoms, that’s. By mid-April, the aggrieved affiliate arrange a brand new extortion racket referred to as RansomHub, and because it nonetheless had the information that it stole from Change Healthcare, it demanded a second ransom from UnitedHealth. In doing so, RansomHub revealed a portion of the stolen information containing what gave the impression to be personal and delicate affected person information as proof of their risk. 

Ransomware gangs don’t simply encrypt information; in addition they steal as a lot information as doable and threaten to publish the information if a ransom isn’t paid. This is called “double extortion.” In some circumstances when the sufferer pays, the ransomware gang can extort the sufferer once more — or, in others, extort the sufferer’s clients, generally known as “triple extortion.”

Now that UnitedHealth was prepared to pay one ransom, there was a danger that the healthcare big could be extorted once more. It’s why legislation enforcement have lengthy advocated towards paying a ransom that enables criminals to revenue from cyberattacks.

April 22, 2024

UnitedHealth says ransomware hackers stole well being information on a “substantial proportion of people in America”

For the primary time, UnitedHealth confirmed on April 22 — greater than two months after the ransomware assault started — that there was a knowledge breach and that it probably impacts a “substantial proportion of people in America,” with out saying what number of hundreds of thousands of those that entails. UnitedHealth additionally confirmed it paid a ransom for the information however wouldn’t say what number of ransoms it finally paid.

The corporate mentioned that the stolen information consists of extremely delicate info, together with medical information and well being info, diagnoses, medicines, check outcomes, imaging and care and therapy plans, and different private info.

Provided that Change Healthcare handles information on about one-third of everybody dwelling in the USA, the information breach is more likely to have an effect on greater than 100 million folks at the least. When reached by TechCrunch, a UnitedHealth spokesperson didn’t dispute the probably affected quantity however mentioned that the corporate’s information evaluation was ongoing. 

Might 1, 2024

UnitedHealth Group chief govt testifies that Change wasn’t utilizing primary cybersecurity

Maybe unsurprisingly when your organization has had one of many greatest information breaches in current historical past, its chief govt is sure to get referred to as to testify earlier than lawmakers. 

That’s what occurred with UnitedHealth Group (UHG) chief govt Andrew Witty, who on Capitol Hill admitted that the hackers broke into Change Healthcare’s techniques utilizing a single set password on a person account not protected with multi-factor authentication, a primary safety function that may stop password reuse assaults by requiring a second code despatched to that account holder’s telephone. 

Considered one of the most important information breaches in U.S. historical past was totally preventable, was the important thing message. Witty mentioned that the information breach was more likely to have an effect on about one-third of individuals dwelling in America — in step with the corporate’s earlier estimates that the breach impacts round as many individuals that Change Healthcare processes healthcare claims for.

1: UnitedHealth CEO Andrew Witty testifies before the Senate Finance committee on Capitol Hill on May 1, 2024 in Washington, DC.
UnitedHealth CEO Andrew Witty testifies earlier than the Senate Finance committee on Capitol Hill on Might 1, 2024, in Washington, D.C.
Picture Credit: Kent Nishimura / Getty Photos

June 20, 2024

UHG begins notifying affected hospitals and medical suppliers what information was stolen

It took Change Healthcare till June 20 to start formally notifying affected people that their info was stolen, as legally required below a legislation generally generally known as HIPAA, probably delayed partially by the sheer dimension of the stolen dataset. 

The corporate revealed a discover disclosing the information breach and mentioned that it could start notifying people it had recognized within the “safe” copy of the stolen information. However Change mentioned it “cannot confirm exactly” what information was stolen about every particular person and that the knowledge might range from individual to individual. Change says it was posting the discover on its web site, because it “may not have sufficient addresses for all affected individuals.”

The incident was so massive and complicated that the U.S. Division of Well being and Human Companies stepped in and mentioned that affected healthcare suppliers, whose sufferers are finally affected by the breach, can ask UnitedHealth to inform affected sufferers on their behalf, an effort seen at lessening the burden on smaller suppliers whose funds have been hit amid the continuing outage. 

July 29, 2024

Change Healthcare begins notifying recognized affected people by letter

The well being tech big confirmed in late June that it could start notifying these whose healthcare information was stolen in its ransomware assault on a rolling foundation. That course of started in late July. 

The letters going out to affected people will almost definitely come from Change Healthcare, if not the precise healthcare supplier affected by the hack at Change. The letter confirms what sorts of knowledge was stolen, together with medical information and medical insurance info, and claims and fee info, which Change mentioned consists of monetary and banking info.

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