Orangeworm Malware Burrows Into Healthcare Industry

A group of cybercriminals, known collectively as Orangeworm, are using their own malware and a custom backdoor called Kwampirs in highly targeted attacks against healthcare organizations, according to Symantec.

Jeffrey Burt, Editor & Journalist

April 26, 2018

7 Min Read

Healthcare organizations have become a favorite target for hackers who see opportunity in the industry's data-rich environments and the move by such firms to adopt such emerging technologies as the cloud, the Internet of Things, big data and containers that make them vulnerable to such attacks.

About 70% of healthcare organizations worldwide have experienced a security breach and the threat is increasing, according to the "2018 Thales Healthcare Data Threat Report," released last month.

The number in the Thales report is 17 points higher than in the firm's 2017 survey.

McAfee in March found a similar trend in its "McAfee Labs Threats Report: March 2018." The security firm found that in the last three months of 2017, security incidents aimed at healthcare organizations fell 78%, but that hospitals and other such health firms saw a 210% increase in incidents year-over-year. (See Majority of Healthcare Companies Suffer a Data Breach.)

This comes at a time when many hospitals and other groups, including clinics and outpatient facilities, are underprepared to deal with such security threats. A report, "2018 Impact of Cyber Insecurity on Healthcare Organizations," noted that only half of such entities have an incident response program in place, opening up the massive amounts of sensitive data they hold on patients, doctors and other staff to risk and exposing the organizations to security breaches than cost an average of $4 million. (See Healthcare Industry Underprepared for Cyber Attacks – Report.)

Now comes word from Symantec of another group that is putting its sights on the healthcare industry.

The Orangeworm has turned
The firm's Security Response Attack Investigation Team this week identified a group called Orangeworm that is targeting large healthcare organizations and corporations with links to the industry in the US, Europe and Asia. The Orangeworm threat group has attacked not only healthcare providers and pharmaceutical companies, but also firms within the supply chain with the goal of eventually reaching their intended targets.

(Source: Pixabay)

(Source: Pixabay)

Almost 40% of Orangeworm's victims have been within the healthcare industry.

"Based on the list of known victims, Orangeworm does not select its targets randomly or conduct opportunistic hacking," the Symantec team noted in its blog post. "Rather, the group appears to choose its targets carefully and deliberately, conducting a good amount of planning before launching an attack."

The attackers are doing this by trying to install a custom backdoor called Trojan.Kwampirs. Among the targets has been devices containing software that controls such devices as X-ray and MRI machines. In addition, Orangeworm also has targeted machines that are used to help patients who are filling out consent forms for procedures.

Kwampirs is a particularly aggressive malware.

Once Orangeworm gets inside an organization's network, the malware gives the group remote access to the compromised computer. It decrypts and extracts a copy of its main DLL payload. To get around hash-based detections, the malware plugs in a randomly generated string into the decrypted payload before writing the payload to disk. Kwampirs also ensures that the main payload is loaded into memory when the system is rebooted. The malware collects such information about the computer like network adapter data, the system version being used and language settings, and using that information Orangeworm determines whether the compromised system is being used by a researcher or a more high-value target. If it's a target they're interested in, the group infects other computers by copying the Trojan across open network shares. Among the hidden file shares Kwampirs may copy itself to are: ADMIN$, C$Windows, D$Windows and E$Windows.

Once this is done, the attackers pull in as much information as possible from the network, including data related to recently accessed computers, available network shares, network adapters, mapped drives and files.

"Kwampirs uses a fairly aggressive means to propagate itself once inside a victim's network by copying itself over network shares," Symantec wrote. "While this method is considered somewhat old, it may still be viable for environments that run older operating systems such as Windows XP. This method has likely proved effective within the healthcare industry, which may run legacy systems on older platforms designed for the medical community. Older systems like Windows XP are much more likely to be prevalent within this industry."

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The malware also runs through a large list of command-and-control servers embedded within it, a task that -- like the way it propagates -- is "noisy," which means that Orangeworm is not very concerned about being discovered, according to the Symantec team.

Large-scale attacks
The motives for the attacks are not yet clear, according to Symantec, but the group is operating on a large stage.

Organizations within the United States have seen most of the Orangeworm attacks, at 17%. However, entities in more than two dozen other countries in Europe, Asia, the Middle East and North America have also been targets. It's clear that Orangeworm is working to learn about technologies running on many of the comprised devices, according to Jon DiMaggio, senior threat intelligence analyst at Symantec Security Response

"Some ways this information could be used include creating pirated versions of the technologies they are observing as well as understanding how they function and operate," DiMaggio wrote in an email to Security Now. "All of this could be used for a competitive advantage or sold the highest bidder. It is difficult to say as there are lots of possibilities, but what is more important here is that the malware and access that Orangeworm had could have been used to turn off equipment, change controls or even destroy the systems themselves resulting in severe costly damage. That is why securing these environments and changing the way we go about creating medical tech to include more security is so vital moving forward."

The Symantec team said they found evidence of the Kwampirs malware in other industries -- such as manufacturing, IT, agriculture and logistics -- that at initial blush appears to have little to do with healthcare.

"While these industries may appear to be unrelated, we found them to have multiple links to healthcare, such as large manufacturers that produce medical imaging devices sold directly into healthcare firms, IT organizations that provide support services to medical clinics, and logistical organizations that deliver healthcare products," the team wrote.

Healthcare will continue to be a popular target for cybercriminals, according to DiMaggio. There is sensitive data in such places as patient records and billing and credit card information, as well as intellectual property used by organizations that can be found within their infrastructures.

"In addition, healthcare organizations have different security challenges to deal with that many other verticals do not have to worry about," he wrote. "For example, medical technologies running on legacy operating systems -- as well as patient portals that provide access to patient information from the internet -- are all aspects of their infrastructure that require strict security controls. In the instance of legacy technologies being used, this often allows an attacker with more opportunities to exploit and take advantage of, compared to industries that do not have to work with dated operating systems and associated technologies."

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— Jeffrey Burt is a long-time tech journalist whose work has appeared in such publications as eWEEK, The Next Platform and Channelnomics.

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