United States: Don't Get Taken Hostage: Practices Must Protect Themselves From Ransomware

Last Updated: July 25 2019
Article by Amanda Gutierrez

Ransomware is a particularly malicious type of illegal software. Hackers use it to essentially kidnap a computer system and then demand that the system's owner pay a ransom, often in digital currency such as Bitcoin, to release it. After the hackers have received the payment, they provide a decryption key to return access to the owner — sometimes.

Are physicians at risk?

Ransomware attacks are more common in larger health care systems because of their size and income levels, but physicians' offices are targets as well. Smaller offices are vulnerable both because of the quality and amount of available data on their computer networks. Many physicians' offices are easy to infiltrate.

Ransomware typically enters a computer system or network when someone accidentally clicks on a bad link or attachment that appears legitimate. Recently, a small medical practice in Battle Creek, Michigan suffered such an attack, with devastating consequences. The attachment resembled a vendor invoice, but was actually ransomware, which then encrypted all the practice's records. The office refused to pay the ransom, and the hackers responded by deleting everything. Some patients lost all or some of their medical records, and the practice eventually closed.

What can you do?

Here are eight tips to help you prevent, or respond to, a ransomware attack on your practice:

  1. Get Educated
    All staffers should receive training about computer security practices within the context of HIPAA, but also within the context of hackers and ransomware. Teach them not to click on links in suspicious emails and not to download information from unfamiliar websites. New hires are required under HIPAA to receive privacy and security training; this training also should align with the practice's information security policies and anti-virus procedures.
  2. Update Regularly
    It is important to install software updates to fix bugs and vulnerabilities, improve administration-level access, strengthen firewalls and improve anti-malware and anti-virus software. When developers or vendors provide patches or updates, download them immediately and consistently.
  3. Establish a Disaster Response and Business Continuity Plan.
    Every physician practice should have a plan on how to respond to disasters — whether fires, floods or other catastrophes. Be sure to include hacking and ransomware attacks as a potential calamity. This means performing regular data backups, verifying backup integrity and ensuring backups are not connected to the networks they are backing up.
  4. Monitor Practices
    Not only do you want to educate the staff on information security, you also want to make sure they are following protocol and adhering to those lessons. Medical practices should be able to monitor user activity in real time — or at least receive regular reports about how staff members are accessing data and whether they are following procedures. Integrate data security into your workplace culture.
  5. Designate A Compliance Committee or Staff Person
    This person or committee's responsibility will be to create compliance policies and procedures, as well as ensure that staff receives appropriate training and continuing education. Many experts suggest conducting an annual drill to practice for a breach.
  6. Review Your Vendors' Qualifications
    Most electronic medical record, portal and practice management software vendors should have security certifications. Are you sure the vendors you use do, and if so, which certifications do they possess?
  7. Update and Review The Practice's Professional Liability Insurance
    Unfortunately, many such policies do not cover for cyberattacks such as ransomware. But you may be able to buy coverage (see "To Pay or Not to Pay the Ransom").
  8. Hire a Consultant
    The stakes are high, and the topic is complicated and potentially time-consuming. If cost-effective, hiring an expert on health care cybersecurity can go a long way toward ensuring that your practice is as prepared as possible.

What could go wrong?

The modern world, with all its technological connectivity, is a dangerous place. The FBI indicates there are currently an average of 4,000 ransomware attacks per day in the United States.

If you intended to visit a place where the likelihood of being stalked, pickpocketed, mugged or kidnapped was as high as it is every day on the Internet, you would likely either not go or take serious security precautions. Keep this in mind and protect the safety of your practice and its patients.

Sidebar: To pay or not to pay the ransom

The FBI has guidelines on ransomware prevention and response, which can be found at Ransomware Prevention and Response for CISOs. One concern in paying ransomware is that the hackers will either not release the captive data or raise the ransom amount — the first demand being a fishing expedition to see how the business responds. The FBI does not recommend paying a ransom, but notes that it is a serious consideration requiring a look at all ways to "protect shareholders, employees and customers."

Some insurance companies cover cyberattacks, including data breaches, digital security issues, cybercrime and hacking. If covered, the terms of the policy may have guidelines or requirements for whether to pay ransomware.

Most experts say to never pay. If you have appropriate up-to-date backups that are isolated from the affected network and a thorough disaster recovery plan, refusing to pay and dealing with the aftermath may be effective. But; if you don't have protections in place and the alternative is losing all of your medical and financial records, you might decide payment is worth the risk. The best solution is to be prepared.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

In association with
Related Topics
Related Articles
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Mondaq Free Registration
Gain access to Mondaq global archive of over 375,000 articles covering 200 countries with a personalised News Alert and automatic login on this device.
Mondaq News Alert (some suggested topics and region)
Select Topics
Registration (please scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions

Mondaq.com (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of www.mondaq.com

To Use Mondaq.com you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.


The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.


Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions