For months, Change Healthcare has faced an immensely messy ransomware debacle that has left hundreds of pharmacies and medical practices across the United States unable to process claims. Now, thanks to an apparent dispute within the ransomware criminal ecosystem, it may have just become far messier still.
In March, the ransomware group AlphV, which had claimed credit for encrypting Change Healthcare’s network and threatened to leak reams of the company’s sensitive health care data, received a $22 million payment—evidence, publicly captured on Bitcoin’s blockchain, that Change Healthcare had very likely caved to its tormentors’ ransom demand, though the company has yet to confirm that it paid. But in a new definition of a worst-case ransomware, a different ransomware group claims to be holding Change Healthcare’s stolen data and is demanding a payment of their own.
Since Monday, RansomHub, a relatively new ransomware group, has posted to its dark-web site that it has 4 terabytes of Change Healthcare’s stolen data, which it threatened to sell to the “highest bidder” if Change Healthcare didn’t pay an unspecified ransom. RansomHub tells WIRED it is not affiliated with AlphV and “can’t say” how much it’s demanding as a ransom payment.
RansomHub initially declined to publish or provide WIRED any sample data from that stolen trove to prove its claim. But on Friday, a representative for the group sent WIRED several screenshots of what appeared to be patient records and a data-sharing contract for United Healthcare, which owns Change Healthcare, and Emdeon, which acquired Change Healthcare in 2014 and later took its name.
While WIRED could not fully confirm RansomHub’s claims, the samples suggest that this second extortion attempt against Change Healthcare may be more than an empty threat. “For anyone doubting that we have the data, and to anyone speculating the criticality and the sensitivity of the data, the images should be enough to show the magnitude and importance of the situation and clear the unrealistic and childish theories,” the RansomHub contact tells WIRED in an email.
“We are working with law enforcement and outside experts to investigate claims posted online to understand the extent of potentially impacted data,” Change Healthcare said in an email to WIRED. “Our investigation remains active and ongoing. There is no evidence of any new cyber incident at Change Healthcare.”
Brett Callow, a ransomware analyst with security firm Emsisoft, says he believes AlphV did not originally publish any data from the incident, and the origin of RansomHub’s data is unclear. “I obviously don't know whether the data is real—it could have been pulled from elsewhere—but nor do I see anything that indicates it may not be authentic,” he says of the data shared by RansomHub.
Jon DiMaggio, chief security strategist at threat intelligence firm Analyst1, says he believes RansomHub is “telling the truth and does have Change HealthCare’s data,” after reviewing the information sent to WIRED. While RansomHub is a new ransomware threat actor, DiMaggio says, they are quickly “gaining momentum.”
If RansomHub’s claims are real, it will mean that Change Healthcare’s already catastrophic ransomware ordeal has become a kind of cautionary tale about the dangers of trusting ransomware groups to follow through on their promises, even after a ransom is paid. In March, someone who goes by the name “notchy” posted to a Russian cybercriminal forum that AlphV had pocketed that $22 million payment and disappeared without sharing a commission with the “affiliate” hackers who typically partner with ransomware groups and often penetrate victims’ networks on their behalf.
Notchy’s post suggested that Change Healthcare faced an unprecedented situation: It had allegedly already paid a ransom, yet jilted partners of the gang extorting it still felt they were owed money—and still possessed Change Healthcare’s stolen data. RansomHub tells WIRED it is associated with notchy.
Now, RansomHub has claimed “the data remains with the affiliate,” and AlphV did not directly have the data originally. WIRED could not verify these claims. “For everyone speculating and theorizing on the situation, AlphV stole our share of the payment and performed an exit scam,” a RansomHub representative wrote to WIRED. “AlphV performed the exit scam before we get to the data deletion part.”
Callow says the incident reinforces that cybercriminals can’t be trusted to delete data, even when they are paid. For example, when a global law enforcement operation disrupted the notorious LockBit ransomware group, in February, police said they discovered that the cybercriminals still had data that investigators had paid to be deleted.
“Sometimes they use the undeleted data to extort victims for a second time, and the risk of re-extortion will only increase as law enforcement up their disruption efforts and throw the ransomware ecosystem into chaos,” Callow says. “What were always unpredictable outcomes will now be even more unpredictable.”
Similarly, DiMaggio says victims of ransomware attacks need to learn they can’t trust cybercriminals. “Victims need to understand that paying a criminal who promises to delete their data permanently is a myth,” DiMaggio says. “They are paying to have their data taken off the public side of the ransomware attackers data leak site. They should assume it is never actually deleted.”
UnitedHealth Group’s website says it is continuing to “make progress in mitigating the impact” of the attack and expanding financial assistance to health care providers that have been impacted. However, the attack has sent long-lasting ripples across medical facilities in the United States, demonstrating how disruptive ransomware attacks can be and the difficulties in restoring services. Clinicians and patients alike have been impacted, with extra strain being placed upon medical business owners.
On Wednesday, the American Medical Association said “serious disruptions continue” across physician practices. A survey of AMA members, conducted between March 26 and April 3, found 80 percent of clinicians had lost revenue and many are using their own personal finances to cover a practice’s expenses. Medical practitioners responding to the survey said they were heading toward bankruptcy, were struggling to “manage pain care” for cancer patients, and that procedures had been delayed. “Practices will close because of this incident,” Jesse M. Ehrenfeld, the president of the AMA said in a statement, “and patients will lose access to their physicians.”
In a message to WIRED, the RansomHub contact claims—for whatever the word of a ransomware gang is worth—that they are different from other cybercriminals, and if Change Healthcare pays them, they wouldn’t try to extort it again. “We will delete the data,” they write. “This data is a bomb for us. If we can't get payment, we have no choice but to sell it. Of course, if we can reach an agreement, it will be better to delete the data and throw the bomb away.”
Updated 4/12/2024, 9:18 pm ET: Added comment from Change Healthcare.
